I have suffered from depression almost my whole life. I am sixty-four years old, and, when I think back to my youth, I am fairly certain that depressive episodes set in when I was in my late teens. I was diagnosed in my late thirties, and have been on different kinds of antidepressants, with varying success, ever since.
For the most part, I have had an active working life, and have raised a daughter. I have also moved twice by myself, once to The Netherlands to work, and ten years later to Portugal, by myself, having chosen the country as the place where I would retire.
I write a blog for an expat website here, and my last entry was on depression. I posted a notice on Facebook without the link, and one of my friends, who also suffers from depression, took the liberty of putting the link up. I did not mind. I had spent an entire lifetime hiding this fact and pretending to be someone I was not. The feedback from my friends was generally positive.
In the months that ensued, I went through a particularly hard time. I have been seeing the same psychiatrist for about five years now, and he is a professional I trust. I generally see him once a month, to review the situation, and see if any adjustment needs to be made to the medications.
It is not my intention to write about what depression is as an illness here, the acute and ongoing pain that involves, and the tendency of those who suffer to isolate themselves because everyday life just becomes a task too difficult to handle. I know the symptoms very well, and I know what I should do to try and help myself. But this time (and every other time when I felt the slow onset of depression creeping in), I succumbed. I did not throw myself into frenetic activity or sports to raise my serotonin levels, because when they are low, you just are not up to it. So the weeks of descent ended in a suicide attempt.
When I was released from the hospital the next day, for the first time in my life I realized I had to have a support system. I don’t live in the U.S. where I could have recourse to support groups. I live alone, and all my life I have been a solitary person by nature. This time, I called two friends that I knew as good people, and whom I trusted implicitly, told them, and asked them (and it was not easy, not easy at all, to ask) to call me occasionally and chat and check up on me. They did, and to be fair, they did so for about three months. But they had their own lives, with work and family and friends, and slowly the calls stopped.
I am active on Facebook and post regularly. Many of my posts are of a serious nature, i.e., links to BBC articles. If I go on a trip on my own, I post the photographs. But since I have no family, and I don’t go out, there are no happy photos of celebrations or revelry. And, as it happens, both of my friends are also on Facebook, so I assume they can also keep track of me that way, if they want to. Naturally, I never write: “I am feeling really, really down and alone, and wish someone would call me.” That is not a Facebook kind of post.
I have been divorced for twenty years. Prior to my divorce, I was married to my husband, a good man, for twenty-five years. We have a daughter together and sometimes, not very frequently, I call him on Skype. So two days ago, feeling I was spiralling downwards into full-blown depression, I messaged my two friends, asking them to call me. One confirmed, and did that evening. The first thing she asked me (and she has been insisting on this, even though I tried it once myself years ago and did not like it at all) was whether I had joined a biodanza group. She knows the reasons for my reluctance (I don’t believe in the concept, and I feel uncomfortable embracing strangers) and she knows I am active in sports and am taking dancing classes in kizomba. I said no and began to relate the latest unpleasant comment I had received in an email from my daughter. “But it was your fault!” she exclaimed. “What do you mean? I haven’t even told you about it,” I said (we hadn’t talked to each other for at least five or six weeks). “You told your daughter she was fat!” (This was a very old story; a conversation my friend and I had had about six months earlier).
By now, I heard myself raising my voice as I spoke with my friend. What she was saying was utter nonsense. So I said: “I”m going to go now, and we’ll talk tomorrow.” And, of course, we didn’t.
The second friend messaged me via Facebook, saying: “I thought you were away traveling.”I had gone to Ireland in April for a week, and had been posting regularly on Facebook ever since. I have no idea as to where she could have imagined that I had gone.
This sounds bitter and it is, but it is leading to something more important, to the words spoken to me by someone who had truly been so close to me for over a quarter of a century.
I called my former husband on Skype. We had been married for twenty-five years, and during those years he had witnessed many episodes of my depression. As we talked, I was crying and lamenting the lack of contact with my daughter. He listened patiently (he is the prototype of a scientist, easily distracted) and suddenly said: “Yes, but all this was in the past. You have to forget that and move on. You are sick, and it is your responsibility to get better. Take Jim, for example. He runs every day.” “I walk five kilometers and go to the gym every day,” I replied. “Good,” he said. “But no one else can help you. You are the only person who can help yourself.”
My former husband is a well-meaning person. He truly has a heart of gold. But when I hung up, I finally understood. You can be highly educated. You can know and care about a person who has depression. But you still don’t have a clue that this is a disease, and not a matter of willpower.
In the pre-Internet era, I read every book on the subject of depression I could find. I have googled endless articles. For years I have been treated by an excellent physician, and take my medication as prescribed. I exercise regularly. I have even done my best with mindfulness, an activity now very much in vogue, taking five courses in Lisbon, spending two separate weeks in and following the regimen of a Buddhist monastery, and spending hundreds of hours of listening to Kabat-Zinn guided mindfulness meditation. It just has not worked. It has not abated my anxiety and it has failed to quiet my mind. Just how much persistence do you have to have to succeed?
So this is the gist of my experience. You would never, ever dream of saying to a friend or acquaintance with a serious illness such as kidney disease or multiple sclerosis: “I empathize. But you know, you’re going to have to do this on your own. Because this is your responsibility and no one else can help you.” This is where our perception of what mental illness is veers wildly away from our conventional approach to serious illnesses: it is a matter of will. The one suffering is essentially intransigent, like a spoiled child, and refuses to get better when it is so simple to get better. But the truth is that mental illness is an illness. That’s why the word “illness” is right there, in its name. Willpower, resolve, and New Age fads are not solutions: if anything, they demonstrate that we are still in the Neolithic age in terms of grasping the nature of mental illness, that last great hurdle, and the last unbreachable taboo, of our time. I suspect it will take us several decades, with the help of advances in medical science during that time, to understand it, accept it, and react accordingly.