When I was first aware that I had been laid low by the disease, I felt a need, among other things, to… — William Styron
When I was first aware that I had been laid low by the disease, I felt a need, among other things, to register a strong protest against the word “depression.” Depression, most people know, used to be termed “melancholia,” a word which appears in English as early as the year 1303 and crops up more than once in Chaucer, who in his usage seemed to be aware of its pathological nuances. “Melancholia” would still appear to be a far more apt and evocative word for the blacker forms of the disorder, but it was usurped by a noun with a bland tonality and lacking any magisterial presence, used indifferently to describe an economic decline or a rut in the ground, a true wimp of a word for such a major illness. It may be that the scientist generally held responsible for its currency in modern times, a Johns Hopkins Medical School faculty member justly venerated — the Swiss-born psychiatrist Adolf Meyer — had a tin ear for the finer rhythms of English and therefore was unaware of the semantic damage he had inflicted by offering “depression” as a descriptive noun for such a dreadful and raging disease. Nonetheless, for over seventy-five years the word has slithered innocuously through the language like a slug, leaving little trace of its intrinsic malevolence and preventing, by its very insipidity, a general awareness of the horrible intensity of the disease when out of control.
As one who has suffered from the malady in extremis yet returned to tell the tale, I would lobby for a truly arresting designation. “Brainstorm,” for instance, has unfortunately been preempted to describe, somewhat jocularly, intellectual inspiration. But something along these lines is needed. Told that someone’s mood disorder has evolved into a storm — a veritable howling tempest in the brain, which is indeed what a clinical depression resembles like nothing else — even the uninformed layman might display sympathy rather than the standard reaction that “depression” evokes, something akin to “So what?” or “You’ll pull out of it” or “We all have bad days.” The phrase “nervous breakdown” seems to be on its way out, certainly deservedly so, owing to its insinuation of a vague spinelessness, but we still seem destined to be saddled with “depression” until a better, sturdier name is created.
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More from this book
Depression is a disorder of mood, so mysteriously painful and elusive in the way it becomes known to the self — to the mediating intellect — as to verge close to being beyond description. It thus remains nearly incomprehensible to those who have not experienced it in its extreme mode, although the gloom, “the blues” which people go through occasionally and associate with the general hassle of everyday existence are of such prevalence that they do give many individuals a hint of the illness in its catastrophic form.
One of the century’s most famous intellectual pronouncements comes at the beginning of The Myth of Sisyphus: “There is but one truly serious philosophical problem, and that is suicide. Judging whether life is or is not worth living amounts to answering the fundamental question of philosophy.” Reading this for the first time I was puzzled and continued to be throughout much of the essay, since despite the work’s persuasive logic and eloquence there was a lot that eluded me, and I always came back to grapple vainly with the initial hypothesis, unable to deal with the premise that anyone should come close to wishing to kill himself in the first place. A later short novel, The Fall, I admired with reservations; the guilt and self-condemnation of the lawyer-narrator, gloomily spinning out his monologue in an Amsterdam bar, seemed a touch clamorous and excessive, but at the time of my reading I was unable to perceive that the lawyer was behaving very much like a man in the throes of clinical depression. Such was my innocence of the very existence of this disease.
There is a region in the experience of pain where the certainty of alleviation often permits superhuman endurance. We learn to live with pain in varying degrees daily, or over longer periods of time, and we are more often than not mercifully free of it. When we endure severe discomfort of a physical nature our conditioning has taught us since childhood to make accommodations to the pain’s demands — o accept it, whether pluckily or whimpering and complaining, according to our personal degree of stoicism, but in any case to accept it. Except in intractable terminal pain, there is almost always some form of relief; we look forward to that alleviation, whether it be through sleep or Tylenol or self-hypnosis or a change of posture or, most often, through the body’s capacity for healing itself, and we embrace this eventual respite as the natural reward we receive for having been, temporarily, such good sports and doughty sufferers, such optimistic cheerleaders for life at heart.
In depression this faith in deliverance, in ultimate restoration, is absent. The pain is unrelenting, and what makes the condition intolerable is the foreknowledge that no remedy will come — not in a day, an hour, a month, or a minute. If there is mild relief, one knows that it is only temporary; more pain will follow. It is hopelessness even more than pain that crushes the soul. So the decision-making of daily life involves not, as in normal affairs, shifting from one annoying situation to another less annoying — or from discomfort to relative comfort, or from boredom to activity — but moving from pain to pain. One does not abandon, even briefly, one's bed of nails, but is attached to it wherever one goes.
