Dimensions of Depression

Mostly I’ll be writing about the kind of depression people get in the second half of life, but I was moved by a this recent blog post about post-partum depression, which is eloquent and… well, beautiful, actually.

There are tangible and intangible aspects to depression. The intangibles revolve around stress: coping with bad things that have happened to you, coping with the expectations of others in light of your expectations of yourself, dealing with developmental phases, and dealing with spiritual issues such as your search for meaning.  The tangible features typically revolve around genetics.  For example, defects of the serotonin transporter gene cause the sort of depression that responds to Paxil.  Bipolar depression is genetic, and that responds to Seroquel.  In post-partum depression, you also have the endocrine (hormone) system to think about, and also the immune system, for the brain is very sensitive and vulnerable to the dance your immune system is doing with the tiny, unique human being that has been living in that special, loving, sacred space in your body.

These things all moosh together.  Depression is always a little physical and a little psychological and a little spiritual.  The depressed person wants to sort this out, and probably needs to, because the question she is asking is, “Who am I, and what does that mean?”  The healer, to whom she turns for help, is probably better off taking an integrative approach, to approach all three domains at once.  The healer and the patient are working on two different timelines.  The answer to the existential question comes with time spent in mindfulness.  Sometimes it takes a lot of time.  Meanwhile, the job of the healer is to alleviate suffering right now.  Medicines can play a role, as long as we remember their rightful role, which is to get a person back to center, or at least moving in that direction.

Why “beautiful”?   Couple of reasons.

First, because there aren’t any really good words to describe what depression feels like. Which is problematic, because you get “What’s wrong?”  all day long.  It is the rare writer who can really nail it; and when she does, look at the comments.  Finally, someone who understands.  Someone finally put words to my hurt.  This is important work.  Painful, but important.

As for the other reason why it’s beautiful.  People who never get depressed don’t fully get this, I don’t think.  But there is an aesthetic dimension to depression that is profound, tender, delicate, vulnerable, and moving.   Think about music.  Happy music is OK I guess.  But it’s not something you carry with you forever, not something you turn to over and over and over again in your life.  This really becomes obvious when you think about artists who are obviously bipolar.  Like Van Morrison, Joni Mitchell, Robert Smith.  These artists are always brilliant but their depressed work is their best.

This is what artists teach us: that the people who love us, see in us a capacity for depth and romanticism.   They see our ability to recognize perfect moments in time and space, and they learn from us the ability fully to be in those moments.  They perceive our keen sense of lyrical beauty and their lives are made richer for it.  I know it’s hard to remember that sometimes.  But it’s true.

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