Major Depressive Disorder (Source: NIMH)

  • Major Depressive Disorder is the leading cause of disability in the U.S. for ages 15-44.
  • Major Depressive Disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year.
  • While Major Depressive Disorder can develop at any age, the median age at onset is 32.
  • Major Depressive Disorder is more prevalent in women than in men.

*

I had to look those numbers up, because too often I feel alone in my diagnosis.

You see, contrary to most people’s impression of me, I am depressive. Clinically. Sometimes, debilitatingly. But only my two closest friends and my psychiatrist (no, not even my family) know how grim I can get.

*

Here’s how it usually goes when I mention it to the uninformed:

“I’m sad.”

“But your life is so awesome. You are so awesome. Cheer up!”

*

I don’t know how to write about it. It’s embarrassing. And I don’t understand it.

But I do know what pisses me off about it.

Articles like this one, recently published in The New York Times:

Talk Doesn’t Pay, So Psychiatry Turns Instead to Drug Therapy

The article examines the switch from psychiatric talk therapy to becoming mere pill factories and how disgruntled older psychiatrists are (or aren’t) about it and how patients are suffering nonetheless.

*

I was going through a crippling wave of depression about seven years ago. I was finally convinced to see my friend’s psychiatrist. I was terrified. This would be my first trip to a real, live, “New York Shrink”.

I had been to one social worker/therapist in Chicago six years before that, but with awful results. After two visits and a recommendation for a bottle of St. John’s Wort and a couple bars of dark chocolate, I was sent home with a treacle-dripping “Feel better!” and a wave.

And that was during the truly borderline years.

So while I told myself that a ‘professional’ would be better than that particular weirdo therapist, I knew I didn’t want drugs to solve my problems. I knew I was a smart person and that I could figure things out if someone would just listen to me and understand me and give me some tools to help me fix the sadness.

*

I got a prescription for Zoloft at the end of my first visit.

“After you’re chemically balanced, we’ll be able to figure out what’s really going on.”

After I was chemically balanced, I had nothing to talk about.

*

Sure, I was no longer on the emotional roller coaster, but neither did I have the capacity to talk about what was making me so miserable, because suddenly nothing was making me miserable.

I spent two years rehashing broken relationships, parental annoyances, professional disappointments, but they seemed so inconsequential. I was putting on a performance for her, because that was what I felt I was supposed to be doing, and I didn’t want to waste a penny of my $200 45-minute hour.

Also, I got fat.

Zoloft stopped what little metabolism my diabetically-inclined body has, and because I was an emotionless blob, I started eating and staring at the television all the time.

More than usual, anyway.

Add ‘overweight slob’ to my weekly schpiel.

*

Eventually, thankfully, my rational senses took over and I weaned myself off of the drugs and the shrink’s staid head-nodding, non-responsive “um-hmm” attempts at fixing me.

And for a while, I was better. I was. My brain came back. I met a guy. The thrill of meeting him was exhilarating, the orgasms were mind-blowing and the break-up was devastating.

As it should be.

*

Life resumed its normalcy.

*

Slowly, ever so slowly, the depression came back. I don’t know where it came from. It’s genetic, I had learned that, so certainly it was in my DNA. A chemical imbalance? Maybe. A learned coping mechanism? Sure. I could see that.

But whatever it was, things were getting bad again.

Really bad.

And I didn’t know how to deal, other than I knew I needed to talk and I didn’t want to keep bothering my two friends. I know friends say that’s what they’re there for, but nobody is there for long when things get like my things get.

So I looked for another psychiatrist.

But no drugs this time. I was adamant.

Plus, it took me two long years to lose those additional 40 lbs.

And I was lookin’ good.

*

I found one. One who was in the business for all the right reasons. He didn’t think I needed drugs. He even gave me a massive discount because I was broker than broke.

I talked.

He talked back.

And it helped.

A lot.

*

I’ve been away from him and our bi-monthly sessions for nine months and I can feel the all-too-familiar twinge creeping back.

But I recognize it now. And I know what to do before it gets too ugly.

I have to go talk to someone.

*

No drugs.

*

Talk.

*

My appointment’s next Tuesday.

TAGS: , , , , , ,

KIMBERLY M. WETHERELL Kimberly's many and varied lives have included actor, stage manager, opera and film director, producer, writer, and restaurateur. She only has three lives left and she's not going to waste a single one of them. The first Arts & Culture Editor for TNB and creator of the TNB Literary Experience, Kimberly has been published by Rizzoli in the book Brooklyn Bar Bites, CRAFT Magazine, The Mighty, and SMITH Magazine, among others. She co-founded the food and drink reading and storytelling series DISH at Housing Works Bookstore Cafe in New York City and she's working on multiple projects including her debut novel, several screenplays, and a documentary about female film editors. She thanks you for stopping by and sitting a spell.

48 responses to “Can We Talk?”

  1. Irene Zion says:

    Kimberly,

    You are a terrific actress, I never, ever would have known from my few contacts with you.
    I know what you’re talking about.
    Take care of yourself.

  2. Gloria says:

    Good for you, Kimberly, for returning to therapy, for looking for the paradigm that fits you best, and for not accepting the big blow off. I won’t use words like “brave” or “survivor” because, if you’re anything like me, those words might make you a little stabby. I will, however, applaud you for using that big, beautiful (chemically wonky) brain of yours.

    I disagree so, so much about talk therapy not being valuable. What a ridiculous suggestion. I’ve been in therapy since September of 2004, with the same therapist (not for depression, but for an “emotional disorder not otherwise specified” – due to a head injury and a lifetime of suffering.) I’ve tried several different medications. I was on one cocktail for five years and, while it was useful, I experienced the same disconnect from my emotions that you mention. So, I went off and after about ten months didn’t feel like I could parent anymore. So, we’re trying something new – lithium – and it’s working great. But that’s just another tool that is helping me. Really, it would be far less useful if it weren’t coupled with therapy, which has saved my life over and over again (and by that, I mean my “live life to the fullest” life). I was lucky to find the right therapist.

    I really hope you find someone that’s a good fit, Kim. And if you don’t, you can always quit him or her and shop around until you do find the right fit. Just like you don’t have to assume you’ve found a long term romance just because you’ve gone on one date, so too is it true that one appointment with a therapist doesn’t mean you’re obligated to commit your life and money to that person. Those’re my thoughts.

    Good luck, sweet, dear woman!

    XO
    Glo

    • Heh. Stabby. Yes.

      I have learned to ask pretty good questions over the phone when interviewing therapists and am also no longer afraid to quit when someone isn’t the right fit for me.

      Here’s hoping this new therapist passes the muster until I can get back to New York and resume my sessions with Dr. Wonderful.

      (And not for nothing, how I wish I had some sort of cool-ass ‘undiagnosable’ diagnosis. Depression is so Elizabeth Wurtzel circa 1994. Not modern-day glamorous in the least.)

      Love and luck right back ‘atcha.

      • Gloria says:

        Hrm. I don’t know about “glamorous.” I was denied life insurance for my sexy emotional (or is it “mood?”) disorder NOS. Apparently, this is on par with batshit as far as the insurance companies are concerned. (Incidentally, Major Depressive Disorder falls under the Mood Disorder category, too.) The NOS part means – THIS PERSON IS CRAZY AND WE CAN’T EVEN TELL YOU WHY. Like I have some sorta Sean Young twitch or something. So, my therapist had to write a note that insists that 1) I’ve never been homicidal, 2) I’ve never been suicidal, and 3) I live a healthy, functional life with chart notes that show an increase in functionality over the course of my therapy. The thing is – if I weren’t being treated for this – if I were just left without help, I could get life insurance. The irony makes me stabby. BUT FOR THE RECORD – NOT LITERALLY!

  3. I saw this in the news as well! Ridiculous. It seems like lately everything that could possibly make life better for people is getting the squeeze. I keep thinking of George Carlin’s “they own you!” bit. Kudos to you, K-dub, for finally knowing what works for you and insisting upon it. Hugs, hugs, hugs!

  4. Zara Potts says:

    Darling Zister.
    Talking is good. Yelling sometimes helps.
    I can’t offer you any solutions, I wish I could, except to say that my ear is always available to you as are my arms.
    Love to you xxx

  5. dwoz says:

    If you’re reading this note, you have my email addy.

    I’m all ears.

    Actually, that’s not true, my ears are quite proportional to the rest of me. In case you were wondering.

  6. Art Edwards says:

    Good listeners are worth whatever you have to pay them, and hopefully you don’t have to pay them too much.

    Good luck, K.

  7. Jim says:

    Keep writing. Keep shooting. Keep talking, K-Dub. And stay cool in the Burg this summer; I know how sticky it can be there.

  8. J.M. Blaine says:

    Yes ma’am
    we can talk
    any time.

  9. Uche Ogbuji says:

    I do look forward to talking to you again, K. To listening to you, whether in the sunny side, or under the clouds. Meanwhile thank goodness for two close friends. And for professionals who care. Be well.

  10. Greg Olear says:

    Good therapists are worth their weight in gold, that’s for sure. Problem is, as in all walks of life, there are any number of bad ones. I hope your new one is the best!

    The rush to prescribe pills reminds me of that great dialogue in BRAVE NEW WORLD, where the guy whose name escapes me tells Mustapha Mond that he doesn’t want to take soma. Huxley knew his shit.

    Thanks for sharing, K-Dub.

  11. Judy Prince says:

    Good for you, writing about your depression, Kim! If you should feel the need to get additional help, I’d recommend David Burns’ *Ten Days to Self-Esteem*. In the UK, the government provides funds for training cognitive (behavioural) therapists. Here’s my amazon.com review of Burns’ book:

    ‘What ended my depression and anxiety (going on 5 years now) was working through David Burns’ workbook, “Ten Days to Self-Esteem,” (admittedly a pitiful title!).

    I’d previously read Burns’ popular book, “Feeling Good,” and well understood his main points, as well as liked his straightforward, practical, humourous, example-filled writing, but, for all that, my depression didn’t lift.

    So I went to amazon.com for customer reviews of his other books. One of the most successful, according to reviewers, was his “Ten Days to Self-Esteem” workbook.

    One stand-out statement by a reviewer proved entirely true: You have to WRITE OUT the answers to the workbook’s exercises. Naturally, I began the workbook, which seemed so simple—and didn’t write out my answers. Burns caught me immediately and made me laugh at myself by saying that I (the reader) probably was not writing down the answers, and he quickly convinced me to commit to it, which I did.

    By the second day, I felt my depression lessening noticeably, and my rating on his brief Depression Checklist showed the same. I persisted in writing my answers, and rapidly my depression lifted.

    I most remember Burns saying that the way we feel is caused by what we think. In other words, our thoughts cause our feelings, not vice versa. And when we’re feeling depressed, we don’t think logically. We reason falsely. Our thoughts are logical fallacies. The main fallacy, for me, was “All Or Nothing” thinking, such as: “I’ll never be able to get the kind of job I want”, or “I’m just no good,” or “I can’t do anything right,” or “No one could possibly love me.”

    Rebuts to the first of those “All Or Nothing” statements might go something like this: “Have you ever had a job that you enjoyed or which had *bits* that you enjoyed?” or “Is it possible that you might read about a job that has some of the things you enjoy?” or “Is it possible that you might meet or read about someone who knows of a job you might enjoy?”

    Writing out your answers to reasonable, logical questions such as these will get one’s brain back to reality, to the actual world, and away from the false world of constant self-negatives.

    I do hope you’ll get and work the workbook!’

    —————–

    All best thoughts to you, Kim.

    • It’s true. Writing helps. Talking helps. Just getting it out any way you can (in a positive, supportive way) helps.

      I keep wanting to delete this post, but I hope that my embarrassment may be someone else’s emboldenment to make a change for the better.

      (oh, and ps: it’s “Kimberly”) 🙂

      • Judy Prince says:

        It’s horrible to be called by “almost” the right name, innit, Kimberly? It has to be exactly what you want to be called, or it grates maddeningly. I did a sweep of the comments and your responses in order to figure out what you’re called, but came up mostly with “K-Dub” which didn’t feel like what I wanted to call you.

        I am so pleased that you posted, primarily because depression’s not an embarrassing thing, and you inherently recognised that. Going into hiding is one of the earmarks of depression. We feel embarrassed about ourselves. We feel hopeless, helpless, worthless and unworthy.

        So you courageously broke the “shame” barrier, which means that countless other folks will now feel freer to talk about their depression and feel empowered to reach out for ways to help themselves. I didn’t have the courage that you have, so was incredibly fortunate to find help in a book. The best investment I’ve ever made!

  12. I have started to comment so many times only to erase. So this is what I am thinking after reading your piece: Life is sticky and we get stuck. It hurts. Sometimes, I feel my body and brain is so heavy, I’m amazed that the skin holds it all. If only it was as easy as pressing finger pads to the tender flesh where it aches. But the body is a tricky, fickle little beast and sometimes I get too comfortable in the silence that isn’t really silent.
    So glad you are here, K, and that you keep on talking…. xxo

  13. Richard Cox says:

    I never really know the right answer to this. On the one hand, it seems like smart people should be able to think their way out of low places, either on their own or with a talented therapist. However, the smarter you are, the less likely it is you’ll be able to find someone whose intelligence you respect enough to be able to guide you. If you’re thinking circles around your therapist, it doesn’t matter how much training she’s had.

    On the other hand, your mind is an intangible thing that emerges from the collective interaction of billions of neurons, which have tangible, electrochemical properties. If something about that delicate balance is out of whack, can the mind adjust to it or fix it? The brain is an entity that’s aware of itself, but does that mean it can repair or effectively correct its own physical problems?

    On another, theoretical third hand, you might say that SSRI’s and other prescribed antidepressants are just another way to medicate yourself, something humans have been doing for as long as we can remember. Alcohol and opium and mushrooms and whatever other way we choose to alter our perceptions, in the end these are just ways to temporarily escape our regular existence, right? And yet clinical depression is a different problem from occasionally feeling down, so maybe it requires a different type of altered state?

    I always wonder about the philosophy of choosing to alter the chemical states of the brain, because the very idea of “mind” and what that really means fascinates me. But I’m probably boring the shit out of you. Thanks for sharing. I hope having a conversation with your TNB mates is a drug-free way of inducing a smile. 🙂

  14. Ronlyn Domingue says:

    Several years ago, a friend of mine said she thought what people needed most in life was to be understood. I wonder if she meant “to be heard.” An attentive, compassionate listener is a tremendous gift. May your life be filled with them so that you can share your gifts with the world.

    • I have to say, for my $2.50 (inflation), I have thought long and hard about the difference between being heard and being understood. Lots of folks, if they shut up for long enough, will/can hear you. But the people who understand you–who really get you–are rare coins, indeed.

      Thank you for the lovely sentiment and wishes, Ronlyn. Right back atcha. ♥

  15. Simon Smithson says:

    Ah, mental health. Such a complete and total son of a bitch of an issue to deal with.

    And often, a silent one, as well, which means problems can be self-perpetuating. So in terms of writing the essay itself, K-Dub, I think it’s a step in the right direction, and one that’s emblematic of a growing awareness in the general population that issues of mental health are as real and valid as, say, breaking your leg. And further-reaching, in many ways.

    You’ve always got a friendly ear here, should you choose to use it.

    • I’m probably a nasty little bitch for saying this in the wake of so much genuine love and sympathy, but all of this delicate tiptoeing in the comment section is really making me giggle.

      And re-evaluate things.

      And snap the fuck out of it.

      So thanks for that.

      All of you.

      (And thanks to you, dear Simon, for your off’ear’ing, you charming devil…)

  16. Honey, I appreciate your honesty here. And this is a beautifully executed piece.

    I, too, have suffered horrific bouts of clinical depression–it runs in my family, too–and I’ve found people either understand it or they don’t. For me, a low dose of Zoloft is effective, but Wellbutrin nearly lobotomized me on its first day and my then shrink couldn’t understand why I wouldn’t stick w/ something that was clearly incompatible w/ neurochemistry.

    I know you know this, but it’s worth repeating: as your stats bear out, you’re not alone.

    And while I don’t believe in romanticizing depression, it’s worth remembering what I call “the creativity tax”: when a high level of creativity and intelligence intersect, horrific bouts of depression will sometimes descend. ‘Twas ever thus.

    I’m glad you’ve got a plan, a good shrink, close friends and, most importantly, your bearings.

    Thinking of you, Kimberly. Litsa

  17. P.S. That should read, “…clearly incompatible w/ MY neurochemistry.”

  18. Tom Hansen says:

    I can’t tell you how many times during my numerous hospitalizations and clinic experiences I had when I was in active addiction or early recovery doctors/shrinks/counselors tried to push brain pills on me. Thankfully, even though it makes life more difficult, I am a cynic and understood they were trying to brainwash me. I firmly believe that the reason ppl are depressed is that we are not living as we should be-relying on our communities, which have been shattered, not using our bodies for physical labor, eating crap, staring at screens, the list is endless

  19. Matt says:

    As mentioned on Greg’s most recent post, I hate the way medical treatment has become a “there’s a pill for that” culture, which that B.S. NYT article really rams home. Yes, biochemical issues are real, and need to be dealt with appropriately. But that should never, ever be a unilateral response. Because really, how is medically doping yourself into oblivion any different or better than self-medicating with food/nicotine/alcohol/narcotics/sex?

    Good for you for figuring out what you need, and for going out and getting it.

    • Kimberly says:

      how is medically doping yourself into oblivion any different or better than self-medicating with food/nicotine/alcohol/narcotics/sex?

      Touché. It’s not.

  20. Ducky Wilson says:

    After my first panic attack, docs put me on Paxil. I was up for four days straight. Felt like I had done an eight ball, without the tingly, talky benefits. I swore then that I would never take that kind of shit again. Too often, docs want us to pop a pill for everything. Fat? Here’s a pill. Sad? Here’s another pill. Oversexed? We have several pills for that. Undersexed, here’s a bottle for that, too.

    GADS! as my Grandpa says.

    In my early twenties, I was diagnosed with a weird spinal condition. Several more meds were given to me. I hated them all and couldn’t afford them anyway (one was 225/month and I had no insurance, so fuck me.) I got off of them and went back to dealing with pain my own way (pot.) Two of those drugs have been recalled, one was causing holes in people’s hearts.

    Not even aspirin would I take from then on. What’s pain to death?

    Then last year hit. Had the cancer scare. Had depression like I’ve never felt. Pot didn’t help. Sex didn’t help. Exercise didn’t help. Nothing helped. Until a blessed specialist looked at my blood work and figured it all out. “You’ll have to take a pill for the rest of your life.” NOT music to my ears. I had spent most of my adult life banishing any sort of pharmaceutical pill and was now being told one will save me. Thing is, I was so out of sorts, I agreed to take it. Desperate people will do anything, and I was desperate to feel better. I was on a oneway train to suicide town. Seriously. I was wacked. So, I took the pill, which is the number one prescribed pill in America (so obviously, this is an epidemic) and now I am on the road to recovery, with the help of a pill. Even the depression has lifted. I hope they don’t recall this one. LOL

    Over time, I learned how to use my mind to deal with my panic attacks. Buddhists use a brain retraining technique to control their body temperature, etc. The brain can be reprogrammed, so I’ve used their tips and applied it to my mental health. It helps. I haven’t had a panic attack in over ten years.

    But there is nothing that replaces being heard and being understood. It’s hardwired into humans, that need, and if it isn’t being filled, I think the brain has a meltdown which manifests in many ways. Although there is also a lot of evidence that the fluoride in our water systems causes a lot of problems. Who the fuck knows.

    Have you had your endocrine system checked by a specialist? If you’re borderline diabetic already, that tells me you have some issues already with your endocrine system. Have your adrenal glands and thyroid checked. They could be causing severe hormonal imbalances that cause depression. It could be something you’ve had your whole life (like me) and not known you’ve had. Thyroid and adrenal issues tend to be misdiagnosed all the time as mental health problems, according to my doctor.

    And you’d better call my ass if you ever need to talk. Seriously. We’re traveling the same road.
    XOXO

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