Oct 23, 2006 
Via TPM Reader DK at Josh Marshall’s place — reporter Chris Rose of the New Orleans Times Picayne describes his descent into clinical depression and how he got his life back with medication.
He starts with an anecdote that perhaps only other depressives can relate to:
I pulled into the Shell station on Magazine Street, my car running on fumes. I turned off the motor. And then I just sat there.
There were other people pumping gas at the island I had pulled into and I didn’t want them to see me, didn’t want to see them, didn’t want to nod hello, didn’t want to interact in any fashion.
Outside the window, they looked like characters in a movie. But not my movie.
I tried to wait them out, but others would follow, get out of their cars and pump and pay and drive off, always followed by more cars, more people. How can they do this, like everything is normal, I wondered. Where do they go? What do they do?
It was early August and two minutes in my car with the windows up and the air conditioner off was insufferable. I was trapped, in my car and in my head.
So I drove off with an empty tank rather than face strangers at a gas station.
Many years ago I went to a DMV office for some reason; I think I had to change my address. After wandering around a bit in the office I found some forms I needed to fill while waiting in line. But there were no pens or pencils handy. I dug around in my purse for a while and found nothing to write with. So I took the form and went home, because I couldn’t bring myself to ask anyone for a pen.
And that’s when I was getting better. At least I got to the DMV office.
Here’s a passage I endorse enthusiastically.
In his book “Darkness Visible: A Memoir of Madness” — the best literary guide to the disease that I have found — the writer William Styron recounted his own descent into and recovery from depression, and one of the biggest obstacles, he said, was the term itself, what he calls “a true wimp of a word.”
He traces the medical use of the word “depression” to a Swiss psychiatrist named Adolf Meyer, who, Styron said, “had a tin ear for the finer rhythms of English and therefore was unaware of the damage he had inflicted by offering ‘depression’ as a descriptive noun for such a dreadful and raging disease.
“Nonetheless, for over 75 years the word has slithered innocuously through the language like a slug, leaving little trace of its intrinsic malevolence and preventing, by its very insipidity, a general awareness of the horrible intensity of the disease when out of control.”
He continued: “As one who has suffered from the malady in extremis yet returned to tell the tale, I would lobby for a truly arresting designation. ‘Brainstorm,’ for instance, has unfortunately been preempted to describe, somewhat jocularly, intellectual inspiration. But something along these lines is needed.
“Told that someone’s mood disorder has evolved into a storm — a veritable howling tempest in the brain, which is indeed what a clinical depression resembles like nothing else — even the uninformed layman might display sympathy rather than the standard reaction that ‘depression’ evokes, something akin to ‘So what?’ or ‘You’ll pull out of it’ or ‘We all have bad days.’ “
Some time before the DMV incident, when I was worse, I abandoned a cart full of food and ran in panic from a grocery store because someone told me to cheer up and smile. (Don’t ever do that to anyone you don’t know.)
Styron is a helluva writer. His words were my life. I was having one serious brainstorm. Hell, it was a brain hurricane, Category 5. But what happens when your own personal despair starts bleeding over into the lives of those around you?
What happens when you can’t get out of your car at the gas station even when you’re out of gas? Man, talk about the perfect metaphor.
Depression don’t get no respect because of the name. The common emotion depression and the disease depression are two entirely different things, but even some doctors and therapists can’t get that.
… here’s my doctor’s take: The amount of cortisol in my brain increased to dangerous levels. The overproduction, in turn, was blocking the transmission of serotonin and norepinephrine.
Some definitions: Cortisol is the hormone produced in response to chronic stress. Serotonin and norepinephrine are neurotransmitters — chemical messengers — that mediate messages between nerves in the brain, and this communication system is the basic source of all mood and behavior.
The chemistry department at the University of Bristol in England has a massive Web database for serotonin, titled, appropriately: “The Molecule of Happiness.”
And I wasn’t getting enough. My brain was literally shorting out. The cells were not properly communicating. Chemical imbalances, likely caused by increased stress hormones — cortisol, to be precise — were dogging the work of my neurotransmitters, my electrical wiring. A real and true physiological deterioration had begun.
I had a disease.
Rose was lucky. His employer realized he was sick and cut him slack, and his wife also recognized he needed help. He got almost immediately relief from a new medication, Cymbalta, instead of going through weeks or months of trial and error — waiting for a new drug to begin working, trying another dosage or another drug if it doesn’t. As Rose’s psychiatrist said, it’s a crapshoot. Many anti-depressants have to be taken for two to four weeks before any effects kick in, and sometimes the effects never kick in.
Do-gooders trying to get anti-depressive meds banned because of anecdotal evidence they cause suicides need to understand that untreated depressives kill themselves at much higher rates than not-depressed people. If someone who just started to take Paxil commits suicide, that doesn’t mean the Paxil made him do it. If the Paxil was a factor at all, more likely the patient became more despondent because it wasn’t working. Or, it’s possible a patient who is too enervated and mentally disorganized to do much but sit and stare into space might get just better enough to carry out a suicide plan.
And don’t forget — people get misdiagnosed. When someone taking an antidepressant becomes violent — Eric Harris of Columbine High School fame, for example — before blaming the drug, ask why he was taking it to begin with. He may not have been depressed; he may have been bipolar, which calls for different drugs, or he may have been psycopathic, a condition that doesn’t respond to medication. Also, the drugs may work differently on juvenile brains than on adult brains.
I hear people who have tried antidepressants say that the drugs suppressed their emotions and made them feel mentally foggy, which suggests to me they didn’t have the disease depression but just the common emotion of depression. If your brain chemistry and neurotransmitters are functioning normally, anti-depressants may make you feel worse. They aren’t “happy pills.” Taking anti-depressants if your brain is healthy is as stupid as taking insulin if you aren’t diabetic. However, if you are depressed, with the right meds your thinking becomes clearer and your emotions are normal. It’s important to understand this, because ignorance may be keeping some people from taking meds who could genuinely benefit from them.
Too many people still have medieval attitudes about psychiatric disorders. Many of them are caused by real physical and chemical changes in the brain, and these should be treated with the same respect as any other disease in any other organ.
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