REFLEXIONS By Robert Ross

REFLEXIONS By Robert Ross

Dancing on the Edge of Depression

“If depression is creeping up and must be faced, learn something about the nature of the beast: You may escape without a mauling.” — Dr. R. W. Shepherd

The Dance "I’ve been meaning to call Dad, but the events of the last couple of months have gotten to me. I just haven’t been able to bring myself to do it,” I told my sister, via e-mail. She was encouraging me to call my dad, and I was attempting to explain why I hadn’t. I knew I should make the call, but I couldn’t. My energy levels were low, I felt listless, and had these heightened feelings of sadness. In order to help my sister understand my dilemma, I told her “I’m kind of dancing on the edge of depression.”

In retrospect, there was no dance, and I wasn’t on the edge of anything. I was just plain old depressed.

It was difficult for me to admit that I was depressed. I thought long and hard about fessing up to the state that I was in. It was the first time in my life I had publicly stated that I was depressed. And so, fearing that I would look helpless or that I would dampen my sister’s general enthusiasm, I came up with this sugar-coated phrase “dancing on the edge of depression.” I wasn’t in the water so to speak, just had my big toe in it!

This episode passed and days later I did make the call. But what didn’t pass was my realization that I too, was vulnerable to depression.

It was time to look into the subject, to map the terrain, so that my next dance will hopefully, be as brief as the last dance.

A search on the internet turned up more than a few web sites dealing with depression. In fact, there were dozens, if not hundreds. One web site didn’t mince words when selecting a name: www.depression.org . This particular site had the commonly agreed upon list of symptoms: loss of energy and interest, diminished ability to enjoy oneself, decreased — or increased — sleeping or appetite, difficulty in concentrating, indecisiveness, slowed or fuzzy thinking, exaggerated feelings of sadness, hopelessness, or anxiety, feelings of worthlessness and recurring thoughts about death and suicide.

Another site, www.nimh.nih.-gov/publicat/medicate.cfm gave a thorough description of the various states of depression (bipolar disorder, etc.), and the evolution of the drugs that are available today. Along with a complete list of the medications currently being prescribed (with both their trade and generic names), was also a list of their side effects.

The amount of information on the internet and at the library that I came across was staggering. My research was cursory, but revealed a world unto itself, from best-selling books like Prozac Nation, to a myriad of information on support groups and pharmacological agents to help one deal with depression.

There were also web sites and books devoted to the discussion of natural alternatives for depression. Dr. Weil (see www.drweil.com ) seems to think that a number of alternative approaches can help those whose depression symptoms are mild to moderate. These approaches include exercise, relaxation techniques, diet changes, and the use of St. Johns-Wort, SAM-e, and vitamin B complex.

As I continued my research, it was clear that the short dance I had experienced was for many, an ongoing waltz. And that, in general, the pharmaceutical industry was in the lead in terms of dealing with this apparent epidemic. The drug companies were offering a quick route to happiness, and it appeared that many were buying.

The promotion of, and easy availability of antidepressant drugs was somewhat disturbing. In this age of quick fixes, one could easily imagine going to a doctor, explaining his or her symptoms — sadness, low energy, etc., and being handed a prescription. No phrases like “hey, let’s figure an escape route out of this dilemma.” No analysis of diet and exercise programs. The magic words for a prescription seem to be “two weeks.” Two weeks of depressive symptoms is the benchmark for falling into the category known as clinical depression. That diagnosis opens the door for a myriad of pharmacological treatment approaches.

The statistics on depression were revealing, confusing and at times inconsistent. Estimates on the number of Americans taking antidepressants at any given time, are difficult to approximate. My local library, when queried, came up with the figure of twenty-eight million Americans who are currently taking antidepressants. The Salomon Smith Barney Brokerage Report on the other hand, quantifies the number of all and new antidepressant prescriptions filled per month. Their figure for an average month was approximately fourteen million prescriptions filled (Report for September 2000 to September 2001).

The statistics continued to indicate that the incidence of depression was noteworthy, if not alarming. According to the National Institute of Mental Health, approximately 18.8 million American adults, or about 9.5 percent of the U.S. population age 18 and older in a given year, have a depressive disorder. Nearly twice as many women (12.0 percent) as men (6.6 percent) are affected by a depressive disorder each year. Also, depressive disorders may be appearing earlier in life in people born in recent decades compared to the past.

To call depression an epidemic is an understatement. The National Center for Health Statistics estimates the number of annual visits to a physician for depression alone to total over ten million!

The Lessons Shortly after telling my sister about this dance on the edge that I was experiencing, things seemed to lighten up. For me, time and acknowledging the problem seemed to be the antidote. I was lucky.

I would be naive and short sighted if I said that dealing with depression is as easy as acknowledgment and time. For many, the road out of depression is long and painful. And for many, the pharmaceuticals that are available today are a godsend, allowing them to live relatively normal lives. Depression seems to be a part of modern life. Statistics tell the tale. Millions are affected, and they seem to be affected at a younger and younger age. Where this is all going is anybody’s guess. Perhaps Dr. Shepherd captured our challenge best when he said “If depression is creeping up and must be faced, learn something about the nature of the beast: You may escape without a mauling.”

My challenge, our challenge, may just well be to learn about the beast, and find our own escape routes.

Robert Ross can be reached by e-mail at: SanDiegoRoss@Yahoo.com

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