episode and aftermath

The title of this blog comes not only from the convergence of the two stories in this early post of mine, but from my interest in depression. It always seemed as not so much an illness or condition as a choice. Until I had my own episode. I will spare you the details of how I slid into depression, though that is how it felt, like a long spiraling slide, down and down. Denial was my shield, or so I thought. If I didn't admit that I was depressed, maybe it would go away. It did not.

All of that happened a few years ago. I have not experienced another episode since, though I learned both during my own stuggle, and by reading this book, that a sequel is a distinct possibility now that I've had the initial depression. I began reading "The Noonday Demon" because I wanted to know more about what happened to me and, if possible, why. This has happened, but there is more.

I just now finished the chapter titled "Poverty" in Solomon's book. Many of the stories in the book are truly heartbreaking, but those in the Poverty chapter are absolultely brutal. I've had many conversations in which well meaning people have insisted that the ultra poor have generally caused their own situations. At the very least, they have perpetuated their poverty by not seeking honest work. I've always felt that this theory and the sentiment behind it smacked of defensiveness. After reading Solomon's explanation of poverty and depression, I'm tempted to view the causality theory as utter nonsense.

Here is a (somewhat lengthy) quote from the final paragraph of "Poverty."

"...I do know this: we have been trying to solve the problem of poverty by material intervention at least since biblical times and have in the last decade tired of such intervention, realizing that money is not a sufficient antidote. We have now overhauled welfare with the cheery thought that if we don't support the poor, they'll work harder. Is it not worthwhile giving them the support, medical and therapeutic, that would allow them to function, that could free them to make good on their lives? It is not so easy to find the social workers who can transform the lives of this population; but without programs of raised consciousness and allocated funding, those who have the gifts and the devotion to work with such people have scant means to do so, and the terrible, wasteful, lonely suffering goes on and on and on."

Earlier in the chapter he had written this, which I found almost scandalous,

"If one makes the conservative estimate that 25 percent of people on welfare are depressed, that half of them could be treated successfully, and that of that percentage two-thirds could return to productive work, at least part-time, factoring in treatment costs, that could still reduce welfare costs by as much as 8 percent--a savings of roughly $3.5 billion a year..."

After citing a few examples of doctors that have had success in treating indigent depressives, he adds, "Each of these doctors, uses techniques of tenacious care. In all of this work, the per patient per year cost is well under $1,000."

Jannotti tag: psyche