An episode of depression can be a devastating experience. This is so first because of the darkness and despair that pervades the person like a poison, and second because the failure of others to comprehend in even a small way what a person is going through. But what happens in a depression? To what can we liken the experience?
One comparison we might make is the following. The inner nature of someone with a vibrant, happy life can be thought similar to a house of single level built on a strong foundation. This foundation forms the shell of the basement in which there are several strong pillars upholding the level above. In the case of a happy and productive life, the foundation is securely in place. The pillars may be a strong marriage, children growing up well, an enjoyable and creative job, health, a convincing faith, supportive friends and relatives, financial security, a variety of hobbies, and travel possibilities. With such pillars firmly in place the person can, as it were, live on the upper level. Occasionally the individual may glance down the stairs into the dark lower region and become aware of the pillars that are lending so much support to the current happiness being felt.
Most of the time the person does not question or even notice the pillars at all. People simply abide on the upper level. They do not question; they simply live. The day may begin with a decision of what to have for breakfast. There is no questioning of why one should have to eat. “What's for lunch?” is asked, not “why lunch?” The afternoon may bring a chance for hobbies or sport. There is no thought that such activities are a waste of time. “What is my wife making for supper?” or “what shall I cook today?” are the questions, not “why another meal?” And then the golden hours of evening arrive when families and friends can share joyous times together as the shadows lengthen and fall. There is no questioning during these hours of the timeless value of human companionship and gentle love. On this upper level there may be at times tears and sorrows but, with pillars firmly in place, the tragedies of life can be borne. Time comes with its gentle healing and life in the upper level goes on.
Depression. How it attacks the house! Foundation and upper level: both suffer damage. “Foundations once destroyed”, what can one do? But what happens? A darkness seems to arise in the basement. It pervades upward into the level above, attracting the person's attention. It draws a person downward into the lower depths, as it were. The “eyes of the soul” or the person's inward attention become focused on these lower regions. All the happiness, joy, and brightness that attended the life on the first story disappear. The energy that accompanies the normal activities of life disappears. The sense of purpose that underlay the ordinary activities of daily life is lost. Nothing seems worth doing. All one's past activities seem impossible now to be carried out.
And the basement! Here most of all changes occur. The person focuses on the dark because it seems inescapable. Now nothing is assumed in place and firm. Instead, all the pillars come under scrutiny. Questioning and more questioning, not on a superficial level but rather on a profound one.
And as the questions continue to be asked with few answers given, the pillars holding up the first level gradually incur damage. Everything is questioned and, as it is questioned, is weakened.
In some cases the pillars holding up the next level gradual crumble. The person's whole focus is on the basement area. Nothing is seen except gloom and broken pillars. The upper level in some ways disappears. No “normal” or average life seems possible. It becomes simply a sweet memory that appears forever lost. What was it like to wake up in the morning and to have little concerns? What was it like to feel energy for the usual activities of life, such as eating, cleaning, walking, shopping, and working? Where has the delightful luxury gone of finding these activities of sufficient interest? How could it ever have been that life was filled with brightness and joy, that little things could bring a smile, that big things could engender positive excitement?
Instead, why is it that I cannot carry on these activities except by sheer force of will? Why is it that all I want to do is to ask these questions about the darkness and about life? Why is it that I want to cling to every person, hoping vainly that someone will have the answers I seek? Why have all the foundations of my life been destroyed? What can I do?
As depression slowly, much too slowly lifts, rays of light begin to appear. The person, as it were, sees light coming from above, down the “staircase” to the basement. At first, for a few fleeting moments only, one can slip up those stairs. Dimly and obscurely the upper lever starts to come into view. Now it seems to be there; now it seems to be gone. Back into the gloom. The darkness swirls relentlessly around. One feels lost and in sadness again. Was the upper level an illusion then? Where, oh, where is it? Once again the light beckons. One ascends. Life opens its hands and calls. One leaps for the gift but it too flees away into the mist. The darkness returns. Yet again a call to the light. Once again, hope begins to kindle. The upper level comes more and more into view. The depression is not yet gone but the chance of recovery seems to exist. The “bright wings” of hope nurture the soul and suggest that the promise of new life will be fulfilled.
Internet Mental Health (www.mentalhealth.com) copyright © 1995-2011 by Phillip W. Long, M.D.