The Sheila Variations

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.

I am a bit haunted by this essay. Poet Donald Hall was married for many years to another poet, Jane Kenyon. She suffered from serious clinical depression her entire life. This is another essay in the book, like Russell Banks’, like Rose Styron’s, about partners to those who are mentally ill, and in some degree become caretakers to their own spouse. Donald Hall’s essay is painful to read. Her illness had nothing to do with him. He had to support her, but not enable her. He had to watch as she would spiral down, and do what he could to help her stay on track. But what can you do when your spouse lies in bed weeping all day from an unnamed wordless grief? It’s just horrible. You feel bad for them both. He stuck it out. He loved her.

But his description of their marriage, and the gloom that sometimes surrounded it, is wrenching. She was such a great person, talented, funny, exciting, but she had this other thing she had to contend with, and was helpless in the face of it. She was not undiagnosed. She, like most depressed people, had been on a variety of drugs and cocktails for the majority of her life. Some worked for a while, then stopped working. Some were awful. You have to become your own diagnostician in these cases: you have to somehow monitor yourself and your reaction to drugs. But since the problem is in your brain and your emotional apparatus, it can be so difficult to separate out the Issues from your Personality. Because … you’re inside your own head. It looks normal from where you are. Even though you are miserable, and buried by small things that others can easily brush off … well, that’s just how you are made. It’s one of the most insidious things about depression. It feels like, in trying to fix it, you are tinkering with your own precious personality – and your personality is the only one you’ve got. Trying to fix your own depression can be terrifying because it seems to strike at the heart of your Identity. This is something often unexplored in the literature.

Jane Kenyon had a good support system. She had her husband, she had a good psychiatrist who worked with her to find proper drugs. She saw him for years, until she died in 1995 from leukemia. Like many depressed people, she would often try to fly solo, without pharmaceutical help. You just want to be free of being on drugs! But the result was often a dive in mood. So back on the drugs she would go. Donald Hall details all of this in his beautifully compassionate and loving essay. Jane Kenyon emerges from this essay, a fully realized person: his memories of her are so strong and so acute that you can FEEL her in between the lines. Jane Kenyon also developed mania, to compound the problem. Her mania manifested itself in mystical visions and experiences. It’s not immediately apparent that “mania” is part of the sickness at all. Because it feels good, often, although destabilizing – and you don’t want to take a drug that will somehow flatten out the GOOD things in your life, too. But Jane’s mania was clearly dangerous. She believed in God, and her faith was very important to her. Her mania was often of the common religious variety. So again: the problem is that mania often feels good, it often feels like you are getting in touch with a Universal Truth, that helps you and soothes you. So to admit that this, too, is part of your illness … that you will need to deprive yourself of these beautiful high-flying feelings … is devastating.

As Russell Banks wrote in his essay, comparing his marriage to that of an alcoholic family – where there is always the presence of That Other Thing in the relationship – Donald Hall describes depression as a “third party in our marriage”. Who knows how much worse Jane Kenyon might have been, had she not had support, and a loyal husband who was okay with representing stability for her. Stability is tremendously important.

I had forgotten one aspect of the essay, which I remembered when I re-read it this morning. In a breathtakingly open moment, Donald Hall describes how orgasm would release her from sadness, and make her feel peppy and ready to get to work and do her writing for the day. So they had sex almost every day, “whether we felt like it or not”, because it did Jane so much good, and seemed to make the gloom disappear for a spell. I know sex is great and all that, and that people love it, and it can make you feel better when you do it. This is true for regular people, too. But something about how Donald Hall described that aspect of their marriage was deeply resonant for me. Or, without going into too much detail, I recognized myself in that. Even when things were at their worst in 2009, orgasms were like that old saying about eating an apple a day … I was in deep shit in 2009, but I never lost my desire in that area of my life. I didn’t say to myself consciously, “Have an orgasm every day. You know it’s good for you.” because that would be ridiculous. Or who knows, maybe I did. The clouds would clear for a couple of hours, and it gave me enough space to take a run, or to write something, or to cook something. The body is a beautiful machine. It knows how to survive. And, because I’ve already revealed this, so why stop now, that’s my fear about certain medication. It is a known fact that sexual desire is often affected by antidepressants and other drugs. I fear losing it. It’s such a good part of my life.

So, weirdly, I thank Donald Hall for expressing that very intimate part of his wife’s life, and their life together. Because it helps to recognize yourself in the wilderness of this literature. So much of it doesn’t resonate, and that’s fine: one size does not fit all. But when something clicks, when you read something that you have experienced, too, the sense of relief can be overwhelming. I’m not the only one! Feeling like you are “the only one” is one of the worst parts of depression. You can know intellectually that you are not “the only one”, but somehow you don’t KNOW it. Or knowing it makes no difference in how you FEEL about it.

Here’s an excerpt from Donald Hall’s essay. It’s a roller coaster.

Unholy Ghost: Writers on Depression, edited by Nell Casey: ‘Ghost in the House’, by Donald Hall

Of her 1984 mania I remember most clearly two or three months, spring and summer of that year. During this first extended elation, I did not know what I confronted. I thought: I must learn to live with an entirely changed woman; I was married to a woman I had never known. Frugal Jane had to buy a peridot ring; indecisive Jane, who always asked me to make choices – what restaurant to go to, which night to see the play, what book to read aloud – knew exactly what we should do, when and where. In her superabundant energy she was bossy: before, she had hidden in my shadow; now she charged forward as bright as the sun of June. She was consumed by desire; on her thirty-seventh birthday we seemed to make love all day long.

The radical change confused and upset me. When Jane went manic I fell into depression. She soared up and I plunged down – a moody seesaw. I felt “suicidal ideation without intent”. Then I understood, with shame, that for years I had used her depression to think well of myself: I was the rock, unchanging in all weathers; I was the protector. Now her manic elation and her certainty cast me down. After this first episode of her mania and my response, I put away my complacent self-congratulation.

She fell into depression after mania ceased. Six months later she turned manic again, weeks not months, and spoke carelessly, hurtfully, without malicious intent – in ways she would not have done without mania. By this time I knew what was happening. Thereafter, mania was brief.

Her friends sympathized entirely with her depression but also suffered. Although we were relatively reclusive, we had friends at our church, poet friends who came for weekends, old friends from Ann Arbor, our families. Jane when she was well spent more time in company than I did, lunching with women friends in New London twelve miles away. Her closest friends were two other writers, Alice Mattison and Joyce Peseroff. They saw each other when they could, and workshopped together several times a year. The excitement of their meetings exhausted and elevated Jane. Depression never canceled a workshop, but once she asked Alice not to come calling from a summer place in Vermont. Every month Jane and I drove to Connecticut to see my mother, in her eighties, to shop for her and to visit. (Jane used the opportunity to see Alice, who lived nearby.) Several times, when she was depressed, I had to drive down alone. Sometimes I put visitors off at Jane’s urging. I telephoned a dying friend to tell him he could not visit. I canceled a skiing visit from my son and friends because Jane could not see anyone. Every summer Jane’s brother, sister-in-law, and niece visited from Ann Arbor. Once I had to telephone them and ask them not to come. It was generally I who telephoned, at Jane’s request, because she herself could not make the call. On occasion when acquaintances made briefer visits, Jane remained in the bedroom with the door closed while I sat talking with them elsewhere.

One of the hardest things, if you are depressed, is to try to hold yourself up in the presence of others, especially others whom you love. I remember a birthday for granddaughters at my daughter’s house. Jane stood looking on, wretched, hardly able to speak. She was quiet, there were many people, and she practiced invisibility. My daughter looked at her and said, “You’re miserable, aren’t you?” When Jane nodded Philippa spoke with sympathy and left her alone. You do not try to cheer up depressives: the worst thing you can do is to count their blessings for them.

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.

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.

I read this essay in 2002 and haven’t read it since (well, I re-read it this morning in preparation for this post), but I was amazed by how intimately I remembered every detail. That’s good writing (not a surprise, considering that it’s by Larry McMurtry). Larry McMurtry had quadruple bypass surgery in 1991. The surgery went well, he didn’t experience too much pain, the surgeon was excellent, and his physical recovery was quick. But he felt altered, on an indefinable level. It manifested itself in various ways, and it seems to have been a delayed reaction. He didn’t wake up from surgery and start having psychological issues. For a while, things were fine. But then began night terrors, and trouble with sleeping. He stopped being able to travel, he was consumed with fear (something he never experienced before). He also, and this seemed the most painful part of it, was unable to read anymore. He stopped being able to read for pleasure for about three years. He clarifies that if he had to read something for research, for an essay or a book, he could do that. But the pleasure of books was closed to him. His pain about this reverberates through every line. He never really recovered his joy in reading. He suggests that the surgery gave him a “less generous level of attention to bestow”, which is a great and painful thought.

When I read this in 2002, I had not gone through my nearly a year of being unable to read for pleasure. So I couldn’t “relate” to that, I suppose, but this morning when I re-read it, I really understood his anguish at this great pleasure being closed to him, seemingly permanently. The last two authors he was able to read were Proust and Virginia Woolf, and he still holds them very dear, in a personal way, because he remembers their books as from “the time before”. He seems glad that he was able to “get them in” before the door of unnamed trauma closed on him.

It’s not clear if he was unable to read books because he was depressed, or if it went the other way around. I don’t think the word “depression” is actually used here at all. He speaks of “trauma”, and he speaks of this overwhelming feeling that he had not just had surgery on his heart – the surgery had somehow left him with a loss of Self. He felt that palpably: his Self was changed. Doctors are trained to go in and deal with the problems of the body. The chest is sawed open, the body kept alive by the “heart-lung machine” while the surgery occurs. McMurtry is grateful for the doctors who did all of this. But the side effects were emotional, unforeseen, and un-planned for. McMurtry wonders about the mind-body-Self connection. He wasn’t a young man when he had the surgery. He was used to who he was, how he walked around in life, his reactions to things … he was used to being himself. That changed, suddenly. And so fiction, with its imaginative and unself-involved outlook, became incomprehensible. Not only could it provide no escape, but he didn’t know how to relate to the written word at all. He himself had changed.

In the past month, I spoke to a psychiatrist and I told him about being unable to read for pleasure in the 8 months or so following my dad’s death. It was so disorienting. I would try to read. I attempted to read the big biography of Nureyev, which was elegantly written and fascinating. I would read a page or two, and then put the book down, exhausted. Nothing was getting through. I couldn’t comprehend language. And then when I would pick up the book the next day, I would completely forget where I had left off, and have to re-read the two measly pages I had read the day before, because nothing had sunk in. This was not a book about rocket science, it was an accessibly written popular biography. I couldn’t handle it. I finally put the book down in despair and then didn’t read for months. The psychiatrist I spoke to said that when you go through an emotional trauma, it is akin to getting a concussion. There are parts of the brain that actually show the effect of the trauma, looking like “bruising”, as though you had a head injury. Emotional trauma affects the memory centers of the brain. It’s like anything non-essential must be left out, your body and brain can’t deal with anything extraneous (and reading, while essential to me, became extraneous that year).

So it was very interesting to read Larry McMurtry’s beautiful, clearly written, and pained essay again this morning, especially now that I have had a bout with being unable to read myself. If you are a lifelong voracious reader, then you know the relationship to the written word and what it can provide. It’s not just pleasure, it’s all kinds of things.

McMurtry is clear that he has written the piece to help others, and that generosity shows through. He writes very personally, but is aware that if he had such a reaction to major surgery, and was blindsided by it, then others must have had the same experience. He hopes his words help.

I think, too, that men may be less inclined to admit they need help. Edward Hoagland covered that in his gorgeous essay. Generalizations are not always helpful, though. I’m a stubborn bitch, and I resist help, too. Who wants to admit something is wrong inside your mind? Of course depression strikes both sexes with equal severity. More men than women commit suicide. Depression memoirs have, in recent years, been the territory of women. I think men could read those things and find them helpful, regardless of the sex of the author, but I am sure it is validating to read the words of another man who has been through what you are going through. He’s shining a light on his own experience, saying, essentially, “You’re not alone. I get it. And, as a man, we have challenges we’re afraid to speak of. I get that, too.”

Here’s an excerpt.

Unholy Ghost: Writers on Depression, edited by Nell Casey: ‘Walter Benjamin at the Dairy Queen’, by Larry McMurtry

Now, looking back from a distance of eight years, I realize that even in the first months after the operation, when I thought I was feeling fine, what I was really feeling was relief that I was alive and not in pain. After all, I had had my breastbone sawn in two, my heart put in coolant. I wasn’t quite myself, but I hadn’t started grieving either, for the self or the personality that had been lost during the process. The violently intrusive nature of that operation – of any operation, really – was bound to dislocate one for a bit, I thought. Car metaphors seem to apply. I had had some serious engine work done and then been jump-started back into drivability. If there was a little sputtering at first, well, that was only to be expected.

In the fourth month matters worsened – the sense of grief for the lost self was profound. I didn’t feel like my old self at all, and had no idea where the old self had gone. But I did know that it, he, me was gone, and that I missed him. I soon came to feel that my self had been left behind, across a border or a canyon. Where exactly was I? The only real sign of the old self was that I could still connect with my grandson, Curtis McMurtry. Otherwise, I felt spectral – the personality that had been mine for fifty-five years was simply no longer there – or if there, it was fragmented, it was dust particles swirling around, only occasionally and briefly cohering. I mourned its loss but soon concluded that gone is gone – I was never really going to recover that sense of wholeness, of the integrity of the self.

That being the case, I began to put a kind of alternative self together, and the alternative self soon acquired a few domestic skills, on the order of loading the dishwasher or taking out the trash. But I still couldn’t read. I was at the time owner of perhaps two hundred thousand books and yet I couldn’t read.

The problem, I eventually realized, was that reading is a form of looking outward, beyond the self, and that, for a long time, I couldn’t do – the protest from inside was too powerful. My inability to externalize seemed to be organ based, as if the organs to which violence had been done were protesting so much that I couldn’t attend to anything else. I soon ceased to suppose that I would ever reassemble the whole of my former self, but I could collect enough chunks and pieces to get me by – as I have.

Such surgery, so noncommonsensical, to contradictory to the normal rules of survival, is truly Faustian. You get to live, perhaps as long as you want to, only not as yourself – never as yourself.