The face of depression

This is what depression can look like.

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  1. Kurt Cobain
  2. Chester Bennington
  3. Whitney Houston
  4. Mac Miller
  5. Robin Williams
  6. Phillip Seymour Hoffman
  7. Chris Farley
  8. Marilyn Monroe
  9. Amy Winehouse
  10. Chris Cornell
  11. Ernest Hemingway
  12. Lucy Gordon
  13. Simone Battle
  14. Layne Staley
  15. Gia Allemand
  16. Anthony Bourdain

Some of these people ended their lives deliberately, others by drug overdose that may or may not have been intentional. But their pictures belie what was going on inside – they were hurting.

While many of the comments in the reddit thread where I found this were insensitive and cruel, a few were on point:

“I used to think the worst thing in life was to end up all alone. It’s not. The worst thing in life is to end up with people that make you feel all alone.”
-Robin Williams

“I wanted to write down exactly what I felt but somehow the paper stayed empty and I could not have described it any better.”
-Unknown

And an essay on depression that spoke more eloquently to me than much else on the subject (slightly bowdlerized):

Depression
Author Unknown

“When you have depression it’s like it snows every day.

Some days it’s only a couple of inches. It’s a pain in the ass, but you still make it to work, the grocery store. Sure, maybe you skip the gym or your friend’s birthday party, but it IS still snowing and who knows how bad it might get tonight. Probably better to just head home. Your friend notices, but probably just thinks you are flaky now, or kind of an asshole.

Some days it snows a foot. You spend an hour shoveling out your driveway and are late to work. Your back and hands hurt from shoveling. You leave early because it’s really coming down out there. Your boss notices.

Some days it snows four feet. You shovel all morning but your street never gets plowed. You are not making it to work, or anywhere else for that matter. You are so sore and tired you just get back in the bed. By the time you wake up, all your shoveling has filled back in with snow. Looks like your phone rang; people are wondering where you are. You don’t feel like calling them back, too tired from all the shoveling. Plus they don’t get this much snow at their house so they don’t understand why you’re still stuck at home. They just think you’re lazy or weak, although they rarely come out and say it.

Some weeks it’s a full-blown blizzard. When you open your door, it’s to a wall of snow. The power flickers, then goes out. It’s too cold to sit in the living room anymore, so you get back into bed with all your clothes on. The stove and microwave won’t work so you eat a cold Pop Tart and call that dinner. You haven’t taken a shower in three days, but how could you at this point? You’re too cold to do anything except sleep.

Sometimes people get snowed in for the winter. The cold seeps in. No communication in or out. The food runs out. What can you even do, tunnel out of a forty foot snow bank with your hands? How far away is help? Can you even get there in a blizzard? If you do, can they even help you at this point? Maybe it’s death to stay here, but it’s death to go out there too.

The thing is, when it snows all the time, you get worn all the way down. You get tired of being cold. You get tired of hurting all the time from shoveling, but if you don’t shovel on the light days, it builds up to something unmanageable on the heavy days. You resent the hell out of the snow, but it doesn’t care, it’s just a blind chemistry, an act of nature. It carries on regardless, unconcerned and unaware if it buries you or the whole world.

Also, the snow builds up in other areas, places you can’t shovel, sometimes places you can’t even see. Maybe it’s on the roof. Maybe it’s on the mountain behind the house. Sometimes, there’s an avalanche that blows the house right off its foundation and takes you with it. A veritable Act of God, nothing can be done. The neighbors say it’s a shame and they can’t understand it; he was doing so well with his shoveling.

I don’t know how it went down for Anthony Bourdain or Kate Spade. It seems like they got hit by the avalanche, but it could’ve been the long, slow winter. Maybe they were keeping up with their shoveling. Maybe they weren’t. Sometimes, shoveling isn’t enough anyway. It’s hard to tell from the outside, but it’s important to understand what it’s like from the inside.

I firmly believe that understanding and compassion have to be the base of effective action. It’s important to understand what depression is, how it feels, what it’s like to live with it, so you can help people both on an individual basis and a policy basis. I’m not putting heavy [stuff] out here to make your Friday morning suck. I know it feels gross to read it, and realistically it can be unpleasant to be around it, that’s why people pull away.

I don’t have a message for people with depression like “keep shoveling”. It’s asinine. Of course you’re going to keep shoveling the best you can, until you physically can’t, because who wants to freeze to death inside their own house? We know what the stakes are. My message is to everyone else. Grab a [] shovel and help your neighbor. Slap a mini snow plow on the front of your truck and plow your neighborhood. Petition the city council to buy more salt trucks, so to speak.

Depression is blind chemistry and physics, like snow. And like the weather, it is a mindless process, powerful and unpredictable with great potential for harm. But like climate change, that doesn’t mean we are helpless. If we want to stop losing so many people to this disease, it will require action at every level.”

There is no one description of depression. There is no packaged solution for depression. While I’ve never dealt with clinical depression personally, I’ve lived with people who do, and my takeaways are fairly basic:

  1. Depression is real.
  2. Platitudes don’t help anything, and usually make things worse: “Snap out of it!” “What’s your problem?” “You need a boy/girlfriend.” A list of 100 things not to say.
  3. The best thing you can say is something like “You are not alone in this. I’m here for you”… and then do it.

battle

Kindness is never wasted, never amiss, never the wrong thing. A kind word or a smile to a stranger might just save a life that day.

The Old Wolf has spoken.

No, Turmeric lemonade is not better than Prozac

In current parlance, the word “woo” is defined at RationalWiki in this way:

Woo is a term for pseudoscientific explanations that share certain common characteristics, often being too good to be true (aside from being unscientific). The term is common among skeptical writers. Woo is understood specifically as dressing itself in the trappings of science (but not the substance) while involving unscientific concepts, such as anecdotal evidence and sciencey-sounding words.

No industry is more susceptible to the propagation of woo than the diet, health, and nutrition sector. Just say “trillion dollar industry” and you have the motivation to do and say anything to get a slice of that pie. Facebook, Pinterest, and Tumblr are all hotbeds for the dissemination of woo. Countless public figures have gotten rich by flogging woo, and in the process have led to believe that various and sundry herbs, spices, and so-called “superfoods” are a panacæa for all sorts of ills – cancer, diabetes, heart disease, and even lupus.

Its-not-lupus-Its-never-lupus

I’ve blogged many times about snake oil and supplements. The industry of deception is alive and well. Even a year after her death, my mother continued to receive slick-looking solicitations for absolutely worthless concoctions like “MentaFit Ultra“, which unsurprisingly is not even sold any more. These products arise in a flash of advertising, are sold to a whole raft of unsuspecting and gullible victims, and then vanish along with their creators, only to surface with another name and a new formulation.

Newser, a popular news aggregator, is still allowing multiple clickbait ads and popups for worthless and expensive supplements to appear on their website,  even though this last particular scam has been widely debunked by multiple sources – two of note are Malwarebytes and Snopes. A percentage of this may be the result of poorly-vetted or supervised automatic affiliate marketing ad placement, but someone has got to know the kind of stuff that’s being hawked here – and Newser is hardly the only offender. I just happen to use them as the teacher in the moment because I’m sad about what they’ve allowed themselves to become in the name of monetization.

Today this showed up on my Facebook page:

http://healthinformative.net/turmeric-lemonade-that-treats-depression-better-than-prozac/

turmeric

Go to the article and they refer to two studies at PubMed:

  1. Multitargeting by turmeric, the golden spice: From kitchen to clinic, by Gupta SC, Sung B, Kim JH, Prasad S, Li S, and Aggarwal BB.
  2. Efficacy and safety of curcumin in major depressive disorder: a randomized controlled trial, by Sanmukhani J, Satodia V, Trivedi J, Patel T, Tiwari D, Panchal B, Goel A, and Tripathi CB.

In the second article, the abstract includes the following sentences:

Traditionally, this spice has been used in Ayurveda and folk medicine for the treatment of such ailments as gynecological problems, gastric problems, hepatic disorders, infectious diseases, and blood disorders. […] Numerous animal studies have shown the potential of this spice against proinflammatory diseases, cancer, neurodegenerative diseases, depression, diabetes, obesity, and atherosclerosis. At the molecular level, this spice has been shown to modulate numerous cell-signaling pathways. In clinical trials, turmeric has shown efficacy against numerous human ailments including lupus nephritis, cancer, diabetes, irritable bowel syndrome, acne, and fibrosis.

Forgive me, but my BS meter just redlined.

BS Meter

Even without digging into these articles beyond the abstract, and analyzing methodologies and statistical significance of the results which I don’t have the time and energy to do, there are just too many red flags to even begin to take these kinds of claims seriously. References to Ayurveda, the fact that almost all the authors are from India, the wild claims of efficacy or references to “showing potential” – nothing here can be construed as “proof” that turmeric is “better than Prozac” for depression.

A caveat: I am not wholesale against nutrition, or nutritional supplements, or natural remedies. Aspirin was once a “natural remedy,” until science isolated salicylic acid and multiple peer-reviewed, double-blind, randomized tests proved its efficacy. There’s a lot we don’t know. Despite my skepticism about the studies above, there may be value in curcumin and turmeric that have not been fully explored. As with anything in science, the key is a large base of peer-reviewed studies and reproducible results.

Until then, woo-articles of this nature need to be taken with a hefty dose of salt – not just a pinch. Be very careful whom and what you trust. There are still people out there hawking “Miracle Mineral Supplement” for all sorts of things, and it’s nothing more than diluted bleach. This junk will kill you.

Depression is a serious illness and can be debilitating. While they are not a magic bullet, FDA-approved meds help many people to be able to carry on normal lives. And there is no one-size-fits-all solution.

This much I can tell you: ☞ It’s not turmeric lemonade. ☜  Be very careful out there.

The Old Wolf has spoken.

 

 

Dorothea Lange – 1939, Motherless family in Yakima Valley

Saw this photo over at reddit and it really pulled at my heartstrings.

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The oldest of the children in this photo by Dorothea Lange takes care of the others in her migrant family, most likely while the father is working in the fields. She is stunningly beautiful, but carries a heavy and unwanted load on her young shoulders.

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Another image of the middle child, wearing a sack dress.

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“Youngest little girl of motherless family.” Toppenish in the Yakima Valley of Washington State. August 1939. Photograph by Dorothea Lange. Seen at Shorpy.

Poverty of this nature still exists in our country, let alone the rest of the world, but these images are a stark reminder of a very difficult time for our nation.

The Old Wolf has spoken.

Don’t send in the clowns… give them love.

The recent and tragic passing of Robin Williams has spawned a flurry of tributes and analyses, and many of these focus on the issue of mental health. That’s not a bad thing, but it’s unfortunate that it takes the death of a beloved actor to focus the public’s ephemeral attention on an ongoing problem. At the same time, it’s not like the issue has been unknown or has been being ignored all this time; my very first encounter with the issue of depression came from the classic poem:

Whenever Richard Cory went down town,
We people on the pavement looked at him:
He was a gentleman from sole to crown,
Clean favored, and imperially slim.

And he was always quietly arrayed,
And he was always human when he talked;
But still he fluttered pulses when he said,
‘Good-morning,’ and he glittered when he walked.

And he was rich – yes, richer than a king –
And admirably schooled in every grace:
In fine, we thought that he was everything
To make us wish that we were in his place.

So on we worked, and waited for the light,
And went without the meat, and cursed the bread;
And Richard Cory, one calm summer night,
Went home and put a bullet through his head.
– Edwin Arlington Robinson

When I read this poem for the first time (probably around 9th grade, which would have been 1964) I thought, “How could someone so rich and powerful and enviable do that?” Then I lived with depression for 30 years. Not mine, but someone else’s, and I learned that this is not something that is tied to external circumstances, and it’s not just something you “get over.” No matter how hard some people work, no matter how much therapy, no matter how many meds, that blackness just doesn’t  go away. You can’t regrow a leg by thinking about it, you don’t make ALS disappear just because you want it to, and depression is just the same. And sometimes it just hurts too badly to keep going.

In 1967, Dave Berg wrote “The Lighter Side of the Mating Game” for MAD magazine. He had his finger on the pulse of the insecure comedian:

Dave Berg Georgie

 

A much darker, but no less accurate summation was created by Nicholas Gurewitch, the creator of the Perry Bible Fellowship:

Perry Bible Fellowship - We Need the Funny

 

In a recent ABC News article, Dr. Rami Kaminski, a professor of psychiatry at Columbia University School of Medicine was quoted as saying, “The reason so many comedians are at risk for mental illness is because being funny is not the same thing as being happy.”  He also said he believes many comedians mine humor as a way to escape depression and anxiety.

Several articles and blogs which appeared pursuant to Williams’ death are worth reading:

The Death of Robin Williams, And What Suicide Isn’t – Elizabeth Hawksworth

Robin Williams’s death: a reminder that suicide and depression are not selfish – Dean Burnett at The Guardian

David Wong, over at Cracked.com, wrote a savagely honest article about the relationship between comedy and internal suffering (he’s a humorist himself, and  speaks from experience, although this is obviously only one scenario, and doesn’t apply to all cases):

  1. At an early age, you start hating yourself. Often it’s because you were abused, or just grew up in a broken home, or were rejected socially, or maybe you were just weird or fat or … whatever. You’re not like the other kids, the other kids don’t seem to like you, and you can usually detect that by age 5 or so.
  2. At some point, usually at a very young age, you did something that got a laugh from the room. You made a joke or fell down or farted, and you realized for the first time that you could get a positive reaction that way. Not genuine love or affection, mind you, just a reaction — one that is a step up from hatred and a thousand steps up from invisibility. One you could control.
  3. You soon learned that being funny builds a perfect, impenetrable wall around you — a buffer that keeps anyone from getting too close and realizing how much you suck. The more you hate yourself, the stronger you need to make the barrier and the further you have to push people away. In other words, the better you have to be at comedy.
  4. In your formative years, you wind up creating a second, false you — a clown that can go out and represent you, outside the barrier. The clown is always joking, always “on,” always drawing all of the attention in order to prevent anyone from poking away at the barrier and finding the real person behind it. The clown is the life of the party, the classroom joker, the guy up on stage — as different from the “real” you as possible. Again, the goal is to create distance.

You do it because if people hate the clown, who cares? That’s not the real you. So you’re protected.

The full article is rather coarse so I don’t quote most of it here, but if you’re not offended by such things, you can visit the source.

For me, the takeaway from all of this is that much more needs to be done in the area of treating mental illness. When people get sick, they visit a doctor without hesitation. But let a person suffer from depression, and it’s usually hidden away in the closet and discussed in hushed whispers using euphemisms like “chemical imbalance.” Those who suffer usually manage to function in society, but are rarely free of judgment; most often heard from others who have no clue are things like “happiness is a choice, just snap out of it.” This and about 100 other platitudes, things that are never helpful to say to someone with depression, can be found at PsychCentral.

The other important point is that there is nothing that you can do for a friend or loved one who suffers from the blackness. Depression is still poorly understood, and there is no “cure.” The same source above provides a list of things that can be done, but this list – while accurate – is highly clinical and omits the two most important things you can do: Love and accept. People with depression need a community of friends who can provide support and acceptance without judgment. Even this won’t make the blackness go away, but it’s the best thing friends and family can offer.

In conclusion, two beautiful tributes to the life of Robin Williams:

Patch Adams: ‘Thank You for All You’ve Given This World Robin, Thank You My Friend’

The Old Wolf has spoken.