Monday, June 27, 2016

On Depression and Taking Action to Achieve a New Life

One of the things I have come to hold in contempt is what might be called the "Confessional Subculture", those people who feel it necessary to share every lurid detail of their private lives with strangers. I sometimes think of it as "The Daytime TV Syndrome". ("Yes, Oprah, I'm into blow-up dolls. You don't know what a BURDEN has just been lifted off me by finally saying this in public." Cue teary-eyed audience members. Oprah: "I'm really not surprised to hear it.") So it is with some misgivings that I tell you what I'm going to tell you.  I have suffered from chronic depression since I was in my late teens, depression that has sometimes hit suicidal intensity. In addition to that, I also developed a really nasty case of Obsessive-Compulsive Disorder, and that has waxed and waned throughout my life. Why am I telling you this? Because I have the sneaking suspicion that more than a few of you are in the same situation and I'd like to share some ideas about how we can climb out of this awful hole we find ourselves in, and maybe help some other people out. For those of who you are not down in the hole, I wanted to try to explain what it's like, and give you some ideas about how best to deal with those of us who live in the gray land of depression and OCD.

And I have an ulterior motive for doing this as well: I'm hoping that if I tell all this to you, that I can re-learn and apply it to myself.

Right off the bat, I must say this: I AM NOT LOOKING FOR PITY OR SYMPATHY. I know you care about me, as I care about you, but this is not me saying, "Oh poor me! Don't you feel BAD for me?" I don't want any of that, OK? All I hope is that you at least hear me out.

First of all, depression needs to be defined. It is a type of conscious state, one exacerbated by myriad subconscious factors. Depression is a pervasive pessimism that colors a human's perception, a sense of utter and complete hopelessness, often accompanied by intense self-loathing. It is not—it is not—necessarily connected to any particular external event. The depressed person quite often comes to believe that nothing, quite literally nothing, is really worth much effort, or any effort at all. A depressed person often comes to believe that nothing will turn out well, that everything in one's life is headed for disaster or at the very least failure. Depression is the sense that everything is futile, and, most tragically, that one doesn't deserve anything from life. It is these attitudes that make depression so difficult to claw one's way out of.

Causes of Depression

The origins of depression appear to be complex. There may be a genetic predisposition to it. Since all human behaviors are the result of genetic factors interacting with cultural factors and life events in an ever-changing mosaic, a genetic predisposition to depression can darken one's perception of the world in general, and depression can lead to vicious cycles wherein no positive action to counter it is taken because the depressed person has already discounted the efficacy of the action. If a person believes nothing can be done, nothing will be done, thereby perpetuating the very factors that are making one depressed. Depression can also spring from repeated disappointments, seeing one's hopes dashed again and again. (Here also a vicious cycle can be established: if I think my hopes will not be realized, I may not take the action required to succeed, thereby increasing the likelihood of failure.) An unhappy family life, especially caused by parents who instill in their children the belief that the world is terrible, can trigger depressive tendencies. Further, depression can be the result of trauma, especially trauma suffered in childhood. Sexual, physical, and/or mental abuse can so assault the well-being of the Self as to convince one that the world is an irredeemably threatening and terrifying place. The horrific memories of this abuse can cling to a person every day, destroying all hopes that life can be something other than the sum of our suffering. And sometimes physical conditions such as chronic or recurring pain, or repeated episodes of serious illness, can plunge an individual into despair. In short, depression seems to spring from many causes. But its effects on those who have it are the same: a life that is less than it could be.

Going deeper into the issue, our present mental state is the result of a long series of events, many of which we have forgotten about, but the impact of which is still being felt at some level. The Self, or ego if you prefer that term, reacts to the world starting in infancy. Then the Self or ego reacts to its own reactions. A chain of reactions to reactions to reactions is established. Certain ways of reacting to the world are deeply impressed on the neuronal configuration of the brain, making it more likely that whenever particular circumstances and/or neurotransmitter balances are present, one will react in a roughly similar way.

And we need to remember something very important: the human brain did not evolve to give us complete understanding of ourselves and others, nor did it evolve to make us happy. The human brain evolved to help us survive. Period. Why? So that we could reproduce our genome and hence fulfill the "goal" of life: make more of itself. The very complexity that makes consciousness possible means that more can go wrong with our brains than those of any other animal. Our brains are a baffling combination of very ancient structures, structures found only in mammals, structures found only in higher-level primates, and structures (such as a highly advanced prefrontal cortex) that are unique to humans. Our brains are remarkable objects, but they are vulnerable in many ways, and they are incredibly difficult to understand. Depression is one of the ways things can go wrong with them. Its persistence in the human race seems to indicate that it doesn't cut down on reproductive fitness enough to be weeded out of our genome. But it has inflicted immeasurable suffering and hardship on countless people through the ages.

Paradoxes and Contradictions of Depression

The depressed person is often stuck in a series of brutal paradoxes and internal contradictions that can make depression extremely difficult to overcome. First of all, chronic loneliness and a sense of having been abandoned by others are frequent manifestations of depression. Yet, depressed people can be very demoralizing and difficult to be around. They can even actively push others away, when it is the very company of others they so desperately need. As I have already noted, depressed people are usually convinced that nothing can help them, so they often get no help, thus establishing a tragic self-fulfilling prophecy. They urgently need to know they are loved, but they very often believe that they are so unworthy of being loved that no one could love them. Thus they tend to discount or disregard even the most sincerely offered expressions of love and support by others. Perhaps most ominously, they very often come to hate themselves for hating themselves. They look at their external circumstances, consider the fact that many others are much worse off than they, and lash themselves mercilessly for daring to feel bad when they have no "objective right" to feel bad. They may call themselves spoiled, immature, ungrateful, childish, and any other number of self-denigrating terms. This can set up a terrible spiral wherein the depressed person's hatred of themselves for hating themselves becomes self-reinforcing. The result of this spiral can be a tragic one.

In general, therefore, the pessimism and hopelessness engendered by depression can come to be a sort of emotional paralysis. A depressed person's reasoning often goes like this: There is nothing I can do. There is no hope that anything will turn out well. All effort is an act of futility. I cannot change myself in any way. It would simply be best if I weren't here at all. It is these lies—and they are lies—that prevent the depressed person from acting to alleviate his or her suffering.

Confronting the Irrational Beliefs of Depression

Although depression can have perfectly explicable origins, it tends to create a false picture of reality (at least as humans perceive it) in those who suffer from it. Let's tackle these distorted perceptions one by one.

1. The world is a place of incessant suffering and grief. This is a form of psychological projection in which many depressed people indulge. Because they are wretched, they see only that which is worst in the world. But in all reality, this picture is very badly skewed. Do you know what the day-to-day world actually is? Ordinary. Mundane in the extreme. Regular. Routine. The vast majority of the human race goes through the day doing ordinary things in an ordinary way, occupying a sort of psychological middle ground between joy and grief. It's really not as bad as many people think. There is genuine cause for optimism, and I'm not just saying this to try to "cheer anybody up". I can back these statements up statistically. War has become less frequent and destructive. Education is more widespread than ever. Mass starvation has greatly decreased in frequency. Medical science has made immense strides. The march of political freedom has touched many millions of lives. There are many happy families. Personal rights have greatly expanded, as have personal opportunities. What needs to be abandoned is the longing for some idealized past in which everything was great. No such time existed. In many ways, the best time to be alive is right now, not the so-called "Good Old Days". This is not to say we don't face towering challenges and complex problems. Obviously we do. But there is no rational basis for believing the world is, to borrow a phrase, "a meaningless nightmare of suffering". In all truth, that simply isn't the case, and to believe so is to embrace an outright falsehood.

2.  Everyone is happier than I am, everyone is having a better time than I am. In a way this is the inverse of the above distorted belief. A depressed person can actually believe both, even though they are contradictory. No, everyone is not having a better time. No, everyone is not happier than you. Those statements are stark, simple truths. For example, depressed single adults may have long periods where they are without a sexual partner. They may simply assume that everyone is having regular sex except them. The absurdity of such a view should be apparent. Depressed people often see the lives of others in such a distorted manner. This is a particularly pernicious form of self-pity, and it's a way of stripping other people of their humanity. We dehumanize others when we see them as caricatures or cartoon figures. To imagine that everyone else, every one of them a complicated person, is enjoying the world is to dehumanize them in a very real way.  They don't have problems. Only I have problems. I am unique in my isolation or sorrow. This is an idea that depressed people must abandon.

3.  The world is so big there is nothing I can do to change it for the better. In fact, the very idea that one can make a contribution is often met with scorn and derision by depressed people. Even though the world is not as bad as one imagines it, there is, admittedly, a great deal of suffering and injustice in it. If we were to know all of the bad things that are happening right now, we would be overwhelmed. What can one person do? It is this sense of helplessness that prevents the depressed person from trying to do anything. We sometimes forget that change is an emergent feature of reality, arising out of the ferment and tumult of individuals acting together, tackling problems in groups, pooling their knowledge and resources, and magnifying their efforts by combining them with the efforts of others. One person, acting alone, can do very little. Millions, acting in concert, can change the world.

Moreover, depressed people often overlook a simple fact: changing the world for the better is often done one life at a time. A small act of kindness can reverberate in someone's life for years. Being there when someone needs you is sometimes the greatest contribution one can make. Doing one's job well can be more meaningful than some abstract notion of turning the bad old world around 180 degrees all at once. Every act of forgiveness, genuine atonement, simple courtesy, simple kindness, simple decency makes the world better in a small but very real way. Depressed people often forget that. They shouldn't.

4. Anyone who is happy is a fool. Depressed people understand the world better than others. Really? All happy people are fools? Preposterous and utterly wrong, not to say insulting and dehumanizing of others. Happy people aren't living carefree lives devoid of hardship. They deal with these hardships in a positive way, and look at life in its fullness, not in the most narrowly pessimistic manner. They're not fools; they're people to be celebrated (as long as their happiness doesn't derive from making others miserable). And depressed people understand reality better? I would argue precisely the opposite is the case. A naive, "This is the best of all possible worlds" outlook is unrealistic. But a "This is the worst of all possible worlds" outlook is equally so.

5.  Being mad is better than being sad. I am a rageaholic. I admit it. I am angry, I mean really angry so much of the time. Know what I figured out? That a lot of anger is simply sublimated grief and sorrow. Being angry gives us the illusion that we are in control, that we are not passive victims, they we are taking action. None of that is true. Anger just feels better than grief. Anger drives people away. It stresses the body terribly. It does actual damage to one's health. And it basically accomplishes nothing, especially if it is mere solitary venting. It just puts off confronting what's really wrong: personal hopelessness and despair.

6. I should never have existed; no one would miss me if I were gone. These are perhaps the most dangerous irrational beliefs of depressed people. Sometimes you just feel so damned lousy, just so down, that you just wish you had never existed at all. It just wasn't worth it is how you feel at those times. Believe me, I know. That's bad enough. But the idea that no one would miss you is perhaps the worst lie depressed people believe out of all of them. It is the precursor to the most tragic toll depression takes on people: suicide. Over 1,000,000 people kill themselves on this planet every single year. Most of them do so because all hope is gone, and they are convinced no one would be sad to see them go. (I should add that in my belief system the only morally defensible justifications for suicide are to stop severe and untreatable physical suffering and to spare one's family the agonies of witnessing one's terrible and protracted dying.) Killing one's self is one of the most brutal acts against others possible. It will emotionally shatter one's spouse or significant other. It will crush the happiness of children and siblings. It will plunge friends into grief and anger. A 17 year-old kid once killed himself right in the school in which I was teaching. At his wake, it was terrible to see his grieving parents. But what struck me the most was the reaction of his friends. Not only were they crying over him. They were so angry at him for hurting them so badly. How could he do this to me was a common refrain. The suicidal person is not in his or her right mind. I understand that. But you're not just killing yourself when you end your own life abruptly. You're killing part of everyone who ever loved you. And you have no right to do that to them.

Taking Charge

It takes courage to change one's life for the better. It takes real courage to wage war on depression, to refute its ugly lies, to refuse to have one's life darkened by it any longer. I have some ideas that have helped me. If you have depression, they may help you. See what you think.

1.  Physical exercise is key. Exercise does so many good things for the body that I fail to see how any person able to do it does not. Exercise can release endorphins that bring about a sense of well-being. Exercise contributes to general health, self-esteem, resistance to stress, resistance to disease, and so much more. It has literally saved my life several times. It does wonders for fighting depression. I cannot recommend it highly enough.

2. Change the balance of neurotransmitters in the brain. In one perspective depression and other such illnesses are the result of disordered brain chemistry. You should look into antidepressants, but I must caution you: they can have very uneven results. I took Prozac for 15 years to combat OCD. It did an excellent job of halting it, but the efficacy of such meds lessens after a time. And getting off of some antidepressants can be harrowing, to say the least. So look into it, but do your homework first. There are alternatives by the way, which I have personally tested:

A. GET RID OF ALCOHOL. This is really hard for a lot of people to do. But alcohol is a depressant. It does grievous harm in so many ways. If you really want to climb out of the hole, stop drinking. I recognize some alcohol ingestion can have benefits to the heart, but in general, the less you drink, the better. Seriously, I'd rather have you smoke or eat marijuana than drink. Alcohol is that bad for depressed people. If you've ever sat drunk and alone at 3 a.m., you know exactly what I mean.

B. GET RID OF REFINED SUGAR. I am a person of Scots and Irish descent. I was raised with such treats as cookies, candy, pastry, cake, pies, you name it. But all of that has to go. All you get from sugar eating is problem after problem. I've found that not eating sugar (or at least very much of it) helps me avoid the insulin-crash of the Sugar Blues.

C. GET RID OF JUNK FOOD AS MUCH AS YOU CAN. Heavy, fatty foods can play havoc with your head and your body chemistry. Breaking down fat makes your body work harder, which makes you tired, which makes you vulnerable. Eat like a sensible adult; it will help tremendously.

D. CONSIDER ALTERNATIVES TO ANTI-DEPRESSANTS. For me, 500 mg of Turmeric in combination with 1400 mg of fish oil has had very positive effects. Others have found St. John's Wort or rosemary to be beneficial. As always, do your homework; see what helps others.

E.  GET RID OF ANTIHISTAMINES. This one might surprise you, but I am in earnest here. I was driven to the depths of absolute despair at one point by taking antihistamines every day. If at all possible. stop taking them. Zyrtec in particular is horrible for me, although your reaction may differ. A lot of depressed people react badly to antihistamines. If you can do without them, I urge you to do so.

3. Make Contact With the Outside World

I hate the human race in general (ha!) but I love my family and friends and I am delighted to greet visitors to my beautiful Kauai. I help with my wife's bracelet business. In doing so I have met people from over 45 foreign countries, all 50 states, and almost every province in Canada. They have overwhelmingly been nice, polite, very agreeable people. You know what? Most people in this world are all right. It's the 5% who are idiots, sociopaths, professional criminals, and just general jackasses that ruin it for everyone else. And that's real.

Do something to help. Volunteer for some cause. Get out and meet people. And for God's sake, stop sitting around and brooding all by yourself. Stop sitting in your little cave, hating yourself and despairing. What have you got to lose?

4.  Get help; give help

If you feel you would benefit from professional counseling and can afford it, it may help you. You should also establish a support group among those you know who are similarly afflicted. Make an agreement that you will call them if you are in trouble and they can call you. Don't just look for help. Be the help sometimes. I think of it as being part of this web of people. They'll spin enough web that if you fall, it will catch you. You do the same for them. You'll get through things together. 

5. Blow Up That Damn Garbage Truck

The Garbage Truck is what one writer calls the sum total of all our bad memories, our mistakes, the bad stuff we may have done, the pain and grief we may have suffered, and the regrets we are plagued by. It follows us around, ready to dump its filth all over us again and again. Well you know what? It's got to go! What are the attitudes we have to take? Again, let reason and rationality be our guides.

Aldous Huxley once put it this way: chronic remorse is the most useless of emotions. Have you behaved badly? Make what amends you can and resolve to do better. What else can you do? As far as mistakes of judgment go, you can't go back in time and alter them. You can only try to rectify their effects and learn from them. I have been driving for over 40 years. Several times in that period I almost managed to get myself killed because of stupid mistakes I made and was 100% at fault for. You know what you do about that? Say, "Well that happened", and resolve to never make those mistakes again. What else can you do?

As far as replaying those bad recordings you have in your head, the ones that contain all the painful and bitter memories: STOP DOING THAT. You must let the neuronal areas of the brain that contain them atrophy and disintegrate. Every time you think of them you STRENGTHEN them. It's like sharpening the very knife that's stabbing you. KILL THEM OFF!! You've experienced  them enough! You have acknowledged their existence already. They are weakening you. They can only drag you into despair.

NOTE TO OCD PEOPLE: Stop unwanted or intrusive thoughts IMMEDIATELY. Do not let them get their claws into you. Do NOT analyze them, especially if they are violent or horrific. That's like throwing gasoline on a fire. STOP THEM NOW! It sounds simplistic, but I know whereof I speak. Trust me. Thought-stopping is an old tried and true technique. Ask any monk who's ever meditated.

By the way, as a teacher, I met kids who had been brutally sexually or psychologically abused. If you were a tormented  kid once, remember this: You are bigger than the people who hurt you now. They no longer have any power over you. Every day you live a good life is a victory over them. They're losers and they do not deserve your forgiveness. You are better than they are, and you will be forever. Period. If one of the people who hurt you was a family member, you no longer owe them your love. And don't you let anyone tell you otherwise.

Learn from the past; stop living in it.

6. Get your sleep in order. This is very important. Chronic fatigue makes you emotionally vulnerable. Try to regularize the hours of your sleep as much as possible. Doing so is one of the best anti-depression moves you can make. A sleep mask to shut out ambient light is an excellent thing to wear.

7.  Other suggestions. Avoid those nasty drugs, like cocaine, heroin, barbiturates, and the like. If you need opioids for pain relief, that's fine, but if you don't, stay away. They're not for entertainment. Ease up on excessive caffeine as well. Re-assess your job situation. I don't care how much money you're making off of it. If it's killing you, it's not worth it. Re-assess your relationships. If you have "friends" who simply like to drag you into the abyss, maybe they're not really friends. Engage your intellect; learn something until the day you die. There's a whole world to learn about out there; it's all at your disposal. Oh, and remember to laugh. Indulge in it frequently. Remember to hug those you love. Indulge in that, too. If you are into meditation or self-hypnosis, do that. If you find peace in prayer and worship, live in those.

If you are VERY serious and you have $$$, you should look into electroshock therapy. It is NOT like you see in old movies. Electroconvulsive therapy can have BIG benefits, but it ain't cheap. Also look into something called Transcranial direct current stimulation (tDCS). I have begun to experiment with this on myself, and while the jury is still out, it looks promising so far. Look it up and see what you think.

And if you are chronically depressed, it might not be the best idea in the world to keep a gun in the house. Over 20,000 Americans kill themselves with guns annually. While other means of suicide do exist, let's be honest: cutting your wrists hurts, a lot, and pills can be vomited up. Shooting one's self is all too effective. Just something to think about.

8. A Note to Friends and Family of Depressives

Your depressed friend or family member does not hate you. Depression is not ordinary, garden variety having the blues. It is a psychological disorder. Those who have it feel bad all the time, to the point where they can hurt physically. It makes them tired and listless. It makes them morose and hard to be around. May I suggest the following:

Don't tell them to cheer up. They can't. They would if they could

Don't be angry with them.

Don't say, "Well, a lot of people are suffering horribly and you're not." That just makes it worse.

Most of all, don't let them push you away. Remember that love is patient; your patience will be needed sorely. And if they ask for help, be unstinting in giving it. You may be saving their lives. They can get better and you can help. Believe me


You do not have to suffer; you do not have to feel sad all the time; you do not always have to be the way you are. Hope is not absurd or silly or pointless, the refuge of weak or unrealistic people. It is a REAL THING THAT REALLY EXISTS. And no, asking for help does not make you a coward or a weakling. It is, rather, a sign of courage and strength. I'm not saying that your life will be all perfect and sunshine and rainbows once you come out of the darkness. There will always be challenges, there will always be problems.

But you know what?

You can handle them.

I'll be here for you, if you'll be there for me.

And you can count on that.