We see many short, popular articles about depression.  Its symptoms are paraphrased from the diagnostic manuals and then listed in modified form, usually spun to match what the author believes to be the best treatment, what cure they happen to be pushing, where they have sold their short work, or a number of other perspectives which seem to have little to do with you if you proceed to read the article.

You know what folks?  When your chronic major depression has lasted a lifetime and you're getting old, it just doesn't fuckin' matter.  You take your medication, you try to stay connected to people and get your exercise, you try to exercise your mind and maintain a positive attitude.  What do you get for this?  Nothing.  Not the sort of nothing one generally thinks of when speaking of things.  It's a different kind of nothing.  It is called anhedonia.  The inability to experience pleasure from events and experiences  due to that depression.

The nothing to which the depression I have had for most of my adult life has led me is a state wherein nothing matters very much, if at all.  I deliberately refer to it as something that is outside my control, whether it is or not.  I most assuredly did not choose to be this way, so I refuse to own it.  I can only fight against it even if it is contained within my own genes, which I am certain that it is. 

If, as you read this, you wonder about the mixture of technical terms, everyday language, and gutter speech, you may need to know one thing about me to pull it all together in a manner that makes sense.  I was a clinical psychologist.  Technically, I still am; I remain current with my license, professional insurance, and professional memberships.  When so inclined, which is most of the time, I can fairly easily convince others that I am relatively normal, bright, and functional.  It is harder to convince myself, though.  I have ceased to do any active practice as a clinician or psychotherapist.  I have for all practical purposes ceased to exist in the real world.  I have virtual friends and acquaintances in the cyber-world of computers who do not realize how depressed I become.  That's OK, though.  I'm not dangerous and having a few people react to me as if I were normal does raise my self-esteem a millimeter or two above totally bottomed out. 

What do my real-life friends think of me?  I don't know.  I no longer have any.  With mixed feelings about that issue, I can definitely state that I would like to have a couple, but beyond that, I don't care.  If I allow myself think about this, it makes me feel angry and hurt.  If I do think about it without immediately suppressing it, I know that it is as much or more my own "fault" as anyone else's.  The depression leaves me without the energy or desire to do any of the social things that normal people do (I've never been a follower, anyway), so why would they even notice that I exist.  Sometimes I don't leave my dwelling except to do necessary shopping or keep required appointments.  I was even told once that my mail would stop being delivered if I didn't get it out of the box more often.  The past few weeks have been like that for me.  I'm thinking about surfacing again, though.

Most of the time I awake only to spend the next hour totally spaced and not knowing where the time went.  The next hour or two, after taking my regular medications and having something to eat and drink, I slowly rise to my usual slug-like level of reality.  By the fourth hour, I have either dozed off again or am beginning to hit my stride for the day, though "striding" does not accurately reflect what I do.  I just am; worried, frightened, sad, and angry with an unjust world that expects me to do something more, but gives no indication what it might be.  I know, I know, it never promised me a rose garden.  It is that symptom, anhedonia, that creates and maintains the vicious whirlpool of not caring leading to why bother and if I don't bother, why do it?  I am thankful for my living circumstances and my cats, though as I pet or care for them the thought of their death and another loss occurs to me.  Another abandonment.  That's what I get for thinking about the future.  Some days they are the only occasion for a smile on my part.

This level of depression was not present in me until several years ago.  I was so busy trying to take care of so many people and responsibilities, I thought I was normal.  I was, I guess, as far as an outside observer could tell.  For as long as memory serves, I thought of myself as better than average, high IQ, great practical sense, able to influence situations and people to effective ends.  I don't recall ever flaunting that, but did show just enough that people had confidence that I knew what I was doing.  That didn't seem wrong.  I did know.  I didn't join any societies with secret handshakes or organizations with high IQ requirements.  I never saw the point of rituals or taking tests I knew I would easily pass to associate with people I didn't much like to begin with.  That didn't feel conceited to me at the time, but perhaps it was.  Or maybe it was that quieter, deeper fear that I wouldn't be accepted or wouldn't measure up to the very rules and requirements that I told myself were silly.  Never great.  Never famous.  Never rich.  But I've had good life with friends, family, enough money, a few hobbies that I enjoyed, and though I was most definitely a statistical outlier in any group I was involved with, I could fit in as well as I chose. 

What happened?  My greatest fears for as long as I can remember have been abandonment and rejection.  These two words are very much the same except that rejection has a much stronger element of deliberate action by another person than does abandonment (which might or might not be intentional.)  As a young child, I remember praying that if my family were to die, that it would be in some manner that we would all die together and that I would not be left alone. 

For those that believe in a god who takes an active part in an individual's state of being, personally intervening in our lives, counting our misdeeds or good works, all I can say is I must have pissed her/him/it off very badly when I was young.  I'm old now.  Perhaps not by a happy, positive-thinking person's standards, but by the statistics derived from my own family's life spans, I am several years overdue.  I don't really accept those stats because I believe there is a basic flaw in their derivation, but they do fit with the way I feel.  I am alone.  I have nothing to lose.  I am free.  I can do almost anything I want.  The ludicrous situation this leaves me in is that there is nothing I want to do enough to go ahead and do it.  Nearly everything I can think of wanting was all in the past.  Actuarially, I can expect to live another ten years or so.  If I could trade that for half the number of years, make it five years, for any period in my life I chose, I would happily and gratefully make the exchange for ages seven to 11, or for ages 16 to 20.  At the moment, my choice would be 16 to 20, but they are nearly equally desirable age ranges for me in different ways.  All my needs were being met then, and I was happy.

Oh well, I'll figure it out eventually.

Peace, Doc

Copyright © 2009, Thomas A Blood, Ph.D.

"Freedom's just another word for nothin' left to lose". – Bobby McGee as sung by Janis Joplin.