Talking About Depression

Sometimes great benefit follows great tragedy . . . Robin Williams’ unfortunate death by suicide has drawn some much-needed attention to the disease of depression.

Addiction is often a gateway to depression, and vice versa. Williams may have had a genetic predisposition toward developing both. The major surgery he underwent in 2009 to replace his aortic valve may also have been a factor. As I recently learned firsthand, major surgery can lead to major depression.

Last photo of Robin Williams via Instagram, July 21, his 63rd birthday
Last photo of Robin Williams via Instagram, July 21, his 63rd birthday

During an appearance on the Ellen Degeneres show, Williams dismissed any suggestion that he may have suffered from depression after the surgery. I suspect he was either in denial or uncomfortable talking about depression.  He did have this to say: “they literally open you up, they crack the box, and you get really vulnerable . . . and you get very, very emotional about everything.”

That was my experience in the hospital following my liver transplant. I was extremely emotional, crying at the drop of a hat. Not sad, I was happy, appreciative. I came home, was fine for a few weeks, and then . . .

Depression following major surgery is caused by a complex mix of physical, emotional, and behavioral changes a patient goes through, and in my case, there was also the medication to suppress my immune system so my body will not reject the new liver and the medicine I take to offset side effects of the anti-rejection meds. Quite a combo.

Like most people, I get depressed from time to time. It usually doesn’t last long. This was something else entirely, and it came to a climax over the 4th of July weekend. I felt alone, hopeless, helpless. I couldn’t eat, read, do any of things I would normally do when I feel blue. All I wanted to do was sleep . . . and I was thinking about the Big Sleep and how to induce it.

For the first time in my life I was afforded a glimpse into the desperation someone in the grip of severe depression must feel, when the agony of trying to get through another day seems so overwhelming that you think, what’s the point? Why try? Who cares?  You sort of just want it over.

That Sunday, I heard from my cousin. She was sick. She was afraid her cancer was back and that it was spreading through her body. I only felt worse after that. The next day I went on a clinic visit and had a meltdown in front of my doctor and the social worker. They were very patient, spent lots of time with me that morning. My doctor wrote a prescription for anti-depression medication. He said it would take 6 weeks for the drug to take effect. Listen, when I take pills, I want ones that are fast acting. I still haven’t filled the prescription.

On the way home, I began to fell lighter. Maybe it was just getting everything off my chest – and I was brutally honest about what I was going through, I didn’t hold back. I began to think about my cousin. What she was facing was much worse than what I was going through. When I got home I had some unexpected interaction with another USC transplant patient, a guy who has been on the waiting list for a transplant six years. I was on the list only a year and a half, cancer put me on a fast track. I reflected on all the people I had met during the that time, some who were very sick and weren’t going to make it, some that I saw just that morning, who had transplants also and were not doing nearly as good physically as I was.

What was I grousing about? I was so fortunate. My recovery was coming along phenomenally.  So many people had gone to bat for me, invested time and energy. What was wrong with me?  Look at all the others who are having a much rougher battle, my dear cousin was probably dying . . . Empathy began to kick in.

One of the books I relied on during my journey through liver disease and cancer was Ultimate Healing The Power of Compassion by Lama Zopa Rinpoche. It is about inner healing, based on the traditional Tibetan Buddhist healing philosophy where to cure any disease, you must first cure the mind.

I went back to the book, found a passage that had always stuck in my mind:

A compassionate person is the most powerful healer, not only of their own disease and other problems, but of those of others. A person with loving kindness and compassion heals others simply by existing.”

When you are suffering from depression, you question the value of your existence, and in your twisted thinking, you wonder if life is worth holding on to, but, here it says that just by existing your life has meaning.  A very powerful thought. Very easy to forget. Analyzing my own situation from a Buddhist perspective, I would say the root cause of my depression was self-centeredness. I was indulging in self-pity, feeling sorry for myself.

Compassion gets you out of yourself.  You can take the Noble Eightfold Path, the Bodhisattva Path, and all the 80,000 Buddhist teachings, and distill them all down to this: the enemy is your self, the battle is to win over yourself.  Compassion is the art of this war.

Lama Zopa Rinpoche has a section on dealing with depression.  I glossed over it before.  I wasn’t depressed then.  He writes,

What made you experience this depression? Your ego, your self-cherishing thought. There is an immediate connection between depression and the strong cherishing of I. You become depressed basically because the ego doesn’t get what it wants or expects.”

A former child star is taking some flak for tweeting that Williams was selfish by committing suicide. But he’s right. A person in a fog of depression has limited vision, and is capable of little wisdom. So wrapped up in their own pain, the pain that they will cause others with their act does not enter into the mind, or if it does, it is dismissed, or overshadowed by the darkness.

Lama Zopa Rinpoche offers three powerful techniques for fighting depression: remember impermanence and death, experience your depression on behalf of others, and give your depression to your ego. I like the last one. Why not? Since your ego is not you, and not real, but just a manifestation of self-cherishing thoughts, let the ego take care of the depression. Lighten your load.

orson-welles_trialI don’t know how serious was my bout with depression. It seems to be over and done with, although some residue lingers. When my thoughts were at their darkest, there was still the faint light of others that shined through – I could never intentionally do something that would inflict that kind of pain on my father and my other relatives or friends. Obviously, the darkness that surrounded Robin Williams was deeper.

I wrote above that Williams might have been in denial about post-surgery depression. It’s also been suggested that his periodic rehab check-ins to “maintain his sobriety” over the years, were covers for depression treatment. Strange commentary on our society where treatment for substance abuse has less of a stigma than treatment for psychological issues.

A few days after my cousin died, a tenant in my building left a few books in the laundry room for others to take, a romance novel, a science fiction adventure, and Against Depression by Peter D. Kramer. I grabbed the latter. I haven’t read it cover to cover but rather have jumped around. Kramer sees depression as a disease (some say it is a disorder), and he advocates an all-out, take-no-prisoners approach similar to the one that allowed us to eradicate smallpox. He says, “Not fearing depression, we might love more generously.”

Only 16 or 17 percent of Americans ever experience major depression, yet Kramer also says,

For a group that extends far beyond the minority who go on to suffer the syndrome, depression is the disease that stands in the wings. Many of us, and here I include myself, spend much our lives fending off depression, in those we care about, but also in ourselves.”

His message is clear. Anyone can have depression. Anyone can feel so alone and hopeless that almost on a whim, even though the thought has been thought many times before, they can try to cut themselves with a knife, hang themselves with a belt . . . unless someone is there to stop them.

Robin Williams has left us. He’s left us laughing, but he’s also left us talking about depression and that is a good thing. I think he would want us not to fear depression, and I think he would be pleased if by talking openly about depression we were able to love more generously.

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10 thoughts on “Talking About Depression

  1. I, too, am glad to see that there is so much more awareness about subjects that have always been so taboo.

    In my journey, I was suffering emotionally because I saw myself as unworthy and inferior to everyone else. I may have acted irrationally, but it was because I was not able to see reality. I desperately sought safety outside of myself, because the abusive environment of my mind was not safe at all. And sadly, I was also unable to understand that I was loved by anyone.

    My healing has been about redefining misperceptions, regarding my mind–EVERYTHING about it!–with nothing but love and compassion, and working toward seeing myself as a part of a greater whole, rather than as isolated and inadequate. It is a very self-centered journey, but it’s led to a much greater understanding and empathy for those around me.

    1. There are different degrees of self-centeredness, and our journey is an inner one, going within ourself – but it’s that self that is, as you say, part of the greater whole, not the isolated and inadequate, or superior/egotistical self, that leads to so much suffering. Walk on.

  2. My experience of depression truly sucks, and it does sometimes require one to press his tongue against the palette of his mouth and brace against the storm. Sometimes samhadi isn’t possible. The same can be true of depressions ugly bed fellow, anxiety. I’m sorry you went through July feeling this way mate. Thinking of you.

    1. Thanks, Steve. I know that depression and anxiety are closely related, brothers, or perhaps sisters, they are. And yes, sometimes seated meditation is not possible at all. Walking meditation has been very helpful. Although trying to practice that in a residential neighborhood is a challenge with all the distractions and noise. Damn, if it isn’t one thing, it’s another . . . if only the world could be perfect . . ?

  3. I have a longstanding family history of depression. I grew up with my mother who was profoundly depressed. I believed the only reason she didn’t kill herself was because of me, I needed her. I always worried that when I grew up she’d kill herself because I wouldn’t need her anymore, and in a way that story did play out, in a passive way. I hated depression and would pump myself up and determine to NEVER be depressed. It was a sign of weakness to allow myself to be depressed, so my thinking went. Over the years my anxiety got worse and worse, to the point where I couldn’t drive in heavy traffic, couldn’t leave the house if it rained, and I became hyper-irritable. A therapist pointed out to me that I may have what’s called an agitated depression and suggested trying an anti-depressant. I was open to it, talked to my DR about it and started taking an anti-depressant. I know they say it could take up to six weeks to start working but for me it started working as soon as I had the prescription in my hand. And it’s just gotten better. All my life I had trouble getting to sleep and trouble waking up. It was painful to wake up. A few weeks on the anti-depressant I could wake up so EASILY and realized that this is how most people wake up naturally. Maybe I’m not a lazy bum, but just a person with a chemical imbalance in my brain. It changed my life.

    1. Allison, thank you so much for sharing your story in this comment. It grieves me to think that if it isn’t difficult enough struggling through the sense of apathy and helplessness depression brings, those suffering from it must also contend with feeling that they are lazy bums or otherwise inadequate, second-class, etc. That’s another reason why it is a good thing that depression is coming out into the open, and in time, perceptions will change, as it has for many other diseases.

      I didn’t intend to dismiss the effectiveness of anti-depressants. That’s just my gut reaction to the whole idea of taking drugs, based on my past orientation to them (as fast tracks to nirvana) and recreational use. Perhaps, I would benefit from anti-depressants. I am having quite a battle with insomnia, for which drugs like benedryl and ambien seem to help only in the short run.

      I am happy that your life has changed for the better and hope that it gets continues to get even better in the future.

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