the wild animal outside the door

Nine years ago, a terrible, silent beast pulled me into a dark abyss. The creature’s name was Depression.

It was late July. Two vacations had been nearly wrecked my my strange physical symptoms. Now it became difficult to go to work, because my stomach hurt all the time. My doctor suggested that I had Irritable Bowel Syndrome and prescribed a medicine that did nothing. I didn’t want to get out of bed; there seemed to be a cloud over everything and everyone.

One Saturday, when my husband was at an all-day church meeting, my two small children and I went to my parents’ house; I didn’t have the energy to take care of them by myself. I lay down and took a fitful nap, waking now and then to look out the picture window at the bright, hot day that seemed so hopeless. Suddenly, my mind was filled with a vision of a cliff; I walked to the edge, peered over — and saw a black, gaping hole that threatened to swallow me.

Tears came then; endless tears. I ran in search of my dad and tried to explain the horrible thing I’d seen, choking out words between sobs so that he could barely understand me. He called my husband to come home, and then he held me close on the couch as I cried. When my husband arrived he made some calls and then drove me to a hospital for evaluation; still I cried.

The counselor walked through a checklist that I now know practically by heart, but which at that time was new to me: the list of symptoms that signal clinical depression. I had every one of these symptoms — except, thankfully, suicidal thoughts. Had I been suicidal, they would have admitted me immediately. Instead, they diagnosed clinical depression and sent me home to find a psychiatrist and seek treatment.

I found a doctor, but he couldn’t see me for almost two weeks — the most horrible period of my life. Fortunately, I was able to obtain a short-term disability leave from work. I was unable to do anything. In the morning, making myself get out of bed required incredible effort. Each day I ate less, until finally it was impossible to force myself to take even a bite of food. I simply had no appetite (a concept I had never before understood); by the time the two weeks had passed, I had lost 20 pounds. There was no light; no happiness, not even from my children; no hope; no pleasure; no desire. There was only darkness, sadness, pain, and complete lack of hope that anything could ever improve.

“The pain is unrelenting, and what makes the condition intolerable is the foreknowledge that no remedy will come — not in a day, an hour, a month, or a minute. If there is mild relief, one knows that it is only temporary; more pain will follow. It is hopelessness even more than pain that crushes the soul. So the decision-making of daily life involves not, as in normal affairs, shifting from one annoying situation to another less annoying — or from discomfort to relative comfort, or from boredom to activity — but moving from pain to pain. One does not abandon, even briefly, one’s bed of nails, but is attached to it wherever one goes.” –William Styron, “Darkness Visible”

Then, finally, the day came to visit the doctor. I sobbed out my story to him, and he wrote a prescription. The medicine didn’t work immediately (they almost never do), but it began to help within a week. Suddenly, miraculously, my stomach didn’t hurt. Little by little the clouds lifted. I once again felt love and happiness with my family, and I could look ahead to the future. By the time my six-week leave was over, I was able to do what had seemed unthinkable a month before: I went back to work.

But at that time I was naive. Like many people with chronic illnesses, I felt so much better that I thought I didn’t need my medicine any more. A few months after my initial depression, I quit taking it — and within a week, the abyss beckoned. Thoroughly frightened, I returned to my daily pills. I tried once again to come off the prescription, some months later; but again, the depression returned almost immediately. Talking with my doctor, I learned that although many people experience a single bout of depression or infrequent recurrences, others are chronic sufferers. Lucky me; my brain chemistry is so thoroughly out of whack that I’ll be on antidepressants the rest of my life.

A couple of years ago, fed up with the side effects of my original medicine, a new doctor and I undertook to find me another antidepressant that would treat my particular illness. During those months I learned even more about this mysterious mental illness: Not all antidepressants work the same way (or at all) for all people, and individuals may require different combinations and doses that can only be determined by trial and error. No one — not the doctors, not even the pharmeceutical companies — really knows how or why antidepressants work. I tried one antidepressant that works beautifully for many people but that made me so desperately sick that my husband nearly took me to the ER. Other medicines helped with only some of my issues or had associated side effects that I couldn’t live with. In the end, desperate for a solution, I chose the medicine that made me feel the best and most normal, despite rejecting it initially due to a side-effect issue. Eventually my doctor suggested adding a second medicine (an anti-anxiety drug), which, fortunately, counteracts the side effect of the first.

These pills are now a cornerstone of my morning and evening. My children are well acquainted with them and what they’re for. My husband is careful to help me stay on track when we’re on vacation or otherwise off our usual schedule, casually asking me whether I’ve taken my medicine. I envision depression as a huge, black, ravening animal that’s always lurking on the other side of the protective door forged by my antidepressant.

I accept completely the fact that my daily pills will always be part of my life. A couple of times each year, I experience a downward turn in mood and faint shadows of the darkness — a dip into a valley that, I believe, would be the abyss, were it not for my medication. The wild animal is scratching at the door, trying to get through, but he can’t.

A well-meaning friend, who has never experienced depression or anything remotely like it, once expressed surprise that I was willing to be taking prescription medication on an ongoing basis. Surely, he said, I didn’t need it. Endless medicine isn’t good for people. I should be able to deal with it. It can’t be that bad.

Depression is a disorder of mood, so mysteriously painful and elusive in the way it becomes known to the self — to the mediating intellect — as to verge close to being beyond description. It thus remains nearly incomprehensible to those who have not experienced it in its extreme mode. —William Styron, “Darkness Visible”

I had no way to explain to him why his suggestion that I, essentially, “suck it up” was impossible and ridiculous. I could only remind him that he had never experienced a day lacking in hope, joy, or happiness, and that he could not begin to understand the intensity of my fear at the thought of ever again being smothered by that darkness. He has no wild animal clawing at the door of his mind.

I do. But, thankfully, it can’t get through.