@duncan

On Depression

It sneaks in like an invited guest to the party, not even noticed at first. Slowly but surely, it grows inside of you and sows its seeds of destruction. Even when it’s something that you’ve dealt with a dozen times, it can still find a way to work its way in and shift the baseline of your reality before you notice that the world has faded into a dim grey place.

By the time you can honestly sort out that you might be in deep, the very perception of that observation is distorted. And that affects your reaction to it, often tempering that reaction with an almost uncontrollable apathy. You know you want help, but the simple act of asking seems too much to bear.


Why do I suffer from depression? I’ve certainly got enough triggers in my past. My parents divorced before I was old enough to go to kindergarten. I was physically and sexually abused by an alcoholic step father and members of his family when in grade school. I only attended one school district for more than two years, and that only lasted three. By the time I moved in with my father at the age of 13, all those things had more than left their mark.

As if that weren’t enough, I also believe that there’s also a hereditary component. Furthermore, it’s not my place to say, but I think that a significant number of people from multiple branches of my family tree have had to deal with depression throughout their lives.

Put the two components together, and there’s really no mystery.


I’ve never seriously contemplated suicide. I always figured that it would be a last resort and definitely one to try some other time. Instead of offing myself, I’d rather simply disappear from one life, destroy everything, move to somewhere new, and start totally over with a new identity. Or, maybe, just maybe, everyone around me would disappear and leave me alone.

I always liked those movies where the protagonist is the solve survivor in a dystopian world where everyone else had vanished.

Saying I’ve never seriously considered or planned it, however, doesn’t mean that I don’t know how compelling the call of immediate nothingness can be. In my early twenties, I was driving down an Interstate in Dallas and felt the strangest compulsion to see what it’d be like if my car were to suddenly veer into the median and plow into the supports of an underpass. Frightened by the attractiveness of that feeling and smart enough to finally do something about it, I made an appointment to see a doctor.

Not long after, I had a prescription for Prozac.


I’m one of the lucky ones. Psychopharmacology works wonders for me. Our medical profession may not know exactly how antidepressants work, despite theories of neurotransmitters and serotonin levels and the like. For me, however, they work extremely well. So well, in fact, that I’m one of those people who feels an immediate and positive side effect the first the first dose. And a few weeks after a regular dosage, the world is pretty ok again and I’m ready to re-engage.

It’s a delicate effect, however. I not only notice the difference between different kinds of antidepressants, but between brands and formulations of the same one. When I switch from one maker’s version to another — say from Prozac to a generic formulation of fluoxetine — there’s almost always a bumpy period. For a long time, I thought that this was because one manufacturer’s process was somehow better than another’s. Lately, my theory is that it just takes several weeks to adapt. But it’s hard to know, given that medical science still really doesn’t know how the stuff works in the first place.

That’s not to say that pills are only thing that works for me. Meditation and cognitive behavioral therapy (CBT) work wonders too. The hard part of both of those is just doing them regularly and with any kind of schedule. Meditation is easier. You can do it by yourself anytime you’d like — there are even some really good apps that help. CBT is harder. I’ve done some of it with the help of a professional, but never could get into the rhythm of it for an extended amount of time.


The hardest thing for me to accept and deal with about any of these forms of treatment is that they all work well enough to alleviate the symptoms and bring positive change. They put the noonday demon back into its cage. The world becomes bright and interesting again.

Then, like somebody who simply can’t get the lesson through their head, I get distracted and stop doing the things that brought the depression under control. Slowly but surely, the uninvited guest creeps out of its cage and warps my perception of the world before I even know what’s happening.

What I have to continually reaccept in my life — even after 45 years on this planet and more than 20 years after first taking an antidepressant — is that there will never be a time when I am cured of depression. It is something that I will have to actively work on every single day for the rest of my life because if (and when) I slip, it’ll be there to corrupt the way I perceive the world. And the first ones who notice won’t be me, it’ll be the ones I love.


To be clear: This isn’t a cry for help. I’m OK and I intend on staying that way.

I write about this publicly about this as a stake in the ground. I’m sick of the stigma that goes with depression. The way that everyone from insurance companies to family members react when they find out. And even if a short bout of it is deemed acceptable, let’s not get started on the reactions when they find out it’s something that needs to be dealt with over a lifetime.

In addition, if I say it out loud—if I tell you—then I have no choice but to own it. It helps me not keep it secret from myself. It removes one more barrier to being proactive about dealing with it the next time I need to.

Which, as I’ve said, is probably going to be every day for the rest of my life.


If depression affect you or somebody you love, get help.