In the
NY Times, Daphne Merkin writes about her life with recurrent and "treatment-resistant" depression.
A Journey Through Darkness is eloquent and honest, but it offers no convincing explanations as to the origin of her bouts of melancholy. Sometimes she is depressed and then eventually the state passes. In Merkin's account, and in my personal experience, being depressed is a brute fact. It is experienced, not understood. To call it a "journey" or anything else which implies some kind of narrative is misleading. And when a depression passes, it goes with a whimper not a bang:
It was about 4:30, the time of day that, by mid-August, brings with it a whiff of summer’s end. I looked up into the startlingly blue sky; one of the dogs was sitting at my side, her warm body against my leg, drying me off after the swim I had recently taken. I could begin to see the curve of fall up ahead. There would be new books to read, new films to see and new restaurants to try. I envisioned myself writing again, and it didn’t seem like a totally preposterous idea. I had things I wanted to say. Everything felt fragile and freshly come upon, but for now, at least, my depression had stepped back, giving me room to move forward. I had forgotten what it was like to be without it, and for a moment I floundered, wondering how I would recognize myself. I knew for certain it would return, sneaking up on me when I wasn’t looking, but meanwhile there were bound to be glimpses of light if only I stayed around and held fast to the long perspective. It was a chance that seemed worth taking.
The Royal Swedish Academy of Sciences issues
a welcome statement condemning "lie-detector" peddlers Nemesysco for their
attempt to gag two Swedish scientists. (See also
Ministry of Truth for an
extensive take-down of Nemesysco and all who use their products). Although, given that this happened several months ago, they certainly took their time about it...
Incidents of this kind are a threat to research freedom and, by extension, to the free dissemination of information in society. Threats to sue must not be used to restrict scientific discussion.
Finally, I know I
said I don't believe in music reviews, but
Neko Case is
brilliant.
4 comments:
The cyclic nature of depression, that curious ebb and flow, high tide, low tide, one would think, would help aid researchers in ferreting something out, but so far, what have we to explain it?
Yeah, you'd think that, wouldn't you? But in fact there is almost no research on mood switches (in depression or bipolar disorder). Indeed, reading most modern research on depression you'd think people with depression were depressed 24/7, at least until they get treated!
one really good study of a single patient over several years would be worth at least as much as some huge RCT of yet another me-too antidepressant.
Neuroskeptic, I am amazed that most of the mental health blogs, including yours, are omitting the fact that this woman was rapidly tapered off of meds when she enters the hospital (5 of them in 10 days). Even tapering one med too quickly can lead to withdrawal symptoms that falsely looks like a relapse but isn't.
Joseph Glenmullen, who is not anti-meds, talks about this issue in his book, the antidepressant solution.
I wish mental health blogs would stop ignoring withdrawal issues as the Furious Seasons Blog was the only one who pointed this out. Maybe this woman would still be depressed but to ignore a major factor like this is simply not right.
AA
Thanks for your comment AA. I was only really linking to the article, rather than properly commenting on it.
You're probably right about abrupt antidepressant discontinuation, but in this case Merkin is very clear that her depressive relapse occurred before she was admitted. Maybe it wasn't a great idea to then taper all her medications, but it doesn't seem to have done her any lasting harm (she says "Soggy as my brain is from being wrenched off a slew of antidepressants and anti-anxiety medications in the last 10 days...") and her depression lifted a few weeks later on a new medication.
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