"Mr. Smith, the problem is that you are overweight. You have to lose weight and then these other problems will disappear, or become manageable." This diagnosis may be appropriate for a particular moment in the doctor's surgery, but it assumes that Mr Smith's weight is the problem, rather than perhaps being a symptom of other issues in his life.
What about the "problem" we call depression. Is it, in fact, a symptom of wider issues in our lives, as much as it is a problem of itself?
Growing up, there was no such thing as a depression in my world. I knew of a bloke called "Old Melancholy," and there were two blokes whose name was preceded by the title "Happy," which was a clear indication that, characteristically, they were not. But men were never mentally unwell, much less depressed. The use of the word grows noticeably from about 1970, according to the Google Ngram.
We knew about shell-shock, but it was kept safely distant to refer to the wounds of World War I. No one used it of the WWII veteran in our small town, who I now recognise to have been badly traumatised. There was no sense that men lived with mental illness; we were either sane or mad. In the latter case you were removed to Glenside.
However, women were allowed to have breakdowns, or nervous breakdowns. I rather suspect this served to help us men stay secure in our perceived strength and stability, and to reinforce and justify our sexism.
I say all this to make a point: Depression is not polio. It is not a simple disease for which we have a vaccine. Our society-wide hiding and repression of the reality of mental illness warns us that there is something much deeper going on.
Somewhere in the nineties, things changed in my consciousness. I had heard about depression a few times, and thought little of it. But then a clutch of sensitivities and wounds in my personal history had their scabs torn off by a work and family crisis. I was obviously and seriously sick, and despite adopting all the correct personal and professional strategies, I was not getting better. My doctor gave this situation a name: Depression. Just a sickness, he said, not a judgment. He ordered me onto anti-depressants, and shortly after this, I woke up one morning in a different reality. It was as though I had been living in a slow-motion black and white movie, but that on this particular morning, someone had turned on the colour. The change was startling and sudden. (I should point out that I remained fragile, and well "below par" for at least another six months.)
Since my job is to talk, I talked about this healing experience, too. And discovered a trickle of people who would tentatively broach the subject of depression, and not scorned, would often pour out stories of long suffering. I began to wonder if there was a silent plague of pain which was finally gaining a name. About then, Jeff Kennett, the former take-no-prisoners and certainly-not-a-wus Premier of Victoria, went public about his depression. Depression entered the mainstream lexicon. Beyond Blue and The Black Dog Institute were formed. People could name what was happening and seek solutions, which was a great advance over the solitary agonies which, with older eyes, I now suspected I had witnessed among the adults of my childhood. And which I saw had circled, unrecognised, around me.
The idea of depression as an illness has gained a certain acceptance. We are less likely to judge a person who "has depression." No longer whispered about, or denied, depression provides a way of understanding what is happening to family members, friends, fellow employees, and even to one's self. To be able to put a name to the choking heaviness which has invaded a life and crushed it, is enormously liberating. A name is a promise of healing, a sign that, perhaps, something can be done.
There is a down side to all this. As I listen to conversations "in the street," and amongst the pews in my congregation, it is almost as though we have begun to think the naming means we have dealt with the issue. "So and so has depression," we say, and therefore: problem solvered. And effectively, we paint over the problem, as though the naming is the solution. I think sometimes it actually lets us dismiss the problem: we can say, "Oh, he's got depression," and absent ourselves from the solution. Naming it seems to let us think it is not so serious. It can also mean we take on an understanding, if this depression has hammered us, that it should be easily solved. That is, it's just another relatively minor problem which drugs will fix. We can then conclude, if it does not go away quickly, that there is something deeply wrong with us.
Drugs can indeed help our immediate situation, and let us regain some stability. They may well have saved my life. But they deal with one of the symptoms of a depression. They may do nothing at all to address the underlying problems of which a depression is itself a symptom.
I want to emphasise this point: There is a test, a list of symptoms, which will indicate to a doctor that we are "clinically depressed." Clinical depression is real. We can die because of it. I seriously considered if it might be better for my family if I killed myself. People kill themselves.
But what I am wanting to say is that I suspect that clinical depression is often a symptom of something awry elsewhere in our life. A blister on our foot can immobilise us; it could, in the worst case, get infected and even kill us. But the blister is not the real problem. The real problem is something rubbing us up the wrong way. The blister, although now a serious problem in itself if we have to walk five kilometres back to the car, is actually a symptom of that other problem.
The blister which bursts may simply be caused by a piece of grit which we didn't remove from our shoe, or notice in time. In a shallow analysis, I could look at the events which brought my life down as just grit in my shoe. It would be easy to say that I was "done over" and betrayed in my work situation, and became seriously ill as a consequence. The drugs helped me recover. After all, we understand quite well that work related trauma can be devastating.
But what became clear to me was that this was not merely grit in my shoe. There was grit, and it was nasty grit. The thing is, that as grit goes, and even compared to other grit that had shown up in my life, it was relatively minor! What meant that I could not simply walk away? Indeed, as we left the town for the last time, I pulled the car over, took off my shoes, and shook off the dust. This symbolic act was a recognition that the problem was theirs, not me, not mine, and that they would still live with it, while I was free to leave. So why did the pain and stress not ease off? Why did I become even sicker?
The problem was that I was already living in shoes that didn't fit. Like all humans, I was living with life-wounds, some unconscious, and some which I knew about. The major wound was intractable. That is, I knew it was there, and I knew I had to do something about it. I was trying to heal, yet could not find a way. I could not work out a way, or even imagine a way, of living differently from the way which had let me survive childhood, but was now quite inappropriate.
To stretch the metaphor, that town, and that job, quite by accident, were as though I had walked through the sheep yards at the shearing shed with bare and bleeding feet. My scabby wounds and tired immune system were suddenly overwhelmed with infection.
What would we think of a doctor who prescribed anti-biotics for infected feet, but who neglected to point out to their patient, that the underlying problem was that their shoes did not fit? Especially if the person had come back multiple times with infected feet?
I wonder if depression is sometimes trivialised by a too quick and easy prescription of drugs. I think we know at a deep level, as a society, that our shoes don't fit. We have looked for meaning and fulfilment in largely material directions, and are afraid of the spiritual; that is, we are afraid of the questions of life's meaning and purpose. And our pursuit of affluence which is now generations long, means we have become impoverished in our spirituality; in our ability to think about meaning and purpose. So when we arrive at the doctor's seriously depressed, our ill-fitting shoes can hold up to the doctor an unwelcome mirror into their own life and pain. Drugs may provide a quick fix for both of us, enabling both of us to avoid the painful task of finding new shoes! As I have said somewhere else, we sometimes know things we don't know.
The major issue involved in growing up and leaving home is to navigate the discovery that we are wearing our parent's shoes, and that they don't fit. It's painful, and it's hard work to find shoes that fit. Do we simply need drugs to fix the pain, or would new shoes be a smarter strategy? We are the society of the quick fix, so we are conditioned to think that drugs will do the trick. My slow learning is that finding my own shoes is a life's work. Drugs were an interim step, but it was only the finding of new shoes which freed me from the drugs, and their side effects. I suspect we are likely ill-served if we only address a depression with drug therapy. And, as I suggest in the article on weight, more of us than we realise are taking drugs.
… in fact, most of us are into substance abuse. We can’t get started without our morning coffee. We keep going, when we are exhausted, by mainlining sugar. We turn off at night with alcohol.
For many of us, substance abuse is done with food; it messes with our appetites and our weight, and the drug companies—sorry, the food producers—are only too happy to supply us. We cope with life by abusing! Some of us, with comfortable homes and relatively trauma free lives, can be functioning alcoholics, never even drunk, while others of us have had such trauma that only blind drunk, or worse, can blot out the pain. Food, caffeine, grog, drugs, or some other thing, become a coping mechanism.
I think I have often been "not quite depressed" because of other coping mechanisms which were quasi-drugs. And when my coping mechanisms failed, the depression pulled me down.
The Finding of New Shoes
My metaphor of the shoes is breaking down here. I want to say that none of us can live barefoot, which is not true, so I need to change metaphors. Gordon Atkinson says that
It is impossible for a human being to live without a guiding life narrative. A worldview, a myth, whatever you want to call it, some explanation for the whys and what fors of life. And it’s not just that we desire these myths. It’s more than that. We are incapable of living without them. Human beings cannot abide a metaphysical vacuum.
Read his article, because it will help make sense of what I am getting at here.
Gordon points out, that like the ten or eleven year old who suddenly finds that a pair of Dad's shoes fit his feet,
You are born into your parents’ narrative, which is kind of like your hometown... Some people don’t venture far from home. They take the myth they were born into, make a few personal adjustments, and pretty much grow into a second generation of their parents. That’s classic. That’s the way humans have lived for most of our history. Nothing wrong with that.
We can be quite happy to live in Dad's, or Mum's, shoes. But sometimes we have to find another way. Here, Gordon punctures our conceit about the originality of ourselves.
You can try to cobble together some kind of narrative of your own, pulling what appeals to you out of existing myths and making a kind of mash-up for yourself. You can try that. Lord knows I have. But you probably fancy yourself to be a lover of truth, so let’s face a hard fact squarely, shall we? That tin shanty narrative you’re living in is one butt-ugly dog of a myth. It looks like a rusty mobile home on the beach with an AC duct running to the window of a van with no wheels where your buddy Moon Dog sleeps. No one can build a decent myth on her own. You just can’t do it. You’re not smart enough and you haven’t lived long enough. Human narratives require time, community, conflict and resolution between varying points of view, and lots of trial and error.
I think a deep depression, ultimately, happens when the narrative we have lived by no longer works, no longer tells a story for us. It's when our shoes don't fit and we can no longer avoid the need for new shoes by cutting holes, here and there, to relieve the pressure.
My depression came when I already knew my shoes didn't fit. And when I already knew that I could not abide any of the "packaged narratives" I could find on offer. Which left this: all that was on offer was that I became a "lost soul," a person "wandering around, looking for a story, living between the various myths of our culture."
That's why life fell apart. Not because I had to retell my story, but because I simply could not bring myself to enter what Gordon calls "the Negev"; that is, the wilderness of not knowing. I'm not sure I even realised that a desert, lost soul, experience was all that was on offer to me. I know I was deeply afraid, and slowly losing hope that I could make sense of life.
New shoes can't be bought. We have to imagine them and live our way into them. We have to rebuild and reframe our story, which means to find the building blocks of the present story by which we live. It's an exploration of the things that make us up and which drive us. It involves discovering the unaccountable, by which I mean, discovering the reasons behind the odd triggers of our lives. Why does this always set me off? Why do I remember that odd little event? Why do I always avoid going home by that road?
And it involves looking at the things which terrify us and shame us; remembering pain and devastation, which cannot be done without a certain reliving. And finding great gaps of meaning, empty places where nothing makes sense, and perhaps realising we are completely adrift. It is to face the fear that perhaps we won't be able to put this all back together.
We are all different, so even the questions we need to ask will be different. The fears will be different.
Rebuilding and reframing a story, finding a new way to live, is equally unable to be defined by another person. There is also something happenstance about the process. What would it have meant, when finally I came to rethink myself, if I had been more aware of the deep need my father and I had for solitude and rumination, and less aware of the damage done to me by school? I cannot say, but I suspect I may have become a different person.
Gordon bluntly says he can't work out how to navigate all this. Somehow, I've been able to find a way back into a variation of the story which both of us found too tight for our feet. Even so, I can't tell you the way. Stories are never, in the end, learned. They are lived and discovered. There comes a day when we look down and ask ourselves, "When did I get these shoes?"
Gordon reminds us that going through the Negev was the way into the Promised Land. It strikes me that when the New Testament writers seek to emphasise who Jesus was, they often place him in the wilderness, the place where Israel definitively meets God. I wonder if, for some of us, anyway, the Promised Land is not actually in the Negev.
Andrew Prior (2018)
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