The Unbearable Ponderosity of Being

Man is least himself when he talks in his own person. Give him a mask, and he will tell you the truth.” – Oscar Wilde

Wilde’s quote has great truth. The Anonymity a Guy Fawkes mask gives an Anon, allows us to speak the truth as we see it. The reason I am writing this is to let others who may suffer from endogenous depression know you are not alone.

I suppose you would call me an introspective person. From the first day I can remember having thoughts, I’ve tried to understand who I am, and why I am that way. but even more, tried to understand what reality really is.

I’ve self diagnosed myself as having “Congenital Endogenous Depression”.  A word about types if depression is appropriate. People often get depressed…”the blues” if you will, but mostly, they know what is making them depressed. They lose a job, lose a loved one, have a “bad day” where everything goes against you, etc, and as a result, feel down in the dumps…depressed. There is also a longer term depression when one finds out they have a terminal illness, lose a limb, get disfigured by an accident or attack by a maniac.

These are called cases of “reactive depression”…they are depressed as a REACTION to some external event, change in their life, etc.

Endogenous is a whole other entity.
“Endogenous depression was initially considered valuable as a means of diagnostic differentiation with reactive depression. While the latter’s onset could be attributed to adverse life events and treated with talk therapy, the former would indicate treatment with antidepressants.[3] Indeed, this view of endogenous depression is at the root of the popular view that mood disorders are a reflection of a ‘chemical imbalance’ in the brain. More recent research has shown that the probability of an endogenous depression patient experiencing an adverse life event prior to a depressive episode is roughly the same as for a reactive depression patient and the efficacy of antidepressant therapy bears no statistical correlation with the patient’s diagnostic classification along this axis.”

So, with endogenous depression, it comes from within without a definable event  or cause generating it.

I tacked on “congenital” because, as best as I can track it in my mental history, I’ve always felt this way.

Having ADD …AND endogenous depression is a bitch, lemme tell you.

Many people with endogenous depression have “anhedonia”.  “Anhedonia (/ˌænhiˈdniə/ an-hee-doh-nee-ə; Greek: ἀν- an-, “without” and ἡδονή hēdonē, “pleasure”) is defined as the inability to experience pleasure from activities usually found enjoyable, e.g. exercise, hobbies, music, sexual activities or social interactions. While earlier definitions of anhedonia emphasized pleasurable experience, more recent models have highlighted the need to consider different aspects of enjoyable behavior, such as motivation or desire to engage in activities (motivational anhedonia), as compared to the level of enjoyment of the activity itself (“consummatory anhedonia”).[1]

If someone has anhedonia and endogenous depression, that’s a much easier and simplistic diagnosis than the Endogenous Depression WITHOUT the Anhedonia. Having both makes you into a human robot, a SAD human robot. From a motivational standpoint, much of our behavior is driven by either seeking pleasure or avoiding pain. So, if you have anhedonia, the only other motivator is avoiding pain, but actually, since depression is a type of emotional pain, it is to avoid MORE or DIFFERENT types of pain.

It’s important to explain how it feels to have endogenous depression and NOT to have anhedonia. Imagine you develop this awful taste in your mouth and it’s there 24/7. Now, imagine you can eat candy, drink a chocolate or vanilla malt, or consume some other pleasant food item. Temporarily, the  good tastes mask the underlying, the default “bad” taste, but you know when the good tasting food’s effects wear off your tongue, you will be back at square one, with the “bad taste”.

If a person has congenital endogenous depression (i.e. from birth, it was always there), I tend NOT to call it a disorder or disease, although I know allopathic doctors want to tuck it in with a nice little diagnosis and label it as being a disorder resulting from an imabalance of brain chemistry. If it is developed later in life, I would tend to be more likely to support a diagnosis of a disorder or mental disease.

As with MOST “diseases”, allopathic doctors turn to pharmaceuticals as their way of treating this condition. SSRIs, or Selective Serotonin Re-uptake Inhibitors, tend to be their first line of treatment. Here’s more on not only SSRIs but other currently popular drugs. . Here’s a selection from that article :
” Reuptake Inhibitors: SSRIs, SNRIs, and NDRIs

Some of the most commonly prescribed antidepressants are called reuptake inhibitors. What’s reuptake? It’s the process in which neurotransmitters are naturally reabsorbed back into nerve cells in the brain after they are released to send messages between nerve cells. A reuptake inhibitor prevents this from happening. Instead of getting reabsorbed, the neurotransmitter stays — at least temporarily — in the gap between the nerves, called the synapse.

What’s the benefit? The basic theory goes like this: keeping levels of the neurotransmitters higher could improve communication between the nerve cells — and that can strengthen circuits in the brain which regulate mood.

Different kinds of reuptake inhibitors target different neurotransmitters. There are three types:

  • Selective serotonin reuptake inhibitors (SSRIs) are some of the most commonly prescribed antidepressants available. They includeCelexa, Lexapro, Luvox, Paxil, Prozac, and Zoloft. Another drug,Symbyax, is approved by the FDA specifically for treatment-resistant depression. It’s a combination of the SSRI antidepressantfluoxetine (Prozac) and another drug approved for bipolar disorder and schizophrenia called olanzapine (Zyprexa). Abilify,  Seroquel, and brexpiprazole have been FDA approved as add-on therapy to antidepressants for treatment-resistant depression. Plus, doctors often use other drugs in combination for treatment-resistant depression. Also, the drugs Viibryd and Brintellix are among the newest antidepressants that affect serotonin.  Both drugs affect the serotonin transporter (like an SSRI) but also affect other serotonin receptors  to relieve major depression.
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs) are among the newer types of antidepressant. As the name implies, they block the reuptake of both serotonin and norepinephrine. They include Cymbalta, Effexor, Khedezla, Fetzima, and Pristiq.
  • Norepinephrine and dopamine reuptake inhibitors (NDRIs) are another class of reuptake inhibitors, but they’re represented by only one drug: Wellbutrin. It affects the reuptake of norepinephrine and dopamine.But, what if those don’t work ? Well, at that point , more drastic measures are considered such as ECT (electroconvulsive therapy) and anti-psychotics (eg Haldol for example). The problem is that many anti-psychotics can create permanent neurological side effects ( a condition called “tardive dyskinesia”).

But, these “treatments” are oriented to returning the patient to some state of “normalcy”, assuming that not being in a state of depression is their norm.

The issue here is that these treatments start from an a priori that a “normal” person is well oriented, optimistic, and wants to enjoy life, and embraces only ONE perspective on life. The Buddhist tenet that life is about suffering, to them, would seem to be a pathological illness.

Some might view folks who have this type of depression as being nihilists. Some may in fact be nihilists, however, many others may not. I think we could say that perhaps all nihilists may have endogenous depression, but not everyone who has endogenous depression is a nihilist.

Perhaps the hardest time(s) to have this type of depression is during childhood. An introspective, introverted loner who is depressed, is quite simply put, a bullies target. So, to avoid being victimized, a child with this form of depression has to learn how to fight, and learn how to become popular…someone others like to be around. One way to accomplish that is to make people laugh. Laughter releases endorphins, those endogenous opiates our body produces, that make us feel good. So, if you make people laugh, and if that laughter causes their body to release the “feel good” chemicals, then people associate  hanging around with you, with feeling good.

It’s impossible to explain this endogenous depression sometimes. I tried to explain it to my first wife, and though she was very intelligent, she just didn’t understand how or why someone, would see the elements of everyday life as “sad” and “depressing”.

Another analogy is the song made famous by Leon Russell (and the book by Robert Heinlein)
“Stranger in a Strange Land”

Some people with this kind of depression, feel as if this world is alien to them, and of course, if you found yourself on an alien world where things feel strange, this could be depressing as well. There is a medical phenomenon called “the Alien hand”. In Alien Hand syndrome ( in the movie Dr Strangelove, the Doctor’s hand demonstrates who someone with Alien Hand syndrome acts) the hand seems to have a “mind of its own”, BUT, after a bit, the person starts to feeling as if the hand does not belong to him or her, that it is attached, but not “their” hand.

So, in effect, you learn to be an actor. If you are an introvert, you become an extrovert, a bit loud mouthed, but always someone that finds the funny or the interesting things in life.
Many well known comedians suffered from depression, and many had very sad and troubling personal lives. Robin Williams is but the latest of actors who are laughing outside and crying inside.

Learning to make other folks laugh when you are deeply depressed is not just compensation…but at times, it’s an attempt by the comedian, by the person who entertains others, to self medicate…to make himself or herself feel a bit of relief, even for a few seconds.

Of course, the tough part of having endogenous depression is when a terrible , life altering event occurs, such as losing a parent, a sibling, a spouse, or other loved one. Then, there is “reactive depression” which comes out , above and beyond one’s default state of endogenous depression.


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s