Saturday, October 11, 2014

The Depression Epidemic and Me

This public domain art has nothing to do with depression.
Right now, most news cycles are feverishly reporting on the latest tidbits about ebola virus and enterovirus 68, but did you know that in 2012 16 million Americans had at least one major depressive episode?

A 'depressive episode' is not a sad day or a passing bad mood, but a kick-you-in-the-ass can't get out of bed want to die total shut down that lasts and lasts for weeks and weeks.

Did you know that suicide is the second leading cause of death among people fifteen to twenty-four years of age. In fact, suicide rates in that category have tripled since the 1950s?

Running with this (since I have the stats in front of me), clinical depression is involved in two thirds of all suicides, and rates of both major depression and suicide have been rising in the US for years.

In spite of these facts, the US is rife with misinformation about both major depression and suicide. Both depression and suicide come with significant social stigma attached, and many people are uncomfortable discussing either one.

Worse, the politics surrounding mental health issues and big pharma, as well as popular bloviation and quackery on the internet lead many otherwise well-meaning people to support wrong and damaging ideas. 

One of the worst of these wrong ideas, IMO, is the belief that depression shows a lack of character or spiritual development or dietary knowledge (or, really you can fill in this blank with any damned thing you want and it will fly), and because of whatever, medication is bad. 

If you take meds you will hear that you are taking the easy way out. You are not fully feeling your feelings so you can not release them and heal, some will say. You are a pawn of big pharma, others will opine. You are weak and misinformed. You are being poisoned. 

And so on.

And the worst one of all: "I don't believe in medication."

To which I say, well, we know it exists. Seriously, I can show you some if you don't believe me.

One Size Does Not Fit All

Three days my ass.
Clinical depression comes in many forms and can occur with or without other disorders and/or physical illnesses. PTSD and depression often happen together, as do chronic illnesses and depression, substance abuse and depression, and and all kinds of other vexing problems and depression.

Medication is about as helpful as daily exercise and cognitive behavioral therapy for mild to moderate depression, and most cases of mild to moderate depression resolve eventually, one way or another, no matter what is done or not done.

I don't say this to diminish the suffering of people working through mild to moderate depression, I'm just pointing out what seems to happen according to the research.

But for about 15% of people who struggle with recurring depression, the condition does not improve on its own and the episodes get steadily more severe. Once you've had two major depressive episodes, the likelihood that you can 'heal yourself' by reframing your perceptions or running or whatever are small.

For people unlucky enough to be in that 15%, medication will likely be needed for life, just like insulin for diabetes, or diuretics for high blood pressure.

I happen to be part of that fifteen percent. The last time I went off my medication I ended up in the hospital for ten days.

It wasn't exactly like being at a spa, but it wasn't all shrieking, manacles, and lobotomies either.

I watched a lot of sit coms until I quit saying the wrong the things.

If you ever find yourself in a similar situation, remember these three tips:

1) You are not getting out in three days.

2) Stop asking when you are getting out because they will always say "three days" and you are not getting out in three days. In fact, you are not getting out until you stop asking when you are getting out, so stop that.

3) Eat the food, all of it, because they are writing all this shit down. (See #s 1 & 2).

The Sociology of Depression

Psychology, sociology, and medicine are always in a state of tension.

For instance, depression is at epidemic levels. However, maybe if society wasn't so harsh and fucked up, fewer people would develop depression that needs treatment.

Still, society can't be fixed through criticism and broccoli. Once your physiology has been messed up by constant trauma, it's been messed up and needs attention.

It's kind of like when a truck runs over your leg. You can go on a crusade against crappy truck driving, but you've still got that broken leg. If all the trucks in America apologize and change their ways, the leg still needs attention.

Medicine is like this too. MSF, the organization that is in Africa treating ebola, was once criticized for creating more new diseases by treating old ones. But that's what medicine does. It is always stamping down one bump in the rug just to get on to another.

When you are affected by recurring depression, or any medical/emotional condition, pragmatism works better than philosophy. If something works, keep it. If something doesn't work, move on.

This may sound comically simple-minded, but it does get down to that.

For me, medication, exercise, and a good support system work.

Philosophy, opinions, intellectual insights, and strongly held beliefs are not really helpful.

So I guess what I'm saying here is, if you are one of the many people in the world who "doesn't believe in medication," how nice for you.

But remember, should you ever find yourself in the nuthouse...

You are NOT getting out in three days.

Doesn't matter what you fucking do or don't believe in.

You're welcome.