Back in the Dark House Again: The Recurrent Nature of Clinical Depression

Douglas Bloch
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“There is not one of us in whom a devil does not dwell.
At some time, at some point, that devil masters each of us.
It is not having been in the dark house,
but having left it, that counts.”

– Teddy Roosevelt

Eighteen years ago, in the fall of 1996, I plunged into a major depression that almost killed me. On the evening of my admittance to a psychiatric hospital I saw the above quote from a documentary on Teddy Roosevelt. For the next ten months, it informed my experience, as I did everything I could to leave the dark house I was in. Eventually, I was healed without medication and wrote about my experience in my memoir, When Going Through Hell…Don’t Stop: A Survivor’s Guide to Overcoming Anxiety and Clinical Depression.

Over the next eighteen years I took what I had learned in my healing and put together a mental health recovery program which I taught through my books, support groups and long distance telephone coaching. In the process, I counseled many people who were in the same desperate straights that I had been in. I shared with them what I had learned through my ordeal—that if you set the intention to heal, reach out for support, and use a combination of mutually supportive therapies to treat your symptoms, you will make it through this. And in the cases where people used these strategies and hung there, they eventually were able, like myself, to emerge from the hell of depression.

During this period, I was aware that that major depression was a recurring disorder, and that while one could successfully mange the symptoms, there was no cure. As Andrew Solomon, author of The Noonday Demon said,

“Depression is recurring and cyclic. What we have is treatments, not cures. You’re never really free of it; you always have to be prepared for a recurrence and be ready to stave it off as it could creep up on you.

Thus, I knew that I was still vulnerable, but after such a long period of “emotional sobriety,” I thought that I might have finally turned a corner.

Then one day, when I least expected it, a series of personal losses led me back into Roosevelt’s dark house. In the midst of my grief reaction, the old symptoms of depression–chronic sadness, lack of pleasure, disrupted sleep, loss of appetite, heaviness in the chest, lack of energy, hopelessness and periodic agitation—were all painfully present.

Now that I am back in the underworld, I am called upon to practice those very techniques that I had been teaching others. Of course I have been using these tools all along as part of my “maintenance program,” but now there is a big difference

I am using them not to stay out of hell, but rather to get out. What makes the latter far more difficult is that you cannot will yourself out of a clinical depression any more than you can will yourself out of a tumor or an advanced case of pneumonia. There is no ten-day course of “brain antibiotics” which you can take and have the condition clear up shortly. In my case, I have learned from my previous episodes that antidepressants do not work for me.

If, then, I cannot directly make the depression leave, what can I do? As I have told my clients, “You have to muddle through and hang in there until things improve. “ Here is how I am attempting to muddle through.

I start with AA’s serenity prayer: God grant me the serenity to accept the things I cannot change, the courage the change the things I can, and the wisdom to know the difference.

Here is what I cannot control and must accept: the biochemical changes in my body and the painful sensations and feelings they bring.

Here is what can I control − how I respond to those sensations and feelings. Here is what I am doing at this time:

  • When I wake up and immediately feel depressed and hopeless, I recommit to my decision that I want to get well, even though I don’t know how.
  • Even though I feel as if a huge black bear is sitting on my chest, I still chose to sit up, step out of bed, and get on my stationary bike for 20 minutes.
  • Throughout the day, I make sure to reach to other people for support.
  • I have changed my appointment times with my therapist from once a month to once a week.
  • I continue to put one foot in front the other, despite feeling as if I am walking into a headwind.
  • When I look into the future and see no hope, I refocus my attention to the present and vow just to get through the day.
  • I affirm to myself, “This too shall pass.” I say to myself, “Right now you are in the acute phase of dealing with your grief. Things will get better over time.”
  • Finally, I am noticing those small bits of grace that come my way. For example, an old friend whom I had lost touch with found out about my plight. Now he calls me every day to check on my progress. In addition, at a recent talk I gave, a member f the audience who sensed what I am going through came up to me and said, “You have to come out of this. What other possibility is there?”

Those words reminded me what a social worker told me during one of my hospital stays–‘The best predictor of the future is the past. You have emerged from these episodes before, and you will do so again.”

Meanwhile, I am still in the dark house. I have been in this prison for two months. I don’t know how much time I have left before the cosmic warden will grant me a reprieve. But I have faith that if I keep “muddling through” and do the things that support my healing then one day, when I least expect it, that reprieve will be granted and I will emerge from the darkness into the light.

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29 COMMENTS

  1. I think for some people it is recurring and some it is not.

    I agree however that if you keep muddling through eventually, with the care of your good freinds, things will get better.

    Grief is greif but it doesn’t always lead to depression, even if it has in the past and if it does it does not necersarily mean it always will in the future.

    Take it easy
    http://www.dorothyrowe.com.au/articles/item/192-the-real-causes-of-depression-february-2007

    • Hi John–You also can have the emotional reaction of feeling depressed, that isn’t bound to lead to an entire change of mood. You know the one: there are all these frustrating things, but wha’t the use, and then you get the automatic reaction. Same with disappointed emotional reactions that happen of a sudden, etc. And it is worth picking them out and noticing the unrealistic ruminations that ensue. I have relied a good bit on Sartre’s distinction in this regard between emotion and feeling, and though not expertly adept, don’t generally fixate upon bad moods and the distressing symptoms, and for me, luckily, they don’t stick around. But I used to think that I had “a disorder”.

      • I think learning to ride ones moods, instead of thinking you will always be stuck in this pit of self hating despair, is partly what Douglas is on about when he is teaching his mental health recovery programme and by doing all the things he listed at the end of his blog that he is doing to help himself.

        According to Dorothy Rowe, you need to do two things to be depressed:

        1 believe in the Just World Fallacy – ie that good things happen to good people and bad things happen to bad people
        2 wait for something bad to happen

        We all define good and bad in different ways though.

        When something bad happens and you blame yourself it is easy to lock yourself away. But it is also possible to realise, eventually that it wasn’t all your fault and that you are not that awful after all – and then the mood lifts.

        Sometimes it takes a lifetime, sometimes a few days, sometimes just a few moments.

        • I take plenty of interest in this kind of overview. Again, I retreat to really well known figures and work in the ideas and associated exercises piecemeal, just to get any handle on getting unstuck and calm. For instance, the problem of “waiting”–I thought Echard Tolle was successful in deconstructing it as (sometimes) pathological–you’d say a very unnecessary headtrip, while physically waiting can hardly be avoided. And–ouch–it could take a lifetime. Maybe so since everything is an experiment, though we often are sure what we’d like to see for results. At any rate, it took careful attention to how and about what particular emotions get triggered and how they are corruptions of the just as natural flow of feelings (about life and people generally) for me to get out of thinking that I had to heal my brain. The alteration of experience to something pleasant and fun answers the craving that persists in depression, but seeing that you face a problem in living rather than some basically medical issue is what kept me able to keep at fighting off the unlucky downer moods. But, of course, lots of physical problems came up and can have something to do with the causes and aggravate the effects. I can relate to the meaningfulness of your points and their relevance to this article very well.

  2. Interesting Kermit.

    I feel a sense of envy for those who come to ‘prison’ (Dark House) for a relatively short period of time. As someone who was given life without parole by mental health services by their intervention 3 years ago I can only hope to get to like the Dark House. It is where I’m going to have to live what is left of my life. Still, they were only trying to ‘help’.

    Good luck to you in your journey outside.

    Regards
    Boans

      • Apologies. I was hurrying to get Doug’s blog up, after a long weekend at the MiA film festival, when I was interrupted for what was going to be an hour and a half; I hit “publish” without realizing I hadn’t assigned Doug as the author (it defaulted to me).

        I was curious when I got an email from a friend offering me support in my dark time. Didn’t realize why until I opened MiA an hour and a half later.

        Sorry to all, especially Doug.

        • No problems Kermit,

          I assumed something like that had happened. Lucky I didn’t explain to a psychiatrist that I was having ‘hallucinations’ and that the authors of articles were changing when I looked at them. They might think I needed to be detained and drugged. I’m sure though that we could have explored the possibilities of it not being a hallucination in the ten minutes they had to make a diagnosis lol.

          Regards
          Boans

  3. Hi, Doug,

    In a similar place myself right now. I am not sure it is about chemicals cycling for me, as much as it is about my life focus changing since my youngest son has left home for college this summer. I am questioning why I am here and what I’m doing with my life. It seems appropriate to me to be going through this somehow, even though I am hating and resisting it most of the time. I think it’s time for me to make a big change in how I’m living, and that’s why I’m feeling this way. Not sure what it looks like yet, but change is coming whether I want it to or not, so I have to work myself around into embracing the idea of a new way of living my life. Meanwhile, I am pretty miserable every single day.

    I think depression for me is often the result of stagnation and feeling trapped. There are so many problems of a huge scale confronting us right now, it’s difficult not to lapse into despair. I am discouraged by the venality and thoughtlessness of my fellow humans and my own inability to impact them on a large scale. Underneath the depression for me is a towering RAGE that my life doesn’t feel like it’s my own, that I’m trapped in the capitalist treadmill of going to work to earn money, and coming home to “relax” in the evening, and looking forward anxiously to the weekend but then finding little to do on that weekend that is truly rewarding, and meanwhile waiting for the populace to wake up to the impending disasters our way of life is creating, not knowing what destruction will happen in the interim. It’s not a happy way to live, even though that’s what we’re all taught to do.

    Someone once said that suicide is a political comment, not on the person committing the act, but on the society in which s/he lives. I kinda feel the same way about depression. If I were unconscious enough not to understand what is going on, I might be able to feel OK about all of this through denial and ignorance. But I am not and I can’t do it. So I am going to have to change the rules of the game somehow. We’ll see what I come up with.

    Hang in there, and know that you are not alone. Perhaps your depression has a meaning you have not yet fathomed?

    —- Steve

    • “Someone once said that suicide is a political comment, not on the person committing the act, but on the society in which s/he lives.”
      Whoever said that said it well.
      I feel kind of the same way and I also know I’m not alone. I can’t but to think that what I’m doing in my life has no effect on the big picture and I am unwillingly a rat in a capitalistic machine. Whether you run or not, you’re still part of the game.

      • I thought the Hunger Games books and movie captured this idea very well. We may not be able to control much about our lives, but we don’t have to let “them” own us. The sad thing is, most of “them” are feeling just as powerless as we are. There are a very few evil folks who do most of the damage, but it’s perpetuated by people not speaking up. Which is why I think we “sensitive” folks are needed – we’re the alarm bells for the rest of the snoozing population!

        —- Steve

  4. Hello Douglas,

    I am sorry to hear that you are depressed again.

    I believe that extreme depression is caused by extremely depressing experiences. I believe that depression is relieved by creating habits that neutralize depressing experiences and promote socially acceptable experiences of well-being. Most therapy programs are long on how you perceive of personal experiences and short on working to improve personal experiences. Please consider the Natural Psychology Therapy program published online at NaturalPsychologyTherapy.org; it is based on seven types of actions that promote therapeutic well-being.

  5. Douglas….sorry to hear you are going through a dark time again. I remember meeting you in May and just felt such a warm and connecting presence from you. I’m sure you bring that to the people you work with…and because you are so open about your experience it helps many fathom the suffering they are going through.

    Anyways, sending you good thoughts your way to get stronger and to move through this challenging time.

  6. Hi Douglas:
    As you said, the important thing to remember is TTSP — this to shall pass. I am also experience many of these same feelings and I think that the main thing is to be fearless and courageous in maintaining an open heart when we want to withdraw and hide. Keep up the good work.

  7. Sorry to hear that you are depressed again. I hope you will find the strength to take good care of yourself and seek out supportive friends. Sometimes I find that spending time with little children helps me a lot. Their excitement and enthusiasm for life is very inspirational for me. Hope you find relief from the darkness soon.

  8. Douglas,

    I am so sorry that you are in such a painful and difficult place right now…I too have been there and back to a more hopeful space…a few times…I guess I see despair and depression, not as a recurring illness but as one place many of us go when overwhelmed by pain…one thing that helped me is to remember that I was not alone, even with my aloneness…most of us go to very hard emotional places at times in this life…I am one more person who has been there and trusts that you can and will come through this dark time…please let us know how we can help…hang in there…take good care of yourself as you would a dear friend…

  9. Hi Doug, I hope this feeling doesn’t last too long. It has been a hard year for all of us on this earth. I send you my best thoughts. I always have found THE MADWOMAN OF CHAILOT to be helpful in times like these. It is a marvelous play and bears reading by all of us right now in more ways than one! Here is one of my many favorite sections.

    The Countess was doing her best to make the young man see how rich life was.Perhaps,” glared the Sergeant, wounded, “you can do better

    *”Of course, in the morning it doesn’t always feel so gay.” She admitted this much. “Not when you’re taking your hair out of the dresser and your teeth out of the glass. And particularly if you’ve been dreaming that you’re a little girl on a pony looking for strawberries in the woods. But then comes a letter in the morning mail. One you wrote to yourself, giving your schedule for the day. Then, when I have washed in rosewater and put on my pins, rings, brooches, pearls, necklaces, I’m ready to begin again.”

    “After that, everything is pure delight. First, the morning paper. Not these current sheets full of vulgar lies. I always read the Gaulois for March 22, 1919. It’s by far the best. Delightful scandal. Excellent fashion notes. And of course the last-minute bulletin on the death of Leonide Leblanc. She used to live next door. And when I learn of her death every morning it gives me quite a start. To recover from which, Chaillot calls. It is time to dress for my morning walk. That takes much longer without a maid . . .”

    Maybe we all should send a letter to ourselves every now and then.Take Care!

  10. Dear Douglas,

    I’m really saddened to hear what you have been experiencing recently. My thoughts are with you and I hope you leave that awful house soon.

    You are such a caring and inspirational person. Your writings, teaching and support come from a beautiful heart – and they are so helpful to so many people. Please never forget that.

    Sometimes we just drop into these dark places – I know them as well – but there are always ways out. Keep working at it and believing.

    My very best wishes from Perth, Australia,

    David

    PS. Thank you for writing this blog. It will help many.

    • An ex-pom also (Geordie) but been here since I was 5.

      I had a quick look at your CV and noticed that your doing some work with people at the Centre for Aboriginal Studies at Curtin. That’s where I did my degree in the Humanities Dept. Dropped psychology after reading Szasz lol.

      I’ll have a look at your websites, because I found myself here as a result of our ‘antiquated’ mental health system, to say the least. And our treatment of Aboriginal people has to be seen to be believed.