The Books: Unholy Ghost: Writers on Depression, edited by Nell Casey; ‘An Unwelcome Career’, by David Karp

On the essays shelf:

Unholy Ghost: Writers on Depression, edited by Nell Casey.

Another essay from Unholy Ghost, a collection with different writers writing about their experience with depression.

As upsetting as David Karp’s essay is, it’s also comforting. Here is a man with gumption enough to be tireless in his self-advocacy. He suffered from depression/anxiety of a nameless nature for years, and still suffers. For all intents and purposes, he has a great life. He is married, he has kids, he has a career he likes. But he is also tormented by depression. He has gone from drug to drug to drug, searching for one that works. He follows the latest news in medication development, hoping that someday someone will invent a drug that will help. There are pros and cons to every drug. Some of the side effects can be not only devastating but destructive: ie: you take a drug to take away your depression. In the process, the drug also takes away your feelings of creativity, your desire for sex, and your ability to taste food – all things that GIVE pleasure. This is common with antidepressants and all psychotropic drugs, although each one comes with different challenges. I sort of laugh, in a wary way, when I see pharmaceutical ads for antidepressants on television and the soothing female announcer lists all of the side effects, which takes about 5 minutes. And some of the side effects are chilling: “increasing thoughts of suicide”, etc., which is just what you need when you are struggling with depression.

David Karp is a sociologist, and has written books on sociology (I haven’t read any of them), and also wrote a book for caregivers of the mentally ill.

His problem mainly stemmed from being unable to get a full night’s sleep. He would wake up every hour on the hour. Sleep deprivation is a serious issue, obviously, and prolonged sleep deprivation can lead to psychosis and all kinds of other problems. David Karp describes a literal desperation to get some sleep.

He, like Styron, would be frustrated by therapists who wanted to waste time (so to speak) talking about his childhood. He was relieved when he finally went to a psychiatrist who only asked about physical symptoms. (I had a similar sense of relief, so I related to that.) He is clearly a logical fellow, Karp – a thinker and an analyzer of data. He does that professionally and he has also done that personally in terms of handling his mental issues. It’s exhausting to read about. You want someone to swoop in and save him. There is no easy resolution here. He still struggles with sleep, still struggles with anxiety, but has found acceptance that this is how he is built. He will continue the search for a drug that will really help and in the meantime he will devote himself to helping others who struggle similarly.

One of the things I found very interesting was his description of identity. We self-identify as things. “I am this type of person.” We go through life, and we choose and discard descriptors like that (either unconsciously or consciously, but mostly unconsciously). Once you begin to realize that “something is wrong” inside your head … it’s amazing how hard it is to connect the dots. It may make no sense to someone who has not struggled in the same way (but that’s why it’s important for people, loved ones, curious people, whoever, to read up on this stuff to understand what their friend/loved one is going through). But if you are a logical person, if you are out there functioning in the world, it is so hard to admit that you have to throw up your hands at some point, say “uncle”, and get some help with your actual brain chemistry. It can be devastating. We also still, unfortunately, live in a world where mental illness has a stigma attached to it. People still have a tendency to disbelieve what depressives tell them, or try to make inappropriate comparisons (maybe they mean well, but still: it’s inappropriate). Comparisons like, “God, I was so upset when Joe broke up with me. I understand what you’re going through.” “You know, whenever I feel low, I just go to the gym and it perks me right up. Have you tried that?” Like I said, people who say such things mean well, but there comes a point when you just have to admit: “Life has actually never felt as anguishing to me as it does to this person, I have no idea what they are talking about, and I need to sit back and listen, and do some research to try to understand.”

David Karp had a hard time incorporating “depressed” into his self-identity. This was because of his own preconceived notions of what “depressed” meant, and he didn’t want to be that, he didn’t want to cop to it. I really appreciated his honesty on that score. It’s something I think a lot of people could relate to.

Here’s an excerpt.

Unholy Ghost: Writers on Depression, edited by Nell Casey: ‘An Unwelcome Career’, by David Karp

People who live with depression often vividly remember the situation that forced them to have a new consciousness as a troubled person. For me, that occasion was a professional meeting of sociologists in Montreal in 1974. I should have been feeling pretty good by objective standards. I had a solid academic job at Boston College, I had just signed my first book contract, I had a great wife, a beautiful son and a new baby daughter at home.

The week I was in Montreal, I got virtually no sleep. It’s true, I was staying in a borrowed apartment in a strange city, but I had done a fair amount of traveling and never had sleeping problems as bad as this. It occurred to me that I might be physically ill, maybe I had the flu, but I wasn’t just tired and achy. Each sleepless night, my head was filled with disturbing ruminations – for example, imagining myself at a podium, frozen, frightened, unable to talk. During the day, I felt a sense of intolerable grief, as though somebody close to me had died. I couldn’t concentrate, the top of my head felt like it would blow off, and the excitement of having received a book contract was replaced by the dread and certainty that I wasn’t up to the task of writing it. It truly was a miserable week and the start of what I now know was an extended episode of depression. It was also the beginning of a long pilgrimage to figure out what is wrong with me, what to name it, what to do about it, and how to live with it.

Despite a progressive worsening of the feelings I had first experienced in Montreal, it took me quite a while before I fully connected the word “depression” to my situation. Being depressed was not yet part of my self-description or identity. It was another prolonged and even more debilitating period of insomnia, compounded with anxiety and sadness, that pushed me to a doctor’s office (an internist, not a psychiatrist). For the first time I heard someone tell me that I was clinically depressed and that I needed antidepressant medication.

I was prescribed a drug called amitriptyline (which, indeed, was a real “trip”). I began taking it in 19 78 just before a family vacation in Orlando, Florida. We went to “enjoy” Disneyworld, Sea World, and Circus World. Even as I got on the plane, I knew that something was desperately wrong. My head was in a state of fantastic turmoil; I was more intensely anxious than ever before. The feelings were so awful, I should have known that the drug was a disaster, but I had no experience with these medications. I thought maybe this was supposed to happen before I became accustomed to the medicine. Things only got worse in Orlando. No sleep. I couldn’t pay attention to anything. An extraordinary panic overwhelmed me.

The contrast between what you are supposed to feel at Disneyworld and what I did feel was so enormous that it engulfed me. Watching my genuinely happy children having their faces painted with exaggerated clown smiles, I felt the fraudulence of my own masklike smile. I was often on the edge of crying, but I managed to hold it together throughout the week. As we drive away from Disneyworld, however, I lost it altogether. I told my wife to stop the car in the breakdown lane and that’s, in fact, what happened. I got out of the car and “broke down”. My mind took over my body with huge, gulping, uncontrollable sobs. Somehow I eventually composed myself and we reached the hotel. I got in touch with a doctor in Boston who told me to get off the medication. Stopping the drug helped, but that experience was unforgettable and pivotal in my developing “career” as a depressed person.