An essay by Brian McLaughlin, Advocate

The Nature of Depression

Milton once wrote: The mind is its own place, and in itself, can make a heaven of hell and a hell of heaven. I believe this quote from Milton speaks to the reality that clinical depression can occur absent an external catalyst or event. This fact is lost on many. Repeatedly explaining this fact can be exhausting for those affected. Well meaning professionals and laymen alike can be obsessive here. It is not their fault they are simply uninitiated; I believe. Most people confuse their experience of sadness to be the same as what the clinically depressed person experiences. Still others are confused as in their experience sadness has always had a solid link to external events.

While I agree everyone gets sad sometimes, sometimes very sad, I am not yet convinced that everyone has experienced a clinical depression. For this reason many will say to a depressed person: "everyone gets depressed." This often leaves the depressed person frustrated, and grasping at just how to communicate their pain in a fashion the unaffected person will understand.

Again, it is important to remember that clinical depression is often experienced as a state disconnected from external events. Second sadness should not be mistaken for clinical depression. Further, persons who are depressed can be frustrated by repeated attempts to connect their depression to something or an event. Similarly, they can feel dismissed when they hear the all too familiar;" everybody gets depressed."

Endogenous clinical depression or a depression not connected to external events is a most painful experience that is much darker and disruptive than sadness.

As a person who has survived clinical depression I will attempt to share my personal experience with the "black dog," as Churchill once called it.

First I will note that depression can "kindle" then erupt. Other times it can hit fast and hard. Often there is a profound emptiness, a negative shift in self-image and worth. All color and energy seems to bleed out of me and the world around me. Everything and everyone loses its appeal. I feel as if I could sleep a hundred years, however, cruelly sometimes sleep does not come denying an escape. I seem to crave isolation and my ability to concentration goes missing. I forget things. Conversation is lost on me, and I fail to comprehend the things I try to read. My thoughts turn sharply inward, confused, anxious, obsessive, and even paranoid. I am less able generally speaking. Things I could do with ease or things that I have some talent for become difficult or impossible. I feel home sick having never left home. Often if not prompted I would not bath, brush my teeth, comb my hair, or have the motivation to change my cloths. Often death comes to tempt me. However, I do not struggle; my impulse is to embrace him.

Respectfully submitted for your consideration,

Brian Patrick McLaughlin MS/CPS
MH Consumer Advocate
Erie County, PA.

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