WEBVTT 00:00:03.627 --> 00:00:07.838 "I felt a funeral in my brain, 00:00:07.838 --> 00:00:10.240 and mourners to and fro 00:00:10.240 --> 00:00:12.900 kept treading, treading til I felt 00:00:12.900 --> 00:00:15.836 that sense was breaking through. 00:00:15.836 --> 00:00:17.605 And when they were all were seated, 00:00:17.605 --> 00:00:19.603 a service, like a drum, 00:00:19.603 --> 00:00:22.315 kept beating, beating, 00:00:22.315 --> 00:00:25.831 til I felt my mind was going numb. 00:00:25.831 --> 00:00:27.707 And then I heard them lift a box 00:00:27.707 --> 00:00:29.994 and creak across my soul 00:00:29.994 --> 00:00:33.053 with those same boots of lead again, 00:00:33.053 --> 00:00:36.070 then space began to toll, 00:00:36.070 --> 00:00:38.210 as if the heavens were a bell 00:00:38.210 --> 00:00:40.201 and being were an ear, 00:00:40.201 --> 00:00:44.069 and I, and silence, some strange race wrecked 00:00:44.069 --> 00:00:46.493 solitary here. 00:00:46.493 --> 00:00:49.670 Just then, a plank in reason broke, 00:00:49.670 --> 00:00:53.011 and I fell down and down 00:00:53.011 --> 00:00:55.686 and hit a world at every plunge, 00:00:55.686 --> 00:01:00.198 and finished knowing then." NOTE Paragraph 00:01:00.198 --> 00:01:03.680 We know depression through metaphors. 00:01:03.680 --> 00:01:07.389 Emily Dickinson was able to convey it in language, 00:01:07.389 --> 00:01:10.130 Goya in an image. 00:01:10.130 --> 00:01:12.113 Half the purpose of art 00:01:12.113 --> 00:01:15.997 is to describe such iconic states. NOTE Paragraph 00:01:15.997 --> 00:01:19.757 As for me, I had always thought myself tough, 00:01:19.757 --> 00:01:21.460 one of the people who could survive 00:01:21.460 --> 00:01:24.614 if I'd been sent to a concentration camp. NOTE Paragraph 00:01:24.614 --> 00:01:27.497 In 1991, I had a series of losses. 00:01:27.497 --> 00:01:29.198 My mother died, 00:01:29.198 --> 00:01:31.324 a relationship I'd been in ended, 00:01:31.324 --> 00:01:33.167 I moved back to the United States 00:01:33.167 --> 00:01:35.268 from some years abroad, 00:01:35.268 --> 00:01:38.556 and I got through all of those experiences intact. NOTE Paragraph 00:01:38.556 --> 00:01:41.539 But in 1994, three years later, 00:01:41.539 --> 00:01:45.932 I found myself losing interest in almost everything. 00:01:45.932 --> 00:01:47.577 I didn't want to do any of the things 00:01:47.577 --> 00:01:49.959 I had previously wanted to do, 00:01:49.959 --> 00:01:51.877 and I didn't know why. 00:01:51.877 --> 00:01:53.697 The opposite of depression 00:01:53.697 --> 00:01:56.934 is not happiness, but vitality, 00:01:56.934 --> 00:01:58.429 and it was vitality 00:01:58.429 --> 00:02:02.082 that seemed to seep away from me in that moment. 00:02:02.082 --> 00:02:04.237 Everything there was to do 00:02:04.237 --> 00:02:06.411 seemed like too much work. 00:02:06.411 --> 00:02:08.058 I would come home 00:02:08.058 --> 00:02:11.440 and I would see the red light flashing on my answering machine, 00:02:11.440 --> 00:02:13.585 and instead of being thrilled to hear from my friends, 00:02:13.585 --> 00:02:15.133 I would think, 00:02:15.133 --> 00:02:18.368 "What a lot of people that is to have to call back." 00:02:18.368 --> 00:02:20.755 Or I would decide I should have lunch, 00:02:20.755 --> 00:02:23.301 and then I would think that I'd have to get the food out 00:02:23.301 --> 00:02:25.340 and put it on a plate 00:02:25.340 --> 00:02:29.389 and cut it up and chew it and swallow it, 00:02:29.389 --> 00:02:33.090 and it felt to me like the Stations of the Cross. NOTE Paragraph 00:02:33.090 --> 00:02:35.541 And one of the things that often gets lost 00:02:35.541 --> 00:02:37.443 in discussions of depression 00:02:37.443 --> 00:02:39.801 is that you know it's ridiculous. 00:02:39.801 --> 00:02:42.537 You know it's ridiculous while you're experiencing it. 00:02:42.537 --> 00:02:44.681 You know that most people manage 00:02:44.681 --> 00:02:46.995 to listen to their messages and eat lunch 00:02:46.995 --> 00:02:48.907 and organize themselves to take a shower 00:02:48.907 --> 00:02:50.167 and go out the front door 00:02:50.167 --> 00:02:51.644 and that it's not a big deal, 00:02:51.644 --> 00:02:55.001 and yet you are nonetheless in its grip 00:02:55.001 --> 00:02:59.276 and you are unable to figure out any way around it. 00:02:59.276 --> 00:03:03.236 And so I began to feel myself doing less 00:03:03.236 --> 00:03:05.126 and thinking less 00:03:05.126 --> 00:03:07.802 and feeling less. 00:03:07.802 --> 00:03:10.142 It was a kind of nullity. NOTE Paragraph 00:03:10.142 --> 00:03:12.647 And then the anxiety set in. 00:03:12.647 --> 00:03:14.694 If you told me that I'd have to be 00:03:14.694 --> 00:03:16.454 depressed for the next month, 00:03:16.454 --> 00:03:19.692 I would say, "As long I know it'll be over in November, I can do it." 00:03:19.692 --> 00:03:21.440 But if you said to me, 00:03:21.440 --> 00:03:24.940 "You have to have acute anxiety for the next month," 00:03:24.940 --> 00:03:26.450 I would rather slit my wrist than go through it. 00:03:26.450 --> 00:03:28.263 It was the feeling all the time 00:03:28.263 --> 00:03:30.399 like that feeling you have if you're walking 00:03:30.399 --> 00:03:31.956 and you slip or trip 00:03:31.956 --> 00:03:33.855 and the ground is rushing up at you, 00:03:33.855 --> 00:03:36.512 but instead of lasting half a second, the way that does, 00:03:36.512 --> 00:03:38.542 it lasted for six months. 00:03:38.542 --> 00:03:41.328 It's a sensation of being afraid all the time 00:03:41.328 --> 00:03:45.242 but not even knowing what it is that you're afraid of. 00:03:45.242 --> 00:03:47.539 And it was at that point that I began to think 00:03:47.539 --> 00:03:51.707 that it was just too painful to be alive, 00:03:51.707 --> 00:03:54.168 and that the only reason not to kill oneself 00:03:54.168 --> 00:03:57.531 was so as not to hurt other people. NOTE Paragraph 00:03:57.531 --> 00:04:00.400 And finally one day, I woke up 00:04:00.400 --> 00:04:02.347 and I thought perhaps I'd had a stroke, 00:04:02.347 --> 00:04:04.986 because I lay in bed completely frozen, 00:04:04.986 --> 00:04:07.430 looking at the telephone, thinking, 00:04:07.430 --> 00:04:10.559 "Something is wrong and I should call for help," 00:04:10.559 --> 00:04:12.340 and I couldn't reach out my arm 00:04:12.340 --> 00:04:14.772 and pick up the phone and dial. 00:04:14.772 --> 00:04:18.911 And finally, after four full hours of my lying and staring at it, 00:04:18.911 --> 00:04:20.395 the phone rang, 00:04:20.395 --> 00:04:22.351 and somehow I managed to pick it up, 00:04:22.351 --> 00:04:24.136 and it was my father, 00:04:24.136 --> 00:04:27.550 and I said, "I'm in serious trouble. 00:04:27.550 --> 00:04:29.652 We need to do something." NOTE Paragraph 00:04:29.652 --> 00:04:32.903 The next day I started with the medications 00:04:32.903 --> 00:04:35.578 and the therapy. 00:04:35.578 --> 00:04:37.855 And I also started reckoning 00:04:37.855 --> 00:04:39.657 with this terrible question: 00:04:39.657 --> 00:04:41.730 if I'm not the tough person 00:04:41.730 --> 00:04:44.116 who could have made it through a concentration camp, 00:04:44.116 --> 00:04:45.879 then who am I? 00:04:45.879 --> 00:04:47.736 And I have to take medication, 00:04:47.736 --> 00:04:51.151 is that medication making me more fully myself, 00:04:51.151 --> 00:04:53.831 or is it making me someone else? 00:04:53.831 --> 00:04:55.558 And how do I feel about it 00:04:55.558 --> 00:04:58.189 if it's making me someone else? NOTE Paragraph 00:04:58.189 --> 00:05:01.470 I had two advantages as I went in to the fight. 00:05:01.470 --> 00:05:04.357 The first is that I knew that objectively speaking, 00:05:04.357 --> 00:05:06.810 I had a nice life, 00:05:06.810 --> 00:05:07.988 and that if I could only get well, 00:05:07.988 --> 00:05:09.503 there was something at the other end 00:05:09.503 --> 00:05:11.180 that was worth living for. 00:05:11.180 --> 00:05:14.222 And the other was that I had access to good treatment. NOTE Paragraph 00:05:14.222 --> 00:05:17.986 But I nonetheless emerged and relapsed, 00:05:17.986 --> 00:05:20.311 and emerged and relapsed, 00:05:20.311 --> 00:05:23.386 and emerged and relapsed, 00:05:23.386 --> 00:05:25.231 and finally understood 00:05:25.231 --> 00:05:27.552 I would have to be on medication 00:05:27.552 --> 00:05:29.832 and in therapy forever. 00:05:29.832 --> 00:05:32.160 And I thought, "But is it a chemical problem 00:05:32.160 --> 00:05:33.970 or a psychological problem? 00:05:33.970 --> 00:05:37.559 And does it need a chemical cure or a philosophical cure?" 00:05:37.559 --> 00:05:39.741 And I couldn't figure out which it was. 00:05:39.741 --> 00:05:41.895 And then I understood that actually, 00:05:41.895 --> 00:05:44.246 we aren't advanced enough in either area 00:05:44.246 --> 00:05:46.152 for it to explain things fully. 00:05:46.152 --> 00:05:49.492 The chemical cure and the psychological cure 00:05:49.492 --> 00:05:51.216 both have a role to play, 00:05:51.216 --> 00:05:54.606 and I also figured out that depression was something 00:05:54.606 --> 00:05:57.416 that was braided so deep into us 00:05:57.416 --> 00:05:59.143 that there was no separating it 00:05:59.143 --> 00:06:01.583 from our character and personality. NOTE Paragraph 00:06:01.583 --> 00:06:03.569 I want to say that the treatments we have 00:06:03.569 --> 00:06:06.175 for depression are appalling. 00:06:06.175 --> 00:06:07.927 They're not very effective. 00:06:07.927 --> 00:06:09.850 They're extremely costly. 00:06:09.850 --> 00:06:12.361 They come with innumerable side effects. 00:06:12.361 --> 00:06:14.890 They're a disaster. 00:06:14.890 --> 00:06:17.660 But I am so grateful that I live now 00:06:17.660 --> 00:06:18.823 and not 50 years ago, 00:06:18.823 --> 00:06:20.303 when there would have been almost nothing 00:06:20.303 --> 00:06:21.982 to be done. 00:06:21.982 --> 00:06:24.870 I hope that 50 years hence, 00:06:24.870 --> 00:06:26.250 people will hear about my treatments 00:06:26.250 --> 00:06:28.168 and be appalled that anyone endured 00:06:28.168 --> 00:06:30.826 such primitive science. NOTE Paragraph 00:06:30.826 --> 00:06:35.473 Depression is the flaw in love. 00:06:35.473 --> 00:06:38.768 If you were married to someone and thought, 00:06:38.768 --> 00:06:42.485 "Well, if my wife dies, I'll find another one," 00:06:42.485 --> 00:06:45.347 it wouldn't be love as we know it. 00:06:45.347 --> 00:06:47.375 There's no such thing as love 00:06:47.375 --> 00:06:50.510 without the anticipation of loss, 00:06:50.510 --> 00:06:52.632 and that specter of despair 00:06:52.632 --> 00:06:56.423 can be the engine of intimacy. NOTE Paragraph 00:06:56.423 --> 00:06:58.983 There are three things people tend to confuse: 00:06:58.983 --> 00:07:02.952 depression, grief, and sadness. 00:07:02.952 --> 00:07:06.285 Grief is explicitly reactive. 00:07:06.285 --> 00:07:09.320 If you have a loss and you feel incredibly unhappy, 00:07:09.320 --> 00:07:11.400 and then, six months later, 00:07:11.400 --> 00:07:14.760 you are still deeply sad, but you're functioning a little better, 00:07:14.760 --> 00:07:15.903 it's probably grief, 00:07:15.903 --> 00:07:18.210 and it will probably ultimately resolve itself 00:07:18.210 --> 00:07:19.736 in some measure. 00:07:19.736 --> 00:07:22.381 If you experience a catastrophic loss, 00:07:22.381 --> 00:07:23.748 and you feel terrible, 00:07:23.748 --> 00:07:26.560 and six months later, you can barely function at all, 00:07:26.560 --> 00:07:29.900 then it's probably a depression that was triggered 00:07:29.900 --> 00:07:31.696 by the catastrophic circumstances. 00:07:31.696 --> 00:07:35.343 The trajectory tells us a great deal. 00:07:35.343 --> 00:07:38.624 People think of depression as being just sadness. 00:07:38.624 --> 00:07:40.899 It's much, much too much sadness, 00:07:40.899 --> 00:07:42.563 much too much grief 00:07:42.563 --> 00:07:45.568 at far too slight a cause. NOTE Paragraph 00:07:45.568 --> 00:07:48.346 As I set out to understand depression, 00:07:48.346 --> 00:07:51.920 and to interview people who had experienced it, 00:07:51.920 --> 00:07:53.397 I found that there were people who seemed 00:07:53.397 --> 00:07:55.565 on the surface to have what sounded like 00:07:55.565 --> 00:07:57.749 relatively mild depression 00:07:57.749 --> 00:08:01.150 who were nonetheless utterly disabled by it. 00:08:01.150 --> 00:08:03.870 And there were other people who had what sounded 00:08:03.870 --> 00:08:04.643 as they described it 00:08:04.643 --> 00:08:06.786 like terribly severe depression 00:08:06.786 --> 00:08:09.678 who nonetheless had good lives in the intercesses 00:08:09.678 --> 00:08:11.879 between their depressive episodes. 00:08:11.879 --> 00:08:14.426 And I set out to find out what it is 00:08:14.426 --> 00:08:15.982 that causes some people 00:08:15.982 --> 00:08:18.343 to be more resilient than other people. 00:08:18.343 --> 00:08:19.810 What are the mechanisms 00:08:19.810 --> 00:08:21.654 that allow people to survive? 00:08:21.654 --> 00:08:25.270 And I went out and interviewed person after person 00:08:25.270 --> 00:08:27.105 who was suffering with depression. NOTE Paragraph 00:08:27.105 --> 00:08:28.949 One of the first people I interviewed 00:08:28.949 --> 00:08:30.646 described depression 00:08:30.646 --> 00:08:34.860 as a slower way of being dead, 00:08:34.860 --> 00:08:36.338 and that was a good thing for me to hear early on 00:08:36.338 --> 00:08:37.766 because it reminded me 00:08:37.766 --> 00:08:39.642 that that slow way of being dead 00:08:39.642 --> 00:08:41.646 can lead to actual deadness, 00:08:41.646 --> 00:08:43.695 that this is a serious business. 00:08:43.695 --> 00:08:46.510 It's the leading disability worldwide, 00:08:46.510 --> 00:08:49.354 and people die of it every day. NOTE Paragraph 00:08:49.354 --> 00:08:51.339 One of the people I talked to 00:08:51.339 --> 00:08:53.620 when I was trying to understand this 00:08:53.620 --> 00:08:54.826 was a beloved friend 00:08:54.826 --> 00:08:56.798 who I had known for many years, 00:08:56.798 --> 00:08:59.248 and who had had a psychotic episode 00:08:59.248 --> 00:09:01.213 in her freshman year of college, 00:09:01.213 --> 00:09:04.300 and then plummeted into a horrific depression. 00:09:04.300 --> 00:09:05.818 She had bipolar illness, 00:09:05.818 --> 00:09:08.940 or manic depression, as it was then known. 00:09:08.940 --> 00:09:10.382 And then she did very well 00:09:10.382 --> 00:09:12.830 for many years on lithium, 00:09:12.830 --> 00:09:13.574 and then eventually, 00:09:13.574 --> 00:09:15.349 she was taken off her lithium 00:09:15.349 --> 00:09:17.230 to see how she would do without it, 00:09:17.230 --> 00:09:19.620 and she had another psychosis, 00:09:19.620 --> 00:09:21.496 and then plunged into the worst depression 00:09:21.496 --> 00:09:23.430 that I had ever seen 00:09:23.430 --> 00:09:26.200 in which she sat in her parents' apartment, 00:09:26.200 --> 00:09:29.630 more or less catatonic, essentially without moving, 00:09:29.630 --> 00:09:32.420 day after day after day. 00:09:32.420 --> 00:09:35.452 And when I interviewed her about that experience some years later 00:09:35.452 --> 00:09:38.430 — she's a poet and psychotherapist named Maggie Robbins — 00:09:38.430 --> 00:09:41.247 when I interviewed her, she said, 00:09:41.247 --> 00:09:45.600 "I was singing 'Where Have All The Flowers Gone' 00:09:45.600 --> 00:09:48.487 over and over to occupy my mind. 00:09:48.487 --> 00:09:51.638 I was singing to blot out the things my mind was saying, 00:09:51.638 --> 00:09:56.143 which were, 'You are nothing. You are nobody. 00:09:56.143 --> 00:09:58.569 You don't even deserve to live.' 00:09:58.569 --> 00:10:00.978 And that was when I really started thinking 00:10:00.978 --> 00:10:03.313 about killing myself." NOTE Paragraph 00:10:03.313 --> 00:10:05.252 You don't think in depression 00:10:05.252 --> 00:10:07.127 that you've put on a grey veil 00:10:07.127 --> 00:10:09.231 and are seeing the world through the haze 00:10:09.231 --> 00:10:11.109 of a bad mood. 00:10:11.109 --> 00:10:13.983 You think that the veil has been taken away, 00:10:13.983 --> 00:10:15.828 the veil of happiness, 00:10:15.828 --> 00:10:18.360 and that now you're seeing truly. 00:10:18.360 --> 00:10:21.155 It's easier to help schizophrenics who perceive 00:10:21.155 --> 00:10:23.212 that there's something foreign inside of them 00:10:23.212 --> 00:10:25.800 that needs to be exorcised, 00:10:25.800 --> 00:10:27.810 but it's difficult with depressives, 00:10:27.810 --> 00:10:31.287 because we believe we are seeing the truth. NOTE Paragraph 00:10:31.287 --> 00:10:34.005 But the truth lies. 00:10:34.005 --> 00:10:36.940 I became obsessed with that sentence. 00:10:36.940 --> 00:10:38.531 "But the truth lies." 00:10:38.531 --> 00:10:40.814 And I discovered, as I talked to depressive people, 00:10:40.814 --> 00:10:43.665 that they have many delusional perceptions. 00:10:43.665 --> 00:10:45.393 People will say, "No one loves me." 00:10:45.393 --> 00:10:47.230 And you say, "I love you, 00:10:47.230 --> 00:10:49.475 your wife loves you, your mother loves you." 00:10:49.475 --> 00:10:51.520 You can answer that one pretty readily, 00:10:51.520 --> 00:10:53.247 at least for most people. 00:10:53.247 --> 00:10:55.253 But people who are depressed will also say, 00:10:55.253 --> 00:10:57.480 "No matter what we do, 00:10:57.480 --> 00:10:59.230 we're all just going to die in the end." 00:10:59.230 --> 00:11:01.541 Or they'll say, "There can be no true communion 00:11:01.541 --> 00:11:03.224 between two human beings. 00:11:03.224 --> 00:11:05.893 Each of us is trapped in his own body." 00:11:05.893 --> 00:11:07.573 To which you have to say, 00:11:07.573 --> 00:11:09.047 "That's true, 00:11:09.047 --> 00:11:10.881 but I think we should focus right now 00:11:10.881 --> 00:11:12.777 on what to have for breakfast." 00:11:12.777 --> 00:11:14.746 (Laughter) 00:11:14.746 --> 00:11:16.538 A lot of the time, 00:11:16.538 --> 00:11:19.250 what they are expressing is not illness, but insight, 00:11:19.250 --> 00:11:21.877 and one comes to think what's really extraordinary 00:11:21.877 --> 00:11:24.949 is that most of us know about those existential questions 00:11:24.949 --> 00:11:27.347 and they don't distract us very much. 00:11:27.347 --> 00:11:29.521 There was a study I particularly liked 00:11:29.521 --> 00:11:31.170 in which a group of depressed 00:11:31.170 --> 00:11:32.995 and a group of non-depressed people 00:11:32.995 --> 00:11:35.755 were asked to play a video game for an hour, 00:11:35.755 --> 00:11:37.584 and at the end of the hour, 00:11:37.584 --> 00:11:39.189 they were asked how many little monsters 00:11:39.189 --> 00:11:40.960 they thought they had killed. 00:11:40.960 --> 00:11:43.218 The depressive group was usually accurate 00:11:43.218 --> 00:11:45.169 to within about 10 percent, 00:11:45.169 --> 00:11:46.548 and the non-depressed people 00:11:46.548 --> 00:11:49.878 guessed between 15 and 20 times as many 00:11:49.878 --> 00:11:51.988 little monsters — (Laughter) — 00:11:51.988 --> 00:11:55.993 as they had actually killed. NOTE Paragraph 00:11:55.993 --> 00:11:59.150 A lot of people said, when I chose to write about my depression, 00:11:59.150 --> 00:12:00.919 that it must be very difficult 00:12:00.919 --> 00:12:04.520 to be out of that closet, to have people know. 00:12:04.520 --> 00:12:06.890 They said, "Do people talk to you differently?" 00:12:06.890 --> 00:12:08.300 And I said, "Yes, people talk to me differently. 00:12:08.300 --> 00:12:10.183 They talk to me differently insofar 00:12:10.183 --> 00:12:13.204 as they start telling me about their experience, 00:12:13.204 --> 00:12:14.900 or their sister's experience, 00:12:14.900 --> 00:12:16.736 or their friend's experience. 00:12:16.736 --> 00:12:18.981 Things are different because now I know 00:12:18.981 --> 00:12:21.463 that depression is the family secret 00:12:21.463 --> 00:12:23.816 that everyone has. NOTE Paragraph 00:12:23.816 --> 00:12:26.906 I went a few years ago to a conference, 00:12:26.906 --> 00:12:30.760 and on Friday of the three day conference, 00:12:30.760 --> 00:12:32.558 one of the participants took me aside, and she said, 00:12:32.558 --> 00:12:35.886 "I suffer from depression and 00:12:35.886 --> 00:12:39.101 I'm a little embarrassed about it, 00:12:39.101 --> 00:12:41.142 but I've been taking this medication, 00:12:41.142 --> 00:12:44.338 and I just wanted to ask you what you think?" 00:12:44.338 --> 00:12:46.895 And so I did my best to give her such advice as I could. 00:12:46.895 --> 00:12:48.722 And then she said, "You know, 00:12:48.722 --> 00:12:51.528 my husband would never understand this. 00:12:51.528 --> 00:12:54.780 He's really the kind of guy to whom this wouldn't make any sense, 00:12:54.780 --> 00:12:57.630 so I just, you know, it's just between us." 00:12:57.630 --> 00:12:58.846 And I said, "Yes, that's fine." 00:12:58.846 --> 00:13:00.663 On Sunday of the same conference, 00:13:00.663 --> 00:13:03.861 her husband took me aside, 00:13:03.861 --> 00:13:05.586 and he said, "My wife wouldn't think 00:13:05.586 --> 00:13:07.943 that I was really much of a guy if she knew this, 00:13:07.943 --> 00:13:10.164 but I've been dealing with this depression 00:13:10.164 --> 00:13:11.871 and I'm taking some medication, 00:13:11.871 --> 00:13:14.376 and I wondered what you think?" 00:13:14.376 --> 00:13:15.722 They were hiding 00:13:15.722 --> 00:13:18.600 the same medication in two different places 00:13:18.600 --> 00:13:21.167 in the same bedroom. 00:13:21.167 --> 00:13:22.711 And I said that I thought 00:13:22.711 --> 00:13:24.302 communication within the marriage 00:13:24.302 --> 00:13:26.240 might be triggering some of their problems. 00:13:26.240 --> 00:13:30.646 (Laughter) 00:13:30.646 --> 00:13:32.363 But I was also struck 00:13:32.363 --> 00:13:34.400 by the burdensome nature 00:13:34.400 --> 00:13:36.650 of such mutual secrecy. 00:13:36.650 --> 00:13:37.981 Depression is so exhausting. 00:13:37.981 --> 00:13:40.841 It takes up so much of your time and energy, 00:13:40.841 --> 00:13:42.560 and silence about it, 00:13:42.560 --> 00:13:45.153 it really does make the depression worse. NOTE Paragraph 00:13:45.153 --> 00:13:46.870 And then I began thinking about all the ways 00:13:46.870 --> 00:13:48.944 people make themselves better. 00:13:48.944 --> 00:13:51.367 I'd started off as a medical conservative. 00:13:51.367 --> 00:13:53.693 I thought there were a few kinds of therapy that worked, 00:13:53.693 --> 00:13:55.442 it was clear what they were, 00:13:55.442 --> 00:13:57.224 there was medication, 00:13:57.224 --> 00:13:58.807 there were certain psychotherapies, 00:13:58.807 --> 00:14:00.976 there was possibly electro-convulsive treatment, 00:14:00.976 --> 00:14:03.820 and that everything else was nonsense. 00:14:03.820 --> 00:14:05.682 But then I discovered something. 00:14:05.682 --> 00:14:07.326 If you have brain cancer, 00:14:07.326 --> 00:14:08.798 and you say that standing on your head 00:14:08.798 --> 00:14:11.655 for 20 minutes every morning makes you feel better, 00:14:11.655 --> 00:14:13.323 it may make you feel better, 00:14:13.323 --> 00:14:14.926 but you still have brain cancer, 00:14:14.926 --> 00:14:17.169 and you'll still probably die from it. 00:14:17.169 --> 00:14:19.543 But if you say that you have depression, 00:14:19.543 --> 00:14:21.802 and standing on your head for 20 minutes every day 00:14:21.802 --> 00:14:24.147 makes you feel better, then it's worked, 00:14:24.147 --> 00:14:26.707 because depression is an illness of how you feel, 00:14:26.707 --> 00:14:28.316 and if you feel better, 00:14:28.316 --> 00:14:31.100 then you are effectively not depressed anymore. 00:14:31.100 --> 00:14:32.994 So I became much more tolerant 00:14:32.994 --> 00:14:35.766 of the vast world of alternative treatments. NOTE Paragraph 00:14:35.766 --> 00:14:38.351 And I get letters, I get hundreds of letters 00:14:38.351 --> 00:14:40.789 from people writing to tell me about what's worked for them. 00:14:40.789 --> 00:14:43.560 Someone was asking me backstage today 00:14:43.560 --> 00:14:44.652 about meditation. 00:14:44.652 --> 00:14:46.964 My favorite of the letters that I got 00:14:46.964 --> 00:14:48.531 was the one that came from a woman 00:14:48.531 --> 00:14:50.559 who wrote and said that she had tried therapy, 00:14:50.559 --> 00:14:51.955 she had tried medication, 00:14:51.955 --> 00:14:53.340 she had tried pretty much everything, 00:14:53.340 --> 00:14:56.700 and she had found a solution and hoped I would tell the world, 00:14:56.700 --> 00:14:59.804 and that was making little things from yarn. 00:14:59.804 --> 00:15:02.911 (Laughter) 00:15:02.911 --> 00:15:05.913 She sent me some of them. (Laughter) 00:15:05.913 --> 00:15:10.155 And I'm not wearing them right now. 00:15:10.155 --> 00:15:12.100 I suggested to her that she also should look up 00:15:12.100 --> 00:15:17.101 obsessive compulsive disorder in the DSM. NOTE Paragraph 00:15:17.101 --> 00:15:19.752 And yet, when I went to look at alternative treatments, 00:15:19.752 --> 00:15:22.598 I also gained perspective on other treatments. 00:15:22.598 --> 00:15:25.748 I went through a tribal exorcism in Senegal 00:15:25.748 --> 00:15:27.422 that involved a great deal of ram's blood 00:15:27.422 --> 00:15:29.422 and that I'm not going to detail right now, 00:15:29.422 --> 00:15:31.422 but a few years afterward I was in Rwanda 00:15:31.422 --> 00:15:33.304 working on a different project, 00:15:33.304 --> 00:15:36.580 and I happened to describe my experience to someone, 00:15:36.580 --> 00:15:37.523 and he said, "Well, you know, 00:15:37.523 --> 00:15:39.633 that's West Africa, and we're in East Africa, 00:15:39.633 --> 00:15:41.652 and our rituals are in some ways very different, 00:15:41.652 --> 00:15:43.542 but we do have some rituals that have something 00:15:43.542 --> 00:15:45.544 in common with what you're describing." 00:15:45.544 --> 00:15:47.301 And I said, "Oh." And he said, "Yes," he said, 00:15:47.301 --> 00:15:49.895 "but we've had a lot of trouble with Western mental health workers, 00:15:49.895 --> 00:15:52.484 especially the ones who came right after the genocide." 00:15:52.484 --> 00:15:54.795 And I said, "What kind of trouble did you have?" 00:15:54.795 --> 00:15:56.587 And he said, "Well," he said, 00:15:56.587 --> 00:15:59.113 "They would do this bizarre thing." 00:15:59.113 --> 00:16:00.982 He said, "They didn't take people out in the sunshine 00:16:00.982 --> 00:16:02.698 where you begin to feel better. 00:16:02.698 --> 00:16:04.315 They didn't include drumming or music 00:16:04.315 --> 00:16:05.810 to get people's blood going. 00:16:05.810 --> 00:16:07.680 They didn't involve the whole community. 00:16:07.680 --> 00:16:09.409 They didn't externalize the depression 00:16:09.409 --> 00:16:11.120 as an invasive spirit. 00:16:11.120 --> 00:16:13.150 Instead what they did was they took people 00:16:13.150 --> 00:16:15.966 one at a time into dingy little rooms 00:16:15.966 --> 00:16:17.552 and had them talk for an hour 00:16:17.552 --> 00:16:19.550 about bad things that had happened to them." 00:16:19.550 --> 00:16:25.410 (Laughter) (Applause) 00:16:25.410 --> 00:16:27.358 He said, "We had to ask them to leave the country." 00:16:27.358 --> 00:16:30.477 (Laughter) NOTE Paragraph 00:16:30.477 --> 00:16:32.982 Now at the other end of alternative treatments, 00:16:32.982 --> 00:16:35.155 let me tell you about Frank Roussekoff. 00:16:35.155 --> 00:16:37.978 Frank Roussekoff had the worst depression 00:16:37.978 --> 00:16:41.600 perhaps that I've ever seen in a man. 00:16:41.600 --> 00:16:43.270 He was constantly depressed. 00:16:43.270 --> 00:16:44.842 He was, when I met him, at a point at which 00:16:44.842 --> 00:16:48.322 every month he would have electroshock treatment. 00:16:48.322 --> 00:16:50.913 Then he would feel sort of disoriented for a week. 00:16:50.913 --> 00:16:52.700 Then he would feel okay for a week. 00:16:52.700 --> 00:16:54.677 Then he would have a week of going downhill. 00:16:54.677 --> 00:16:57.610 And then he would have another electroshock treatment. 00:16:57.610 --> 00:16:58.700 And he said to me when I met him, 00:16:58.700 --> 00:17:01.160 "It's unbearable to go through my weeks this way. 00:17:01.160 --> 00:17:02.729 I can't go on this way, 00:17:02.729 --> 00:17:04.963 and I've figured out how I'm going to end it 00:17:04.963 --> 00:17:06.550 if I don't get better. 00:17:06.550 --> 00:17:08.782 But," he said to me, "I heard about a protocol 00:17:08.782 --> 00:17:11.220 at Mass General for a procedure called 00:17:11.220 --> 00:17:13.430 a cingulotomy, which is a brain surgery, 00:17:13.430 --> 00:17:16.340 and I think I'm going to give that a try." 00:17:16.340 --> 00:17:17.955 And I remember being amazed at that point 00:17:17.955 --> 00:17:19.302 to think that someone 00:17:19.302 --> 00:17:22.429 who clearly had so many bad experiences 00:17:22.429 --> 00:17:24.350 with so many different treatments 00:17:24.350 --> 00:17:27.395 still had buried in him somewhere enough optimism 00:17:27.395 --> 00:17:29.945 to reach out for one more. 00:17:29.945 --> 00:17:32.110 And he had the a cingulotomy, 00:17:32.110 --> 00:17:34.151 and it was incredibly successful. 00:17:34.151 --> 00:17:35.767 He's now a friend of mine. 00:17:35.767 --> 00:17:38.721 He has a lovely wife and two beautiful children. 00:17:38.721 --> 00:17:42.100 He wrote me a letter the Christmas after the surgery, 00:17:42.100 --> 00:17:43.304 and he said, 00:17:43.304 --> 00:17:45.758 "My father sent me two presents this year, 00:17:45.758 --> 00:17:48.114 First, a motorized CD rack from The Sharper Image 00:17:48.114 --> 00:17:49.750 that I didn't really need, 00:17:49.750 --> 00:17:51.555 but I knew he was giving it to me to celebrate 00:17:51.555 --> 00:17:53.498 the fact that I'm living on my own 00:17:53.498 --> 00:17:55.684 and have a job I seem to love. 00:17:55.684 --> 00:17:57.460 And the other present 00:17:57.460 --> 00:17:58.851 was a photo of my grandmother, 00:17:58.851 --> 00:18:00.781 who committed suicide. 00:18:00.781 --> 00:18:03.839 As I unwrapped it, I began to cry, 00:18:03.839 --> 00:18:05.795 and my mother came over and said, 00:18:05.795 --> 00:18:08.680 'Are you crying because of the relatives you never knew?' 00:18:08.680 --> 00:18:13.260 And I said, 'She had the same disease I have.' 00:18:13.260 --> 00:18:15.948 I'm crying now as I write to you. 00:18:15.948 --> 00:18:19.990 It's not that I'm so sad, but I get overwhelmed, 00:18:19.990 --> 00:18:21.364 I think, because I could have killed myself, 00:18:21.364 --> 00:18:23.344 but my parents kept me going, 00:18:23.344 --> 00:18:25.740 and so did the doctors, 00:18:25.740 --> 00:18:26.916 and I had the surgery. 00:18:26.916 --> 00:18:29.240 I'm alive and grateful. 00:18:29.240 --> 00:18:31.362 We live in the right time, 00:18:31.362 --> 00:18:35.917 even if it doesn't always feel like it." NOTE Paragraph 00:18:35.917 --> 00:18:37.752 I was struck by the fact that depression 00:18:37.752 --> 00:18:39.446 is broadly perceived to be 00:18:39.446 --> 00:18:43.830 a modern, Western, middle class thing, 00:18:43.830 --> 00:18:45.289 and I went to look at how it operated 00:18:45.289 --> 00:18:47.200 in a variety of other contexts, 00:18:47.200 --> 00:18:49.720 and one of the things I was most interested in 00:18:49.720 --> 00:18:51.170 was depression among the indigent. 00:18:51.170 --> 00:18:53.290 And so I went out to try to look at what was 00:18:53.290 --> 00:18:55.501 being done for poor people with depression. 00:18:55.501 --> 00:18:57.566 And what I discovered is that poor people 00:18:57.566 --> 00:19:00.200 are mostly not being treated for depression. 00:19:00.200 --> 00:19:03.120 Depression is the result of a genetic vulnerability, 00:19:03.120 --> 00:19:06.246 which is presumably evenly distributed in the population, 00:19:06.246 --> 00:19:08.153 and triggering circumstances, 00:19:08.153 --> 00:19:10.780 which are likely to be more severe 00:19:10.780 --> 00:19:11.931 for people who are impoverished. 00:19:11.931 --> 00:19:14.174 And yet it turns out that if you have 00:19:14.174 --> 00:19:16.576 a really lovely life but feel miserable all the time, 00:19:16.576 --> 00:19:18.576 you think, "Why do I feel like this? 00:19:18.576 --> 00:19:20.260 I must have depression." 00:19:20.260 --> 00:19:22.213 And you set out to find treatment for it. 00:19:22.213 --> 00:19:24.276 But if you have a perfectly awful life, 00:19:24.276 --> 00:19:26.790 and you feel miserable all the time, 00:19:26.790 --> 00:19:28.955 the way you feel is commensurate with your life, 00:19:28.955 --> 00:19:30.677 and it doesn't occur to you to think, 00:19:30.677 --> 00:19:32.384 "Maybe this is treatable." 00:19:32.384 --> 00:19:35.504 And so we have an epidemic in this country 00:19:35.504 --> 00:19:38.372 of depression among impoverished people 00:19:38.372 --> 00:19:41.114 that's not being picked up and that's not being treated 00:19:41.114 --> 00:19:42.832 and that's not being addressed, 00:19:42.832 --> 00:19:45.248 and it's a tragedy of a grand order. 00:19:45.248 --> 00:19:46.858 And so I found an academic 00:19:46.858 --> 00:19:48.522 who was doing a research project 00:19:48.522 --> 00:19:50.449 in slums outside of D.C., 00:19:50.449 --> 00:19:53.259 where she picked up women who had come in for other health problems 00:19:53.259 --> 00:19:55.130 and diagnosed them with depression, 00:19:55.130 --> 00:19:58.274 and then provided six months of experimental protocol. 00:19:58.274 --> 00:20:00.480 One of them, Lolly, came in, 00:20:00.480 --> 00:20:03.700 and this is what she said the day she came in. 00:20:03.700 --> 00:20:05.525 She said, and she was a woman, by the way, 00:20:05.525 --> 00:20:08.156 who had seven children. She said, 00:20:08.156 --> 00:20:10.745 "I used to have a job but I had to give it up because 00:20:10.745 --> 00:20:12.913 I couldn't go out of the house. 00:20:12.913 --> 00:20:15.203 I have nothing to say to my children. 00:20:15.203 --> 00:20:18.400 In the morning, I can't wait for them to leave, 00:20:18.400 --> 00:20:21.205 and then I climb in bed and pull the covers over my head, 00:20:21.205 --> 00:20:22.836 and three o'clock when they come home, 00:20:22.836 --> 00:20:24.606 it just comes so fast." 00:20:24.606 --> 00:20:26.692 She said, "I've been taking a lot of Tylenol, 00:20:26.692 --> 00:20:29.574 anything I can take so that I can sleep more. 00:20:29.574 --> 00:20:33.452 My husband has been telling me I'm stupid, I'm ugly. 00:20:33.452 --> 00:20:36.864 I wish I could stop the pain." NOTE Paragraph 00:20:36.864 --> 00:20:39.474 Well, she was brought into this experimental protocol, 00:20:39.474 --> 00:20:41.720 and when I interviewed her six months later, 00:20:41.720 --> 00:20:46.252 she had taken a job working in child care 00:20:46.252 --> 00:20:50.117 for the U.S. Navy, she had left the abusive husband, 00:20:50.117 --> 00:20:51.939 and she said to me, 00:20:51.939 --> 00:20:54.461 "My kids are so much happier now." 00:20:54.461 --> 00:20:56.377 She said, "There's one room in my new place 00:20:56.377 --> 00:20:59.600 for the boys and one room for the girls, 00:20:59.600 --> 00:21:01.200 but at night, they're just all up on my bed, 00:21:01.200 --> 00:21:03.812 and we're doing homework all together and everything. 00:21:03.812 --> 00:21:05.717 One of them wants to be a preacher, 00:21:05.717 --> 00:21:07.723 one of them wants to be a firefighter, 00:21:07.723 --> 00:21:10.550 and one of the girls says she's going to be a lawyer. 00:21:10.550 --> 00:21:12.510 They don't cry like they used to, 00:21:12.510 --> 00:21:14.837 and they don't fight like they did. 00:21:14.837 --> 00:21:18.863 That's all I need now is my kids. 00:21:18.863 --> 00:21:20.852 Things keep on changing, 00:21:20.852 --> 00:21:26.460 the way I dress, the way I feel, the way I act. 00:21:26.460 --> 00:21:29.885 I can go outside not being afraid anymore, 00:21:29.885 --> 00:21:33.125 and I don't think those bad feelings are coming back, 00:21:33.125 --> 00:21:36.114 and if it weren't for Dr. Miranda and that, 00:21:36.114 --> 00:21:39.471 I would still be at home with the covers pulled over my head, 00:21:39.471 --> 00:21:42.157 if I were still alive at all. 00:21:42.157 --> 00:21:45.766 I asked the Lord to send me an angel, 00:21:45.766 --> 00:21:49.281 and he heard my prayers." NOTE Paragraph 00:21:50.467 --> 00:21:53.605 I was really moved by these experiences, 00:21:53.605 --> 00:21:56.560 and I decided that I wanted to write about them 00:21:56.560 --> 00:21:57.555 not only in a book I was working on, 00:21:57.555 --> 00:21:58.957 but also in an article, 00:21:58.957 --> 00:22:01.850 and so I got a commission from "The New York Times Magazine" 00:22:01.850 --> 00:22:03.264 to write about depression among the indigent. NOTE Paragraph 00:22:03.264 --> 00:22:04.848 And I turned in my story, 00:22:04.848 --> 00:22:06.444 and my editor called me and said, 00:22:06.444 --> 00:22:08.387 "We really can't publish this." NOTE Paragraph 00:22:08.387 --> 00:22:09.783 And I said, "Why not?" NOTE Paragraph 00:22:09.783 --> 00:22:12.241 And she said, "It just is too far-fetched. 00:22:12.241 --> 00:22:15.818 These people who are sort of at the very bottom rung of society 00:22:15.818 --> 00:22:17.784 and then they get a few months of treatment 00:22:17.784 --> 00:22:20.277 and they're virtually ready to run Morgan Stanley? 00:22:20.277 --> 00:22:22.209 It's just too implausible." 00:22:22.209 --> 00:22:24.290 She said, I've never even heard of anything like it." NOTE Paragraph 00:22:24.290 --> 00:22:26.793 And I said, "The fact that you've never heard of it 00:22:26.793 --> 00:22:29.809 is an indication that it is news." 00:22:29.809 --> 00:22:35.696 (Laughter) (Applause) 00:22:37.165 --> 00:22:40.150 "And you are a news magazine." NOTE Paragraph 00:22:40.150 --> 00:22:42.270 So after a certain amount of negotiation, 00:22:42.270 --> 00:22:43.512 they agreed to it. 00:22:43.512 --> 00:22:44.973 But I think a lot of what they said 00:22:44.973 --> 00:22:47.144 was connected in some strange way 00:22:47.144 --> 00:22:49.302 to this distaste that people still have 00:22:49.302 --> 00:22:50.811 for the idea of treatment, 00:22:50.811 --> 00:22:52.616 the notion that somehow if we went out 00:22:52.616 --> 00:22:55.312 and treated a lot of people in indigent communities, 00:22:55.312 --> 00:22:57.272 that would be an exploitative thing to do, 00:22:57.272 --> 00:22:58.960 because we would be changing them. 00:22:58.960 --> 00:23:01.470 There is this false moral imperative 00:23:01.470 --> 00:23:02.813 that seems to be all around us 00:23:02.813 --> 00:23:05.260 that treatment of depression, 00:23:05.260 --> 00:23:07.435 the medications and so on, are an artifice, 00:23:07.435 --> 00:23:09.777 and that it's not natural. 00:23:09.777 --> 00:23:12.610 And I think that's very misguided. 00:23:12.610 --> 00:23:15.895 It would be natural for people's teeth to fall out, 00:23:15.895 --> 00:23:18.795 but there is nobody militating against toothpaste, 00:23:18.795 --> 00:23:21.709 at least not in my circles. NOTE Paragraph 00:23:21.709 --> 00:23:23.887 And people then say, "Well, but isn't depression 00:23:23.887 --> 00:23:25.994 part of what people are supposed to experience? 00:23:25.994 --> 00:23:27.874 Didn't we evolve to have depression? 00:23:27.874 --> 00:23:29.858 Isn't it part of your personality?" 00:23:29.858 --> 00:23:32.388 To which I would say, mood is adaptive. 00:23:32.388 --> 00:23:35.702 Being able to have sadness and fear 00:23:35.702 --> 00:23:37.590 and joy and pleasure 00:23:37.590 --> 00:23:39.532 and all of the other moods that we have, 00:23:39.532 --> 00:23:41.442 that's incredibly valuable. 00:23:41.442 --> 00:23:44.550 And major depression is something that happens 00:23:44.550 --> 00:23:46.685 when that system gets broken. 00:23:46.685 --> 00:23:48.387 It's maladaptive. NOTE Paragraph 00:23:48.387 --> 00:23:49.944 People will come to me and say, 00:23:49.944 --> 00:23:52.388 "I think, though, if I just stick it out for another year, 00:23:52.388 --> 00:23:54.726 I think I can just get through this." NOTE Paragraph 00:23:54.726 --> 00:23:56.998 And I always say to them, "You may get through it, 00:23:56.998 --> 00:23:59.646 but you'll never be 37 again. 00:23:59.646 --> 00:24:02.165 Life is short, and that's a whole year 00:24:02.165 --> 00:24:04.182 you're talking about giving up. 00:24:04.182 --> 00:24:05.936 Think it through." NOTE Paragraph 00:24:05.936 --> 00:24:08.751 It's a strange poverty of the English language, 00:24:08.751 --> 00:24:10.598 and indeed of many other languages, 00:24:10.598 --> 00:24:12.862 that we use this same word, "depression," 00:24:12.862 --> 00:24:14.698 to describe how a kid feels 00:24:14.698 --> 00:24:16.548 when it rains on his birthday, 00:24:16.548 --> 00:24:18.861 and to describe how somebody feels 00:24:18.861 --> 00:24:21.391 the minute before they commit suicide. NOTE Paragraph 00:24:21.391 --> 00:24:24.775 People say to me, "Well, is it continuous with normal sadness?" 00:24:24.775 --> 00:24:27.579 And I say, in a way it's continuous with normal sadness. 00:24:27.579 --> 00:24:29.749 There is a certain amount of continuity, 00:24:29.749 --> 00:24:31.736 but it's the same way there's continuity 00:24:31.736 --> 00:24:33.738 between having an iron fence outside your house 00:24:33.738 --> 00:24:35.538 that gets a little rust spot 00:24:35.538 --> 00:24:38.192 that you have to sort of sand off and do a little repainting, 00:24:38.192 --> 00:24:40.854 and what happens if you leave the house for a hundred years 00:24:40.854 --> 00:24:43.368 and it rusts through until it's only a pile 00:24:43.368 --> 00:24:45.186 of orange dust. 00:24:45.186 --> 00:24:47.190 And it's that orange dust spot, 00:24:47.190 --> 00:24:48.979 that orange dust problem, 00:24:48.979 --> 00:24:52.231 that's the one we're setting out to address. NOTE Paragraph 00:24:52.231 --> 00:24:54.331 So now people say, 00:24:54.331 --> 00:24:57.124 "You take these happy pills, and do you feel happy?" 00:24:57.124 --> 00:24:58.779 And I don't. 00:24:58.779 --> 00:25:01.386 But I don't feel sad about having to eat lunch, 00:25:01.386 --> 00:25:04.177 and I don't feel sad about my answering machine, 00:25:04.177 --> 00:25:07.251 and I don't feel sad about taking a shower. 00:25:07.251 --> 00:25:10.106 I feel more, in fact, I think, 00:25:10.106 --> 00:25:12.660 because I can feel sadness without nullity. 00:25:12.660 --> 00:25:16.928 I feel sad about professional disappointments, 00:25:16.928 --> 00:25:19.383 about damaged relationships, 00:25:19.383 --> 00:25:21.224 about global warming. 00:25:21.224 --> 00:25:24.240 Those are the things that I feel sad about now. 00:25:24.240 --> 00:25:26.805 And I said to myself, well, what is the conclusion? 00:25:26.805 --> 00:25:29.366 How did those people who have better lives 00:25:29.366 --> 00:25:31.889 even with bigger depression manage to get through? 00:25:31.889 --> 00:25:34.425 What is the mechanism of resilience? 00:25:34.425 --> 00:25:36.662 And what I came up with over time 00:25:36.662 --> 00:25:39.255 was that the people who deny their experience, 00:25:39.255 --> 00:25:41.333 the ones who say, "I was depressed a long time ago 00:25:41.333 --> 00:25:43.256 and I never want to think about it again 00:25:43.256 --> 00:25:44.898 and I'm not going to look at it 00:25:44.898 --> 00:25:46.772 and I'm just going to get on with my life," 00:25:46.772 --> 00:25:48.653 ironically, those are the people 00:25:48.653 --> 00:25:51.259 who are most enslaved by what they have. 00:25:51.259 --> 00:25:53.761 Shutting out the depression strengthens it. 00:25:53.761 --> 00:25:57.318 While you hide from it, it grows. 00:25:57.318 --> 00:25:59.655 And the people who do better 00:25:59.655 --> 00:26:02.178 at the ones who are able to tolerate the fact 00:26:02.178 --> 00:26:04.261 that they have this condition. 00:26:04.261 --> 00:26:06.531 Those who can tolerate their depression 00:26:06.531 --> 00:26:08.544 are the ones who achieve resilience. NOTE Paragraph 00:26:08.544 --> 00:26:10.281 So Frank Roussekoff said to me, 00:26:10.281 --> 00:26:11.967 "If I had it again to do over, 00:26:11.967 --> 00:26:13.949 I suppose I wouldn't do it this way, 00:26:13.949 --> 00:26:16.500 but in a strange way, I'm grateful 00:26:16.500 --> 00:26:17.585 for what I've experienced. 00:26:17.585 --> 00:26:20.941 I'm glad to have been in the hospital 40 times. 00:26:20.941 --> 00:26:23.744 It taught me so much about love, 00:26:23.744 --> 00:26:26.661 and my relationship with my parents and my doctors 00:26:26.661 --> 00:26:30.958 has been so precious to me, and will be always." NOTE Paragraph 00:26:30.958 --> 00:26:32.960 And Maggie Robbins said, 00:26:32.960 --> 00:26:35.841 "I used to volunteer in an AIDS clinic, 00:26:35.841 --> 00:26:38.640 and I would just talk and talk and talk, 00:26:38.640 --> 00:26:40.622 and the people I was dealing with 00:26:40.622 --> 00:26:42.661 weren't very responsive, and I thought, 00:26:42.661 --> 00:26:46.635 'That's not very friendly or helpful of them.' 00:26:46.635 --> 00:26:48.492 And then I realized, 00:26:48.492 --> 00:26:50.514 I realized that they weren't going to do more 00:26:50.514 --> 00:26:52.992 than make those first few minutes of small talk. 00:26:52.992 --> 00:26:54.864 It was simply going to be an occasion 00:26:54.864 --> 00:26:57.680 where I didn't have AIDS and I wasn't dying, 00:26:57.680 --> 00:27:00.685 but could tolerate the fact that they did 00:27:00.685 --> 00:27:02.610 and they were. 00:27:02.610 --> 00:27:06.166 Our needs are our greatest assets. 00:27:06.166 --> 00:27:08.198 It turns out I've learned to give 00:27:08.198 --> 00:27:12.100 all the things I need." NOTE Paragraph 00:27:12.100 --> 00:27:14.930 Valuing one's depression 00:27:14.930 --> 00:27:16.278 does not prevent a relapse, 00:27:16.278 --> 00:27:18.861 but it may make the prospect of relapse 00:27:18.861 --> 00:27:22.694 and even relapse itself easier to tolerate. 00:27:22.694 --> 00:27:25.262 The question is not so much 00:27:25.262 --> 00:27:27.437 of finding great meaning and deciding 00:27:27.437 --> 00:27:29.371 your depression has been very meaningful. 00:27:29.371 --> 00:27:31.512 It's of seeking that meaning 00:27:31.512 --> 00:27:33.255 and thinking, when it comes again, 00:27:33.255 --> 00:27:35.880 "This will be hellish, 00:27:35.880 --> 00:27:37.657 but I will learn something from it." 00:27:37.657 --> 00:27:39.752 I have learned in my own depression 00:27:39.752 --> 00:27:41.903 how big an emotion can be, 00:27:41.903 --> 00:27:44.385 how it can be more real than facts, 00:27:44.385 --> 00:27:47.704 and I have found that that experience 00:27:47.704 --> 00:27:50.688 has allowed me to experience positive emotion 00:27:50.688 --> 00:27:54.208 in a more intense and more focused way. 00:27:54.208 --> 00:27:57.526 The opposite of depression is not happiness, 00:27:57.526 --> 00:27:59.304 but vitality, 00:27:59.304 --> 00:28:02.104 and these days, my life is vital, 00:28:02.104 --> 00:28:04.803 even on the days when I'm sad. 00:28:04.803 --> 00:28:07.963 I felt that funeral in my brain, 00:28:07.963 --> 00:28:10.480 and I sat next to the colossus 00:28:10.480 --> 00:28:11.896 at the edge of the world, 00:28:11.896 --> 00:28:14.384 and I have discovered 00:28:14.384 --> 00:28:16.328 something inside of myself 00:28:16.328 --> 00:28:18.537 that I would have to call a soul 00:28:18.537 --> 00:28:22.740 that I had never formulated until that day 20 years ago 00:28:22.740 --> 00:28:26.904 when hell came to pay me a surprise visit. 00:28:26.904 --> 00:28:30.848 I think that while I hated being depressed 00:28:30.848 --> 00:28:33.136 and would hate to be depressed again, 00:28:33.136 --> 00:28:35.496 I've found a way to love my depression. 00:28:35.496 --> 00:28:37.921 I love it because it has forced me 00:28:37.921 --> 00:28:40.704 to find and cling to joy. 00:28:40.704 --> 00:28:44.269 I love it because each day I decide, 00:28:44.269 --> 00:28:45.932 sometimes gamely, 00:28:45.932 --> 00:28:48.200 and sometimes against the moment's reason, 00:28:48.200 --> 00:28:51.240 to cleave to the reasons for living. 00:28:51.240 --> 00:28:55.640 And that, I think, is a highly privileged rapture. NOTE Paragraph 00:28:55.640 --> 00:28:58.960 Thank you. NOTE Paragraph 00:28:58.960 --> 00:29:02.096 (Applause)