Reflection on Depression

Terrorism and the Helplessness Hypothesis

I don't rejoice in the death of another human being, and I'm agnostic as to whether we should respond to killing with more killing.  Even so, I was elated to find out that Osama bin Laden is dead.  It wasn't a joyful elated, but rather a relieved elated -- a little like finishing the last exam of a grueling semester but orders of magnitude more significant. 

Terrorism is uniquely calibrated to instill a sense of powerlessness in its victims. It is unpredictable, and seemingly unpreventable. The measures we took over the past decade -- confiscating water bottles at the airport, a terror alert system that remained on "orange" for years at a time, and two frustrating wars -- didn't go far in restoring our collective sense of self-efficacy.

A psychological theory of depression called "Learned Helplessness" posits that a perceived loss of control over adverse events can induce depressive behavior. The theory resulted from a 1960s experiment in which two groups of dogs received electric shocks. The dogs in group 1 could stop the shocks by pressing a lever--they had some degree of control. The dogs in group 2 received the same shocks but seemingly at random--they had no control. Dogs in group 2 recovered from the trauma much more slowly than dogs in group 1.

In the second part of the experiment both groups of dogs received shocks again, but this time they could escape by jumping over a small partition. While the dogs from group 1 jumped over the partition, most of the dogs from group 2 didn't even try, lying down and acting helpless--depressive behavior. (Notably, roughly one third of the dogs in group 2 appeared "resilient" and did jump over the partition.)   

The lack of control the group 2 dogs experienced is a little like what people go through when they are subjected to unexpected trauma or sustained abuse. On September 11, 2001, the nation experienced a collective trauma that highlighted our vulnerablity. In this case, reclaiming our power--asserting ourselves against our abuser--has been healing, lifting our collective depression.

The elation I felt when bin Laden died reminded me of the relief I experienced a few years ago when a jury returned a guilty verdict against the man who raped my sister. When the verdict came back I felt sad that a young man had thrown his life away, and ambivalent about the 57 year prison sentence, but my sense of strength and effectiveness was restored.

As a child, my father used to advise "Don't fight back" if another family member was upset at me.  He reasoned (correctly) that the unpleasantness would be over sooner if I "just let it happen," even when I wasn't at fault. It felt good, however, to fight back. It showed that I didn't condone unjustified emotional outbursts, and that I wouldn't be subjected to them. (In all fairness, I did my share of instigating fights and emotional outbursts as well.)

Although "turn the other cheek" may be the Christian thing to do, and "don't fight back" may be the most practical course of action, sometimes the healthiest thing to do is to strike back--to demonstrate an ability to defend oneself and to reclaim power that has been lost.

The healthiest thing to do is not necessarily in line with ethics of the highest order. Maybe that's why the most ethical decisions are sometimes difficult and self-sacrificing. While I admire the folks who can turn the other cheek in response to bin Laden's attacks, I also understand the healthy impulses behind our retaliation, and why that retaliation is cathartic.

The long-term effects of childhood mental illness

I've advocated before that parents and doctors take childhood mental illness seriously. The developmental stakes are high, and an untreated mental or emotional illness can affect a child's academic, social, and emotional development for years to come. Also, an early age of onset is often a sign that a case is especially severe, warranting aggressive treatment to reduce the child's suffering. 

Prompt and effective treatment can also prevent or minimize the trauma of severe mental illness. The initial onset of mental illness can be so painful, so frightening, and so damaging to a child or adolescent's understanding of themselves that it leaves indelible scars. In my case, many of the most insidious effects of depression did not result from the illness itself, but arose from the long-lasting effects of that unresolved trauma. 

This article describes the results of a study that examined how children with mental illness fare later in life. Overall, they are less financially stable and less likely to form long-lasting relationships. I can relate, as my own illness has made work and school difficult at times, and was probably the biggest contributing factor to a major romantic breakup.

Of course, treating childhood mental illness is tricky because it's sometimes difficult to differentiate normal childhood behavior issues from the initial phases of mental illness. But by taking the possibility of mental illness seriously parents can get an expert evaluation early on to help tell the difference.

En route

Tonight I have the quiet serenity of a home office and an unexpected gift of time to put my thoughts in writing. Although scheduled to board a late-night flight from Washington-Dulles to San Francisco around this time, mechanical problems grounded the aircraft and I've been re-booked on a flight tomorrow. The extra time means one more night in my teenage bedroom, and in my parent's house, and in the city where I spent twelve of my most formative years.

My feelings toward my hometown are evolving. In part a place of love, it was also a place of anguish after I became ill. Local reminders of the trauma at 15 (the doctor's office, the houses of friends I've lost) once pierced tender wounds, but now those same reminders are less overwhelming. Like a scared child avoiding a haunted house, I used to avoid the school where I deteriorated from a bubbly freshman to a despondent senior. Now driving past that school isn't as stressful. Those memories--ghosts of events and experiences I would like to forget--no longer evoke overwhelming emotions.

While visiting my hometown I've been able to reflect on those early years when depression first hit; on the academic and developmental consequences of that trauma; and on the interpersonal effects that depression had in well into my twenties. Processing those feelings frees up bandwidth to enjoy the present.

Winston-Salem will always be a place of mixed emotion for me, but now those emotions are manageable with less effort, leaving more energy for fun.