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I guess this is going in Commentary, as I don’t have a category for “out and out whining”.

Some number of my friends know that I’ve suffered from depression for a good long part of my life; I think my first real acute episode was when I was 13 or so, and certainly I had an acute episode when I was 16 that lasted for, I would guess, most of a year. I remember that there was a time during high school when I suddenly thought “maybe other people aren’t unhappy all the time”, which oddly was the beginning of the end for that acute episode.

Well, I’m depressed now. There are a bunch of stresses that go with it, that precipitate it, and I don’t doubt that some of them will come out in these pages in the next few weeks — and I don’t doubt that some of them are completely fantasies. I also, through long practice, know that the depression will ease on its own before too long; I’ve got the Good Drug, Prozac, and I haven’t had a long acute episode since I started taking it. But it makes life a little hard while it’s happening.

Depression, a real depression, is a funny thing: it’s not the same feeling as “being sad.” It’s not like grief or disappointment. It feels more like some combination of having a mild flu — you often have odd aches and discomfort — while being buried in sand up to your collar bone and having a black chiffon bag over your head. It’s hard to move, it’s hard to think, you want to just lie down because you’re exhausted but you can’t sleep very well. You often — especially with the kind of depression I often suffer, “atypical depression“, which paradoxically is the most common kind — have a craving for carbohydrates. (That Wikipedia article just pointed out that chromium picolinate supplementation is known to help that. I should try that, I think I even have some.)

Update, 3 July: First, “chiffon” is spelled with a “c”. Second, I’ve been taking 800 mcg of chromium picolinate a day for a couple days now, and damned if it doesn’t seem to be helping. Certainly the carbo cravings, and I think the depression as well. I hit MedLine, and there’s extensive literature that seems pretty uniformly positive on both chromium picolinate as a treatment for atypical depression, and as a treatment for insulin-resistant “type II” diabetes, as well as a good bit of stuff pointing out that depression, and especially atypical depression, is correlated with diabetes. This is very interesting; expect more details after I have a chance to read some papers.

Maybe the thing that most frustrates me is that since depression is a “mood disorder”, it’s not usually understood to be a “real disease.” There are still plenty of people who will tell you to pull up your socks and get over it. But there is a good bit of research to the contrary: besides having very consistent symptoms and increasingly well understood physiology, it turns out people with depression have associated co-morbidities — other diseases or pathologies that show up with it. Depressed people have suppressed immune systems. Depressed people are more prone to blood clots, so they’re more prone to both strokes and heart attacks. There’s a strong association between depression and type II diabetes — and one of the little stresses I mentioned is that I was diagnosed as being borderline type II diabetic a few months ago. (Dealing with type II diabetes while feeling hopeless and craving sweets is a particularly exquisite, if somewhat ludicrous, annoyance.) Peter Kramer’s book Against Depression goes into it in some detail.

What I don’t have is an ending for this note. I’m sure the depression will be better; if not tonight, then tomorrow or the next day, or a couple days after that. There are things I can do to help it, like force myself to get lots of sleep. (There’s some reason to believe disordered sleep is a precipitating event for an acute episode; in any case, I know that extra sleep helps me get past it.) So this is really just a whine, with perhaps just a hint of a suggestion that if you know someone with depression you think, just for a second, what you’d say to them if they, say, had a long-lasting case of bronchitis.

Here’s a hint: it wouldn’t start with “Pull yourself together and stop being a baby.”

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