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His Depression Is ‘Real,’ All Right

Robert Dawidoff is a professor of history at the Claremont Graduate University

The state of California is considering legislation that would declare, among other things, that mental illness is real. The Assembly bill would amend health and insurance codes to require health care service contractors or disability insurers to provide coverage “for the diagnosis and medically necessary treatment of severe mental illnesses.”

The definition of severe mental illness includes, along with schizophrenia and bipolar disorder and others, “major depressive disorders.” It is odd to think that what has plagued me and so many other Americans may be declared real.

Like many of the staggering number of people who experience some level of severe depression, I have been able to lead a reasonably productive life with causes for satisfaction. It took me years to see myself as someone who needed professional help, and it is taking years of therapy and medication to be helped. I still struggle with shame and guilt, just as I bear the scars of the shame I felt about being gay, even after coming out. I resisted medication for years, but finally I realized that were I diabetic, I would take insulin.

When he initially prescribed anti-depressants, the doctor said to call him if I had a problem. I called because I was frightened and disoriented by the new feelings I was having. After a long pause, the doctor said, “I don’t know how to say this to you, but what you are experiencing is called a feeling of well-being.” The feeling was fleeting but has given me something to work toward in the years since.

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Depression is still shameful. Everybody who admits to suffering from it--and it is an admission still--has heard the responses: “I know what just what you mean, today I had the most depressing experience . . .,’ not realizing that those of us who suffer depression also have those bad days, rough times, misfortunes and disaster but that depression is something else, virtually a defining condition. Sometimes people tell us to just get over ourselves, snap out of it, go to a movie--as if depression was lassitude and deliberate. Family and friends blithely question your taking medication or express confident doubts about your doctors and wonder if all that therapy is doing any good. They seldom have any useful alternatives in mind yet would be horrified and hurt if we replied, “OK, but will you deliver the eulogy when I kill myself?”

Then there is the problem of how you are perceived when you tell people that you suffer depression. Ordinary disagreements become instances where you are “difficult” or other code words for “crazy.” You become, in effect, a scapegoat. The problem isn’t them, it’s you.

Being candid about depression can create difficulties; in many working situations, it can spell real trouble. And realizing this can cause people not only to avoid treatment but can intensify the self-blame and self-doubt that frequently accompany depression.

Then there are the costs, which is presumably what this Assembly measure seeks to remedy. Most insurance plans are geared for short-term mental illness services, if any. Depression is frequently not a short-term problem. My friends have mortgages; I have therapy and medication bills.

There are also costs in time. It can take hours out of your day to go to therapy, not just the drive and the session but the hours it often takes to recover. Then there are the days, months, years sacrificed to the immobilization of depression. I usually meet my responsibilities, but nobody will ever know how much of my life I have lost to the sitting and waiting and to the desperate trying that my depression has required.

Medication causes its own problems. In my experience, “side” effects are center ring attractions. Even when medication helps, it isn’t the transformation I read about. One of the medications that seems to be helping now had me searching the phone book for gun shops a few years ago.

When people would ask me how I was, I used to think I should try to tell them. Now, I know better; I am practicing saying, “Fine, thanks.” I cannot imagine answering “good,” since of course I am not good. If you don’t understand this last sentence, I am happy for you, but we are not alike.

This is just some of what millions who suffer from a condition that cuts them off from human fellowship experience.

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Mental illness makes people uneasy. It is hard to identify with--even for many people who suffer from it. It is important for people to learn about this condition. Only then will it become real to those who don’t experience it.


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