A Daughter asks about Grief & Depression

Dear Dr. Neimeyer,

I assumed I would always know what my dad would say if he were here today. We were best friends, and he was very, very outspoken. Without blinking, I feel in sync with his priorities. Yet lately, I’ve been wondering how he would respond to something. I’m not the type for séances, so the question is on hold indefinitely, but maybe I can explain it to you.
Approximately 2 years after my father’s death, I was diagnosed with depression. It took me months to communicate what I was feeling. I’ve been relatively articulate since I was a young child, but I had no words. Finally, I explained that the pain was so large; describing it was like trying to fathom the size of our planet – beyond my capacity.

I took that diagnosis seriously, and I worked really hard to be happy again. However, I always looked at this as short term. I mean to say: I thought that the whole depression thing would go away after some time passed. After all – this was because my dad died, right? It was tragic, I was traumatized, but we all move on.

When I got better, I really thought that I had been right, and this was over. Now, I see that I was just having a particularly good run of it.

Things changed sophomore year of college, when I got depressed again. It wasn’t as bad as the first low point, but it hurt in a different way. I guess I thought I would never be in that place again.  I thought I was done staring off into the distance, hearing the faint muffle of a psychiatrist tell me, “Caitlin, it sounds like you’re seriously depressed.”

Returning to the present pondering, I am in a good spell, but I live in fear of its return: the private, ugly beast in my mind.

This summer, I’ve been thinking. If this depression will continue beyond the immediate aftermath of my dad’s passing, is it possible that it was here before he was on his deathbed?

I am reminded of one afternoon in my freshman year of high school. I was schlumping in bed after school, as I tended to, when my parents walked in. My mom said she was concerned that I was lethargic. I didn’t know what the word meant, so naturally, I thought it was a fatal disease. When explained to me as being chronically tired and lazy, I scoffed at it. I’m not lethargic – I’m a teenager!

Unbeknownst to me, earlier that day, my mother had expressed concern to my father that I was depressed. He scoffed at that. She’s not depressed; she’s just a Dorman!  Well, I can’t argue with that one. I am certainly a Dorman. Now for the real inquiry: was my Dorman Dad depressed too?

He had told me stories of rough teenage years, times he was miserable, but he never made a big deal of it. He barely accepted psychiatric medication when he was fighting, and losing a battle with stage four Colon Cancer.  My mother knew my father since they were 12 and 15, respectively. I think if you asked her, she would say yes, my dad was depressed at times in his life.

It’s hard to imagine how my dad would advise tackling a problem that he never acknowledged himself, but I often wonder if he could’ve helped me through this having, albeit unknowingly, been there before.

Caitlin

Dear Caitlin,

Perhaps your father would tell you not to make the same mistake he did.  Ignoring depression–a vulnerability to which can indeed be passed down through the generations–doesn’t make it go away.  Only awareness, skillful management of one’s actions and choices, the support of relevant others, and often appropriate professional care can do that.  Although a gritty attitude of determination to keep moving through the darkness plays a part in this adaptive response, it is often not enough on its own.  What is necessary is understanding “the ugly beast in your mind,” in all of its complexity, and then trying earnestly to address the needs implicit in it.  Without wanting to oversimplify what can be a complex and multidimensional problem, here are a few tips on managing what seems to be a recurrent life challenge.

1.  Figure out what you are dealing with. This is harder than it sounds, as depression often rolls up like a fog bank, making everything it envelopes hazy and indistinct.  But by exploring the feeling rather than merely trying to banish it, we can often get a sense of its meaning and origin.  Does it indeed feel like yearning and aching for a lost loved one?  Anxiety and paralysis in the face of looming demands?  Retreat from the world in the face of a sense of failure or shame?  A response to loneliness, and the craving for deep companionship?  A sense of being stuck, having made life choices that seem to have led to dead ends, with no apparent way out?  An utterly mysterious cycle that sets in at a similar time each month, or each year, perhaps as days of sunlight grow shorter?  In other words, “depression” is not one thing, but many, and discerning as clearly as we can its meaning and origin gives us a much clearer idea about how to address and assuage it.  Without this, it is like shooting in the dark.

2.  Take action.Depression tends to shut us down–mentally, emotionally, behaviorally and socially.  Resisting this pull toward inertia and inactivity–which only compound the original problem with many others–can begin with active reflection.  This can take the form of personal journaling or honest and sustained conversation with a counselor, therapist, or someone else we trust and who cares about us, as we look for themes and triggers in our depression that give us a better sense of what we need.  Activating ourselves–especially in directions that address these needs–is a crucial step in managing our mood.

3.  Don’t go it alone.As implied above, depression can isolate us from others, at the very time we most need their engagement and support.  We sometimes back away from people when we feel this way in order not to burden them, but this often only compounds their sense of helplessness to assist us.  Instead, move toward others, reaching out with a specific request or invitation–to talk, have lunch, take a walk, or simply to unwind together–and balance this with genuine offers to do things for others.  Remaining engaged in the give and take of the social world can go a long way toward mitigating the sense of solitary confinement in the prison of our depression, directly addressing some of the sources of mood disorder, and mitigating others.

4.  Acknowledge biology.Some forms of depression clearly arise from life events–like the death of a loved one, the breakup of an important relationship, or an experience of failure in some important life domain–while others are more mysterious, seeming disconnected from any clear cause.  But both ultimately are registered in changes in every part of our lives:  in our daytime activities and in our sleep cycles, in our mood and in our actions, in our brains and in our bodies.  And for some, a biological disposition toward or expression of depression may be fundamental, and require specialized intervention to supplement our own psychosocial efforts, in the form of light therapy, medication, and other treatments.  Antidepressant medication in particular is rarely a panacea for depression, but it is an essential part of the answer for many, and something worth discussing with a trusted physician.  Much more help in this area is available to you than was available in your father’s generation, and the loving part of him would unquestionably have wanted you to take advantage of it.

–Dr. Neimeyer

[Editor’s Note: if you want to read more of Caitlin’s grief odyssey, CLICK HERE]

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