Comments issue

Just wanted to take a moment to thank the folks who left the two (!) comments here so far. Unfortunately I have not had any luck responding/replying to comments due to internet issues beyond my ken. I'll see if I can get this sorted out in the next few days. Since my readership is not exactly massive, I will place this issue in the bucket of things that do not require immediate attention!

I want to see the colors, Part I

As I mentioned recently, last month I called the local community mental health center to give the world of pharmaceutical psychiatry a crack at my condition. In the next few posts I want to cover some of the history that led me here. In order to keep the navel-gazing to a minimum, I will try to focus on insights that might be of use to others and to keep the discussion centered, whenever possible, on our current understandings of depression and dysthymia. But this is, in fact, all about me, so I apologize in advance! These posts will involve going back a bit in time, to a long major depressive episode. Back to the revelation, for me at least, that depression is not, and need not be, the normal reaction to setbacks in life, even major setbacks. And, as a way of finding focus, it goes back to the suicide of a man who seemed to have the perfect life.

The music of depression

in the New York Times

That is all.

Depression kills (Outsourced to Aaron Swartz)

I imagine most people have not been following the internet conversation centered on the recent suicide of Aaron Swartz. Briefly, he was a coder and an activist and a proponent of open information. One might summarize the circumstances that led to his death like this: he was hounded to death by the Obama administration's Department of Justice. Here is civil libertarian Glen Greenwald on the background, for those interested.

When I heard that Swartz killed himself I wondered if there were underlying affective issues at work, in addition to the disproportionate penalties he was facing.  And, sure enough, Swartz had long battled depression. Here he is addressing that issue in his blog in 2007 (linked to in the Greenwald piece) (emphasis mine):

Surely there have been times when you’ve been sad. Perhaps a loved one has abandoned you or a plan has gone horribly awry. Your face falls. Perhaps you cry. You feel worthless. You wonder whether it’s worth going on. Everything you think about seems bleak — the things you’ve done, the things you hope to do, the people around you. You want to lie in bed and keep the lights off. Depressed mood is like that, only it doesn’t come for any reason and it doesn’t go for any either. Go outside and get some fresh air or cuddle with a loved one and you don’t feel any better, only more upset at being unable to feel the joy that everyone else seems to feel. Everything gets colored by the sadness.

At best, you tell yourself that your thinking is irrational, that it is simply a mood disorder, that you should get on with your life. But sometimes that is worse. You feel as if streaks of pain are running through your head, you thrash your body, you search for some escape but find none. And this is one of the more moderate forms. As George Scialabba put it, “acute depression does not feel like falling ill, it feels like being tortured … the pain is not localized; it runs along every nerve, an unconsuming fire. … Even though one knows better, one cannot believe that it will ever end, or that anyone else has ever felt anything like it.”

The economist Richard Layard, after advocating that the goal of public policy should be to maximize happiness, set out to learn what the greatest impediment to happiness was today. His conclusion: depression. Depression causes nearly half of all disability, it affects one in six, and explains more current unhappiness than poverty. And (important for public policy) Cognitive-Behavioral Therapy has a short-term success rate of 50%. Sadly, depression (like other mental illnesses, especially addiction) is not seen as “real” enough to deserve the investment and awareness of conditions like breast cancer (1 in 8) or AIDS (1 in 150). And there is, of course, the shame.

Yes, there is of course the shame. We can look to cancer, for example, as an issue around which there is much less shame than there used to be, and hope that the shame of depression might one day be a relic of a less tolerant past.

But one thing that jumps out at me here, in addition to the excellent characterizations of depression from Swartz and Scialabba, is Swartz's statement that the bleakness takes no account of one's own accomplishments. By the time he wrote that, Swartz was already a highly accomplished coder and entrepreneur: he had helped create RSS and was a founder of Reddit (NY Times obit). He had accomplished much and promised much more. Yet none of that could keep depression at bay. Depression does not care who you are or what you have done. It does not care what you might accomplish; it is indifferent to your promise, to your intelligence, to every good quality you might possess. Like the black death, bringing down prince and peasant, it is an equal opportunity scourge.

By all accounts Swartz was a kind and generous person who tried, with much success, to make the world a more decent place. His own suffering would be tragedy enough. But the tragedy here extends beyond the personal, and we will surely never know the full social cost of one life cut short by demons.

For more on Swartz, I recommend:

A nice piece at Gawker, including a lovely passage from a former partner.

Crooked Timber (the good folks at CT have a series of posts up on Swartz)

Lawrence Lessig on the overzealous prosecution.

Thoughts on comfort and joy

Those who are depressed or dysthymic will recognize the holiday season as an especially poignant time. The demands to feel joy, and in particular to find joy in one's networks of family and friends, are particularly acute.  We often refer to those networks with the shorthand term "home." "Home" of course carries a massive and unruly load of meanings and associations, many of them real, certainly, but many of them manufactured, especially  in the context of the holidays.