Scientists link DNA variations to major depression for the first time
Arielle Duhaime-Ross, www.theverge.com

Descent

Occasionally science likes to remind us that we don’t know what depression is.

Millions of people get depressed, but we have no idea what is happening to them, to their bodies and minds. Right now, one of them is me.

For the last six weeks I’ve been fighting depression and slowly losing. This is not new for me, though it’s been a while since it happened. I’ve been descending into what would probably be diagnosed, if I could afford a diagnosis, as an episode of clinical depression. In my lifetime I’ve been diagnosed and rediagnosed with emotional disturbance, Major Depression, Bipolar, some ambiguous form of ODD, Learning Handicapped, having an anti-social personality, and PTSD. Most of my diagnoses have been withdrawn at some point. I’m not an easy case. But then, neither is depression. In 150 years of scientific study, it has been so elusive that it would be tempting to not believe in it at all, except that is it also so real.

I am sure I have PTSD, which is easier to nail down, in terms of cause-and-effect. I know I have it because that was the only treatment I really responded to, and because do I ever have intrusive imagery and hyper-vigilance. Maybe the Major Depression comes out of PTSD instead of some genetic source, but who the hell knows? I’ve never experienced mania, but my depression cycles. It lifts. But it seems like perhaps it will always come back. It doesn’t matter what it’s caused by. I’m depressed, and that’s what it is.

I think the three prodrome hints I get are being moody and impatient, everything hurting more physically, and headaches. Right now my arms feel like they have RSI. They tingle and ache. I even began to wonder if I have arthritis recently too, because my fingers and hands have been hurting. I started getting a constant stomach ache, and then crying when I was alone. This is what the descent feels like. My work is suffering, and that’s causing me more anxiety than usual. Despite technically having an anxiety disorder, I am not usually affected by the anxiety part. I feel fear, but it’s never had much hold on me. I let it go, sometimes I have to push it a bit, but it drifts away, even when I’m breaking like this. Fear has never been much of a cage for me. Depression has always been my trap.

What It’s Like

This disease wraps me in gauze. It’s like a layer between me and reality, that makes everything fuzzy and distant. Sometimes I’m sad, but often I just feel like I’m on the verge of throwing up all the time. Sometimes I feel like I’m not real, or dead already.

Right now sensory life is diminished. Nothing tastes right. Sometimes I don’t eat much, but then sometimes I will wildly overeat. I’m not eating my emotions, I don’t really have much beyond gray despair a lot of the time. I’m looking for something that tastes nice, but nothing ever does.

Recently I’ve been reading about the way people describe being colorblind, that the world is flatter, indistinct. That feels deeply true right now — except I can see the colors. They just don’t make it through into me. I’m wrapped in gauze and they don’t matter.

When I’m depressed I cry randomly, and often in public. I don’t have much shame about it anymore, it’s just how my life is sometimes. It’s become a way I learn about cities. In NYC people ignore you or look a bit annoyed. So far in Istanbul people have been incredibly sweet, while still giving me my space. Big ups for Istanbul.

I apologize too much to my loved ones and friends for being a burden. I know they hate it, and it makes me feel even more ashamed and more like they’d be better off without me. We go through a ritual in which they tell me I’m not a burden, but I know how stressful depressed people are, so I know I am. I try to remember how much I hate it when depressed people tell me they’re burdens. Of course they are, and they aren’t. It’s not so simple as my broken brain is trying to make it right now. All sick people are burdens, but we’re humans, and carrying each other is where we find the best of ourselves. I know it’s the shame talking, and there’s truth in the shame. I also know that losing my burdens is literally the worst thing I can imagine. So perhaps I will tell people: you are a burden, but a burden I want to carry. And then I will try to remember that for myself now.

I don’t notice my surroundings. Normally I’m an eagle eye, great with detail, but right now I’m covered in bruises from running into things. I always look a bit battered and skinned when I’m like this, and people ask me how things happened, and I can’t remember. I stumble a lot. I leave bits of myself on street furniture.

I ate some fries today, and then I got a stomach ache. Eating is hard, but I wanted something to be lovely. It doesn’t manage to be, but I think that hoping it will be is something to hold on to.

I have to make myself shower. I don’t feel the point of it, but I usually manage to make myself do it. But on the other hand, cleaning is extraordinarily hard, because little things can disgust me so easily. A dirty sink can bother me at an existential level. Cleaning it can feel like wading into a latrine. It’s strange, because I know I’m normally the one who can do the gross jobs. But right now, a few hairs in the drain can seem untouchably foul. This makes me think sometimes that my amygdala, which is implicated in disgust, is behind some part of it. But then, it doesn’t matter, because I have it and pointing to the bit of my brain I think is malfunctioning won’t change a thing.

People think depression is an emotional disorder wherein you feel sad. But many people, myself included, often don’t feel anything. Sometimes it’s like being a walking void, like all human motivation is gone. Sometimes it’s like being made of sadness, then suddenly like being made of mud. Being sad also fails to explain the physical symptoms I and many others experience, and the fact that depressed people are at severely increased risk of heart attacks. We are dying of broken hearts, and no one knows why.

I think the thing that kills in depression, be it from heart attacks or alcoholism or suicide or whatever, is mostly shame. Shame doesn’t cause the suffering, but it causes the isolation and the stupid choices depressed people make.

In these decades, I have learned that like Dostoyevsky’s Love, Hope in action is painful and grueling compared to Hope in dreams and movies and kitten posters. Hope’s value is not in being something you feel, but something you practice and build in the face of all the things that tear at it. Hope is something you decide on, and then devote your life and actions to.

Choosing What Goes Overboard

I’m living on credit cards right now, hoping this doesn’t last long, and I can make my minimums. There’s plenty of articles out there on how money problems cause depression, but being unable to work is obviously hard on the budget. One of the reasons I left the idea of day jobs behind me is that I never knew when depression was going to intrude, and lose me jobs. That’s less serious as a freelancer — just not taking work for a bit doesn’t destroy your reputation like getting fired for depression can. Going into credit card debt is my American version of temporary disability. It’s a struggle, but it’s also a way of investing in the future, a way of believing I’ll get better without having to burn down my life in the mean time.

All my energy right now goes into my child. I cook for her, look after her, give her summer lessons, and drag her out of our apartment to see Istanbul. I am proud to say this: she is well cared for. I am hanging on tight to that before anything else. We are talking about this so that she understands that this is not her fault, and there’s nothing she can do about it. I explain what it’s like, and that it’s a medical problem, and that it will pass. I think she understands. She’s probably getting more sugary treats than I normally let her have.

My biggest source of persistent anxiety is my work, and money. I can’t really write when I’m like this.

Right now here is what I should have written or be writing for you:

• Several Instructables, including my incarceration installation from May
• A piece on being gentle on the internet, which is mostly done, but I can’t put it together
• Part three on my series on whiteness, on how white people can change for the better
• A piece on the tendency towards genocide in our species, and thoughts on overcoming it
• A letter to my father on the 20th anniversary of his death (It has not escaped me that this anniversary could be playing a role in my troubles)
• Several science explainers with 3D printable files that help explain the principles.
• One still kind-of secret project which I’m obviously not making progress on.

I can add words to the various pieces, not many, but I can consistently add them. They just don’t come out structured. Trying to get this as structured as it is has felt like slowly moving a wall, stone by stone.

The Noonday Demon

We don’t know what depression is. We know it’s not just being sad. We have these neurotransmitter ideas, but they don’t answer the question about what causes depression or other mental illnesses. We see some correlates, but we don’t even know which way the causality might go, if it’s there at all. We just know that sometimes taking drugs that affect neurotransmitters seems to help some people. Sometimes, drugs with opposite actions are used to treat the same disorders with equal effect. Our theories about mental health are often little better than Phlogiston and Ether for the mind.

I am not on any antidepressant drugs. I have tried dozens, and they either did nothing or had such terrible side effects I had to stop them quickly. I am done going down that road for now, but only after years of effort, and even learning a fair bit of neurophysiology and psychopharmacology. Honestly, I resent it when people won’t take their meds. If you have this problem, and you can get rid of it or even improve it by taking a pill, take the goddamn pill. I would take a pill in a heartbeat, but I can’t. I would dance naked in streets or sacrifice goats or pay witches for spells or stand atop buildings announcing that I AM A CLUB SANDWICH if it would help. I have what alcoholics call “the gift of desperation.” Say what you will, it keeps saving my life.

All that helps this time is admitting that I’m depressed, and waiting.

I forget what I’m doing a lot in the middle of doing it. I mean, there’s a bit of that for everyone, but this is different. Sometimes when I’m just sitting I feel like I’m falling — not emotionally. I am just sitting, but I’ll get dizzy and feel like I’m falling. I forgot to eat dinner today.

I think about the S word, but not in a dangerous way. I was often suicidal when I was younger, but now I know this cycles, and I have learned to bide my time. I have learned to manage this body and brain — as imperfect as they are — I know them and they are mine. Often when a younger person talks about the chronic urge to suicide, I tell them to wait. I tell them that it gets easier, and that they must learn their body and mind. You can always kill yourself later, I tell people. But with a little luck and a little learning, chances are quite good you won’t want to. Hang on, one minute at a time. Just put it off and treat the pain you have now.

Right now I’m not working much. Sometimes I feel like such an asshole for not being more productive, for not getting my work done. I have friends that write whole books and articles on top of that and maintain day jobs and raise children and work on politics and art and so on. Why can’t you just get it done? the little poisonous voice in my head says. You’re falling behind, Quinn. You’re way behind where you should be in life, depressed girl. That voice might not be wrong, maybe I should be accomplishing more. And yet, I live in this brain and body. I don’t get any other. This is the reality of what I get to work with in this life, and what I have is one curse and one gift. The curse is the depression, and the gift is the desperation to do whatever I can, whether I happen to like what I have to work with or not.