Depression and the Shackles of Shame

There is no blood test for depression, no x-ray nor sonagram.  Depression is the label that is given to a constellation of symptoms.  There are theories about the cause of the symptoms.  But the diagnosis is more like tea leaves. 


Depression Diagnostic Criteria 

· Lasting sad, anxious, or empty mood
· Loss of interest or pleasure in activities once enjoyed, including sex
· Feelings of hopelessness or pessimism
· Feelings of guilt, worthlessness, or helplessness
· Decreased energy, a feeling of fatigue or of being “slowed down”
· Difficulty concentrating, remembering, making decisions
· Restlessness or irritability
· Sleeping too much, or can’t sleep
· Change in appetite and/or unintended weight loss or gain
· Chronic pain or other persistent bodily symptoms without physical cause
· Thoughts of death or suicide, or suicide attempts.

If you have five of the above, including one of the first two, for more than two weeks, and without appropriate reason (like, your mother died) then that's depression. You've got the Grim at the bottom of your teacup. 

Guilt

I have done enough intake interviews that I recognize the differential diagnostic tree when it's coming at me. I used to get nervous when they asked about guilt. No, I don't actually feel guilt, except appropriate guilt for recent misbehavior, not the horrible self-judgment for imagined offenses. I don't feel guilty for my depression. I am not the offender but the offended.

Shame

No, what I feel about my depression, and events that are related, is shame.  And what I really feel shame about is feeling shame.

Thank You For Being My Friends

Try this experiment on yourself.  Imagine that you are standing at the base of the hill.  What do you see, smell, hear?  Put yourself in this picture.  Are you with anybody?  If so, who is it?  What is your relationship like? 

Now, tell me. How steep is the hill?  Really steep?  Sort of steep?  Not so steep? 

Friends And The Perception Of Difficulty 

I Am Not SAD

What month has the highest rate of suicides in the northern hemisphere?  What about the lowest? You will find the answer at the end of this post. 

Seasonal Affective Disorder

Some people get depressed in the winter.  Along about October or November, they start to feel lethargic.  They want to sleep a lot.  They crave carbs and gain weight.  They may lose interest in their normal activities, not want to see people, feel hopeless, think about death.  The deeper the winter, the sadder they feel.  In April, they start to feel better, regain their energy, and even feel giddy by the time May comes round.  It happens almost every year.

This is a specific kind of Major Depressive Disorder called SAD, Seasonal Affective Disorder.  It is no fun.

In The Beginning

In the beginning I went to my doctor for a med check. I had been on Prozac for three months. I was anxious and agitated, irritable, couldn't concentrate and couldn't sleep. I thought I needed a higher dose.

I was wrong. 

As I walked in the door, I had a thought. It was more intrusive than a fantasy, and less welcome. Never mind for now what it was, but it involved a nail file... I didn't tell my doctor about this thought. I just got my higher dose.

That is when things started to get really bizarre. 

The Birth Of Prozac Monologues 

A short while later, while coming off Prozac, I tried to imagine how I could tell people about what it was like to have to come off Prozac. The only medium that seemed appropriate was the stand-up comedy routine.

And that was the birth of Prozac Monologues, with its first chapter, Bizarre.

Someday, Prozac Monologues will be available to the purchasing public. For now, come here to find out about depression and its treatment, drugs and research, the brain and its wonders.

Welcome -- Willa

photo modified from original by Tom Varco

reformatted 11/26/10