Severe depression is a monster the lurks in darkest regions of the mind. It slowly eats at the sufferer slowly, draining her of her strength until only a speck of the person she truly was survives. She is a lost soul, caught in a deep well that she cannot escape and feels powerless to change her situation. They have a feeling of weakness, desperation and pain that others do not always understand. Comments from friends and family to "just get over it" or "just pray harder" only serve to worsen the pain and make the sufferer feel more helpless as every effort she makes fails and damages her weak self esteem further. At times they find the pain so unbearable, that thought of death and suicide do seem like the only option to relieve their suffering. Most people will fight this choice, but many will make attempts. Fortunately, most will fail. Sometimes they succeed, leaving a lot of questions and grief in the survivors of the lost person. But sometimes a person is just done. She has had all the agony she can take and cannot go on any further.
Patients describe what they are feeling in many different ways, but they all have a similar feel to each other. There are milder cases of depression which are far more common. And there are the ones that reach the point of desperation like this.
A very wise supervisor of mine once told me that people do not want to die, they just want the pain to end. I have told this to many of my patients who have made serious suicide attempts, and they for the most part relate to that statement. Depression is a pain that cannot be seen and although it is hard to judge the extent of physical pain a person may be experiencing, there are objective signs that can be observed to give one an idea of what the patient is feeling. There are signs of severe depression, but sometimes they are more subtle. A trained eye can pick them out better than a lay person, but there are times when the sufferer can hide the pain well enough that the amount of emotional despair they feel is not evident. I have had patients that have committed suicide that did surprise me, but most of the time, I saw it coming. Some people will never be cured fully and the best treatment available will not help all. Cancer is a lethal disease, and depression is, too.
Patients have described what they feel in various ways. Severe depression is hard to explain. It must be experienced first hand to truly understand the full intensity of the suffering one can feel so they rely on metaphors to relay their feelings.
I have heard the monster analogy repeatedly, or the description of a demon controlling a person's soul, a vampire like creature draining the life from a person slowly.
I have heard about the feeling of being lost in a tunnel with no light at the end and no hope of rescue. Of being in a deep hole, unable to climb out, trapped and no one is there to come to one's rescue.
I have been told of feelings of being unable to move, feeling like one is walking through gelatin or heavy syrup, or rigor mortise. Technically called leaden paralysis, difficulty with slowed motor skills is noted in some variants of depression.
They speak of having their brain slowed down. Unable to process information or think. Like their mind has shut down and is moving in slow motion. They cannot concentrate or stay on task. In fact, there is some truth to this. It is believed that part of depression is cause by the decreased production of some neurotransmitters, the compounds that the brain uses to send its signals. The brain essentially is running too slow.
Some talk about having a coating on their brain cutting them off from reality, like a thick syrup or paint that closes them off from reality. Some even feel like their eyes have been covered by a haze that clouds their vision.
The most severe forms of depression are accompanied by psychosis where the patient loses touch with reality and often develops paranoia about friends and family. Trying to talk with them can be more difficult because the paranoia is so pronounced and patients have a hard time trusting the people they have come to for help. They are often tormented by voices telling them things and cannot always distinguish what is real and what is not but the voices will often tell them that people are trying to harm them
Depression can be treated, although sadly, most cases are not treated to remission, either due to lack of aggressiveness on the part of the provider, non compliance with the patient or both. If the initial case is not treated to remission quickly, the patient may never fully recover. Even for those that do fully recover, the chances of relapse is well over 50%. Returning to treatment is often successful, but only if aggressive and the patient may need to accept the idea of remaining on antidepressants for life if she does not want to run the risk of another relapse.
The monster can be controlled, locked away in a dungeon and possibly ignored for a time, but once someone has been overtaken by the monster, it will always be there with her. The threat that the monster will return will always be there, as the likelihood that it will escape its cell is high. Even if it never does, the sufferer will never forget the experience of being controlled by another creature and the memory will always be there. The victim will have to carry that "what if?" fear forever because she knows, the monster lurks.
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