But I can tell you, there is no “why.” There is no reason. You can blame it on this or that—a romantic disappointment, a bankruptcy, a particularly flattening failure or trauma. But basically, what it comes down to is that you are in too much pain to consider living any more. It doesn’t matter that there are millions or maybe even billions of people who are worse off than you, that you might be considered “lucky” in outward terms, that you have a roof over your head, enough to eat, friends, family … None of that matters when you’re in the grip of a crippling depression.

 

It’s true what Kelly says—there is still an incredible stigma attached to depression, despite how many of us are taking antidepressants, how much has been written and studied about it, how enlightened we’re supposed to be as a society about these things. You’d be surprised (or maybe not) how many people expect you to suck it up or just get over it, or who want to plaster some kind of Pollyanna chirpiness over it. Or think that if you just start taking antidepressants, that’ll take care of it.

 

But antidepressants don’t work for everyone (more about this later), not everyone can tolerate the side-effects, and, guess what? An increased risk of suicide is one of the side-effects of most antidepressants. We love to think that we can pop a pill in this day of pharmacological miracles and take care of whatever ails us, but our psyches and minds are just not that simple or straightforward (or well-understood when it comes to emotional or mental illness).

 

Depression is a serious illness. It is potentially fatal. Unfortunately, depressed people can be very difficult to be around, even harder to help. Often certain types of depression express themselves as extreme anxiety, paranoia, anger or substance abuse. I’ve often joked that perhaps depression should be called “Asshole Personality Disorder.” And yet, no matter how irritating or maddening someone suffering from depression might be, it doesn’t help to get mad at them. For someone in the depths of a major depression, it’s all too easy, especially for a teenager, to go from there to “my friends/family/loved ones/the world would be better off without me.”

 

For most of us, it’s a lifelong struggle that starts somewhere in adolescence. Those of us who suffer from it have a genetic predisposition for it, a predisposition that can be triggered by physical, emotional, or verbal abuse, by trauma, or by unrelieved stress. Sometimes you think, why bother to try to get better? I’m just going to get clobbered by it again sometime, no matter how well I seem to be doing at other times. It’s … well, depressing to consider.

 

And yet. Those of us who struggle with serious depression have other people to consider besides ourselves. There are devastated loved ones left behind from a suicide, wrecked families, terrible suffering, agonizing self-recrimination. That alone is enough for most of us to grit our teeth and slog through. But yes, we have ourselves to consider, too. Because, just as surely as we can expect depression to return, we can expect better days, too. And there are things we can do to cope, to lessen or shorten our episodes, and to have longer periods of time between episodes.

 

The most effective treatment I’ve discovered (and this is backed up by numerous studies) is to get regular aerobic exercise, whether it’s running, biking, skating, spinning, dancing, whatever. Meditation is also extremely helpful. Focusing in the present to an almost obsessive degree can help as well; people in the throes of depression often have a difficult time not obsessing over failures and mistakes they’ve made in the past and projecting glum or disastrous scenarios into the future. When I say focus in the present, I mean, focus with laser-like intensity on whatever mundane task you might be engaged in—washing dishes, going for a walk, chopping wood … It doesn’t matter. Just get your brain out of that vicious, deadening cycle. If you have creative abilities—and many creative types suffer from depression—be sure to give yourself some outlet to express them. Cognitive therapy may help some people, too. For SAD sufferers, light box therapy can help, but be aware that there is a possibility that some light boxes can exacerbate an innate propensity for macular degeneration. Do some research before buying.

 

And there is medication. For some people, this is absolutely necessary. Be forewarned, though, about the side-effect I mentioned above, an increased risk of suicide, and the fact that you may not ever be able to stop taking them. Most antidepressants have severe rebound effects. And they can have other serious side-effects as well. In addition, for some people, they stop working.

 

 

Finally, for those of us who don’t tolerate pharmaceuticals well, there are herbal approaches to try. St. John’s wort has an excellent track record for mild to moderate depression, and I have recently started taking two herbs that were recommended by an herbalist for mild bipolar tendencies: Rhodiola rosea and Korean or American ginseng. They do seem to help quite a bit, and I have been through the wringer these last two years, on top of my genetic predisposition for depression (both sides of the family, thank you very much).

 

Of course, any time you consider taking any kind of herbal supplement, check with your health care provider, whether it’s your physician or your acupuncturist or whomever. These types of illness are too serious for self-medication (note: alcohol may be the worst form of self-medication for depression and one of the most common). And as we’ve seen with this poor young man here in Shasta County, deeply loved and mourned, and with the gifted and beloved David Foster Wallace, the consequences can be dire.