No one seeks out depression, especially in the springtime, when our world seems at last to be coming back to life after its long, cold sleep. But depression doesn’t need to be sought: no, it comes unbidden and unwelcome. And making it go away again can be extremely difficult. I’ve been thinking about this because people important to me struggle with the problem. Maybe you do, too, or someone you know does. Is there anything we can do to help?
One of my natural first thoughts was to survey books on the topic, but that’s not as easy as one might think, either. The authors of one site I found had done the same thing and concluded:
On [sic] the main ... we are disappointed with the majority of books on depression. They fail to distinguish between the different types of depression. They waste valuable space debating whether depression is a "disease" like diabetes or a problem of adaptation and poor coping skills. For us, the answer is that depression is a syndrome, with many different causes and solutions.
Well, fine, but then I looked at their list of books and found myself still disappointed. What I really want to do is throw the question “out there” and ask you:
Is there some particular book on depression and/or bipolar disorder that you have found especially informative and/or helpful?
You needn’t be depressed to weigh in on this question, and you can register your comment as “Anonymous” or even send it to me in e-mail, if you’d like.
Here’s another question:
If you are sometimes depressed, is there anything you would like friends to ask or say to you during those times?
As for me, here’s what (little) I know from my own experience:
1) Depression is not “feeling sorry for yourself.” If a depressed person could “snap out of it,” he or she surely would. In fact, the burden of what I think of as meta-depression can exacerbate the problem, as a thoughtful person compares his or her life and problems to those of others and thinks, “I shouldn’t be depressed.” Depression is not a matter of should or shouldn’t.
2) Neither is it true that “everything is relative” because all personal experience is absolute. We can observe other people living their lives, but the only one any of us lives is our own. The only life any of us knows “from the inside” is our own.
3) Depression is not “all in your head.” Depression is an overwhelmingly physiological experience, as much as a state of mind. During the winter of my worst and longest depression, I could only sleep two to three hours a night and would awake feeling encased in a suit of dread from head to toe. Every day and every night were draining and exhausting.
4) There is a lot a depressed person can do to try to push depression away, but no cure is guaranteed to work. Exercise can help. (I forced myself to go to the pool three mornings a week.) A cheery environment can help. (I repainted a dull beige room a light, sunny yellow.) It’s a good idea to see a doctor. (I did.) Prescription medication helps some people. (I tried it for a while.) “Getting out of the house,” yoga, meditation – all are good ideas. Talking can help. But nothing is a guaranteed, instantaneous cure.
5) You cannot assume that someone who continues to be depressed is “not trying” to feel better. You may have no idea how hard that person is trying or how many things he or she has tried and is continuing to practice. Second-guessing and guilt-tripping a depressed person for being depressed is no help at all.
I’ve numbered these as if they are separate “points,” but it should be clear that they are all interrelated.
A big problem with Internet “research” is that so much of what turns up in search results comes from people with something to sell, whether it’s a book or a pill or a program. When I remembered that NIH is my go-to for general health questions (thus avoiding sites focused on sales), I turned to NIMH to see what they had to say about depression, and right away I found it more helpful:
Most likely, depression is caused by a combination of genetic, biological, environmental, and psychological factors.
Depressive illnesses are disorders of the brain. Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression. The parts of the brain involved in mood, thinking, sleep, appetite, and behavior appear different. But these images do not reveal why the depression has occurred [emphasis added]. They also cannot be used to diagnose depression.
To me this is helpful not because it claims to have all the answers but for the clear statement that answers are elusive. The brain of a depressed person looks different, but the difference does not reveal the cause. Is it situational? Chemical? A symptom of some other illness? Brain image can’t show answers to these questions.
Every generation, it seems, has its popular answers, but there is still so much we don’t know.