A lot of Bruce Springsteen fans seemed shocked by the chapters in his 2016 autobiography, Born to Run, that describe his dark struggles with clinical depression. How, they wondered, could a guy afflicted with depression accomplish what The Boss has accomplished?
First, that reflects how erroneously we equate accomplishment with well-being.
But just as important, it points to
how superficially we approach clinical depression—even today, in the age of Zoloft. The disorder affects seven percent of the U.S. population, yet we’d rather pop pills for it than take a close look at it.
Like The Boss, Wabash men themselves
are creatures of accomplishment. But I can guarantee you more than a few of them also battle clinical depression. That includes me—even though people who know me probably ask themselves when they find out, “How can he have depression when he has such a big ego?”
Truth is, most depressives will tell you our biggest accomplishment today, and every day, was simply getting out of bed. That’s because for us, getting out of bed means facing the day with burlap bags full of melancholy, fatigue, dread, irritation, loss of enthusiasm, lack of focus, and low self-esteem hanging from every part of our bodies.
Anyone who has clinical depression knows what I’m talking about. (I say “who has,” not “who’s had,” because you don’t really cure the condition; you manage it.) They know what a millstone it is. Winston Churchill called his depression The Black Dog. My preferred analogy is a cage, one you’re always straining to escape—with medication, therapy, alcohol, religion, a good dirty joke, whatever lets you inhale the more lighthearted oxygen you see everyone else breathing out there.
Clinical depression may not ruin your life. But it definitely ruins your ability to enjoy your life. It doesn’t exactly make it easy for the people around you to enjoy theirs, either. All of which is why suicide too often visits depression sufferers. I stared at it once myself as a Wabash undergraduate.
When i arrived at the College in 1980, I had it all going for me, including a Lilly Scholarship. Every dime of my education was paid for. But depression, in its ever-insidious fashion, twisted all that bright fortune into dark pressure—most of all a morose belief that I was a fraud, that I didn’t deserve the scholarship. Instead of making it a boon to rejoice in, I turned it into a burden to live up to.
In my delusional panic to be Lilly-worthy that first year, I made the Dean’s list, lettered in soccer, had a meaty part in a play, and wrote for The Bachelor. I was president of my fraternity pledge class and Wabash’s freshman of the year.
I was also the most unpleasant jerk on campus.
Depressives are often convinced—irrationally, but this isn’t about rationality—that everyone is judging us at every moment. And harshly. That made me gloomy, selfish and self-absorbed, arrogant, prone to angry outbursts, unkind to women I dated, and a pretty obnoxious drunk. Ask my pledge brothers, who will rightly rank me the worst pledge class president in Wabash history.
When the year ended, I was one of the College’s unhappiest students, even though my full ride and packed transcript said I had every reason to be the jolliest.
The cage felt tighter than ever, and I seriously considered taking my life. A necktie in hand, I walked down to the basement bathroom and contemplated hanging myself. That is, until I tested the strength of the overhead pipe and it broke in two, flooding the floor. I suddenly felt more dumb than despondent, and fortunately—perhaps thanks to that embarrassing interruption—I never pondered suicide again.
I wish I could say that was a turning point. Depression still kept my mental health caged for years to come. Why couldn’t I free myself? Because I simply didn’t grasp what depression was—and didn’t for far too long.
During my childhood, when my father suffered depression to an even worse degree—depression, by the way, is fiercely genetic—treatment for and understanding of the condition was fairly Neanderthal. Even in the 1980s it bore the stigma of a character flaw.
So I never got real help until I was in my 40s. After yelling at a kid at my son’s ninth birthday sleepover for not following the rules of a scavenger hunt, I fell into a self-loathing tailspin and realized I had to find a way out of my cell.
Today i can say I’ve learned how to pick the lock.
But that means more than finding the right meds for depression’s chemical source—that shortage of human happy juice known as serotonin and the imbalance of other chemicals, including dopamine and norepinephrine. And it means more than finding the right therapy for dealing with depression’s social detonators—family dysfunction, career setbacks, a dinner party faux pas.
It’s also about knowing the enemy and its shrapnel grenade of symptoms. I call them depression’s Seven Deadly Symptoms, which I’ve collected in a convenient, travel-size acronym: STAALLS, because the condition so frustratingly stalls your life.
• Sadness. This is the no-brainer. Depression makes you sad, right? It’s not that simple. Most people think depression just makes you more susceptible to sadness. But this is clinical depression. You’re not sad because you just watched Brian’s Song or a Sean Spicer press briefing. It’s because the serotonin deficiency, among other factors, makes sadness your default setting, your normal state, your 24/7 mental delivery service.
It’s why Springsteen—and I and so many other depressives—know what it’s like to sit at an intersection waiting for the light to change when suddenly, without warning or reason, you start sobbing uncontrollably. It’s why every glass of water we see is half empty. And speaking of glasses, it’s why we sometimes drink too much—and like to joke and laugh too much when we drink too much—because any moment spent outside the cage is a good moment.
• Tiredness. What’s perhaps least known about depression are its physical effects, and fatigue is arguably the most prominent.
Depression seems to intensify gravity; it wears down not just your soul but your body. It can make your joints ache, your very skin sag. There’s an image of depressives wanting to curl up in bed in a fetal position—but it’s from exhaustion, not self-pity. And that’s true whether you’re 15 or 55.
• Anxiety. You’d think the tiredness would at least help you sleep. No such luck. This symptom—perhaps depression’s most poisonous dart—keeps you staring at the ceiling at 3 a.m.
That’s because clinical depression is like a mental health version of an immunodeficiency disorder. It makes you vulnerable to emotional pressures most people fend off quite easily.
Primarily, it keeps your angst and dread constantly at DEFCON 1, the highest threat level. You wake up each morning and fall asleep each night convinced you’ve f—ed everything up and p—ed everyone off. You’ve said and done the wrong thing in every encounter. You assume everyone in the room thinks you’re an a—hole. And you may deal with that by having one drink too many…and becoming an a—hole.
Meanwhile, you’re sure that you’ll never be able to manage the mountain of tasks and red tape on your plate. That you’ve let the whole world down. And so you often prefer to withdraw from the world. Messes up your social life.
• Anger. This symptom is the bane of my existence and one that seems especially common among clinically depressed men, largely due to macho shame.
In the novel Brideshead Revisited, Charles says about his depressive friend, Sebastian, “He’s ashamed of being unhappy.” Exactly. When you’ve got so much to make you happy—in Sebastian’s case lavish wealth; in mine, a beautiful family, good physical health, a successful career—yet you’re always inexplicably unhappy, you feel ashamed. Then frustrated. Then irritated. Then angry. The yelling-at-customer-service kind of angry.
And I can never apologize enough to all the people I’ve subjected to that.
• Loss of Interest. Here’s a new SAT word for you: anhedonia. In Greek it means “without pleasure.” In depression-speak it means the inability to experience delight or summon enthusiasm for things you’d otherwise get excited about.
It’s one of the most important gauges of how severe someone’s depression might be. But it may also be one of the hardest to detect. So parents, friends, teachers, and doctors need to keep an especially keen eye out for it. One red flag for my family: when they notice I’m not reading or writing much.
• Loss of Concentration. As a writer, I know few plagues worse than writer’s block. But I’ve discovered serotonin doesn’t just facilitate happiness; it also lubricates focus—and the lack of it can make me feel like a fifth-grader who needs Ritalin. It’s no surprise you find doctors today prescribing ADHD meds for depression.
• Self-Loathing. I have a theory for why many depressives are still achievers. We can’t imagine anyone liking us as people—we believe that the
six other symptoms I’ve just described confirm our toxic characters, if not the complete absence of character. So work accomplishment becomes the only likable quality we think we can offer. Either way, this seventh symptom is perhaps the heaviest burlap bag we carry.
I can now manage these seven scourges. Each day, I’m breathing more of that lighter oxygen. Sure, I still hit ditches; but I drive out of them more quickly.
I won’t discuss my treatment here, because it’s different for each individual, and because the drugs, like the famous SSRIs—selective serotonin reuptake inhibitors, which must have been named at the Pentagon—have side effects that harass some patients and not others. (A fellow depressive I know told me one SSRI made him impotent. “You’ve made me a eunuch,” he told the doctor.
“Yes,” said the shrink, “but a chemically balanced eunuch.” He found an alternative.)
My faith has played an important role as well, if only because the core belief of any religion is that light ultimately overcomes the kind of darkness that depression disgorges. I also married a wonderful woman who conveys that message to me every day.
But I’m convinced that if you don’t appreciate depression’s realities you won’t benefit as much as you hope from its remedies—medical, therapeutic; or otherwise.
Popping a pill isn’t enough. Know the enemy you’re battling. Know why you’re taking the pill and getting the therapy. You’ll get out of depression’s cage faster. And you’ll accomplish more.
I think The Boss would agree.
Tim Padgett is WLRN-Miami Herald News' Americas correspondent covering Latin America and the Caribbean from Miami. He is the recipient of Columbia University’s Maria Moors Cabot Prize, the oldest international award in journalism, and the College's Alumni Award of Merit.