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Depression: A Personal Account

GUEST COMMENTARY

Biochemical Revolution: My own condition and that of many others have been treated effectively only with the contemporary biochemical options available. The vast majority of depressive and manic-depressive illnesses can now be considerably improved and well-controlled with medicines. I also find certain psychotherapeutic perspectives valuable, but more for dealing with the effects of depression and with the life issues that everyone faces than for alleviating any symptoms of depression. I would rather discover therapeutic insights and enrich my community service commitment talking with Robert Coles than anyone else, but I will benefit and contribute a great deal more if I am already being treated with the appropriate medicine.

On a most personal note: Thank God (actually, certain biochemists) for __! (I cannot name my current medicine here because someone may wrongly conclude that they need the same thing, when there are many medicines available and no two brains are the same). I share the widespread aversion of sensible people to the intake of chemicals and anything that seems "unnatural," yet I know for my own case the existence of__is a medical miracle. It went so completely against the grain for me to accept that any pills can be so important to my well-being that for too long I resisted the idea and appropriate treatment. Now I know that it is a basic fact of my life.

The Good Life: Such medicines are not any part of life's 'telos' (sorry, Aristotle), they are more of a precondition for returning to the world of energy, mental concentration and varied feelings. Some very loose analogies can be found with thyroid medication for those who need it, insulin for diabetics and in fact adequate nutrition for everyone: intake of any chemicals and nutrients to sustain a decent life is not the final goal but the means to be fully capable of pursuing other goods.

Whether or not the widespread need for extreme privacy in these matters ever changes, there are several suggestions I have which affect everyone who reads this. Because I went through far too many years of life untreated for chronic depression and misled by several well-meaning but ignorant people, I make these imperative statements:

Anyone who suffers or thinks they might suffer a signficant mental illness should seek evaluation and treatment immediately. There may be no panaceas, and some conditions will improve or subside with time, but if you suffer very much for any length of time there is hope for improvement if you get medical help; the sooner you start, the better.

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It takes enormous resilience, determination and courage (both for the patient and for people closet to her) in order to seek obtain and carry through on treatments; there are often false starts (unhelpful medications, useless therapists, etc.) and tough times ahead before improvement occurs.

The patient has to do a lot of informed seeking. Many physicians and patients need to be more eclectic in welcoming whatever combinations of treatments may help. Persevere and find out the more relevant options.

Please, everyone, strive to help each other! Not to play amateur therapist, but to learn when and how to try to steer someone toward help. Everyone encounters people daily who are silently suffering in ways we may not imagine. We can all be much more alert for warning signs: often changes in sleep patterns, diet and weight, energy levels, and/or mood (`affect'), or perhaps simply the arrival of midterms can indicate some underlying condition which should be addressed.

A huge variety of more recognizable `physical' illnesses may involve changes in these areas, but the tricky thing about mental illnesses can be the lack of a simple sign on the forehead saying "Help, I'm depressed!" In my own case, it was after being exhaustively tested for a myriad of other possibilities that my perceptive and enlightened M.D. at UHS told me, "The times I have seen such persistent unexplained symptoms have usually been cases of depression."

I have never wanted to make my life such an open book, but I will regard this as worthwhile if enough good comes of it. Many silent sufferers need treatment and loving support, and our society's public policy needs drastic reform in this area.

For students, I think the structures and resources for assistance at Harvard are generally impressive, although much better training of resident tutors and proctors for recognizing subtle signs would help greatly. Please, make my public "soul-baring" more than an exercise in agonizing self-exposure! Your education, indeed your lives, should be better for it.

John Duvivier received his M.A. in philosophy from Harvard in 1988. He was the head teaching fellow of "Justice," and served for seven years as director of the First-Year Outdoor Program.

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