Hey, I'm tired and grouchy, so what the hey...
First up is the family I just passed on the sidewalk outside. Their small boychild was outfitted in brightly colored shoes that emit a high-pitched squeal with every step. It's intentional; it's as if he had a squeaky toy on each foot. Dogs like squeaky toys; they sound like prey. So it's kind of like this kid's family put a big sandwich board on him that says, "FREE LUNCH FOR PITBULLS!" I don't know who's stupider, the family for buying this product, or the idiots who designed it.
Next up we have the American voters. They've finally registered the fact that Dubya is a wee bit out of touch with their priorities. "Better late than never" hardly applies when we're stuck with the asshat for another 3 1/2 years. Come on people, like you couldn't have figured this out in, oh, I don't know... sometime before NOVEMBER 2004!?!?
And finally... we have Carey Tennis, an advice columnist with Salon.com. Now, Carey is a subject of some disagreement... some like him, some find him deeply annoying. Normally, I enjoy reading his stuff... it's kind of like an existential version of Dear Abby. But today, he really goofed big time.
If you don't have Salon access, here's the story: a woman wrote to him and asked what she should do about her brother, who, in the wake of a series of major personal setbacks, has retreated to his basement apartment, no longer appears to eat or bathe properly or interact with the outside world, and exhibits every sign of major depression and anxiety. The sister also mentions that she has a history of addiction and depression, and has been taking antidepressents.
So we have: 1) all the clinical signs of depression and 2) a familial history of depression.
So what does Carey advise? He casually tosses out a suggestion that yeah, maybe taking him to be evaluated by a doctor would be a good idea.
But then he goes off on a really weird tangent...
It could be that he is clinically depressed. If at all possible, have him examined. The stress of events may have triggered an episode. But I must be careful with such speculation; not only am I unqualified to diagnose, but as a writer, my bias is toward meaning, not pathology. So perhaps this is not illness at all. Perhaps it is a kind of journey.
What kind of journey could it be? You say that he is talented and attractive, but not proactive, and that his success at work was largely due to the favorable actions of others. You say that in his first relationship he deferred to the needs of his partner. That leaves the impression that he is affable and charming but somewhat passive. Perhaps in the past whenever he faced adversity he would give up until someone came along to rescue him. This time there is no one to help him to his feet -- not his dad, not his wife, not his co-workers -- only you, big sister, only you.
I always look for signs that the soul is seeking knowledge. The soul seeks knowledge through adversity. Sometimes that adversity is self-generated. People break the law and get locked up; we call it acting out; we call it antisocial, as if in a perfect world none of it would happen. We do not often pause to consider the value of our dark journeys, the priceless material we carry back with us when we return, shaken but sobered by what we have seen.
While we are sometimes too quick to assume that abnormality is illness, that deviation is pathology, as I say, I am no kind of doctor. (If I were, I would be a crazy doctor crawling in the muck, a scary bearded banger of bells, a gonger, a shouter, a vibrating and unreliable sage. I would be applauding the insane as they are led away in wagons. I would not be the kind of doctor you want to mend an arm or fix a tooth.) So, again, you should have a real doctor find out if he's clinically depressed, if he needs to be treated. If he is physically in danger, if he becomes suicidal, then perhaps to save a life a doctor has to intervene.
But perhaps he is struggling to accept adversity on his own. Perhaps, stricken by grief, alone in the world for the first time, he is trying to find out what difference it makes if he smells bad or not, if he answers the phone or not, if he succeeds or just sits alone in the dark with his dog. Perhaps he is on a twisted journey toward self-reliance. Perhaps in this way he is trying to become a man! As much as I want him to be OK, I also want to honor his decision to descend into a kind of funky, ugly madness.
I fired off a letter to the editor suggesting that Carey Tennis might
want to
extract his head from his posterior nether regions (not that I put it
in quite those words) and read another
article that appeared in Salon earlier that week, reviewing a book by
the author of Listening to Prozac, Peter Kramer. His view:
depression is a disease, not an artistic journey of discovery into your
deepest self.
...Research in the past decade (since "Listening to Prozac" was published) suggests that serotonin and similar neurochemicals may ... serve a protective function. They help shield the brain from the negative effects of the stress hormones that prompt the body to respond to threats. Certain brains are rendered particularly vulnerable to stress hormones by genetics and sometimes, in addition, early childhood trauma. This kind of brain loses the ability to protect and heal itself from the effects of those hormones, and also loses the ability to turn off the production of the hormones. The stress response system can get stuck in the "on" position, eventually weakening and diminishing nerve cells and further eroding the brain's capacity to cope with the hormones. This vicious circle results in clinical depression.
The manifestations of the disease include "low mood, apathy, diminished energy, poor sleep and appetite, suicidality, loss of the capacity to experience pleasure, feelings of worthlessness," and so on. Some depressed people can't sleep; others sleep way too much. Some feel misery; most feel something closer to emptiness. But the cause, Kramer maintains, is measurable organic damage to the brain, damage that prevents the brain from repairing itself and leaves it ever more susceptible to further damage. This is why often very slight stressors can incapacitate a depressed person or trigger an episode of depression, and why a third or fourth episode is harder to treat than the first.
Rather than seeing depression as arising from a lack of certain chemicals, Kramer defines it as a deficit in resilience, the ability to bounce back -- neurologically and emotionally -- from stress. To treat depression you don't pump the afflicted full of artificial happiness, you restore their ability to absorb and recover from the unavoidable bumps, knocks and tragedies of life. That's why, Kramer feels, doctors should vigorously treat depression (using a combination of medication and psychotherapy), as soon as possible. Delayed or insufficient treatment risks further weakening of the brain itself...
...[T]reating depression doesn't consist of changing someone's personality, but of restoring it. Genetics and early trauma might have set Margaret up for depression, by making her brain more vulnerable to stress, but the depression was not her fundamental self, or a window into buried feelings -- in fact, it was quite the opposite.
So while the
depressed brother may indeed need to take a journey through his
innermost depths, it's kind of hard to do that with an impaired brain.
If someone wrote to Dear Abby and said, "Hey, my brother has stopped eating and he keeps talking about his stomach hurting, and he's throwing up blood," I'm reasonably sure Abby would say he needs medical treatment... no caveats, no "but I'm not a doctor!", no reservations, no theories about what psychological trauma might have set off the condition. Just the recognition that there's some illness at work, and illnesses get worse if they're not treated. But as usual, when we're talking about the brain, somehow that's a license to go off into woo-woo territory. It seems deeply irresponsible to me.
(One last thing
that is stupid: Salon's search engine. I kept trying to find that book
review. I typed in "depression" and then I tried "mental
illness" and
totally failed to find it. I had to go back to an email I'd sent to
myself with the article in it.)
Updated to add: looks like I'm not alone in my assessment of the column! (http://tabletalk.salon.com/ webx?14@357.9MVjarbiw0M.10@.773a837c/4147)
I was infuriated by Cary's response to today's LW. Debilitating depression is not some groovy shamanistic state wherein one journeys to the Dark Gods and returns armed with arcane knowledge. It's a miserable fucking illness. As with all illnesses -- or other pesky setbacks on what Cary would probably call the Glorious, Agonizing, and Unknowable Road of Life -- some people are ultimately able to emerge with new-found strength and certainties, forged by the Fire of Adversity into more powerful beings. And many people just get made into toast. What's next? Hurrah for cancer! Bring on diabetes!
I'm sorry, this is bullshit adolescent romanticism at its most repellent. Depression is an illness, and one of its calling-cards is its ability to persuade those suffering from it that they are doomed to misery, that brighter lives are not an option, and that all attempts at help, change, therapy, etc. will be fruitless, irritating, and serve only to deepen everybody's sense of disappointment...
All those copies of Bullfinch's Mythology, The Golden Bowl, and R.D. Lang that Cary has sitting on his desk, marked with jaunty little Post-Its? They need to be forcibly confiscated. And then he needs to spend a little time on the locked ward of a county hospital and see just how much those poor souls and their exhausted, tapped-out caregivers come in for applause.
