I feel certain that I am going mad again. I feel I can’t go through another of those terrible times. That I shall not recover this time. I begin to hear voices, and I can’t concentrate. So, I start doing what seems like the best thing to do. I start writing, again, for the zillionth time without really knowing if what I’m writing will ever see the light of day or be read by another soul. I can’t even write properly. The coherency of my thoughts is the least of my problems. In that state, I am least concerned with the aesthetics.
It feels like I’m asleep; but just enough to know that I don’t want to be disturbed. I don’t want to wake up. I am having a much better time asleep. It is almost like a reverse nightmare, like when you wake up from a nightmare, you’re so relieved. But in this moment, I am afraid I will wake up into a nightmare.
I feel a little lost in that sensation. Like I am out in the woods. And when you’re lost in the woods, it sometimes takes you a while to realize that you are lost. For the longest time, you can convince yourself that you’ve just wandered off the path, that you’ll find your way back to the trailhead any moment. Then night falls again and again, and you still have no idea where you are, and it’s time to admit that you have bewildered yourself so far off the path that you don’t even know from which direction the sun rises anymore.
You wander in there too long you start feeling a sense of heightened self-consciousness, apartness, an inability to join in, physical shame and self-loathing and you start thinking; maybe this is not all that bad. These devils have now become your angels. Without them you would never have disappeared into language, literature, philosophy, the mind, laughter and all the mad intensities that made and unmade you.
You become the guy who gets lost in space, the philosopher who is always disappearing, forever fading away and receding farther and farther into the background. You become more and more aware that someday you will suddenly leave; for good this time, but the artificial warmth of your smile, that phony, clownish curve, the kind you see on miserably sad people and villains in Disney movies, will remain behind as an ironic remnant. You are the guy people see in the photographs from some hike party someplace or some road trip in the middle of nowhere, the one who will in fact soon be gone. You feel you will soon be erased from history, like a traitor in the Soviet Union because with every day that goes by, you feel yourself becoming more and more distant and invisible.
You attend funerals of loved ones but don’t want your picture taken because you are sure you are going to cry. You don’t know why, but you know that if anybody spoke to you or looked at you too closely the tears would fly out of your eyes and the sobs would fly out of your throat and you’d cry for a week. You could feel the tears brimming and sloshing in you like water in a glass that is unsteady and too full.
Your friends no longer understand you. They don’t understand how desperate you are to have someone say, they love you and they support you just the way you are because you’re wonderful just the way you are. They don’t understand that you can’t remember anyone ever saying that to you. They don’t understand how subliminally demanding and difficult you are to your friends because you want to crumble and fall apart before them so that they will love you even though you are no fun, lying in bed, crying all the time, not moving.
At heart, you have always been a coper, you’ve mostly been able to walk around with your wounds safely hidden, and you’ve always stored up your deep depressive episodes for weeks even when there was time to have an abbreviated version of a complete breakdown. A brilliant excusable moment to throw shitloads of ‘FUCK YOUs’ into people’s faces. But in the end, you don’t.
You get up and on with it, crying. But not the usual. This is the worst kind of crying. Not the kind everyone can see; the wailing on street corners, the rolling on the ground and the tearing of clothes and putting on sack-cloths and rubbing ash on your face. No, the worst kind happens when your soul weeps and no matter what you do, there is no way to comfort it. A section withers and becomes a scar on the part of your soul that survives. A soul that ends up containing more scar tissue than life.
People are a lot more sympathetic if they can see you hurting, and for the millionth time in your life you wish for measles or smallpox or some other easily understood disease just to make it easier on you and also on them.
You also wish you could understand something else. What music was created for. Being the rational being you are, you do what you do best; you rationalize. If perfume was first created to mask the stench of foul and offensive odors; and spices and bold flavorings created to mask the taste of putrid and rotting meat, it then follows that music was created to drown out the voices of others, or the voices within ourselves. I crack it up; listening to Alec Benjamin’s Let me down slowly. Pleading with the incessant voices in my head to let me down slowly.
Every man has his secret sorrows which the world knows nothing about; and often times we call a man cold when he is only sad. Almost half of us have suffered or will suffer from depression at some point in our lives, but the condition remains badly misunderstood and therefore often poorly treated. At the heart of our collective difficulty with depression is a confusion about what it actually is; and in particular, how it can be distinguished from a state all of us know very well and with which it has a distracting number of similarities, namely sadness. It’s because we unwittingly tend to apply to cases of depression a number of assumptions drawn from, and better suited to, an understanding of sadness that we end up suffering far more than we should.
There are, on the surface, some notable similarities between those who are sad and those who are depressed. Both groups cry; both withdraw from the world; both lock themselves up in the house with ice cream and cry for days; some with booze; both complain of restlessness and a sense of alienation from their normal lives; both complain of an empty feeling inside them. But there is one categorical difference between depression and sadness. The sad person knows what they are sad about; the depressed person doesn’t.
Sad people can, without difficulty, tell us what is troubling them. For instance, my wife of 10 years left me for a Kenyan guy called Kevin. Or I am sad that my grandmother has died. Or that my two girlfriends left me because they realized I was playing them with one another. Or that I lost my job when the Covid-19 pandemic hit. Or that my friends are being unkind to me. And though it might sound strange, this is precisely what the depressed person is not capable of doing. They may be tearful and at a very low ebb, but they can’t conclusively put a finger on what has drained a life of meaning for them: they simply say it has no meaning. They aren’t depressed about this or that as one might be sad about that or this. They are, first and foremost simply depressed.
If you know someone who is depressed, please resolve never to ask them why. Depression isn’t a straight forward response to a bad situation; depression is just like the weather. It is what is. Try to understand the blackness, lethargy, hopelessness and loneliness they are going through. Be there for them when they come through the other side. I know how hard it can be to be a friend to someone who’s depressed, but it is one of the kindest, noblest and best things you will ever do. You would know if you have.
The inability of the depressed person to account concretely for their mood can lay them open to unwarranted charges of faking, malingering or exaggerating. People who begin in a well-meaning search for a solution to a problem can end up frustrated by the lack of progress. When pushed, the depressed person may latch on to rather odd or minor-sounding issues to account for their state: they might complain that there is no point going to work because the earth is due to be absorbed by the sun in 7.5 billion years. Or because scientists have projected a collision between the earth and a huge rock in space in about 200 hundred years to come. Or because Mombasa will be no more in fifty years because it will have been submerged by the ever-rising seas. Or they might insist that life lacks all meaning because they’ve just dropped a glass on the floor and everything is now completely hopeless. Or that they no longer see the point of holding on to their savings because Covid-19 is probably the end of the world and it will wipe us off anyway. I know I have called in sick at my workplace for far much less.
At this stage, one can hear it said that if depression doesn’t have any sensible psychological causes, the problem must be bound up with some kind of imbalance in brain chemistry, which it would be kinder and more effective to treat with pills; an idea of great appeal to the pharmaceutical industry first and foremost, but also to worried families and schools and employers who crave rapid and cost-effective solutions.
But there is another approach to depression which, though slower and more arduous, may be a great deal more effective in the long-term. This stems from insights drawn from psychotherapy, the discipline that has arguably been able to understand depression better than any other. The basic premise of psychotherapy is that the depressed person isn’t depressed, as they suggest, for no reason. There is a reason. There is always a reason.
They are very distressed about something but that something is proving extremely difficult to take on board, and has therefore been pushed into the outer zones of the conscious mind from where it wreaks havoc on the whole person, prompting boundless feelings of nihilism. For the depressed, realizing what they are concretely upset about would be too devastating, so they unconsciously choose to remain dead to everything, as opposed to very distraught about something. Depression is sadness that has forgotten its true causes, forgotten because remembering may generate overwhelming, untenable feelings of pain and loss.
Now, what might these true causes be? Perhaps that we have come to realize that we married the very wrong person. Or that our sexuality isn’t what we once believed. Or that we are furious with a parent for abandoning us or their lack of care in our childhood. Or that your best friend fucked your partner and you just can’t deal with that level of betrayal. Or that our best friend conveniently failed to share an intimate detail of their lives that ultimately affects ours. In order to preserve a fragile sense of peace of mind, one then ‘chooses’; though that may sound more willed than it is in reality, to be depressed rather than to have a realization. We pick unceasing numbness as protection against dreadful insight.
To make things yet more difficult, the depressed person doesn’t typically or consciously feel that they are in fact lacking insight. They are not aware of a gap in their self-understanding. Furthermore, we are nowadays often taught to assume that we are ‘just depressed’, as one might be physically ill; a verdict that can be of appeal as much to the pharmaceutical industry as to certain people close to the patient with an interest in insights remaining buried.
There’s another key difference to note between sadness and depression. Sad people are grief-stricken about something out in the world but they aren’t necessarily sad about themselves, their self-esteem is unaffected by their grief, whereas depressed people will characteristically feel wretched about themselves and be full of self-recrimination, guilt, shame and self-loathing paranoia that may, at tragic extremes, culminate in suicidal thoughts.
For psychotherapy, the origins of these violent moods of self-hatred lie in anger due for, but unable to be directed towards, someone else in this world that has then turned against the sufferer. Wrathful feelings that should have gone outwards, towards a partner who is relentlessly defensive and denies one sex or a parent who humiliated one in childhood, or a girlfriend who cheated, or a crush who turned you down are instead driven back onto the sufferer and starts to attack them. The feeling: ‘so and so has horribly let me down’ turns into a very unpleasant one and in some ways more unbearable than ‘I’m an unworthy and an unbearable wretched piece of crap.’ One starts to think that it is their fault that the other person did what they did. One becomes self-hating as a defense against the risks of hating someone else.
Worth noting in all this is that, in many cases, depression is associated with an apparently opposite mood, a kind of a euphoric state of mind termed mania, hence the term ‘manic-depressive’. The mania in question looks, from a distance, a bit like happiness, just like depression can look like sadness. But in one area in particular, the relationship between mania and happiness is identical to that between depression and sadness. The common element is a disavowed self-knowledge. In mania, one is euphoric, but cannot go into one’s own deep mind and discover its bitter truths. Which explains one of the leading characteristics of manic people: their habit of being in flight from themselves, talking too fast about nothing, over-exercising, working continuously or spending too much all as a form of escapism from a submerged grief, rage and loss.
It is from this kind of diagnosis that a suggested cure emerges. What these people in depression need above all is a chance to arrive at insight or self-knowledge. For this, they will tend to need a hugely supportive and patient listener. They may also, used appropriately, benefit from temporary use of medication to lift their mood just enough so that they can endure a conversation. But the assumption isn’t that brain chemistry is where the problem either begins or ends; the despair is caused by an undigested, unknown and unresolved trauma. Far from needing to be taken through reasons to trust that life is beautiful, depressives must be allowed to feel and to remember specific damage and to be granted a fundamental sense of the legitimacy of their emotions. They need to be allowed to be angry, and for the anger to settle on the right, awkward targets.
The goal in treating depression is to move a sufferer from feeling limitlessly despaired to mourning the loss of something in particular: the end of a marriage, the loss of a job, the hope of one day being loved by one’s estranged father, being stood up on the altar by your fiancé, the end of a long relationship that you were heavily invested in etc. These must always be preferable to allowing loss to contaminate the totality of one’s perspective however agonizing the insight and mourning might be. There are plenty of dreadful things in every life which is why it is absolutely normal to feel sad on a regular basis. But there will always be a sufficient number of things that remain beautiful and hopeful, so long as one has been allowed to understand and know one’s pain and anger and adequately mourn one’s losses.