Over the past twenty years of living with major depression, I’ve met many people in our Western New York community seeking help for depression. The questions are often the same: “Where do I go for help? What local resources are there? I have an adult child, co-worker, or elderly parent struggling with depression. How can I help and support them?”
As a lawyer and mental health advocate, people have asked me these questions for years because they know about my work fighting stigma. When stigma goes down, treatment goes up.
Our community has terrific mental health resources, but most folks don’t know how to find them or learn about what they do. I thought it was time, perhaps long overdue, to create a website that provides not only resources, both local and national, but more: podcasts, videos, and a place where I blog about living and working with depression. I chose the name – The Buffalo Depression Project – because it is a work in progress, an ongoing “project” that I hope will change and grow as the conversations about mental health in our community evolve, especially about depression, but generally, about any form of mental illness.
I know about the struggles people with depression face – at work, at home, and living in the world with mental illness. The two pillars of depression – a sense of helplessness and hopelessness – can darken the days of sufferers and those who care about them.
But things can get better. People can learn to manage their depression or help a loved one to do so. I have experienced this and known hundreds of people who have done so across the U.S. and in our community.
We all need help sometimes. So many of us can’t fix depression on our own.
That terrible mood of depression, whether it’s any good or not, is what is known as The Artist’s Reward. Ernest Hemmingway
Others imply that they know what it is like to be depressed because they have gone through a divorce, lost a job, or broken up with someone. But these experiences carry with them feelings. Depression, instead, is flat, hollow, and unendurable. It is also tiresome. People cannot abide being around you when you are depressed. They might think that they ought to, and they might even try, but you know, and they know that you are tedious beyond belief: you are irritable and paranoid and humorless and lifeless and critical and demanding, and no reassurance is ever enough. You’re frightened, and you’re frightening, and you’re “not at all like yourself but will be soon,” but you know you won’t.Kay Redfield Jamison, Night Falls Fast
That’s the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it’s impossible to ever see the end. Elizabeth Wurtzel, Prozac Nation: Young and Depressed in America
In depression . . . faith in deliverance, in ultimate restoration, is absent. The pain is unrelenting, and what makes the condition intolerable is the foreknowledge that no remedy will come – – not in a day, an hour, a month, or a minute . . . It is hopelessness even more than pain that crushes the soul. William Styron, Darkness Visible: A Memoir of Madness
They flank me-Depression on my left, loneliness on my right. They don’t need to show their badges. I know these guys very well. …then they frisk me. They empty my pockets of any joy I had been carrying there. Depression even confiscates my identity; but he always does that. Elizabeth Gilbert, Eat, Pray, Love
A friend recommended me to the man who would become my therapist for the next twenty years. Jerry was a psychology professor at Buffalo State College. From the Bronx, he has a beautiful, salty sense of humor. Not only was he brilliant, but he was also warm and engaging. I felt at home, and we quickly bonded.
Is therapy effective?
A recent article in The New York Times explored whether therapy, based on the most current research, really works. What the studies show, and this has been both my experience and hundreds of others I’ve been privileged to meet over the years who struggle, is that it’s the combination of a good therapist and antidepressant medication that is the most effective treatment. In my case, I have been on Cymbalta (an antidepressant) and Lamictal (a mood stabilizer) for the past fifteen years. The meds quieted the physical symptoms enough so that I could benefit from my therapy with Jerry. Without the medications, I found that my time with Jerry was not as effective because his insights could not penetrate the hard shell of the physical side of depression that my brain was generating.
Some have told me I was lucky to find a therapist as good as Jerry. Others have said that they’ve had therapists who have been real duds or ineffective. As The Times article points out, it’s not always the educational background that matters (Jerry had a Ph.D., but many other therapists have M.S.W.), but, interestingly, if a patient emotionally bonds with a therapist. Bonding and its relationship to the efficacy of the therapy was challenging to measure in all the studies reviewed for the piece. The article reviewed some research that suggests how therapists react to the negativity of a patient that matters. For example, while this was not the case with Jerry and me, many patients can and do blame their therapists for they find the therapy not helping. Sometimes, they outright say this to them. If a therapist responds with empathy rather than being defensive, that is the key.
“Once you choose hope, anything is possible.” – Christopher Reeve
There are two pillars upon which depression rests.
Helplessness
When in the grip of depression, we feel helpless despite our efforts to pull out. The more we struggle, the more exhausted we become. In her book Eat, Pray, Love, Elizabeth Gilbert writes, “They flank me – Depression on my left, loneliness on my right. They don’t need to show their badges. I know these guys very well, but then they frisk me. They empty my pockets of any joy I had been carrying there.”
Hopelessness
Helplessness often leads to profound hopelessness about the future. In her book Prozac Nation, Elizabeth Wurtzel writes, “That’s the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious and compounds daily that it’s impossible ever to see the end.”
What I have learned over the past twenty years of living with depression is we need to chisel away at these twin pillars. I began to discover helplessness and hopelessness are disempowering: I had no choice but to live my days under this rock of sadness. My healing involved learning that I did have options in how I related to life when depressed. And I found this power to choose empowering and life-affirming.
How did I leave helplessness and hopelessness behind?
Dr. Carrie Barron is a board-certified psychiatrist on the Columbia College of Physicians and Surgeons clinical faculty who also has a private practice in New York City.
She has published in peer-reviewed journals, won several academic awards, and presented original works related to creativity and self-expression at national meetings of the American Psychoanalytic Association.
I think the stress level has increased enormously because we have so much to do, and we’re on twenty-four hours a day. So I think because of technology, which offers us so many great things but gives us much to do. I think that’s part of it. I also believe, especially for children, we’re in a striving, ambitious, productive time mentality – for children and adults. We need to play, we need to hang out, we need to have spontaneous time. I think spontaneous thought does a lot for alleviating depression and anxiety.
Dan:
We have so many different words in our culture for unpleasant experiences. We might say things like, “I’m sad,” “I’m burnt-out,” “I’m stressed out,” or “I’m depressed.” But what is the difference in your mind, as a clinician, between sadness, say, and depression?
