Tales from the Dark Wood In the middle of the journey of life, I was plunged into a dark wood, for I had lost the right path. — Dante, The Inferno Part IV: "Don’t You Wish You Were Me?" by Douglas S Johnson Don't you wish you were me? I know I do! — Dudley Moore, Arthur Thus far in the series, we have seen the more somber face of depression, but it has another, stranger countenance, one that wears a convincing smile. One of the reasons why depression is so difficult to diagnose or be recognized by family and friends is that unlike, say, the measles or appendicitis, this disease does not necessarily manifest itself in outward or exigent symptomatology, especially at first. In fact, depression is oftentimes masked by the sufferer from the world, and it is sometimes even masked by the sufferer from the sufferer himself/herself. There are many ways in which depression is hidden or repressed: a false front of brio, a wild or ribald sense of humor, daredevil behavior, sexual promiscuity; but the most common method of masking depression is by way of drugs and alcohol. Drugs, alcohol, and depression may not have an immediate up-link in the minds of most people, but there is a very definite connection. The literary roll call of depressives who drowned the disease in drugs and alcohol is impressive: Edgar Allan Poe, John Steinbeck, William Styron, Carson McCullers, William Faulkner, F. Scott Fitzgerald, Ernest Hemingway, Eugene O'Neill, Tennessee Williams, Thomas Wolfe, Robert Burns, Dylan Thomas, Albert Camus, Charles Baudelaire, Evelyn Waugh, Jean Rhys, Arthur Rimbaud, and Fredrich von Schiller, just to name a very few; we should need several pages to begin listing depressed artists and painters who were alcohol and drug abusers and several more to list the famous actors and singers. Most telling, perhaps, is Malcom Lowry's line as quoted by Donald Goodwin in Alcohol and the Writer: "gin and orange juice are the best cure for alcoholism, the real cause of which is ugliness and the complete baffling sterility of existence as sold to you." Here we see the true connection between the abuse of alcohol and drugs and depression. Ongoing awareness of the ubiquitous "ugliness" and the "complete baffling sterility of existence" of which Lowry writes is the very hallmark of clinical depression. He is quite correct, in most cases, when he states that alcohol and drugs are, in fact, not the problem at all (at least not initially), but rather the feelings of "ugliness" and "sterility" which the use of drugs and alcohol is designed to mask or obliterate. Thus the reason a depressed person would use alcohol and drugs becomes obvious: to feel like a person who isn't depressed. But even the diagnosis of "depressed chemical dependent" is at best tenuously made. Usually the latently depressed alcohol or drug abuser is not the weaving, slaphappy chap with slurred speech and funny gait, á la Dudley Moore's Arthur. Nor is he the bottomed-out Bowery bum drinking cheap wine from a bottle wrapped in brown paper, nor the punk rock acidhead. Much more common is the long-term drinker or chemical dependent who keeps a steady smile and a steady hand, sometimes for decades, before the walls come crashing in. The writer William Styron is a good example of this; he abused alcohol for forty years as a dodge from the depression that constantly threatened him after the death of his mother, until, at last, his body simply refused to have any more. He was left "high and certainly dry," "unhelmed," and abandoned to face the onslaught of the "howling madness" which was made manifest in his brain after there was no more booze to protect him. The difficulty here is obviously multi-pronged. First of all, the person in question suffers from depression. Then, on top of that, she refuses to deal with the first disease by way of introducing yet another: chemical dependency. In the end, the drinking and drugging only magnify the initial problem many times, and then, all of this is complicated further by the fact that she must deny and mask not only the depression but the eventual addiction as well, until she wears one mask laid on top of another, an endless succession of personae that disguise the real person, even from herself. This explains why so many depressives as well as chemically dependent people must "hit bottom" before seeking help. It is why family and friends frequently can do little more than offer repeatedly refused aid until the manifest crisis occurs (and if one is lucky, the crisis does not result in death, either by suicide or accidental overdose). In short, the trouble is that, often enough, the masking works all too well and allows the poor sufferer the illusion of self-control. Coincident to this last assertion, there is one more feature of this complex crossing of disorders that needs to be considered. In many cases, the depressive who turns to alcohol and drugs as a cover is from the outset a ferocious perfectionist who can allow no one to see fault in him and can, in fact, allow no fault to exist, even in his own mind. How many times have you heard of people who drink "to forget," "to go to sleep," to effect what, in Long Day's Journey into Night, playwright Eugene O’Neill termed "the KO punch"? It is the inevitable end of one who demands perfection from life and from self: despair and the desire for annihilation, extermination of consciousness, rien. How long can the depressive hide behind a forced smile and remain upright (paradoxically headed ever downward) with the aid of a chemical prop? It all depends on the individual; some have the capacity for what would otherwise be considered heroic strength, were they not battling against their own salvation. "Wendy," whose interview will appear as the next installment of this series, put it quite well when she said, "everybody's bottom is different; it all depends on how deep you want to go and how capable you are at digging." It is with this very principle that we can begin to see a way out. What is the solution? One must hit bottom. How does one hit bottom? One must merely stop digging (or wait for the eventual collapse that forces one to stop digging, if one is of adventurous bent or must go about things the hard way). Thus, the final paradox is that the only way to get control is through the total relinquishing of control. This is, in a lot of ways, as true for the depressive as it is for the alcoholic and drug abuser. Most usually, the problems must be dealt with in reverse order relative to how we have discussed them here. First, the perfectionism must give way. The sufferer must admit both the depression and the addiction. Then, when the played-out victim is detoxed and finally finished with grinning masks and with alcohol and chemical fixes, she may at last address the depression that was the original demon. The basic AA principles work as well for the depressive as for the alcoholic or chemical abuser, especially if the depressive is chemically dependent. First of all, he must seek out others (especially those who have suffered similarly) and come to allow himself the occasional reliance on them; again, this means turning loose of ideas of perfectionism or unswerving strength and knowing that there is no such thing in regard to human beings. Secondly, she must find and accept qualified medical treatment and one-on-one or group therapy. (The relative merits of group therapy over one-on-one therapy, both for alcoholics and depressives, are beginning to be demonstrated. Group therapy can be used by itself or in conjunction with individual psychotherapy.) Thirdly, there must be the recognition, acceptance, and deep knowing of a Higher Power that guides and protects. (It must be noted that this last is not an act of religion but of spirituality, the acknowledgment that the all-in-all is not in one's self or even in this material world.) Does all of this magically put the sun back in the sky and cure the depressive? No. It merely allows him to face the problem truthfully and honestly, so that he may wear the smile only when he is truly happy and admit sadness when he is sad. It allows him to relinquish harmful chemical crutches and place himself in the hands of others and in the hands of God when he is no longer safe in his own. Is it probable that the depressive will be happy again and see the sun, even if not magically or immediately? Yes. In fact, she has a very good chance. As has been noted before, in the vast majority of cases, professionally treated depression is not fatal, nor is it usually a lifelong illness. If there is anything at all that the depressive may look forward to, it is that her brain's demon is at some point likely to lay down its vile weapons, allowing her to smile and laugh again without chemical aid, leaving her to a life that she can appreciate anew, through honest and opened eyes. This is the fourth in an eight-part series on depression written by Douglas S Johnson exclusively for The New Times. Please send SASE for any reprints desired.