Define "a Life"...

... still searching for a clear definition of that thing people keep telling me I need to get...

Location: Springfield, PA

Saturday, April 26, 2008

This Thing of Darkness

Listen to NPR at your peril; it can get you thinking.

Generally, I consider that a virtue. Sometimes, though, it gets me thinking on things that I’m not necessarily all that comfortable thinking about. I’m not talking about topics like Darfur, which ought to make one uncomfortable. I’m talking about things that I’m not comfortable thinking about.

Like my depression.

Even the basic problem of language is frustratingly tricky, defining as it unavoidably does one’s relationship with the Thing. Do I have depression? Am I depressive? Or am I a depressive? Parts of speech aren’t happy making commitments here. Am I a person with Depression? Or just a depressed person? When I find myself referring to it as “my depression,” I feel a catch of inaccuracy snag somewhere in the language. It sounds too much like “my foot” or some such, implying a relationship that is certainly not the case. My foot is my foot; its presence does not define me. Although I suppose its absence would define me to a much greater extent. So in that respect the relationship is almost the direct reverse: the presence of my depression does define me.

Or, at least, at this point in my life it feels as though it does.

And here we get to the NPR bit. The topic on a recent Talk of the Nation was the physical and psychological effects of taking anti-depressants long-term. It’s a fact that none of these drugs, including SSRIs, have been in use – or existence – long enough for any sense of truly long-term physical effects to have presented itself. So when you’re talking about the prospect of being on a drug permanently you’re touching on a big unknown. The thing that caught me, though, was the psychological effects. One specific focus was people who’re prescribed anti-depressants in their teens and remain on the drugs through much or all of their adolescence. Is this chemically effecting their development as individuals in ways that extend beyond merely controlling the depression? And in a more general sense, how does a dependency on a drug like this effect your sense of self and define your identity?

This is a situation distinct from, and essentially different than, being on cholesterol or blood pressure control medication. At least I see it so. If I drop my cholesterol medication, my bad cholesterol will probably go up. But the way in which I view the world is not likely to change as a direct result. Every time I’ve gone off anti-depressants that exact change has been a consideration. Will dropping the drug nudge a return of the depression? In other words, will dropping the drug alter my perception of reality, effectively changing the world? Have I reached a point where the presence of the drug is the only thing preventing the constant and controlling presence of the depression?

In retrospect, it looks like I’ve been cycling through bouts of recurrent depression since at least my teens; I can’t be sure of identifying things before then. Back in the good old days, things moved faster – a full cycle could manifest and pass in a matter of weeks. Somewhere in, I think, my freshman year of college I began seeing this, and actually started thinking of things as a sort of growing outward spiral. As I moved around the circle I’d pass the same things again and again. At the time it didn’t occur to me that this could be a perspective of perception; I thought of it as a sort of cycling of life. The model holds up better than it has any right to, though. If a depression lasted, say, 12° around the circle twenty years ago, and still lasts for 12° today, we’re talking about a lot more line now than we were then. Each spiral outward needs a longer line to circumscribe all of the concentric circles within it. What took a few weeks when I was 15 would take months at 35.

And that’s pretty much exactly what’s happened. It didn’t take twenty years to become a problem, though. Only seven or so, then I hit a depressive trough that lasted long enough to have an impact. Before, I’d never been non-functional for so long a time that I couldn’t catch up once the depression broke. Then I got hit with a depression that kept me down for so long that once I got out from under it I was so far behind that there was no way I’d ever get caught up. And that was the first major change in my relationship to “my depression” and, I guess, the beginning of this problem of identity.

The NPR program had a few callers, talking about whether or not they felt that their “me” on anti-depressants was their “real me.” Having been on and off and on assorted anti-depressants since 1991, this has become a valid question for me. My answer is far from satisfactory, and makes me rather uncomfortable. Hell, it freaks me out.

No, I don’t feel the “me” on anti-depressants is the real me. I don’t feel like the “me” that’s utterly under the sway of the depression is the real me, either. So I find myself in the awkward position of depending on a treatment that forestalls the advance of the illness but does not restore me to my unafflicted state. I can’t help feeling that it’s a situation where the drug masks the symptoms but does nothing to eradicate the illness itself.

For that matter, a whole pile of the known potential side-effects of the drug are exactly the same as symptoms of the depression itself. The constant fatigue – unrelieved symptom of the depression or side effect of the medication? Who knows?

You see how this can be a problem. The matter is further complicated by the fact that the depression hits things that have been essential to my identity. It takes away things I enjoyed in as much as I don’t – can’t – find the enjoyment anymore. It impedes – or outright prevents – my reasoning and critical faculties from functioning as they ought, or at least as they otherwise did. It leaves me feeling disconnected from everything and everyone.

The drugs do not restore that feeling of connection; the drugs don’t clear away all the impediments to my thinking; they don’t bring back the missing enjoyment. What do the drugs do, then? They allow me to continue in this unsatisfactory condition. They allow me to function. They allow me to existent in a state of being that, frankly, has little intrinsic to justify itself. It’s like some sad echo of Civil War medicine – the leg wound is festering, so we cut off the leg to prevent it from spreading. Congratulations! You don’t have gangrene. You don’t have a leg, either, of course. But, hey, at least you don’t have gangrene.

It feels like the options are gangrene (and death) or hobbling around without a leg. Actually being what you were before the leg wound is simply not an option, not a possibility.

But this isn’t a wound, it’s not an infection. It’s me. If I’m at a point where being off medication means being in the grip of the depression, then I’m really not sure where to look for the “real me.” I feel like the real me is neither depressed nor medicated. I also feel like the real me hasn’t put in an appearance in quite some time. Between the depression and the drugs, I feel as distant and disconnected from that “real me” as I do from everything else, probably more so in some ways. It’s like a sort of experiential amnesia – I can remember doing a thing, and enjoying it, but I cannot recall what it felt like to enjoy.

So it’s like there were two real mes before the drugs. One was the me who actually enjoyed things. He’s more or less an historical figure at this point. The other was the me who could bear not enjoying things. Or perhaps just detach and compartmentalize and not feel the ache of absence and the presence of pain. Whatever it was, there was a me who could abide and endure, and whose existence did not conflict with or contradict the other’s.

Anymore, it feels like the real me is the Greg with the unendurable depression. That’s what’s real. So, yes, the real Greg is on drugs, because the real Greg maybe can’t function otherwise. But this isn’t either of the mes from before the drugs. This doesn’t feel like it’s the real me. Because at this point the depression isn’t an aspect, one characteristic among many; at this point, the depression is the characteristic; at this point, the depression is the defining characteristic, which has either overshadowed or eliminated all others.

I guess the difference is that I used to be able to accept the depression as a part of my life, because that was what it was. At some point, the proportions flipped. Now there’s no part of my life remaining that is not effected, definingly effected, by the depression. It’s no longer just a part of my life, and I am not able to accept that.

There’s a world of difference between “This thing of darkness I acknowledge mine,” and “This thing of darkness I acknowledge me.”


Blogger Brian R Tarnoff said...

When you stare into the abyss, the abyss doesn't stare back at you. The abyss had problems of it's own, it doesn't need to get dumped on right now. The abyss says "fuck you Nietsche!" The abyss, however is always willing to share a dark beer with a fellow soul.

11:32 AM  
Blogger Sharon GR said...

I wish I knew what to say.

When "Depression" became recognized as an illness, it became acceptable to be a person with depression. It allows us a perspective that depression is a manageable condition even if chronic.

Sometimes it doesn't feel that way. Sometimes it feels like the clouds will never clear.

The abyss doesn't own you.

9:55 AM  
Blogger Nicole Maynard-Sahar said...

I have heard it said that someone suffering from a mood disorder might say "I have depression" rather than "I am depressive" because of the self-definition issue you raise. Moods effect personaity as well as how one perceives the world (to simplify -the glass is half-empty, half-full example). It seems to me, however, that personality/behavior are expressions of the self and that the self can have a wide range. I would also say that each individual gets comfortable with a certain way of being that is familiar, and that this pattern may not change so much in an indivdual without a mood disorder. Whether taking medication or not, a mood disorder stretches the range of the self, brings out different aspects that you might not have known were there. It is a kind of emotional, psychic keyboard. I think rather than seeing it as a limitation, medication can relieve suffering from the darker aspects of a mood disorder, but it does not reduce yourself or make one numb. Don't forget that there are other characteristcs that often come with such conditions, such as being extra compassionate and creative. It is a struggle and treatment isn't always perfect. People with depression tend to be deep thinkers and are often too hard on themselves, so I think the best one can do is to try to surround oneself with what gives meaning and happiness.

10:31 AM  
Blogger Michael Heath said...

First of all, you've managed to say something I have been having difficulty putting into words for years. On that single feat alone, you have my appreciation and respect.

Like any other perception-altering mood disorder, it's difficult to maintain a sense of 'reality' for sure, not to mention a sense of 'self' (I use 'reality' and 'self' as loosely defined terms for the soul purpose of explanation, despite the fact they are such abstract ideas). I have to remind myself that not everyone hates me, regrets knowing me, or wishes I was never born. While the nature of the depression I am afflicted with isn't nearly as bad as it was when I was younger, there are times I have to remind myself that some chemical my body is producing/not producing enough of (either could be true, considering how little is known about the human brain) is causing me to think this. Sometimes, the feeling is a little too overbearing.

As far as 'taking ownership' of depression, I can encompass the idea of saying 'my depression' from what I have learned from martial arts, surprisingly enough:

Miyamoto Mushashi professed that he never practiced 'a form' when he exercised, he practiced 'my form'. When he wrote The Book of Five Rings, in the last section teaching about 'void' he mentioned that the book was not teaching 'the way' of thought for a samurai, warrior, or anything, rather 'his way' or 'a way' of thought. Your way might be different.

I view depression as being no different. 'My perception', 'My actions', 'My behavior', 'My depression'. While there is commonality between human perception, actions, and behavior, ultimately they have to be recognized as being different. While I suffer depression, it is infrequent and lasts a day or two. Your depression is different from mine. It is unique in its' occurance, despite similarities to mine.

Since I know that depression is like many other mental or mood disorder, I recognize the cause(s) depression (whatever it is) as a scientific stimulus. Depression doesn't make me do anything; my reaction to depression is what causes what I do. Personally, that's what helped me gain control. I was able to separate 'depressive' thoughts from what I consider 'normal' because I knew that, on an even keel, I would think that nobody cares or that I'm completely worthless and better off dead (because, well, on the whole, I quite enjoy doing the whole living thing).

Defining 'self' is a completely different can of worms that happens to be the size of Texas. I won't begin to even scratch the surface with that term because it's so open for interpretation. All I can say is this:

I have but one perception, I will never fully understand someone else's, but I have to consider what I experience in life is in some fashion similar to what someone else does, yet somehow unique. The way I feel and how I conduct myself the majority of the time, the way I am when I am depressed, and the way I would like to be feel like three entirely separate perceptions, but they are all one. My brain is working a mile a minute to make sense of what I am experiencing, and the common human thing to do in the mental department is try to make heads or tails with all of that information. What information I retain, how I feel about it, and what I do about it is about as close an idea I have as to what defines 'me'.

12:43 AM  
Blogger Michael Heath said...

...And I should really learn to type long messages in a text editor of some sort. I just noticed a few typo's (including one that makes it look like I'm suicidal on 'normal days' and I like living all at the same time). In spite of my poor grammar, I hope the idea comes across.

12:50 AM  
Blogger Rob S. said...

Ah, Greg. I don't know what to say.

I don't have any real personal experience with depression, and doubt I have much to offer regarding the sense of dissociation from yourself.

But I do know that, "real" you or not, the guy I've known for nearly a quarter-century now, through all the changes you've gone through, is one I treasure knowing.

I realize that's all from the outside, and doesn't really address the problem at hand. But it seems to me worth saying.

10:39 PM  

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