What is Depression? (In three paragraphs)

I make the joke about the three paragraphs because many millions of pages have been written, and similar numbers of "subjects" studied on this still topic. And, while much meaningful information has been discovered, and much solace is to be found in the art created by those suffering, depression for me remains elusive.

As a medical psychotherapist with over two decades of experience in intensive mental health care, I try to walk the line every day with my patients. I use "proven" therapies such as cognitive behavioural therapy and mindfulness-based practices; we explore a trauma-based perspectives; we work through writing and other art forms for healing; and, we work on self-care. I also prescribe medication for some, and more often that not, while medication is never the "answer," it often lifts the veil of depression enough for psychotherapeutic endeavours to be more successful.

Patients ask me, "What is it, depression?" I answer ever in a blur of explanations involving physiology, neuroscience, family history, trauma, triggers, and so on. The truth, I admit every time, is that we really don't know. We just don't know. We know enough to often be able to be of some help, but we don't really know.

I do know this: that the ebb and flow of depression in my own life at times feels intolerable. That it is easy to blame ourselves, harder to be still and to keep trying to heal. That I may need to let go of the possibility that I will ever "kick it" completely. That while there are complex neurological underpinnings to depression, what rings most true for me is that it is an oppression of the soul. That truth is often excruciating in the paradox that when one is depressed it is hard to muster self-compassion, and yet that in the end this is the only "magic bullet." And still, that bullet is not one solid form, it is an ever deepening process of vulnerability and terror which often doesn't feel so great, until sometimes it does. Nothing permanent or certain. Not a very impressive "treatment," is it? Well, it's the main thing I'm working on these days. Fumbling through, really. 

Tragically Hip

I stood mesmerized for two and a half hours at the Tragically Hip show last night. Just one of over 20,000 people, leaning over the edge of my front row balcony seat, swaying.

Like many Canadians, I have been somewhat obsessed with Gord Downie's tragic diagnosis of terminal brain cancer, and his radiant light through this tour. It's as if he exposes us to the core of being alive, and while we can't touch it, we reach...so close, so far...ever closer in the yearning.

In the epic "Ahead By A Century," Gord Downie
sings about "illusions of one day casting a golden light." Last night he cast that light, and we were held in it. The power of the twinkling in the stadium was all the more immense against closeness of the dark.

When one is struggling with depression, the veil can lift in moments like this. We can come alive in the places we felt dead. We can twinkle. But we must hold ourselves gently, because these moments are not in fact antidotes to our darkness. They are treasured, powerful moments for potential awakening, but they must be supported by a fuller, more persistent process of healing too. We must be patient. We must be present.

At the end of the concert, singing Grace Too, Gord Downie screamed, "Now!" again and again. "Now! Now! NOW!"

Not "No," but "Now."

That scream is still reverberating inside me.
I am grateful.

*Photo courtesy of Ari Kaplan

Sky

Well it's been three days and the sky still seems to be holding up. The Globe and Mail suggests that some major world events are converging on catastrophe, but still the sky stays up for now. I float heavily through the days, not looking up much, but when I do the sky is still there.

In front of me is a grey, gauzy veil. Things look mostly like the darker, broken parts of themselves. If you have ever faced depression, you know this experience. One can no longer see what is, particularly as it relates to personal perspective.

I am sane. I can work. I can help others. But, I am loathe to help myself. It will shift eventually, but to endeavour to describe what it is now seems a meaningful human effort.

In front of me, but largely beyond my reach, is so much love. Love outward, love inward. My daughters' delicious silliness and seriousness both. My partner's abiding. My father's abiding—the longest history of all. I know. I see. I have gratitude. Just my armour is thick, limits my permeability.

I walk on. I do not settle into the dangerous non-space of self-pity (though I do have my moments). But while depression can be a comforting cocoon, it is also a steely stuckness. The thing is to keep looking up from time to time, to note the sunshine, even if I can't feel it.

Don't Fall On Me

Walk down the cool side of the hot street early this morning, make my way to work. Listen to REM's unthinkably beautiful old song, "Fall On Me." Hum along quietly, aware I am trying to contain the impulse to "lift your arms up to the sky, ask the sky...don't fall on me." If I let myself, I might drop to my knees on the hard pavement, look up and beg the sky....

I have been a fan of REM since their emergence in the early 1980's. My then-boyfriend, later husband, and father of my children introduced me to them before they busted into pop music. My older daughter too is a great fan of their early music. My younger daughter, ever on her own tangent to eternal sunshine, can't stand the band. She is wiser than me—if a song makes her sad, she turns it off.

Me, I'm drawn these days back to a sadness more bitter than ordinary sadness. An ordinary depression, perhaps. Yes, this is the haunting I experienced—starting its way in, ever so insidiously—nine years ago. A haunting that pulled me away from my work and into intensive treatment for a year. A haunting I thought I had conquered, until lately again....

I watch and wait. I turn inward and outward for support. Harder to access inwardly, the wires aren't connecting so well now, especially to self-compassion, the crucial antidote. I turn to blogging again because I want to call out to all those who suffer this curse: Let us gather our collective courage, and endure toward the blessing of the other side of sunset.

If only the sky won't fall on me.