My Personal Opinion
This is by far the best book I have ever read concerning depression and its effects thereon during the period of time one is going through a depression. As far as I’m concerned depression is completely indescribable and undefinable to anyone who has not suffered through it. But the brilliant prose excerpted here contains the most comprehensive set of examples of what depression can truly be like. And I can assure you, based on my own experiences with this dark beast, that all of these passages listed below are stunningly spot on, based on my own opinion, so much so as to allow myself to believe that maybe I’m not alone.
For the thing which I greatly feared is come upon me, and that which I was afraid of Is come unto me. I was not in safety, neither had I rest, neither was I quiet; yet trouble came. —Job
Depression is a disorder of mood, so mysteriously painful and elusive in the way it becomes known to the self—to the mediating intellect—as to verge close to being beyond description. It thus remains nearly incomprehensible to those who have not experienced it in its extreme mode, although the gloom, “the blues” which people go through occasionally and associate with the general hassle of everyday existence are of such prevalence that they do give many individuals a hint of the illness in its catastrophic form.
…so it came as an astonishment to me that I was close to a total ignoramus about depression, which can be as serious a medical affair as diabetes or cancer.
…however, I could not put to practical use. The most honest authorities face up squarely to the fact that serious depression is not readily treatable. Unlike, let us say, diabetes, where immediate measures taken to rearrange the body’s adaptation to glucose can dramatically reverse a dangerous process and bring it under control, depression in its major stages possesses no quickly available remedy: failure of alleviation is one of the most distressing factors of the disorder as it reveals itself to the victim, and one that helps situate it squarely in the category of grave diseases.
…and a sense that my thought processes were being engulfed by a toxic and unnameable tide that obliterated any enjoyable response to the living world. This is to say more specifically that instead of pleasure—certainly instead of the pleasure I should be having in this sumptuous showcase of bright genius—I was feeling in my mind a sensation close to, but indescribably different from, actual pain. This leads me to touch again on the elusive nature of such distress. That the word “indescribable” should present itself is not fortuitous, since it has to be emphasized that if the pain were readily describable most of the countless sufferers from this ancient affliction would have been able to confidently depict for their friends and loved ones (even their physicians) some of the actual dimensions of their torment, and perhaps elicit a comprehension that has been generally lacking; such incomprehension has usually been due not to a failure of sympathy but to the basic inability of healthy people to imagine a form of torment so alien to everyday experience.
“It is a positive and active anguish, a sort of psychical neuralgia wholly unknown to normal life.”
This memory of my relative indifference is important because such indifference demonstrates powerfully the outsider’s inability to grasp the essence of the illness.
….was in the sure understanding that tomorrow, when the pain descended once more, or the tomorrow after that—certainly on some not-too-distant tomorrow—tomorrow—I would be forced to judge that life was not worth living and thereby answer, for myself at least, the fundamental question of philosophy.
Randall Jarrell almost certainly killed himself. He did so not because he was a coward, nor out of any moral feebleness, but because he was afflicted with a depression that was so devastating that he could no longer endure the pain of it.
My annoyance over all this was so intense that I was prompted to write a short piece for the op-ed page of the Times. The argument I put forth was fairly straightforward: the pain of severe depression is quite unimaginable to those who have not suffered it, and it kills in many instances because its anguish can no longer be borne.
…but to the tragic legion who are compelled to destroy themselves there should be no more reproof attached than to the victims of terminal cancer.
But never let it be doubted that depression, in its extreme form, is madness. The madness results from an aberrant biochemical process.
What I had begun to discover is that, mysteriously and in ways that are totally remote from normal experience, the gray drizzle of horror induced by depression takes on the quality of physical pain. But it is not an immediately identifiable pain, like that of a broken limb. It may be more accurate to say that despair, owing to some evil trick played upon the sick brain by the inhabiting psyche, comes to resemble the diabolical discomfort of being imprisoned in a fiercely overheated room. And because no breeze stirs this caldron, because there is no escape from this smothering confinement, it is entirely natural that the victim begins to think ceaselessly of oblivion.
In depression this faith in deliverance, in ultimate restoration, is absent. The pain is unrelenting, and what makes the condition intolerable is the foreknowledge that no remedy will come—not in a day, an hour, a month, or a minute. If there is mild relief, one knows that it is only temporary; more pain will follow. It is hopelessness even more than pain that crushes the soul.
There he must, despite the anguish devouring his brain, present a face approximating the one that is associated with ordinary events and companionship. He must try to utter small talk, and be responsive to questions, and knowingly nod and frown and, God help him, even smile. But it is a fierce trial attempting to speak a few simple words.
But the hospital also offers the mild, oddly gratifying trauma of sudden stabilization—a transfer out of the too familiar surroundings of home, where all is anxiety and discord, into an orderly and benign detention where one’s only duty is to try to get well. For me the real healers were seclusion and time.
Most people in the grip of depression at its ghastliest are, for whatever reason, in a state of unrealistic hopelessness, torn by exaggerated ills and fatal threats that bear no resemblance to actuality. It may require on the part of friends, lovers, family, admirers, an almost religious devotion to persuade the sufferers of life’s worth, which is so often in conflict with a sense of their own worthlessness, but such devotion has prevented countless suicides.