Escape from Depression

depressionI met a young woman yesterday who got me thinking about the reasons why I feel so strongly about the work I do as a psychiatrist, helping people with chronic mood problems.

She came in for help with what she described as a “mild but chronic depression.” She had already seen one psychiatrist, and he had not been terribly helpful; she had side effects from her medication, and he had insisted she stay on it anyway.

It seemed like a pretty straightforward story except that, the further we got into it, the more I was struck by how profoundly depression had affected not only her life, but the lives almost everyone in her family of origin.

She became noticeably depressed when she went off to college at the University of California in Los Angeles at age 18.

She made a quite serious plan to commit suicide and took a number of steps to follow through on that plan. She was only prevented from doing so when a roommate came across the note she had written before she made the attempt.

The roommate called her parents, and her family came down and took her back home, and she withdrew from school.

She lived at home under close supervision for a year, but she never went to see anyone to get help with her depression. She stopped going to college and, instead, found a clerical job working for a large company near her family home.

Because she is very bright, she advanced from that clerical job and she now has a position working as a low level administrator at the same company.

Probably because she remained depressed, she never had a serious relationship, and hasn’t made many friends, either.

As it happens, the reason that she never sought treatment was because of her very strong family history of depression. Her father and her sister both suffer from severe, recurrent, depression. Her father has never been treated; her sister did get treatment, but that fact is something that is never discussed.

Her father’s mother was also very seriously depressed, and that is probably the reason why the topic of depression and psychiatric treatment is an absolute taboo in her family. Her father grew up in the shadow of that depression, and his struggle to overcome the emotional abandonment by his mother (she was hospitalized for almost a year soon after his birth) left him with a deep sense of shame and anger.

In fact, the closest her father ever got to talking about depression with her was when he went to get some counseling help after his mother’s death. After the one visit he made to a Kaiser therapist, he bought a self help book on how you can use cognitive therapy techniques to cure your depression and put that book on his daughter’s dining room table. There was no note, and they never discussed it.

This shame-based family belief system about depression and its treatment has crippled the lives of almost everyone in the family.

I am always moved when I hear a story like this,  and begin to work with someone who wants to escape from the trap of a depressed family.

The Silver Ribbon Coalition to fight stigma against disorders of the brain is this website’s official charity. We give every person we see a silver ribbon to commemorate their struggle, and to remind them that you don’t have to stay trapped in shame about depression.