Beyond Blue: May 2007 Archives

I hereby apologize for my anti-Oprah remarks in past posts. Until last week's show on depression I didn't realize all the support she offers (online chat rooms and tons of resources via her media kingdom, which starts at www.oprah.com) to people like me who struggle with mental illness. Because she often speaks positively about "The Secret" and famous medical-intuitive Caroline Myss I leaped to the judgment that Oprah approaches depression like many other Secret-loving, Myss-disciples do: think positive, toss out the intention of happiness into the universe, and you'll reach the land of milk and honey in no time.

To get to last Wednesday's extremely informative show, click here. Her website lists all kinds of personal assessments, books, and online support groups that depressives like me should take advantage of.

The first celebrity she interviewed on the show was actress Lorraine Bracco (who plays the psychiatrist Dr. Jennifer Melfi on "The Sopranos").

This is my favorite part of the interview, from an online summary of her appearance:

"Depression is very insidious and sneaks up on you. There are simple things in people's lives that can bring you down," [Lorraine says].

Eventually, Lorraine sought professional help. "When I finally made that step into the psychiatrist's office and he said to me, 'Well, Lorraine, you're clinically depressed,' and I said, 'Okay, I know what's going on. I am going to fight like hell to figure out my life,'" she says.

Lorraine credits antidepressants with pulling her out of her fog. "I was very against any kind of medication because I felt, 'Oh, my God, I'm an actress. I need my emotions. And if I take an antidepressant, I'll never feel again and I'm going to be hooked on them forever," she says. "I was very, very, very wrong about the whole medication thing. And I think that's very important. I feel that it's really what saved me."

She says she also spent time learning about herself and deciding what kind of person she wanted to be. "I lived at Barnes & Noble at the self-help department and I sat there for a long time," she says. "And I went through books, and even the kids who worked there said, 'Miss Bracco, would you like a chair?'"

And about mothering with depression, this part tugged at my heart:

During her depression Lorraine says she was simply going through the motions of motherhood. "They had clean clothes and a warm meal and they had a roof over their head, but I was missing," Lorraine says. "My soul, my vibrant being, was nowhere to be found." Although she had thoughts of suicide, Lorraine says she never would have acted on them because her daughters, Margaux and Stella, were her lifeline.

For the first time, Stella discusses how her mother's depression affected her. "Watching the person who's supposed to be taking care of you in pain is the hardest part. It was hard for me because I felt responsible. She fought to make me happy. For me to have the life that I wanted. And I think that took a lot out of her," Stella says. "I just wanted to be able to make it all okay, and I couldn't. It's painful. It's hard to watch someone you love deteriorate. And it's even harder to watch as a child when there's really nothing you can do."

At times, Stella says it felt like her mother was lost forever. "She might as well have been lying in a hospital bed with IVs—it's the same thing," Stella says. "She was dying. She was already dead. For me, it felt like she was never going to come back."

Now, Margaux says she sees a different person in her mother. "More recently I've seen someone who's made the choice to be an active member of her life," she says. "And that's something she wasn't before. And that's a wonderful thing."

On Wednesday’s show Oprah also interviewed Phil Aronson, husband of Emme Aronson, formerly the world's leading plus-size super model and Revlon cover girl.

I think his story is important to tell too because our society often thinks of depression as a women's disease when six million American men are diagnosed with depression each year. (And I apologize if I leave the guys out sometimes on my blog.)

The summary of Oprah's interview, found on her website, gave me chills because I've been exactly where Phil was...unable to think of anything but suicide for days on end, and hating myself for what that was doing to my family.

Here's his story, (and their story as a couple):

In 2001, shortly after the birth of their first child, Emme began to notice changes in her husband Phil's personality. "Right after Toby was born, strange things started to happen," she says. "Phil was retreating, not vivacious and bubbly. And [he had] outbursts of anger."

Phil spiraled into a severe depression after developing a debilitating pain that he says tortured him. He discovered later that the pain was caused by prostatitis, the inflammation of the prostate gland located at the end of a male's urethra.

During this time, Phil says he wouldn't get out of bed for days on end. "I wouldn't comb my hair. I wouldn't shave. I hated myself," he says. "It's just the deepest, darkest abyss that anyone could ever imagine." Phil was prescribed antidepressants, but he says they had little effect.

Afraid for Phil's well-being, Emme put her career on hold so that she could be there for her husband. "For two and a half years, she stepped out of her life and into my life and it affected everything," he says. "She was the housekeeper, the breadwinner, the mother and the father during my illness."

As months turned into years, Phil sank deeper into depression. His thoughts soon turned to suicide. "He started talking about how he was going to kill himself," Emme says. "It started to happen every week, and then it started happening every hour, practically. Then he would get into descriptive details as to what exactly he was going to do.... I was a woman on the brink of her own disaster--of her own emotional breakdown."

Phil remembers telling his wife, "I'm going to kill myself," almost every 15 minutes when he was at his lowest point. "Our family would gather together and they would say to Phil, 'You can't say this to Emme every single hour. You're making her crazy,'" Emme says.

Finally, Phil says he couldn't take it any longer. One night, he went into his sleeping daughter's bedroom to say goodbye. Then, he locked himself in the bathroom and tried to kill himself by overdosing on prescription drugs.

Emme found him the next morning, in bed and not moving. "I looked to my side and I saw the note, and I'm like, 'Oh, my God,'" she says. "I was very angry at Phil for trying to leave us."

After Phil's suicide attempt, he was committed to a psychiatric unit for two and half months. While under lockdown, Phil's safety was the number-one priority. Doctors didn't let him have access to medication, sharp objects or sheets.

"It was the darkest, deepest, most horrific time I could ever imagine in my life," Phil says.

Psychotherapy and medication didn't seem to be helping, so doctors recommended that Phil undergo electroconvulsive therapy (ECT). This procedure isn't like the shock treatments from the '30s and '40s, Phil says.

In the book, "Morning Has Broken," Phil talks about the day he broke free from his crippling depression. Shortly after his ECT treatments, Phil's younger brother lost his long battle with brain cancer.

"[My brother] came to visit me at the psych ward, he said, 'Phil, life is for the living and I love you and I promise you're going to get better,'" he says. "And in fact, I did. When he died, that next morning I woke up and it was the first time in two and a half years that I got out of bed and actually wanted to live."

Emme says she immediately knew that the man she married was back. "I could see in his eyes," she says. "When someone is depressed, they go away.... And that next morning, he was back."

Phil and Emme credit his recovery to a loving family and access to the best treatments. As one of millions who have suffered from depression, Phil says he felt that it was important to tell his story. "Everyone has their own story," he says. "But if we can talk about it, we can help to initiate change."

On Oprah's website, I found this interesting article about the difference in symptoms between women and men who suffer from depression:

According to psychiatrist Dr. Gail Saltz, author of "Anatomy of a Secret Life," major depression and dysthymia affect twice as many women as men. This two-to-one ratio exists regardless of racial and ethnic background or economic status. Although it's the same condition, it's important to note that the signs of depression in women and men can be very different.

Women and Depression

A variety of factors that are unique to women's lives are suspected to play a role in developing depression. Research is focused on understanding these factors, including:

* Reproductive
* Hormonal
* Genetic or other biological factors
* Abuse and oppression
* Interpersonal factors
* Certain psychological and personality characteristics

Still, the specific causes of depression in women remain unclear, and many women exposed to these factors never develop depression.

In particular, societal factors may contribute to a woman's depression, because Dr. Saltz says women are more socialized to be passive and tend to blame themselves when something doesn't go right. Women are more likely to suffer guilt and appear genuinely hopeless and genuinely feel bad about themselves. "Women particularly feel tremendous overwhelming guilt. You don't take pleasure in anything," Dr. Saltz says. "[They feel] guilt about everything and anything and things that are irrational--'I'm a bad person.'

In fact, when you go on to have severe, severe, severe depression, which can become psychotic, you can have delusions that, 'I am so bad that my insides are rotting. My brain is rotting.'"

Men and Depression

According to a February 2007 "Newsweek" cover story, 6 million men will be diagnosed with depression this year alone. Millions more will go undiagnosed, Dr. Saltz says, because men do not generally display the more outward signs of depression, such as crying or expressing a sense of hopelessness.

Instead, Dr. Saltz says men tend to shift the blame for how they are feeling from what they feel on the inside to outside things. "Men exhibit through anger or irritability. Men are more likely to be overlooked because they appear to be a 'jerk,'" Dr. Saltz says. "They are less likely to think it is depression because they will externalize. It's the 'bad boss' or the 'bad wife.'"

In addition to being less likely to see a doctor or a health professional who might notice signs of depression, Dr. Saltz says men are more prone to using alcohol or drug abuse as an outlet, making it more difficult for others to see the signs of depression. "People may think, 'He's a mean drunk,'" Dr. Saltz says. Eventually, people may just assume a man suffers from alcoholism, not depression.

Oprah lists several resources on her website for people struggling with mood disorders.

Two online support groups that she offers are the bipolar support group (click here), and the dealing with depression and on meds support group (click here).

For readers like "Citizen," I think it's important to list the symptoms of major depression covered by the DSM-IV (the current edition of the Statistical Manual of Mental Disorders) published by the American Psychiatric Association.

According to the DSM-IV, a person is suffering from a major depressive episode if he or she experiences items number 1 or 2 from the list of symptoms below, along with any 4 others, continuously for more than 2 weeks:

1. Depressed mood with overwhelming feelings of sadness and grief
2. Apathy--loss of interest and pleasure in activities formerly enjoyed
3. Sleep problems--insomnia, early-morning waking, or oversleeping nearly every day
4. Decreased energy or fatigue
5. Noticeable changes in appetite and weight (significant weight loss or gain)
6. Inability to concentrate or think, or indecisiveness
7. Physical symptoms or restlessness or being physically slowed down
8. Feelings of guilt, worthlessness, and helplessness
9. Recurrent thoughts of death and suicide, or a suicide attempt.

And the following description of major depression comes from the 2007 Johns Hopkins White Papers on Depression and Anxiety written by Karen Swartz, one of the physicians who evaluated me in March of last year:

The diagnosis is more certain when a person also has a family history of depression; a previous episode of depression or bipolar disorder; a general medical problem likely to trigger depression, such as a recent stroke or heart attack; or is taking a medication known to cause mood disorders.

Other symptoms of depression include disorganized thinking and delusions. In addition to these disturbances in mood and cognition (thinking), people with major depression may experience physical changes such as constipation or decreased sexual drive.

Episodes of major depression range from mild to severe. In mild episodes, symptoms barely meet the requirements for a diagnosis and the person is able to get through the day without too much trouble. Severe episodes are characterized by several debilitating symptoms, including worsening mood that markedly interferes with daily life. People who are struggling with severe depression have difficulty with almost every activity--going to work, socializing, and even getting up in the morning. They may be unable to feed and dress themselves or to maintain personal hygiene. Major depression is twice as common in women as in men.

In the same Johns Hopkins White Papers on Depression and Anxiety, Karen Swartz, the Director of the Affective Disorders Consultation Clinic, distinguishes between "complicated grief" (also called traumatic grief), which occurs in approximately 10 to 20 percent of bereaved persons,...

Click here to read Shankar Vedantam's entire "Washington Post" article on the new guidelines for diagnosing depression.It begins:Up to 25 percent of people in whom psychiatrists would currently diagnose depression may only be reacting normally to stressful events such as...

Awhile back a reader asked if I would address the topic of weight gain as a side effect of medications. She feels less depressed now, but is struggling with the excess weight.In the Winter 2007 Issue of the Johns Hopkins...

Thanks to reader "Citizen" who posted the following question on my "Labor Pains" post:How do you distinguish depression from ordinary feelings, if it isn't as obvious as what you have described?Separating clinical depression from the sadness and normal anxiety caused...

The most meaningful religious holiday for me doesn't involve a fat, jolly man sliding down a chimney, or a life-size rabbit hiding baskets of jellybeans. It's a feast that usually gets overshadowed by Memorial Day picnics and graduation parties.The Pentecost...

What is the worst possible question you could ask a woman with a history of an eating disorder (or any female, but especially a female with body-image issues)?I'll give you a hint—it's three words long and ends with an eight-lettered...

When Ed is around, my brain abandons all logic and thinks like this: If the Chinese government won't allow anyone with a BMI of over 40 to adopt their babies, then I should be less than half of that. Preferable...

Albert Camus once said, "What doesn't kill me makes me stronger." And Carl Jung said, "There is no coming to consciousness without pain." During the year of my depression, I would have replied, "Please shoot me then, because I never...

I found this beautiful excerpt on butterflies from "Zorba the Greek" by Nikos Kazantzakis:I remember one morning when I discovered a cocoon in the back of a tree just as a butterfly was making a hole in its case and...

Depression is a lot like childbirth. Once you've climbed out of the Black Hole (i.e. are holding your newborn in your arms) you forget (at least temporarily) about all the cursing you did during the labor that got you there.In...

I laughed out loud when I read reader Tammy's remark on my "Gretchen Rubin: How Do You Move Beyond Blue?" post:"I know that God will not give me more than I can handle. I just wish he didn't trust me...

I think God wants us to get mad at him. It means we're in a living, normal relationship with him.Catholic author Ronald Rolheiser goes so far to say that wrestling with God is a form of prayer. In his book,...

Jim McDermott, associate editor at "America" magazine, recently invited me and others (lawyers, artists, peace activists, academics, religious leaders) to contribute a piece of advice for college graduates that he published in a special education issue.This is what I wrote...

Speaking of advice for graduates, here are a few passages from recent commencement addresses that I found especially meaningful. From them I gleaned many insights on how to live more gracefully with depression and anxiety.Toni Morrison at Wellesley College, 2004:...

"Enough about me. What do you think about me?"Does that sound familiar? You know the type of self-absorbed person I'm talking about. And I really try not to be her. That's precisely why I didn't write about myself for a...

I thought reader Becky made an excellent point with regard to self-indulgence and depression in her comment on the "Unrealistic Expectations: Perfection's Trophy Wife" post:I'm having a very hard time seeing what in this post would prompt criticisms of "selfish"...

In "Being Perfect," bestselling author Anna Quindlen advises high school and college graduates to work from a clean slate ... to give up on being perfect. I keep the gift book beside my computer (with Miguel Ruiz's "The Four Agreements"...

From Ruiz's "The Four Agreements":Whatever happens around you, don't take it personally.... If I see you on the street and I say, "Hey, you are so stupid," without knowing you, it's not about you; it's about me. If you take...

I'm pretty sure that I won't get too many more opportunities to sing the "Mourner's Kaddish Prayer" (Yit-gadal v'yit-kadash sh'mey raba...) right before the lyrics of "Moon River" ("Moon River, wider than a smile...") and say the prayer of "Hinei...

Yesterday I popped in on Bill to see how he was doing. I suspect the week after the funeral is the hardest, when all the company has left, and you're there among her dresses and jewelry and paintings and books,...

I will be discussing my post from last Friday, "Depression: It's Spiritually Incorrect" on Sirius radio, on the Catholic Channel, Wednesday morning at 6:40 a.m. If you're up, tune in!...

I learned a very important lesson about jealousy driving back from J. C. Penny's last night.David and Katherine had just picked out 15 new pairs of underwear (I'm on day three of potty training Katherine, if you hadn't already picked...

If perfectionism is a crippling bastard, then unrealistic expectation is his obnoxious trophy wife. The two are disgustingly inseparable, and their full-time job is manufacturing anxiety inside a depressive's head.Take this morning's breakfast in my household.Eric practically hyperventilated in between...

Speaking of races, triathlons, and contaminated Annapolis water, I was so relieved to read Charles Henderson's article on how long distance running can be an important spiritual practice, because, here's my confession: I can only meditate when I'm moving. The...

Here's an excellent article written by Douglas Todd for Religion News Service about Archbishop Roussin's depression and how he is fighting for better understanding of mental illness within religious communities.Once again, Roussin is my hero!Archbishop Raymond Roussin remembers the shame...

I mentioned in my "Celebrity Depression, Spiritual Lessons" gallery how Brooke Shields' memoir, "Down Came the Rain," gave me permission to cry all I wanted, especially in the months after I started breastfeeding Katherine, when I started to sink into...

Gretchen Rubin and I are on the same mission: to find peace and happiness for ourselves and to spread it to others. The only difference between us, I think, is that 1) I couldn't find the part where she has...

Every Wednesday is Tip Day on Gretchen's blog. I might actually start a similar feature myself, but on Tuesday's ("Tuesday's Tips" sounds catchy, no?). Let me know if you'd like to see a regular feature like this on Beyond Blue....

As I read the story "I Dreamed I Was a Ballerina" by Anna Pavlova to Katherine last night, I couldn't help but think about my dream of becoming an inspirational writer--how that dream energizes me in the face of depression,...

I usually read other writers' biographies in the same way that I ride a roller coaster--with my hands over my eyes, but peeking every now and then--because I sort of want to know what's coming next, and I sort of...

Here is the text of "Desiderata," the timeless classic (found in Old St. Paul's Church in Baltimore, which was founded in 1692, and thought to have been written in 1927 by Max Ehrmann) that hung in the laundry room of...

I go to confession once a month, where I sit down at the City Dock Café in Annapolis across the table from Deacon Moore (one of my older, balding male friends), and I tell him everything I'm feeling guilty about.He...

Deacon Moore is the same guy who assured me that visiting my mother-in-law as often as possible with the kids, and trying to help her out when I can, qualifies as legitimate charity work--that goodwill starts at home, and sometimes...

My heart goes out to reader Nancy, who posted the following message on my "Depression Is Conquerable" post:"I read with interest your posts about depression. I have been a long-time sufferer--since I was a child--of major depression as well as...

Speaking of helpful mental health practitioners, I wanted to mention Beliefnet's very cool new tool "Find a Therapist," powered by "Psychology Today."I hope you don't need it (you know, I wish you peace), but if you do, there it is!...

I mentioned Deep Brain Stimulation (DBS) the other day, but the link to the article on it required a password. Sorry about that.Here are some excerpts from an interview with Helen S. Mayberg, M.D., professor of psychiatry and neurology at...

I recently dragged my kids to Baltimore so that I could have lunch with an old colleague (he's young...but we've known each other for 13 years) at the National Catholic Education Association convention. A gifted writer and speaker, my friend...

Here are some more of the lyrics from Leonard Cohen's "Anthem":"The birds they sang at the break of day Start again I heard them say Don't dwell on what has passed away or what is yet to be. Ring the...

I have a magnet on my refrigerator that reads "Jesus loves you, but everyone else thinks you're an a—hole." It's a gentle but effective reminder that on those days that I manage to piss off every person around me, God...

What do the Christian existential thinker Soren Kierkegaard and the movie "The Full Monty" (the 1997 flick about six unemployed steel workers who form a male striptease act) have in common?Let me tell you.Kierkegaard described despair as not being conscious...

There are three words in Hebrew that mean essentially "the full monty." They are "Ehyeh asher ehyeh," translated as "I am who am" (or "I-shall-be that I-shall-be"), the response God gave Moses when he asked for his name.My theology professor...

Ever since my friend helped forge the connection between Kierkegaard's act of kenosis, or self-emptying (in my case sharing with the world my story of depression and recovery) and "The Full Monty," I've been on the lookout for other flashers...

Another poignant testimony is the 4,500-word article entitled "Hell and Back" by Chris Rose, a columnist for The Times-Picayune in New Orleans, who reported on the post-Katrina life, and, as a result, got sucked down the "rabbit hole" (as he...