Black Dog Daze
Yesterday, I received an email from a former work colleague, who I had not heard from for sometime, telling me she had recently “formed a plan to take her own life”, but had luckily been rescued by a mental health crisis team. She had stabilised, but every day was now spent in that state so familiar to people with clinical depression – extreme fatigue leading to day after day in bed, inability to concentrate, constant crying or flighting back tears, inability to feel anything but fear and dread of the future. Total despair.
Only a few days earlier, I exchanged some emails with a dear American musician friend, where our struggles with depression, and those of our artist friends, featured prominently. As my highly talented buddy said:
“it makes me sad to see my musician friends struggle through the days trying to be things they aren’t or don’t want to be in the first place…i don’t know why these wonderful people i know are so trapped being alone.”
But clinical depression is not just the crown of thorns for many artists, it strikes people in all walks of life. And personalities. My former work colleague is outgoing, vivacious, good looking, wonderful company, successful in her career. Who would have guessed she is “clinging to each day by her fingernails”? I went to a talk recently by Andrew Robb, a highly successful Australian politician, who spent most of his life barely able to function in the mornings, due to a particular kind of diurnal depression. In his harrowing description of how he balanced his “public life with his private demons”, he made the observation that he thinks thousands of people with depression become “very good actors” ie despite the constant pain, their coping personas are their key to social acceptance, holding down a job, and general survival.
So I’ve decided to dedicate this blog to depression, because, paradoxically, for the first time in years, I’m actually feeling pretty good. I weaned myself off my last SSRI quarter dose a few days ago. But only after 12 months of anti-depressant treatment, with a few scary experiments to get the right drug and dosage. Only a few months ago, I had been felled once again by the black dog gnawing at my leg, unable to go to work (again), and so in the grip of metaphorical canine jaws, I slipped out of bed and crawled across the bedroom floor, into my bathroom, looking for that jar of sleeping pills I had been prescribed in the US. But I’d run out.
A couple of days later, my doc said “Are you sure you want anti-depressants again? You always seem in such good humor”.
To SSRI or Not To SSRI?
It took me a long time to get to the point of trying seriously to treat myself via a course of anti-depressants. About twelve years ago, when I’d had my first collapse and had to drop out of my office job for the first time, a friend of mine (who has subsequently had his life saved via Effexor), was incredulous that I could “possibly endure” a protracted period of clinical depression without pharmacological treatment.
And now I look back over that collapse, and subsequent ones over the years, I can only offer the observation that when you break your arm, lets say – you go “oh CRAP! OW! look at my useless, dangly arm! Quick, someone get me to a doctor so I can get it bandaged up and stop the pain!.”
But when you break your brain…your brain often doesn’t know its broken. You can go around for years thinking…I just need to change my attitude, think more positive, change my career, cut bread and dairy out of my diet, exercise more, find my spiritual purpose in life, drink less, stop watching television, get therapy, keep a journal, get reiki treatments, believe in myself, be of service to others, stop thinking about myself, focus on my needs more, slow down and embrace yoga and meditation, face my past, let go of my past, keep really busy, eat goji berries, get back to nature, commit to changing the world. All of these things are worth doing, and there are no shortage of people, and courses and causes and therapies that will help you do all these things – usually at a cost. The anti-depression industries in the West – including the ‘New Age’ industries – add up to multi-billion dollar enterprises.
And the pharmaceutical companies that manufacture the new generation of anti-depressants – SSRIs – are also a multi-billion dollar industry in their own right. In Australia, out of a population of about 22 million people, more than 12 million scripts are prescribed every year for depression. Women are more susceptible to depression than men. In the USA, about a quarter of American women between the ages of 45 and 59 are on anti-depressants.
Its these kinds of staggering statistics that makes many in the complementary medicine and ‘anti-psychiatry’ movements legitimately raise the question whether pill based treatments are just one big corporate money making fraud. But this is only partly true. There have indeed been recent much publicised meta-analysis of clinical trials that suggest that taking SSRIs may be just about as effective as taking a placebo for many people diagnosed with depression.
This may well be the case for the majority of people who suffer mild or moderate depression. But for the minority of people with clinical depression – the total nutters ‘crawling across the floor to the medicine cabinet’ or ‘making detailed plans to top oneself’ kind (like my father, who successfully executed his plan when I was 14), modern anti-depressants do help people, they help save lives. I can vouch for that. And the medical research still backs this up.
But even then, it can be a game of Russian roulette. Because (to quote the above linked Time article):
“Overall, the scientific evidence confirms that not all patients respond the same way to antidepressants, and not all antidepressants — even those in the same class — work the same way in any given individual. One drug can, in fact, have profoundly different effects in the same patient at different times in his or her life.”
And thats not to say that Western medical treatments for depression are any more advanced that Western medical treatments for cancer. As someone who has experienced both cancer and clinical depression treatments I can say a) I am very grateful for their assistance in saving my life, thanks b) the side-effects suck.
But just how ‘medical’ is clinical depression?
Clinical depression is just as ‘medical’, ‘biochemical’, ‘physical’ as a broken arm.
Its only because we live in a Western culture that splits the human lived experience into Cartesian ‘mental’ and ‘physical’ realms, that we can even have this debate at all about how much of the agony of depression is “really” spiritual or psychological, or “really” medical. The reality is that, it is often a mixture of both. A kind of a tossed salad of St John of the Cross gnostic knowing, chaffing against prevailing contemporary corporate and social pathology, as documented by Noam Chomsky, fear of being rejected by the larger primate group for ‘not coping/ being a quitter’, the side-effects of illness, pregnancy, being extremely run down; and – if you are a woman – Simone de Beauvoir’s The Second Sex – is just as useful for explaining women’s ‘madness’ now as it was 80 years ago.
To explain the statistics, you can also throw in the hormonal changes that afflict women’s emotional stability. These become acute in our 40s and 50s, and present challenges of spirit and courage that frankly make Hemingways Old Man and The Sea or Melville’s Moby Dick look like Enid Blyton adventures. Not to mention our beauty – the prime currency of our worth throughout recorded history – starting to fade. There is a Homeric Odyssey of the epic female journey yet to be written.
But if we consider the social side of depression, then you have to admire its ability to inspire really catchy tunes.
“I wear black on the outside because black is how I feel on the inside”
One of the many happy memories Gen X’ers can reflect on, is listening to The Smiths as we sobbed ourselves to sleep as teenagers. Thanks to Morrissey on the bedside cassette deck, we soon found our raked breath started to settle down. Morrissey crooned all our youthful self-obsessions and pathos, flinging them out with a loose paisley shirt and making us hear our own thoughts out loud, glistening like splattered vodkas sliding down the club wall:
“And you go and you stand on your own
And you leave on your own
And you go home and you cry and you
Want to die.”
Well, when you put it into words, what you felt wasn’t exactly noble, was it? But Morrissey never mocked – is there such an emotion as “passionate studied indifference?” “Sincere affectation?” This whole category of self-dramatizing depression for Generation Xers at least, had a patron saint in Morrissey, and we were well looked after.
But even then, some of us were drawn to Joy Division most of all. I didn’t realise just how much I listened to Closer until one day I remember looking up from my study books at the kitchen table in my group household in South Brisbane to see hands held towards me, making sawing motions over each wrist. “You listen to this wrist slashing music all the time!” the lesbian lover of one of my flatmates exclaimed, then kind of jumped back in her multicoloured leg tights and laughed nervously.
A projectile from the cosmic trebuchet
And finally, here is the reality of our individual existences. We manifest from nothing. A cosmic trebuchet, possibly manned by an extra out of Monty Python’s Holy Grail movie, hurtles us screaming across our life-spans, and before we can say “WHAT THE F…??”, we’re back to nothing again.
So given conscious human existence is, by its nature, uncertain and frightening, and human culture and organised religion helps us ignore that fact via all manner of ingenious distractions, one interpretation of clinical depression is suddenly not being distracted. It’s like you’ve dared to open your eyes a crack, and you’ve noticed “WHOAAA…!! its completely dark and mysterious out there, and I’m actually spinning through space, lost, like Major Tom…”
But thats just one factor. Clinical depression can encompass a vast range of factors. The first modern European text to try and encompass the vastness of this dark world was Burton’s Anatomy of Melancholy, first published in 1621. Burton manages to explore his topic for a whopping 900 pages, drawing on every extant branch of 17th century knowledge about human emotion – from digestion to the geography of the Americas. Burton declares at the start that he “writes of melancholy by being busy to avoid melancholy”, one of the most succinct description’s of the artist’s calling ever penned.
Despite its antiquity, in many ways Burton’s ‘anatomy’ is no less ‘true’ than the American Psychiatric Association’s controversial Diagnostic and Statistical Manual of Mental Disorders.
In contrast to the DSM, Burton’s tome at least has the benefit of being literary, multi-disciplinary and never loses its sense of humor. It recognises that melancholy is at the root of so much human experience, and that some of us will succumb to the black dog, but others will figure out a way of painting a minstrel mask on it, teaching it a few tap-dancing tricks, and making it pay.
Unemployed at last!
My full-time, office day job with the Victorian Department of Health ended last week.
Here is Exhibit A, a typical day in the life of a gainfully employed office worker:
And here is exhibit B: a typical day in the life of a dissolute, depressed unemployed artist:
Hooray for exhibit B:-)
The Dust Revival Band is booked into a country studio just north of Marysville for a few days in mid-September, we are going to record our new album. It features spoken word narratives from LA based screen writer Dave Gebhard, and a couple of awesome tracks from Pittsburgh based artist Carole Blaze. We intend to release it as a limited edition vinyl with digital downloads. We’ll probably need to secure funds via crowd-sourcing to make the vinyl happen, so I suspect my next blog may well be a marketing/ plea for assistance plug.
Meanwhile, thanks for getting to the bottom of what has turned out to be a much longer rant than I expected. This blog – like my music and the wonderful musicians I have worked with over the years- have helped me pulled through the darkest of times. And every now and then – tendrils of enthusiasm and love have shot back to me out of the digital dark from complete strangers – and these have been the most powerful anti-depressants of all:-)
Many thanks to all the people who have emailed me in response to this blog. Few people’s lives remain untouched by the black dog, but it still feels like an ‘unsafe’ topic to bring up in anything but the most private of conversations. A special thanks to Eric who blogs about office life and has put out some very compassionate advice about how to identify and help people who are depressed in the workplace.