I thought it had only been several months since I had last written a post to this blog.  In fact, it’s been over six months, at once an eternity and an instant, because time moves in relative terms when life has no structure to mark its passing.  And, free time isn’t free when the mind is trapped in a prison of despair.

Last week, I read a post by one of my favorite Open Salon writers, Cranky Cuss.  A tongue-in-cheek curmudgeon known mostly for his acerbic wit, Cuss’s essay, Suicide Isn’t Painless, (http://open.salon.com/blog/cranky_cuss/2012/08/23/suicide_isnt_painless) received both an “Editor’s Pick” and “Reader’s Pick” and inspired me to write a comment.  You can imagine my shock when, upon opening my messages, I learned my comment had also been selected as a “Reader’s Pick” (I didn’t know “Comments” were even in the running).  I wish I knew who selected me (there is a nominating processed followed by a seconding process – it all seems very “black box” to me).  Try as I might, I can’t identify the specific writers involved, so I will issue a blanket thank you to everyone at Open Salon.   

Much like the woman at the end of Cuss’s essay who was pulled back from the edge by a passing stranger, the small act of sitting in front of the keyboard, has for the moment, rescued me from a prolonged state of depression.  And, knowing my comment touched Open Salon readers enough to receive a “pick” now inspires me to keep writing.  Again, my thanks to all.

For years now, I’ve wondered if I actually do suffer from “depression.”  I’ve read books and essays and medical journals, all of which attempt to define depression from various angles.  After Cuss’s essay, I couldn’t wait to read Darkness Visible: A Memoir of Madness by William Styron.  I am also looking forward to reading Every Love Story Is a Ghost Story: A Life of David Foster Wallace by D.T. Max, which was recently reviewed on Salon.  (http://www.salon.com/2012/09/03/d_t_max_discusses_david_foster_wallace/)

The commonalities of words and phrases used as literary devices to characterize this enigmatic disease span from the scientific to the symbolic.  Styron does extraordinary work in describing the ravages of the mind he suffered during his dark descent which culminated in a thwarted suicide attempt and prolonged hospitalization. 

DFW, as Wallace is known to fans, hung himself in his own home after months of deep depression.  (http://www.nytimes.com/2008/09/15/books/15wallace.html)  While there is no published memoir of his own dark journey, those who knew him speak of his all-consuming self-hatred.  And, the biography, reviewed by Scott Timberg, “…sketches a brilliant, despairing protagonist whose life can be seen as a search for personal and literary meaning.”     

Despite recognizing so many attributes of depression in my own thoughts and behavior, there is still one aspect that is unfamiliar – depressives should be happy, but aren’t.  Both Styron and Wallace were happily married with well-respected careers.  Unlike the speculation surrounding the recent suicide of Director Tony Scott (http://www.latimes.com/entertainment/movies/moviesnow/la-et-mn-0821-scott-death-20120821,0,5115040.story), neither had been handed a death sentence via cancer or other terminal illness.  And, neither suffered through an external event (i.e., causative agent) which normally triggers sadness.    

Perhaps the most expedient way to explain this aspect of depression is through example.  Styron writes, “Loss in all of its manifestations is the touchstone of depression—in the progress of the disease and, most likely, in its origin.”  Most people cope with loss, such as the death of a loved one, through sadness, which might manifest itself as a desire to stay in bed all day.  Still, both the response and the behavior are normal because loss is the causative agent.  But, staying in bed all day, without a causative agent, is considered abnormal.  In other words, it’s depression.

However, after a year, if the sadness caused by loss still manifests as a desire to stay in bed all day, it is now considered depression.  Even in the presence of a causative agent, the response is abnormal (in this case, lasting longer than the normal healing process would indicate).  So, depression appears to be profound and lingering sadness which occurs either in the absence of, or in disproportionate response to a causative agent, usually loss. 

Loss is not only experienced through death, but in many other forms both sublime and superficial.  For example, Styron writes, “the acute sense of loss is connected with a knowledge of life slipping away at accelerated speed.  One develops fierce attachments.  Ludicrous things—my reading glasses, a handkerchief, a certain writing instrument—became the objects of my demented possessiveness.”  Loss spans across the external, i.e., jobs, fortunes and marriages as well as the internal, i.e., self-esteem, independence and passion.

Over the past 11 months, I have lost my job, my home, my dog, most of my possessions and my financial security.  Yet, each day for months, I got out of bed (even though it was in the back of a van), got dressed (even though it was in a locker room), got connected (even though it was in a public library) and attempted to reclaim that which I had lost.  And, each day, I failed.  Each day, the universe told me I am worthless.  Each day, the universe told me there is no value in what I have to offer.  Is it any wonder I now have very little confidence or joy for life?  Wouldn’t profound and lingering sadness be considered an appropriate response to a lengthy series of causative agents?  Could anyone argue that I should be happy after such devastating losses?  

And, for these reasons, how can I claim to suffer from depression?  (I should also disclose that the term “depression” holds no stigma for me.  As with most things considered human behavior, my knowledge and beliefs are based on scientific research demonstrating depression arises from observable phenomena related to biology, biochemistry and physiology, not abstract concepts such as character, determination, fortitude or will.)  When I have shelter, security and purpose, I am happy.  When my entire existence implodes, I am sad.  Go figure! 

The difference between when I am happy and when I am sad can be described in one word—STRESS.  Yes, most everyone has stress.  Job stress, family stress, financial stress, and many other types of stress ad infinitum.  How we respond to stress often defines us as individuals and as a society.  (Some people actually “stress” over what to wear on a first date.  Really?)  I tend to think of stress in terms of “beneficial v. non-beneficial.”  When I hear people complain about how stressful their jobs are, I ask, “Is there any benefit to working?”  The reply is always, “Of course… a steady paycheck!”  When I hear people complain about how stressful raising their kids can be, I ask, “Is there any benefit to having a family?”  Again, “Of course… we love each other!”  Then, I hit them with my zinger… there is no upside to my particular brand of stress.  There is no benefit to being homeless.  There is no satisfaction in job hunting (because there are no jobs!).  And, there certainly is no reward for being abandoned.  All there is in my day-to-day existence is penetrating, unrelenting, unforgiving stress.  

When the brain is in equilibrium, neurotransmitters (norepinephrine and serotonin) maintain mood.  Under stress, neurotransmitter levels drop, creating the condition recognized as depression.  Yet, the question of sadness verses depression is far from a simple philosophical distinction.  With sadness, the condition is usually short-lived and the brain is able to heal itself.  With depression, the condition is prolonged, intensified and often requires treatment.

Of the 40 anti-depressant medications listed on WebMD, I have been prescribed Elavil, Pamelor, Prozac and Wellbutrin, but not necessarily for depression.  In my case, these medications were taken to treat prolonged episodes of severe cluster migraine headaches I suffered after (illegal) exposure to environmental toxins in my workplace.  Anti-depressants work by increasing the neurotransmitter levels, but they do nothing against the underlying stress.  In constant pain, sometimes to the point of literally wanting to jam a knife in my eye, is it any wonder I was also a little blue? 

Any reasonable doctor, upon hearing my current set of circumstances, would have little trouble prescribing anti-depressants (if only I had health insurance).  But, until my life improves, I know from experience there is no magic pill that will elevate my mood.  Rather than depressed, I say to others that I am in a state of depression, not that the distinction matters to anyone but me.  You see, like most other things in my life, depression has become a luxury I simply can’t afford.