Third Entry in the Low Road Dialogues Series by Paul Coffee
In round numbers, everybody in America is depressed. About 13% of us over the age of 12 take antidepressant meds, which is a pretty depressing statistic since it leaves 87% of us in the wind. Maybe it’s not such a meaningful number. Those meds probably don’t really work, anyway. Perhaps this is for the best.
It’s become impossible to avoid being advised that depression is not just a case of the blues, a bout of feeling sad about something. No, we’re told, it’s a medical condition, a malfunction of the brain, the glands, the material of our selves. Researchers are seeing differences in brain structure, brain function, and in the chemistry that powers the network.
Nobody with a white coat on wants to say so, but one reason that so few depressives get diagnosed and treated with meds is that depression is so common that it’s become The Way People Are. Normal. Expected.
Rob, 41, is a diagnosed depressive who has refused medication. Rob doesn’t get out of the house much, so Coffee had to set up with him in his compact residence. After a wandering and inconclusive negotiation, he finally agreed to go on the record, behind a pseudonym, with identifying details redacted, altered, or fictionalized at edit time.
Coffee: Thanks for sitting for us. I know this must be difficult for you.
Rob: It is, Paul, it is. I was worried that it wouldn’t be, but now that you’re here, it is difficult for me.
Coffee: That’s a relief. Rob, when were you diagnosed ? What was your diagnosis at that time?
Rob: Paul, I was diagnosed in 2005. They told me I had dysthymia. They wanted me to start taking medication for it.
Coffee: Yes,Rob, but as I understand it, you decided not to take the medication.
Rob: Paul, I wonder, could we please stop including each others’ first names in every sentence? That’s how life insurance salesmen talk to prospects.
Coffee: Rob, I was only doing it because I thought that’s what you wanted.
Rob: No, I don’t like being reminded of life insurance.
Coffee: Okay, that’s settled. Back to your depression, having decided not to try medication, did you come up with alternative approaches to manage your condition?
Rob: My condition?
Coffee: Your dysthymia. That’s a type of depression, right?
Rob: It used to be.
Coffee: Wait, I’m here to interview a depressive. You’re telling me you’re no longer depressed?
Rob: In 2013, they changed their minds and even though nothing really changed in my mind, they decided that what I have is persistent depressive disorder.
Coffee: Because it was still there, eight years after your first diagnosis?
Rob: Well, they decided that what they used to call chronic major depressive disorder is actually the same thing as dysthymia, so now they call them both persistent depressive disorder.
Coffee: How did that change affect you? Any improvement?
Rob: It’s a nuisance. Three words instead of one. But it doesn’t really matter.
Coffee: Back to my question, if we could. Having opted out of medical solution, how have you managed living with persistent depressive disorder?
Rob: One thing I’ve done is I’ve become an advocate for depression. Not a real active advocate, but I make the case passively from time to time. By personal example.
Coffee: That sounds very constructive, very empowering. You’re talking about fundraising, supporting research for a cure, that kind of thing? Marches? Lapel pins?
Rob: No. I advocate for depression.
Coffee: What am I missing here?
Rob: Doesn’t matter, forget it.
Coffee: It almost sounds like you mean you promote depression. Encourage it.
Rob: That’s right.
Coffee: You’re a political depressive.
Rob: I’m politically depressed.
Coffee: Why in the world would you want other people to become depressed?
Rob: Everybody’s depressed. A lot of people just won’t accept it. At first I thought I couldn’t accept it, but soon I realized it wasn’t that I couldn’t, but that I wouldn’t. Seemed pointless.
Coffee: Interesting. There’s more?
Rob: I don’t think there’s any use going into it.
Coffee: I’m feeling a bit depressed now myself.
Rob: I’ve been depressed all my adult life. Or so I’m told. I don’t feel like I’m depressed, I feel like me. I feel like myself. I don’t think it makes any sense for me, or for anyone, to make a big project out of trying to feel like somebody else. That’s crazy. Literally crazy. ( Pointing to his forehead) There’s only room for one guy in here.
Coffee: Have you ever talked this over with someone? A psychiatrist, a therapist of some kind, some kind of mental health professional?
Rob: I did, yes, when I was diagnosed with dysthymia.
Coffee: Did you tell him what you just told me? About, well, embracing your depression?
Rob: Her, I told her about what I just said to you, yes. Except right then I hadn’t gotten into advocating yet. I just talked about myself.
Coffee: Okay, her. What did she have to say about your, um, policy?
Rob: She thought I was kidding. She said it was a very positive thing I could joke about my problem. She said I could be a deadpan standup comic. I went over it a few times for her, but she just kept laughing and telling me to continue. The whole hour went that way.
Coffee: You only saw her the one time?
Rob: No, she called a week later and asked me to come in again for follow-up.
Coffee: Go on…
Rob: I went to see her. Her attitude had changed. She said she’d been thinking about what I said, and decided I was right.
Coffee: You’re telling me you converted a practicing mental health professional to your embrace of depression as a way of life? She like, came out as a depressive?
Rob: I guess. I never heard from her again.
