Monthly Archives: August 2014

Depression and Choice

Depression, ,

I’ve already seen some people wondering, about Robin Williams, how he could have made such a “choice.”

Depression is a hallucination, or a set of hallucinations, but instead of telling us that the walls are melting, or that our shag carpet has turned into a coral forest, or that Ozzy is singing to us personally, it tells us that there has never been any joy in our life, only loss, and that whatever purpose we had in life, be it love, friendship, work, hobbies, art, relationship with God(s), was only fooling ourselves.

It tells us that there is no possibility of positive outcome in any undertaking, be that calling a doctor, calling a friend, getting out of bed, going to church, taking a shower, checking the mail. And it offers as proof that we’ve been doing those things all our lives and it’s come to nothing but this horrible misery. And if we do manage to do any of those things, and even if there is a positive outcome, the disease will come rushing back and tell us that it was useless, that our friend is bored with us, our deity either doesn’t exist or has abandoned us, our doctor can’t help.

It tells us that the only way to make the world a better place is to remove our miserable presence from it. Then our loved ones will be free to find someone happy and good for them, our doctor can treat patients who will actually get well, our friends will no longer be wasting their time on such a loser.

Depression is a captor and we are its hostage, and it controls and filters every piece of information that we receive. We are not allowed any information that would result in our developing a positive view. Information that will lead to a negative view is blasted into our heads at high volume 24 hours a day. We’re not even allowed access to happy memories! They’ve all been converted to shame-ridden examples of our own inadequacy.

Is anything someone does under such conditions a choice? I suppose it is, but I would argue that it is not a choice in the sense that healthy people make choices, based on a weighing of pluses and minuses. The depression sufferer only has minuses to work with, so the conclusion can only come out negative.

Should I call my friend? Nothing she can do to help, and I’ll just drag her down. Should I call my minister? No, I don’t need to talk to someone who’s even more deluded than I am. Should I call my doctor? She’ll take my money and give me more drugs that don’t do anything. Should I go on living at all? With the next day offering more of this?

If someone makes a choice based on faulty information that they believe is true, is it really their choice? It’s everyone’s responsibility to seek out good information before they make drastic decisions that affect other people, but what if they are not able to do that? What if all the information they are given points to the same false conclusion?

It’s a choice, but is it really THEIR choice? Should they be judged as harshly for it as a healthy person for theirs?

Who Killed Robin?

Depression

Robin Williams died from depression because he hadn’t been treated to the point of full remission.

One of the biggest shortcomings in the treatment of depression is that doctors and patients are encouraged to accept a partial cure. Part of this is because the tools psychiatrists have for treating refractory depression (which is the kind I have) are inadequate. I do not envy them. They are not at fault, and are usually doing the best they can with the tools available to them.

The therapies we have today to treat depression were mostly developed 35 years ago or earlier. When was the last time you heard about a depression therapy making it to market that wasn’t just another rejiggering of the standard reuptake inhibitors? Sometimes they work a little different, but the mechanism has been around since the late ’70’s at least.

Where are the drugs that target closer to the source?

There needs to be the kind of visibility and activism we have had for other diseases such as AIDS, breast cancer, heart disease, etc. Where are the TV commercials asking us to donate money for depression research? Seen any ballplayers wearing depression awareness ribbons? Even know what color a depression awareness ribbon is?

Activism is important on a personal level, and it starts with the patient’s relationship to their healthcare providers.

If you are reading this and being treated for depression and feel that you are not fully free of the disease do the following:

Next time the doctor asks you “are you feeling better?” or “are you doing okay?” Don’t just answer “yes” and take your prescription and walk out. “Better” and “okay” are not “well.” Look her or him in the eye and say “I am not suicidal, but I am also not in full remission.”

We have a right to seek full remission, which is when all symptoms of the disease are gone. You know the difference between being depressed but functional and not being depressed. Do not settle for the former. You have a right and a duty to seek the latter.

If anyone, be they professional or otherwise, tries to tell you otherwise, with some condescending crap about “nobody feels happy all the time,” or whatever, be firm, and say “I know that. Can you treat me to full remission?” If they ask you what you mean by that, say “to the point where I have no more symptoms.”

If they can’t cure you, at least make them cop to it. And then you have the option to seek treatment elsewhere.

Many healthcare plans restrict the medications their doctors are allowed to prescribe due to economically favorable deals the insurance provider has made with the pharmaceutical companies. Ask your doctor if there are any depression treatments that they are not able to prescribe. The answer may surprise you.

These suggestions are part of what is called “self advocacy” in healthcare. The quality of my care has improved greatly since I started practicing it.

Mental health is worth fighting for, for ourselves and for others. Robin Williams was a depression sufferer who had been treated to partial remission.