Exposing our most devastating affliction

kw: book reviews, nonfiction, depression, bipolar, mental health

I think of it as having lost seven years. Not at the end of life. I don't know when that might be. Rather, two major periods that total seven years were spent unfeeling, in sadness beyond weeping, vascillating between paralyzing lassitude and desperate attempts to feel good, or feel anything.

I underwent psychoanalysis as a pre-teen because I was considered "withdrawn." That was before. As a youngster, I didn't feel so numb; I felt a lot, just most of it was bad, or mixed at best. Yet, there were times of great energy, when I was just the opposite. This became important later. As a young adult, and into middle age, I simply thought I was depressive.

When a third very low period arose in my 50s, I realized I was thinking about suicide quite a bit, so I talked to my doctor. He prescribed Zoloft. That made me rather sluggish, then set me off. On my next visit, I was a full-blown maniac. He suggested I was really cyclothymic, a diagnosis also called Bipolar 3. Bipolar 1 is the worst, the well-known Manic-Depression, and 2 is in between. A couple of other medicines were tried, but had very distressing side effects.

I went to a Psychiatrist. She determined Bipolar 2, with some Social Anxiety thrown in. The more common medications hadn't worked, so I saw one of her colleagues for cognitive therapy and learned to cope, to observe any trend in mood and compensate for it. However, I am now considering that further trials with medication may be in order.

A large part of my change in thinking came through reading Against Depression by Peter D. Kramer. His earlier, better-known book was Listening to Prozac. Let us hope that this new book becomes at least as well-known and -read.

Dr. Kramer's book clearly shows two things, which run parallel courses through the volume. He performs a very valuable service by demolishing the various myths of depression as somehow noble or enlightening. Many people have asked him, "What if Van Gogh (or pick your favorite agonized artist) had used Prozac?" He can clearly state, "We would have a much larger body of even better artwork."

He performs an even more valuable service by showing that depression is, as he states early in Chapter 12, "the most devastating disease known to humankind."

Have you heard or read about the view by AA leaders that Alcoholism is a progressive, terminal illness, that cannot be cured or reversed, but can be treated. That holds in spades for depression. Contrary to a number of other chronic diseases, depression is found to be one thing, a progressive decrease in resiliency of the central nervous system; a brain disease that progressively reduces the size of those portions of the brain that retain memories, enable higher thinking, and feel our most precious emotions.

Dr. Kramer dares to hope that we can eradicate depression, without eliminating ourselves. Someone may have a melancholy or introverted personality. That doesn't guarantee depression, though it is a pretty likely result. Someone properly medicated for depression can still feel sadness at sad events, without the consuming, obsessive anhedonia that many experience.

All told, about 16% of people experience major depression; and twice as many women as men. As mentioned, it is progressive and terminal. These 16% not only have a high risk of suicide, they have more heart disease, diabetes, and tendency to strokes. Their lives are measurably shortened. Using MRI, doctors now can observe the progressive destruction of brain tissue as the disease progresses.

The 18th chapter parallels depression with bipolar disorders. The chapter title is "Art," because of the common belief that depressive and bipolar artists produce more profound and creative art. Here is where the rubber hit the road for me. One writer stated, "When I am manic I write; when I am depressive, I edit." I have known for years that I get most of my creative work done in a few days each month or so, and the rest of the time, I am better doing stuff where I can sit alone and plod away at less demanding work.

However, the author made it clear that bipolar disorder is also progressive and terminal. Some of the brain areas affected are different than in depression, but there is progressive damage in either case. While brutal medications such as Lithium definitely dull the creative edge—and working artists will purposely go off Lithium when they need to make a buck—others of more recent vintage do not.

It may take another generation or longer for society to view depression in a clear light, as a disease with no nobility about it whatever, and set about making life better for one-sixth of the population (and the much greater number of those who love them). A smaller number are bipolar, but need similar levels of help. Until then, if I can get one doctor to take bipolarity as seriously as Dr. Kramer takes depression, I may be able to make life better for at least myself and those who love me best.