Tuesday, November 21, 2006

Depression: Genetic Destiny or Personal Choice?

Two articles for you to consider while I pound away at my novel's backstory. One is a peak inside how I deal with disability over at The Absentminded Bookshelf, and the other is contributed by guest blogger and good friend, Soozcat. Both focus on personal responsibility being the best medicine for self improvement.

If depression is a genetically heritable trait (and there is some research to indicate that it is), I've got it coming at me from at least three directions. There's a long history of depression and other illnesses, both mental and physical, on both sides of my family. My dad's ancestors were quiet, melancholy Southern men who tended to drink themselves to death. On my mom's side, one of my great-grandfathers was a roaring drunken Swede who used to come home in the wee hours and vomit on the kitchen floor just before he passed out; another one, my Dutch great-grandpa who died before I was born, passed away in a mental hospital. As my auntie the nurse used to say, "We don't have a gene pool, we have a cesspool."

So of course, with all these marvelously dysfunctional genes to my credit, I'm destined to become a despairing sot, right?

*BZZT* Wrong! There's more to me than what my ancestors brought to the table, and I'm out to prove it.

Of course, I haven't always felt this way. For a long time I felt like a genetic victim, and indulged in a great deal of poor-pitiful-me time because of it. Depression hit me fairly early, and I didn't know how to hit back. By the time I was seven I had a streak of melancholy, developing into a sense of haunted fear in my 'tweens, and eventually resolving into your basic full-on depression as I hit puberty. To be fair, there were some events in my life -- including the sudden death of a parent when I was 12 years old -- that would have affected anyone, depressed or not, with feelings of loss and sadness. But just at the time most other people would be expected to start recovering from these events, I began to get worse. Around this time my mom, recognizing something weird when she saw it, took me to the doctor, who diagnosed me with clinical depression. Because teenagers are notorious for living only in the moment, I was convinced that the constant feeling of grim bleakness that hung over me like a shroud would continue to cover me all the rest of my days, and eventually suffocate me in darkness. (Yes, the diaries from my teen years aren't exactly cheery, dearie; they pretty much read like Gothity Ann and the Pit of Despair.)

When I first started clinging to the ship's wheel of life, barely weathering the ever-deepening storms of depression, I would ask myself, over and over again, a simple rhetorical question: why? The way I saw it, I was basically a good girl. I was active in my church, had a clear sense of right and wrong, and tried my best to do what was right. Why, then, I asked myself, would the God I worshipped allow this terrible burden to weigh on me? Why had He created me this way? Was He trying to punish me for something I'd done, and if so, what was it? Why couldn't He lift the depression from me, leaving the rest of my personality intact and healthy? It just wasn't fair!

Ah, the cri de coeur of the teenager: IT'S NOT FAIR! I was in the slow process of discovering, as most adults eventually do, a startling little secret: life is not fair, even though we somehow expect it to be so. Life has many delightful things to offer us -- love, Yeats, truth, beauty, guinea pigs, and Chocolate Mousse Royale ice cream, just to name a few -- but fairness is not on the menu. Part of the experience of becoming an adult is coming to terms with this fact, and learning to route around the damage when possible -- but most of all, realizing that if you predicate your own happiness on some arbitrary personal standard of "fairness," you are never going to be happy. It took me a while to learn to accept that there would always be some unfairness in life -- in this case, living with a mental disorder that, far from being the will of God, was probably simple genetic inheritance -- and even longer to come to the realization that I could experience peace, even happiness, without demanding fairness as a prerequisite.

When I wasn't busy demanding accountability from God, I was indulging in a phenomenon Douglas sometimes refers to as "wallowing." At the time I thought of it as surrendering to the inevitable. I knew my family history well enough; I was all too aware that I had scads of ancestors who had, so to speak, hung themselves from the family tree. Depression was like the family curse, and apparently there was no getting free of my genetic destiny, so why even bother to try?

Well, for one thing, "genetic destiny" is a somewhat overrated notion. Although genetic inheritance certainly does have a say in helping to form who you are as an individual, it is not the single most powerful force to shape a personality or direct a destiny. The most powerful force of all in determining who you are is your desire to effect change in your own life. This force can, in and of itself, be blunted by depression -- believe me, I know -- but if properly nurtured and encouraged, it will grow. And it can grow to a size and strength where it can overpower the crippling feelings of despair and emptiness so common to depression.

To put it another way, at some point the central question of my life became neither "Why me?" nor "Why bother?", but simply "What are you going to do about it?" The first two questions, although very common, are also essentially useless to a sufferer of depression. They have no clear answers, and are merely rhetorical devices to justify rolling out a full-service pity party, complete with wet blankets and cold tea. More to the point, they tend to lead you in only one direction: down toward despair. Does it make any difference to your mental health to know where the depression came from and who to blame? From past experience, I'd say no -- so why torture yourself with them? The last question, by comparison, does a number of productive things: it places your individual destiny back in your own hands, rather than encouraging you to fruitlessly blame other entities such as God or your ancestors; it encourages you to think, discovering or seeking out methods to combat the depression; and, once you've found methods that have helped you drive off the blackness or at least keep it at bay, it gives you the strength and confidence to continue your efforts.

Of course, knowing that you have some genetic predispositions can also help, if you're willing to learn from that information. For instance, I have successfully used diet, exercise and cognitive therapy to combat my own depression, but if those fail I am prepared to explore other avenues, including medication; however, I will not relinquish responsibility for my own health to any professional, no matter how learned. Since I know there's a long history of chemical dependency in my family, I won't touch alcohol, tobacco or illicit drugs with a ten-foot pole; I know I can't afford to become addicted. Likewise, I need to start eating better and exercising more if I don't want to develop Type II diabetes or heart disease, illnesses which frequently cause deaths in my family. I may not have complete control over all genetic factors -- medical science, for instance, isn't completely sure about the root causes of cancer, which is yet another common complaint (what did I say about a cesspool?) -- but I ought to exercise control over all the factors I can control.

Otherwise I'll feel that I've done all those gentle Southern ancestors, Swedish sots and Dutch depressives a terrible disservice. Because in this day and age, I have access to more options, more possibilities for treatment and assistance, than at any other time in recorded history. In their day, the only social option was turning to the bottle. If I sit still and allow depression to plow me under in the midst of all this bounty of options, then I've earned the right to feel ashamed of myself on their behalf. Sorry, but I choose not to do that.

17 November 2006

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