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Blues Everlasting: An Essay on Depression

by Brett Schlund

English 102 Professor Mark Brown 03 October 2005

2 Table of Contents Blues Everlasting: An Essay on Depression Works Cited Appendix Anatomy and Physiology Brain Imaging Images of Depression Neurotransmitters in action: From macro to micro Neurotransmitters in action: How brain cells communicate Neurotransmitters and depression C1 C2 C3 C4 C5 C6-7 3-14 15

3 It was a typical Sunday afternoon, I had just finished going to church meetings, and now two other gentlemen and I were going to a fellow church members house. We had been asked by his wife to come by and visit him because of some problems. I personally didnt get a chance to talk to the wife, and really had no idea what those problems might be. It was early fall and things were changing everywhere, the trees, children starting school, harvest, and finishing up summer projects. As we reached their house, I admired the aspen trees with their colors of gold and yellow. They are so beautiful, and the temperature is changing to cooler weather. I love that time of year. We entered the living room and automatically I could tell something was definitely wrong. The shades were drawn, shadows lingered everywhere, the children were a little apprehensive, his wife on edge. What was going on? The home felt like a prison; it was lonely, sullen, and depressing. It was so beautiful outside with the fresh air, clean breeze, the feelings of fall, but what a contrast the two were to me. As the young man entered the room his eyes were red and swollen with bags under his eyes, his shoulder slumped over like a he was carrying a huge weight. He didnt greet us with his normally happy demeanor; we were instead met with a person that literally expressed little emotion. We asked how he had been doing, he responded, Not good at all. He explained he recently finished his teaching degree, had spent some time at the start of the school year teaching at the local high school. He explained that it wasnt what he thought it would be like to teach. He said he had doubts as to why he had even wanted to teach school, and was feeling really depressed. Depression had a hold of him and he was unable to free from its grasp. Even getting out of bed was a chore, he would cry for no reason, sleeping during the day, and be wide awake at night. The feelings of helplessness

4 were prominent in his mind, and all confidence in his abilities was gone. He suddenly began to cry, becoming overwhelmed by the whole event, and then his wife began to cry. He said, I feel like ending it all, I cant take the constant pain anymore, it is just too hard. Did I just hear him correctly? This guy is talking about taking his own life. We tried comforting him, gave him some advice, and told them both we would do whatever it took to help them through this trying time. As we left I felt pity for the guy. I wondered why he didnt just Cowboy Up, grab the bull by the horns, and quit whining about life and move on. I really saw him as weak, and I really didnt understand why he would want to end it all. How selfish could he be? Could it really be that bad? He said he was depressed, but I said he is weak. How wrong could I be, to make such a judgment and not know anything about what was really happening? I really had no idea what this man, and his family were going through. Depression, what is it really? Is it something that one person can control on a whim? Does it mean that he was weak because he suffered from an illness called depression? From a booklet published by the National Institute of Mental Health it reads, In any given 1-year period, 9.5 percent of the population, or about 18.8 million American adults, suffer from a depressive illness. The economic cost for this disorder is high, but the cost in human suffering cannot be estimated.(Robins) It also goes on to say that depression interferes with peoples live, and causes pain for all involved. In serious circumstances it can destroy lives. I had no idea that there were so many people that suffered from this illness, and the impact it has on their lives, that is until it happened to me. Because of how it affects all sorts of people, I want to educate others as to the causes of what is classified clinical

5 depression or major depression and how it truly does affect its host. Are they weak, can they control the black dog as Winston Churchill classified depression?(Cronkite5) I want to show that clinical depression is a chemical change in the body, what some of the symptoms are, and why we should as a society be more understanding of those that suffer from the debilitating illness. Perhaps the most vivid account in recent years of depression's impact came from novelist William Styron, whose works include Lie Down in Darkness and Sophie's Choice. In Darkness Visible, a Memoir of Madness published in 1990, Styron described a bout of severe depression that began shortly after he had renounced alcohol. Depression, he asserted is, a wimp of a word for an affliction that amounts to nothing less than a howling tempest in the brain.(26) Afternoons were ... the worst, Styron explained, beginning at about 3 oclock; when I'd feel the horror, like some poisonous fogbank, roll in upon my mind, forcing me into bed. There I would lie for as long as six hours, stuporous and virtually paralyzed, gazing at the ceiling and waiting for that moment of evening when, mysteriously, the crucifixion would ease up .(58) To say suffering from depression is like a crucifixion is strong terminology, but in my experience so accurate to describe the pain and anguish that plagues the depressive. Sleep literally became a place of refuge, a time when the fog would lift from my mind, left in peace. That is if I could even sleep. Often I was left staring at the ceiling, and feelings of anxiety would crush my chest as if death were imminent. I have reflected many times on the meeting with that young man, how helpless he had become. He seemed to be less like a real man, more like a child; he had no

6 direction and was seeking for answers. I moved to a different city, bought a house, got a spectacular job managing a multi-million dollar construction project. Needless to say life was good; I had money, position, power, and all the stress a guy could choke down. I worked literally more than I was off, and decisions could save thousands or break the bank. Then one day it all caught up to me, the darkness that had possibly pursued me most of my life, had now found its prey. Depression has set its sights on me, had locked on solid, and I was now spiraling downward. I felt sick like the flu at first, puny and basically feeling down. I figured it was a typical cold. Getting out of bed was a major deal; I couldnt even bring myself to leave the house. Sleeping at night was almost impossible, and I would lay in bed worrying about life, and what ifs. Understanding what was happening to me was beyond my comprehension. In 2001, the Mayo Foundation for Medical Education and Research, published a book called, Mayo Clinic on Depression. In it the book describes the ins and outs of depression. In the introduction they express that depression is much more than bad days, being blue for a time, or having a difficult time with loss. Literally, it is an illness that causes changes in the way the depressives brain functions. The illness affects how a person thinks, feels, and acts. (iii) I really thought the young father should have been able to overcome his feelings, but until now I had no idea that he physically wasnt able to. There are literally so many causes of depression that a person could study it for a lifetime and never really know everything there is to know about the illness. For many it is the imbalance of chemical neurotransmitters in the brain that limit the functions of the brain (C4-7). When a persons brain is functioning properly, it adjusts so that the

7 situation and emotion match. When you suffer from depression, the levels of neurotransmitters are out of sync. A depressive may feel unhappy all the time, and may even be sad under situations that one would enjoy (Mayo Clinic38). Studies show that literally the brain function in clinically depressed person is lowered. In C3 in the appendix, you see the imaging of a persons brain that is depressed and one that is not. It shows that in some cases, more often than not, it is not the choice of the depressed to change their situation. It is chemical. Whether it is neurotransmitters or hormone imbalance in that the levels are out of whack. The Mayo Clinic also states that if a person is in highly stressful situations, or has experienced an event that was traumatic, the body can respond in such a way as to change the levels of hormones in the body, and that can cause depression in certain individuals. The increased levels of these hormones can cause problems because the brain is sensitive to these changes. It can cause impaired memory and ability to even function (34). This is only one of the many ways that depression can be caused by changes in the afflicted persons body. Often times it is created by outside forces, to which the body responds accordingly. Changes in the body are numerous, and specific to individuals because everyone is different, so many doctors misdiagnose depression as just a common cold or some other ailment. Jed

Diamond, author of The Irritable Male Syndrome states that, Depression causes and contributes to other illnesses, such as alcoholism and heart disease, and then is masked by these other diseases. If one takes that in to consideration, depression may be the biggest killer on earth (80). Until a depressive honestly visits with a doctor will they get the help they need. People need to understand the symptoms and signs of depression to better

8 help in diagnoses. So what are some of the symptoms of depression, how does a person really know if it is depression or just a case of the blues? As the weekend came to a close, my wife came home from a trip; I had spent the whole weekend alone with my son. Terrible thoughts had haunted my mind, ones that to this day surprise me. I would lay in bed trying to sleep, thinking about how bad I felt. I had a thousand demons screaming in my head, the hosts of hell dragging me down to their private party. I began to think of how horrible life was at that very moment, alone, one thought stacked onto another, until hopelessness began to surround me. I suddenly began to feel as though I couldnt breathe, my chest getting tighter, harder to breathe, I was gasping for air. I would cry to God to release me from my pain, but still no release. Sleep escaped me, I couldnt find any peace of mind, and darkness seemed darker than ever. The most noticeable feeling was that as the sun descended from the sky; a veil was pulled over my mind, a stupor of clouds, and a fog of debilitating pressure filling my head with despair. I felt like a tree in winter, no leaves to protect me, stripped, alone, and weary. My wife came home to find a shell of a person, crying, seeking comfort or answers. At the time I forgot and didnt care that I was not alone, no one could help me. Author, doctor, and depression sufferer Lewis Wolpert in his book Malignant Sadness The Anatomy of Depression wrote that symptoms of clinical depression consists of, a period of at least two weeks in which there is a depressed mood or loss of interest or pleasure in nearly all activities. In addition, five or more of the following symptoms must be present during that two week period: depressed mood most of the day, significant gain or loss of weight, diminished interest or pleasure, inability to sleep or sleeping too much, reduced control over bodily movements, fatigue, feelings of

9 worthlessness or guilt, inability to think or concentrate, or thoughts of suicide or death.(17) It is not limited to this list nor is the depth of the depression. There are so many more symptoms, and the degree to which a person suffers may be greater or less severe. Doctor J. Raymond DePaulo Jr., M.D. in his book Understanding Depression comments that to be depressed is different for everyone, and the experience varies. You can feel as though you have the flu or a common cold, but very often its as if you should be able to overcome or shake it off, but you cant. The world may seem different to you, and your ability to think and behave calmly is beyond reach. A person may wonder what is wrong, and how will I regain normalcy, and become convinced that they will never become normal again (9). I wonder if this guy studied my life, he really seems to know, he has been there. I knew deep inside there was something really wrong, but it just wouldnt go away. My wife stated that I needed some help, but I resisted and said that I thought I had the flu and I would get better soon. She called my sister who is an RN, and she requested that I get on the phone. On the verge of tears, I began to listen to her as she asked how I was really doing. She then asked the tough question, Have you thought of hurting yourself? My silence was followed by a rush of emotion and tears which answered her question. My wife stood there astounded at what she was hearing. When I was able to talk I said, It hurts, I cant describe how hopeless I feel, I just want it to end and go away. I remember talking to a friend in high school after several people from our school had taken their own lives. I had said to him, How bad does life have to get to take your own life? Is there really such a thing? Suicide is so selfish an act, you dont think of

10 anyone but yourself. I now know how bad life has to get, I found that point, and yes, it is selfish. I hurt and to me that was the solution. At my families request I was promptly put on anti-depression medicine, and slowly the fog began to lift, or did it? Had depression attacked all at once, or was it something that had been coming for a while? Did the stress of the job bring it on, or was it bound to happen? Author of the book The Noonday Demon: An Atlas of Depression, Andrew Solomon states, If one imagines a soul of iron that weathers with grief and rusts with mild depression, then major depression is the startling collapse of a whole structure.(17) He talks of how many times the depressive may feel like depression overtook them all at once, but it really is the culmination of so many events. Solomon draws a parallel between a rusting structure and a person, rust destroys the building slowly, and inside and outside factors eat away at the depressive. We think that the collapse happens all at once, when in reality it is little by little. I know now that it was a culmination of many events, conditions, years and stress. I also have the knowledge that it is my genetic predisposition to have depression as it is passed down from your parents. A life that seemed normal turned to pure chaos. The accomplishments, events, pleasures, pursuits, and life that I knew before the collapse, seemed to be the life of another. It was as if I were trying to recall the movie of the week on TV, because the events of my prior life seemed so distant. I felt as though the person before had been demolished and construction had just begun on a new person that I was becoming. Wolpert talks of the stigma that is associated with depression and the fact that when he suffered from depression, his wife told people it was exhaustion from a minor

11 heart condition. Her main concern was how it would affect his career for his colleagues to know of his condition. After he wrote an article in The Guardian newspaper about his depression he received positive support. He talks of the severe social stigma associated with depression and the added burden put upon depressives, as he calls the sufferer (vii). Very often the stigma is applied because of the lack of understanding and the amount of knowledge of those applying that judgment. He also talks of William Styron and his description of depression, pain of severe depression is quite unimaginable to those who have not suffered it, and it kills in many instances because it cannot be borne (Wolpert x). In my own experience, people around you can be very cruel. I have heard it all, everything from yah, yah, yah, Ive been depressed, you just have to cheer up and move on, to buck up man, its all in your attitude, mind over matter, if you dont mind, it doesnt matter. Obviously, these people have absolutely no experience with true clinical depression. A good friend of mine criticized me often when talking about depression, until one day it became part of his life. The world as he knew it came crashing down. Many depressives feel that for those that have not experienced the disabling affects of depression, it is difficult if not impossible to understand. Just as I judged that young father over 6 years ago, I had no idea the pain and suffering that he was inflicted. Even after taking medication, it was close to a year before my life took on any amount of normalcy, just as it had been for that young father. In the beginning work was unbearable, I just wanted to get home and sleep. To accomplish work on the project that before was second nature had now become a physical feat to complete. I had to force myself to do everyday tasks, and was forced to

12 find different employment because I couldnt cope. My employer wanted me to stay because they said I was just having a hard time. They wanted to help but I just couldnt find the strength to make it work. Many days I would have to fight off crying. There was no real reason for the emotion, it just happened. Some weeks I had absolutely no appetite, others I couldnt get enough food to satisfy my cravings. Hobbies and activities that before brought me such joy, became a burden, too much work and planning, not worth the effort. Even when in the middle of otherwise joyous activities, I was not happy. Yes, a change in attitude is a great help, but its only that, a help. I can see that others who have not experience depression might not understand, only because I too didnt understand. I still dont. For someone not to be able to control emotions, feelings, or thoughts are less than someone who can. We want to believe that we are stronger than our bodies, and that we have the ability to control our lives. No one wants to believe that their life too can be turned upside down without reason or cause. For me it has been a long difficult battle to overcome the demons that would dance around me day to day. With the help of good friends, family, and medical help, I feel better everyday. As with so many depressives, we all have bad days, but we listen to our inner dialogue, and reason ourselves out of the fog. It may be that youre bummed out, but it may last much longer with more severe reactions. In an essay by Richard L. Worsnop he states, That 10 to 20 percent of the American population suffer from depression, unfortunately only a third are diagnosed and treated. He goes on to say that everyone experiences clinical depression differently. The symptoms that depressives have and the length of time they suffer also vary. Even with all the talk shows, magazines and publicity about the effects of depression, people are still ignorant to the facts. A

13 nationwide survey conducted last year for the National Mental Health Association found that 43 percent of those interviewed believed that depression resulted form personal or emotion weakness. I have found this to be true in my own life. Many people just dont know what it is truly like to be weighed down with the disabling effects of depression, and thus they pass such uninformed judgments. Hopefully by educating others, we can all become better poised to respond to this troubling illness. Depression costs society billions every year, but losses inexpressible in dollars are the hardest to bear. The U.S. Department of Health and Human Services states that, research may never be able to capture the complexities in an individual's life as the result of one or more episodes of clinical depression or a series of them: potentials never developed, roads not taken, love lost, jobs lost, relationships ended. Multiplied by millions, the cumulative result of the disruptions caused by depression is indeed beyond measurement. As members in a society we need to try to understand that if a person could avoid depression, they would, but it really is not their choice. I experience the judgments of others when they receive the knowledge that I suffer from depression. I wish I could say that the black dog doesnt visit me anymore. There are many days that I hope that I can be free of depression forever. That young father, he too still finds that depression holds on tight. But we both find life a little better, brighter, and a lot less blue. Depression can be cured, and depressives are not weak or inferior. It just happens, and it may happen to you or someone you love. Odds say that its a guarantee. When a person is able to step out of the darkness, it is truly inexpressible. Maybe we can all be more understanding, and less judgmental of those that suffer from depression. Who knows,

14 some day you might be the one that is suffering from the literal hell that depression imposes on its host.

15 Works Cited Cronkite, Kathy. On the Edge of Darkness Conversations about Conquering Depression. New York: Doubleday, 1994. DePaulo Jr., M.D., J. Raymond. Understanding Depression What We Know And What We Can Do About It. New York: John Wiley & Sons, Inc., 2002. Depression. National Institute of Mental Health. 2000. 21 September 2005 http://www.nimh.nih.gov/ Diamond, Jed. The Irritable Male Syndrome Managing the 4 Key Causes of Depression And Aggression. Rodale Inc, 2004. Downs, Ph.D., Alan. The Half-Empty Heart. New York: St. Martins Press, 2003. Kramlinger, M.D., Keith. Mayo Clinic on Depression. Rochester, MN: Mayo Clinic Health Information, 2001. Robins LN, Regier DA (Eds). Psychiatric Disorders in America, The Epidemiologic Catchment Area Study, 1990; New York: The Free Press. Solomon, Andrew. The Noonday Demon An Atlas of Depression. New York: Scribner, 2001. Styron, William. Darkness Visible Memoir of Madness. New York: Random House, Inc., 1990. Wolpert, Lewis. Malignant Sadness The Anatomy of Depression. New York: The Free Press, 1999.

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