The Forever Decision by Paul Quinnett   Chapter 8

THE GOOD NEWS ABOUT DEPRESSION

What would you think if I told you that no matter how depressed you are today, at this very minute, that your depression is going to lift and that, sooner or later, you are going to begin to feel better?

What if I told you that if you are like most depressed people, you're going to get over your depression and it will all become just a bad memory?

You'd probably say I need to have my head examined by a qualified psychologist. Well, you'd be wrong.

The good news about depression is that except for the rare case, depression is a sometime thing. The common cold of emotional problems, millions of people worldwide suffer from depression. In fact, it may be the leading cause of loss of joy and happiness and productivity the world over. And, like the common co1d, and as miserable as they can be, most depressions eventually run their course and the person gets back to normal.

If you will take a minute to think back over your life, I think you will find that you have been sad and depressed before and gotten over it. Maybe more than once. Maybe you've never been this depressed before, but surely this isn't the first time you have felt low and down and rotten and hopeless. Unless you have been leading something of a charmed life, you've had to go through what all the rest of us have gone through from time to time - and that is the feeling of depression.

Without getting too complicated here, I want to tell you a few things about this depression business. Because I know that about sixty percent of the people who try to kill themselves are depressed when they do it, I know there is a better-than-even chance that you are depressed.

Because I know you may not be an expert on depression, I'm going to try to bring you up to speed and put a little information in your head about this most common form of emotional distress. (If you are sure you are not depressed and just angry or lonely or stressed to the maximum or feeling hopeless and helpless, you can skip ahead to those chapters and leave us occasionally depressed people to ourselves. On the other hand, if you're feeling hopeless and helpless, maybe you'd better stay with us.)

Since I've worked with hundreds of depressed people and have been there once or twice myself, I know what a chore it is to read something about depression when what I'd really like to do is go off somewhere and sleep for a couple of days or turn on the TV and let someone try to cheer me up. So, I promise to keep this short and to the point.

Being depressed is a life-threatening state of mind. Being seriously depressed is a life-threatening state of mind and body. It is the one human experience that, when it won't go away, makes us sicker and sicker until, when we are way down in the bottom of that black hole, we can't imagine ever feeling any better. It is as if our interior psychological landscape is entirely black, without joy, or even the possibility of joy.

I once asked a very depressed young man if he was anxious about something. "No," he sighed, "I'm too depressed to be anxious."

I know that when you are depressed, all other feelings begin to lose their power. Nothing tastes good when you are depressed, nothing sounds good, nothing seems funny. The things that used to be worth living for lose their value. Being depressed is not caring whether you respond to life or not. And that is what depression means - failing to respond vigorously to life's demands.

When you are seriously depressed, it is as if nothing can be imagined ever to be good again. Not only do you feel depressed, but you begin to think depressed. This “stinkin' thinkin'” leads you deeper and deeper into the black hole until, finally, there doesn't seem any way out of it. Depression, as the psychological and biological disorder it is in its worst form, results in a kind of mental and physical paralysis.

Losses
There are lots of reasons people get depressed, more reasons than even we so-called experts think we know about. But some of the reasons are obvious and it doesn't take a genius to figure them out. We can start with losses.

Anytime we suffer a loss, we tend to get depressed. Some don't, but most of us do. If we are vulnerable to depression (had parents or grandparents who suffered from depression), a serious loss can trigger symptoms of depression.

If we lose a close friend, we feel the loss and we feel grief at not having that person with us. If we lose a job we wanted, we feel that too and often in the same way. If our boyfriend dumps us for another girl, that is a loss and our reaction is hurt, anger, and maybe depression. The same feeling follows losses of health, prestige, or things we wanted but find we cannot have. Even failing an important exam is a loss - a loss to our self-esteem. Anytime we suffer a loss, the chances are good that we may become depressed.

But here are a couple of things to think about. Obviously, there are losses and then there are losses. It is one thing to lose a little finger; it is quite another thing to lose a hand - especially if you are a piano player.

There are big-ticket losses and little-ticket losses and though most of us can agree that losing an arm is a big loss, we can't ever know how big a loss it is unless we are the piano player. My point is this: I can never know just how you will interpret your loss and neither can anyone else. Likewise, you cannot truly understand my experience of loss.

Some years ago I knew an elderly lady who had to go into a hospital for some tests and found out she was quite sick and would have to stay in the hospital for at least a month. Her husband had died the year before and the only living thing she had left in this world that meant anything to her was her cat. But they would not let the cat into the hospital. And so, when she asked her only son to see after the cat, he did what he thought was the right thing: he had it put to sleep. The lady slumped into a huge depression and stopped eating. In three days she was dead.

Now you can tell yourself that this older lady was silly, that it is stupid for anyone to die over the loss of a cat. But it doesn't matter what you think. What matters is what our lady thought about losing her cat. And that is the way it is with all of our losses - it only matters what they mean to us.

But let's look at some of the big-ticket losses, the ones we hope we will never have and yet, because life is the way it is, we may have to deal with - like it or not.

We can lose people we love. They may abandon us, they may move away, they may even die. There is no getting around it, losing someone you love is going to hurt like the dickens and, unless you are made of stronger stuff than the rest of us, you are going to grieve that loss. Grief and depression are different things, but some people who begin to grieve a loss become clinically depressed, and it is important that they get help and treatment when this happens. No one can put a time limit on grief, but if grief goes on too long – and especially if you experience thoughts of death or suicide – it is time to seek help.

We can lose our health. Until we get sick, we never understand what good health means. Most of us think we will live forever, but getting sick changes all that. Once you get good and sick or are injured and lose some major function, you can no longer pretend you are made of stainless steel. Physical pain that goes on and on is, by the way, a major cause of depression and almost no one who has suffered pain for any length of time can avoid becoming depressed.

We can lose our money. You might not think that losing money could lead to depression, but it does. Money, in most societies, equals personal power, and personal power equals control over our own lives. When we lose a lot of money, or maybe all we have, we lose the power to control what happens to us. And when we lose control over what can happen to us, the loss can be unbearable and lead to depression.

These are examples of big-ticket losses and there are many more. Sometimes people suffer more than one major loss in a short period of time and, as sure as the clouds of depression begin to gather, there will follow a long dark storm.

Maybe you are wondering, if these kinds of losses can lead to depression, so what?

So this: What if you've had a very bad year? What if, as you run down the list of things we may all have to lose someday, you've found yourself saying, "Yes, I lost that." And, "Yes, I lost that, too.” What if, as years go in your life, you've had an unusually rotten one? Maybe the worst one you will ever have.

Then please consider this. What if, as rotten as this last year has been, it is the worst one you will ever have? What if they couldn't possibly line up one like it again?

Then, even though you are depressed now, can you imagine ever being this depressed again?

Let's hope not.

So, assuming you are depressed, maybe you deserve to be. Maybe anyone in exactly your same position would be depressed. Your depression could very well be a normal reaction to the losses you've suffered.

Maybe you are not as different as you think you are. Because if you think you have a corner on depression, you couldn't be more wrong. Remember I said that as of this morning, there are millions and millions of your brothers and sisters all around the world suffering the same symptoms. The depressed crowd is a big one; it’s standing room only.

Because everyone loses something sometime, depression is going around like a bad virus and anyone who isn't depressed today certainly has been at one time or another, or is likely to be at some time in the future. None of us can get off and on the planet and entirely avoid getting depressed a few times -unless, of course, we have figured out how to get through life without feeling the pain of losing something dear to us.

So, if you have suffered some terrible loss or losses, it is true I cannot know what they are or just how, exactly, you will take them. But I know this: You are no different from the rest of us. If cut, you will bleed. If injured, you will feel pain. If you lose greatly, you will grieve and, perhaps, become depressed. If you lose something very important to you, you will may become a depressed person, or become a reasonable facsimile thereof. This is as it should be and no one, least of all me, is going to pretend you shouldn't have the feelings you have.

Three things it would be good to memorize: 1) It is not wrong to be depressed, 2) It is not stupid to be depressed, and 3) It is not a sin to be depressed. To be depressed is, rather, how human beings react (and I mean naturally) to the losses we all have to suffer.

Another important lesson: some depressions occur without any apparent loss, or triggering event. They just come on us like a storm out of the East, complete with howling winds and black clouds. These low moods (sometimes accompanied by a mix of high moods) are most likely biological in nature and are often associated with an undiagnosed and often quite treatable general medical condition, for example, bi-polar disorder.

If the mood state is an ongoing depressed one, it could be untreated hypothyroidism or some other problem with the endocrine system. Some medications can trigger depressive symptoms. Some drugs of abuse can do the same. The point is this: we certainly do not want you to kill yourself because of a treatable medical condition.

Getting Better
Now let's go a little further with this. Let's suppose that you have been depressed for some time -maybe three weeks, maybe a month, maybe several months. When, you have probably asked yourself, am I going to begin to feel better?

If you've been answering your own questions lately, we know what your answer has been -never! That is the way depressed people think. Ask depressed persons to tell you about the happiest thing that ever happened to them and they're liable to tell you they once had a root canal. Even though most depressions are treatable medical conditions, when you're depressed you think depressed, and you can't possibly see your way out of the cup. Like the bug trapped there, you simply can't imagine ever getting out.

I know your symptoms. You have no interest in things that you used to like to do. You're having trouble concentrating. You haven't any energy. You can't seem to get anything done at work or school. Your willpower has four flat tires and your ambition just ran out of gas. Your spirits not only can't soar, they can't even get off the ground. You’ve no interest in food, fun or sex. And you’re thinking of suicide to end the pain. So why wouldn't you begin to think you can never get out of the cup?

But hold on. What if I told you that the great majority of depressions get better all by themselves? What if I told you that almost all depressions end by themselves within a few months? And what if I told you that your depression could be fixed up in a few weeks or months with a bit of counseling and/or some medicine?

What if I told you that your depression might not be your fault at all?

What if I told you that you may have inherited a tendency to be depressed, that there was something in your body chemistry that was out of kilter and that, however it got screwed up, your body is making your mind depressed and causing you to think about the only solution that seems available to you (the forever decision)?

Would you be surprised to learn that maybe because your body was a little short on a certain kind of salt (lithium carbonate) that you couldn't help being depressed? Or that, once this was discovered, you could literally take what amounts to a salt tablet once a day and maybe never be depressed again?

What if your brain’s serotonin system is out of whack and your brain needs a tune up? You wouldn’t shoot your car if it ran low on oil, so why would you shoot your only brain if it ran low on serotonin?

What if, after delivering a baby, your body has been depleted of essential chemicals necessary to maintain a positive state of mind? Did you know that post-partum depression can be so serious as to lead to thoughts of death and suicide?

Trust me, I know a lot about depression, and what I’m telling you here is scientifically true. The research on depression is quite good and getting better everyday. Some depressions are biological in nature and the cure is medicine, not death. Other depressions can be turned around by diet and exercise. Still others end all by themselves, for reasons none of us understand all that well.

Remember this, most people stop feeling depressed within six months, with or without treatment. Counseling is a powerful antidote for many depressions, and some breaking research suggests that something called cognitive-behavioral therapy is especially effective in treating depression.

For those depressions counseling can't help, many modern medicines can. Counseling and medicine together wage a hell of a war on the most serious of depressions. In most cases, people who start into counseling and start taking antidepressant medication start to feel a whole lot better within two weeks, or a bit longer.

Sure, there are a few depressions we can't seem to help very much. We can't figure out why a person continues to be depressed even after we've tried everything we know. But this is a small number. And it isn't like research scientists aren't discovering new things about how to treat depressions every day.

You may be thinking, "He's talking about someone else's depression, not mine. He can't know what my depression is like."

You're partially right, but you're partially wrong, too. Unless you're a visitor from another planet or an android, your depression can't be all that different from the rest of ours.

You may have lost your appetite and can't get to sleep. You may wake up with nightmares, and in the middle of the day. You may lie in bed at five a.m. and play what I like to call those "dirty little records" in your head -you know, the kind that go around and around and around over some problem you can't seem to solve and then, when the recording gets near the end and you still haven't found a solution, it starts all over again at the beginning. By the time you finally get up, you've already put in a full day's work.

You may not care about sex or the movies or your favorite food or any of the things you used to like to do, but, sorry kid, you're just like the rest of us when we get depressed.

So even if you've got a whopper of a depression on your hands and don't know what to do about it, it doesn't mean you won't ever feel better. And if I had to bet on it – even when I don't know you or what your situation is – I’d bet that you are going to get over it, through it, or around it. And I would win the bet.

Because I know you've put your life in the balance and are thinking about suicide as a way out of the depression and the cup you are in, I want you to remember something else that bears repeating. When we finally make the decision to kill ourselves, we suddenly begin to feel better. Settling on suicide as the best possible solution available to us, we feel a wonderful sense of relief and, maybe for the first time in weeks, a surge of energy and a renewal of vigor. Now and at last, we have enough physical and emotional strength to act on our decision.

But just one minute. Is this not a cruel hoax? Have we not invented the cure that kills the patient? Our decision to die may set us free from the pain and suffering of our depression, but it also sets us free from existence and all the things that might someday be. To my way of thinking, suicide is just too strong a medicine for what amounts to a passing illness.