Get your own Free Home Page"I feel like a helpless child being punished for all the things I've done wrong. I can't seem to call on any of the adult parts of me." (qtd. in Thorne, 14.)
"I fear everything and everyone. I fear being forgotten and overlooked." (qtd. in Thorne, 14.)
"I'm lying on the sidelines of life. I feel as if I could live in this bed and not eat or drink--just dry up." (qtd. in Thorne, 32.)
The people quoted suffer from depression, a mental illness that strikes one out of every five Americans (Hales 13.) This disease attacks both the body and the mind, plunging the sufferer into an intense world of guilt, hopelessness and despair. Much more than normal human sadness, it is responsible for an untold number of job losses, marriage breakups and school failures (Talley vii) and is responsible for 60 percent of all suicides (Hales 16.) Yet many depressed people suffer in silence and refuse to get the help that they need. This paper will explain depression, and try to clear up some of the myths and misconceptions surrounding this disorder.
What is depression? Major clinical depression, the most common of all depressions, is characterized by a persistent sad mood, changes in appetite, sleep problems, changes in activity (either apathy or agitation), sexual dysfunction and feelings of helplessness, hopelessness, worthlessness, guilt and anger (Leidlich 1). Oftentimes it will leave a person incapacitated for days on end. A depressed person will be most often unsociable, turning cold and distant to even their closest friends and family, and draw inward, haunted by past failures and obsessed with thoughts of death, dying, and suicide (Leidlich 58-59, 62). If left untreated, a depressed person may choose to commit suicide before anything ever improves.
This disease is not limited to a select few. Anyone can get clinical depression, regardless of race, gender, or age. Even young children can come down with depression (Leidlich 5).
Even though depression can strike at any age, there are two age groups that it seems to hit the worst. The elderly are 4 times more likely to become depressed than younger adults, and the suicide rate is 15 times higher than the general population (Leidlich 5). Teenagers are also hard-hit. Nearly 5% of all teens are identified as clinically depressed every year, and suicide is the second leading cause of death in this age group (Monahan 42).
There are many factors that can trigger depression. Genetics is a major cause that is being researched today, since depression seems to run in families. Physical illnesses, along with the medications used to treat these illnesses are other triggers. Certain illicit street drugs can also bring on depression. Heavy episodes of stress seem to be the major trigger to depression, especially when combined with genetic susceptibility.
Most doctors believe that depression is brought on by a chemical imbalance in the brain, namely, depletion of the neurotransmitters serotonin and norepinephrine. Drs. Frank Minirth and Paul Meier, in their book Happiness is a Choice, explain how this can occur: "Internalized stresses result in adrenalin release. The adrenal gland is the "fight or flight" gland, and its hormones are always released under stress. Initially there is an increase in adrenalin (epinephrine) and noradrenalin (norepinephrine). However, as stress continues and anxiety is not dealt with...the system eventually becomes depleted, and the norepinephrine level becomes low... Norepinephrine is a neurotransmitter that controls emotions such as depression or euphoria. Among other important neurotransmitters are serotonin and dopamine...[which] are also responsible for dreaming...When the norepinephrine decreases to a certain level, the depression becomes physical and biochemical (in addition to being emotional.)" (213)
What kinds of stresses bring on depression? The most common stress that precipitates a depression is suffering a significant loss. This can be the death of a loved one, a divorce, or even the loss of a job (Minirth 98-99). Lisa, a 59-year-old from Columbus, Ohio, says: "For the first year and a half after my husband died I couldn't read a full paragraph at one sitting. I couldn't concentrate. If I stayed still I would be overwhelmed with memories and anguish. I was living in a fog the consistency of cotton candy." (qtd. in Thorne, 41.)
Loss of a loved one also brings worries of security that heighten the depression. Ethan, a man whose wife had died, was overwhelmed with worries like: "Who's going to look out for me? How am I going to get out and see people? How am I going to eat? I don't have a good short-term memory; I can't remember if I took my medication. I can't remember if I went to the store or not until I look for food and there isn't any. I can't just get up and walk down the street, certainly not in winter." (qtd. in Thorne, 36.)
A blow to the self-image can also bring on depression, such as that that comes from rejection and failure (Minirth 99). Divorce is a major stressor that can bring on these types of feelings. "My wife has moved out," says Hal, 42. "I'm devastated. I don't understand what I did wrong...I don't know that I can keep my life together. I go to work and my mind is rattling, like pebbles in a tin box...I feel so alone." (qtd. in Thorne, 33.)
Depression can also result from not only failure to live up to your own expectations, but to others' fantasies as well (Braiker 205). This often happens around the holiday season, where people are often inundated by the Currier and Ives version on the way things aught to be. Maggie, 69, dreads holidays. "There is so much expectation for happiness and love. All my memories are of exhaustion. I cooked for days, the kids fought, and my husband bickered about how much money we spent" (qtd. in Thorne, 22.)
Other events in a person's life that occur in the past may cause anger and stress to build up until full depression is reached. This action can be either conscious or unconscious. Drs. Minirth and Meier believe that this pent-up anger is the root problem in nearly all depressions, "either toward ourselves (true or false guilt) or toward others (holding grudges)" (50). These events often go back far into a person's childhood, like child abuse and sexual molestation (Thorne 58), both very traumatic experiences that can change for the worse one's views on life.
What does it feel like to be depressed? Mercedes Leidlich, author of Feel Well Again!, explains it like this: "Try to imagine yourself in a totally dark, windowless, very small and claustrophobic room with no escape possible. You can't see, you can hardly breathe, you have nothing around you for stimulation. You are virtually unable to participate in life at all--you are trapped and unable to escape from this dark and frightening situation. This is how a depressed person often feels." (57)
As one can imagine, depression is, for one thing, a very lonely place to be. Most depressed people are unable to concentrate on personal relationships, or anything else for that matter, for depression saps all of their energy (Leidlich 58). However, the depressed person often feels guilty that he or she is unable to talk to people, which sinks them into a deeper level of depression. This author can vouch from personal experience that this is so. Another reason that depressed people feel so lonely is that even though they want so desperately to tell someone that they have a problem and that they need help, they cannot admit it. If they do, they risk being looked down upon as "crazy" or "insane", and feel they will lose their jobs, their spouse, their relationships, everything that they are. Sam, 52, a corporate lawyer, has this to say: "Tell me who you know that would want their million-dollar legal work done by a person suffering from depression? The first thing a client would say is, 'I don't want that guy touching my case!' The first thing the partners of my law firm would say is, 'I don't think Sam is up to handling a challenging case.' Then slowly they'd pull all my work away and I'd be a professional cripple with nothing to distract me from my emotional anguish. If they took my work away, who would I be?" (qtd. in Thorne, 18.)
Even though many of their fears are unfounded, many depressed people strongly believe that they cannot divulge their secret to anyone, so they must turn to other sources in order to release their negativity. Some turn to food for solace. Marie, 16, would "pig out on ice cream all the time," sometimes eating a whole pint in one sitting (Monahan 45). Some turn to drugs and alcohol as a way to numb the pain. Some people engage in self-destructing behaviors like perfectionism (Thorne 37) and cutting themselves with razor blades (38). Still others, especially teenagers, vent their anger towards others by committing socially unacceptable behaviors. "Adolescents can feel overwhelmed by their symptoms. They react by acting out their distress [with] truancy, substance abuse, rebellion, sloppy grooming, or social isolation" (Leidlich 60).
Still many others go one step further and decide to end their pain once and for all. They commit suicide. Suicide claims about 40,000 lives in the United States every year, and of those, about 6,000 of those are teenagers (Leidlich 65). People who consider suicide feel that they are beyond all hope. They do not see their problems as being only temporary and solvable (Minirth 33). They see their lives as not being worth living. Jocelyn, 16, felt: "Why go on living if it's going to mean waking up dreading every day? I felt like I was a headache for my mom, not a very good role model for my sister, and that the world probably wouldn't miss me anyway" (Karlsberg 59).
Suicides are not committed in a vacuum. Even months before a suicide occurs, several warning signs appear. The contemplator of suicide often hoards medications, gives away possessions, talks about futility and hopelessness, comments about life not being worth living, sets affairs in order, among other behaviors (Leidlich 64). A threat to commit suicide is, more than anything, a cry for help. Oftentimes, it is the only way they can say, "Help me, I'm falling apart" (Karlsberg 59-60).
A suicide attempt should always be taken seriously. A person who tries to commit suicide should seek help immediately. The person's loved ones should help him or her to seek help. The stigma of seeing a "shrink" is far less pain than death.
Curing depression often entails seeing a psychologist or psychiatrist. The doctor may prescribe psychotherapy. Psychotherapy "is a structured, focused treatment for mental disorders, especially nervous disorders...It's helpful because it teaches a person how to identify certain beliefs and behaviors that may be causing distress...it [also] helps a person establish more effective coping mechanisms...A close and trusting relationship is involved...the atmosphere is safe and non-threatening" (Leidlich 75). Adjuncts to psychotherapy include self-help groups and family therapy.
However, if "talking it out" does not work by itself, psychiatrists may also prescribe anti-depressant medications. Anti-depressant medications help re-establish normal brain signal patterns, and prevent the loss of serotonin and norepinephrine in the brain, as was discussed earlier. One of the more popular anti-depressant medications is called fluoxetine, or more commonly as Prozac. Even though it only works on serotonin, Prozac has become very successful. "Finally, there are drugs that clear the fog from your life," says Zoe, 32. "With clear vision you feel as if there's more hope, more potential. You're willing to try more. 'My God!' you say to yourself after a week on Prozac...'There's a whole world--a whole way of being--I never knew anything about.'" (qtd. in Thorne, 65.)
Braiker, Harriet B. Getting Up When You're Feeling Down. New York: G.P. Putnam's Sons, 1988.
Hales, Dianne. Depression. New York: Chelsea House Publishers, 1989.
Karlsberg, Elizabeth. "'I Wanted To Die'--Teens And Suicide." Teen August 1993: 56-62.
Leidlich, Mercedes. Feel Well Again! 350 Questions and Answers about Depression and Anxiety. Gainesville, FL: Maupin House, 1991.
Minirth, Frank, and Paul Meier. Happiness is a Choice. Carmel, NY: Guideposts, 1978.
Monahan, Julie. "True Stories Dealing With Depression." Teen October 1993: 42-45, 104.
Thorne, Julia, with Larry Rothstein. You Are Not Alone: Words of Experience and Hope for the Journey Through Depression. New York: HarperCollins Publishers, Inc., 1993.
Copyright 1998 By Jack Mileur. All rights reserved.
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