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It's heartbreaking to read this story of secrecy around depression. I'm fortunate to have been part of a culture that tolerates it, kind of the wear-your-weirdness-or-dysfunction-on-your-sleeve kind of artistic Los Angeles crowd. Thank god for that---the cameraderie of not having to pretend is the biggest relief! I forget that not everyone is comfortable with the depression diagnosis. I've had my own for so long....and there's just no shame in it, or really shouldn't be. It's a brain condition, it responds to treatment (but not always--there are combinations of meds and types of specific therapies and every individual is different). But yes there is a shame, still, even for me---there's still the voice in my head that tells me that the happy shiny people I see are better off in their heads than I am in mine. I know this is not true, necessarily, though. Once you get to know people, everyone knows heartbreak in life at some time. Every person has his or her own mystical path, truth, soul conditions, storms and trials. Not everyone knows depression, and that's fortunate for those who don't. Those of us who do should remember the great figures in history who also had this condition, like Abraham Lincoln. Thanks to the author for this piece of bravery.
I doubt there is anybody who hasn't been depressed (or had a headache, for that matter), it's just part of living, when things go sour. But if it becomes chronic, and pervasive, disabling us from relating to others or sustaining a job, action must be taken, beyond a dedicated spouse, so the burden is shared. Trouble is, we men are usually reluctant to admit we have a 'weakness', especially in this 'macho' society of ours, a big disservice to our frail ego and, not least, some underlying natural cause as yet uncovered. waiting too long to be revealed. In addition to a caring professional sorting things out, nowadays we are lucky there may be a'magic pill' just for you, the sufferer, usually with good results.
1
Leave me alone.
Please don't leave me alone.
2
Last July, on a beautiful sunny day in the South, my sweet, funny, brilliant little brother committed suicide. Alone in his home after his wife left him, he stewed for weeks, silently suffering his loss. His work suffered as he used up his personal leave and his vacation time, but his boss agreed to let him work from home for a specified time. Big mistake. With no reason to get out of the house, he barely functioned, doing minimal work - just enough to justify his working from home - but he interacted with no one.
Another brother, living only 15 miles away, called him often to check up on him, but Jake fooled him into believing that he was doing fine. He declined every invitation to dinner, holiday get-togethers, and any other family gathering. He "ghosted" his family and friends.
He chose to end his life that day, suffering silently to the end, without leaving a note, a clue as to why he could not go on. We now know that he had been depressed for some time, and that his wife left him for that reason. We only wish that she had shared that information with the rest of us in time for us to offer our support.
Thank you for sharing your personal struggle and that of your husband. It should be instructive to many dealing with the illness of depression. It is an illness, not a shameful condition, and it is much more prevalent than I ever knew. It could be striking someone in your family, and you might never know until it's too late.
4
Depression is such an albatross, even when the person admits they are depressed. But what about when they chalk it up to, "I'm tired/sick/need a better diet or job..." but don't take care of any of those things because they are too depressed to do it but deny it? And then they refuse all medical interventions? THEN what is a spouse to do? My husband refuses pharmaceuticals as he is "philosophically opposed" and won't see a psychiatrist. Said he would consider taking a "natural" supplement, but hasn't done so, and doesn't really see himself as depressed anyway. He just constantly complains that he is physically sick, can't sleep, has acid reflux, sweating, fatigue etc--all of which are depression and anxiety symptoms, and wants me to massage him and coddle him with, "I'm so sorry honey I'm so sorry honey." When I fail to live up to these standards he will punish me with distance. I am not keeping this secret from anyone but I am sick of talking about my husband and his moods. We have been in marital counseling but the therapist has said he is very difficult to work with because he is so resistant. I still keep dragging him there but it's like he shows up in body but not in mind. I am at my wits' end. I thank God for my friends and social life, but I want a spouse too.
7
Please google my article in Stat News November 20, 2017: Stat News Trupin. I had a three year episode of major depression. Two hospitalizations, a course of ECT and ten psychotropic medications later, I became entirely well thanks to an old and rarely used medicine.
4
May I share a recommendation to those who are trying to cope - just a tiny tool for the toolbox - check out the podcast, The Hilarious World of Depression. It is not minimizing the issue, but does acknowledge that humor is one of many, many tools that can come in handy. John Moe and his guests share their experiences with depression and coping. Best wishes to all.
6
I have a relative who has struggled with anxiety and depression for years. Now she has a degenerative illness that will eventually end her life and she has also hit rock bottom emotionally. What I don't understand is how resistant she is to help and how little self awareness she has about her condition. Telling her she is depressed and needs to make changes does nothing. Begging her to get new meds, see a different therapist, see a specialist instead of a nurse because of her complicated medical situation has gone no where. That is the part about depression I can't wrap my head around.
5
Those buttons that you are pushing, those are the ones that aren't working in the disease of depression. It is hard for you to wrap your head around it because we all interpret other people's mind through knowledge of our own mind. It is as if you lived in a world where all the doorbells worked. You go to your neighbor's house and push their doorbell and they come to the door. Then they stop coming. You can see them moving around and know they are there and alive. They must be angry at you or no longer interested. But actually, the button just doesn't work anymore.
3
I think the view of the mentally ill has swung from one pole of "tortured genius" like Hemingway or Sylvia Plath to "anti-social terrorist" like the mass shooters. Neither pole is helpful in dealing with the daily reality of mental illnesses. I have known intelligent people who write off students with mental illnesses as if due to the mental illnesses, nothing can be expected of the students. Yet there are many successful (in the conventional sense) people who are achieving like Kay Jamison and William Styron and others. Because of the strong stigma surrounding mental illness, many people with mental illnesses hesitate to tell their employers, colleagues, friends, and family about their mental illness, and they also delay dealing with and treating their illness. I have not shared my diagnosis with any of my employers, although my family most definitely knows. The police, clearly, lack a reasonable understanding of mental illness and shoot first talk second in emergency psychiatric situations. The discussion around mental illness needs to be fact-driven and calmly reasoned, rather than this swirling vortex of hysterical fears and admiration.
3
It's swung that way because the National Republican Army wants it to swing that way. Gives the shooter an out. But mass shooters aren't "ill." They are evil.
1
I am living this right now. Mine quit his very good job in early November, and I had to go back to work full-time, and I'm only earning $8/hour. I have a master's in social work and was a clinical therapist for a while (until I burned out). Sometimes SOMETIMES he comes up for air and acknowledges his behavior, but now he's withdrawing again - because he's out of work and isn't exactly job-hunting. It's excruciating. I know and he knows, and only his brother and my family know about it. He won't even answer his mother's calls. He has NO friends. He goes days without getting dressed, and at the start of April it will be two years since I found him in a bathtub full of blood-water while I was in the house. It's frightening, and you're right, the public mental health system is HORRIBLE. sigh.
4
So sorry, Vee. I know what you are going through. I am really sorry. Buy you need to reach out; there must be something in your community to offer you and your husband support.
4
I am glad the writer and her husband have progressed to understand that humans are always as sick as their deepest secrets.
5
Beautiful! Couldn't be more apt.
2
Those of us who are 60 or older can remember a time when the word “cancer” was rarely mentioned in public, or was spoken in a whisper if it was (“she has - voice dropping to almost nothing - cancer, they say”). How much better to be able to talk about it openly, share experiences, medical information, feelings, then to bury it under that weird mask of fear and shame that insisted on maintaining silence. The goal must be to get to the same place with major depression and other mental illnesses, and - as this author suggests - we are slowly getting there. Those of us, like the author and myself, who have experienced major depression themselves or in their family members must lead the way by “coming out” similarly to the way that gay and lesbian folks did or that people who’ve experienced sexual assault have recently started to do. Honest talk doesn’t solve all the problems, but it’s a crucial first step.
19
A very powerful story, and I am so happy he has has improved. I can relate first hand as I have suffered from depression for decades, and have done everything to hide it from my family. Its not something you want to share, I was afraid of the stigma, even from my wife and best friend. Even afraid she may become tired of dealing with me and want to leave. But I learned this was not a helpful behavior. Once I could express myself and my moods to her, I felt supported, and even though she could not completely understand how I felt, a weight was lifted. I do my best to not overburden her, but I do share how I feel on a daily basis. Communication is so critical in a relationship. Sharing this with her helped me, and helped our marriage, as we work through things together. You cannot pretend depression does not exist. Kudos to you for being there over those tough years, and to your husband for opening up to you and being persistent about feeling better.
6
I openly discuss my 55+ years of combatting depression, managed nicely for the last 35 with therapy and medication. I have thus lived a wonderful period of life with an amazingly supportive husband, whom I informed as soon as he became my friend when we met. I have been An advocate of open discussion about depression for all these reasons. People need to understand that we can live an enriching life within depression!
6
The stigma makes it difficult to talk about it. I have been dropping my conditions (depression and anxiety) in conversations for years trying to make it sound as normal as possible and get the support I need. Sharing my struggles as helped me continue my journey; without my support system, I would not be here. It took me years (three or four years) to open up to anyone. It is difficult but necessary.
5
Thank you kindly for your perspective. As a 40-year old male with varying degrees of depression, I often try to conceal my condition from others for the sake of shielding them from what seems an insurmountable obstacle. It's refreshing to hear someone on the other side of the "ledger" call for greater engagement in dealing with an individual's depression.
Thank you so very much for sharing! Sincerely, MK!
4
My brother was expressing vivid suicidal thoughts. He even told me there was a 'working noose' in his basement. I talked to him for weeks, until I finally decided to involve his adult son (23) and daughter (mid-30's), urging them to get help for him. My brother was so angry I'd 'broken his trust' he has since cut me out of his life forever. I'm still glad I did the right thing. What other choice was there?
9
100% the right choice.
3
You did the right thing. Your brother did not. I suspect he blames you because he doesn’t want to take responsibility for his inaction. He is acting defensively and selfishly.
3
@ Marc Groman
It has already been proven that people who are suicidal in general are TOO judgmental when it comes to their own self-image, certainly not lacking self-criticism.
They often became that way because their environment only taught them to hate and judge themselves.
After a certain number of years, the "inner critic" becomes so severe that they constantly suffer in silence. And then they see how that suffering is hurting people they love more than anything else in the world, which makes them hate themselves even more, until they start thinking that the only way to stop hurting those they love, is to disappear forever, by committing suicide.
People who are suicidal are taking way too much responsibility for their actions and inaction. They are the exact opposite of being selfish.
The more people around them can understand and see this, the more they'll be able to help and prevent the worse.
4
My husband developed depression, anxiety and panic attacks over a year ago. I reached out to family and some friends during his most difficult moments. I don’t believe in keeping his disorder a secret but not all people understand and tend to judge. I choose what I say wisely. I hope for the best to all those who are suffering.
7
My husband suffered from both alcoholism and depression. He was in denial about both and interpreted any concerns I had as overreactions and betrayal. I asked him to go to his Dr and get antidepressants, but he refused. I asked him to go to counseling but he never found one he liked. He tried AA from time to time but could not stick with it. I finally called his siblings (who lived out of state) to express my concerns and they were also in denial, and accused me of overreacting and even lying. This hurt me deeply because I had known them for over 30 years and they just flat out refused to believe me. Finally we separated and divorced, and he went to live with his siblings. Only 2 years later he died at 60 of alcohol-related complications, after a few attempts at sobriety. It was such a tragic ending to his life.
Regarding insurance - it typically will not pay for a full 28 day rehab program. Detox and rehab are 2 different things - once he went through detox, the insurance would not pay for more than 2 or 3 days of rehab. Once it stopped paying, he would leave (he did have the funds but he did not want to pay out of pocket). The same was true when our daughter was hospitalized for depression - the insurance would only pay for a few days. This is so short sighted of insurance companies, and of course against good medical protocol.
I guess the bottom line is, even if you speak up, others may not believe you, especially if the patient can pull it together for special events.
6
Feeling alone and helpless in the first days, weeks, and months of navigating a world changed by the mental illness of someone you love is the first bewildering introduction to mental health treatment, U.S.-style. The system is inadequate and is based on societal denial, as the author so painfully captures. One in five of us can expect to encounter this in our lives! If you have money and can pay hundreds of dollars out of pocket for each 45-minute visit to an experienced professional, it is true that an appointment won't be available for weeks. Most psychiatrists and psychologists don't seem to participate with insurance plans, we can assume (charitably) because of low reimbursement rates. God bless the ones who do. You have to be rich to access care this way or happen to live in a locality with adequate services. But think about it: a complication of mental illness, whether ongoing or episodic, is often an inability to work or keep a job, much less do the research to find help and an affordable solution. Because of ignorance and stigma, the suffering is worse than it needs to be. If someone you love needs your support, find your local National Alliance for Mental Illness (NAMI) chapter and take the free Family-to-Family course. You will learn, be empowered to help, and draw strength from fellow advocates fighting for the people we love. Far from being alone, we are everywhere. Thank you for sharing your story, Ms Ali. All the best to you and your husband.
3
I made an appointment for a family member who was depressed. It was covered by insurance, and the appointment was available in a matter of weeks. 8 months is positively ridiculous for a person who was not functioning at all.
Ideally, everyone should have access to medical care, but this story doesn't exactly sell me on the Canadian system.
Words I ran across many years ago: we are born alone, we die alone. The trick is to try not to live that way.
I believe that involves actively opening up to others and letting them into our lives - our imperfect, unhealthy, mentally disturbed, messy, dysfunctional, [and sometimes even absurd or uproariously funny] lives. We MUST let them in. Our world is, in many ways, a broken place and we cut ourselves on the shards - we NEED others to help us stanch the bleeding and bind the wounds!
5
Oh, what a different perspective. Could I please counter the first part of that quote. We certainly are not born alone. Now that I've given birth twice, become a mother twice, I believe there is no closer bond between two humans: physically, physiologically, psychologically. The rest of life is to create as many meaningful connections as the original, first connection, changes. We all grow away from our mother - I see that already with my not-even-3-year-old - so we do need others to help us, nurture us, support us in all the different ways as we age. Yup, even at 3 years old. One thing I hate to agree with is that we can die alone. But I'll use the life in between to avoid that!!
1
Youre one of the lucky ones. My experience has been that if youre not fortunate enough to have the financial resources to help - then there is no help available. We see our loved ones end up homeless or self medicating or worse. There is a complete lack of will to provide services, supportive housing is non existent and the mentally ill just cannot make do on the $800 SSI allots them. Your husband made it out alive. Give thanks. Others including my family member just arent as lucky.
2
My married daughter suffered from depression since she was a teenager. She was hospitalized once for stating she was going to commit suicide. Ten years later, as a young adult, she is again suicidal. I recently found a neuropsychiatrist who was able, finally to correctly diagnose her as bipolar. She is still struggling; medications take months to work and in the meantime, I am struggling to support her return to wellness.
I recently found out that she was so depressed for so long and feeling without hope that she turned to heroin to just get through the day and function as she worked and went to school and took care of her home. Now she has that demon to overcome as well!
Mental illness is as real as the chronic physical illness from which she also suffers. But untreated, or untreatable, it can be more debilitating for the patient and for her family. The state of mental health care in this wealthy country is pathetic and abysmal. Reason and compassion need to be at the forefront of our efforts in mental health care.
5
I can relate. My husband has depression and was referred to a behavioral health office by his PCP. That was in December; the first available appt. was on October of this year. I'm glad it wasn't an emergency or anything. /sarcasm/
15
Right. Well, it used to be called "mental health". Now the insurance companies call it "behavioral health" to imply that those suffering from "behavioral health" issues do so voluntarily. And HR people welcome this change, because it enables them to blame the victim as well.
4
I met my spouse when I was 3 and he was 5. We married when I was 34 and he was 36. We had 22 years together combatting his M.I. He succumbed to it in October, 2010. How confusing, frightening and debilitating it can be when someone you love does not have any love for himself. Huge parcels of shame can weigh down both people, and most does not even belong to them. The 12 steps help me cope with today.
11
This is yet another case of the patriarchy co opting and dominating a field. The vast majority of depression clinical, bi polar and suicides are cis males. The mental health gap, like the wage gap and the war on women's productive rights has been co opted by men to force women out. Suicides as attention seeking ploy to obfuscate from millennia of female oppression by men. Resist sisters.
1
*With arms raised, suggesting peace and genuine curiosity*
I am trying to understand your point re: the patriarchy co-opting and dominating a "field" ... the field in this case, being MDD, BPD, and ultimate suicide. Are men purposely defying historical & societal gender stereotypes to make themselves more susceptible to mental health issues? Without even getting into more specifics on the gender stereotypes and the [ironic] motivation for men to enter the "mental health" field and dominate ... are men purposefully following through on suicides to stack the numbers in their favor? What is their aim? Gendered treatments for mental health? Prioritization? And as it stands with your point re: suicides as attention-seeking; on the surface, I don't disagree. Though the way you've set up your argument, the cis males would be the martyrs, while everyone else that- statistically- fail in their suicide attempt would be the attention-seekers. Which brings my back to the point of martyrdom and "end-goal" of the patriarchy co-opting and dominating the mental health field. Is it a malicious attempt to prioritize healthcare and empathy for cis males? I'm genuinely curious.
Killing yourself in order to maintain the patriarchy seems, if nothing else, counterproductive.
2
Not sure if this was cut off from the last post/reply/comment but:
Also, comparing this to the wage gap and the hijacking of woman's voices in reproductive rights isn't quite fair; the former [2 e.g.s] involve explicit political and systemic corruption perpetuated by males in offices. To suggest the patriarchy [in their theoretical words:] 'are sacrificing their brethren' to gain...
…a statistical advantage in the mental health crises so that may in turn lead to prioritized/streamlined care for those within the patriarchy is rather a simplification of the concept of patriarchy. I would be more than happy to continue this conversation, if interested. Given that it is already so long, I’ll withhold my elaboration on the simplification of “patriarchy” in your comment.
I sincerely appreciate your reading!
Beautiful story of surviving a terrible disease every bit as terrifying as cancer.
8
I have had clinical depression for most of my life. Four close relatives and friends died in March, May, July and August 2014. In April 2015 I had three suicide plans in place and was ready to act on the best one. I suffered a complete breakdown and spent time in a psych hospital. Fortunately my husband never gave up on me, and we agreed to tell our family and friends the truth about my illness. I paid for short-term disability insurance at work. I missed four months of work and did not get one cent from the insurance company. I was getting used to new meds and trying to get better, but I had to make multiple phone calls trying to get paid. Ultimately I went over the agent’s head and asked to speak with a supervisor. She informed me that “mental health cases are different.” So if I had a limb cut off there’d be no problem, but since I didn’t kill myself, this was “different”. I got a lump sum check from them 3 months after I returned to work. So yeah, people with mental illnesses are held to a completely different standard.
19
That was disraceful of the insurer. Mental illness is an "illness" and those suffering have every legal right to full medical care. Insurers put up roadblocks but have to follow laws and protocols of administering medical care.
13
You might have had a legal case under the Mental Health Parity Act, passed about 2010. There are several ongoing class actions challenging insurrers’ refusal to treat mental illness the same as physical illness.
6
In my experience which includedhospitalization.. finding an inadequate psychiatrist was nearly impossible.... and group therapy worked best.. also very hard to come by. Getting help from friends and family members was also nearly impossible. Confrontation is difficult and we need more of it in many cases. Many people o the wrong thing so far as the well being of others even in their spheres. Perhaps we need to discuss disabeling and well as enabeling.
Why did it take eight months for your husband to see a psychiatrist?? Was it your insurer (if in the US) or the under-staffed medical system (if in Canada?).
8
Actually, it it the grossly understaffed mental health system in the US....average wait time up here in Maine to see a psychiatrist runs about that long.
12
From personal experience I can answer that - because most localities have very few psychiatrists, and even fewer that are any good and who can help you. And the good ones are scheduled months and months out until you can get an appointment to see them.
Then there's all the US healthcare system dysfunction to deal with as well.
Eight months is a long time to wait, but I have had friends and family who suffer from depression or other mental health problems who have waited longer, over a year, to get to see a good pyschiatrist.
12
You can wait a long time if you are using insurance. If you pay out of pocket the wait is significantly shorter. Sometimes you really do pay for what you get.
I think you could reduce the stigma by separating the terms "emotional illness" from " mental illness." When someone is depressed or has PTSD, the individual isn't crazy
8
I do understand what you have written. In fact it is very understandable. Still, I'm going to have to side with the folks who lump it all into one mental illness designation. There should not be a stigma towards those who might be deemed "crazy" just because we (the non crazy) don't want to deal with their mental health issues.
Temporary madness befalls ALL. Think black friday shopping. Think road rage.
God help us, but for the grace of LUCK/GOD there go I.
3
Try being alone and depressed. I suffer from major depressive disorder. I’m not married or involved with another adult. My siblings have abandoned me. I am truly alone.
I am on antidepressants that have stopped working. Trying to switch to another one causes major medical issues, at least for me.
I wish I knew of a support system. They either cost too much money which I don’t have. Or they don’t exist.
It is of some comfort to read what others have Witten. My friends know of my struggles but don’t know what to do or don’t want to get involved.
This was a helpful article to read as it gives hope to those we are hope is running thin.
18
Try NAMI - there is bound to be a chapter near you. They offer support for those suffering, in addition to support for friends and family.
13
I also want to suggest that you consider some alternative therapies. I did. I went to a gifted First Nation Shaman here in Seattle who is also an MFCC.
2
I empathize with your situation. I recently went through a similar situation with my husband when he was diagnosed with cancer. He refused to tell anyone about it and as you said, I did not feel I had the right to either. However, I needed support in order to be able to support him. Ultimately he told his family and a few select co-workers right before he had surgery. Balancing the need for support with honoring his right to be as open as he wishes about his health challenge was difficult.
7
I admire your loyalty. I understand where your husband is coming from, but he had zero empathy for the very difficult spot in which he put you. A cancer diagnosis affects the entire family. There is a gross underappreciation of the stress it puts on spouses, children, parents, friends, coworkers, etc. Everyone has a right to get the support they need. I'm glad he finally told a few people, and hope he does well.
1
"Don't tell anyone". Did he really think his parents and close friends didn't notice him crawling into his closet? As someone who has suffered from clinical chronic depression for decades I know what he was feeling, but the idea that no one noticed he slept 18 hours a day is foolish.
Get to a shrink! A MD that can prescribe! 8 month wait? Find another! This is nothing to procrastinate about.
9
Assuming they were in Canada, finding another doctor was not an option. You get who they give you.
This is a very common misapprehension. A Canadian can go to any primary care provider he or she wishes, even across the country if desired and the home province will agree to pick up the tab. We don't have silos of "preferred providers" mandated by some insurance company.
Specialist appointments, on the other hand, are not directly available and one must be referred. This tends to prevent redundant visits, such as to a rheumatologist, neurosurgeon, sports medicine provider, etc. for the same back problem. Gatekeeper family docs tend to know better than the patient who s/he needs to see.
1
It’s possible and important to be supportive while reminding those with problems that they are adversely impacting others. I would have refused to keep secrets, involve everyone, get a therapist without insurance immediately and say “hey! I’m here too and you may be hurting but it’s hurting me”. Sounds like this guy did not get what he needed to course-correct. Sad.
3
I think that this is a really, really hard question to answer if you have not lived this. I don't know you or your experience, but I would ask you to rethink your assertion that you would have "involved everyone" in treating a struggling partner.
I've been where the author's husband was, and my then-partner and I initially struggled with drawing boundaries. But we figured out that it was my responsibility to get help, not his responsibility to save me. We learned to set limits with each other. At no point did he ever try to make a decision for me. This was one of the most important things he did, and it was a critical part of my recovery.
Encouraging your partner to go to therapy, yes. Clearly outlining boundaries for each other, yes. Assuming decision-making authority for your partner -- no, no, no.
1
Prevention is always better than cure. Affective disorders are mostly caused by external factors. In order to build a good defense system, it is absolutely essential to be aware of causes. If things do go out of hand, the medical care is the only logical way. However, recurrence remains a concern if the person has not worked out his or her defense mechanism.
1
I'm not sure it's helpful to say that mental health diseases are caused by "external factors." There are biological causes and biological solutions and downplaying that often delays treatment, to catastrophic effect. That's like saying that because cancer is "caused by external factors" a patient should work on "defense mechanisms" before seeking medical help.
2
I guess the idea is to recognize that once the internal system is tripped, one should not delay seeking out the medical help. However, once recovered, one should develop awareness to the factors that can potentially trip one's internal system and work out a defense plan to avoid getting into the same trap again.
When my brother was diagnosed with a serious blood disorder he didn't want me to tell the rest of our large family. Then I was diagnosed with the same thing. My doc said that the family will be sad that we isn't trust them. That gave me a way to convince my brother to be open. I did the "nurse-splaining" and it lifted a big weight from my brother and brought us closer. Depression is not unusual and keeping quiet is not going to change anything plus more people than you know suffer it. We know that too.
3
Families and patients can find support through NAMI, (National Alliance on Mental Illness) reducing stigma and encouraging advocacy. Thank you for the important statistic about the commonality of illness over the lifespan and the need for dialogue and treatment. Caretakers also need encouragement and care as well as recognition of the ongoing realities. Hope there will be follow up articles on this important topic. Men must not be taught shame where their feelings and vulnerabilities are concerned.
8
She left a little more than 10 years ago. Still married, she asked for separation 5 years later. Then I learned about delusional parasitosis. Advised to bolt, I demurred. Love, honor, obey, that sort of thing. It’s been a tough few years. I know what the author has been through.
3
For anyone interested in depression or suffering with it.......RUN, do not walk to your local Indie movie house for Academy Award Nominated Shorts - Documentaries, Heaven is a Traffic Jam on the 405 (or close to that). It’s about a beautiful soul named Mindy Alper who suffers from depression, anxiety, etc. who is an outstanding artist.....pen and ink and paper mache sculptures that will blow your minds!!! What a loveable and lovely genius!
1
You are a very good person to have stayed with your husband until he got better. I know it must have been hard for you. I recently went through a year long relapse into depression after one of my mood stabilizers was changed. My husband abandoned me after 10 months. He had a PhD from Stanford, yet despite his smarts, he seemed unable or unwilling to understand I was going through an illness that is truly debilitating. He had absolutely no empathy. It was at the 12th month mark and on a new medication when I finally was back to my normal self. But he was long gone by then. For those who have spouses who are clinically depressed, I would say that it CAN get better, you just need to be patient, and please understand your spouse with depression is truly suffering from a disease. Would you abandon someone who came down with cancer or broke a leg and couldn't go out and socialize, or go to the gym, or be peppy? No? Then why would you be so cold-hearted as to abandon someone with a disease that resulted in similar side effects, but was caused by a chemical imbalance in the mind?
11
The truth is that many are abandoned because of physical illnesses or injuries. I myself anticipate my relationship ending in the next year if my partner decides he doesn’t want to be with someone who may be disabled for the rest of her life.
6
If your husband's primary care physician had prescribed an anti-depressant
and referred him to see a psychotherapist, NOT a psychiatrist, his depression may have resolved earlier.
7
This article highlighted for me some of the difficulties if knowing when or how to get a loved one the right help. My sibling has been suffering for the last 6-8 years with mental illness that's led to exceptionally angry and irrational outburts which are pulling our family apart. There has been no therapy of formal diagnosis. Their partner is an enabler who just wants to "keep the peace" in their home (i.e. don't make my sibling mad) and will not support my mother's and my requests to get my sibling help. My mother and I have no real way to get my sibling the help they need.
It is a similar affliction as my father suffered and he ended up pushing his family away. He expressed his regret to me for not getting help and healing himself and his family before he died. He also begged me to get my sibling help, as he saw that they were acting in much the same way he had.
I feel truly helpless in this situation. Reading this article made me feel like my sibling's partner is acting similarly to the wife in the story with the secrecy in dealing with their mental illness. I can only imagine the difficulty this partner has had to handle in their home and, especially, to protect their son. However, I am exceptionally angry that the partner won't step up snd get my sibling into therapy.
I wish there was something I could actually do. I've asked my sibling to get help, but, unfortunately, the partner absorbs their issues and won't press to get them into therapy. Very frustrating.
2
I was open with my history of depression with my graduate students, hoping to show them that it can be treated, and offered to be a contact for support services if anyone needed help themselves or with family. Some students gratefully came to me over several years. I felt I was doing the right thing. Then came comments on the course evaluations, the withdrawal of colleagues, odd times when I was bypassed for administrative posts or awards, a dean commenting that 'people thought I had mental problems' even though I've been healthy and successful in my work for years. I was able to reach top rank, but sidelined, and frankly happy to be so given the culture. I stay silent now and do my own work, and focus on family, including a husband with depression, an adult child with depression and a close brother with bi-polar disorder. There are legitimate but sad reasons people hesitate to come out. I learned others in my department have always kept their illness hidden or who are openly hostile to 'claims' of mental illness by students when they are just lazy. How wonderful it would be if the world could change!
26
My heart goes out to you. No one who has not lived with a loved one with mental illness can imagine how excruciatingly painful it is to watch the other suffer, and to be mostly helpless. Often, too, the person suffering can be difficult to live with, especially when they’re in denial about the illness. Depressed people can be ruthlessly critical of others, and to be the one urging the loved one to get help can cause its own brand of suffering. We need to remove the stigma of mental illness so that all affected can get all the care, support, and love they need.
12
Who is not depressed? Those who totally lack self awareness? I don't know anyone who is reasonably sure they are human beings who are not depressed. Oh sorry, maybe the 1%.
8
Depression as a mental illness is far less common.
It means having lost all interest in everything - even the simplest things like brushing your teeth or eating dinner. You feel totally disconnected from everything, including yourself - feeling of disconnection that increases even more when you try to force yourself to do something.
Things that you've always loved to do and even defined who you are, all of a sudden lost their typical "flavor" making you to want to do them irresistibly. You're constantly fearing that somehow you won't survive this, afraid to move because any move could be one too much, and at the same time, you don't have ANY idea of what's happening, let alone how to do something about it.
What often seems to lie behind is, is an "inner critic" who's on automatic pilot and extremely ferocious/irrational - so violent that the only way for your brain to survive his attacks is to completely shut down and try to no longer feel anything at all.
Every human being has an inner critic, but normally you've learned how to welcome this kind of voice inside your head in such a way that it doesn't take over but simply allows you to be your best possible self. In the case of a depression, however, almost all self-awareness disappears, because that becomes the only way to survive an inner critic who lost all sense of reality.
Being self-aware means first of all realizing why you deserve to live and to be loved. It's doesn't simply mean to criticize yourself, remember?
16
As someone with reasonably severe bipolar disorder, the idea of not informing my family and friends was unfathomable. They aren't able to provide support simply because they have no frame of reference, but trying to hide the effects of my illness and the damage done by 3 suicide attempts would have been impossible.
I'm open about my mental illness and other disabilities; they're like any other chronic illnesses, and giving into the stigma doesn't help myself, or anyone else with these illnesses. I've been passed over for jobs after disclosing it, and I've lost friends, but I'm ultimately glad that I'm being honest with myself and others.
8
I’ve suffered more and less intense depression for almost 30 years. For me, the issue of whether or not to announce any new plunge in mood is complicated by my concern that, if i announce the depressed episode, other people will consider the things that I say or do or don’t say or don’t do as part of the disorder, major depression. I feel the credibility of my experience is suspicious. Generally I am loathe to give someone such a handle on me.
Strangely, perhaps, This is more true for my partner than my sibling. My sibling is not so immediate in my life. My partner, though, a different story.
In short, if I am able to weather it without my partner’s knowledge, so much the better. Many will disagree, not least probably therapists of every stripe!, but it is how I negotiate those dark stretches.
3
I'd tend to think that that's simply a realistic way to deal with it, as unfortunately, today most people don't have any idea about what a depression or a mental illness actually mean.
So yes, at least part of them start to attribute totally false (and often too negative) things to people they know suffer from a mental illness, whereas once you have a mental illness, you need the exact opposite: a supportive environment, understanding that nobody can be DEFINED by an illness, and that having to cope with a mental illness can even help you to mature and discover important things about life that other people don't always discover.
Conclusion: nobody can decide in someone else's place whether it's better to speak up or shut up. So nobody can judge someone else's decision ...
Good luck and take care.
4
I've dealt with depression much of my life and don't tell people. Why? They typically do not understand. This includes friends and family. They can't understand how encompassing the condition is. In the workplace, I had to tell a supervisor - fortunately she was trustworthy and helpful but I was lucky. People don't want to hear about other people's problems, and are quick to assume it's "whining" or "self-pity" or whatever other framework they have. The fact is, people will use this type of thing against you. I wish that were not the case, but it sometimes is. There are good reasons why people do not talk about their depressive episodes. In my case it's not shame, just self-preservation. I talk about it more now because I've come to the conclusion that people with mental illness need to speak out, and I have less to lose professionally.
13
I’m a psych nurse. Stigma is alive and well, services are few and far between, and it takes patience and energy to find the combination of therapy and meds that works for you. Once you find that combination you should consider writing a PAD. Psychiatric Advance Directive. In it you detail what courses of treatments you want should you become unstable again and need to be hospitalized. Then join a support group. Sharing your story helps to heal you, and heal others who hear your story. There will always be a special place in my heart for those who struggle with mental health problems.
17
Dhoppe55 ~
thank you for sharing your thoughts.
I never heard of a PAD; I will do this.
You are a kind, empathetic psych nurse with very helpful advice. Thank you so much.
4
I have to point out as a physician with 35 years of experience, now retired, that by definition a disease is a disordered response stimulus. Contrary to what many lay people believe, diseases are just models that we use as intellectual constructs to try to further our understanding and treat patients. At one time fever was considered a disease and little if anything was known of its cause. In medical school we used to joke that you went to the dermatologist to find out what was wrong with you in Latin . You learn very quickly in practice that many patients with a given disorder do not follow the norms for their disease. the old saying is that, "patients do not read the textbooks." This is our failure not the patients.
Much of what I learned in my training 40 years ago is now considered nonsense. Many common severely disabling neurologic diseases have no clearly definable cause. Mild unhappiness or dissatisfaction with the vicissitudes of life is normal but if you ever see a severely or psychotically depressed patient you will understand that it is no joke.
Let's hope with time our understanding of mental illness becomes clearer and the pathophysiology more apparent.
Just for the record I was a hand and reconstructive surgeon.
9
My friend suffers from severe depression. He stepped forward to share his struggle by writing a book, Russian Roulette (by Martin Magoun). In it he explores the impact of his illness upon his loved ones, and his search for well-being. Yes, it is risky telling the truth, but in doing so he helped many others to seek the care they needed, and the courage to be honest. We know the book was worth the effort when this information is reaching an audience of people who are, for some reason or another, ashamed of an illness that does not deserve a stigma.
2
Severe depression can be contagious. How could it not be? The person you love is withdrawn, suffering, unresponsive or belligerent, and nothing you can do seems to help. The emotional shroud they're wrapped in begins to drift around you, too.
Depression can be "endogenous" (arising within) or "exogenous" (arising in response to external circumstances)--like the depression of a loved one. If the latter doesn't hit a family member who struggles to help in vain, it's a wonder.
7
I have a sister who's supposed to be bipolar and schizophrenic, and yes, I also don't want to tell anybody. I'm afraid that people will start looking at me as if something is totally wrong with our family gene pool and I can become "crazy" at any moment too.
Why the "supposed to be"? As always in today's psychiatry, simply because she calms down and has less horrifying hallucinations when she takes drugs called "anti-bipolar" and "anti-schizophrenic ".
When she was still in the hospital, years ago (today the drugs clearly stabilized her and she's now able to work part-time), I too browsed the internet looking for info.
That's how I discovered that a whopping 17% of today's population has hallucinations. Many of them, however, don't suffer from it at all, and even find it pleasant to hear and see things that nobody else can see and that probably don't even exist, but are simply beautiful, or giving interesting advice etc. So whether hallucinations become a problem or not seems to be depending on your own emotional state: if you're struggling with a lot of negative emotions, they will become extremely negative too, creating a vicious cycle of anxiety and even more horrible hallucinations.
Today she suffers less, but the drugs make her no longer feel any intense emotions, she even has the impression of not being in contact with them anymore. As a consequence, a real conversation isn't possible with her either, so more than ever I have the feeling of having lost my sister...
5
My mother had depression most of my childhood. My parents kept it a secret from me, and from most of their family and friends.
Depression is not like a physical illness you can see; it’s not like a dysfunctional action, like abuse you can experience. They never spoke to me or acknowledged the mental illness.
As a child I heard and saw things that metacommunkcation from my parents said-don’t trust your own senses, feelings, or thoughts because you’re not supposed to know about this.
It’s never a good practice to not communicate, and therefore not get the support, love and attention you need. That goes for the parent, and the child.
21
My family talked openly about my mother's mental illness by shaming her and telling everyone she was crazy
2
@ Rebecca
Exactly, many people don't know how to handle mental illness, don't understand it or ignore what it means, and simply judge people suffering from a mental illness rather than being willing to or able to help.
When you're living in such an environment, it's obvious that you better shut up until you don't need any support from you environment anymore, and can start to use your own knowledge of your illness to start to educate them.
Nobody can decide in your place that the best is to "communicate", once you're mentally ill. So you cannot ever judge someone with a mental illness and who decides to shut up - in many cases, that me even be the best thing to do.
2
You think the stigmatism is bad in the US? Try living in Germany. Here, people are ashamed to see a therapist, let alone a psychiatrist. One friend's mother in Switzerland swore me to secrecy and then told me that his mother was seeing a therapist for mild depression. She drove one hour each way to ensure that she would not run into anyone she knew. I couldn't believe it. This wasn't even a debilitating depression and the shame felt around it was huge. Many people have to go for a "Kur" (Cure) for some weeks (paid!) under the premise of some physical challenge when their real problem is e.g. a depression. Burnout is accepted though, because that means you worked hard. Even after living here for years, I still don't understand it. Why be ashamed to get help when you need it? (And, health insurance would cover it).
18
That Kondor pilot who crashed the plane a few years ago kamikaze-style was in psychiatric treatment in Duesseldorf, wasn't he? Perhaps the stigma in Germany arises from the Nazis having killed anyone and everyone who had mental illness or any other thing wrong as not being suitable to breed their master race.
7
I am of German ancestry (they immigrated to the US in the 19th century) and this stigma predates the Nazis. You're either "normal" or "crazy."
2
~ The stigma and silence surrounding mental illness not only prevents individuals from getting the crucial help they need, ~
~The waiting list to see the psychiatrist was eight months long.~
20
My husband has been depressed for years. As he ages, his symptoms have gotten worse. We have excellent insurance, he has both a psychiatrist and therapist and has had numerous medication trials as well as an unsuccessful course of ECT.
The healthiest decision we made as a couple was about ten years ago, when we decided to "out" him. I refer to his depression with my friends and colleagues the way others talk about their arthritis or diabetes. Keeping this a secret had made a difficult situation exponentially worse. We continue to experience an outpouring of stories from other folks about their or their loved one's psychiatric illness. Keeping that secret was as bad as the illness itself.
38
Men have been taught from an early age to not be emotional. So they suck it up and kill half of their humanity. This leads to feelingless or what is referred to into the jargon as alexithymia. Genetic predisposition or vulnerability may lead to depression if the environment clicks on the genetic array coded for depression. The culturally perfect American family is a traumatogenic sea that nearly guarantees that the vulnerable will become depressed.
14
It's also important to realize that a lot of people are diagnosed with depression when they actually have other conditions. I even met someone whose *cancer* was misdiagnosed as depression for several months.
http://www.science20.com/florilegium/too_many_people_misdiagnosed_depres...
https://www.psychologytoday.com/blog/the-truisms-wellness/201609/4-condi...
6
I also took antidepressants for over a decade before realizing that I actually have PTSD from childhood traumas.
9
Those antidepressants perhaps created some ‘breathing room’ for your mind to put together the more accurate story of PTSD.
Especially when the problem originated with a parent and that parent instills her paranoia and fear into her child. Why shouldn’t the child experience depression as she is too young to understand that ‘it’s not about her.’
Depression often seems the natural result of being blocked from seeing a toxic parent for what she is.
4
Your comments could describe my family exactly. I was the one who suffered from a toxic mother and an absent father. It’s probably more common than we know.
Roxy (see below, from California) put it succinctly. The criticism that depression is not reliably distinguished on medical grounds from sadness or "problems in living" has been suppressed by nearly the entire psychiatric establishment, medical schools, and the media until recent skepticism of “mental illness” as a bona fide illness has resurged through such figures as Johann Hari, Gabor Mate, and Alan Frances. I met a psychiatrist recently who went to Columbia Medical School, one of the most prestigious in the U.S. She told me that she had not once in her entire program heard of Thomas Szasz. This is astonishing and at the same time completely predictable. Ever since the publication of the Myth of Mental Illness in 1961, the psychiatric-industrial complex has struggled to answer the book’s central argument, that mental illness is a metaphor (and could only ever be a metaphor), without any enduring success. As a result, psychiatry is conceptually a mess. Those in Szasz's penumbra are falsely labeled stigmatizers, when in fact it is the psychiatrists who stigmatize through their power to define people as ill, and thus a “patient”, when they are not clearly afflicted with a disease (or the weasel word, “disorder”). I'll believe that depression is a disease when there is uncontroversial proof of the proposition in some universally agreed-upon bodily dysfunction. But then it wouldn’t be a mental illness, but a regular bodily disease.
7
Also Paula J Caplan, They Say We're Crazy, exposes flaws in psychiatry. Steven Hatch's book, Snowball In A Blizzard, strongly criticizes the way psychiatrists diagnose illness.
5
As a psychiatrist for many years I can agree with a part of your assertions, Kansas. The illness metaphor is a 'mess'. And not just in the mental health field. The interaction between a person, their life story, their world, its demands and how they engage with it contributes to their quality of life. When being overweight, years of corn sweetener exposure, continuous ads for tempting foods, and a body's natural response to these and other genetic and historical factors makes blood sugar rise to the point of being dangerous we call it type II diabetes. Is it a disease? Is that different than living a world of competitive pressures since youth, optimizing performance at the expense of sleep and play, traumas of many sorts, dispersing family, social media and the ubiquitous cell phone causing despair and suicide called depression and also a disease? The suffering of Carolyn's husband may not be 'illness' but it is all too real. And hiding, as most seem to want to do in our Western culture, heaps on burden, blocks the conversation that can bring true social change, and isolates people in precisely the way we know is catastrophic to the recovery that such suffering demands. I applaud this article, its author and husband, and the people in the behavioral health field who try to make a difference every day.
8
Some day depression will not be viewed as "mental illness." Instead it will be viewed as an adaptive response to the tumultuous and pernicious world we live in. Think "A Boy and His Dog."
26
Yup.
4
Exactly
1
Thank you for your bravery in writing about deep depression which is often behind closed doors. You opened the door a crack to so much more. My husband never recovered.
17
Re mental health care shortage, read "The Kitchen Shrink".
3
When my son was diagnosed with schizophrenia, and we finally accepted that diagnosis, we didn't tell my siblings, my husband's family, not even our best friends for years. We worried about the stigma he would be labelled with, perhaps that was our denial that this was a serious mental illness he could "pass" as not having. It wasn't until about 20 years later that I found the parents' support group through SARDAA (https://sardaa.org/); at the first phone call I made to the weekly group meeting, I wept. I had no idea I'd been so lonely. My husband had become depressed but I didn't have words for that; when he started to come out of it after about 10 years, I wept then too, and knew I would not be silent any longer. Thank you for your article. I hope it helps others share and become stronger as a result.
41
The etiology of depression is much more complicated than the simplistic idea of a ‘chemical imbalance’. Depression and other affective disorders are not a justification for irresponsibility and bad behavior. Of course, when one is depressed, there are chemical changes in the brain, just as there are chemical changes when one is solving a math problem. So do the brain chemicals ‘cause’ one to become better at math? If your child died and you were not grieving or depressed, most people would - rightly - suspect that there is something wrong with you. But if depression can be caused by an external event, be it loss of a job, a child or a spouse, how can it, then, be claimed that it is a purely physical malfunction, unconnected to individual behavior and environment? Cognitive therapy is reasonably effective in treating many varieties of depression but cognitive therapy will do nothing for cancer or diabetes. So perhaps depressed individuals should take some responsibility for their actions and not expect unconditional support from all and sundry.
2
Depression is defined as a condition NOT caused by an external event, such as a death in the family. It is normal for such an event to make people sad, and possibly unable to carry out their daily responsibilities. They are not ill. People with that condition but without a proportionate cause may be depressed, a mental disease state.
17
Your attitude is symptomatic of the ignorance that causes the stigmatization of mental illness. Blaming the person suffering. Read Andrew Solomon’s book “The Noonday Demon” if you want to learn what depression is about. It will help you locate your compassion.
5
Though it hasn’t been proved why should environment not shape brain chemistry?
If patients needed to wait eight months to see a doctor for a physical condition, it would be viewed as a healthcare crisis.
Unfortunately, many psychopharmacologists and talk therapists do not take insurance. It can takes weeks to find one who does.
24
Thank goodness your husband finally realized that there is no shame in this illness called depression. If he had gotten a diagnosis of diabetes, I'm sure most of the people close to you would have been told, but a mental illness still carries a stigma. Unlike your husband, my husband was a high-functioning depressive most of his adult life and recently went on antidepressants. His illness was getting worse and he wasn't a very happy camper. It's not as if he got a personality transplant, but he's a much more upbeat version of himself. He always had the saving grace of humor and has always been incredibly politically aware and concerned. Now, when the talking heads recount Trump's daily outrage and I turn to him in horror, wanting validation, he smiles and shrugs and says, "Hey! I'm on antidepressants!" I'm glad he can joke and admit to friends and family that he has an illness that may not have a "cure" but certainly can be helped. I wish you and your husband continued health and happiness together. I'm glad you came to realize that you are not alone and are now accepting the help and support that is available all around you. And, as to how you handled it before - if you had known better, you would have done better. That's true for all of us.
17
What a shame that it takes so long to see a psychiatrist, even when one is in crisis. The US is far from alone in failing to treat psychiatric illness seriously. As I understand it the situation is even worse for children. Time and again we fail ourselves, our friends, neighbors, etc.
12
The brain is a miraculous creation. It is a wonder that it works at all. So it is not surprising that it gets ill. What is even more miraculous is that it can heal and even expand in its capabilities in so many ways. Not being an expert, but having studied with some, I believe that depression stems from trauma most of which occur in childhood. Because childhood trauma occurs at a very young age it is difficult to know that it even occurred because as children we think of it as being a normal part of life, it is after all the only thing we know. In later life when we experience depression we may, with appropriate help, get to understand and heal our traumatic wounds. Unwinding the beliefs and behaviors we adopted to cope with our childhood trauma(s) can be a life long process. The best source I have found to understand how trauma affects us is Bessel Van Der Kolk’s book “The Body Keeps the Score”. Another excellent source is NICAMB.com.
15
The stigma is especially alive and well in the military, which is rife with suicides. It is considered a weakness to admit psychological issues as it affects one's career and one's relationship to their unit and chain of command, despite the public pronouncements from the Pentagon about PTSD and depression or whatever. Soldiers know to keep their mouths shut and "suck it up".
As a former VA psychologist, who still does exams for veterans, I can't tell you the number of them whose symptoms started in the military, but remained untreated for months and years, for fear of being found out.
Like sexual assault and harassment in the workplace, which has been in silence too, (and in the military equally) mental illness is kept under the rug. You will not advance in the military, and are likely to be discharged if it comes out.
This culture, as well as military culture, truly have to change, especially when treatment can be effective fairly quickly, and not just give it lip service. And this needs to start at the unit level, and all the way up the chain of command.
21
Post WWII many in a whole generation grew up without even having a clue as to what their 'dads' went through. There was a silent 'pact' in the Pacific and to an extent in Europe as well. There was also a great deal of fuzzy reporting about the 'facts' surrounding the post-war - it was a trauma that unfolded for years.
10
its fall-out s still unfolding...go to any VA hospital and see the Korean, Vietnam and Iraqi sons and daughters of that psychological carnage...we will never recover....
6
My WWII vet dad screamed in his sleep for years. He drank every day no one ever discussed it in our family. Only now am I putting two and two together...15 years after his passing.
2
Sometimes a person who is clically depressed fears what he or she might *not* get from friends and family if they reach out for help. Don’t asume that overflowing empathy and understanding are a given. I have fought with this my entire life. When I fell into a prolonged depression in my 20s, I opened up to my mother about it. She told me to get over it. My fiancé left me. The rest of my family took no interest, and my friends drifted away. Take it from one who has been through it: you don’t want to screw up your courage to reach out for help, only to be rebuffed. It easier to slowly claw your way out of the the pit by yourself than it is to be disbelieved or diminished. So you keep quiet about your demons.
When I experienced another, seemingly endless plummet in my forties, my husband did what he always does when things get bad. He waited for it to go away. He made me lots of tea. We adopted a puppy. Once again, I climbed my way out on my own.
(Later I tried a slew of mood disorder drugs, prescribed off-label for migraine. I could not tolerate any of them.)
Not long ago I told my siblings about my history of clinical depression. None of them were supportive or empathetic, and one even told me that I could not have been depressed because I had gotten through it, and people he knew who were *really* depressed had not been able to. Really? I can’t have been truly depressed because I didn’t off myself?
So, yes, some of us are alone with this.
48
I truly just want to give you a hug right now. Bless your heart and your tenacity for continuing on in such difficult times and sadly with no support. You are a pillar unto yourself and should be commended. Depression is a universal condition, as this narrative and insuing comments so beautifully describe. It is unfortunate that an illness/disease/disorder whatever you want to call it can have such a ‘bad’ rap that we can’t collectively talk about it and ‘out’ it to the point of coming up with understanding, acceptance, and everyday common sense about what to do, how to act, and how to HELP ourselves, our loved ones and even perfect strangers that could use a hand.
5
Having survived major clinical depression twice, I cannot stress enough the importance of finding a psychiatrist who specializes in psychotropic medications along with an empathetic circle of support, most often not your family or friends. I learned my lesson the hard way when my GP just shrugged his shoulders and told me to get over it. You can't just "get over" depression any more than you can cancer or heart disease.
41
No, you don’t just “get over” it, but you can work through it, and work around it. There have been many prolific artists and writers who battled depression. Even Churchill was a depressive. Drugs are not a one-size-fits-all fix for mood disorders. There are other ways to harness the beast, Baxter.
10
There are many prolific artists and writers who died due to their mental illness.
Churchill didn't have the medication options we have today. Maybe he would have opted for medication.
14
Churchill "treated" his depression with alcohol.
3
There is absolutely no shame in depression. I think not telling one's parents and extended family is normal but the person should confide in at least another good friend and enlist the aid of a good therapist. Anti-depressants can be helpful for even 6 months if the person feels hopeless or very sad.
This happened to me after multiple, consecutive miscarriages.
I agree that burdening the wife with this 'secret' ends up isolating both of them.
17
My father hid his secret of depression from me and my siblings while we were kids. I learned about it from my mother many years later when she let slip that their minister had to come to the house several times to persuade my father not to kill himself. Or her revelation that she finally decided to divorce my father because “he just wanted to be alone.” Of course my mother hid the fact that she preferred women for the thirty years of their marriage too. They are both in better places. She’s with her lesbian partner. He’s remarried but has more time alone. What I learned is that the institution of marriage seems to compel people to live lies for years in order to conform and be accepted. I’m grateful that people who choose not to ever marry, including me, are more accepted than they were back in the 50’s and 60’s when both my parents felt pressured to live a heteronormative marital lie in order to be accepted.
34
Check out the FB Group, Community of Single People. You'll find lots of like-minded people there.
3
Don't judge them too harshly...they did the best they could with the skills they had during decades when "how it looked" was all that mattered...I was verrrrrry angry at both my parents for decades until one day I said to myself..."forgive them...they didn't know any better"...dad is dead now and I didn't attend his funeral because I just couldn't put myself through that "how it looked" act, but mom is alive and I do the best I can to see that she is safe, warm and clean...things she never did for us...let that sink-in...
10
Thank you so much for this essay. I struggled with depression and anxiety beginning in early childhood, having inherited the genetic tendency from both sides of my family. I did not begin taking medication until I was in my 30s, when Prozac was introduced as a more effective alternative to the tricyclic antidepressants. Once my depression was treated, I was incredulous that I had been able to function up until that point, including attending graduate school in Clinical Psychology. As a psychologist, my absolute passion is the identification and treatment of biologically-based disorders as early in life as possible. The most significant impediment to my work is the vast amount of misinformation in the media about the evils of medication and the overdiagnosis of mental disorders. The reality is that mood disorders, anxiety, and other conditions are underdiagnosed. Millions of people are suffering unnecessarily, including family members, as this essay depicts so eloquently. It is indeed difficult for men to acknowledge depression, although I see this improving somewhat. Unfortunately, it can take a tragedy such as the suicide of Robin Williams for some men to admit that they need help.
33
I have a similar history: looking back, I think I had my first "depression" as early as four years old, triggered by some losses, but also with a family history, including suicides, and possibly a mother who suffered postpartum depression. While I had enough insight to seek therapy, nothing worked until Prozac - in my 40's. It isn't that I think talk therapy, including cognitive behavioral therapy, is of no use. But understanding didn't make me feel any more alive when in a depressed state.
Thank you for your passion: if we could find ways to successfully stop the onslaught of depression early, people would be more productive and just simply able to experience happiness. It interferes with all of the experiences in young adulthood which shape our entire lives.
9
Thank you for this article. While different circumstances, I share these feelings and the isolating result. My husband’s two children developed serious substance abuse issues in their teens, which have continued into their adulthood. The stigma and shame was overwhelming. He did not feel comfortable sharing this information and the many difficult and heartbreaking situations we experienced — not with family or friends. So, I didn’t share either. In addition, my husband and I work in the same profession so I did not tell anyone at work because I felt it was “his story” to tell. We went to 12 step meetings and individual and couple counseling over the years. But, now over 20 years later, we find ourselves distanced from family and without close couple or individual friends. We had avoided close interaction with others for so long. If I could do it over, I would have talked about things more openly and honestly. Perhaps others will handle differently as a result of this article.
31
Sounds like you made depression really easy for him. Why not?
1
Depression isn't easy for anyone.
14
Easy? What does that mean? Have you ever seen depression up close? If you had, you would not say such a cruel thing. Would you say to someone that they’d made cancer easy for their loved one? Or ALS? Or MS? Why do people not understand that depression is a debilitating illness that affects the entire body, not just the brain, and that it is no more in the power of the sufferer to overcome it through willpower than it would be for someone to will away their cancer.
7
When I first collapsed at work my GP suggested it was work related stress and I took two months recovering. During this time I met the man I would marry. Six years later, and before the end of a long visit to India, he attacked and abused me the worst way possible for the last three nights we were in his Ashram. His guru Amma requested celibacy, truthfulness, kindness, honesty and respect for the dignity of others. After that I insisted on going home and did so, in the face of a savage tantrum which lasted for the two days it took to get a flight.
After a call to my sister threatening suicide, I was quickly referred to an excellent psychiatric hospital. For the 5 weeks there I talked about everything except the rapes because I was too frightened. For the 10 years of excessive drug dispensing and regular visits to hospital to be monitored I was still being treated for bi-polar disorder and was getting fatter and fatter because of the many drugs prescribed.
My narcissistic husband died 6 years ago and it still took me another two years to ask for referral to a woman psychotherapist. Now, because I felt safe I couldn't keep the lid on my anger and shame, yes shame, my therapist couldn't stop me talking. After 2 years of intensive therapy I am not ashamed, guilty, depressed or angry to the core.
When I asked for help it was there. Am off all but one of the drugs, all done under the care of my GP and therapist I am well, content, not depressed and grateful to be alive.
36
I suffered in silence and secrecy through recurrent bouts of depression as a young adult (and, looking back, even as a child). In England, in those days, you just didn't talk about it and help was not easy to find. Finally after heavy-duty therapy and a few years of necessary medications here in the US, the "re-set" happened and I've never had a bad bout again. But "my friend the enemy" sometimes opens one eye when I've been overdoing things or denying a loss, just as a signal to get some support. It's been a long time since I outed myself as someone who suffered from depression. I have never found that choice to be other than positive, and I'm grateful to all the others who said, "Me too," and reached out to me. As a priest, I still take the opportunity to speak openly about it over and over again in public, to encourage others to reach out for the help and support it took me so long to ask for. Shame should never prevent anyone from getting well, but alas, it so often does.
23
Silence can kill. Get help to build a life you were meant to live.
18
Thank you, Carolyn, for sharing, finally, with others of us. On Feb. 1, I hit 81 years . I am a long-retired Lutheran pastor and also was a Licensed
Family Therapist for 40 years. A Stroke has hindered my mind and memory, but I am grateful for your Sharing. Hopefully, you and your Husband are, in that Sharing, helping others who, too commonly also
Take the Lonely Road. Long ago I had a phrase for the aloneness too
commonly lived: "Sometimes the sanest reaction to an insane situation...
in Insanity". I'm honestly Grateful that the Two Of You Are now in a better,
healthier Place. You are finding Others in this World who also Understand
and Empathize with You. Thank You for opening a crucial Door of Life.
18
How can we attack this and mitigate depression and anxiety?
Can anyone suggest methods? I see suggestions about treatment and medication, but what treatments are they referring to? It would e great to have a report on this.
3
It isn't just shame. Many, many employers and HR departments are NOT sympathetic, and the stigma is still very, very real and very tangible - you will NOT be hired if you have any kind of history of mental illness, most anywhere. Our work culture more than tolerates bullying, shaming, tacit or spoken threats unless you're a top level executive or protected by a union. It is worse than ever for ordinary workers. You are free to leave. Period. You have no where to go, if you have an issue such as depression and the need to care for someone like a spouse or parent, and more often than not, YOU will lose your job. After all, the only thing that counts in this country today is the bottom line and your monetized net worth.
41
Very true. My employer gave me the boot (right after giving me a promotion) when they found out what meds I was taking (it was a small company, they controlled the health care and saw everything). As I was escorted out like a common criminal, my co-workers worried that I would come back with a gun. Never mind that I never, ever showed any inkling of violence, let alone made any threats. They were scumbags, but so are a lot of companies when it comes to treating employees they deem "defective" in any way--even if it's a non-mental health illness.
As a side note, that company went out of business about six months after they (illegally) fired me. I was not sad to see those people lose their jobs and I sincerely hope they all had a difficult time finding new jobs because of how they treated me. What goes around comes around.
18
Yes, even now when people are better educated about the realities of depression, the stigma remains.
I am surprised no one in the comments has mentioned the Thomas Eagleton situation. I'm sure that set back people's willingness to "come out" for years.
11
This is yet another reason to separate health care from employment. There was a NYT article about that recently. Wish these writers would talk to each other!
6
Thank you for this article. Clearly, many of us have benefited by these meds, which have saved many of our lives.
I am wary, however, in our exclusive reliance on medications to the exclusion of psychotherapy. Even though the patient described here clearly required pharmacological intervention (or maybe ECT or TMS) the role of psychotherapy in alleviating depression and other disorders has been amply demonstrated, and may have been beneficial.
It may speak to the addictive nature of our society that we often ask “what do I take for that” before, “what can I do about that”. A balance needs to be found, in general and for patients as described here.
9
Shame...it's about shame. Shame is a killer. Be it depression, addiction or other struggles -- what paralyzes us, keeps us from reaching out, getting help - and sometimes what s even at the root of our self hate, is shame. Our society needs to become more compassionate about our vulnerabilities, our differences, and our struggles.
82
My first two bout of depression lasted a few months to a few years during my college years. Medication in the early 60's era and some counseling helped me beat something that was really scary and disruptive. My third bout of depression started at about age 50. I sensed immediately that I had depression again and made an appointment with my great family doctor.
He told me I had chronic depression and would be on medication for the rest of my life. He gave me samples of an antidepressant and told me to come back if it didn't work. I couldn't get used to it, so I went back. He gave me two different antidepressant samples and said if they didn't work, come back again. When the next two samples didn't work either, he referred me to a psychopharmacologist. That physician got me onto the first medicine I had tried for this bout, Prozac, by starting with a very small dose, a fraction of a capsule. Every ten to fifteen years the medication I am taking stops working. I see my family doctor and get a prescription for something else. At 76 I am now long retired from a great career. I could not have kept working if not for antidepressants. Now I have depression for which I take medication, but I am not depressed!
I know they don't work for everyone, but today's medications are much better than those available decades ago. For many people, It takes real persistence to find a physician who will work with you to get a treatment for your problem and to keep following up as needed.
54
For me, the point of this article is how to honor your spouse’s request for secrecy. After our divorce, my ex-husband told me he was gay, that he had just figured it out and wanted to keep it a secret from our children. I agreed. Over time, as I struggled with his news on my own, I found it had a big effect on a teenage son. I was clearly struggling with something, but by honoring my husband’s request, I could not let my son know what was going on. My ex-husband would also not tell our son, fearing it would affect his relationship with him. In the end, by the time our son found out about his father, MY relationship with our son had been changed and still has an affect to this day. I so wish I had found a way to tell my son, he was old enough to understand, but felt that honoring a person’s request for secrecy was more important. I would do it differently today.
46
I've seen the revelation that the divorced father is gay have a significant negative effect on his male teen child. IMO the kids do not need to know about parental sexual preferences until at least after they graduate from highschool.
Everyone at sometime is anxious, and everyone at sometime is depressed!
I always told patients that the time to seek help - and there IS lots available - is when the above begin to interfere with, and intrude on, one's daily life.
It appears to me that, unfortunately, the writer and her spouse waited far, far too long to seek treatment or guidance.
13
If the wait is long to see the psychiatrist, then in the meantime go back to the personal physician often for meds adjustment, get a referral for counseling, find a support group, and don't be afraid to take the sick one to the hospital emergency room for evaluation if things are really bad. Very unfair for a spouse to try to carry this burden all alone.
6
A female friend has been mentioning for more than once that she feels depressed. Her husband doesn’t think much of it, her only one child , a grown daughter doesn’t get along with her . I try to talk about it with her but she brushes me off by saying: I just don’t talk to people if I’m depressed...(including me). I don’t know what to do. She is in her late 60.
11
NAMI, the National Alliance on Mental Illness: find a local chapter wherever you live. There you will always find support if you have a mental illness, or if you are a family member of someone who does. The damage and delays the secrets cause can be prevented or reduced. Call today!
15
Spin the narratives...when said and done, the "help" was a disguise for criminal cruelty.
You know it, I know it, everyone should know it. And they will.
2
Beautifully written.
11
Two things I know I can't fix -- someone's mental health and someone's adduction(s). If that someone is a partner, you must seek help outside your relationship. There is no other way.
20
Brave author! Good job!
14
The request for full privacy regarding depression, alcoholism, cancer, and other diagnoses (each with a special flavor) throws any confidante into a moral and emotional pit. And the physically debilitated patient who insists that only his/her spouse tend to their needs creates an even more overwhelming problem. It is only natural that patients be self-focused and a little oblivious to their caregiver/partner. And it is usually out of love and respect that caregivers and partners want to honor such requests. But illnesses are shared. Frankly, when counseling folks in such circumstances or living through them, I observed that caregivers had the harder trial, mustering the necessary help while also carrying on daily obligations 'as usual'. And total privacy/secrecy usually implies shame which is often unwarranted and needs working through. Caregivers need support which their patients cannot provide. Recall airplane safety instruction: put your own oxygen on first! Otherwise you cannot help the other.
37
Successful Americans think it's a sin to be sad. Call it despair, or call it depression. It's something you have to hide.
Someone who isn't depressed about the state of the world.
There's something wrong with them.
15
You're not getting it. Everyone gets sad some of the time. Depression is a totally different animal - it needs treatment. Admitting that you need help is the first step to getting help, and a professional can help. There is no need to be burdened by depression, but the one who suffers has to be fortunate enough to have someone who cares and sees the problem. Don't try to do this alone.
22
You don't get it. It's not our fault the world is in bad shape.
If you are a sensitive person you will be depressed. If you get drugs to treat it you will be a medicated zombie.
I'd rather be depressed. That's honest.
4
Depression is NOT the same thing as sadness. Most people who are appropriately medicated are not "medicated zombies" but functioning human beings. Ben is correct. You do not get it.
2
It’s odd how depression and other mental illnesses are treated with such a stigma. I guess the individual may feel somewhat responsible, like it’s their fault. In my opinion, mental illness should be treated like any other medical condition. What’s so odd is that, I’m assuming it would have been easier to tell coworkers and family that your husband had a serious disease or something like cancer. In which the family would be very supportive. Depression should really be no different. It requires support from family and coworkers just like any other illness. I do see things changing in regards to this, which is good. But, in truth we probably have a ways to go yet.
23
Coming from a family riddled with mental/emotional malaise, I can say that the only salvation I had was leaving at 17 to go to college far, far away.
I don't know if I was depressed, dysfunctional or diseased, but once I was away from the vortex of emotional chaos, I felt as if I had been re-born. In my dorm room, I found a place for all my "stuff" and I could find it all even in the dark.
The years went by and I felt my face smiling sometimes when the sun shone on it. I could laugh and sometimes even giggle...both very foreign experiences.
Decades later, I can look back on my childhood and I feel sadness and sorrow for all those who suffered around me during the 40s, 50s and even the "liberated" 60s. I went on to experience good and bad relationships (I had never learned the difference), but through it all, I would tell myself to put one foot in front of the other and that I would survive...and I did.
I often lived a solitary existence, while my colleagues and friends asked..."how come you're not with anyone...your smart, handsome and funny". What most didn't know was that I had barely survived the hell of my childhood and was not willing to allow anyone near my life for fear they would set my peace and tranquility on fire.
And one day, much to my surprise, I met someone who was peaceful and tranquil but not for the reasons I had become so. He was this way because he grew up in peace and tranquility. 25 years and going strong...I never stop thanking God...never!
53
I've suffered from depression my whole life, now in remission with a good cocktail of meds. Many years ago, a partner of mine told me that I needed to treat my depression as a chronic illness that I must treat assiduously (like the psoriasis she suffered with), with diet, exercise and therapy. A helpful way to view it, I thought.
And, IMHO, the author 'caught' the disease of depression from her husband by agreeing to keep his secret. Yes it's contagious.... neither person is at fault.
40
My mother-in-law was diagnosed with bipolar disorder in the 1970s. She was so ashamed. When she took her lithium, she was warm, loving, funny...a wonderful woman. When she had to have back surgery, her doctor demanded that she stop all meds prior to surgery. The surgery was successful, but she never took her lithium again. The last few years of her life were a nightmare for her and those who loved her. I remember asking her prior to her surgery if she would look down on a diabetic because their body chemistry wasn’t right. Of course she said no. I tried to get her to see that her imbalance in her body chemistry was similarly nothing to be ashamed of, but I wasn’t able to convince her. I regret that failure to this day. That shame has to be eradicated from our culture.
29
People tend to conflate serious clinical depression with the ordinary sadness all of us sometimes feel, sometimes referred to as being "down in the dumps." Because we can often be cheered up or cajoled out of simple sadness, they mistakenly think seriously depressed people should just be able to shake it off. Serious clinical depression is completely different thing and it is too bad we use similar terms to describe very different conditions
36
Great article.
Depression Anxiety is a cruel, cruel disorder.
Finding treatment in our dysfunctional health care industry is as paralyzing as the disease itself.
The effects on relationships are staggering.
22
My dad was a doctor in a small city. His bipolar disease had to be kept a secret lest he lose patients. Or so went the family line. Maybe back then that may have occurred.
I had some depression in college and beyond, but found it helped to talk to people about it. I learned that the secret made the disease worse.
Now I approach retirement as a family doctor. I was lucky to realize taking care of myself meant exposing part of myself, which made that part less fearful. I wish my dad could have learned that too. He suffered all his life. He would have been better off losing a few patients.
23
Don't beat up on yourself because you think you could have done it better in hindsight. You stuck with him. You supported him the best way you knew how. Some spouses flee. Some react with anger, panic, even contempt that makes the ill spouse regret having even spoken about their depression. You are a good woman.
73
I don't think we should award medals to people for staying and honoring their marriage (or other commitments). Whatever happened to "for better or worse"? Is it considered a Nobel prize-worthy when someone honors what they signed up for? That's part of the stigma about "mental illness"--that the "healthy" spouse is considered a "hero" because they stick with the oh-so-sick spouse. I want to gag whenever I hear about someone being praised for doing what they're supposed to do in the first place.
2
One in five Americans are nuts every year?
I don't believe it. The government slugs who came up with the numbers have an incentive to run the numbers up. Look around you. Are 1 in 5 nuts? No way.
1
Depression is not nuts. You took the time to read this article, how about spending more time understanding mental illness and not reducing it to juvenile terms and then turning it political.
8
I'm confused. Try to look around one more time to see if the number changes. Good luck Pal.
No. Not" nuts". Ill.
Depression is not a government conspiracy, nor is the flu.
Who would be served by inflating the number of people who struggle with mental illness?
Not "government slugs" who receive no benefits from high numbers of suffering citizens.
How does denying its impact make you feel better?
29
Dr. Brad Reedy, author of The Journey of the Heroic Parent, calls anxiety the common cold and shame the cancer of mental health. Shame stunts us emotionally.
Brene Brown, an expert researcher on vulnerability and shame, says shame needs 3 things to grow out of control in our lives: secrecy, silence, and judgment. In order to work through this we must find someone we trust and tell our story. She calls it “shame resilience” and she writes: Name it. Talk about it. Own your story. Tell your story. Story is about worthiness and embracing the imperfections that bring us courage, compassion, and connection.
We must keep talking realistically about our mental health struggles and brain differences in order to destigmatize mental health issues in our society. People will follow your lead if you talk about it without shame and guilt.
And NEVER wait 8 months for a psychiatric appointment. Ask around and get a referral from someone you trust.
30
I am a psychiatrist in central California. There is an incredible shortage
of us here and in almost every state; maybe not in the big cities, but certainly elsewhere. The insurance companies, with their excessive rules and restrictions, are forcing many of us out. Be thankful you are where you are. The wait is at least several months in a lot of places. I take as many new patients as I can but there is still a long wait. It’s another way to take advantage of the shame and stigma.
7
Thank you for writing this. You helped me by doing so.
19
Part of the problem is that depression and alcoholism often go hand in hand, meaning that one has 2 secrets. Keeping these secrets, especially from one's children, is exhausting.
25
That was the case in my house. My husband's depression worsened considerably when his drinking got really out of control. For two years I basically hid him from the kids and made excuses for his absence at family gatherings. Life for me was scary and lonely. Looking back at that period, how scared I was that he might commit suicide or harm the kids while I was working, I can't believe I went through it alone.
At my insistence, he went to rehab, got on medication, went to therapy etc. The depression lifted and he was sober for about 15-16 months before I noticed he was secretly drinking again. I warned him repeatedly during that year and a half that I was not going to be able to do it again, especially as the children were getting older and would certainly start to ask what was wrong with Daddy. But he couldn't resist the alcohol, and was soon skipping therapy and off his meds. We separated almost a year ago, before I would be dragged back down to that dark place together. When I told everyone why we separated, they could not believe it. I guess I had been very good at keeping it all a secret.
I'll never do that again.
39
Silence only perpetuates stigma. Thank you for your honesty. Thank you for putting your story into words.
27
I actually remember when my mother began to manifest chronic depression. I was seven years old. Over the decades she has tried and refused treatment. She "does not like the way it makes her feel." Apparently she accustomed to it and enjoys it. Though we live in the same community I see her maybe once a month. Pre-visits are accompanied with a sense of overwhelming dread and self talk about how to respond to her mean, nasty, wet-blanket ways because, as the author says, people who are depressed cast a pall on everyone and everything. She does not smile. She does not laugh. Every positive is countered with a negative. She does not even try to be happy and she does her best to make sure no one else is either. Right. And how long has she lived this way? Eighty years. Sick indeed. And, as I said, dreadful.
27
Well, you tell us a sad story but I'm impressed with your resilience G.
14
Mainly, it's the stigma attached to depression (mental illness) that makes sharing it so difficult. Especially if your job could be threatened by letting other know....
22
Our feelings, our emotions which guide us are chemical reactions in our brains caused by ductless glands. As we age, their mix of neurotransmitters changes, and that changes us.
Mental conditions are not from weakness but the consequences of chemical imbalances. Mine was restored by medication.
7
Having experienced depression, and then having been successfully treated with medication and psychotherapy, I can tell you that being depressed feels like being a different person in a different universe.
I am thankful to live in a time when treatment is available and I am not dismissed, or worse yet abandoned to end my life as my aunt did at age 26.
I do not take life for granted. Not being depressed is a gift. Getting help is a big hurdle when you feel like there’s no hope, so please don’t dismiss people who are doing their best to heal.
45
Everyone handles illness in the family differently. I am sorry that the author and her husband went through it this way. Sounds like they were very young when it started. Personally I would have disregarded the request to keep it a secret because as a caregiver that is too much to ask, to shoulder alone without telling anyone. Caring for depressed family members is frightening.
16
Thank you for sharing your story. I'm currently on the tail end of a major depressive episode that has lasted 3 years. The first year was the worst because being around people was just too exhausting so agoraphobia set in. Most people simply don't understand what you're going through and you learn not to share because people say things like "snap out of it" and you constantly feel like you're being judged which just makes things worse.
If you're the problem solver you quickly discover that your responsibilities don't end just because you're sick. You try to keep it together and do what you're expected to do but the effort to keep up appearances is just overwhelming.
Your husband is very lucky that he had someone who was there for him and fought to get him help. We need to empower people to get help when they are suffering. Changing the stigma that surrounds mental illness and making it easier to get help would save lives.
If you have someone in your life suffering from depression here is what they need from you; acceptance, compassion, and support. Allow them to set boundaries because they need feel some control. The friend who took me to acupuncture saved my life because antidepressants don't work for everyone. Eventually things will get better but they're going to need support as they start to resume their lives.
If they have a significant other, give that person someone who will listen because that person shoulders most of the burden. This does get better.
15
This is sad because of all the mental sufferings people go through, modern medicine has the most to offer for depression. Much of his unhappiness might have been assuaged with medical help. And you should know depression is quite likely to recur ; perhaps a different approach will make life easier if this should be the case.
2
You are not kidding! Depression is uniquely human (I believe, although I haven't spoken with the many sad looking dogs in the neighborhood), in the sense that we fall into it with the veiled knowledge of it's effects, the withdrawing from any social life, family, even our job and hobbies we used to love. Some adopt an escape into alcohol and/or drugs, others just fade away, emotionally dead while still walking. Personally, it did occur after having to retire early because of kidney failure, and placed on steroids plus, when from being active and productive, one falls into a state of crying uselessness, detached from the joy of living, and where dying or not becomes irrelevant. As you mentioned, it happens often and in all walks of life, and in need of support (of which you enlightened us). But, with help, once we snap out of depression, we start to smile and smell the flowers once again. And life, however short, becomes precious.
8
Nothing is uniquely human.
3
"The waiting list to see the psychiatrist was eight months long."
This confused me until I saw that the author is from Vancouver.
Private psychiatrists are expensive no doubt. Public, walk in services are available in clinics and emergency rooms to varying quality but they are there without an eight month wait.
I want universal single payer care like Canada but is this what we would be in for? Is there a better way?
6
In the suburbs of Washington, with the best health insurance plan money could buy, there was not 1 single psychiatrist who took insurance.
Otherwise, it's $300+ / hour.
15
Actually, in the US in many areas, these waits can also be true. Especially for child or adolescent psychology and psychiatry. The child is in a crisis. The parent is frantic. The waiting list is often a year or more.
5
You may not be familiar with the shortage of psychiatrists in the United States. And in many major metropolitan areas, it is common for mental health providers not to accept insurance. So: right here at home, many of your fellow citizens get both the waiting list and the financial hit. ER services for mental health are catastrophically bad.
7
Courageous. And oh so true. The only up-side of going through something like this, besides getting out from under the shadow of depression, is helping others see that help is available, but the problem must first be named and owned. Thank you.
6
Although I feel like the spirit of this piece is certainly in the right place, I have to admit I'm somewhat confused by it in that I'd like to think the national conversation on depression and mental health would've moved past this by now. This article treats depression like this foreign, alien thing when in reality it's been a well-known mental health issue since, gosh... at least the early 1990s when big pharma and Prozac, in particular, started becoming a thing. Tons and tons of people deal with depression.
I suppose I find it very surprising that in this day and age people are still so afraid to talk about it.
6
You'd be afraid--and with good reason--to talk about any kind of illness--physical or mind based if you knew you could get fired from your job(happens all the time) and/or your social circle would disown you if they knew(also happens all the time). Blame it on a repressed and irrational society that says anyone with an illness is defective.
4
Very well written! Prayers and good wishes to both of you! Hope you are both in a better space! Namaste!
1
So pleased that your story has a happy ending. Mine did not. My partner of 20 years died last month after years of depression and refusing not only psychiatric help but even basic medical help. When his depression turned into emotional and physical abuse against me, I had to leave. He spent the last three years of his life not setting foot outside his apartment or having any interaction with family and friends. The helplessness all of us felt was as overwhelming as his depression. So truly, I am pleased to hear your story and know that it all worked out. I am very happy for you.
14
I would strongly encourage family members and others who love and provide support for individuals struggling with mental illness to seek out your local NAMI affiliate and consider taking the "Family to Family" class. This is a 12 session evidence-based class that provides a tremendous amount of information, support, and skills training. The opportunity to learn and share our stories with others who "get it" is hugely therapeutic, and knowing the facts about mental illness also gives us the tools we need to support our loved ones AND to educate others and reject stigmatizing stereotypes. In my family's personal journey, we have found that sharing our story about our daughter's struggles with severe depression almost invariably elicits a story from others - "oh, my brother has bipolar", or "my mother suffered from depression", etc. We feed ignorance, stigma and shame if we give in to the impulse, as understandable as it may be, to hide and isolate. As others have commented, by letting people in, we bring light and understanding to the realities of mental illness, and more often than not we find community and connection with others. The circle of kindness and compassion expands, and opportunities to improve our very broken mental health system are enhanced.
16
A few unconnected thoughts after reading this piece and comments:
If we were a kinder, more welcoming society, perhaps there would be less loneliness exacerbating depression.
As we've moved from a society interested in broad strokes Time and Life, to obsession with more gossipy reality shows to singular braggy instagram/Facebook pressures, and spending more time isolated either alone or with one partner, we've lost connection to the world and to people in it and it's lonelier.
One commenter mentioned family to family support programs - something like that in every community, or the depression version of Al-Anon, to support family members seems critical.
That's no mention of hormone levels or career counseling or exercise - three big contributors to how people feel about themselves - seems they should be part of evaluating and potentially ameliorating depression symptoms.
Last, feeling useful is so important - making contributions and seeing and feeling your impact on other people, animals and/or our planet seems really important in this time when so many people feel like their jobs are dead ends but they need to stay with them for the paycheck (or extra career counseling if there's no job in the picture - unemployment is a huge trigger). Finding new ways to be with others while serving a purpose, and doing good, is powerful.
I know depression is often chemical - but it seems that good chemicals can help to outweigh, even periodically, depression symptoms.
9
On the flip side of this compelling story, I had very good colleague and friend who was a diagnosed as an alcoholic and depressive. In any event, he sought and received therapy and medication early on, and it seemed, at least initially successful. He returned to work and had a productive life with his family and professionally. Then unaccountably, it all began to slip away from him.
He sought help, his former wife and some therapists urged him to try shock therapy. Finally he did. All the while insisting that he wasn't drinking and had not 'fallen off the wagon' as others were sure he had. But, it seemed to many of those who knew him, too late. His depression 'won' and he took his own life.
In New York State, suicides statutorily require post-mortems.
It turns out he had a Pulmonary embolism, something a CAT scan might have caught.
The take away from this sad story is that a 'notorious' or 'public' diagnosis - and 'medical history' can hurt a patient by blinding doctors and specialists to always being vigilant for alternative or contributing conditions.
When I last saw my friend he complained of a persistent cold (he exhibited signs of one with a cough, inflamed nose, low energy). He looked withdrawn and deoxygenated. His facial skin and nose displayed discoloration and cyanosis. He was sweaty. These are all symptoms that might accompany a heavy drinker or alcoholic on the way down. They are also completely consistent with a pulmonary embolism.
23
Thank you jwp-nyc. Thank you so much--this is what I went through with misdiagnosis(thankfully I didn't die, but I was very much on the verge because of the "treatments" which nearly killed me).
If things don't look good, despite all that psych help, then chances are good there's something else going on which is not psychiatric in nature. Misdiagnosis happens a lot--especially when it comes to psychiatric "diagnosis" often done on the fly--no other medical tests. The patient is rarely believed. Unfortunately, the real diagnosis often comes too late and the patient dies.
2
Norton - I am glad you made it through. Did you get support when you went for your independent diagnostic? Did it come from the doctors or you or your family? Whatever the source, you are lucky. Doctors are human. We are all prisoners of our specialties and in danger of seeing the world through their prism. The old trope of hammers looking for nails. With dentists and psychiatry the danger of a medical disconnect between head and body for some reason is especially high. The NYT's should pay greater attention to it. The AMA, ADA, and other professional advocacy groups unfortunately are conditioned more by fear of malpractice suits, mainly because that's what is used to shake contributions out of them.
1
NAMI (National Alliance on Mental Illness) has many courses and means of support. I took the Family to Family course that is for family memebers (anyone really) with a loved one with mental illness. The course provides resources, education on mental illness, and group sharing and support. So many peopl don't know about NAMI and it can be life saving.
9
The conclusion of this article is particularly well stated. As a clinical counselor who developed major depression that sidelined me from age 45 on, I know very well how isolating major depression and other mental illness can be. Twenty-five years later, I am doing much better, but now my diagnosis is Post Traumatic Stress Disorder with major depression and I am still on medication. At this point, I am 70 and permanently retired. Without the stress of thinking that I "should" be working, I am somewhat healthier, but when the nightmares, a cardinal symptom of PTSD start, I know I need to be careful.
The more we feel a stigma attached to mental illness, the less we are willing to talk about, but in fact, talking about it reduces the stigma. I discovered that some people don't even realize that depression is a mental illness.
These days, in appropriate circumstances, I am open about my two mental illnesses. I encourage others to likewise talk about theirs. We will all be better off.
52
EMDR
3
Thank you.
40
I suffer with chronic depression and am not shy about telling friends and family but it is scary telling new people, (not that big a deal now that I think about it, I don't like meeting people). My point though is that many of the problems we have as a society is a lock of trust of our fellow human beings. We have the "television show" expectations that all should be solved in 30-60 minutes or maybe 2 1/2 hours for the really big stuff. But generally we seem to think everybody is as happy as their facebook page. This applies to other aspects and exacerbates our problems. If we talked openly about sex there would be less harassment, (the idiots would be identified and addressed). Mentally ill people would get treatment before it came to a crisis. Bullied isolated kids could be identified and helped. The world is not perfect but we are quite capable of making it better.
68
Depression is a mood disorder. Calling it mental illness is histrionic. So is writing a column about it over a decade later. This is why Trump won, folks.
10
Lack of empathy is what got us here.
And an inability to consider the relationship between time and change.
86
Depression is a devastating mental illness. It destroys lives and families when it isn't treated successfully. What on EARTH does this illness have to do with the US electing Trump?
134
I would guess that you have never suffered from severe depression. A condition that makes a normal life impossible is an illness, mental or otherwise.
69
Maybe the headline is wrong? Alone? Alone "except for your family and a few close friends." That's not "alone". The suffering was the same - alone or not. Spouses suffer when their partner is ill. Additionally, when a spouse must tentatively enter an apartment "not knowing what will be found" it's time to call 911 and get your loved one to a hospital. That man suffered and I'm glad he's better.
9
Did you see the part where the author honored her husband's request to tell no one? For a time, she was alone.
It's astonishing how often our neighbors are secretly buckling under the weight of invisible burdens. In their place, we might make better choices. Or we might only imagine that we would do so.
76
Yes . . . for a time . . . until she broke her promise. Sometimes one partner’s need to be open about something trumps the other’s wish for privacy? Where to draw the line? By the pledge? Readers should know that confidential help is widely available without having to be shared with your spouse’s friends and family first.
Your flippant advice that she should have called 911 shows how ignorant you are. In most cases hospitals won't even admit a person if he isn't actively suicidal or homicidal or psychotic. The fact that the wife is extremely worried about him is not enough to meet admission criteria in most places. Usually 911 won't even send an ambulance unless the caller says someone is threatening or has attempted suicide. And if you present to the ER with this scenario, you will usually be told to "make an appointment to see someone." In many states the wait to see a psychiatric specialist is months. Literally.
You seem oddly hostile to and critical of the wife who wrote this. I'm not sure why. I applaud her willingness to share her story, and I wish more struggling people had loyal, supportive and steadfast partners like her.
19
I can't wait for the day when people can say "I have depression" just like they say "I have cancer" or "I have diabetes."
95
That's a good analogy, because people used to be ashamed of having those, too, and "cancer" was unmentionable.
11
Totally agree. And then maybe funding for depression treatment would increase commensurately. Though not the focus of the article, it seems pretty clear that health professionals were of limited, if any, help to her husband. That was surely my experience. Having had cancer, kidney failure, and major clinical depression, and survived all, I can say the first 2 were a walk in the park compared to the latter.
6
Wonderful article, thanks for sharing.
28
Not all cultures categorize the complex we call depression as an 'illness'. The term "mental illness" has resonances with "mad," crazy" and just plain "nuts." If you suspect you are going nuts, loony, deranged would you really want others to know?
There are a few other terms that sound just as bad, but actually are suggestive, like 'out to lunch' or 'unglued'. In any society as fast moving as our own, fundamental re-organization of thinking and habits is often a necessity. As our everyday mechanisms devolve and re-organize, as we become unglued, we lose efficiency and focused psychic energy. We go 'out to lunch'. Then, as we move toward a new and more responsive way of thinking and acting, as we regroup, so to speak, our efficiency and focus returns - but we also become more effective than previously. Depression is often self-limited. Therapy can help us move along in the process of regrouping, by providing a safe space to learn and practice new ways of thinking.
Some 'primitive' cultures saw what we call mental illness as a positive sign of visitation by the gods or spirits. There is a wisdom in this, as what we call mental illness is very often a transitional state between mental habits which no longer serve us well and those that do. We would be well to learn from these earlier cultures and invent entirely new and positive vocabularies and support practices for those we now label as "sick". Perhaps instead of hiding their condition we could share it proudly.
7
I agree on the need for some new vocabulary to minimize the stigma. While you are correct that depression can be self-limiting, this is not always the case. When it is not, it is devastating and dangerous. Moreover, the patient is often not in the best position to see that happen. Even watchful and aware loved ones may not be, because it builds gradually. Depending upon the circumstances and person involved, therapy may not be needed for mild depressive episodes. Some people shake off pneumonia without drugs. However , quality therapy and pharmaceuticals should be widely available to all bc once a small limited episode tips over to full blown depression, help is critical. And sometimes that can be avoided if help were more available earlier on.
2
Leonard Walks,
Thank you for your interesting perspective, and I agree that vocabulary shapes social attitudes. I'm skeptical, however, that merely changing vocabulary will remove all stigma from a diagnosis of mental illness, and depression in particular.
In 'western' economies, we are often valued by others primarily for what we can produce, providing an obvious rationale for concealing any potentially disabling condition. We've all seen the alarming statistics on reduced productivity due to major depression. And as others point out, depression seems particularly difficult for those who've never had it to empathize with. For these and other reasons, the right of medical privacy must extend to mental health treatment.
Politics aside, employers have found it cost-effective to offer health care coverage that includes mental and mood conditions. Any publicly-funded health care coverage should do the same.
2
I am at the moment being treated with chemotherapy for lymphoma, which came as quite a shock as I am one of the healthiest people I know. I, however, chose a very different path from the day of my diagnosis, deciding that I would be open and honest about my situation with everyone I knew for two reasons. First, even the scintilla of a rumor spreads with alarming speed, morphing into dire prognosis with often little reality to back it up; I wanted the truth out, and that had to come from me. Second, I didn’t want people shuffling their feet around me, unsure and uneasy about what to say. I hoped that being open and honest would make it comfortable for my friends and everyone else to talk frankly about what was happening to me ... and to see that I could laugh in spite of it.
That honesty has paid off in spades! I have been surrounded by such a loving and caring community from people as far back as kindergarten (I am 70!) to people in my present community whom I don’t even know well. Their constant daily support has enabled me to spend not a single day focusing on myself and my illness but reveling in the kindness of others who are always there for me. On the day of my diagnosis, when I told a friend, the very first thing she said was, “We are all in this together,” and that has been shown to me over and over in the past months.
My advice: Allow people in. The kindness of others has made all the difference on this shared journey and will continue to light my life forever.
141
I, too, chose to tell my high school students and their parents as well as my colleagues my exact diagnosis (Stage 2) and plans for treatment ( complete return to work post surgery) in order to forestall rumor and feel in control of the situation. Having thing in the open led to trust and understanding that helped me cope and recover in relative peace.
2
I totally agree with the premise of this article - the diagnosis should be shared. But as a patient with major depression, you (me) still run the risk of being called "crazy" when you do. Having lymphoma presents different risks than major depression, as it is a different disease with its own particular terrors. But, Sally, you probably didn't risk being labeled as "crazy" and worse, "lazy" when you were open about your disease.
9
A close friend of mine was diagnosed with bipolar disorder, mostly experiencing depression. As she struggled with the illness her friends disappeared, although all knew of her diagnosis. After a short time of mental stability, she was diagnosed with breast cancer. All her friends rallied around, helping with child care, meals, dr appts, etc. Once her cancer treatment was over, and she was back to struggling with mental illness, they all disappeared again. She said she would take a cancer diagnosis a hundred times over a diagnosis of mental illness. I have heard this more from others who have been in a similar situation. Unfortunately, it's not just about honesty.
13
Thank you for this article.
I hope that insurance companies and employers will be more supportive in the future also, it is terribly daunting when you need help but can't afford it and can't afford to miss work.
65
The stigma surrounding mental illness causes so much unnecessary isolation, self-medication/addiction, and it compounds the illness itself. As the parent of a young adult who had her first symptoms of psychosis at age 12, I’ve lived this experience for over a decade. If my daughter had a physical disease, every one would bring dinners. People don’t know what to do when you say your daughter’s in the psych hospital. We still don’t really have parity in insurance coverage either. Stories like Carolyn’s are important for the mainstream media to keep covering.
163
Such an important piece, and applicable not only to depression.
Not communicating with others is burdensome not just for the considerable effort required not to spill the beans, and for the isolation it creates. It's also burdensome because it means hunting down information and solutions from square one.
Talking about a problem increases the possibility of crossing paths with someone who has already been there -- who can share useful knowledge, and put his own experience to good use sparing the next person a steep learning curve.
27
No offense. But, to each their own path. As a NSCLC survivor, I can attest to my relief from not having had my seven year (and counting) journey taken up by having my remaining existence defined by my 'fatal diagnosis' (as my first doctor described it).
I can also attest to the idiocy of our insurance system, which did not support my correctly getting my specific cancer analyzed and genetically assayed using the widest testing information obtainable from my biopsies. Additionally, there was an immediate round of 'counsellors' and would be 'palliative caregivers' I had to inform to 'call me later.' They can be invaluable, but they can also be as constructive as a visitor from the undertaker instead of doctor if they are not wanted. They certainly aren't trained oncologists - they are what they are, working off of the assessment of a pathologist, who works at the mercy of yesterday's 'common knowledge' - disproven by tomorrow's discovery.
Over the years I've read columns in this paper riddled with bromides and palliatives that rankle and challenge me as a survivor to speak up. Today the Times caught in a mood to share publicly opinions you're less likely to hear from someone who choses to fight their own battles to survive privately with the love and support from those I normally chose to share it with who are my immediate friends and family. I do this in the spirit to let others of a similar inclination know that they are also not alone, but need not go 'on FB.'
5
Thank you. Probably of your generation. There was a recent piece by a 35 year old theologian mom whose idea of 'going public' was to write a book on her cancer experience and post about it constantly on her Facebook pages, which is her choice,certainly. But, in "50 shades of Grey" that's tilting toward the extreme shade or white light sides of the spectrum I would say! It's more like "send me and my public disease your 'likes' or if you're part of my small community I may guess you're my enemy.
3
Simon Says,
I think we're actually on the same page. Sharing with immediate family and/or close friends is still sharing -- and may for many (as it is for you) constitute sharing enough.
I'm no fan of FB, so while people may use that if they wish, I certainly wasn't advocating blanket or indiscriminate sharing -- just to the level that may prove helpful.
Mostly, I'm glad you found what works for you, and I wish you continued (I believe this is the term) survivorship.
4
Poignant story that speaks to a major gap in the dialogue about mental health - stigma and the caregiver's experience. Thanks to NYT for publishing this important article. I look forward to more writing from the author.
30
Carolyn: Thank you so much for your beautiful expose. I am a long time child/adolescent psychologist trained in the 70's and have watched my profession move steadily away from client-centered sensitivity and human potential and towards a service delivery model that prides itself on confidentiality and inadvertently I think makes people ashamed of having to access it. I am only now after many years of work beginning to appreciate how many of my young clients have suffered because their parents had to suffer in "confidential" silence. Thank you so much for breaking some of that wall of silence, MH
56
Your description of his reaction to depression was exactly what I experienced with my husband. Unfortunately, mine did not accept his depression. Instead, he blamed everyone in his life. When I finally got him to take antidepressants he became manic - we later discovered he had bipolar disorder and SSRIs can exacerbate the illness. A proper diagnosis is so important but few GPs are trained to do so. He has since spent a month inpatient and now chooses to live alone, rarely venturing out, paranoid and depressed, and still blaming everything outside of himself, despite being on many drugs and seeing top psychiatrists in Boston weekly. The medicine simply hasn't been developed to successfully treat a number of mental illnesses. Much more research is needed.
56
Small comfort, I imagine, but -- this is a beautiful piece of writing. Flawless.
22
Great article about a very real problem. Depression is an illness, and like any other needs to be treated as soon as the individual or the person's closest friends/spouses etc... get a hint that something is amiss. Often the affected person is the one least likely to be able to make that decision. Hopefully this piece will encourage people to seek treatment for their loved ones suffering under this dark and dreary cloud. Treatment works, and, with time heals, the sufferer's deepest hurts.
23
my wife of 55 years just died... actually since she had cancer, she spent the last four years dying ... and i have spent the last four years getting depressed... i notice a lot of similarities to this piece (similar but NOT any where near as intense)
and of course i will not seek help
however, i recognize the symptoms, and so i run around a lot, shopping, going to museums, shows and cleaning, talking to strangers, but not to folks who are important to me ..
i am trying to force myself to meet family members...
Several men that i know (thru church) who have lost wives tell me I am not alone.
38
I am very sorry for your loss. There is an added danger, I think, for those who are grieving and may already be isolated and lonely (due to long years of caregiving and retirement from work). I hope you are able to find ways to be with people on a daily basis, even if you don't talk about sadness, loss, loneliness or depression. I wish you well.
4
Though it was not directed to me, I thank you for your kind and meaningful comment. Somehow the empathy behind it managed to radiate out to me also.
I have noticed your name on other comments and always find what you have to say is reasoned and humane.
2
Carolyn, thank you for sharing your story with such courage. Depression runs in my family. We all struggle with it, some more than others. The struggle is certainly lessened if we can acknowledge that mental illness is just that: an illness that affects us all. As with so many other illnesses, we can take the necessary measures to give ourselves a greater chance to live more effectively and joyously. To do that, we mustn't hide behind a mask and play a role. Unfortunately, there continues to be so much shame involved where mental illness is concerned.
Shame is the ego's defense mechanism. Shame keeps us in denial. Shame prohibits us from being vulnerable and letting others be vulnerable in their own right. Shame inhibits loving connections. Shame thwarts risk-taking and living fully with conscious intention. Shame is often somebody else's value judgment that we unconsciously adopt. Shame keeps us from being whole and aligned with our deepest needs and desires. Shames prevents us from making sound decisions. Shame leaves us in shackles.
Your shameless narrative is a gift. May you and your husband continue to feel all that you're feeling -- both that which is pleasant and unpleasant -- and express your feelings and needs to one another and to the people you care about. It's so heartening to see how you have given meaning to your suffering and how you are using it to enlighten and inspire others. Thank you again. I plan to share your story with several members of my family.
40
Thanks for sharing your heart... again it shouts we MUST remove the STIGMA re mental illness...Simple as that. If your husband had cancer you would share and be surrounded by friends, neighbors, families, pulling you along, cheering you and your husband along. That support in dark times is what we all need. If we all shared our behind the scenes trials, we would all feel much better. Nothing like the fellowship of suffering. It's like a hot cup of tea w/ a friend. Wishing you well.
18
Admitting that your spouse/child/whatever suffers from clinical depression is easy. People will admire your strength/compassion/love. You’re the Hero.
Admitting that you suffer from clinical depression is another game entirely. They question your every decision. If you are upset about something, they assume that you’ve lost control. You’re not as much fun anymore. You’re automatically needy and more trouble for them.
If you work with them, they assume that they will have to “deal” with you eventually. Might even have to find a safe reason to remove you from your job. God forbid the clients find out that they’re working with a mentally unbalanced person! Will you ever find another job if you tell the truth on the application form?
Your husband had very good reasons for not wanting to broadcast his problems. The smaller the community, the more reason to feel the need to hide and the fewer resources available for either of you. It’s a daily problem and doesn’t go away.
30
Her husband's big secret may have been that his brain was inflamed. A recent study was published in the journal Biological Psychiatry (Holmes et al., 2017).
It revealed that essentially people experiencing suicidal thoughts have a certain type of inflammation in their brain. Microglial cells activate as part of the body’s inflammatory response.
The researchers found that these immune cells were more active in depressed people who were also having suicidal thoughts.
The study suggests that neuroinflammation could play an important role in suicidal thoughts and behavior. It may also offer another route to treat this type of depression: through the use of drugs to reduce inflammation.
Dr Peter Talbot, one of the study’s authors, said:
“Our findings are the first results in living depressed patients to suggest that this microglial activation is most prominent in those with suicidal thinking.” (Holmes).
14
Very moving to read. I'm not well educated about depression but have observed there's a wide variation of states that would qualify -- which can make it tough to address. I wonder if the changes that the husband experienced were due to a brain chemistry imbalance -- that made coping difficult on any level the more it went on? The request to keep it secret implies that the husband also saw the condition as a personal failing rather than physiological changes beyond his control. I appreciate how the wife was able to come through and he was able to reach the other shore. The last paragraph was especially powerful and one I will keep.
27
This is how many people in the US (maybe other countries) view people with mental illness: "a personal failing rather than physiological changes beyond his control".
I empathize with you, Carolyn. I've been through this many times (married for 36 years). Depression can come and go, and it is a beast. When we keep it to ourselves, we deprive ourselves of the wisdom that others who have experienced this before can offer. For those of us who have never experienced depression, and think it is just a form of sadness, I direct you to William Styron's magnificent account of his own battle with depression, "Darkness Visible." He described the moment when he first felt the inklings of despair, watching crows fly upwards in a cornfield. I don't have the book with me as I write this, or I would transcribe that passage. It chilled me to the bone and gave me insight into what my husband struggled with--and continues to struggle with to this day.
123
A Great Book... "I have felt the wind from the wings of madness..."
13
Also check out Andrew Solomon's The Noonday Demon. Depression 101.
1
Is there anything more frustrating than people thinking that depression is just like "feeling blue?"
2
An important and timely message well delivered. Thank you for sharing this painful journey, Carolyn.
Until I watched a friend, and her family, suffer in this way many years ago I had no idea what 'depression' actually meant. I've never forgotten.
Proud that you, and your husband, have shared your story. I'm sure it will encourage others.
37
The sadness is that many marriages crash under the weight of a mood disorder.
It's not until they are stable, and with someone else who's side-stepped the entire episode, ugliness and all, that it becomes clearer.
Had the honesty about their depression been brought forward, it may have been helped, and with a better outcome for many.
30
My late husband wanted me (and everyone) to assume he would beat his lung cancer. Also terribly isolating. I was fortunate to find a group therapy group where I could rage and cry; without it, I'm not sure how I would have coped for the 2 1/2 years until his (inevitable) death.
32
Susan - I completely understand having been through the same thing. My husband died last August after a 14 month battle with lung cancer. I thought I had done most of my mourning but found that the depression it brought to me had just really begun while he was still with me. I didn't go to group therapy but did seek help. December was particularly tough with the holidays and our anniversary on the 26th. I never held back with friends and family and, while some people backed away, others were there for me with a lot of support.
Anyone out there living with depression, don't keep it a secret. People are ready to support you. If you're the caregiver, don't be afraid to speak up and get help, too. As with alcoholism, if the alcoholic doesn't want to get help, it doesn't mean that you have to suffer with them. Get the help you need and discover the support and coping mechanisms that are out there.
13
Dear Susan, I write you this as a Stage IV NSCLC survivor, who shared your husband's prognosis was told "to make plans and seek counseling."
With all my sympathy and respect, please accept my condolences, my thanks and respect for your support of your husband's positive attitude and determination to survive.
My response was to learn as much about my cancer as possible, and beat it.
I was fortunate enough to have a comfortable nest egg and supportive family. I elected to keep my condition 'close' and never 'went public.'
This was not out of 'shame' - it was out of a desire to not be defined by my illness or have to sacrifice time (irreplaceable) listening to every stranger's 'cancer story,' however intended.
I spent money (which my Platinum insurance would not support) to receive not one, but three different genetic analyses of my cancer- mutations were found. Instead of passively accepting rounds of general radiation I went for specific immune therapies to the mutations exhibited in the consistent features of the separate assays I had paid to have performed.
I avoided critical months (actually about 18 months) of 'required therapies' - stop gap chemo - and radiation that would not have productively attacked my specific onco-genetic drivers, and likely facilitated its spread. Instead, I have received drugs and therapies that have specifically facilitated by progression free survival.
I am grateful for every day alive with my wife of 50 years.
5
Advise to those without access to your resources and pluck? Good for you by the way and for sharing your input from the other side of this sensitive issue.
NAMI offers a free twelve week Family to Family class where family members of people with mental illness can learn about these diseases and get support from other family members. I co-teach the class for our local chapter and often it is the first place where family members have felt safe enough to open up. Some people drive an hour or more in each direction to attend.
When I took the class myself (before becoming a teacher), it was the first place where I was able to speak openly about my husband’s bipolar disorder - in a confidential environment with others who understood what I was going through. I cried with relief at finally being able to get the support and informations I needed.
I would encourage anyone going through this experience to see if the Family to Family class is offered nearby. It is a lifesaver.
76
NAMI in Rhode Island, my home town, was where I participated as a leader in the Family to Family program. Depression shaped my life beginning when I was 18, in my first year of college, and still does at 91. Over those 73 years so much more has become known about how emotion and thought shape the way we function in our lives and, even more important, the ways in which we can control and/or change them for the better. We, in our bodies, live with THE MOST tangled and knotted web of physiological and psychic threads - and it's alive! Nothing happens that doesn't affect everything. In many of us, very little works well. The one thing it is not, is a personal failure. Choose to deal with it. Choose to hope. Let in all the light, air, love, laughter and experience around you - find it and pull it in. Fight for it. That's my advice - and the sooner you begin, the better.
25
With depression, it’s important to tell the person (unless you, too, have suffered clinical depression) that you don’t understand what he is going through and can’t pretend to. They have to know that you understand that it’s nothing like the kind of normal depression that everyone experiences occasionally. One big difference is that mentally healthy people become depressed for a concrete reason, an event in their lives, that they could point to, whereas clinically depressed people don’t know precisely why—or why others who experienced the same event, if there was one, were not affected similarly.
But you’re there to help.
40
Right. I call that 'situational depression'. A response to an event. With 'systemic' depression (my term) there is nothing - no event that can be pointed to. One day you wake up - the sun is shining and the sky is blue - birds are singing and you only see grey. What happened? Nothing. Even before there was talk of selective serotin uptake inhibitors I knew there was something chemical that should be able to be seen in blood work. What else could it be? How could I be sad in the middle of a lovely summer's day with nothing to do but play?
I remember a valiant but completely uninformed effort on the part of my partner at one of those times, driving me around the countryside in hopes that I would 'cheer up'. Of course it didn't. But Lexapro did.
5
Carolyn,
Thank you for sharing your story. As one whose journey with depression has lasted several years, it deeply resonates with me.
Reading your piece reminded me once again of how amazingly supportive my wife is of me. I continue to be happy that she’s got close friends she can be open with, and receive emotional support.
Glen
49
"Today my husband is no longer depressed." But he could be again one day and be blindsided by it, thinking he had freed himself. It is true that "stigma and silence" are the enemies of healing from depression. However, I will not forget what a professor of psychiatry once said in a lecture I attended that if you have had major depression once, you are likely to have it again. Yes there is a political side to this. Republicans are more likely to expect people to "deal with it", to deny the very existence of "mental illness", to believe that families must find their own resources. Whatever the diagnosis, getting professional support will greatly alleviate suffering. Mental illness treatment must have parity with physical illness. Yes, this administration has set us back in ensuring the rights of those with these kinds of disabilities.
40
Yes there is a political side to this. Republicans are more likely to expect people to "deal with it", to deny the very existence of "mental illness", to believe that families must find their own resources.
----
I am a Democrat in a red state, and I don't believe your premise at all. Repubs just hate spending money, is all.
6
And I am a Republican in a very blue state. Maintaining stigma about mental illness has nothing to do with it. Stop making this about politics.
2
And these days Republicans seem to hate the very idea of compassion.
5
I know how frustrating it can be looking for proper care. But, I am surprised he waited 8 months to get an appointment with a psychiatrist or another prescription for an antidepressant. Did anyone follow-up with his physician after hearing there was an 8 month wait? I realize you were doing all of the work. I don't know where you live, but there are low-cost community mental health care programs. Also, if he was in graduate school, he could have received confidential low cost care or referrals for such care.
In regard to confidentiality, there are circumstances in which it is STILL prudent to be circumspect. Mainly, on the career ladder. Yes, if we all spoke out about it we could help to reduce the stigma. However, in reality there are still workplaces where being "on meds" or going to "a shrink" could hamper a career path. Unfortunately, deciding who you tell or who you don't tell could be like walking a tightrope. In certain situations, it is nobody's business. In others, divulging may be the only avenue in finding effective mental health care.
60
I know it seems surprising that someone would wait eight months to seek professional hep. However, as someone who has been lucky enough to benefit from the very expensive, often “out of network” mental health professionals, it can be trying if you don’t have the correct insurance. I have benefits which cover these services and even still, it’s like pulling teeth to get reimbursement for my care. Add to that being clinically depressed and it’s hardly surprising.
7
Please, around here, in the middle of the prairie, you can wait a month to see an oral surgeon for a tooth that needs removal immediately. So you head to the ER, hoping someone is on-call who can do the extraction. And this is for infections. I can only imagine the wait for mental health services 20 years ago.
3
I see your point as someone living with mental illness and also working in finance. But to perpetuate stigma in the name of prudence and discretion is really to collude with the devil. Ask anyone who has tried desperately and failed to get a loved one into treatment... A society that stigmatizes mental illness is one that implicitly discourages any insight or awareness in a person that he or she is suffering from a disease and needs help.
5
Your husband's depression is not "his" - it is yours too. As you write, his depression had a broad and profound impact on you, especially the inability to share your burden due to the stigma of mental illness.
Stigma shames. The stigma associated with mental illness interferes with our ability to forge open and honest conversations about mental health and suicide prevention. Stigma tears at the fabric of social connectedness and alienate both those who are ill and their loved ones.
Each year there are more than 12 million Americans who consider, plan, or attempt (and do not complete) suicide – persons with lived experience. So long as we view persons with lived experience as different or “other” we remain blind to the truth: suicidal thoughts and behaviors do not happen to others, they happen to us. They happen to our fathers and mothers, sisters and brothers, sons and daughters, spouses and partners, friends and colleagues.
We benefit from talking about mental illness and suicide and not just when there is a crisis when mental illness or suicide is the topic sucking all the air out of the room. We must speak openly, honestly, and shamelessly about mental illness and suicide so that we may save lives and bring hope to those struggling and their family and friends.
29
Wow, Carolyn. I had no idea, seeing you in town at various events what was really going on behind the scenes. I think I've only seen your husband out once during that time, and I am happy for you both that he was finally able to grasp his depression, seek help and get healthy again. It sounds like an enormous weight has been lifted off your shoulders, even though those difficult times still loom in the background.
11
Powerful story Carolyn, and kudos for sharing it. You have inspired me to share a depression that I endured for 10 years and self-medicated rather than tell my family and friends how much I was suffering.
34
So wise.
I wish you both only healing and peace ahead.
23
You were a trooper , loyal and compassionate, but exhausted and demoralized . . . he is fortunate that you were as strong and committed as you are.
Your husband elicited a personal promise from you that was unfair, unwise, and had the risk of making you "complicit" in his deterioration. It robbed you of any possible way to solicit support . It isolated you in a way that mirrored his increasing self isolation.
SO -One lesson for family and friends of people with depression is: do not accept the distorted and usually shrunken boundaries of their world. ( I've lived in that world myself) The partner/ parent/friend needs to be social, exercise, eat well, etc -- because abandoning what they need to sustain themselves will not help. It's like trying to save a drowning person when you can't swim.
IF the identified patient does get treatment, s/he will have need of those supports again, and having a model of healthy normal interaction with the world is a big help. And the caring friend or relative also won't resent the patient so much for the turmoil.
93
What you forget is that the depressed individual will believe you to be disloyal or somehow working against their interests. Unfortunately sometimes the depressed can behave much like the stupid and become cruel to those who seek to assist.
6
I'm sorry you and your husband had to go through this for so long without anyone else knowing. It can be very hard to be open about a mental illness. As Americans we're so conditioned to believe that it's our fault if we're depressed and can't get over it. And sometimes, even when we do reach out to friends they walk away when the depression doesn't dissipate fast enough. I won't go into our "wealth care" system except to say this: if depression were cancer they'd cover it better.
Good luck to you, your husband, and the rest of your family. I hope that you never have to go through this again, alone or with anyone else.
57
Your husband is lucky to have you. I don't know the number, but have often wondered how many people are abandoned by loved ones after being stricken with depression. That's what happened to me. My wife was supportive at first but got tired of "dealing" with me. She could understand why you might not want to go out with friends if you had a broken leg or cancer, but NOT if you were depressed. Take a pill! Pull yourself together! Eventually she kicked me out of our home because I was "dragging her down." And this wasn't because I didn't talk about it. I got into therapy and medication quickly but it took time--lots of time--to work. I had to finish it on my own, and after many nights of thinking about suicide and feeling like the only person in the world, I did finish it. I finished therapy and now live it every day. I am open with my friends about my depression, the stigma, and the healing process. It's very difficult. But it's much harder when you have to do it alone. I know.
255
My ex-husband was diagnosed as bi-polar after we separated. We did break up - at his instigation. He "wanted to be happy" and thought that our relationship was what was making him unhappy. I knew at the time (and told him) that he wasn't unhappy because of me - but he was desperate to blame someone and find an easy fix. After we split, of course, and he only got worse, he realized the truth of what I had said. Too late as I admit I felt tremendously unburdened without having to deal with his depression and anger on a daily basis.
3
I am so glad to hear that you are doing better and hope for your continued recovery. Depression is a terrible illness that runs in my family and I can offer you my most sincere empathy.
I must say that I also empathize with the spouses and family members of those suffering from severe mental illness. It is extremely difficult to live with a person who is, for example, bipolar or depressed when you are not. That is the truth. A few years of patience and empathy may be common, but decades of "hanging in there" probably less so. Although the mind knows that the patient is sick through no fault of his own, it is hard to stay in that clinical mindset when you just want a cooperative/supportive/responsible/functioning spouse, child or parent.
Those of us who have found a family member or friend to stick with us through the highs and very deep lows of depression are truly blessed. It's not easy for us, and it's not easy for them either.
7
Im so sorry that your wife treated you that way. I tend to have bouts of depression in my life. Early in my marriage, when going through an episode, my husband would by sympathetic for maybe a week. But then he would lose patience with my "moping around" and tell me to snap out of it. He was not an emotionally expressive man. Then, when he was in his mid 40's, his father passed away and a few other things going on in his life caused him to have an emotional breakdown. He cried alot and I held him. Years later, he apologized for all the times he made light of my depression and said he never knew what it felt like to be so unhappy in his own skin until he went through it. Im happy that you are healing and hope you continue to do so.
3
This is a fine description of depression. I commend you and wish you and your family the very best.
45
very powerful and moving -- we can feel their pain
7
Being honest is the only path to getting the support you need. But you must also be prepared for hurtful, ignorant responses. When I told my family about my daughter's depression, within a few weeks, the next time I had a disagreement with a sibling, she claimed I was the cause of my child's depression. I was literally in shock that someone who knew what a loving parent I was, as well as loving aunt to her son, would say something so cruel. It was very hard to absorb that in my own weakened emotional state. So it's important to seek supportive care, but recognize, some people will be judgmental and cruel. Phillip Roth has a moment in American Pastoral very much like this, where a man's brother blames him for everything wrong with his daughter, and the man wonders what it is in human nature that in your moment of greatest anguish, would cause someone to be so deliberately cruel. I've contemplated that passage many times. But most of all, I learned to recognize and reach out to people whom I suspect may be dealing with similar issues, and finding great solace and support and inspiration in our shared experiences.
147
---and he has challenged the stigma himself...
He has faced the specious argument "stigma" and gotten past it. It is an argument we ought all reject.
25