Tuesday, November 10, 2009

Depressed or Thinking Deep - My Take

Therese Borchard of Beyond Blue always has a way of making me feel that on a planet of six billion strangers I have at least one person I can talk to. Last week, she opened a blog piece this way:

I spent my adolescence and teenage years obsessing about this question: Am I depressed or just deep?

When I was nine, I figured that I was a young Christian mystic because I related much more to the saints who lived centuries ago than to other nine-year-old girls who had crushes on boys. I couldn't understand how my sisters could waste quarters on a stupid video game when there were starving kids in Cambodia. Hello? Give them to UNICEF!

Now I look back with tenderness to the hurting girl I was and wished somebody had been able to recognize that I was very depressed.

See what I mean? I just know that had we been in the same class at grade school, while the other kids played ball during recess, Therese and I would have found a quiet spot to sit under a shade tree, sharing cookies our moms packed and discussing how Augustine of Hippo must have felt after Alaric the Visigoth sacked Rome in 410 AD.

So, what was it? Were Therese and I two sensitive souls waxing philosophical, or two depressives acting strange? Therese cites both Paula Bloom PsyD (from a blog on PBS) and Peter Kramer MD, author of "Against Depression" (from a NY Times piece) in support of the proposition that depression and thinking deep are clearly distinct. Says Dr Kramer:

"We idealize depression, associating it with perceptiveness, interpersonal sensitivity and other virtues. Like tuberculosis in its day, depression is a form of vulnerability that even contains a measure of erotic appeal." First the ancient Greeks, then Renaissance thinkers, and later the Romantic movement assigned spiritual and artistic and even heroic virtues to melancholy. Nonsense, Dr Kramer responds. "Depression is not a perspective. It is a disease."

If I interpret Therese correctly in her blog piece, she found comfort in this. It came as a great relief to her to realize that her capacity to think deep, even at a young age, although unusual, was not pathological.

I, on the other hand, have an entirely different reaction. "Wait!" I want to scream at Dr Kramer. "You mean my depressions have all been for nothing?" My lost hours, lost days, entire lost years, a lost life practically, served no useful purpose whatsoever?

Screw you, Kramer! I want to keep screaming for no logical reason, whatsoever. Something that took so much from me, so much out of my life, I demand some kind of return - Jedi powers, a mystical third eye, roll-over phone minutes, whatever.

Yes, Dr Kramer is right, but so is everyone else. When it comes to the enduring question - Who the hell am I? - we are all struggling to find the truth. Here's what I'm looking at right now:

Proposition One: Any depression that is not part of my temperament sucks - whether mild or severe. Take my depression - please. They throw me off my game, ruin my day, wreck my life. Whether it's a depression that is the equivalent of a mild cold or one that is psychic double pneumonia I seriously don't want to be inside my brain on this planet when my neurons have gone on strike. If this is the disease that Peter Kramer is talking about, I'm behind him one hundred percent.

Proposition Two: At the same time, mild to moderate depression is part of my temperament, my personality (as is hypomania). As opposed to my disease depressions, I'm very comfortable in this state. It is a part of who I am. My energy is down, my thoughts tend to be very dark, but - here's the key difference - I thrive in this state. My neurons are working with me, or perhaps me with my neurons. It's as if I'm calmly sifting through the ideas I rounded up in my hypomanic frenzies, whether I'm lying in bed, at my desk, or taking a walk. If this is Dr Kramer's version of just thinking deep, I would have to respectfully disagree.

What we are talking about is the classic distinction between "state" and "trait." Trait is who we are. State is invasion of the brain snatchers. But no distinctions are ever as clear-cut as they seem.

We tend to get hung up on DSM-IV check lists while ignoring a key DSM injunction - namely that we are only in a state of mental illness when the symptoms interfere with our ability to function (as in work or relationships). So - from my personal perspective - if I am comfortable and not struggling while depressed, then I hardly have an illness that needs treatment.

Now let's flip it. I also get hypomanic, and I've written a lot about this. Here's the test: For Marilyn Monroe to act like Marilyn Monroe (at least when she's up) - that's normal, for Marilyn, anyway. For someone else to act like Marilyn Monroe, on the other hand - that's probably a sign that very bad things are about to happen.

So, back to depression. For me to act like me (when I am down), under most situations that is normal for me. I can handle it, it is healthy. For someone else to act like me, trust me, that is cause to get one's personal affairs in order.

Here's where it gets complicated. When does my productive depression start becoming a nuisance and when does this nuisance seriously start messing me up? Similarly, when does my upbeat hypomania cross over into social embarrassment and in turn morph into something that causes me to make very bad decisions?

It's as if we're turning up the heat. When, in effect, instead of a nice warm soak in the tub, do we find ourselves in hot water? Everyone has different tolerance thresholds, and you can make a good case that we can expand the range of these thresholds to lead healthier lives. Of course, every time I congratulate myself on doing this, God just laughs and throws a psychic lightning bolt in my direction.

So - my normal would probably cause most people to stay in bed for six months, or (in the other direction) have neighbors dialing 911.

One more twist. In her blog, Dr Bloom reported on this confused reaction from a patient: "When I reflected to her that she sounded depressed she said 'I don’t think so, that is just my personality.' So many people confuse depression with just being a lazy, unmotivated person."

So our depressed state tends to give us a wrong read on our baseline traits. Who the hell are we? It's a question I'm still trying to figure out.

Therese is my fellow terminal deep thinker and favorite blogger. Please check her out at Beyond Blue.


Paula Bloom said...

I so appreciate your candor and transparency! It is nice to know that people are reading what I put out there!

For another piece of this conversation you may want to read a follow up blog post I wrote for PBS "Accessing faith though treating depression."


You might consider commenting on the PBS website with a link to your blog post!

Best wishes on the continued journey,

Paula Bloom

John McManamy said...

Hi, Paula. It was such a pleasant surprise to wake up and find your comments. You'd love having me for a patients. No, I take it back - I'd drive you crazy. :)

Louise Woo said...

Can you be depressed and not be deep? Can you be deep and not depressed?

This is a question many of us have pondered for a lifetime.

I don't think depression -- or mood disorders in general -- are "required" to prompt deep thinking. Some of the most interesting, intellectual-thinkers I know are not mood-disordered, (although one is pretty severely anxiety-disordered.)

BUT, I have noticed that "deep" thinking seems to accompany depression, for better or worse. I've noticed this in my friends and contemporaries, but I have particularly noticed this in my sons, one who has depression and the other with bipolar hypomania.

From his earliest years, the older one (dx'd with depression at age 13) was the deeper thinker. Although he had no signs of mood abnormality until puberty, he was always the kid who liked talking to adults, asking questions, dissecting social situations, looking at things from different angles.

Even now, with his depression well-managed by lamictal, he is the one who wants to sit and TALK. But not just talk: dissect, ponder, analyze, hypothesize. It's not depressive-obsessing either. It's not negative or pessimistic. He just likes to "go deep."

The bipolar one? Never. No way. No time to sit around talking with adults. He has too many things to do. He acts before he thinks. I wish he'd slow down and think more. Hell, I wish he'd slow down and check the answers on his tests! (His grades would be better.) He is NOT deep, not like his brother. Even during his wintertime depressed days, he doesn't care to talk. He just wants to sleep.

So I think a common "side-effect" of depression is deep-thinking. But I don't think all people with depression are deep-thinkers or that you have to have some depression to think deeply.

It is an interesting comorbidity though, don't you think?

Pam said...

Who are we? Dying..

John McManamy said...

Hey, Louise. Very interesting side effect. Very interesting observations.

John McManamy said...

Hey, Pam. Depression has a way of reminding us all that we're dying in slow motion. But what depression doesn't tell us and prevents us from appreciating is there is an interlude called life that is worth checking out. Depression robbed me of that appreciation for a long long time.

Gen said...

After I read Therese's original post I searched out Peter Kramer's "Against Depression" and am reading it now. I've lately been struggling with the whole "what's me and what's the depression" question and the book is proving quite helpful.
I've suffered from depression since my teens (I'm now 33) and I have to go so far back to figure out my original personality before the depression took over and clouded everything.
I recommend the book to everyone struggling with this issue. Dr. Kramer has such interest and expertise in depression - I wish he was my psychiatrist! Although the book focuses on unipolar depression, he does get into a discussion of bipolar in the third part of the book when he talks about mental illness and creativity.

John McManamy said...

Many thanks, Gen, for your review. I'll put Dr Kramer's book on my list. Welcome to Knowledge is Necessity. Make yourself at home.

Anonymous said...

I look forward to reading Dr. Kramer's book. I don't think depression automatically makes you a deep thinker. But, pain has a way of forcing you to consider the important questions of why? who? and what? are we doing here. And depression is very very painful.

I have/had all the reactions mentioned to being diagnosed at 49, almost 50 w/ bipolar II. First reaction, no way, I've functioned well most of my life. Continuing now, how does this diagnosis change my perceptions of idenity? Finally, amazement, I am living a life where I don't have to engage in continuous mood monitoring and analazing, something I did intuitively to survive and function. It worked well until it didn't and then crashing came very very dramatically.

I hate this illness, the days, weeks, months it took from me, the days it grayed when I knew it should be sunny, and the weakness it now exposes. But I don't hate the person I've become as a result of this illness, sensitive to other's pain, sure of God's presence and interventions, sharply aware of beauty. But I am also deeply aware to stigma, especially in the workplace, so I remain Still Anonymous.

Anonymous said...

I think about what this illness has taken from me and it hasn't been dayss, weeks or even months....but only moments. Moments with my children or spouse or in the country or working with a student...moments that should have taken my breath away, but didn't. And now they're lost. Does depression make you a deep thinker? No, I think being a deep thinker makes you more suseptible to mental illness. There has to be a connection between creativity and mental illness. In those times when I'm depressed or manic, I've missed moments. And when I'm in remission, I'm thinking deeply about what I've missed when ill. It's a vicious circle. One I'm sure you can relate to. And there is a correlation, but as I am in a depression state, I can't find it in my mind. I'm too busy missing the moment.

April said...


Thank you so much for this article! I am so happy that there's someone else out there who thinks the way I do! I have written a piece on The Connection Between Deep Thinking and depression, where I mention a lot of different factors. Including one about being depressive is my nature. You are so right about state vs. trait. I am a depressive person, so for me to be happy and chipper all of the time is quite unusual. Anyway, thanks for the insight! Visit my article at http://capric222.hubpages.com/hub/The-Connection-Between-Deep-Thinking-and-Depression

John McManamy said...

Hey, April. I just read your piece and left a comment. I'm so happy (Wait! I'm never happy)that you have a similar take on this. Psychiatry is still in the Dark Ages on this. No one wants to be miserably depressed, of course. But for many of us, depression is a true part of our personality, and in this context is neither all-good nor all-bad. Certainly, the thinking-deep aspect is an enormous asset. Please keep stopping by and adding comments. I look forward to checking out other pieces on your blog.