On Depression

I’m trying light therapy for the first time. I even like the name of it. Light therapy sounds like it’s both a gentle, milder version of therapy (it’s not that “heavy” therapy where you cry on a sofa in an office somewhere—which I’ve also done before), and it also sounds like a lightbulb battling forth against the darkness. After all, that’s what depression is, really. Darkness. (This is the moment where I realize that I haven’t read William Styron’s Darkness Visible, despite having read quite a bit of Styron, and having met him. Into my Amazon cart it goes.) And darkness is only a part of it. You can’t shake your thoughts, and they circle around you relentlessly like vultures picking apart your heart. So then you can’t quite feel your heart anymore, because the constant vulture tearing eventually anesthetizes some of you (but not all of you), and you’re tired and sluggish and inertia/vultures drag you along down the road, and there’s nothing you can do, oh god.

We don’t know a lot about depression. We know what it feels like, but we don’t know why it feels that way. We do know that some neurotransmitters appear to be out of balance when depression occurs. But we don’t know if the imbalance causes depression, or if depression causes the imbalance. It’s a pretty important distinction because either way could lead to different treatment options. We also know now that many of those neurotransmitters are actually in our guts. Which is really strange, because that means that most antidepressants aren’t all that effective in the ways they were thought to be effective. So how they work remains rather mysterious. Much like depression itself.

Antidepressants never worked for me. But that’s partly because my depression (and maybe that should be plural, because I don’t ever feel like I get the exact same depression twice) is only one of hundreds of types of depression. We talk about depression like there’s one type of depression, but I’m not sure that’s true. And I don’t mean there are multiple types of depression like mild or severe or clinical. Those are grades of depression, not types. I mean there are types of depression like trauma depression, anxiety depression, fear depression, sad depression (like grief you can’t seem to escape), happy depression (like you’ll never reach that peak of joy ever again), resigned depression. And there’s circumstantial depressions, too. Mid-life depression. Post-collegiate depression. Job search depression. Illness depression. Seasonal depression. Age depression. And there’s relational depression. Family depression. Friend depression. Partner depression. Lonely depression. There are so many kinds of depression, and we’ve never explored most of them because our concept of depression, of mental health, is so very limited.

Not all depression needs medication. Not all depression responds to medication. Not all depression fits the DSM criteria for depression. Once, I spent a week laying on my mother’s sofa watching The Princess Diaries on repeat. I must have watched it 400,000 times. I cried every time I watched it. And finally, one day, I got up, turned off the TV, and left the house. I wasn’t better. But I wasn’t stuck anymore, either. Did watching The Princess Diaries incessantly “cure” me? I wouldn’t say that (for many reasons, with the primary one being that I’m not broken or in need of fixing, but you get my drift here). But it certainly did something.

I’m not a health care professional (anymore), and I’m not a psychologist (although I once studied psychology fervently), and I’ve never heard anyone suggest anything quite along these lines. But I do hear people discuss mental health awareness, and depression in particular, as if what was once called “the biomedical model” (is it still called that?) is the only way to look at depression. And it’s not. Ending the stigma against depression (not to mention other forms of mental illness), isn’t going to happen when you only look at depression as a chemical imbalance. It’s so much more than that, for so many people. Depression, like most things involving people, is complicated. And we need to look at it as the complex problem that it is. And then we can try the solutions that seem best suited for it. Like, in this case, light therapy, which seems to be going swimmingly.

I’m not saying that medications are wrong, or that they don’t work. Lots of folks are dependent upon medications for their mental health. But not all solutions work for all people, which is important, too. And sometimes, there just isn’t a solution, and you’re just stuck for a while, and that’s okay, too. Be kind to yourself, and gentle with yourself, because depression sucks. And keep trying things until you find the thing that helps.