Monday, July 30, 2007

Depression and Books and More Books

Wrestling With Wolpert
(Understanding Depression)

As anyone who has read these pages will know its author suffers from endogenous or unipolar depression. It was diagnosed some 9 years ago this October. This diagnosis and the treatment of the disease necessitated a stay of seven weeks in hospital. However, I have been well since because I take my medication and involve myself in a legion of other pursuits to lower stress – attending counselling and psychotherapy courses, getting certificates in counselling skills, suicide studies and doing as many self-help courses as possible. As well as these pursuits I am an inveterate reader and literally read anything and everything – it’s hard to navigate your way around my house because of literally thousands of books. I also write – I have written a novel (which remains unpublished and probably always will) and a book of meditations which was published in 2002 and sells about 250 copies per year. I have another book on meditation and health written and am looking for a publisher for the same. I also write poetry in two languages and have had some success in little insignificant competitions around the country. Outside that I maintain and write three blogs – one in English, one in Irish and one in Italian. I also meditate, garden and walk. Another thing is that I love travelling and spend 2 to 3 weeks annually in Italy and at least a week in Paris. Then if I have time I spend some time in the Gaeltacht that is those western areas of Ireland where Irish is spoken. All of these activities involve relaxation. Without these activities I would not survive. They are my life line as it were. That’s the only reason I mention them here. Before 1998 when I had my one and only great breakdown I was overworking and I did not even realise it. Each summer I used do supervision of exams and then some TEFL that is teaching English as a foreign language to Italian students. Actually this last activity is where I got my love of Italy and Italian from.

Anyway, as anyone who suffers from depression will tell you it is notoriously difficult to diagnose. I reckon that I had it since I was 28 some 12 years before it was diagnosed. I had quite literally got tired of going to various doctors in the hope of getting a cure for my complaints which I shall outline briefly below. When I was released from hospital I read everything and anything I could get on depression, because quite literally this was and is definitely one defining characteristic of the depressed person as cancer or diabetes would be of persons suffered from those diseases. My favourite book on depression is that of Lewis Wolpert who is Professor of Biology as Applied to Medicine at University College London. Why so? Firstly he is a brilliant writer and communicator. Secondly he is an astute scientist. Thirdly and most significantly his description of his experience of depression tallied exactly with mine.

Now, as I said above depression is notoriously difficult to diagnose quite simply because it shares many common symptoms with other diseases. I was checked for cancer because I was suffering from abnormal night sweats. I was checked twice by two different neurologists to check if I had MS or ME. I’ll let Wolpert describe how his depression affected him and this is precisely how I was affected:

“It was the worst experience of my life. More terrible even than watching my wife die of cancer. I am ashamed to admit that my depression felt worse than her death but it is true. I was in a state that bears no resemblance to anything that I had experienced before. It was not just feeling very low, depressed in the commonly used sense of the word. I was seriously ill. I was totally self-involved, negative and thought about suicide most of the time. I could not think properly, let alone work, and wanted to remain curled up in bed all day. I could not ride my bicycle or go out on my own. I had panic attacks if left alone. And there were numerous physical symptoms – my whole skin would seem to be on fire and I developed uncontrollable twitches. Every new physical sign caused extreme anxiety. I was terrified, for example, that I would be unable to urinate. Sleep was impossible without sleeping pills: these only worked for a few hours, and when I woke up I felt worse. The future was hopeless. I was convinced that I would never work again or recover. There was the strong fear that I might go mad.” (p. vii of Malignant Sadness: The Anatomy of Depression, Faber and Faber, 1999)

Practically every sentence, if not every word of the above paragraph, applied to me as I suffered in 1998. To describe how I felt before I was hospitalised would be that if my brother had told me my mother was dead, I would have said, “thank you for telling me, but I feel terrible!” There was no way I could possible take any news at all on board because I was so “totally self-involved” and so “seriously ill” as Wolpert puts it. I, too, contemplated suicide – suicidal thoughts but I made no plans at all – I had not quite got that bad thankfully. However, suicide was appealing as a way out of this terrible mental torture. I almost jumped out of the seat in delight when I read Wolpert’s list of symptoms because these were the symptoms I had at least twice yearly for a week or so since I was 30 and which three doctors and two specialists failed to catch. It’s not a nice experience when you are actually quite ill to be told there’s nothing wrong with you – it’s almost an accusation that you are a malingerer. If anything I was a workaholic. I had all of Wolpert’s physical symptoms and I was delighted with myself as not alone had my consultant psychiatrist rightly diagnosed endogenous or unipolar depression, but now all my symptoms were not alone validated by a fellow sufferer, but by a Professor of Biology as well!

Now Wolpert is a scientist and atheist and is a person with strong intellectual and rational qualities – I loved these last two points about the book. My experience in the psychiatric hospital left me rudderless and faithless I must admit. I entered St Pat’s a suffering Christian and I came out a healing agnostic which I remain. (I will admit that I am open to all spiritualities, and even to the more spiritual dimensions of organised religions – I see them as healing in a specific concrete sense minus the heaven part as it were. I still love well-celebrated liturgies as moving human (not divine) experiences).

I have always loved metaphor. Take this brilliant metaphor used by Wolpert. Once again I’ll let the eminent scientist speak:

“If we had a soul – and as a hardline materialist I do not believe we do – a useful metaphor for depression could be “soul loss” due to extreme sadness. The body and mind emptied of the soul lose interest in almost everything except themselves. The idea of a wandering soul is widely accepted across numerous cultures as negative. The metaphor captures the way in which we experience our own existence. Our “soul” is our inner essence, something distinctly different from the hard material world in which we live. Lose it and we are depressed, cut off, alone.” (Ibid., p. 3)

Images are important for anyone struggling to come to grips with what is ailing them as they experience any disease whether of body or mind. In fact, modern studies show that invariably to suffer from one implies that we must suffer from the other also. Images I have heard other sufferers of depression use are: ‘cloud,’ ‘fog’, ‘glasshouse,’ ‘long dark tunnel’, ‘bottomless pit,’ ‘prison’ and ‘dungeon.’ I am sure there are many more. Notice how concrete these images are. I suppose in a way all images are, but you know what I mean – how precise they are. They immediately conjure up situations that are extremely painful. For me my depression was quite literally a fog – I could in my mind see an actual fog or mist through which I simply could not penetrate. In a sense for the unaided sufferer communications are definitely down and can only be restored with outside help.

Many stray stimuli have put all these thoughts again in my mind – reading bits and pieces from Wolpert’s latest book Six Impossible Things Before Breakfast: The Evolutionary Origins of Belief in tandem with Richard Dawkins’ The God Delusion , both of which I shall review in these pages if I get the chance. Wolpert like Dawkins is a hardened atheist and materialist, and the former is Vice-President of The British Humanist Association. While I would not agree with the hardened atheistic and materialist stance of both these authors, I believe the write like angels. I’m using the verb “believe” here and the noun "angels" for pure devilment of course!!

Above I have pasted a picture of a rather ominous cloud which I took over San Gimignano in Tuscany July 2006


Alan said...

A beautiful piece of writing. Thank you.

TQ said...

Thanks, Alan. Your comment is much appreciated. I've bookmarked your blog which is also very interesting!

A. C. said...

Thank you, Tim, for your honesty and sharing your experience. Ironically, I also was diagnosed with depression nine years ago.

You mentioned some of the books that you enjoy reading Wolpert's books. I have found a lot of books that I enjoy from New Harbinger (NH). They have a wide selection of psychology and self-help books on a lot of subjects, and it's given me different, more clear perspectives.

I have an idea what you mean when you mentioned the depression was more terrible than watching your wife die from cancer. I've not experienced that, but I do know how depression can be so debilitating that nothing else compares to it.
Ironically(?) I just finished reading a galley for a NH book that deals with cancer and overcoming the depression, anxiety and fear that usually goes along with it. (The book is supposed to be out in December.)

Anyway, this long post is just to say I hear you, and thanks for sharing what's helped you heal and deal with your depression.

TQ said...

Thanks A.C. Your comments are much appreciated.