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.
 

14 Responses

  1. Knowbody Special says:

    Well, this flipped my Monday morning upside down. Thanks for having the knowledge & courage to speak the truth, Jonny. You’re one hell of a writer, sir.

  2. Anonymous says:

    Yeah, I’ve pretty much gone with door #1 (I faded out and accepted my fate.) Maybe it’s time to reassess things for many reasons but especially because I’ve been doing a lot of research recently about SSRIs and I don’t at all like what I’ve discovered as far as both short and longterm risks and side-effects. Thank you for this deeply insightful article, Jon.

  3. Jared says:

    Damn, f-ing brilliant.

  4. bbull says:

    Good stuff Jon.

  5. Donna M Van Kirk, EdD says:

    I agree with so many of your ideas. Contentment (i.e., general satisfaction) is a realistic goal goal.A cure or permanent happiness are not because life circumstances provide stress and coping challenges. Acceptance of depression as an aspect of one’s make-up is an essential first step to coping with it. Research shows that medication is beneficial in 50% of cases and it is the most effective in conjunction with Cognitive Beharior Therapy (CBT). Remember that drug research typically involves (1) a group that takes a specific medication compared to groups who received (2) the same medication and therapy, (3) therapy only, and (4) no intervention. The results cannot be generalized to all antidepressants. It’s only chemistry, and drugs affect individuals differently. There are also different classes of antidepressants, so one type may be effective although another isn’t/wasn’t. I encourage anyone with a mental illness to obtain helpful therapy. Don’t settle for a “therapist” who lets you ramble about how tough life is and doesn’t help you think and act more like the way you actually want to be. There will be ups and downs and ups again, so it’s important to be realistic and hopeful and forgiving of ones self. It’s all about learning coping skills that get you through the rough times. That is called mental health.

    • Jon says:

      Thank you for the thoughtful and intelligent response. I particularly agree with your claim that it’s important to find a therapist who is both willing and able to assist patients in becoming the individuals they ultimately want to be. Antidepressants and Cognitive Behavioral Therapy (I’m a proponent of the latter) mean very little in the absence of cautious guidance from a competent mental healthcare professional who has an open-minded but fundamentally realistic worldview. Instant gratification is such a defining characteristic of American culture that it’s disconcertingly easy for people to overlook the fact that mental health is a lifelong pursuit. In fact, that sobering truth immediately brings to mind the widespread misconception that antidepressants are “happy pills,” which is an alarmingly ignorant and hazardous belief to subscribe to. Although I alluded to the notion that traditional antidepressants can indeed be beneficial for certain members of the population for certain lengths of time (as evidenced by some of what you pointed out), I nonetheless remain deeply skeptical about them on a personal level – which is an issue that I’ll further address in a future article. Coping skills are absolutely integral to learning how to navigate the ups and downs you mentioned, but it’s equally important to ensure that the treatment isn’t worse than the disease. I know that I’ve spent much of my life coping with depression and other issues in a flagrantly destructive manner, which, unfortunately, is an all-too-common phenomenon. Finding and maintaining healthy/productive coping strategies, as essential as it is, can be a surprisingly challenging endeavor.

  6. Ruston says:

    Very well written and conveyance of what people are faced with, and deny to varying degrees. Someday, when I am prepared, I have a story I would like you to read.

    Though you may not accept it fully, you writing gives insight and understanding.

    Hammer it out.

    • Jon says:

      Thanks for the candid feedback and the encouragement. While I completely believe in my ability to provide insight and understanding via my writing, I’m not always optimistic about the likelihood of my audience acting upon their newfound knowledge. That having been said, I’d be more than happy to read your story when you’re ready. You know where to find me.

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