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October 17, 2006

Can It Really Be a Disease?!?

Health, for the most part, has not been a major problem for me. But there have been some significant markers. The one that I think most people do not understand and for which I am only just figuring out myself is the disease of depression. I do not want to suggest that everyone that has been depressed is suffering from a disease. I think it is a lot like alcoholism, not everyone that drinks is an alcoholic, but there are definitely alcoholics and if they are to function they need to manage the disease. Depression manifests itself in much the same way. From what I understand, clinically if one has at least three major episodes of depression they are considered to have the disease. I certainly qualify on that count.

Treating the disease is not straight forward, either. Taken to the extremes, psychiatrists and other MDs want to prescribe drugs, and psychologists feel that it is more of behavioral thing and that it can be shifted through therapy. Different things work for different people, but to me it seems that it tends to be a combination of both. I find that I can get depressed when things are otherwise OK, but it can increase if there are negative situational factors in the environment.

Depression is in much the same way. I am not sure that all doctors even see depression as a disease. But if you look into the pathology of it, you start to see that it is. Depression is, for many people, the moody teenager that will grow out of it;  the temperamental artist that must suffer for their art, etc. These characterizations can often deflect the insidious nature of the beast. Jeffrey Kramer, in the book, Against Depression, helped me to see this as a disease and the pathology behind it. The funny thing is that as you see it as a disease it becomes a little easier to treat. In some ways it takes away some of the stigma. I probably do not need to go through the litany of problems that plague a person suffering from depression: wrecked marriages, relationships, suicide, problems with jobs (getting and keeping them), drugs and alcohol, on and on. Marriage, job problems, self esteem and to some degree alcohol seem to be my issues. I would say that from an outward perspective that I cope with it reasonably well. It is the profound sense of wanting to hide from the world that really hits me.

It sneaks up on you and those around you. And it comes up in places that you do not understand, or would not expect. You suppress it one place, it comes out another.

I grew up as a PK (Preacher's/Priest's Kid). My father was/is an Episcopal (every where except the US they are considered Anglican) priest. For this and other reasons, we moved quite a bit. Being a PK is a little like being an Army brat, but different. They tend to be wild or quiet, conforming or not. I was kind of the quiet, non-conforming type. Being a little bit of a smart alec did not help either.

It seems that PKs that move around quite a bit, particularly quiet, non-conforming types, fitting in and getting friends did not seem to help much. When I did get friends we would move away. I know that is one of the most painful issues of my separation and impending divorce from my wife is that while we were working on it, we let relationships with good friends atrophy.

It seems that from a fairly young age, I was getting setup for anxiety and depression. In hindsight, I go back and forth on the nature versus nurture. There are definitely some behavioral things that occurred, but I am also of the belief that brain chemistry plays a role. They say that anxiety and depression often have genetic roots. My father is a psychologist, so he essentially does not seem to agree, but I see much of the behavior that I have also in his.

I guess that net issue is that I suffer from depression, and that it is relating to where I am now.

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Posted by mlwhall at October 17, 2006 7:54 PM

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