Beth has been working on writing about depression. Depression is something I know a little about. I see people in my office everyday who are depressed and I certainly have my own ups and downs with it the way most of us do- maybe even a bit more so as I work my way through my early fifties, that being a time that lends itself to moodiness. One thing I worry about is that between the media, prevalence of medication and our own declining ability to self comfort the whole damn world is becoming depressed. The expression “I’m depressed” is becoming meaningless. Nowadays it carries about as much weight as saying, “my seven year old son has ADHD.” Well, he can join the other 85% of his buddies who are also tipping over desks and falling into the drinking fountain every time the bell rings. It will pass.
So, too, with most of our depression. It will pass. I worry that the cute little sad guy cloud on the television commercial, the one who, a pill and moments later, is happily bouncing around like a manic widget-well, I worry that he’s the guy with the mood disorder.
I think that our decreasing tolerance for distress combined with our ever increasing demand for the quick, generally external, fix leaves us feeling entitled to no moods. We’re not even satisfied for life to be a bowl of cherries with pits and a few rotten ones; we want life to be pasteurized cherry yogurt with a shelf life of forever.
But then there is serious, clinical depression. The real deal. The “I would rather not be here and everyone would be better off if I weren’t“ depression. One area of depression that I specialize in is post partum depression. My post graduate training, a thousand years ago, was in infant mental health. People used to ask, “how can you do therapy on a baby?” Well, only by doing therapy with at least mother and baby and sometimes mother, father and baby. One reason little babies come to be at risk for mental health problems or begin to fail to thrive is because their mothers have serious post partum depression.
The first time I witnessed true post partum depression was as an intern in a prehistoric backward of a mental hospital. This was in the early 70s before we turned all the psychotic people out on the street to become today’s ambulatory schizophrenics living in homeless shelters. Anyway, I was a snip, merely 23, and I carried more keys on my waist than I weighed. Every door, elevator and stairway had to be unlocked and locked against escape. Three years later we were dumping these same people wholesale out into the street, begging them to escape and go away.
My job was to take histories from patients- family, social, psychological- to try to put together the puzzle pieces that would help explain their current condition. Most of them weren’t talking because the night before, on admission, they had been so pumped full of drugs they couldn’t sit up, let alone deliver a coherent piece of information. After I took a history, or not, a resident psychiatrist who had English as a fourth language would interview this poor hapless soul in front of a room full of students, interns, residents and nurses.
The dopey patient would be flopped over in a chair and Dr. Kim would say, “Wa mean ‘it in time say nine?’ ” Blank stare. “Wa mean ‘wowing tone gada no mau?’ ” Blank stare. Whoops! More drugs and three weeks for you. ( A humorous aside is that at one time we had 3 Dr. Kim Lees, 2 Dr. Lee Kims, a Dr. Kay Lee, and Dr. Kee Lim on staff. With one Dr. Ronald Johnson who was 89 years old and himself catatonic.)
One day I unlocked and locked my way onto the ward and went into the day room ( no one had any privacy) to interview a young woman who had been admitted overnight. She was in her early 20s, Chinese, tiny and sobbing uncontrollably. This in itself was an unusual display of emotion in this particular place. I also noticed that the entire front of her shirt had wet stains covering her breasts. Her English was almost non-existent but I was able to finally, between some scratchy admission notes and an hour of “fifty questions,” figure out that she had recently moved from China with her husband, leaving behind her entire extended family in the small village where she had lived her all her life. Most importantly, she left behind her mother. Every other sentence was punctuated with a wail for her mother. Eight days before admission she had given birth to a girl (uh-oh). Her husband, a beginning engineer, was absorbed with work 18 hours a day and added to that , he was keenly disappointed to have daughter. This poor woman lived in an apartment building in Wayne, Michigan (uh-oh) and the baby cried endlessly. Day after day she spoke to no one.
I knew nothing. I was a first year social work intern. She was my fourth ever “patient”.
But I surely did know that she was depressed. I could see it, hear it, feel, it, And as we spoke I had a few ideas about what might help it. She needed her baby with her. She needed someone to sit with her while she nursed her baby to talk with her, comfort her, “nurse” her. She needed someone else to admire that baby and think she was wonderful and beautiful. She REALLY needed her mother with her but that wasn’t going to happen. She needed someone who spoke her language besides an overworked and disappointed husband. She need an interpreter to help bridge the gap between her and her husband, her and the rest of her new world.
I was so full of fresh enthusiastic social worker “do good” that I went back to the basement office I shared with 4 other students and spent the day calling pediatricians, public health nurses, the Chinese-American Association in the greater Detroit area and her husband. By the end of the day I had a fairly workable plan and I went up to talk with Dr. Lee about it. I was so full of inspiration and energy I looked like that widget on Zoloft.
And at the end of the day, this is what she got: Anti-psychotic drugs. Three weeks observation. No babies allowed in the hospital. At the end of the first week she had stopped speaking, one breast had dried up, one was still engorged and infected and her husband had flown with the baby back to China.
That was my first real experience with and understanding of true depression. Endogenous (biochemical), situational, institutional, professional. After that I thought I fully appreciated the concept of depression.
Not so. Seven years later I would suffer a relatively brief but very severe post partum depression following Dan’s birth. The treatment and the outcome for that poor woman and myself would be as different as night and day and my appreciation for true depression would be solidified.