Whenever I've written about my experience of recovery, many readers comment that turning their lives around, as I've been able to do, is not going to happen for them.
They've accepted the fact that their depression will last for the rest of their lives. Even if they're coping well right now, they understand that depression is going to come back. They'll be taking medication for as long as they're around.
Everyone has to make peace in their own way with a chronic illness like major depressive disorder. There are no rules. The course of depression is different for everyone. They differ in reactions to various medications and forms of treatment, the severity and length of each episode and the degree of disability the illness imposes.
If you've gone through one major depressive episode after another and neither medication nor therapy have been very effective, it's only natural to accept what your experience is telling you. I'm stuck with this, so I'd better figure out how to live with it.
That's exactly what I believed for much of my life. It's only in the last few years that my expectations about my future with depression have changed. And I have to say that the mental health professionals haven't been much help as I've experienced that change.
As I wrote in the last post, psychiatrists and therapists, except for the few blessed exceptions, don't "do" well-being. They aim for remission of symptoms and define recovery as getting over a major episode rather than recovering from the illness itself. The diagnosis is never retracted and the patient never declared cured.
There's an important book on how people with a long history of depression have adapted their lives to the illness. David Karp's Speaking of Sadness bases its conclusions on intensive interviews with 50 people, as well as the author's own experience.
He found that almost everyone he interviewed had gone through four major phases in reacting to the illness. These four tally with my experience, and I wonder if they do with yours.
* First comes a period of inchoate feelings when you notice a number of problems long before you have any idea about depression, or even the words to describe it. That's especially true in childhood through the teen years. Spending more and more time alone, feeling gloomy, sleeping more or less than usual might become common. Migraine headaches might set in. Perhaps it's weight gain or increasing anxiety in groups or at work. You're aware of these problems but don't relate them to each other. It's just the way things are.
* Next comes a recognition that these are serious problems. You start to think that "something must really be wrong with me." This can’t be normal, and you look more closely at each sign of trouble. As you grasp how often you feel terrible and can’t function well, you start to think about how to get rid of such a pervasive despairing attitude about yourself and your life. But whatever you try doesn’t work.
