Depression, the secret we share | Andrew Solomon | TEDxMet

It's West Africa and we're in East Africa, and our rituals are in some ways very different, but we have some rituals that have something in common with what you're describing." And I said, "Oh." And He said, "Yes." He said, "But we've had a lot of problems with Western mental health workers, especially those who came right after the genocide." And I said, "What kind of problems did you have?" And he said, "Well, they would do." this strange thing." They didn't put people out in the sun, where you start to feel better. They did not include drums or music to encourage people.

They did not involve the entire community. They did not externalize

depression

as an invading spirit. Instead, what they did was take people, one by one, into small, dirty rooms and make them talk for an hour about the bad things that had happened to them." (Laughter) (Applause) He said, "We had (Laughter) Now, on the other end of alternative treatments, let me tell you about Frank Russakoff. Frank Russakoff had perhaps the worst

depression

I have ever seen in a man. He was constantly depressed. He was, when I met him, at a time when every month he would get electroshock treatment, then he would feel kind of disoriented for a week, then he would feel fine for a week and then he would have a week of decline he would have another electroshock treatment and he told me when he did. "It's unbearable to spend my weeks like this." I can't go on like this, and I've already figured out how I'm going to end up if I don't get better.

But, he told me, "I heard about a protocol at Mass General for a procedure called cingulotomy, which "It's brain surgery, and I think I'm going to try it." And I remember being surprised. That's the point of thinking that someone who clearly had so many bad experiences with so many different treatments still had enough optimism buried somewhere to seek out one more. And he had the cingulotomy, and it was incredibly successful. He now he's friends with. Mine has a lovely wife and two beautiful children. He wrote me a letter the Christmas after surgery and said, "My dad sent me two gifts this year.

First, a motorized CD rack from The Sharper Image that I made. I don't really need it, but he knew he was giving it to me." to celebrate the fact that I live alone and have a job that I love. And the other gift was a photo of my grandmother, who committed suicide. As I was unwrapping it, I started crying, and my mother came up to me and said: ' Are you crying for family members you never met?' And I said, 'She had the same illness as me.' I'm crying now as I write to you.

It's not that I'm that sad, but I think it overwhelms me because I could have committed suicide, but my parents helped me, the doctors helped me, and they operated on me. I am alive and grateful. We live in the right time, even if it doesn't always seem like it." I was struck by the fact that depression is generally perceived as a modern, Western, middle-class thing, and I went to see how it operated in a variety of other contexts, and one of the things I was most interested in was depression among the homeless, so I went out to try to see what was being done for poor people with depression.

Most poor people do not receive treatment for depression. Depression is the result of genetic vulnerability, which is presumably evenly distributed in the population, and precipitating circumstances, which are likely to be more severe for impoverished people. That if you have a really beautiful life but you feel miserable all the time, you think, "Why do I feel this way? I must have depression." And you set out to find a treatment for it. But if you have an absolutely horrible life and you feel miserable all the time, the way you feel is proportional to your life, and it doesn't occur to you to think, "Maybe this is treatable." And so we have an epidemic of depression in this country among impoverished people that is not being detected, is not being treated, and is not being addressed, and it is a tragedy of great magnitude.

Then I found an academic who was doing a research project in slums on the outskirts of D.C., where she took in women who had arrived with other health problems and diagnosed them with depression, and then gave six months of the experimental protocol to one of them. they. , Lolly, came in, and this is what she said the day she came in. She said, and by the way, she was a woman who had seven children. He said: "I used to have a job, but I had to do it. I left it because I couldn't leave the house.

I have nothing to say to my children. In the morning, I can't wait for them to leave, and then I get into bed and I cover my head with the blankets, and at three o'clock, when they get home, everything comes very quickly. She said: "I've been taking a lot of Tylenol, anything I can take to help me sleep more. My husband has been telling me I'm stupid, I'm ugly. I wish I could stop the pain." Well, they included her in this experimental protocol, and when I interviewed her six months later, she had accepted a job babysitting for the US Navy, had left her abusive husband, and told me, "My children are very happier now." She said: "There's a room in my new house for the boys and a room for the girls, but at night, they're all just up in my bed and we're all doing homework together and everything.

One of them wants to be a preacher, another wants to be a firefighter and one of the girls says she will be a lawyer. They don't cry like before and they don't fight like before. That's all I need now is my children. Things keep changing, the way I dress, the way I feel, the way I feel. I can go out now without being afraid, and I don't think those bad feelings will come back, and if it weren't for Dr. Miranda and that, I would still be at home with the blankets over my head, if I was still alive. "Lord, send me an angel and he heard my prayers." These experiences moved me greatly and I decided that I wanted to write about them not only in a book she was working on, but also in an article.

Then I received an assignment from The New York Times Magazine to write about depression among the homeless. I turned in my story and my editor called me and said, "We can't really publish this." "Why not?" And she said, "It's too far-fetched. These people who are at the bottom of society and then they get a few months of treatment and they're practically ready to run Morgan Stanley? It's too far-fetched." She said: "I've never heard of anything like this." And I said, "The fact that you've never heard of it is an indication that it's 'news'." (Laughter) (Applause) "And you are a news magazine." So, after some negotiation, they agreed.

But I think a lot of what they said was connected in some strange way to the distaste that people still feel about the idea of ​​treatment, the notion that somehow if we went out and treated a lot of people in destitute communities, that that would be something exploitative to do, because we would be changing them. There is this false moral imperative that seems to be all around us that depression treatment, medications, etc., are artificial and not natural. And I think that is very wrong. It would be natural for people to lose their teeth, but no one is against toothpaste, at least not in my circle.

And then people say, "Okay, but isn't depression part of what people are supposed to experience? Didn't we evolve to have depression? Isn't it part of your personality?" To which I would say that the mood is adaptive. Being able to have sadness, fear, joy, pleasure, and all the other moods we have is incredibly valuable. And major depression is something that happens when that system breaks down. It is maladaptive. People will come to me and say, "I think if I last one more year, I think I can get through this." And I always tell them, "You might get over it, but you'll never be 37 again.

Life is short and you're talking about giving up for a whole year. Think about it." It is a strange property of the English language, and indeed many other languages, that we use this same word, depression, to describe how a child feels when it rains on their birthday, and to describe how someone feels one minute before committing suicide. . People say to me, "Well, is this a continuation of normal sadness?" And I mean, in a way it's a continuation of normal sadness. There is some continuity, but it's the same way there is continuity between having an iron fence outside your house that gets a little rust spot that you have to sand and repaint a little, and what happens if you leave the house for 100 years and rusts to just a pile of orange dust.

And it is that patch of orange dust, that problem of orange dust, that we intend to address. So now people say, "You take these happy pills and you feel happy?" And I do not. But I don't feel sad about having to eat lunch, or about my answering machine, or about taking a shower. In fact, I think I feel more because I can feel sadness without nullity. I feel sad about professional disappointments, about damaged relationships, about global warming. Those are the things I feel sad about now. And I said to myself, well, what's the bottom line? How did those people who have a better life even with major depression manage to get ahead?

What is the resilience mechanism? And what occurred to me over time was that the people who deny their experience, the ones who say, "I was depressed a long time ago and I never want to think about it again and I'm not going to look at it and I'm going to move on with my life." "Ironically, those are the people who are most enslaved by what they have. Letting go of depression strengthens it. As you hide from it, it grows. And the people who do best are the ones who can tolerate having this condition. Those who can tolerate their depression are those who achieve resilience.

Then Frank Russakoff told me, "If I had to do it over again, I guess I wouldn't do it this way, but in a strange way, I'm grateful for what I've experienced. I'm glad I got to do it." I've been to the hospital 40 times. It taught me a lot about love, and my relationship with my parents and my doctors has been very valuable to me and always will be." And Maggie Robbins said, "I used to volunteer at an AIDS clinic, and I would just talk and talk and I was talking, and the people I was dealing with weren't very receptive, and I thought, 'That's not very friendly or helpful for them.' And then I realized, I realized that they weren't going to do more than those first few minutes of small talk.

It was just going to be a time when I didn't have AIDS and I wasn't dying, but I could do it. "I tolerate the fact that they did it and they were it. Our needs are our greatest assets. It turns out that I have learned to give everything I need." Appreciating one's own depression does not prevent a relapse, but it can make the prospect of a relapse and even the relapse itself easier to tolerate. The point is not so much to find great meaning and decide that your depression has been very significant. It's about searching for that meaning and thinking, when it comes back, "This will be hell, but I'll learn something from it." In my own depression I learned how big an emotion can be, how it can be more real than the facts, and I discovered that that experience has allowed me to experience positive emotions in a more intense and more focused way.

The opposite of depression is not happiness, but vitality, and these days my life is vital, even on the days when I am sad. I felt that funeral in my brain, and I sat next to the colossus at the end of the world, and I discovered something inside me that I would have to call a soul that I had never formulated until that day 20 years ago when Hell came to pay me a surprise visit . I think that while I hated being depressed and would hate to be depressed again, I have found a way to love my depression.

I love it because it has forced me to find and hold on to joy. I love it because every day I decide, sometimes bravely and sometimes against the reason of the moment, to cling to the reasons for living. And that, I think, is a very privileged rapture. Thank you. (Applause)