The teenaged daughter of a good friend was just hospitalized for depression. Yes, depression. Not cancer. Not some runaway infection. Although in my mind, depression is both. A cancer that destroys your life from the inside out and an infection that, if not treated early and well, becomes resistant to the best therapies and turns septic.
I talked about my own depression a bit in an earlier blog. But the situation with my friend’s daughter reminded me again of how differently we respond to a mental illness than a physical illness.
For instance, as this girl was being driven to the hospital, her brother left her a voice mail telling her, basically, to “buck up.” To get her act together and “beat this.” Once the girl was out of immediate danger, her grandmother emailed and said she hoped she could “get her life on track” since she had so much promise.
Um, people. This girl was not out stealing cars, shooting up drugs and failing school. She was caught in what I can tell you from personal experience is a quicksand of apathy and pain into which, unless you are by the miraculous combination of medication and therapy pulled out in time, you keep sinking.
My friend’s daughter is not alone. The inpatient adolescent unit where she stayed for four days had 16 beds–all full. Several of the kids had been there more than once. “Do you know the first thing they say when they meet you?” she asked when I visited. “Hi, my name is ‘Susan.’ How did you try to kill yourself?”
For depression is far more than a bad mood. It’s the second leading cause of death in adolescents (behind accidents), and the eighth leading cause of death overall in this country.
People who are as depressed as my friend’s daughter–as I’ve been in the past–cannot simply “pull it together.” The first step is getting the medication right. Then you’re able to tackle the rest of the work needed to slowly, one step at a time, pull yourself out of the pit.
We also know that major depressive disorder (MDD) is not a personality disorder or malingering. It is a true biochemical disorder in which the neurotransmitters that keep our brains on an even keel get out of whack. That’s the same thing, by the way, that happens with diabetes or hyperthyroidism. Get the medication right for those diseases and wow! The symptoms disappear and you feel great.
The same is true of depression. As soon as my friend’s daughter’s meds were adjusted, she was transformed from a sullen, angry, uncommunicative child who cut herself and heard voices telling her to kill herself into the energetic, smiling, focused teenager of old. For when the meds start working, it really is like flipping a switch.
During my first major depressive episode, I broke up with my fiance (kicked him out, actually), convinced that it would make me feel better (for the record, he’d been nothing less than perfect. There was no reason to break up with him other than my own disordered thinking). As I continued to spiral down, my therapist recommended a new drug — Prozac. I started on Prozac in early December. And our anniversary is January 11. That’s how much better I felt (and I’m happy to report we just celebrated our 22nd anniversary).
Medication can’t cure depression and, on its own, it can’t prevent a recurrence, just as medication alone won’t “cure” diabetes or even prevent complications. You have to treat the disease holistically, with therapy, exercise, rest, and recognizing, managing and avoiding situations that can trigger a relapse, just as people with diabetes need to manage their diet and weight to avoid a hypo- or hyperglycemic episode.
So please, the next time someone you know is dealing with depression don’t tell them to get their act together or highlight the fact that they have a wonderful life and thus nothing to be depressed about. We know that there is no specific “reason” for the depression. That makes us feel guilty and increases the self-loathing that is the hallmark of MDD.
Instead, talk to them, let them share how they feel, and recognize you can’t “fix” it. But you can listen without judging. If more of us did that, maybe someday we’d be able to eliminate the stigma that keeps most of us from sharing our stories, and which contributes to the misinformation and misunderstanding that remains a part of this and other mental illnesses.