There was a song that we used to sing in church. It went:
Out of the ivory palaces
Into a world of woe;
Only His great, eternal love
Made my Savior go.
The intended message, of course, was that Christ, while retaining His Godlike splendor and self-knowledge, willingly left a life of spiritual ease to join humankind in suffering on the physical plane. However, as a child, I always visualized it differently. In my mind, He had been kicked out of the ivory palace, pushed out the door or thrown through the window, abandoned, isolated and without the Father he thought he could depend upon for all eternity. It wasn't the blue-eyed hero with the white robes and the welcoming arms that I imagined, but rather a perpetually lonely, downcast man, lost and unsure why he had been forced to come to such an awful impasse as this world. In my youthful fantasy, he didn't know why he was here or what he was doing, and he sometimes wondered about whether he wanted to be at all. In other words, he was one of us.
This image was brought home to me again recently when a favorite niece of mine, at 14 years of age, threw herself out of her bedroom window in an attempt at suicide. When I try to picture what happened that strange morning, I don't see her parents' two-story house with the moss-covered roof, but instead, that same ivory palace. She is not jumping from the window, but is rather being shoved out, out of the ivory palaces of childhood and innocence and freedom and into the dark, dusty, desperate realm of adulthood. It is a sad and curious thing, but I can no longer get in my head the vision of the happy, laughing girl she was not more than a year ago. All I can see is the agony and anger-ridden face she turned to me the other day when she told me that she hated me and that she wanted me to stay out of her life forever.
Out of the ivory palaces,
Into a world of woe...
I'd never felt these words more keenly.
When internal tragedy strikes in our lives, as it has with my niece of late, and similarly with me a dozen years before, and with many of my friends in between times, it is perhaps useless to question "why?" All that we can really know for sure is that, as Job put it, "the thing that I have greatly feared has come upon me." For an increasing number of people in the world today, this "greatly feared thing" is clinical depression.
Depression is a tragedy, as powerful and as capable of deeply upsetting a life as any outward calamity, and in a lot of cases, more so, for it is often the source of an ongoing, seemingly pointless pain, whereas the mishaps that occur roundabout most usually have resolutions or at least some kind of closure. In the occurrence of a fractured romance, there is pain and an eventual renewed spark of amour; in losing a loved one, there is pain and an eventual farewell; after a crippling accident, there is pain and an eventual adjustment to circumstance; in depression, there is only unappeasable pain.
Ironically, the pointlessness of the pain of depression is one of the things that make it so painful. All the depressed person knows is that one day she was living in her ivory palace, seemingly safe and secure, and the next she was cast out, or made to feel as though she had to throw herself out, but, in any case, rejected at levels that are often ineffable.
In fact, the "ineffable" nature of depression is one of its most telling hallmarks, and one of its cruelest tricks. The dark horror and the moribund failings of self-esteem, which have often come about with no direct or definable catalyst, would and do seem ludicrous to many who have never been given over to the throes of this merciless mental short-circuiting. Thus, the depressive may well walk around with no other thought than that of self- destruction, but he cannot speak of it because of the anticipation of the inevitable question of "why?" which, alas, has no answer for the uninitiated. Even when the sufferer is able to formulate some analogy to speak of the feelings he is experiencing, its macabre images may only evoke from friends and family uncomfortable shudderings and the unintentional "space alien" treatment, borne of their own discomfort and helplessness to render aid.
Then there is the "internal" aspect of clinical depression, which is perhaps its most intriguing and certainly its most inhumane characteristic. Cancer, though it happens "on the inside," can be validated by X-rays. A gnawing ulceration of the stomach can be detected by laser scopes that are less than daintily shoved down the patient's gullet. Diabetes can be affirmed by the administration of a series of glucose tests. Depression, however, is still something of a mystery, and it yields its secrets slowly and reluctantly.
Scientists and pharmacologists know now that it may have something to do with brain chemicals like norepinephrine and seratonin, but how exactly the weaving patterns and matrixes of this disorder work and, more importantly, "where it resides" remain a puzzle. Again, there is irony in that this murk and mystery are a significant part of the disease itself. The sufferer cannot point here or there and say, "This is where it hurts," nor can she look at a glucose strip or an X-ray and "see" what is wrong and so have greater hope of isolating and treating the problem.
Even though many do not see it as such, depression is undisputedly a disease, and one that occasionally responds to drug therapy alone (though psychotherapy is usually also indicated as necessary for most depressed persons), but it is, in a lot of ways, an anomaly. Take the difficulties mentioned above and combine the complexities of genetic and environmental involvement (and, no doubt, many other factors as yet unknown), and depression becomes a disease whose indecipherability perpetuates, and, again, even feeds the disorder itself. (Has anyone ever described it as being a "mental cancer"? Perhaps this comes close to being an apt metaphor.)
Still, maybe worst of all is not the patient's inability to comprehend what is happening, but the quandary, the perplexity, and, dare we say it, the almost-disguised shame betrayed by onlooking family and friends once the problem is revealed to them. To be fair, they are in a fix. They may wonder a great variety of things: Is it best to leave the depressed person alone, due to fear of codependency through coddling or anger through harassment? How does one call for a "pulling up by the bootstraps" without sounding trite? Does one suggest a night on the town or bed rest? Will therapy make the depressed person better, or simply over-reliant on some psychiatric Svengali? Will drugs render the sufferer ebullient once more or merely be the equivalent of a chemical lobotomy?
And so it goes for those who become the confused caregivers to the depressive. Many, unfortunately, eventually fold their hands and shrug their shoulders and do nothing at all, well-meaning but hapless, waiting for the miracle that they themselves cannot supply. So begins the self-fulfilling prophecy of depression. The depressed person feels alone and isolated, and so becomes alone and isolated. And so the cancer continues to eat at the mind and the soul of the sufferer.
In the end, one can't even assert that depression, that vile crucifixion of esteem and purpose, "builds character," as we can for other forms of existential trial; in fact, it does quite the opposite while one is in its throes. At best, if there is recovery or at least management of the disorder, it may lend the afflicted person the gift of insight, the ability to approach another nailed up in the same manner, the capacity to pat a shoulder with empathy and say, "There, there...there, there." In this, depression shares a trait with war: it is hell, but curious and lasting camaraderies can be forged by its metaphysical soldiers, those who live to tell the tale; and eyes, haggard from the fray, sometimes meet in a way that says, "I understand."
It might be beneficial to add at this point that this article is the first in an eight-part series about coping with depression in its many forms: depression caused by brain chemical imbalance, depression caused or augmented by alcohol and drugs, depression caused by trauma early or later in life. Three of these essays will be narratives formed from interviews with people who "in the middle of life's journey" reflect on what it is like to be lost in the dark woods of clinical depression.
The Southern writer, William Faulkner, who himself struggled mightily with alcoholism and depression, once wrote, "Given pain and nothing, I will always choose pain." It is a puzzling truth that life is undeniably painful; in fact, paradoxically, there could be no joy in it if a good deal of it weren't grievous and unpalatable, for we cannot appreciate and thus feel the one without the persistent presence of the other.
Therefore, one need not read these articles looking for instructions about how to make existence easy or endlessly pleasant (such breeziness would be tantamount to discouragement and insult for an individual with depression), or even how to escape forever the cruel grip of the monster, but, rather, how to live with what sometimes amounts to considerable ongoing unpleasantness.
These essays, which are dedicated to the brave souls who shared their stories with me, are about staying alive when it seems easier and even preferable not to. They are essays about coping, not curing. There are in them no fast answers or glib recipes for happiness. I guarantee that none of them will be about returning to our ivory palaces; in fact, if anything, they should dispel the idea that there ever was anything of the sort. After all, people who think they live in such places are not being realistic; thus they are not facing their own afflictions; thus they are not bearing their own crosses; thus they know no pain; thus they know no real joy; thus they feel nothing; thus, they are not truly living at all. One cannot go on that way; life simply won't allow it. Eventually, life will force even the most cunning practitioner of denial into the harsh light of truth. And so it is that, in the end, the only thing an ivory palace is good for is getting thrown out of, headfirst into the painful world of reality.