Thursday, June 22, 2006

Joining the world of the undepressed

A thirtyish woman was in my office this week. New to my practice, she was once again seeking relief from lifelong depression after numerous unsuccessful attempts at therapy with various antidepressants. We devised a strategy based on a new possibility that she was, in fact, bipolar, and that previous treatments hadn't addressed this specific problem. She asked me "How will I know if I'm better?"

How does someone who has really never not been depressed know when the depression has lifted? I've likened depression to "looking at the world through black-colored glasses," dreading the day when there's no particular reason to feel that way. The undepressed, on the other hand, look forward to the hours ahead though nothing special is planned. I told her she'd know if the new meds were working if she made it through the day without thinking in an unhappy self-concious way about herself.

Here's an excerpt from a poem by a man successfully on Paxil, undepressed for the first time in his life:

I feel more like myself,

a feeling that can hardly be true

after 60 years of prowling

outside the fence, with the gates

locked, or scarier still, open,

swinging and I would stand there

paralyzed, afraid to step in

my feet starved for affection

and serotonin shooting itself

in the foot each time a foot perked up

and started to dance. But that can

hardly be true, the way I feel today,

so vividly myself, so grounded

you might say the first draft is done.

I'm in the process of revision.

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