How to Be a Gentle Ally When Depression Comes For Someone You Love
And other things I learned in hospital waiting rooms.
Well hello! I’m so glad you’re here. I know it’s been a minute. This week’s essay is about the internal struggles we don’t talk about much, and not just because May is mental health awareness month. It has been embarrassingly tough to write this piece or any piece. It’s precariously close to events still unfolding in my world. But here goes.
You’ll also find some inspirational delights below. And soon, I promise you a little humor, maybe even with a touch of news. (As always, if you love this newsletter, please forward it, or subscribe.)
I spent a few long days in the vast windowless lobby of a big city hospital complex recently. According to the signs everywhere, it was the "Costco Wholesale Atrium." I had no idea that hospitals are now sponsored like stadiums, but clearly, the next step is corporate logos on doctors' coats like NASCAR. (Insert joke here.)
There is so much inevitable, interminable waiting in clinics and hospitals. Waiting for tests, waiting for your turn to go up to the patient floors, waiting for someone to come back down to tell you what's going on. This has become acute in the age of COVID visitor restrictions when more people must wait for longer.
Not surprisingly, the Costco Wholesale Atrium is worse for wear. The awkward lobby sofas are frayed, colors muted. The staff looks tired too–like they've been in a war, which I guess they have. And absurdly, all these dramas, all these weary fraught hours, are playing out under giant decorative hot air balloons with still more logos. And it definitely seemed like the balloons were racing to escape through the atrium skylight. (Ok, maybe I was projecting.)
Watching people moving through this crossroads between sick and well I was often reminded of that proverb: "Be kind, for everyone you meet is fighting a hard battle."
I wondered which of my atrium-mates were just visiting planet hospital, maybe for a hernia or appendicitis, and which were regulars. The young guy pushing a stroller in circles under the Costco Wholesale Atrium balloons looked new and anxious. The cheerful woman across from me unwrapping homemade snacks said she's been coming here for years with her now-grown son who has a severe form of epilepsy. He's here today for tests before surgery to correct an issue with his eyes because, as his mother explained, "it's never just one thing." This latest operation is not a big deal in her world. I want to hug her or send her to a spa.
People are gentle with each other here. They step aside in the coffee shop line when someone looks overburdened. And they clear space on a coffee table for a mom so she can put down a small rectangular machine that is somehow attached to her baby. I don't ask what it is. She's probably tired of explaining. The child gives me a gummy grin from under the tape of his feeding tube. He's unaware that his days are not ordinary baby days and he just keeps doing ordinary baby things, like waving at strangers. It reminds me of "People Like That Are the Only People Here," an iconic short story by Lorrie Moore about the alternate universe that is a pediatric cancer ward.
I'm here for someone in my extended tribe of beloved friends. Her child is upstairs, and like millions of teenagers, the battle they're fighting is with depression. It is like wrestling smoke. Terrifying, mercurial, and utterly consuming. It's also epidemic and was so before COVID. But now it's something more. Depression and anxiety will shape the identity and hopes of an entire generation in ways we can't imagine yet. But at the moment, we're still in triage and adolescent treatment centers are overflowing.
While I don't know this waiting room, I know this kind of waiting. I know what it is like to love someone who has been in the ring with this confounding condition. It can swoop in without warning, sometimes for a season, sometimes for a lifetime. Unlike a broken bone or cancer, there isn't an MRI machine that can map depression accurately or give you an all-clear scan. And the medications are usually prescribed with hope and a prayer, like: "let's try this one first."
In the absence of certain science, we become hyper-observant. We develop new emotional antennae and scan for signs that something, anything, is working. On good days, it's like a scrim is lifted, and there is your beloved person, clear-eyed looking to you, not beyond you. We learn to cherish sweet normalcy and “to give the mundane its beautiful due,” as John Updike put it.
It has been more than 20 years since my little sister was ill, yet it doesn't seem like much has changed in the mental healthcare most people receive. Sure there's less stigma and more meditation, and the lingo has changed (crafts and music are now called "expressive therapy"), and we have a bevy of new personality disorder diagnosis possibilities.
But the core insurance-covered treatments are remarkably unchanged. There's little that reflects what we've learned about this disorder's genetic and biochemical roots. And while we do know that lots of fresh air, physical activity, healthy food, and connection with nature and animals can be transformative, the covered treatments are still mostly indoors and sedentary.
A few years ago, I spoke to a leading psychiatrist in this field, Dr. Fadi Haddad, for a TIME cover story on teens, and he said flat out that mental healthcare is a hundred years behind the rest of medicine. It's beyond frustrating that there's not more widespread use of new treatments like psychedelics, or more research funding on this, a brain condition that affects 12% of teenagers and 6% of American adults (with similar numbers globally).
So let's just say that if Elon Musk decides to fund a mental health moonshot instead of buying Twitter, I'd gladly sit on Tesla chairs in a Musk Atrium and drink Space X coffee if it meant we could harness the world's best minds and technology to solve this riddle. Think of the creativity, joy and even productivity we could recoup!
But here we are.
For now, our best defense might be each other. Even if we're fighting blind, we're not alone anymore. There are just too many families who've dealt with severe depression or anxiety. Ask around, tell almost anyone that your beloved child, friend, partner, or parent is facing this devious foe, and they will most certainly have their own story, their own beloved. And oh, the relief to realize that you're not the only one.
Given that we’ll all find ourselves in one kind of waiting room or another eventually, what if we decided to this particular burden the way we would if a family were coping with any other serious illness? Maybe set up meal drop-off schedules, walk the dog, do a school pick-up, or leave something sweet on the porch without expecting to come in, or check-in via text without expecting a response. It’s like sending up flares of loving solidarity: “I'm here. I'm here. I'm here.”
Because, as it turns out, we are all people like that.
RELATED
On Loving Someone Who Battles Inner Demons
Why We Need a Mental Health Moonshot
Teen Depression and Anxiety: What Parents Can Do
RESOURCES
The National Alliance on Mental Illness (NAMI) HelpLine can be reached Monday through Friday, 10 a.m.–8 p.m., ET. 1-800-950-NAMI (6264) or info@nami.org. Find the NAMI Connection support group nearest you. Suicide Prevention Lifeline: 1-800-273-8255. Crisis Text Line: Text HOME to 741741 to connect with a Crisis Counselor. The JED Foundation Mental Health Resource Center for Teens and Young Adults
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INSIGHTFUL DELIGHTS
“Bittersweet: How Sorrow and Longing Make Us Whole,” is a new book and TED Talk, by author Susan Cain about embracing that bittersweet place where joy and sorrow meet. In her bestselling book “Quiet,” Cain celebrated introverts. Now she’s back with an ode to us melancholy types who react intensely to music, art, nature, and beauty, and who adore listening to a sad song on a sunny day:
“Bittersweetness is a tendency to states of longing, poignancy, and sorrow; an acute awareness of passing time; and a curiously piercing joy at the beauty of the world. It recognizes that light and dark, birth and death—bitter and sweet—are forever paired.
“Love Letters to Strangers:” This episode of the Story Corps podcast will almost certainly make you cry. The producers asked their audience about unforgettable acts of kindness and they received beautiful, transformative generosities, great and small.
Actress Ashley Judd published a heartrending essay about her first Mother’s Day without her mom, country singer Naomi Judd, writing: “I ask you to honor your own mother, if you are lucky enough to have her. Honor her for more than her labor and sacrifice. Honor her for her talents and dreams.”
Small Dog shamelessly posing amid the annual pinking of Prospect Park, Brooklyn.
Kwa Tjong-Liem For a number of years now I have been, out of necessity, visiting hospitals, On several occasions, I was the patient myself. Then there was my wife's illness. Hospitals are like that, all those who visit hospitals have some reason to be worried. Still everybody puts on a brave face. I vividly remember when somebody in the adjoining ward passed away, there was all of a sudden loud wailing by his (it was a male patient) relatives. We try to cope with this as good as we can.
Kwa Tjong-Liem
Thank you for writing again about depression. I have been free of it now since 2/22/22. I have a diagnosis of major depression, recurrent, severe. Hoping that this uplifted state is more permanent this time. The last stretch lasted 9 months and was triggered by a trauma last May.
I can recommend an incredible book about C-PTSD which is common in combination with major depression. What my Bones Know by Stephanie Foo. I have dealt also with healing from C-PTSD.
In my case Ketamine infusions and Spravato treatments have been very helpful. I have not done any for the past few months and have continued to do well. Spravato (Esketamine) has the advantage of being covered by many insurance plans for treatment resistant depression. I found infusions more powerful, but generally, people have to pay out of pocket for them. I know of someone who was able to treat her teenager with Ketamine infusions. Not sure if Spravato is available for teens. They are both psychedelic therapies.