To Make Them More Lost

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Chris

Chris lives in Austin, TX, where he once shook Willie Nelson's hand.

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  1. Avatar Rufus F. says:

    This is great. Thanks for posting it!Report

    • Avatar Chris in reply to Rufus F. says:

      Great is an exaggeration, but thank you. Frustration.

      I don’t explicitly say so in the post, but I’ve suffered from depression (a few, which is a few too many, major depressive episodes, and disthymia, now officially Persistent Depressive Disorder) for much of my life, though it’s now been several years since my last bout.Report

      • Avatar Rufus F. in reply to Chris says:

        Yeah, I surmised you know of what you speak. I think the hardest thing about depression is actually figuring out you have it. I’ve never had clinical depression, but have some sense this last year has been a long bout of depression. I almost feel like I don’t have time to figure it out, much less do something about it.Report

      • Avatar Rufus F. in reply to Chris says:

        And I’m sure it goes without saying, but one of the most insidious things about depression is that it’s an illness that can make you think treating the illness will be hopeless.Report

      • Avatar Chris in reply to Chris says:

        Yeah, the first time I suffered a major depressive episode, I was an undergraduate psychology major, so I was learning the success rates for the various types of treatments. Since negative thoughts are a big part of depression, it wasn’t difficult for me to convince myself that I would be one of the people for whom the treatments didn’t work.

        I have a friend from college who spent more than 2 years trying to find the right combination of meds, with talk therapy. That was brutal to watch, though he finally made it out of it.Report

    • Avatar Rufus F. in reply to Rufus F. says:

      I know so many people who I work with or who are close friends who I’d say “could really use a vacation” by which I mean could really use a month in a secluded spot with someone to hold them while they cry their eyes out about things they’ve lost along the way. Instead, they’re waiting to save up enough to spend a weekend in the local casinos. Which, from a working standpoint, is more reasonable.Report

  2. Avatar Glyph says:

    Good piece Chris. I fixed a typo in the first para (“discorded” to “discarded”); I suspect this is a typo, but wasn’t 100% sure, so I didn’t:

    (3rd para):
    Major Depressive Disorder of Major Depressive Episodes – is the “of” supposed to be an “or”?

    I do feel the need to push back, just a little.

    1.) As I have said before, one of the ways stigmas or taboos are able to remain stigmas and taboos, is because we all agree not to talk about them. Being prone to depression should, in most if not all ways, be no more remarkable or necessary for us to speak carefully around, than being prone to asthma.

    So despite sharing reservations about the irresponsibility of media speculation (always, on every topic), I do think it at least possible that reading about this incident, or depression in the resulting articles, might prompt someone struggling with depression to think “I better get some help, or tell someone else about what I am dealing with, before I hurt myself or someone else”, and that’s to the good.

    As long as sufferers of depression are being looked at with sympathy and an eye to understanding, rather than stigmatization or demonization, then I can forgive some clumsiness or speculation. The only way for people to figure things out is to talk openly about them.

    2.) That said, IMO some chronic medical conditions, despite needing no stigma, can still be looked at cautiously w/r/t certain jobs. Saletan had a piece at Slate about other pilots who committed suicide-by-plane, that were in most cases true suicides (unlike Lubitz, they mostly did not intentionally take many others with them).

    But a plane or a rocket or a space station is an incredibly-expensive piece of hardware, and if there is a substantial risk that it could get wrecked via an intentional act like suicide (which, generally speaking, is more likely to occur if a person is depressed than if not), or even a moment of careless inattention because the pilot is suffering a bout of severe depression, I see no reason that an employer might not want to take that medical condition into account, with no moral judgement, just as they might a history of heart attacks. And obviously if it is a piece of hardware which is either carrying a bunch of other people, or has the ability to kill a bunch of other people via its intentional or unintentional misuse, then that responsibility increases.Report

    • Avatar Chris in reply to Glyph says:

      @glyph you’re right, that should have been or (and thanks for the other correction).

      1.) So despite sharing reservations about the irresponsibility of media speculation (always, on every topic), I do think it at least possible that reading about this incident, or depression in the resulting articles, might prompt someone struggling with depression to think “I better get some help, or tell someone else about what I am dealing with, before I hurt myself or someone else”, and that’s to the good.

      I worry that, given the realities of depression (e.g., the lack of energy or motivation) that make seeking treatment less likely than many other disorders with similar stigmas, the reaction to “depression might have made a guy kill 149 people and himself” might just as likely be, “Well, I better kill myself now before I hurt someone else.” In fact, I really, really worry that will be some people’s reaction.

      I do like when depression gets attention, but I don’t think this sort of attention helps.

      2.) This is tricky. On the one hand, people who are depressed are much more likely to commit suicide than those who are not, this is true, but on the other, the vast majority of depressed people won’t commit suicide (much less murder, or very public suicide like flying an otherwise empty plane into the ground). I’m not comfortable singling out depression for this reason alone.

      I do agree that any illness which limits things like reaction times and fine motor skills that might be necessary for some jobs should ground them (literally, in the case of planes, figuratively in the case of most other jobs), so to the extent that depression does that, I agree it should be part of an evaluation. Of course, I’d hope that companies that do ground employees for depression have generous mental health plans so that those employees can get treated and get back to work.Report

  3. Avatar trizzlor says:

    Is this a problem of how we see the symptoms or the cause? There’s a lot of cutting-edge research showing that MDD and SCZ have very substantial genetic components and a strongly correlated genetic basis. Do you think such findings will make it more likely that they are treated like other non-psychiatric diseases?Report

  4. Avatar Rose Woodhouse says:

    Thanks for the link!

    People are motivated not to seek treatment because they may lose their jobs due to stigma. Depression and job performance worsens. Ideally, there would be a way of welcoming well-treated mental illness.

    But are there any mental illnesses that should rule people out as pilots? I tend to think yes. Depression just happens not to be one of them. Someone with a history of psychosis, I’m less comfortable.

    We have NO reliable way to find the tiny minority of people who have any mental illness who will become mass killers. None. There is no testing that should have been done or could have been done.Report

    • Avatar Chris in reply to Rose Woodhouse says:

      Well said, and I agree about psychosis, with the qualification that it depends on the cause (some are truly temporary). The meds alone would make some occupations problematic.Report

      • Avatar Rose Woodhouse in reply to Chris says:

        Right, I should have been more clear. One instance of drug-induced psychosis, say, is different and less worrisome from other psychoses that are more worrisome.

        I had major depression throughout my teen years and early-to-mid-twenties (as Russell, who met me then, will recall if he is reading this). Whenever people look back fondly on their youths, I just have no idea what they are talking about from a first-person perspective.

        I thought it was a beast I had put behind me, but after my third child was born (interestingly, not my second child, who had the disabilities), I started an on-and-off cycle of mild depression. I don’t think I’m entirely out of it yet, but I’m much better than I was. I’m seeing a good shrink and am taking a fairly aggressive approach to treatment. I can’t tolerate SSRIs, which limits our options – they make me sleep 16 hours a day and yawn the rest. Totally weird.

        Anyhow, I share both to share, in the interest of destigmatization, and because I was moved by your wonderful post, but also because here are some thoughts I have:

        1) I have never told anyone I work with that I have depression. Not ever ever ever. I never will. I am happily writing this under my pseudonym. The stigma is too great. (Delegitimizing the paragraph before this)

        2) I have had genuine grief in my life, which is nothing like depression. At some point just after we received the news that my son would likely never walk or talk (which is no longer a source of grief and fear to me, but it certainly was then), I noted to my husband that I actually didn’t feel as bad during that time as I did when I had major depression. Depression feels to me most essentially not as sadness but as a combination of self-loathing and an impairment of motivation (that is, it is the inability to translate the will which you do indeed have into an action). That is how it can impair your seeking treatment. Further, in your tendency to self-loathe during depression, it’s hard to recognize when treatments aren’t working. Not all shrinks are good shrinks by any means. You tend to blame yourself for treatment failures.

        3) I might have committed suicide – at least, when I was younger. There is no way on God’s green earth that even in my most terrible times it would literally even have occurred to me to kill anyone else. I can’t state emphatically enough how not necessarily violent depression is. If I had been a pilot during the WORST period of depression, my problem would have been showing for work at all. If I showed up, I have zero doubt in my mind that everyone would have arrived safely. I can understand people not wanting to trust that, but it’s hard to express how deeply I know that. I drive my kids everywhere, all the time. I love them with the fire of a thousand suns. I would never ever ever drive them if I thought for a second I might suddenly drive off the road. I would never ever ever drive – even without kids – if I thought I might drive into another car and hurt someone else.

        4) I found out after this crash that I would be disqualified from being a pilot. The only meds that are permitted for pilots are SSRIs, which I can’t take. I’ve had to muck around with other meds. When my depression is well-managed, which has been the case since my teen years, I feel like I am perfectly capable of piloting a plane. The restrictions on the type of treatments available seem, well, too restrictive to me.Report

      • Avatar Rose Woodhouse in reply to Chris says:

        Sorry, my depression has been well-managed since my twenties, not my teens. And I will add that I always drove a car, even during my major depressive episodes – never hurt anyone with it, never thought about hurting anyone with it.Report

      • Avatar Chris in reply to Chris says:

        First, thank you for sharing.

        Re 1) I don’t think I have either, and stuff like this definitely makes me less likely to in the future, if that is possible.

        2) This is one of the more difficult things to explain to people. Everyone gets sad, and everyone experiences grief at some point in their lives, and they understand how painful both sadness and grief can be, but depression is something different, something in some ways worse, and trying to explain this to people who’ve never been depressed is pretty much impossible.

        In the midst of depression, the self-loathing, the almost complete inability to have positive thoughts about one’s self and one’s life, is soul-crushing, but when I look back on it, the thing that I regret the most is the almost complete inability to enjoy anything at all.

        I will say this, though: the uniqueness of depression combined with the how consuming it is, and therefore how much it changes those who go through it, have for me at least resulted in one of the few good things to come out of it, an ability to bond with others who’ve been through it. This is probably why group therapy works so well for mood and anxiety disorders, but it works out in the world. I’ve developed close friendships with people built, in large part, on that shared experience. I am in some ways grateful for that, even if I’d have preferred that none of us had to go through that.

        3.) This is precisely how I feel, and I suspect it’s how the vast majority of people who are depressed or have been depressed feel: however possible suicide may have been or may be for the vast majority of us, homicide simply isn’t on the table. I was as committed to non-violence when I was depressed as I am when I’m not depressed.Report

      • Avatar Rose Woodhouse in reply to Chris says:

        I will say this, though: the uniqueness of depression combined with the how consuming it is, and therefore how much it changes those who go through it, have for me at least resulted in one of the few good things to come out of it, an ability to bond with others who’ve been through it.

        This. Although sometimes I don’t like to talk about it, even with those who’ve been there. Maybe because I’m afraid of letting even the mindset in the door. But usually, I feel this.Report

      • Avatar Glyph in reply to Chris says:

        Although sometimes I don’t like to talk about it, even with those who’ve been there. Maybe because I’m afraid of letting even the mindset in the door.

        I personally feel that the two major episodes I passed through were not as serious as those encountered by many others I have known, including those in my immediate family (as I’ve mentioned before, my maternal grandfather committed suicide; my mother required heavy-duty antidepressant medication back before SSRIs were really a thing, and that medication not only helped her, but it helped me – to say that there is always absolutely no link between depression and aggressive behavior toward others is simply not true in my experience, and we will leave it at that) – I tried prescription medication very briefly but did not care for the side effects, and took SAM-e for depression for quite a while.

        I never seriously contemplated active suicide, but I did wish I could simply be “gone”, and failed to self-preserve (I distinctly remember doing little things like not bothering with seatbelts when I drove – not only did buckling up seem a pointless additional step between me and my destination, but I felt that there was certainly no reason for me to try to avoid death if it came to me, and such would probably be the best outcome for everyone).

        Everybody’s different, but I feel no shame or awkwardness discussing this with anybody, and when I was going through the second episode (right around the turn of the century), I talked to my boss about it and got a little time off (I was useless at work anyway, couldn’t focus or accomplish anything, wasn’t sleeping at night, walking around at work like a zombie).

        I know it’s for personal reasons, or desire for privacy, or fear of stigma, but I continue to feel that being reticent to discuss personal instances and experience of depression, perversely helps enable the stigma; inadvertently supports the idea that these things SHOULD be judged or are embarrassing, or are somehow uncommon. Maybe this is an offensive analogy to some, but it sounds sort of like “being in the closet” to me.

        And again, everybody’s different – but in my experience, ideally, I probably should not have been driving a car at those times. And I definitely feel I shouldn’t have been piloting a plane. Who’s to say that in the split-second of a critical decision, my lack of will to live mightn’t have caused the scales to tip one way and not the other (or cause me to hesitate, evaluating those scales just a split-second too long)?

        If I wanted to be a private pilot now? I would hope that we could look back on my history of mostly-successfully coming through those rough patches and of learning to recognize the warning signs, and come to an agreement that if a major episode seemed to be in danger of recurrence, I would ground myself.

        If I wanted to be a jet pilot, with many others’ lives in my hands? I couldn’t blame an employer or the FAA for saying, “sorry, it’s just too much of a risk”. As others have noted, depression can sneak up on you, and by the time you realize it’s happening, you have little will to do the difficult work needed to help climb back out. It’s a medical condition, and certain medical conditions have certain real-life implications. It’s not a moral judgement to accept the realities of the situation.

        This may not apply to Lubitz specifically, since he probably had other things going on (though I have to say that even with a sample of 1, it will likely be an uphill opinion battle for people to say that a depression so severe that he had previously obtained multiple dispensations to miss training and work for it, is entirely-unrelated to what happened).

        But I don’t see it as inherently-invalid, either.Report

      • Avatar Rose Woodhouse in reply to Chris says:

        I know it’s for personal reasons, or desire for privacy, or fear of stigma, but I continue to feel that being reticent to discuss personal instances and experience of depression, perversely helps enable the stigma; inadvertently supports the idea that these things SHOULD be judged or are embarrassing, or are somehow uncommon. Maybe this is an offensive analogy to some, but it sounds sort of like “being in the closet” to me. Here’s the funny thing: I absolutely agree with this. Talk about lack of will….Report

      • Avatar Chris in reply to Chris says:

        I think there’s a difference between being depressed and having a history of depression. Of course, having having a history of depression increases the likelihood of future episodes, but the effects of depression are, for the most part, limited to the episodes themselves (some of the lack of enjoyment can be more persistent, particularly after extended or chronic bouts). So yeah, I can understand grounding a pilot in the middle of a major depressive episode, because doing so makes perfect medical sense. But grounding someone with a history of depression? There’s no medical basis for that.Report

      • Avatar Glyph in reply to Chris says:

        @chris – considering depression as a(n often-chronic) medical condition, I don’t think “history of” and “currently-experiencing” can be disentangled as neatly as we might like here.

        Consider: We would definitely ground a pilot actively having a heart attack.

        If he has a history of having heart attacks, we might say it is too risky for him to be a commercial jetliner pilot, because it could recur in the air, and put others at risk.

        Now, we can say that a heart attack is a sudden event, whereas a major depressive episode is not; but what is the difference between an event that is “sudden”, and an event that anyone who has experienced it knows can be subtle and insidious, and by the time you realize it is happening (you might have a “sudden” or “dawning” realization of it), it often has already happened (or is at minimum well-underway)?Report

      • Avatar Chris in reply to Chris says:

        I imagine all pilots have to get pretty regular checkups. I think that would be enough to deal with potentially recurring conditions like depression. Perhaps also a requirement to seek treatment when conditions arise.Report

      • Avatar Kim in reply to Chris says:

        Glyph,
        Come on now, we’re not talking pot-smoking Elmo here (or other evidences of mania, a state of mind in which other responsible humans are likely to go along with completely stupid ideas that cost them a ton of money because They Sound Good).
        **you’re welcome for the qwikster reference.Report

      • Avatar Glyph in reply to Chris says:

        I am 100% in favor of mandatory grounding of pot-smoking Elmo.Report

  5. Avatar zic says:

    Sometimes, I think we are too focused on ‘something’s wrong; there’s a problem’ thinking, and this leads to “something’s broken, I’m broken” thoughts. I get chronic migraine, chronic brain inflammation, and it often causes depression. It can be a real suck on your quality of life, leave you feeling damaged and incompetent.

    Dealing with that, I’ve found it’s really important to step away from “I’m broken,” toward “this is how I am, how can I best live as I am?” thinking. It’s okay to be not perfect.Report

  6. Avatar greginak says:

    Many years ago, when i lived in New Joisey, i had a job doing outreach to potentially mentally ill people. We got a call from a woman about her mom who had said a bunch of morbid and scary things to the womans daughter. The woman said her mom had been depressed for many years. So i went to the persons house to offer her services. She was friendly and said she did say some freaky, morbid things to her granddaughter. She knew it upset her daughter so she wouldn’t do it again. She admitted to having felt deeply depressed (hopeless, sad, weepy, unable to feel joy) for her entire adult life. She took meds once for about a month but they made her feel”different” so she stopped taking them. She wasn’t interested in meds or talk therapy. I called the daughter back, she remembered her mom taking meds, it was the only time she could remember her mom smiling or seeming happy….ever.

    The woman wasn’t a danger to herself or others so that was the end of the case. Free country. But she had been miserable for so long, not being miserable felt wrong and she didn’t have enough desire, for whatever reason, to want to change. Not an uncommon situation. But sad as hell. She actually seemed like a person who meds worked for but she was set into not changing which meant a depressed miserable life.Report

    • Avatar Chris in reply to greginak says:

      Stories like that break my heart, because it is so treatable. People don’t have to suffer like that.

      I know what she meant about feeling weird. I got so used to the feeling of depression that, when I finally came out of it, nothing felt right, and I was actually worried something was wrong with me health-wise.Report

    • Avatar ScarletNumber in reply to greginak says:

      Many years ago, when i lived in New Joisey, i had a job doing outreach to potentially mentally ill people.

      Isn’t that everybody?Report

  7. Avatar Zane says:

    Wonderful essay, Chris. I’ve wondered if the familiarity of experiencing sadness or a “down” mood undermines society’s understanding of depression as a mental illness. It’s not like psychosis; few people have direct experience with hallucinations or delusions in their day-to-day life.

    But because everyone feels sad or blue at least occasionally, I think we’re more prone to underestimate how devastating and debilitating clinical depression is. I think that’s why we hear people provide “helpful” advice like: “just get out”, “get some exercise, you’ll feel better”, and “shake it off”. This could be useful advice for someone feeling blue, but it’s likely to make a depressed person feel even worse.

    I think this sense of familiarity also makes it hard for people to get a sense of how disabling anxiety disorders can be.Report

    • Avatar Pinky in reply to Zane says:

      Agreed. It’s comparable to a weight problem. There’s debate about what “normal” is, and everyone experiences a little bit of the problem at some point in their lives. But there’s a spectrum, and at one end is “you should exercise more” and at the other is “you need to see a doctor quick”.

      I’m in an odd position on the issue of depression. One, I recognize that there is a lot that an individual can do to avoid it in many cases. Two, I’ve suffered from serious depression. Three, I’ve completely blacked out the coverage of the plane crash (as I typically do with news stories about isolated calamities) so I can’t comment on the press’s handling of it.Report

    • Avatar Glyph in reply to Zane says:

      “I think this sense of familiarity also makes it hard for people to get a sense of how disabling anxiety disorders can be.”

      I’m not proud of this at all, but in college I had a friend who had an anxiety disorder and got panic attacks, and I was completely unsympathetic. “‘Panic attacks’? What, you mean that you get really scared or nervous sometimes? Jeez, join the club, happens to everybody, woman up!” One time when she was having one, I basically abandoned her on a ski slope. “Get over it already!”

      Few years later, when *I* had a panic attack, I regretted that. I did run into her after that a couple of times, and when we had a few minutes to talk, I apologized profusely for my dumb college self.Report

  8. Avatar James Pearce says:

    Great post. The events of the past week, I’m sure, has had a lot of depressed people thinking to themselves, “Man, I’m glad I never really got help. The stigma!”

    I’m sure of this because I’m one of them.Report

    • Avatar Notme in reply to James Pearce says:

      Thats pretty selfish. It is one thing to hurt yourself but it is another to kill other innocents because that is the only way you can kill yourself.Report

      • Avatar James Pearce in reply to Notme says:

        Yeah.

        But don’t misunderstand. Not all depressed people are suicidal. And this wasn’t a suicide. It was a homicide.

        It was a homicide the killer knew he wouldn’t survive, but a homicide nonetheless.Report

      • Avatar Notme in reply to Notme says:

        I know not all depressed people are suicidal. This guy wanted to kill himself but couldn’t do it directly so he took others with him in the process, just like people who commit suicide by cop. I see it as the lowest form of cowardice.Report

  9. Avatar Stillwater says:

    Good post, Chris. And a good reminder. Depression sufferers suffer from both stigma about coming out as well as a general absence of public interest in it. Doubly taboo. (We’re a nation of shiny happy people!)Report

  10. Avatar Tod Kelly says:

    This was really great, Chris.Report

  11. Avatar Jaybird says:

    Dude this was an awesome post.

    When I try to think of a solution to this problem, every single solution that I can come up with is very, very bad to the point where I compare it to a pile of bodies and I’m stuck saying “ugh”.

    I wish the world were not this way.Report

  12. Avatar Oscar Gordon says:

    I wish I could offer something more than a slow & sincere clap.

    Well done sir!Report

    • Avatar Chris in reply to Dand says:

      What matters is that no matter what the reason, this crash was caused by mental illness.

      While I agree with his conclusion — we need a better mental health care system, basically — he makes this statement as though it were self-evident. I mean, why else would someone fly a plane into the ground? He had to be mentally ill. Perhaps he’s right, he was mentally ill, but if so it is not a self-evident fact. What’s more, “this crash was caused by mental illness” is just too easy: it allows us to avoid all of the other things that had to go into this particular person deciding in this moment to fly a plane into a mountain.Report

      • Avatar Kim in reply to Chris says:

        Was that bloke in Austin any way shape or form mentally ill?

        There’s being an idiot (Join the Club!), and then there’s legitimately out of your mind.
        (and now I am being an Adult and regretting the silly reference to a pot-smoking Elmo).Report

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