The first time I can remember experiencing a bout with depression I was 19 years old. At 19 years old, on a scale of 0 to enlightened, I was about a one. Circumstances and experiences in my life prior to that depression left me with psychosocial issues that contributed to an unawareness or disconnectedness that rendered the feelings of depression incomprehensible to me. Sure, I was fat, ugly, stupid and disgusting, but depressed? Nah! Not me! I was the life of the party. I was the happy-go-lucky girl. When you are always telling jokes, keeping it light and smiling, it constructs a very secure wall.
Before I explain my behaviours, I will attempt to explain to you what was happening that could not be seen. Neuro-scientifically speaking, my chemical messengers (neurotransmitters) were having difficulty delivering messages to my nerve cells. There are three basic molecules that are largely responsible for mood regulation. Chemically they are referred to as the monoamines called norepinephrine, serotonin, and dopamine. These chemicals are packaged and travel in packets in our brains. Their main purpose is to keep our brains balanced. The brain, much like the soul, seeks to remain in balance, and is continually working to provide this balance. To explain further. Imagine that the nerve cells are mountain tops. We need to get a message from one mountain top (pre-synaptic cell) to the next mountain top (post-synaptic cell), 
and we are going to use messenger birds to do this. We release the birds (serotonin) to send the message and at the other mountain top there are helper birds waiting to receive the message (serotonin receptors). If all the helper birds have met the messenger birds and received their message and there are still some messenger birds flying around, they are just sent back to the original mountain top. So, message received. Balance. All is well. Easy peasy right? Well, hold on. There are several things that could go wrong. 
For instance, it could be that; there are not enough messenger birds (serotonin) available to send the full message, there are not enough helper birds (serotonin receptors) to help receive the message, or some of the messenger birds are turning around and flying back before they deliver the message, to name a few. The point is, if there are any breakdowns anywhere along the path it can lead to the observable symptoms we see and call depression.
I have taken the time to describe the physical components of depression because this is what is going on behind the scenes. What we can’t see. There are a lot of judgements that are passed based on our inability to see the “breakdown” before the breakdown. I have had many clients who have come to me with confessions of past judgements made. It is not uncommon to hear, “I was so judgemental because I had no idea what depression felt like. I always thought that people used depression to be lazy, as an excuse to get out of doing things. I really had no idea how painful it is.” You really don’t want to be in that group of people. What depression does with simple thoughts of regret and guilt is turn them into damaging thoughts of worthlessness and hopelessness. Depression doesn’t need an excuse to make you feel miserable, but if you give it one, it will take it and use it to advance its cause. So, please, understand, it happens, it is chemical and it hurts – like hell..it hurts beyond what you can imagine if you have never experienced it. If you can imagine a brain, bruised, battered and torn apart, that is what depression looks like, it is also what depression feels like.
The causes of depression are like a car crash in the making. A complicated interplay of genetic, biological, and environmental circumstances that come together to create a mangled, paralyzing affect. There is not a status, culture, skin colour, age or gender that can shield you. You are not immune. Like many other physical illnesses or conditions, there are things you can do to avoid or minimize the effects of depression. There are lifestyle approaches you can adopt to optimize your mental health, especially if you have a pre-disposition to depression, but, do not think for a moment that you will not suffer from depression because you are stronger, or wiser, or not a wuss. It simply does not work like that.
The causes in my life are a combination of the very circumstances I spoke of. There is a long and storied history of depression on both sides of my family. Environmental circumstances changed my biological workings. Trauma and abuse will do that to a developing brain. And so, there I was, at 19 years old, thinking that the world would be better off without me. Crying inconsolably because I was convinced everyone that I loved was going to die. Feeling to the depth of my bones that I was alone in this world. It was as if someone had flipped a switch in my brain, and now my world was dark, depleted and cold. In retrospect, I know there must have been signs and symptoms that lead up to the day the switch flipped, but to my recollection, it happened in one fell swoop. One day the lights were on, the next day, the next moment, they were off. I used to go down to my basement, where I thought nobody would hear me and let out guttural screams, as if trying to release the beasts that had gathered inside of me. Screaming them out only made room for more blackness, more beasts, more pain, but still it was the only thing I knew at the time.
There were suicide attempts. Only few people know this about me. What people need to know is that the suicide attempts weren’t because I wanted to die, they were because I didn’t want to live in pain and blackness. I wasn’t educated, I wasn’t enlightened, I simply did not know what to do, or what was wrong, I just wanted it to stop. I knew it wasn’t “normal”, I knew other people couldn’t “deal” with it either. It was too painful for others to see, so they avoided me, told me they couldn’t help me, turned me away, because – they weren’t educated, they weren’t enlightened, they did not know what to do, they just wanted it to stop. 
For some reason; maybe because I learned to live with it, maybe because the imbalance regulated itself, maybe because I “normalized” it, maybe because a higher power gave me strength, or maybe it was a combination of all of the aforementioned, but for some reason, I went on living, adapting and re-adjusting, learning, experiencing. And then BOOM! Seven years later, it hit me again, after the birth of my son Gregory. And I mean BOOM! BANG! SLAM!! This time my sisters put me in the back seat of a car and dragged me, kicking and screaming, literally, to the hospital. I got medicated. The angels sang and the light entered. Yes, just like that. We had taken care of the biological source of my depression. Life was good. I went on living, adapting and re-adjusting, learning, experiencing. Then, six years later. Hello. The birth of my twins. Lights out. Sound gone. Darkness.
But wait, I know this game. I’ll just go to the doctor and get medication. And so I did, but..ummm, hey medication, we have a deal remember? I take you and deal with your nightmares and dry mouth, and you turn the lights back on. Nope. Wrong medication. No therapy. Deep, deep despair. All of this while trying to raise 3 boys, twin babies, one is in intensive care with collapsed lungs. Is there a way out? Suicide, but I couldn’t. I was a mother now. Death was not an option. So, what else? Therapy. Therapy and time. No medication. I was starting to gather more pieces of the puzzle. Life goes on, I live, I learn, re-adjust, adapt, and then 5 years later I get divorced. Yep, you guessed it. On my own, with 3 boys. Hello old friend, just take me now, because you win. I cannot live like this and do not want my children my family and my friends to see me like this. It’s just not fair to any of us. Death is welcome. End the pain for everyone please. Still, God, the universe, a higher power, something whispered..there is a way. You have all the pieces of the puzzle, now you need to put them together.
By the time I had suffered my fourth bout with depression, my family was beginning to recognize that I wasn’t just lazy, or spoiled, I was sick. My parents, having witnessed some of my “episodes” – being frozen, zombie-like, incoherent, confused, panicked..just..stuck, understood that the Laurie experiencing this debilitating pain, was not the Laurie they knew. They offered their support, they understood, because they witnessed things that parents shouldn’t have to witness, and they did what they could do. But, what can you do when someone you love is going through this? You can educate yourself and you can support them, but painfully, that’s about all you can do. The real work, the real healing lies in the sufferer. Do not shame them, don’t tell them to count their blessings. Don’ t tell them to suck it up. Just listen. Listen and support.
Nearly 2 years ago, I experienced my fifth depressive episode. It was a particularly difficult time, but, I gathered more of the pieces that I needed to put the puzzle together. I am not above or below doing whatever it takes to be healthy now. If it means leaving a relationship that is toxic. Minimizing contact with negative influences, meditating, praying, going to therapy, and yes, taking medication. I have a very open relationship with my doctor, and we discuss new advances, new research, and new options continually. Every time before the last time, I went off my medication when I felt well. This time, together with my doctor, we decided that I am most likely a lifer. I have experienced a sort of balance that I have not been able to enjoy for most of my life. I know that menopause is approaching, and with it, perhaps more challenges with mood will appear, but I don’t live in fear. There is always a way. There is always a path, and for me, there is always a voice, leading me on, guiding me forward, even when I haven’t wanted to move. I have lived, I have learned, I have experienced, I have re-adjusted, and I have adapted. I know what depression is, and I know it’s a battle to conquer it. I have been to war and back, and I know that I have what it takes to carry on. And you can too.
To know this, you need to be educated. Many symptoms of depression appear in adolescents, and so if you are a parent, you can help your children if you educate yourself on the subject of your family history, your child’s environment and their lifestyle habits. My son knows about the history of depression and alcoholism in his family. He understands that some of the circumstances of his childhood have made him susceptible to depression. You might think this knowledge in itself is depressing. It isn’t. It is empowering. He is educated on the effects of sleep and diet. He understands the difference between hormonal moodiness, appropriate sadness over life events and how to best avoid sinking into a depression. He feels as though he gets to make choices that will give him the best chance of not experiencing this debilitating, heartbreaking pain. Best of all, he knows that if ever he does experience depression, there is no shame in saying it out loud, in seeking treatment. He is not a sitting duck, he has choices and he knows it…and all of this is not because he has done research and obsessively studied depression. This because his mother has talked to him about her depression, openly, honestly, and without shame.
You can do the same. That is how we educate others. We share our stories with each other. We create a community of caring, supportive and educated family and friends. We become comfortable with who we are.
We live without shame, and we don’t keep our secret.
The Psych Prof 