Saturday, October 6, 2007

Sunday Scribblings: The Ethics of Depression

This week's Sunday Scribblings topic is "Sorry".

I'll tell you what deeply bothers me about depression or any mental illness.

It puts a person in a terrible ethical bind. If, in part, my ethics constitute what I understand is acceptable to do in my life and what is not, depression terribly complicates my ethics. Furthermore, if acting contrary to my ethics leaves me responsible for what I've done, and I think it does, depression complicates this even more.

As I explained earlier, being under the ongoing, not situational, plague of depression, I did things that I would never do when in my right state of mind. I punched a windshield over a cookie; I slugged walls; I said mean, accusatory, paranoid things; I obsessed over things like my checking account, checking my balance several times a day online, or before e-banking, called the automated service on the telephone. Under the plague of depression, I often let my hygiene go. I'd go several days without showering. One quarter at LCC, I wore the same sweater every day. It was worn out, covered with lint, ill fitting, a source of good-natured laughter among my students, but it was a sign of illness.

So, where does illness end and personal responsibility begin? If elements of my brain's function were misfiring or if chemical imbalances were driving my behavior, then to what degree could I feel responsible for my actions?

If you've suffered from long-term depression or been close to someone who does, then you probably know that depression sufferers are always apologizing, desperately seeking forgiveness and acceptance.

"I'm sorry. It won't happen again."

"I'm sorry. That's not the way I am."

"I'm sorry. I don't know what came over me."

"Please, don't be mad. I'm sorry. I didn't mean to do that."

"I'm sorry. Please don't leave. I'll be better. I promise."

These repeated apologies ring hollow because the erratic behavior continues. I can't begin to count the innumerable times I did or said things I was ashamed of, apologized for, clung to my wife or girlfriend about, desperately seeking affirmation and approval, and then turned around and within hours or days repeated the very behavior I'd been so sorry for.

Maybe it really doesn't matter whether I was held responsible. What really mattered was that my actions had impacts, always negative, that led to it being difficult to trust me, let alone difficult to want to be in my company.

Often my response to not wanting to repeat my offenses has been to retreat away from those I've been close to. Depression, for me, has been isolating, not only because of the fatigue it causes, but also because I've thought that if I cut myself off and went in a room with the door closed and either slept or listened to the radio, I couldn't cause any harm.

For me, feeling responsible for my behavior was never a problem. Guilt and shame smothered me. The problem was that I couldn't stop myself from feeling like a loved one was belittling me or treating me as inferior; I couldn't stop feeling inferior. When I tried to act like I was positive about myself, I expended a great deal of energy because I was masking how I really felt. I then suffered the fatigue of trying to lead a double life.

The worst part of this illness is that it's contagious. My erratic behavior and my periods of isolation put everyone around me on edge. I didn't realize this. Depression turned my attention to myself and I hardly recognized that the black hole I was in was also a social vortex, sucking those in my home, especially, into the darkness with me.

So, if as a depressed person I had trouble controlling erratic behavior, because of this illness, and if I was only dimly capable of seeing the impact of my illness on others, how could I be an ethical person? How could I take responsibility for how I was?

The best response I could muster was to say I was sorry.

Almost two years ago, I woke up one Tuesday morning paralyzed. I could hardly walk, my mental and physical system was so shut down. I'd been to Lincoln City on Sunday and part of Monday, joining friends from Kellogg to watch the Super Bowl and enjoy the casino. When I arrived home Monday from Lincoln City, I fell into bed and didn't wake up until it was time to go to work Tuesday morning. I thought I was just worn out from staying up too late Sunday night and called in sick.

But the weight of the fatigue wouldn't lift. I called in sick for the rest of the week and was barely functional. Finally, on Thursday, under advisement from her therapist, the Deke took me to the Emergency Room at Sacred Heart Hospital. Upon review, thank goodness, the doctor concluded I was not a danger to myself, but I was sent to a psychiatrist, who I saw the next day.

At this point, with the help and urging of the Deke, I was at an ethical crossroads. Was I going to believe those who told me I was seriously ill and take serious steps to try to gain my health, or was I going to risk my marriage and whatever sense of security I had, and continue to try to cure myself?

Slowly, very slowly, painfully slowly, I began to give in. Nothing like this condition changes very quickly. It took more episodes of erratic behavior. I've written about this before: getting together with Kellogg friends and being so excited I drank over a half a fifth of whiskey in under an hour and had to be put to bed, vomiting and barely able to walk; a week or so later, a night of low stakes gambling at Spirit Mountain, getting pulled over for speeding by a state policeman, not getting home until six in the morning, the Deke not really sure of where I was. Apologizing. Saying I was sorry.

But, out of these episodes came an experiment with some new medicine, added to what I'd been taking.

By now, I could finally see that the only ethical thing I could do was give in to taking medicine and to try out different medication, if necessary.

The medicine has stabilized me. I now have what feels like the luxury of making measured decisions. I can respond to what happens around me free of paranoia and suspiciousness. Little things look like little things. I let things go. I sometimes think I'm being apathetic because I spent so many years thinking that anxiety was caring. I thought I blew up because I cared so much. I thought obsessing about things was demonstrating how much I cared.

This more stable life is much easier. It feels better to see and experience things closer to what they really are.

What's more, it feels good not to say time and time again, "I'm sorry."


Jo said...

This is a remarkable piece. Thank you.

Robin said...

Thank you for sharing this, and helping us to understand a little. It must have been very hard to do.

Jen B said...

Ok, I'm crying over here. I never heard anyone write out exactly how I feel. I commend my husband's patience and understanding with me and my depression. The days of hiding and sleeping. Once I crawled into a closet and didn't come out for 3 days (unless I had to use the bathroom) He was so good to me. It's been under control for the last few years but what a trial at the beginning of our relationship. (15 years of being together) Thanks for sharing that, it's brought my memories back to me and made me realize how far I've come. I am no longer sorry for that part of my life, I'm thankful for this part.

Beau Brackish said...

This post hit home for me. I have two relatives who've struggled with depression for years. One sought help, takes medication, and seems to have their life back on the track. The other, has refused to admit to their problem for a long time. We've tried to get them to get help, but I don't think intervention works with depression unless that person is ready to get help.

Thank you for sharing your story. It is remarkably honest and makes my reexamine what my relatives are going through in a new light.

Desert Diva said...

What amazing courage you have to be so forthright and honest describing your depression. I applaud you for that - obviously I'm not there.

Depression is such a cruel disease that manifests itself in a myriad of way. You couldn't control things when "the beast" had power over you.

I'm glad that your life is better now. I'm reading through some of your past posts regarding depression. I'm so sorry for your past pain...

Joseph C. Harris said...

Wow. That post just left me, well, speechless. You have hit on the head what so many of us struggle with. Thank you for posting this and also visiting and commenting on my site.

Cherie said...

Ohhh what a post ... I'm rarely speechless but you've got me this time. Thank YOU so much for your brilliance, your honesty, you're an inspiration ;~)

Anonymous said...

I agree. One has to mean it. As you are aware, I wrote somewhat in similar lines.

Pinehurst in my Dreams said...

Bravo, Brave One! It is a difficult hill to climb, but the air at the top is so clean and clear. As a fellow traveler, I applaud your honesty and your success. May your medicine work forever!

Hope said...

I've had trouble commenting on this. I've lived both sides of "Sorry" and understand what it means. For me it has come to mean very little when I hear it and everything when I say it.

Anonymous said...

I'm dealing with the same things. Very hardcore, it tears me up and breaks me down. It's tiring and frustrating; you've explained my feelings almost verbatim. Little things are huge things to me, and big things are gigantic monstrosities of confusion and frustration; an utter loss for hope. I can't explain it. I try to fix things up, to narrow my problems down to a single attribute, hoping I can work on it and fine tune it; to shape myself into a more complete, fulfilled individual who knows who he is.

But no. It hasn't seemed to work for me yet.

Christy Woolum said...

I am moved by your courage to share this because I know it will help many others that haven't figured out what is causing these things to happen to them. Bravo!