When The Black Dog Goes For A Walk

988 is now the suicide prevention hotline throughout the United States. If you, or someone close to you, is experiencing profound, intense emotional distress and a suicide attempt is in play, call 988. There is help, there is hope.

That message once upon a time seemed distant from me. At this point in my life, writing it pulls a few tears into my eyes.

Okay. On with the post.

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I saw news on Thursday, waiting in line at the food cart for my lunch. Senator John Fetterman has been admitted to Walter Reed Hospital just outside of Washington D.C., and is being treated for clinical depression. My internal mental reactions were roughly thus:

That is a super inappropriate thing for reporting. Depression is super personal and there’s stigma attached to it. Fetterman should be able to keep that private if he wants to.

Well, no, he’s a United States Senator. We do have an interest in the ability of our leaders to lead us.

Damn it that’s what I’m talking about! That’s perpetrating the stigma! You, of all people, should know that people can and do function effectively even while they struggle with depressive episodes! There’s no reason to think he made a bad public decision because of this.

But everything’s a matter of degree, isn’t it? Especially with something like this. You don’t know if he’s functional or not, and if he’s admitted, maybe the issue is more serious than your own. No one can know that but him and his family and his doctors. At least, no one ought to know that but those people.

The assholes are going to mock him. They’re going to say “the other guy wouldn’t have done anything like this.” They’re going to shame him. Everything about everyone is shamefodder because that’s the world we live in. This won’t be any different.

Oh, look, Fetterman’s office released a statement, so the report is based on a public disclosure. And look, right there between the lines, he and his wife are not very real happy about the public statement. That’s why his wife asked for “privacy.”

Which only goes to show, the real issue here really is the stigma. Inevitably someone’s going to hold up this man’s mental health as a reason to mock him and question his ability to be a Senator.

Well, what’s there to do about it?

“Head to a computer and write” wound up being my answer.

 

My Story, Briefly

I think I realized that I was kinda-sorta-depressed at some level about ten years ago. I thought it was because of external factors. Dissatisfaction with where my career was. And I felt guilty about feeling that way, because I was surrounded by people who genuinely cared about me, who did things to improve my professional experiences when they didn’t have to. And despite recognizing that, I still felt listless and disengaged.

Because the problem wasn’t the work. The problem was within me. I wasn’t equipped to recognize that fact. It was easier to blame other things, other people. Now I realize that was not fair. Now I realize that this was depression, lying.

I’m sure now that my depression played a substantial role in eroding my marriage. The divorce came as the last of several very bad life events within about a twelve-month period of time, each of which would independently have catalyzed what was already going on in my brain by whatever causes depression.

Divorces, of course, are particularly depressing events. The first time I tried therapy in the wake of the divorce, the intake sheet had a question: “Is there a particular event that brings you here? 1. Job loss; 2. Divorce/Breakup; 3. Other ____.” Missing from the list? Among other things, “death.” That told me something about what the therapist actually saw and heard in hands-on practice.

My initial experience with therapy was… suboptimal. The emotional wounds I sought to heal were too profound, too fresh. My therapist wasn’t a particularly good fit for me, but was literally the only mental health professional in my area taking on new patients. I took what I could get. And I didn’t really understand what mental health therapy was supposed to do, and I felt kind of ashamed to be getting it. I now know that it’s an incremental thing, it doesn’t help a lot or all at once, but the insights and small mental and emotional connections build up over time.

Ultimately I summoned up some will to alter my circumstances, and changed what my life had become. Regardless of how much I liked the people at my workplace, I had to make a shift in my professional path. Regardless of having a lot of good friends around me, living in the same area I’d grown up in was not healthy for me; I needed to be somewhere else. I quit my job and took a new one in a different area. Ultimately I moved to Portland, where I am now, and soon enough went into business for myself. I’ve built a new life for myself here, one that mostly makes me happy.

And I’m still taking therapy for my depression. Which is a bit of a financial strain, but I won’t do without it. Because I’m not kinda-sorta-depressed, I’m for-real-actually-depressed. And that’s something that needs to coexist with being happy. That may be the most extraordinary thing I’ve learned: a generally happy life (particularly when happiness is defined in Aristotelian terms) can be punctuated by periodic episodes of depression.

Here’s some more of what I’ve learned.

 

Danger

Profound depression, particularly acute episodes that strike with high intensity, can be treated therapeutically. I suspect an acute, intense strike is what’s going on with Senator Fetterman because he was hospitalized and that’s kind of a big deal. I’ll not speculate about what the contents of that episode were, and confine myself to nothing that Fetterman perceived what was going on, or at least enough of it, such that he reached out for help.

Which is exactly what he should have done. And that’s exactly what you should do if you find yourself in such circumstances.

Why? Depression can kill. When you call around to find mental health assistance, you get voice mails that deal with suicidal ideation in very direct terms. Lots of suicide attempts happen when people are stricken with the feelings of sadness, hopelessness, and most of all powerlessness that pervade such a moment. Sir Winston Churchill spoke of those moments when the black dog came to visit him:

I don’t like standing near the edge of a platform when an express train is passing through…I like to stand right back and if possible get a pillar between me and the train. I don’t like to stand by the side of a ship and look down into the water. A second’s action would end everything. A few drops of desperation.

This isn’t suicidal ideation, exactly, but that kind of feeling does kind of flirt with it.

As I struggled to put my depressive episodes in their place (because they won’t ever go away, it’s about management and not defeat) I’d find myself in that same moment Sir Winston describes. Except I found it with heights. I’d look over the railing on a bridge and see how far above the ground or river below I was. In a flash, I’d realize it would only take a quick, easy jump to be on the other side of the rail, and gravity would take care of the rest. It’d be terrifying for a couple of seconds, and then…

And then it would be unimaginably horrible. Come on. There’s no guarantee at all death would be instantaneous. There could be a lot of pain. And the world would go on without me. There’d be a lot of people who would miss me once I was gone. Family, friends, clients. There’d be all the things I haven’t done yet that I’d never do.

Moreover, I’m not a believer in any flavor of the supernatural. I don’t believe you get a do-over, a second life, a reincarnation, an afterlife. There’s nothing for you or I after death extinguishes consciousness. To the point here: death doesn’t lead to something better in the great beyond. There’s only the void. Your belief system may vary from that, but this is mine. And it’s why what’s below the bridge has never been attractive no matter how depressed I got.

Worse yet, I might survive the impact. Undoubtedly with terrible, permanent injuries. No part of my body would be spared injury, not even the cognitive centers of my brain, raising the terrifying specter of losing my very identity to sudden deceleration trauma. Looking over that rail, I’d always think “There’s nothing good waiting for me below this bridge,” and keep on walking. I’ve always been very certain of how bad that fall and its aftermath would be.

But still, I had looked down, and I had thought about it, even if only for a second or two. Is that suicidal ideation? I don’t think so, at least not the kind that mental health professionals worry about. That’s because I don’t imagine, even for a millisecond, any advantage to anyone would be realized by my going over that rail. But if you do, I beg of you, please immediately call 988.

 

Deception

The second thing I’ve realized about depression is related to this first point. The way depression can kill you is with deception. Depression lies. Worse, it lies to you in your own voice.

In addition to telling you the lie that you’d be better off dead, depression tells you that you don’t have the power to do much about the things that are making you feel bad. Depression tells you that you’re at fault for all the things that aren’t right with your life. You wish you had more money? Of course you do, you’re a loser who isn’t living up to your potential. Your romantic life isn’t what you’d prefer? That’s because you’re unattractive and unlovable and that’s never going to change and only ever get worse. Staying home alone at night playing Skyrim (in 2023? Come on Burt, get a new game!) when everyone else is out having fun? Well, that makes sense, because after all, nobody really likes you, your so-called friends just haven’t figured out yet how to shake you out of their social lives, but you should believe they are trying. (Also, clearly, you suck at video games.)

Now, if you hear me say it, your instant response is surely, that’s a steaming pile of crap, that it simply can’t be true and it flies in the face of all available evidence. Maybe that’s easy for you to say. You don’t have a little demon constantly mocking you in your head with those insulting lies all the time. If like me, you do have such a demon plaguing you, it can be hard to remember that the demon is really so many milliliters of foul, brackish chemicals accumulated in your brain, playing havoc with your interpretation of the world around you. It isn’t always effortless to find the ability to purge those chemicals,¹ that you might see the world with clearer, kinder, eyes than the demon’s.

We all have self-doubt and anxieties about our own self-perceived inadequacies, of course. But if you aren’t depressive, take away from this essay the knowledge that your depressed friends and neighbors hear those kinds of self-loathing statements in their own heads often. That’s a frequent experience of depression. A steady diet of it periodically creeps up out of the unconscious and can from time to time govern someone’s generalized emotional posture. It sets up a negative feedback loop making it ever-harder to cleanse the brain of despair.

 

Degree

It seems that everyone has thoughts like these from time to time, and it’s not always easy to tell when and to what degree those kinds of thoughts are caused by depression. Which means depression and non-depression differ from one another by a matter of degree. This means that if you experience these sorts of emotions, you aren’t unusual, you’re “normal.” So it is now and will forever be difficult to measure just how common depression is. It can be hard for anyone, depressive or not, to tell if they’re actually depressed or if just running through a low point.

In those low points, my ability to function diminishes. My energy and motivation levels feel low; I move slower. My focus is not as sharp as I’d like. It’s harder to fall asleep, stay asleep, and get deep enough into sleep that it rejuvenatives. Food can be a temporary comfort, but it’s as often not an interesting one and it can take a conscious reminder to even seek it out rather than just sit there and be hungry. Stresses from the outside world tax and wound my ego more deeply. Unpleasant memories become painful, painful memories become unbearable. Humor deadens. Libido decreases. Most of all, my belief that things will improve, particularly things that really are issues I should be dealing with, is sapped from me. What I want is to withdraw, be alone, and to find a way to silence the demons in my head shouting their insults at me. A darker, quieter room to do this in is preferably to a brighly-lit, well-decorated one filled with music. I don’t want my mood elevated when I’m like this.

Like Sir Winston, when I need to, I can rise to the occasion despite my brain being a little bit out of whack. Usually it takes something like an imminent deadline or an appointment of some sort. I can dig down into the reserves and use fear or shame as a motivator to get moving, and get the thing that absolutely has to get done, done. After that, it’s a crash down to a place worse than where I started. Only a few times since I’ve learned to pay attention to these things have I found myself absolutely unable to do something immediately needful. And never yet in the professional context anything worse than missing and then needing to reschedule a potential new client meeting, thank the Lawyer Gods. (One can only imagine how many oh-shit-gotta-feel-bad-later put-out-the-fire-right-now moments Sir Winston had to deal with.)

As constellations of depressive symptoms go, what I’m describing here is generally on the mild side. Some people get it much worse than me.

There are people who experience bursts of psychosis when their brain chemicals get out of whack. Many people express their depression through inappropriate aggression, which sometimes advances into physical violence.  These can become more significant and prevalent if other mental health issues are also present. Some people find that antidepressant medication is helpful. My own experience with that sort of thing was brief and awful, I’ve never had worse nightmares than those three nights, and I don’t actually care to address that particular part of my journey further because even years later, those very dark memories still haunt me.

Hopefully this means two things to you, my friend the non-depressive reader. You don’t and can’t know how bad it is in someone else’s head; and, to believe you’ll never find yourself with a black dog of your own would be near the heights of arrogance. Depression’s seeds rest within all of us and yes, that includes you; for some, issues of genetics, stress, brain chemistry, environment, substance use, or trauma can catalyze it and bring it to the fore. When you hear about someone, perhaps a celebrity or perhaps an acquaintance, suiciding or attempting it, I hope your response will be compassionate and humble.

 

Stigma

Thus, our society attaches moral opprobrium to qualities like laziness, sensitivity to insult, doubt, self-control, and particularly in men, outward displays of emotional vulnerability. Depression can be seen as manifesting in those things. The very word “depression” implies an emotional vulnerability that men, in particular, are supposed to be “strong” and never demonstrate.

Western monotheistic religions condemn suicide as sinful, and I’ve read multiple essays condemning suicides as cowardly and intentionally cruel to the survivors. And suicide and depression are associated. I posit that even if most of the readers of this essay (like me) not even have been born when it happened, Sylvia Plath’s suicide, resulting from the major depression she suffered much of her life, looms large in contemporary culture because it became a significant global media event, a lodestar from which reports of subsequent suicides were modeled. The already-famous poet was only thirty years old in 1963 when she took her own life. The stories of her death find shame in her suicide, interpreting it as succumbing to emotional frailty and callous, if not cruel, to her children who were in the house when she did it.

It sets the stage for a heart-wrenchingly long list of other, more recent suicides of public figures. Suffice to say that depression surely played a role in at least a majority of these.

We ought to be able to accept that the brain is like any other part of the body. Things can go wrong with it. When they do, you get help getting them back to where you want them to be. You wouldn’t feel very much shame if your arm were broken and you needed a doctor’s help to re-set the bone and get you taped and casted up to heal.

Why, then, should you (or Senator Fetterman) or I feel shame about it? Or about needing and getting some help putting the mind in balance?

Yet I do. Writing and offering up this essay has been particularly difficult for me. Why I’ve started and stopped writing on this subject repeatedly for years now. Normally I feel pretty fearless as a writer, even when writing about things that have hurt me. But this? I feel real vulnerability. To confess even fleeting, always-rejected, never-acted-upon thoughts of looking over the edge of that bridge is about the most intimate thing about myself I’ve ever published, here or anywhere else. It’s more than a bit embarrassing.

It’s why I reacted so viscerally to seeing this news about Senator Fetterman. Such an invasion of his privacy to blast this all over the news! The idea that someone, like myself, should have this deeply personal thing exposed and castigated by his political opponents for the purpose of shame (for what subject matter is not these days?) angered me.²

There oughtn’t be stigma attached to mental health issues at all. Depression, a relatively common condition, is one that ought to be most easily accepted free of stigma, precisely because there really are a lot of people out there who have it.

Ought and is are so frequently different things. We’ll see how it plays out for Senator Fetterman. As for me and this essay? There’s nothing for it now but to trust in your empathy.

 

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Please call 988 before you start doing something drastic that you won’t be able to reverse. There is hope, even if it’s sometimes hard to see.

Yes, there is.

1. Even a casual glace through recent psychiatric scholarship casts significant doubt on last decade’s conventional wisdom that an imbalance of seratonin reabsorption blockers in the brain are a root cause of depression. Depression’s material etiology is almost certainly complex, and definitely not yet well-understood.
2. Ironically, of course, this essay is a complete waiver of my own privacy. But at least I chose to disclose these things about myself, arrogantly hoping I might educate people and mold their reactions to future stories dealing with depression, hopefully in the direction of compassion.