Depression

I remember the first time I ever felt depressed.  I think I was in 8th grade and I just felt very bleh but there was no reason for it that I could think of.  I told my mother. She said to me either, "That's what they call depression," or "That's what they call the blues." I think it was the first, but I am not entirely sure. I can remember exactly where I was standing. I guess as a child I was some combination of happy and oblivious because I remember thinking that this is just very odd to feel bad for no apparent reason. Later in life, I remembered feeling despondent at around age six, but when I was in eighth grade I had no memory of that, and this felt like something new.  It was not overpowering or debilitating and I don't think it lasted very long, but feeling bad for no apparent reason was just odd.  

I am sure that in the next years of high school I probably felt bad or blue or depressed  again at some point, but there was always a reason for it, as I remember. Feeling isolated socially, pining after some unattainable crush.  It was all pretty standard and unexceptional.  My senior year of high school there was a pronounced period of depression where I cut myself off from others and spent a lot of time alone in my room, writing in a journal. But with that, there seemed to be reasons for the feelings.  I was lost. Struggling to find a direction, a belief.  Something to guide me that "would be good on Monday and also good on Thursday."  There was sadness, even depression, but it seemed spiritual in nature.  

This culminated in a conversion experience. I converted from being an episcopalian who had been confirmed for writing out the apostle's creed and going to enough Sunday school classes. Someone told me that senior year, that Christians believe that Jesus was God. "Really? Did not know that?" I thought. I suppose it is there in the apostle's creed, but clearly that had slipped by, unregistered by me. So I say that I converted from nominal episcopal to actual Christian who prayed for Jesus to be my savior, who confessed my sins and asked for forgiveness which I learned was something that God could offer me because his son, Jesus had paid the penalty for my sins when he was crucified, and only because of that. I asked the Holy Spirit to make me a new person, to give me grace.  How that all happened is the topic for another talk, but it did happen. Actually I was as surprised as anyone, and this had a profound effect on my life. Christianity made sense to me, gave me direction, connected me with people, namely other Christians. As my sister said to me once when I was considerably older, "If anyone was ever saved by Jesus, it was you."  And she is right. I have no idea what might have happened in my life if I had not converted to Christianity at age 17 from … 1980 East coast secularism -- whatever that was -- see if you can find something to hand on to  in Hemingway or Virginia Wolfe or who knows where.  

My movement towards becoming a christian believer is a lot easier for me to explain than my movement away from being a christian believer.  And let me say, there may be ways in which I am still a christian believer, but not a practicing, church-going christian believer.  I just came to call it all into question. There is one moment that played a pivotal role. Eva Suchy. Eva was an amazing woman from Austria, raised Catholic, but never really religious; just smart and intuitive. We were very close for a very short time. We went to an episcopal service together and when it was over, I asked her what she thought. "So incredibly sad," she said. I was so surprised. I had not experienced it as sad, but her comment caused me to pay attention. As time went I started to see that what made me happy in the christian service was a continual confession of the ways in which I was no good. Eva and I went our separate ways and that made me very sad. She was something. And I became sadder and sadder. I entered into a depression, a deep depression. 

One day after sitting on my bed for 30 minutes deciding whether or not to put on my sock, I knew it was time to seek help. I went to a therapist recommended by someone I trust.  I don't remember what I said to her, but at the end of the session, she said to me, "I think you should see a psychiatrist that I work with."  I had no hesitation about this and made an appointment. I was 28 years old.  

I don't remember what I told the psychiatrist in our first meeting, but I do remember what he said to me, at the end of the session. "It's kind of amazing," he said, "that it took you this long to show up here. I think you have clinical depression, and I would strongly recommend that you try going on an antidepressant."  I remember feeling incredibly relieved and started on a medication, Prozac.  A few days after starting to take Prozac, I was walklng up the steps at work, and I remarked to myself, "I feel different."  I continued sessions with Dr. Morales and learned a tremendous amount from him. He was that rare psychiatrist who was also a skilled therapist.  

In future sessions, Dr. Morales told me he was surprised that it took me so long to show up because my older brother and older sister had struggled with depression and because my mother was bi-polar.  He told me that given those facts, the chances that I would "show up" at some point at the office of a psychiatrist were extremely high. As he said, "It's amazing that it took you this long."  

Ending a relationship put me into a deep depression, deep enough to get to a therapist, but what I realized in talking to Dr. Morales was the following: I did not think I had been depressed because my norm was to look at the world through the lense of a depressed person.  

He told me to imagine taking a hike. It's a beautiful day, he said, and you are in a beautiful place.  You have a good breakfast, get to the trail early, and are excited to get going.  Everything looks wonderful, feels wonderful. But as you continue things start to look less beautiful and little things start bothering you. The problem is that you have a pebble in your boot and the pebble is rubbing against your skin, only you don't know that you have a pebble in your boot. You keep going; as the pebble continues to dig into your skin, your thoughts about the hike get worse and worse.  You start to wonder, why the hell did I decide to go hiking. And your day is just going to get worse and worse with each step. It's inevitable and only one thing is going to change that.  

He told me that clinical depression is just like that pebble. As long as it's there, you can try to keep going, but with each step, things are just going to start looking worse and worse, and the braver you are trying to keep going, the more that pebble is going to rub, and the grimmer your thoughts are going to become. There is only one thing that's going to make a difference.  Take the pebble out.  

On the basis of what he heard from me. Dr. Morales told me that I had been walking with a pebble in my shoe for a long time, without knowing it was there. That pebble affected the way that I felt, the way that I thought, every time I put on my shoe. It was not until much later that I thought about the following: no wonder I spent 30 minutes sitting on the edge of my bed wondering whether or not to put my sock on. 

Dr. Morales and I talked about the stigma of taking a medication. He said to me, "When a doctor told you that you need glasses in order to see properly, did you say no because of the stigma?"  He said it's no different, except the science behind it is harder to understand. Making sight-improving lenses was a snap in comparison, he said.  

I have taken an antidepressant medication -- and worn my glasses -- every day since I was first diagnosed. I have been in therapy almost every week since I was first diagnosed because they are both important.  Have I been successful at everything I have tried since I started taking an antidepressant? No, not necessarily. Have I had a job, fed, and clothed myself since I started taking an antidepressant? Yes, I have. Do I have concerns about taking an antidepressant every day for the rest of my life? Yes, some. Do I still struggle with depression?  Yes, at times I do. Where would I be if I had not started to take an antidepressant? I have no idea, but I am thankful I am not there.