The Self-World of Depression (Part Two)

It's been strange to have the world around me suddenly change. When I first moved to New York and first had friends who made no pretense about being gay, they would say things like 'this actor is gay' or 'that comedienne is gay and her lover writes all her material' and 'Michelangelo was gay' until it seemed unbelievable. All these gay people couldn't have been there, under my nose, this whole time. But they were of course. The older I get, the more it seems as if the world is made up of enormous numbers of people who are living all around me and yet who are parts of cultures and webs of societies about which I am utterly oblivious.

So there are all these people around me on anti-depressant medication. For awhile it seemed impossible, the way for awhile when I was twenty-two it had seemed to me that all these gay people had come out of nowhere. One out of five women in the United States will suffer from depression at some time in her life. That's better than 25 million people. Some part of me thinks this is absurd. Prozac nation indeed. For years I thought everybody was depressed, although I didn't think of it as depressed I just thought everybody felt like me. I'm still not sure most people don't feel like me. What is depression if well over 25 million people get it, is it an illness or just the human condition?

It seems to me that depression is a difference in degree rather then kind. The symptoms of depression are not sadness, they are prolonged sadness, inappropriate sadness, not anxiety but extreme anxiety. Clearly, some people have something called depression and it is debilitating and even fatal. Probably some people are asking for and getting anti-depressant drugs who don't really need anti-depressant drugs. What am I? Someone who is ill? Someone who whines? I see a psychiatrist every six months to a year and he asks how I'm doing and I say good, or not so good. I'm overwhelmed, I say. He smiles and says, like a lot of us. I'm sleeping a lot. It says in my chart that I have always slept a lot, which is true, and he asks me if I'm sleeping a lot more? How much am I sleeping each day? I'm thinking, how much do I sleep each day? How much do I sleep a week? Is it enough? Does it count? I feel as if I can't do enough, I say. Don't we all, he says.

Yes but...am I depressed? Or is it the human condition? How many hours do I have to sleep? How do I measure what I do and what I don't do? How much of my depression comes from the fact that I think of myself as depressed? I've known some treatment junkies in my time. I was suicidal in college but not much since then. But once I was diagnosed as depressed, then suicide started cropping up again. Not seriously, thank god, more as a kind of parachute, you know, if things get too bad I could always kill myself. I assume that I'm thinking about it because I associate suicidal thoughts with depression. All those years I didn't think of myself as depressed, I didn't much think about it, now that I think of myself as suffering from depression, I'm allowed to think of it again.

If it is the human condition, is a fault in the neurological wiring? Is it the result of environmental stress--we humans are evolved for significantly different conditions than the ones we live in. Is there some ecological advantage to having some people depressed? Depressed people are probably less energetic, less likely to be the ones who go over the hill and explore. Maybe we depressed people provide a counter-balance to the more energetic. Maybe we sometimes survive because we sleep late rather than go out early and get killed. I don't know. It's hard to say what might be an advantage. Sickle cell anemia survives as a genetic problem because it is sometimes an environmental advantage against malaria. Someone born with two sickle cell genes doesn't survive long enough to reproduce, but one sickle cell gene makes a person somewhat resistant to the malaria parasite. It also makes the person sickly, but in many places in the world, malaria is such a problem that even some resistance is worth the disastrous effects of the illness.

One thing about depression is that it worsens as I get older, so maybe it usually allows people to reproduce before it debilitates them, rather like Huntington's Chorea, the disease that killed Woody Guthrie--it doesn't come on until someone is in their forties or fifties. Or maybe it's an environmental reaction, a kind of brain injury. Maybe the epidemic of depression at the end of the twentieth century is something like the epidemic of asthma in children, an artifact of our society from causes we haven't yet defined. Or maybe its the human condition and a lot of us are whinging and whining.

The idea that we all have the right to life, liberty and the pursuit of happiness is a political one, not a biological one. I don't think wild rabbits, for example, have much happiness. I think most of the time they're anxious about being eaten. I have yet to be convinced the unhappiness may not be the human condition. I'm hopeful it's not. I used to think that unhappiness was valuable for an artist, that it made artists sensitive and artistic, but I don't think that anymore. Mostly now I think unhappiness makes me mean and narrow. But by the same token, I don't think central heating is a biological condition, and I don't want to abolish it. If anti-depressants make unhappy people more happy, then by all means, dispense them. But if anti-depressants merely make me a victim of my own biology, if they allow me to identify myself as depressed and then I use that knowledge to stop taking responsibility for myself, that's a trap and a dead end.

(End.)