WINTER UNDERWORLD

Wednesday, January 18, 2012

By Meg Daly

Jackson Hole, Wyo.-For years, I was eager to divulge that I take an antidepressant. “I have depression,” I’d say, the way one might announce a common cold. Enough of the shame, I’ve bellowed. This is a manageable health issue, I told others and myself, thinking that I’d cracked the code to how to live sanely with this particular form of insanity.   

This November, when most locals were decrying the dearth of falling snowflakes, I was descending furiously into one of the worst major depressive episodes of my life. Only last week, in the first days of January, did I begin to surface. Along with the giddy relief of returning to myself came a more somber reckoning. All these years I too have been cowed by the stigma attached to depression—and its medications—even as I attempted to demystify it. I hid from myself and others just how pervasive and debilitating this illness had been to me.

The terminology we have to label depressive disorders are feeble, cheery even. Think of “S.A.D.,” Seasonal Affective Disorder. I imagine a yellow smiley face with its smile turned upside down. “Major depressive disorder” and its low-grade, chronic cousin “dysthymia” (my particular afflictions) at least sound a little bit medical.

But I agree with novelist William Styron (Sophie’s Choice), a long-time sufferer, who rejected the term “depression,” calling it, “a noun with a bland tonality and lacking any magisterial presence, used indifferently to describe an economic decline or a rut in the ground, a true wimp of a word for such a major illness.”

Styron wrote a brilliant, searing memoir, Darkness Visible, in which he describes his depression this way, “The madness of depression is the antithesis of violence. It is a storm indeed, but a storm of murk. Soon evident are the slowed-down responses, near paralysis, psychic energy throttled back close to zero. Ultimately, the body is affected and feels sapped, drained.”

Beloved poet Jane Kenyon battled depression her whole (too short) life. In her poem, “Having It Out with Melancholy,” depression inhabits her body not unlike a parasite:

A piece of burned meat 
wears my clothes, speaks 
in my voice, dispatches obligations 
haltingly, or not at all.
It is tired of trying 
to be stouthearted, tired 
beyond measure.

I hope you cannot empathize. We’re not talking about having the blues, being bummed out, or feeling out of sorts. We’re talking intractable pain, both psychic and physical, that lasts for weeks. Because this is a pain that presumably originates in the mind, society has long had the prejudice that the sufferer can “think” her way out of her pain. “Buck up!” “Look on the bright side!” “Be the change!”

Fighting for Happiness
I was first diagnosed with major depression in 1996 when I was 26 years old. It was the era of “Prozac Nation,” and indeed the author of the book that coined that phrase, Elizabeth Wurtzel, was an acquaintance of mine. (Like seeks like.) People “came out” right and left with their stories of mental imbalance and thusly gobbled their doses of the apparent new salvation. When my psychotherapist determined I was suffering major depression—including non-stop crying, phobias, social isolation, and a vision of the world disappearing behind a dark curtain before my very eyes—I was prescribed a Prozac-like drug called Paxil. It helped. But it didn’t cure.

In the 16 years since my first diagnosis, I have engaged in what I dare say is a full-scale assault against my illness. Over the years I enlisted five psychotherapists, four psychiatrists, numerous massage therapists, two spiritual healers, and one naturopath to help me. I took up, variously, running, hiking, yoga, Pilates, cycling, and cross-country skiing. I did deep breathing exercises and meditation; I listened to music, I listened to silence, I burned candles labeled “Peace.” I sat in front of a light-box in the winter and sat in a biofeedback chair in the summer. I read memoirs about depression as well as scientific articles. I got off Paxil. I tried St. John’s Wort and homeopathy. I went on Effexor. I adopted a dog.

I adopted two cats. I took news sabbaticals to avoid reading about nuclear disasters, genital mutilation, and Rick Santorum. I employed cognitive behavioral techniques to train my brain to be more relaxed and positive. I repeated affirmations from New Age card decks. I read Pema Chodron and Rilke. I got a colonic. I took aromatheraphy baths and drank endless cups of chamomile tea. I avoided sugar. I moderated my intake of caffeine and alcohol. I got together with friends even when I felt like shit. I moved close to my family. I found an amazing husband. I volunteered my time to help others. I took art classes and joined support groups. I took plenty of vitamin D. And even though I am an atheist, I many times knelt down in my bedroom or in the shower or in the middle of doing dishes, wracked by sudden sobbing, and prayed to God to please, please let it end.

So far, it hasn’t ended. It ebbs away. Then it finds a way to creep back in.

Shedding the Stigma
The problem with depression is that it’s not well understood, even by the experts. What we know is that it is a brain disorder, involving an imbalance of neurotransmitters. Apparently, despite my healthy lifestyle, that imbalance remains. My brain simply doesn’t function the way it should. I’m told that all the good things I do—from meditation to medication—are helping my neurotransmitters to get their act together. But there is no one-size-fits-all sure cure for everyone. Some people have single episodes of depression. For others, it’s a life-long struggle.

In Jackson, depression is uniquely relegated to the invisible because we’re all supposed to be livin’ the dream, privileged to reside in such a gorgeous, fun-filled place. My guess is that Jackson residents, however adventurous and hardy, follow national trends. According to the National Institute of Mental Health, “Depressive disorders affect approximately 18.8 million American adults or about 9.5% of the U.S. population age 18 and older in a given year.” 

That means there are likely just shy of 1,000 of us secretly slogging around the valley. With Wyoming perpetually vying for first in suicide rates in the nation, and the number one cause of suicide being major depressive disorder, I think there is good reason to put a name and face on depression in Jackson Hole. One hallmark of depression is the accompanying shame—Why can’t I make myself better?

This isn’t who I really am! I thought it could be worthwhile to muscle my shame out of the way for a moment to offer myself up as an example of an active community member who struggles with depression. I don’t want pity. What I do want is a recognition that mood disorders and mental health issues affect individuals in our community, the same way other medical issues do. The less shame and stigma we attach to depression, the more we open a door to health and balance for a significant portion of our community.

I also want to offer some advice. The following thoughts are entirely mine, totally opinioned, woefully incomprehensive, and not at all certified medically or otherwise. But maybe they are helpful.

First off, if you have depression—which means you experience things like suicidal ideation, extreme fatigue, feelings of worthlessness, lack of concentration, social phobia, persistent sadness, persistent anxiety, persistent feelings of emptiness, and even aches and pains—run don’t walk to the Jackson Hole Community Counseling Center or the yellow pages, and find yourself a professional therapist. Coping with this monster is not to be done alone.

Second, whatever you’ve heard about antidepressants, it may well be misinformed and incomplete. I’ve been on medication for more than 10 years and the worst side effect I’ve experienced is the need to drink more water. So chuck your bias, keep an open mind, and consider seeking psychiatric help with the help of your therapist. Antidepressants save lives every day.

Third, exercise. Aerobic exercise can be as effective as antidepressants, some studies claim. Plus it keeps you looking sexy which makes you feel good. Or is it that it makes you feel good so you look sexy? Speaking of which, if you can muster the energy, sex is a great antidepressant.

Now for you well-meaning heroes who are trying to help someone with depression. Whether you are a friend or family member, your support is inestimably important for this person’s recovery. Thanks for being there. Some words of wisdom from my own experience:
Refrain from suggesting the following as cures: the Mayan calendar, Eckart Tolle, yoga inversions, vitamins, a YouTube video of “Don’t Worry, Be Happy,” or mega doses of kale. Though possibly supportive, in and of themselves these palliatives amount to shooting spitballs at a bison to move it off your porch.
Instead, be willing to listen to your friend’s specific experience. Just having someone listen open-heartedly is HUGE.

If the person mentions thoughts of suicide, don’t shut the conversation down. Ask questions and help the person find help.

For your purposes, pretend your friend is grieving or down with a horrible flu. Bring her soup and comfort food, flowers, candles labeled “Healing,” or “Happiness,” or “Fuck This.” Hang out with her and hold her hand. Tell her that she hasn’t always felt this way and she will feel better again soon.

A New Day
As I write this, it’s week 2 of trying a new medication. My energy is returning, clarity of mind is restored, I don’t want to crawl to get from room to room. I feel suddenly enamored with my own quirky journey, and I’m redoubling my acceptance that life includes a good deal of suffering. That’s the irony. Despite being prone to depression, I’m an optimist (an idealist, even). I just listened to my stress-proof-your-brain CD.

I’ve got frankincense burning because it’s just been discovered to be good for the brain. I had a nourishing breakfast of brown rice and, dare I admit, kale. I’m at my desk, cat on lap, concentrating on the little things that make today wonderful: the yearling moose nibbling dogwood outside my window, a funny video of a seagull stealing a camera, a truffle from Oscar’s. Oh, and the swirling, darting, delicately alighting (at last) flakes of snow.

“Del Mar Tree at Night,” ink on paper, 30x22, 2011 by Aaron Wallis

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