I suspect I might suffer from minor depression, but I’m not sure. It’s not constant, but I get into a pretty serious funk periodically. There are a couple of things that weigh on me. First, even though I know this is my own problem, it seems to me that the world should be a better place. If you’re not occasionally depressed by the news, you’re not paying attention. I’m also disappointed with how parts of my own life are working out so far. I’ve managed to surround myself with great people, and I know a lot of less fortunate guys would love to trade places. But there are plenty of reasons to be disappointed in any situation if you set your expectations high enough.
To improve my mindset, I figure I have three options:
- Drugs.
- Lower my expectations.
- Change my situation.
Is it wrong to want to be happy?
Po Bronson pointed out that we always talk about high self esteem and low self esteem, but rarely talk about middle self esteem - a realistic self-view. I think something similar may be going on with depression. Most of us would like to be happy, or at least content, all the time. We’re OK with feeling sad temporarily when some unwanted event occurs, but after an appropriate period of grief we’d like to get back to the happy side of neutral asap.
I think that might actually be working against us. It seems like a healthy person should spend an equal amount of time happier than average and sadder than average. The peaks and troughs should be roughly the same magnitude. It would be nice if your average mood was on the happy side, but that seems like an unrealistic expectation that just sets us up for disappointment.
Drugs
Rory Blythe wrote one of his best blog posts last week. In it he confesses to being addicted to morphine for the last few years:
Part of the reason I got into drugs in the first place was that I thought I could control the way I experience life. I wanted to eliminate all anxiety, doubt, fear, sadness, and I succeeded for a while. But life isn’t quite the same when you go around feeling nothing but joy. The whole time, you love it, but you know something’s wrong.
Never thought I’d be happy to be able to be sad about something. Uncertainty has found its way back into my life. I’m no longer trying to steer my feelings with things I snort, inject, and swallow.
Life is much more interesting this way.
One shrink’s experience with depression
Gary Greenberg did an interview on NPR’s Think a couple of weeks ago. He was promoting his cover story in Harper’s Magazine this month (subscription required). I haven’t read the article, but I’ll summarize the interview.
Greenberg is a writer and practicing psychotherapist with plenty of experience diagnosing depression. For his article, he took part in a clinical trial testing the effect of Omega 3 fatty acids on depression. Going into the initial testing he felt a little melancholy, but considered it a normal part of modern life. During the test they asked him a raft of questions: How are you sleeping? Do you take naps? Are you feeling guilty about anything? Greenberg uses similar questions in his own practice, but being on the receiving end he realized that qualifying for a diagnosis of depression is almost unavoidable at some points in normal life.
To his surprise they diagnosed him with chronic depression. Greenberg says he was at the minor end of the scale. In Rory’s blog post he describes not being able to get out of bed and being generally incapacitated. Greenberg was not close to that state. However, he did qualify to take part in the drug trial. He took six pills every day for 8 weeks, and was retested for depression every 2 weeks. He was told the pills were either Omega 3 fatty acids or placebos, but he didn’t know which. He said the pills did make him feel better, but he was uncomfortable with how it all played out. He said the doctors and nurses were intelligent, helpful, and did their best to make him better, but the process was broken.
What’s wrong with the diagnosis of depression
The logic is: if you find a drug that makes you feel better, you must have been depressed due to a chemical imbalance. The drug corrected your imbalance, and you’ll be fine if you keep taking that drug. The only problem with that is - it’s not true. Greenberg says we don’t actually know that you had a chemical imbalance to begin with. Our brains have receptors for these chemicals, and an extra jolt of them feels good. That doesn’t mean we were deficient. It’s circular logic.
You could also use morphine, marijuana or LSD to feel better. They work great, but they aren’t legal. Instead, you’re supposed to see a doctor, explain that you feel rotten, and he’ll prescribe a legal drug. When he finds one that works to improve your state of mind he prescribes it for you, and you take it indefinitely. If it stops working, the doctor switches drugs until you find a better one. He called the whole process medicalizing depression.
The weird thing is, with the legal system you’re still self medicating. You decide that you want to feel better and visit the doctor. The doctor picks a drug for you to try, but you tell him whether you like the way it makes you feel or not. If at any point you decide it has stopped having the desired effect, you return to the doctor and try another one. Then you decide if you like the new one. Reread that paragraph and substitute dealer for doctor. Smoking a joint just cuts out the middle man.
Feeling bad may not be all that bad
This is an excerpt from Rory’s follow up post today:
During my entire course of opioid abuse, I felt only several of the many emotions anybody else might experience throughout the day. Oddly, feeling good all the time eventually becomes horrible. It’s monotonous. Part of being alive is experiencing the unpleasant bits of life as well as the pleasant ones. You don’t feel whole when you’re separated from reality by 200mg of morphine.
I look forward to feeling bad when I should feel bad, rather than feeling bad because my brain is begging for another shot of powder.
It sounds like Rory has his head on straight, and I hope he can keep it that way.
So?
Back to my original question. The real problem is, I can’t figure out whether I’m depressed, I’m correct that my life is crappier than it should be, or I’m just having trouble coping with normal ups and downs of life. I’d like to feel better all the time, but not at the expense of losing touch with reality. I’m not convinced that our medical system has this figured out any better than I do.
I got some drugs (prescription), but I haven’t taken any of them and don’t want to. Lowering my expectations is not that simple because I’m not the one that put most of them in my head to begin with. Most of what we like and expect out of life is determined by our childhoods. If I’d been raised in as Masai tribesman, I’d have a totally different set of expectations. As I see it, realizing that fact, and deciding for yourself is what it means to be born again. I’m working on it, but it I’m not there yet.
Until I get my expectations better aligned with reality, that leaves changing my situation or feeling bad about it. More on that later…
depression, drugs, psychology, self esteem
