I spent my adolescence and teenage years obsessing about this question: Am I depressed or just deep? When I was nine, I figured that I was a young Christian mystic because I related much more to the saints who lived centuries ago than to other nine-year-old girls who had crushes on boys. I couldn't understand how my sisters could waste quarters on a stupid video game when there were starving kids in Cambodia. Hello? Give them to UNICEF!
Now I look back with tenderness to the hurting girl I was and wished somebody had been able to recognize that I was very depressed.
Not that I would have accepted the help. I believed, along with all the other adults in my life, that my melancholy and sensitivity were part of my "special" make-up, that they were gifts to celebrate, not neuroses to treat. And should I take meds that helped me laugh and play and design cool barrettes like the other girls, well, then I would lose my depth.
On the PBS website "This Emotional Life"--a multi-platform project centered on a three-part series documentary to be broadcast in early 2010 hosted by Harvard psychologist and bestselling author Daniel Gilbert--psychologist Paula Bloom discusses the topic of being deep versus being depressed. On her blog post "Am I Depressed or Just Deep?," she writes:
Sometimes, people confuse being depressed with being philosophical. If I had a dollar (well, maybe $2) for every time I hear "I am not depressed, I am just realistic", "Anyone who isn't depressed isn't paying attention", or "Life has no meaning and I am going to die, how can I be happy?" I could likely support a hardcore latte habit. Depression can have such an effect on your worldview.
There are a few basic existential realities we all confront: mortality, aloneness and meaninglessness. Most people are aware of these things. A friend dies suddenly, a coworker commits suicide or some planes fly into tall buildings-these events shake most of us up and remind of us of the basic realities. We deal, we grieve, we hold our kids tighter, remind ourselves that life is short and therefore to be enjoyed, and then we move on. Persistently not being able to put the existential realities aside to live and enjoy life, engage those around us or take care of ourselves just might be a sign of depression.
We all get sad sometimes, struggle to fall asleep, lose our appetite or have a hard time focusing. Does this mean we are depressed? Not necessarily. So how do you know the difference? The answer, as with most psychological diagnoses comes down to one word: functioning. How are you sleeping and eating? Are you isolating yourself from others? Have you stopped enjoying the things you used to enjoy? Difficulty focusing and concentrating? Irritable? Tired? Lack of motivation? Do you feel hopeless? Feel excessively guilty or worthless? Experiencing some of these things may be a sign of depression.
Peter Kramer, clinical professor of psychiatry at Brown University, devotes an entire book to this question. He wrote "Against Depression" in response to his frustration of repeatedly being asked the same question: "What if Prozac had been available in van Gogh's time?"
In a New York Times essay, "There's Nothing Deep About Depression," which was adapted from "Against Depression," Kramer writes:
Depression is not a perspective. It is a disease. Resisting that claim, we may ask: Seeing cruelty, suffering and death -- shouldn't a person be depressed? There are circumstances, like the Holocaust, in which depression might seem justified for every victim or observer. Awareness of the ubiquity of horror is the modern condition, our condition.
But then, depression is not universal, even in terrible times. Though prone to mood disorder, the great Italian writer Primo Levi was not depressed in his months at Auschwitz. I have treated a handful of patients who survived horrors arising from war or political repression. They came to depression years after enduring extreme privation. Typically, such a person will say: ''I don't understand it. I went through -- '' and here he will name one of the shameful events of our time. ''I lived through that, and in all those months, I never felt this.'' This refers to the relentless bleakness of depression, the self as hollow shell. To see the worst things a person can see is one experience; to suffer mood disorder is another. It is depression -- and not resistance to it or recovery from it -- that diminishes the self.
Beset by great evil, a person can be wise, observant and disillusioned and yet not depressed. Resilience confers its own measure of insight. We should have no trouble admiring what we do admire -- depth, complexity, aesthetic brilliance -- and standing foursquare against depression.
Kramer's words are consoling to a depressive who spends 90 percent of her energy a day combating thoughts saying she is depressed because she lacks the stamina to be optimistic. In fact, the first time I read Kramer, I experienced profound relief. However, I still maintain that some of my depth caused by depression is a good thing. Not on the days where I'm in excruciating pain, of course. But should I have been one of those nine-year-olds who got excited about which color ribbon I could use to make my barrettes and wasted her quarters on Pacman ... well, I wouldn't be writing this blog.
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powerfully written, Therese. All the best with your book!
This is a good read. I especially like the part where you differentiated feeling sad with feeling depressed. I thought that these two words were synonyms but there is, in fact, a difference - particularly in functioning. Thanks for sharing your wisdom!
Hey, Therese. Interesting conversation, here. From my personal perspective:
1. Any depression that is not part of my temperament sucks - whether mild or severe. Take my depression - please. They throw me off my game, they wreck my life. Whether it's a depression that is the equivalent of a mild cold or one that is psychic double pneumonia I seriously don't want to be occupying my brain. This is the true illness.
2. At the same time, mild to moderate depression is part of my temperament, my personality (as is hypomania). As opposed to my illness depressions, I'm very comfortable in this state. It is a part of who I am. My energy is down, my thoughts tend to be very dark, but - here's the key difference - I thrive in this state. My mind is quiet and contemplative. It's as if I'm calmly sifting through the ideas I rounded up in my hypomanic frenzies. Most of my best writing occurs in this state, as do my comtemplative moments taking walks.
We tend to get hung up on DSM-IV check lists while ignoring a key DSM injunction, namely that a mental illness is only a mental illness when the symptoms interfere with our ability to function (as in work or relationships). So - from my personal perspective - if I am comfortable and not struggling while depressed, then I don't regard myself as having an illness that needs to be treated.
Now let's flip it. I also get hypomanic, and I've written a lot about this. Here's the test: For Marilyn Monroe to act like Marilyn Monroe (at least when she's up) - that's normal. For someone else to act like Marilyn Monroe, on the other hand - that's probably not normal and bad things may happen.
So, back to depression. For me to act like me (when I am down), under most situations that is normal for me. I can handle it, it is healthy. For someone else to act like me, that's probably not normal. They can't handle it. They would like freak out. Bad things are likely to happen.
It gets complicated when we get to those in between areas. When does my productive depression start becoming a nuisance and when does the nuisance seriously start messing me up? Similarly, when does my upbeat hypomania turn into social embarrassment into something that causes me to make very bad decisions?
It's as if we're turning up the heat. When, in effect, instead of a nice warm soak in the tub, do we find ourselves in hot water? Everyone has different tolerance thresholds, and you can make a good case that we can expand the range of these tolerance thresholds to lead healthier lives. Of course, every time I congratulate myself on doing this, God just laughs and throws a psychic lightning bolt in my direction.
So - my normal would probably cause most people to stay in bed for six months, or (in the other direction) have neighbors dialing 911.
So, to your question - is it depression or being just deep? For me - personally - depression is depression. Physical stuff is happening in the brain, whether it interferes with our lives or not. Same with blood pressure. We may call blood pressure something else when it gets too high, but when all is said and done blood pressure is blood pressure.
I hate the word, depression. It would be a lot more helpful to our understanding if we came up with something different, or went back to the old term melancholy.
Anyway, these are my personal views only. I don't claim any special knowledge here. All of us together are trying to figure this out, and I look forward to hearing from all of you.
Depression, like any other disease does, not form symptoms, cures, or the ability to cope for life with the disease, the same for any one person. If so, there would be ONE kind of PILL, but there are hundreds or thousands. THE TRUTH ABOUT antdepressamts is that each one works in less than 20% of the people who take them and they aren't sure why or how they work.
So, I am patient. I try something that seems it might work, and then it doesn't, so my Doc and I go thru the guessing game some more. The bottom line is, are YOU more comfortable being depressed. I know I was (and sometimes still am), but you have to WANT TO GET WELL OR MAKE PROGRESS to do it. YOU HAVE TO TAKE ACTION, meds, therapy, pastoral counseling, getting the F out of bed the days you don't want to and move on. YOU ARE NOT THE CENTER OF YOUR UIVERSE OR ANYONE ELSES. Do the WORK or STAY THE VICTIM (where you feel safe and comfortable cause you been there so long).
WE HAVE A POSITIVE OR NEGATIVE IMPACT ON OUR LOVED ONES AND WE HAVE THE SAME FOR PEOPLE WHO UNDERSTAND WHAT WE ARE GOING THROUGH. You were called to freedom, brothers and sisters; only do not use your freedom as an opportunity for self-indulgence, but through love become slaves to one another. For the whole law is summed up in a single commandment, "You shall love your neighbor as yourself."
FOR ME, THE REST IS JUST COMMENTARY. DO THE WORK. LIVE AND I WISH YOU LOVE AND PEACE--I WORK FOR IT ALL THE TIME AND SOMETIMES IT IS WONDERFUL...OTHER TIMES NOT, BUT IT IS NOT A PERSON IN MY LIFES FAULT. IT IS A DISEASE LIKE ANY OTHER. HOPEFULLY YOURS AND MINE WILL UNDERSTAND IT SOMEDAY. IT IS BETTER THAN THINKING OF WAYS TO DIE THAT WILL NOT HURT WHO I WISH I COULD LOVE IN ACTION. BOTTOM LINE, THEY WOULD GET OVER IT, THINK OF YOU LESS AND LESS AS DAYS, MONTHS AND YEARS GO BY TO WHERE YOU ARE BROUGHT ONLY OCASSIONALLY.
Wonderful piece! It is nice to know that people are reading what I put out there! This is a topic near and dear to my heart. For another piece of this conversation you may want to read a follow up blog post I wrote for PBS "Accessing faith though treating depression."
http://www.pbs.org/thisemotionallife/blogs/accessing-faith-through-treating-depression
You might consider commenting on the PBS website with a link to your blog post!
Best wishes on the continued journey,
Paula Bloom
www.paulabloom.com
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