After the Fireworks
Hemingway once wrote that happiness in intelligent people was the rarest thing he knew. Late on the evening of July 4th I sat in my apartment and considered that assertion while drinking a beer and intermittently looking out my bedroom window at the spirited fireworks display illuminating Boston’s skyline. About that time I decided to take a walk, so I headed in the opposite direction of the city square where I live, through a handsome, upper-middle-class neighborhood populated by various people celebrating outside. As I rounded a corner, several individuals in a large group of thirty-somethings enthusiastically motioned for me to join their party on a sprawling lawn. Feeling uncharacteristically social, I accepted the invitation and soon found myself washing down a porterhouse steak with a flagon of frigid ale. And then I met Alicia.
Alicia is an intelligent, educated, fit, funny, attractive, stylish, and prosperous professional. She also suffers from deep-seated, long-standing depression that has been a periodically paralyzing struggle in her life despite the fact that by all outward appearances she is well adjusted and successful. For two hours we sat on the front porch, discussing sundry details of her past, as well as my background in psychology. Shortly thereafter she asked me to share my views on antidepressants and depression in general, which I’ve dealt with personally, to varying degrees, throughout adulthood. The following is a transcript of my explanation:
“It’s curiously challenging to explain depression to someone who hasn’t experienced it on a personal level, as the ever-shifting nuances of gloom, agony, and despair can be so subtle or all-consuming that they escape even the most eloquent and astute writer’s ability to adequately describe them. I would say that depression feels like being inexplicably trapped within an invisible box, forced to observe a never-ending parade of gleeful passersby. The transparent prison prevents you from both becoming part of and fully comprehending their seemingly joyous world. However, you can’t help but watch it in a near-perpetual state of envy, isolation, frustration, and bewilderment. Depression itself is an extraordinarily complex, multi-faceted phenomenon that shouldn’t be pigeonholed as a mere biochemical imbalance. Sure, neurochemical genetics are of primary importance, but so are environmental and psychosocial factors. Modern American society places an agonizing amount of pressure on us to conform to specific, white-picket-fence expectations with the promise of shimmering gold at the end of the end of the rainbow. Do A, B, and C, and you’ll ultimately transform into a better, happier person. The problem is that happiness is a human construct and an unsustainable model. The notion that reaching a storybook ending is as easy as adhering to a set of clear-cut norms is grievously misguided, romantic nonsense. However, countless people nonetheless spend much of their lives fashioning themselves into what they’re told they must become in order to be happy. Unfortunately, once they’ve achieved a particular look, occupation, bank balance, family unit, social circle, and so on, they discover that they aren’t automatically beaming with jubilation. In fact, they’re often fucking miserable. Others never manage to achieve those pursuits and find themselves equally despondent as a result. Many individuals from both groups wind up seeking guidance, either from their GP or in our crippled mental healthcare system. Upon meeting the predetermined criteria for clinical depression, such as expressing a loss of enthusiasm for an activity they previously enjoyed, or having feelings of hopelessness, they’re commonly prescribed antidepressants. These medications can be advantageous for certain people under certain circumstances, muting their melancholy to the extent that they’re once again able to crawl out of bed and trudge on. But it’s an impermanent, risk-riddled solution and it does exactly nothing to address the external forces that very probably led to the condition in the first place. Forces such as unhealthy marriages, dispiriting careers, limiting surroundings, unfulfilled potential, and additional phenomena that are terribly difficult for the average human being to overcome in the face of mortgages, children, and other forms of crucial responsibility. In other words, the majority of adults in contemporary America simply aren’t in a position to reinvent themselves. This, of course, creates a poignant existential quandary. Do I swallow the pills and resign myself to my fate, or forgo the pharmaceuticals in favor of accepting that I was lied to all along. That life isn’t a smiling selfie. That, beyond my own disappointments, it’s a fucking rough and tragic world out there, fraught with horrifying stupidity, unrelenting evil, gross injustices, needless pain, and undeserved suffering. That this happiness horseshit is a manufactured illusion best reserved for comforting childhood fairy tales and mushy Hollywood productions. That, contrary to popular belief, it’s actually okay, highly logical, and, dare I say it, HEALTHY to be sad. Either way, I think the best one can do in this life is to strive for a succession of fleeting moments of contentment. That’s more realistic and, I believe, sustainable.”
Issues this fundamentally complicated and elusive require ongoing attention, so in an upcoming article I’ll explore, among other things, my thoughts on what I foresee as an eventual collective movement away from conventional antidepressants, such as SSRIs, in favor of clinically administered psychedelics (ketamine, for example, is showing tremendous promise in terms of its ability to rapidly alleviate major depression). As for Alicia, she insists that my little rant, in combination with several follow-up conversations, helped her more than 15+ years of lackluster therapy. I’d like to think that’s true.