The Landscape of Cancer: Depression, Grief and the Undertoad

Today, we leave for Europe, for a trip of a lifetime. One would think I would have been extremely excited about it, especially during the past few weeks.

But I wasn’t. 

Until last night. Mark has been excited for the past two weeks. He kept saying so, when all I could do was smile and wonder why I wasn’t experiencing the same thing.

Last night, thanks to some thoughts shared in an email from a friend and a couple of other thought-provoking circumstances, I realized why I haven’t been excited: I’ve been experiencing depression. I didn’t recognize it, however, until within the last 24 hours. As I wrote a year ago, I have experienced (mainly undiagnosed) depression most of my life, but it has been a long time since I’ve had a bout of it. So long, in fact, that I didn’t realize that what I had been experiencing the past few weeks was depression. 

Signs? I didn’t feel motivated to do much of anything. I simply couldn’t get excited about Europe. I lost interest in reading. I was feeling physically ill, having headaches that I haven’t experienced in a long time, feeling exhausted, nervous stomach, etc. At times, I was irritable. At other times, many tears came.

Why? To some extent, I’m not sure. But I think it was probably connected to another realization that came to me this morning. I didn’t recognize it because I’m not that familiar with it. 

Grief. 

I have grieved over things in my life, but I don’t think I’ve ever (consciously) experienced true grief, a grief that comes from the permanent loss of someone you are deeply in love with. This kind of grief is a stranger I don’t know very well, but whose strange power I have felt in the past couple of weeks. 

Of course, I’m referring to Mark, who has advanced, inoperable prostate cancer. There are times when his mortality comes sharply into focus and overwhelms me. As I looked toward taking this trip, the thought that this will likely be our last big trip was always there, tempering my excitement. And as we drew closer to leaving, those thoughts – I came to realize – engendered grief.

In my friend’s email, she referred to the presence of the “undertoad” – a word, she explained to me, that was used by children in the book, The World According to Garp (which I never read) to refer to the ocean’s undertow. The undertoad is always there. Sometimes I can hardly feel it. At other times, it is extremely powerful and can sweep me out, I have realized, into a sea of depression and grief if I am not prepared. This has been an important lesson for me to learn at this point of my journey with Mark through the landscape of cancer. 

As of last night, I am officially excited about our trip. Thoughts of Mark’s mortality have again been faced, but I’ve turned a corner. I intend to enjoy every day of our trip together and let whatever lies in the future stay there.

Coming Out of the Depression Closet

I was going to title this post, "I Struggle With Depression," but then decided that wasn't appropriate, especially after reading this article by Tom Hawking that my teenage son sent to Mark and me. Depression is not something one "battles"; this term implies that one can vanquish depression once and for all. That is, generally speaking, a falsehood.

One also does not "struggle" with depression as one might, for example, "struggle with addiction." True, sometimes one struggles mightily with the effects of depression and what it does to us; but both of these terms - battle and struggle - imply that depression can be "beat." It can't. It is a chronic condition that must be acknowledged and addressed. Furthermore, the terms both imply that dealing with depression is a battle one wages with oneself. That very attitude leads to a deepening of depression. (I can't help but think how this analysis also applies to being gay. One may "struggle" and "fight" same-sex attraction, but this war that one launches upon oneself is horribly, sometimes terrifyingly, destructive.)

I could use the term, "I 'have' depression," but that term also doesn't sound right somehow. It makes it sound like depression is somehow contagious, e.g., "I have a cold." Depression, however, is not "caught." It is not even like a cancer. I'm not a doctor or a psychologist, but my own experience is that a tendency toward experiencing depression is something one is born with. (Like being gay.)

What about "suffer" with depression? It is true that depression can cause a lot of suffering. But I personally, thank goodness, don't currently "suffer" because of depression (though I did for many years). I experience depression.

But enough about semantics.

I base my views about depression on what I have personally experienced in myself and my own family, both my family of origin and my children. I didn't realize I had in fact experienced depression for most of my life until circumstances forced me to confront this reality. I liken it to the experience of my son-in-law, who suffered throughout his teenage and early adult years from undiagnosed Type-1 diabetes. He didn't know what caused him to be lethargic, depressed and otherwise unhealthy, and he blamed himself (as did others) for results of the undiagnosed diabetes.

It wasn't until my oldest son came home early from his mission, suffering from previously undiagnosed depression, that I started to look around myself and actually see depression. It was only then that I realized that I myself experienced depression and had done so for many years.

It started with my mother. Looking back on what she went through while I was growing up, I now realize that she suffered greatly from depression. My memories of it start when I was in 4th grade. She would shut herself in her room, coming out only to make meals, sort of, then go back to bed. She suffered from migraines, which also sent her to her room. She was irritable and cold, often angry. I wonder what she would have been like had anti-depressants existed in the 60's and early 70's. I can't help but think that my life might have turned out significantly differently.

I then looked at my family of origin. I knew that my younger sister had been on anti-depressants, and I strongly suspected - as I looked through new lenses of awareness - that my older sister had suffered, and still suffers, from undiagnosed depression. I also suspect that my older brother, who died in his mid-40's, experienced depression.

Then my children. My son, who had coped with undiagnosed depression for several years before it became terrifyingly apparent. A daughter who revealed that she, too, had experienced dark moments in high school, unbeknownst to me.

And then there was me. Superman. I had so convinced myself of my own invincibility, was so confident in my dogged determination to overcome my own "weaknesses" (such as being gay), and so divorced myself from the reality of my own upbringing, that I had never before considered that I experienced depression. In fact, to my shame, I used to make fun of people who took anti-depressants (just like I used to be homophobic), considering them weak and self-absorbed.

My revelatory moments came in the aftermath of my son's return from his mission and in the midst of  what turned out to be the last months of my terminally-ill marriage (and several months before I unexpectedly came out). After looking around myself, I came to accept the reality that I, too, experienced depression. I went to a doctor. He prescribed anti-depressants, the same medication that my son took. 

When I first started on anti-depressants, I had no idea - could not have possibly conceived - what lay ahead of me during the next few years. And now, I shudder to think what might have happened had I not been on meds. There were dark moments. Moments when suicide seemed like a very logical option. As Tom Hawking points out in his article (linked above): 

"Suicide is an act that makes perfect, terrifying sense if you’re suicidal, and no sense at all if you’re not. If you don’t understand why someone would kill themselves, I’m happy for you, and I hope that you never do."

I still take anti-depressants. It is likely that I will continue to do so for years to come. I once tried to "wean" myself to a lower dosage, as if brain chemistry could be controlled by my own will; as if being on meds is a sign of weakness, or that I'm not "tough" enough. I learned that this was not a good idea. 

I have accepted the fact that I experience depression. It is something that I was born with a tendency toward, just like being gay. When I read the article that my son sent us, something clicked inside of me. I knew the time had arrived to come out as someone who experiences depression. In so doing, I was reminded of the sea change that has occurred in the gay rights movement due to the fact that more and more men and women have come out about their sexuality. As a result, more and more people have realized that someone close to them is gay or lesbian, and the world has become a more tolerant, loving place as a result. I hope the same results will manifest as more and more people come out of the depression closet.