‘Back in the Dark House Again: The Recurrent Nature of Clinical Depression’ by Douglas Bloch

dblochOne my favourite bloggers is in a dark place at the moment. He’s had the courage to write about it on Mad In America and what he has to say will help other people. My thoughts are with Doug, a truly caring and inspirational person.

“There is not one of us in whom a devil does not dwell.
At some time, at some point, that devil masters each of us.
It is not having been in the dark house,
but having left it, that counts.” Teddy Roosevelt

Eighteen years ago, in the fall of 1996, I plunged into a major depression that almost killed me. On the evening of my admittance to a psychiatric hospital I saw the above quote from a documentary on Teddy Roosevelt. For the next ten months, it informed my experience, as I did everything I could to leave the dark house I was in.

Eventually, I was healed without medication and wrote about my experience in my memoir, When Going Through Hell…Don’t Stop: A Survivor’s Guide to Overcoming Anxiety and Clinical Depression.

Over the next eighteen years I took what I had learned in my healing and put together a mental health recovery program which I taught through my books, support groups and long distance telephone coaching.

In the process, I counseled many people who were in the same desperate straights that I had been in. I shared with them what I had learned through my ordeal – that if you set the intention to heal, reach out for support, and use a combination of mutually supportive therapies to treat your symptoms, you will make it through this.

And in the cases where people used these strategies and hung there, they eventually were able, like myself, to emerge from the hell of depression.

During this period, I was aware that that major depression was a recurring disorder, and that while one could successfully mange the symptoms, there was no cure. As Andrew Solomon, author of The Noonday Demon said,

“Depression is recurring and cyclic. What we have is treatments, not cures. You’re never really free of it; you always have to be prepared for a recurrence and be ready to stave it off as it could creep up on you.”

Thus, I knew that I was still vulnerable, but after such a long period of “emotional sobriety,” I thought that I might have finally turned a corner.

Then one day, when I least expected it, a series of personal losses led me back into Roosevelt’s dark house. In the midst of my grief reaction, the old symptoms of depression–chronic sadness, lack of pleasure, disrupted sleep, loss of appetite, heaviness in the chest, lack of energy, hopelessness and periodic agitation – were all painfully present.

Now that I am back in the underworld, I am called upon to practice those very techniques that I had been teaching others. Of course I have been using these tools all along as part of my “maintenance program,” but now there is a big difference

I am using them not to stay out of hell, but rather to get out. What makes the latter far more difficult is that you cannot will yourself out of a clinical depression any more than you can will yourself out of a tumor or an advanced case of pneumonia.

There is no ten-day course of “brain antibiotics” which you can take and have the condition clear up shortly. In my case, I have learned from my previous episodes that antidepressants do not work for me.

If, then, I cannot directly make the depression leave, what can I do? As I have told my clients, “You have to muddle through and hang in there until things improve. “ Here is how I am attempting to muddle through.

I start with AA’s serenity prayer: God grant me the serenity to accept the things I cannot change, the courage the change the things I can, and the wisdom to know the difference.

Here is what I cannot control and must accept: the biochemical changes in my body and the painful sensations and feelings they bring.

Here is what can I control – how I respond to those sensations and feelings. Here is what I am doing at this time:

When I wake up and immediately feel depressed and hopeless, I recommit to my decision that I want to get well, even though I don’t know how.

Even though I feel as if a huge black bear is sitting on my chest, I still chose to sit up, step out of bed, and get on my stationary bike for 20 minutes.

Throughout the day, I make sure to reach to other people for support.

I have changed my appointment times with my therapist from once a month to once a week.

I continue to put one foot in front the other, despite feeling as if I am walking into a headwind.

When I look into the future and see no hope, I refocus my attention to the present and vow just to get through the day.

I affirm to myself, “This too shall pass.” I say to myself, “Right now you are in the acute phase of dealing with your grief. Things will get better over time.”

Finally, I am noticing those small bits of grace that come my way. For example, an old friend whom I had lost touch with found out about my plight. Now he calls me every day to check on my progress. In addition, at a recent talk I gave, a member f the audience who sensed what I am going through came up to me and said, “You have to come out of this. What other possibility is there?”

Those words reminded me what a social worker told me during one of my hospital stays – ‘The best predictor of the future is the past. You have emerged from these episodes before, and you will do so again.”

Meanwhile, I am still in the dark house. I have been in this prison for two months. I don’t know how much time I have left before the cosmic warden will grant me a reprieve. But I have faith that if I keep “muddling through” and do the things that support my healing then one day, when I least expect it, that reprieve will be granted and I will emerge from the darkness into the light.’