1 00:00:03,627 --> 00:00:07,838 "I felt a funeral in my brain, 2 00:00:07,838 --> 00:00:10,240 and mourners to and fro 3 00:00:10,240 --> 00:00:12,900 kept treading, treading til I felt 4 00:00:12,900 --> 00:00:15,836 that sense was breaking through. 5 00:00:15,836 --> 00:00:17,605 And when they were all were seated, 6 00:00:17,605 --> 00:00:19,603 a service, like a drum, 7 00:00:19,603 --> 00:00:22,315 kept beating, beating, 8 00:00:22,315 --> 00:00:25,831 til I felt my mind was going numb. 9 00:00:25,831 --> 00:00:27,707 And then I heard them lift a box 10 00:00:27,707 --> 00:00:29,994 and creak across my soul 11 00:00:29,994 --> 00:00:33,053 with those same boots of lead again, 12 00:00:33,053 --> 00:00:36,070 then space began to toll, 13 00:00:36,070 --> 00:00:38,210 as if the heavens were a bell 14 00:00:38,210 --> 00:00:40,201 and being were an ear, 15 00:00:40,201 --> 00:00:44,069 and I, and silence, some strange race wrecked 16 00:00:44,069 --> 00:00:46,493 solitary here. 17 00:00:46,493 --> 00:00:49,670 Just then, a plank in reason broke, 18 00:00:49,670 --> 00:00:53,011 and I fell down and down 19 00:00:53,011 --> 00:00:55,686 and hit a world at every plunge, 20 00:00:55,686 --> 00:01:00,198 and finished knowing then." 21 00:01:00,198 --> 00:01:03,680 We know depression through metaphors. 22 00:01:03,680 --> 00:01:07,389 Emily Dickinson was able to convey it in language, 23 00:01:07,389 --> 00:01:10,130 Goya in an image. 24 00:01:10,130 --> 00:01:12,113 Half the purpose of art 25 00:01:12,113 --> 00:01:15,997 is to describe such iconic states. 26 00:01:15,997 --> 00:01:19,757 As for me, I had always thought myself tough, 27 00:01:19,757 --> 00:01:21,460 one of the people who could survive 28 00:01:21,460 --> 00:01:24,614 if I'd been sent to a concentration camp. 29 00:01:24,614 --> 00:01:27,497 In 1991, I had a series of losses. 30 00:01:27,497 --> 00:01:29,198 My mother died, 31 00:01:29,198 --> 00:01:31,324 a relationship I'd been in ended, 32 00:01:31,324 --> 00:01:33,167 I moved back to the United States 33 00:01:33,167 --> 00:01:35,268 from some years abroad, 34 00:01:35,268 --> 00:01:38,432 and I got through all of those experiences intact. 35 00:01:38,432 --> 00:01:41,539 But in 1994, three years later, 36 00:01:41,539 --> 00:01:45,932 I found myself losing interest in almost everything. 37 00:01:45,932 --> 00:01:47,577 I didn't want to do any of the things 38 00:01:47,577 --> 00:01:49,959 I had previously wanted to do, 39 00:01:49,959 --> 00:01:51,877 and I didn't know why. 40 00:01:51,877 --> 00:01:53,697 The opposite of depression 41 00:01:53,697 --> 00:01:56,934 is not happiness, but vitality, 42 00:01:56,934 --> 00:01:58,429 and it was vitality 43 00:01:58,429 --> 00:02:02,082 that seemed to seep away from me in that moment. 44 00:02:02,082 --> 00:02:04,237 Everything there was to do 45 00:02:04,237 --> 00:02:06,411 seemed like too much work. 46 00:02:06,411 --> 00:02:08,058 I would come home 47 00:02:08,058 --> 00:02:11,440 and I would see the red light flashing on my answering machine, 48 00:02:11,440 --> 00:02:13,585 and instead of being thrilled to hear from my friends, 49 00:02:13,585 --> 00:02:15,133 I would think, 50 00:02:15,133 --> 00:02:18,368 "What a lot of people that is to have to call back." 51 00:02:18,368 --> 00:02:20,755 Or I would decide I should have lunch, 52 00:02:20,755 --> 00:02:23,301 and then I would think that I'd have to get the food out 53 00:02:23,301 --> 00:02:25,340 and put it on a plate 54 00:02:25,340 --> 00:02:29,389 and cut it up and chew it and swallow it, 55 00:02:29,389 --> 00:02:33,090 and it felt to me like the Stations of the Cross. 56 00:02:33,090 --> 00:02:35,541 And one of the things that often gets lost 57 00:02:35,541 --> 00:02:37,443 in discussions of depression 58 00:02:37,443 --> 00:02:39,801 is that you know it's ridiculous. 59 00:02:39,801 --> 00:02:42,537 You know it's ridiculous while you're experiencing it. 60 00:02:42,537 --> 00:02:44,681 You know that most people manage 61 00:02:44,681 --> 00:02:46,995 to listen to their messages and eat lunch 62 00:02:46,995 --> 00:02:48,907 and organize themselves to take a shower 63 00:02:48,907 --> 00:02:50,167 and go out the front door 64 00:02:50,167 --> 00:02:51,644 and that it's not a big deal, 65 00:02:51,644 --> 00:02:54,985 and yet you are nonetheless in its grip 66 00:02:54,985 --> 00:02:58,737 and you are unable to figure out any way around it. 67 00:02:58,737 --> 00:03:03,236 And so I began to feel myself doing less 68 00:03:03,236 --> 00:03:05,326 and thinking less 69 00:03:05,326 --> 00:03:07,694 and feeling less. 70 00:03:07,694 --> 00:03:10,049 It was a kind of nullity. 71 00:03:10,049 --> 00:03:12,415 And then the anxiety set in. 72 00:03:12,415 --> 00:03:14,694 If you told me that I'd have to be 73 00:03:14,694 --> 00:03:16,283 depressed for the next month, 74 00:03:16,283 --> 00:03:19,507 I would say, "As long I know it'll be over in November, I can do it." 75 00:03:19,507 --> 00:03:20,623 But if you said to me, 76 00:03:20,623 --> 00:03:23,923 "You have to have acute anxiety for the next month," 77 00:03:23,923 --> 00:03:26,296 I would rather slit my wrist than go through it. 78 00:03:26,296 --> 00:03:28,078 It was the feeling all the time 79 00:03:28,078 --> 00:03:30,306 like that feeling you have if you're walking 80 00:03:30,306 --> 00:03:31,708 and you slip or trip 81 00:03:31,708 --> 00:03:33,593 and the ground is rushing up at you, 82 00:03:33,593 --> 00:03:36,311 but instead of lasting half a second, the way that does, 83 00:03:36,311 --> 00:03:38,249 it lasted for six months. 84 00:03:38,249 --> 00:03:41,281 It's a sensation of being afraid all the time 85 00:03:41,281 --> 00:03:45,057 but not even knowing what it is that you're afraid of. 86 00:03:45,057 --> 00:03:47,477 And it was at that point that I began to think 87 00:03:47,477 --> 00:03:51,476 that it was just too painful to be alive, 88 00:03:51,476 --> 00:03:54,060 and that the only reason not to kill oneself 89 00:03:54,060 --> 00:03:57,191 was so as not to hurt other people. 90 00:03:57,191 --> 00:04:00,184 And finally one day, I woke up 91 00:04:00,200 --> 00:04:02,208 and I thought perhaps I'd had a stroke, 92 00:04:02,208 --> 00:04:04,939 because I lay in bed completely frozen, 93 00:04:04,939 --> 00:04:06,888 looking at the telephone, thinking, 94 00:04:06,888 --> 00:04:10,451 "Something is wrong and I should call for help," 95 00:04:10,451 --> 00:04:12,186 and I couldn't reach out my arm 96 00:04:12,186 --> 00:04:14,648 and pick up the phone and dial. 97 00:04:14,648 --> 00:04:18,802 And finally, after four full hours of my lying and staring at it, 98 00:04:18,802 --> 00:04:20,164 the phone rang, 99 00:04:20,164 --> 00:04:22,412 and somehow I managed to pick it up, 100 00:04:22,412 --> 00:04:24,212 and it was my father, 101 00:04:24,212 --> 00:04:27,365 and I said, "I'm in serious trouble. 102 00:04:27,365 --> 00:04:29,528 We need to do something." 103 00:04:29,528 --> 00:04:32,856 The next day I started with the medications 104 00:04:32,856 --> 00:04:35,224 and the therapy. 105 00:04:35,224 --> 00:04:37,531 And I also started reckoning 106 00:04:37,531 --> 00:04:39,410 with this terrible question: 107 00:04:39,410 --> 00:04:41,483 if I'm not the tough person 108 00:04:41,483 --> 00:04:44,039 who could have made it through a concentration camp, 109 00:04:44,039 --> 00:04:45,679 then who am I? 110 00:04:45,679 --> 00:04:47,628 And I have to take medication, 111 00:04:47,628 --> 00:04:51,335 is that medication making me more fully myself, 112 00:04:51,335 --> 00:04:53,754 or is it making me someone else? 113 00:04:53,754 --> 00:04:55,450 And how do I feel about it 114 00:04:55,450 --> 00:04:57,989 if it's making me someone else? 115 00:04:57,989 --> 00:05:01,300 I had two advantages as I went in to the fight. 116 00:05:01,300 --> 00:05:04,280 The first is that I knew that objectively speaking, 117 00:05:04,280 --> 00:05:05,901 I had a nice life, 118 00:05:05,901 --> 00:05:07,786 and that if I could only get well, 119 00:05:07,786 --> 00:05:08,994 there was something at the other end 120 00:05:08,994 --> 00:05:11,010 that was worth living for. 121 00:05:11,010 --> 00:05:14,052 And the other was that I had access to good treatment. 122 00:05:14,052 --> 00:05:17,816 But I nonetheless emerged and relapsed, 123 00:05:17,816 --> 00:05:20,095 and emerged and relapsed, 124 00:05:20,095 --> 00:05:23,139 and emerged and relapsed, 125 00:05:23,139 --> 00:05:25,092 and finally understood 126 00:05:25,092 --> 00:05:27,336 I would have to be on medication 127 00:05:27,336 --> 00:05:29,632 and in therapy forever. 128 00:05:29,632 --> 00:05:32,006 And I thought, "But is it a chemical problem 129 00:05:32,006 --> 00:05:33,770 or a psychological problem? 130 00:05:33,770 --> 00:05:37,466 And does it need a chemical cure or a philosophical cure?" 131 00:05:37,466 --> 00:05:39,525 And I couldn't figure out which it was. 132 00:05:39,525 --> 00:05:42,002 And then I understood that actually, 133 00:05:42,002 --> 00:05:44,076 we aren't advanced enough in either area 134 00:05:44,076 --> 00:05:46,013 for it to explain things fully. 135 00:05:46,013 --> 00:05:49,260 The chemical cure and the psychological cure 136 00:05:49,260 --> 00:05:51,062 both have a role to play, 137 00:05:51,062 --> 00:05:54,805 and I also figured out that depression was something 138 00:05:54,805 --> 00:05:57,308 that was braided so deep into us 139 00:05:57,308 --> 00:05:58,927 that there was no separating it 140 00:05:58,927 --> 00:06:01,413 from our character and personality. 141 00:06:01,413 --> 00:06:03,445 I want to say that the treatments we have 142 00:06:03,445 --> 00:06:05,990 for depression are appalling. 143 00:06:05,990 --> 00:06:07,817 They're not very effective. 144 00:06:07,817 --> 00:06:09,650 They're extremely costly. 145 00:06:09,650 --> 00:06:12,099 They come with innumerable side effects. 146 00:06:12,099 --> 00:06:13,888 They're a disaster. 147 00:06:13,888 --> 00:06:16,766 But I am so grateful that I live now 148 00:06:16,766 --> 00:06:18,576 and not 50 years ago, 149 00:06:18,576 --> 00:06:20,087 when there would have been almost nothing 150 00:06:20,087 --> 00:06:21,488 to be done. 151 00:06:21,488 --> 00:06:24,069 I hope that 50 years hence, 152 00:06:24,069 --> 00:06:25,926 people will hear about my treatments 153 00:06:25,926 --> 00:06:28,059 and be appalled that anyone endured 154 00:06:28,059 --> 00:06:30,885 such primitive science. 155 00:06:30,885 --> 00:06:35,441 Depression is the flaw in love. 156 00:06:35,441 --> 00:06:38,582 If you were married to someone and thought, 157 00:06:38,582 --> 00:06:42,177 "Well, if my wife dies, I'll find another one," 158 00:06:42,177 --> 00:06:45,223 it wouldn't be love as we know it. 159 00:06:45,223 --> 00:06:47,173 There's no such thing as love 160 00:06:47,173 --> 00:06:49,817 without the anticipation of loss, 161 00:06:49,817 --> 00:06:52,401 and that specter of despair 162 00:06:52,401 --> 00:06:56,130 can be the engine of intimacy. 163 00:06:56,130 --> 00:06:59,059 There are three things people tend to confuse: 164 00:06:59,059 --> 00:07:02,859 depression, grief, and sadness. 165 00:07:02,859 --> 00:07:06,145 Grief is explicitly reactive. 166 00:07:06,145 --> 00:07:09,104 If you have a loss and you feel incredibly unhappy, 167 00:07:09,104 --> 00:07:10,737 and then, six months later, 168 00:07:10,737 --> 00:07:13,959 you are still deeply sad, but you're functioning a little better, 169 00:07:13,959 --> 00:07:15,687 it's probably grief, 170 00:07:15,687 --> 00:07:17,979 and it will probably ultimately resolve itself 171 00:07:17,979 --> 00:07:19,428 in some measure. 172 00:07:19,428 --> 00:07:22,179 If you experience a catastrophic loss, 173 00:07:22,179 --> 00:07:23,393 and you feel terrible, 174 00:07:23,393 --> 00:07:26,390 and six months later, you can barely function at all, 175 00:07:26,390 --> 00:07:28,975 then it's probably a depression that was triggered 176 00:07:28,975 --> 00:07:31,449 by the catastrophic circumstances. 177 00:07:31,449 --> 00:07:35,081 The trajectory tells us a great deal. 178 00:07:35,081 --> 00:07:38,439 People think of depression as being just sadness. 179 00:07:38,439 --> 00:07:40,775 It's much, much too much sadness, 180 00:07:40,775 --> 00:07:42,439 much too much grief 181 00:07:42,439 --> 00:07:45,368 at far too slight a cause. 182 00:07:45,368 --> 00:07:48,115 As I set out to understand depression, 183 00:07:48,115 --> 00:07:50,950 and to interview people who had experienced it, 184 00:07:50,950 --> 00:07:53,981 I found that there were people who seemed 185 00:07:53,981 --> 00:07:55,394 on the surface to have what sounded like 186 00:07:55,394 --> 00:07:57,748 relatively mild depression 187 00:07:57,748 --> 00:08:01,195 who were nonetheless utterly disabled by it. 188 00:08:01,195 --> 00:08:03,053 And there were other people who had what sounded 189 00:08:03,053 --> 00:08:04,365 as they described it 190 00:08:04,365 --> 00:08:06,616 like terribly severe depression 191 00:08:06,616 --> 00:08:09,431 who nonetheless had good lives in the intercesses 192 00:08:09,431 --> 00:08:11,586 between their depressive episodes. 193 00:08:11,586 --> 00:08:14,271 And I set out to find out what it is 194 00:08:14,271 --> 00:08:15,874 that causes some people 195 00:08:15,874 --> 00:08:18,127 to be more resilient than other people. 196 00:08:18,127 --> 00:08:19,686 What are the mechanisms 197 00:08:19,686 --> 00:08:21,530 that allow people to survive? 198 00:08:21,530 --> 00:08:24,699 And I went out and interviewed person after person 199 00:08:24,699 --> 00:08:26,874 who was suffering with depression. 200 00:08:26,874 --> 00:08:28,825 One of the first people I interviewed 201 00:08:28,825 --> 00:08:30,706 described depression 202 00:08:30,706 --> 00:08:33,967 as a slower way of being dead, 203 00:08:33,967 --> 00:08:36,091 and that was a good thing for me to hear early on 204 00:08:36,091 --> 00:08:37,457 because it reminded me 205 00:08:37,457 --> 00:08:39,456 that that slow way of being dead 206 00:08:39,456 --> 00:08:41,491 can lead to actual deadness, 207 00:08:41,491 --> 00:08:43,495 that this is a serious business. 208 00:08:43,495 --> 00:08:46,154 It's the leading disability worldwide, 209 00:08:46,154 --> 00:08:49,184 and people die of it every day. 210 00:08:49,184 --> 00:08:50,953 One of the people I talked to 211 00:08:50,953 --> 00:08:52,927 when I was trying to understand this 212 00:08:52,927 --> 00:08:54,595 was a beloved friend 213 00:08:54,595 --> 00:08:56,613 who I had known for many years, 214 00:08:56,613 --> 00:08:59,155 and who had had a psychotic episode 215 00:08:59,155 --> 00:09:01,059 in her freshman year of college, 216 00:09:01,059 --> 00:09:04,115 and then plummeted into a horrific depression. 217 00:09:04,115 --> 00:09:05,541 She had bipolar illness, 218 00:09:05,541 --> 00:09:08,184 or manic depression, as it was then known. 219 00:09:08,184 --> 00:09:10,228 And then she did very well 220 00:09:10,228 --> 00:09:11,936 for many years on lithium, 221 00:09:11,936 --> 00:09:13,311 and then eventually, 222 00:09:13,311 --> 00:09:15,271 she was taken off her lithium 223 00:09:15,271 --> 00:09:17,106 to see how she would do without it, 224 00:09:17,106 --> 00:09:19,081 and she had another psychosis, 225 00:09:19,081 --> 00:09:21,419 and then plunged into the worst depression 226 00:09:21,419 --> 00:09:23,291 that I had ever seen 227 00:09:23,291 --> 00:09:26,306 in which she sat in her parents' apartment, 228 00:09:26,306 --> 00:09:29,383 more or less catatonic, essentially without moving, 229 00:09:29,383 --> 00:09:31,865 day after day after day. 230 00:09:31,865 --> 00:09:35,082 And when I interviewed her about that experience some years later 231 00:09:35,082 --> 00:09:38,413 — she's a poet and psychotherapist named Maggie Robbins — 232 00:09:38,413 --> 00:09:41,646 when I interviewed her, she said, 233 00:09:41,646 --> 00:09:45,030 "I was singing 'Where Have All The Flowers Gone' 234 00:09:45,030 --> 00:09:48,240 over and over to occupy my mind. 235 00:09:48,240 --> 00:09:51,375 I was singing to blot out the things my mind was saying, 236 00:09:51,375 --> 00:09:55,865 which were, 'You are nothing. You are nobody. 237 00:09:55,865 --> 00:09:58,691 You don't even deserve to live.' 238 00:09:58,691 --> 00:10:00,869 And that was when I really started thinking 239 00:10:00,869 --> 00:10:03,082 about killing myself." 240 00:10:03,082 --> 00:10:04,990 You don't think in depression 241 00:10:04,990 --> 00:10:07,127 that you've put on a grey veil 242 00:10:07,127 --> 00:10:09,107 and are seeing the world through the haze 243 00:10:09,107 --> 00:10:11,001 of a bad mood. 244 00:10:11,001 --> 00:10:13,721 You think that the veil has been taken away, 245 00:10:13,721 --> 00:10:15,643 the veil of happiness, 246 00:10:15,643 --> 00:10:18,067 and that now you're seeing truly. 247 00:10:18,067 --> 00:10:21,031 It's easier to help schizophrenics who perceive 248 00:10:21,031 --> 00:10:22,842 that there's something foreign inside of them 249 00:10:22,842 --> 00:10:25,029 that needs to be exorcised, 250 00:10:25,029 --> 00:10:27,193 but it's difficult with depressives, 251 00:10:27,193 --> 00:10:31,040 because we believe we are seeing the truth. 252 00:10:31,040 --> 00:10:33,987 But the truth lies. 253 00:10:33,987 --> 00:10:35,985 I became obsessed with that sentence. 254 00:10:35,985 --> 00:10:38,360 "But the truth lies." 255 00:10:38,360 --> 00:10:40,813 And I discovered, as I talked to depressive people, 256 00:10:40,813 --> 00:10:43,495 that they have many delusional perceptions. 257 00:10:43,495 --> 00:10:45,162 People will say, "No one loves me." 258 00:10:45,162 --> 00:10:46,813 And you say, "I love you, 259 00:10:46,813 --> 00:10:49,335 your wife loves you, your mother loves you." 260 00:10:49,335 --> 00:10:51,258 You can answer that one pretty readily, 261 00:10:51,258 --> 00:10:52,923 at least for most people. 262 00:10:52,923 --> 00:10:55,190 But people who are depressed will also say, 263 00:10:55,190 --> 00:10:56,895 "No matter what we do, 264 00:10:56,895 --> 00:10:59,168 we're all just going to die in the end." 265 00:10:59,168 --> 00:11:01,371 Or they'll say, "There can be no true communion 266 00:11:01,371 --> 00:11:03,024 between two human beings. 267 00:11:03,024 --> 00:11:05,600 Each of us is trapped in his own body." 268 00:11:05,600 --> 00:11:07,449 To which you have to say, 269 00:11:07,449 --> 00:11:08,770 "That's true, 270 00:11:08,770 --> 00:11:10,588 but I think we should focus right now 271 00:11:10,588 --> 00:11:12,484 on what to have for breakfast." 272 00:11:12,484 --> 00:11:14,669 (Laughter) 273 00:11:14,669 --> 00:11:16,338 A lot of the time, 274 00:11:16,338 --> 00:11:19,234 what they are expressing is not illness, but insight, 275 00:11:19,234 --> 00:11:21,891 and one comes to think what's really extraordinary 276 00:11:21,891 --> 00:11:24,825 is that most of us know about those existential questions 277 00:11:24,825 --> 00:11:27,115 and they don't distract us very much. 278 00:11:27,115 --> 00:11:29,274 There was a study I particularly liked 279 00:11:29,274 --> 00:11:30,954 in which a group of depressed 280 00:11:30,954 --> 00:11:32,855 and a group of non-depressed people 281 00:11:32,855 --> 00:11:35,478 were asked to play a video game for an hour, 282 00:11:35,478 --> 00:11:37,291 and at the end of the hour, 283 00:11:37,291 --> 00:11:38,942 they were asked how many little monsters 284 00:11:38,942 --> 00:11:40,806 they thought they had killed. 285 00:11:40,806 --> 00:11:43,018 The depressive group was usually accurate 286 00:11:43,018 --> 00:11:45,076 to within about 10 percent, 287 00:11:45,076 --> 00:11:46,547 and the non-depressed people 288 00:11:46,547 --> 00:11:50,092 guessed between 15 and 20 times as many 289 00:11:50,092 --> 00:11:51,834 little monsters — (Laughter) — 290 00:11:51,834 --> 00:11:55,945 as they had actually killed. 291 00:11:55,945 --> 00:11:59,011 A lot of people said, when I chose to write about my depression, 292 00:11:59,011 --> 00:12:00,780 that it must be very difficult 293 00:12:00,780 --> 00:12:03,904 to be out of that closet, to have people know. 294 00:12:03,904 --> 00:12:06,104 They said, "Do people talk to you differently?" 295 00:12:06,104 --> 00:12:08,176 And I said, "Yes, people talk to me differently. 296 00:12:08,176 --> 00:12:10,090 They talk to me differently insofar 297 00:12:10,090 --> 00:12:12,880 as they start telling me about their experience, 298 00:12:12,880 --> 00:12:14,715 or their sister's experience, 299 00:12:14,715 --> 00:12:16,489 or their friend's experience. 300 00:12:16,489 --> 00:12:18,781 Things are different because now I know 301 00:12:18,781 --> 00:12:21,462 that depression is the family secret 302 00:12:21,462 --> 00:12:23,539 that everyone has. 303 00:12:23,539 --> 00:12:27,167 I went a few years ago to a conference, 304 00:12:27,167 --> 00:12:29,820 and on Friday of the three day conference, 305 00:12:29,820 --> 00:12:32,711 one of the participants took me aside, and she said, 306 00:12:32,711 --> 00:12:36,116 "I suffer from depression and 307 00:12:36,116 --> 00:12:38,885 I'm a little embarrassed about it, 308 00:12:38,885 --> 00:12:40,988 but I've been taking this medication, 309 00:12:40,988 --> 00:12:43,936 and I just wanted to ask you what you think?" 310 00:12:43,936 --> 00:12:46,540 And so I did my best to give her such advice as I could. 311 00:12:46,540 --> 00:12:48,490 And then she said, "You know, 312 00:12:48,490 --> 00:12:51,281 my husband would never understand this. 313 00:12:51,281 --> 00:12:53,854 He's really the kind of guy to whom this wouldn't make any sense, 314 00:12:53,854 --> 00:12:56,721 so I just, you know, it's just between us." 315 00:12:56,721 --> 00:12:58,507 And I said, "Yes, that's fine." 316 00:12:58,507 --> 00:13:00,616 On Sunday of the same conference, 317 00:13:00,616 --> 00:13:03,660 her husband took me aside, 318 00:13:03,660 --> 00:13:05,354 and he said, "My wife wouldn't think 319 00:13:05,354 --> 00:13:07,789 that I was really much of a guy if she knew this, 320 00:13:07,789 --> 00:13:10,255 but I've been dealing with this depression 321 00:13:10,255 --> 00:13:11,609 and I'm taking some medication, 322 00:13:11,609 --> 00:13:14,114 and I wondered what you think?" 323 00:13:14,114 --> 00:13:15,537 They were hiding 324 00:13:15,537 --> 00:13:17,752 the same medication in two different places 325 00:13:17,752 --> 00:13:20,690 in the same bedroom. 326 00:13:20,690 --> 00:13:22,418 And I said that I thought 327 00:13:22,418 --> 00:13:24,102 communication within the marriage 328 00:13:24,102 --> 00:13:26,116 might be triggering some of their problems. 329 00:13:26,116 --> 00:13:30,307 (Laughter) 330 00:13:30,307 --> 00:13:31,962 But I was also struck 331 00:13:31,962 --> 00:13:33,768 by the burdensome nature 332 00:13:33,768 --> 00:13:36,141 of such mutual secrecy. 333 00:13:36,141 --> 00:13:38,026 Depression is so exhausting. 334 00:13:38,026 --> 00:13:40,794 It takes up so much of your time and energy, 335 00:13:40,794 --> 00:13:42,298 and silence about it, 336 00:13:42,298 --> 00:13:45,029 it really does make the depression worse. 337 00:13:45,029 --> 00:13:46,762 And then I began thinking about all the ways 338 00:13:46,762 --> 00:13:48,728 people make themselves better. 339 00:13:48,728 --> 00:13:51,167 I'd started off as a medical conservative. 340 00:13:51,167 --> 00:13:53,539 I thought there were a few kinds of therapy that worked, 341 00:13:53,539 --> 00:13:55,902 it was clear what they were, 342 00:13:55,902 --> 00:13:56,992 there was medication, 343 00:13:56,992 --> 00:13:58,468 there were certain psychotherapies, 344 00:13:58,468 --> 00:14:00,913 there was possibly electro-convulsive treatment, 345 00:14:00,913 --> 00:14:03,588 and that everything else was nonsense. 346 00:14:03,588 --> 00:14:05,420 But then I discovered something. 347 00:14:05,420 --> 00:14:07,172 If you have brain cancer, 348 00:14:07,172 --> 00:14:08,644 and you say that standing on your head 349 00:14:08,644 --> 00:14:11,639 for 20 minutes every morning makes you feel better, 350 00:14:11,639 --> 00:14:13,153 it may make you feel better, 351 00:14:13,153 --> 00:14:14,741 but you still have brain cancer, 352 00:14:14,741 --> 00:14:17,030 and you'll still probably die from it. 353 00:14:17,030 --> 00:14:19,542 But if you say that you have depression, 354 00:14:19,542 --> 00:14:21,647 and standing on your head for 20 minutes every day 355 00:14:21,647 --> 00:14:24,131 makes you feel better, then it's worked, 356 00:14:24,131 --> 00:14:26,491 because depression is an illness of how you feel, 357 00:14:26,491 --> 00:14:28,100 and if you feel better, 358 00:14:28,100 --> 00:14:30,930 then you are effectively not depressed anymore. 359 00:14:30,930 --> 00:14:32,963 So I became much more tolerant 360 00:14:32,963 --> 00:14:35,888 of the vast world of alternative treatments. 361 00:14:35,888 --> 00:14:38,042 And I get letters, I get hundreds of letters 362 00:14:38,042 --> 00:14:40,788 from people writing to tell me about what's worked for them. 363 00:14:40,788 --> 00:14:42,989 Someone was asking me backstage today 364 00:14:42,989 --> 00:14:44,452 about meditation. 365 00:14:44,452 --> 00:14:46,917 My favorite of the letters that I got 366 00:14:46,917 --> 00:14:48,391 was the one that came from a woman 367 00:14:48,391 --> 00:14:50,482 who wrote and said that she had tried therapy, 368 00:14:50,482 --> 00:14:51,445 she had tried medication, 369 00:14:51,445 --> 00:14:52,985 she had tried pretty much everything, 370 00:14:52,985 --> 00:14:55,822 and she had found a solution and hoped I would tell the world, 371 00:14:55,822 --> 00:14:59,634 and that was making little things from yarn. 372 00:14:59,634 --> 00:15:02,633 (Laughter) 373 00:15:02,633 --> 00:15:06,157 She sent me some of them. (Laughter) 374 00:15:06,157 --> 00:15:09,845 And I'm not wearing them right now. 375 00:15:09,845 --> 00:15:12,022 I suggested to her that she also should look up 376 00:15:12,022 --> 00:15:17,008 obsessive compulsive disorder in the DSM. 377 00:15:17,008 --> 00:15:19,536 And yet, when I went to look at alternative treatments, 378 00:15:19,536 --> 00:15:22,444 I also gained perspective on other treatments. 379 00:15:22,444 --> 00:15:25,347 I went through a tribal exorcism in Senegal 380 00:15:25,347 --> 00:15:27,114 that involved a great deal of ram's blood 381 00:15:27,114 --> 00:15:29,422 and that I'm not going to detail right now, 382 00:15:29,422 --> 00:15:31,422 but a few years afterward I was in Rwanda 383 00:15:31,422 --> 00:15:33,180 working on a different project, 384 00:15:33,180 --> 00:15:35,976 and I happened to describe my experience to someone, 385 00:15:35,976 --> 00:15:37,352 and he said, "Well, you know, 386 00:15:37,352 --> 00:15:39,556 that's West Africa, and we're in East Africa, 387 00:15:39,556 --> 00:15:41,390 and our rituals are in some ways very different, 388 00:15:41,390 --> 00:15:43,403 but we do have some rituals that have something 389 00:15:43,403 --> 00:15:45,390 in common with what you're describing." 390 00:15:45,390 --> 00:15:47,053 And I said, "Oh." And he said, "Yes," he said, 391 00:15:47,053 --> 00:15:49,695 "but we've had a lot of trouble with Western mental health workers, 392 00:15:49,695 --> 00:15:52,452 especially the ones who came right after the genocide." 393 00:15:52,452 --> 00:15:54,779 And I said, "What kind of trouble did you have?" 394 00:15:54,779 --> 00:15:56,325 And he said, "Well," he said, 395 00:15:56,325 --> 00:15:58,789 "They would do this bizarre thing." 396 00:15:58,789 --> 00:16:00,874 He said, "They didn't take people out in the sunshine 397 00:16:00,874 --> 00:16:02,574 where you begin to feel better. 398 00:16:02,574 --> 00:16:03,976 They didn't include drumming or music 399 00:16:03,976 --> 00:16:05,579 to get people's blood going. 400 00:16:05,579 --> 00:16:07,510 They didn't involve the whole community. 401 00:16:07,510 --> 00:16:09,285 They didn't externalize the depression 402 00:16:09,285 --> 00:16:10,718 as an invasive spirit. 403 00:16:10,718 --> 00:16:13,349 Instead what they did was they took people 404 00:16:13,349 --> 00:16:15,977 one at a time into dingy little rooms 405 00:16:15,977 --> 00:16:17,320 and had them talk for an hour 406 00:16:17,320 --> 00:16:19,550 about bad things that had happened to them." 407 00:16:19,550 --> 00:16:25,010 (Laughter) (Applause) 408 00:16:25,010 --> 00:16:27,372 He said, "We had to ask them to leave the country." 409 00:16:27,372 --> 00:16:30,429 (Laughter) 410 00:16:30,429 --> 00:16:32,873 Now at the other end of alternative treatments, 411 00:16:32,873 --> 00:16:34,908 let me tell you about Frank Roussekoff. 412 00:16:34,908 --> 00:16:37,961 Frank Roussekoff had the worst depression 413 00:16:37,961 --> 00:16:40,876 perhaps that I've ever seen in a man. 414 00:16:40,876 --> 00:16:42,869 He was constantly depressed. 415 00:16:42,869 --> 00:16:45,010 He was, when I met him, at a point at which 416 00:16:45,010 --> 00:16:48,168 every month he would have electroshock treatment. 417 00:16:48,168 --> 00:16:50,743 Then he would feel sort of disoriented for a week. 418 00:16:50,743 --> 00:16:52,546 Then he would feel okay for a week. 419 00:16:52,546 --> 00:16:54,246 Then he would have a week of going downhill. 420 00:16:54,246 --> 00:16:56,931 And then he would have another electroshock treatment. 421 00:16:56,931 --> 00:16:58,346 And he said to me when I met him, 422 00:16:58,346 --> 00:17:00,898 "It's unbearable to go through my weeks this way. 423 00:17:00,898 --> 00:17:02,405 I can't go on this way, 424 00:17:02,405 --> 00:17:04,577 and I've figured out how I'm going to end it 425 00:17:04,577 --> 00:17:06,226 if I don't get better. 426 00:17:06,226 --> 00:17:08,934 But," he said to me, "I heard about a protocol 427 00:17:08,934 --> 00:17:11,157 at Mass General for a procedure called 428 00:17:11,157 --> 00:17:13,183 a cingulotomy, which is a brain surgery, 429 00:17:13,183 --> 00:17:15,754 and I think I'm going to give that a try." 430 00:17:15,754 --> 00:17:17,708 And I remember being amazed at that point 431 00:17:17,708 --> 00:17:19,008 to think that someone 432 00:17:19,008 --> 00:17:22,229 who clearly had so many bad experiences 433 00:17:22,229 --> 00:17:24,088 with so many different treatments 434 00:17:24,088 --> 00:17:27,210 still had buried in him somewhere enough optimism 435 00:17:27,210 --> 00:17:29,760 to reach out for one more. 436 00:17:29,760 --> 00:17:31,940 And he had the a cingulotomy, 437 00:17:31,940 --> 00:17:33,981 and it was incredibly successful. 438 00:17:33,981 --> 00:17:35,474 He's now a friend of mine. 439 00:17:35,474 --> 00:17:38,966 He has a lovely wife and two beautiful children. 440 00:17:38,966 --> 00:17:41,915 He wrote me a letter the Christmas after the surgery, 441 00:17:41,915 --> 00:17:43,104 and he said, 442 00:17:43,104 --> 00:17:45,511 "My father sent me two presents this year, 443 00:17:45,511 --> 00:17:48,113 First, a motorized CD rack from The Sharper Image 444 00:17:48,113 --> 00:17:49,534 that I didn't really need, 445 00:17:49,534 --> 00:17:51,231 but I knew he was giving it to me to celebrate 446 00:17:51,231 --> 00:17:53,359 the fact that I'm living on my own 447 00:17:53,359 --> 00:17:55,406 and have a job I seem to love. 448 00:17:55,406 --> 00:17:56,967 And the other present 449 00:17:56,967 --> 00:17:58,543 was a photo of my grandmother, 450 00:17:58,543 --> 00:18:00,795 who committed suicide. 451 00:18:00,795 --> 00:18:03,730 As I unwrapped it, I began to cry, 452 00:18:03,730 --> 00:18:05,610 and my mother came over and said, 453 00:18:05,610 --> 00:18:08,925 'Are you crying because of the relatives you never knew?' 454 00:18:08,925 --> 00:18:13,013 And I said, 'She had the same disease I have.' 455 00:18:13,013 --> 00:18:15,594 I'm crying now as I write to you. 456 00:18:15,594 --> 00:18:19,189 It's not that I'm so sad, but I get overwhelmed, 457 00:18:19,189 --> 00:18:21,410 I think, because I could have killed myself, 458 00:18:21,410 --> 00:18:23,113 but my parents kept me going, 459 00:18:23,113 --> 00:18:24,862 and so did the doctors, 460 00:18:24,862 --> 00:18:26,716 and I had the surgery. 461 00:18:26,716 --> 00:18:29,531 I'm alive and grateful. 462 00:18:29,531 --> 00:18:31,791 We live in the right time, 463 00:18:31,791 --> 00:18:35,670 even if it doesn't always feel like it." 464 00:18:35,670 --> 00:18:37,567 I was struck by the fact that depression 465 00:18:37,567 --> 00:18:39,292 is broadly perceived to be 466 00:18:39,292 --> 00:18:42,829 a modern, Western, middle class thing, 467 00:18:42,829 --> 00:18:44,981 and I went to look at how it operated 468 00:18:44,981 --> 00:18:46,984 in a variety of other contexts, 469 00:18:46,984 --> 00:18:49,103 and one of the things I was most interested in 470 00:18:49,103 --> 00:18:50,893 was depression among the indigent. 471 00:18:50,893 --> 00:18:52,905 And so I went out to try to look at what was 472 00:18:52,905 --> 00:18:55,254 being done for poor people with depression. 473 00:18:55,254 --> 00:18:57,412 And what I discovered is that poor people 474 00:18:57,412 --> 00:18:59,969 are mostly not being treated for depression. 475 00:18:59,969 --> 00:19:02,888 Depression is the result of a genetic vulnerability, 476 00:19:02,888 --> 00:19:06,046 which is presumably evenly distributed in the population, 477 00:19:06,046 --> 00:19:07,999 and triggering circumstances, 478 00:19:07,999 --> 00:19:09,902 which are likely to be more severe 479 00:19:09,902 --> 00:19:11,777 for people who are impoverished. 480 00:19:11,777 --> 00:19:13,866 And yet it turns out that if you have 481 00:19:13,866 --> 00:19:16,175 a really lovely life but feel miserable all the time, 482 00:19:16,175 --> 00:19:18,344 you think, "Why do I feel like this? 483 00:19:18,344 --> 00:19:20,013 I must have depression." 484 00:19:20,013 --> 00:19:21,936 And you set out to find treatment for it. 485 00:19:21,936 --> 00:19:24,029 But if you have a perfectly awful life, 486 00:19:24,029 --> 00:19:25,896 and you feel miserable all the time, 487 00:19:25,896 --> 00:19:28,722 the way you feel is commensurate with your life, 488 00:19:28,722 --> 00:19:30,446 and it doesn't occur to you to think, 489 00:19:30,446 --> 00:19:32,229 "Maybe this is treatable." 490 00:19:32,229 --> 00:19:35,365 And so we have an epidemic in this country 491 00:19:35,365 --> 00:19:38,278 of depression among impoverished people 492 00:19:38,278 --> 00:19:40,790 that's not being picked up and that's not being treated 493 00:19:40,790 --> 00:19:42,846 and that's not being addressed, 494 00:19:42,846 --> 00:19:45,046 and it's a tragedy of a grand order. 495 00:19:45,046 --> 00:19:46,534 And so I found an academic 496 00:19:46,534 --> 00:19:48,351 who was doing a research project 497 00:19:48,351 --> 00:19:50,092 in slums outside of D.C., 498 00:19:50,092 --> 00:19:53,089 where she picked up women who had come in for other health problems 499 00:19:53,089 --> 00:19:54,868 and diagnosed them with depression, 500 00:19:54,868 --> 00:19:58,134 and then provided six months of experimental protocol. 501 00:19:58,134 --> 00:20:00,463 One of them, Lolly, came in, 502 00:20:00,463 --> 00:20:02,760 and this is what she said the day she came in. 503 00:20:02,760 --> 00:20:06,155 She said, and she was a woman, by the way, 504 00:20:06,155 --> 00:20:08,247 who had seven children. She said, 505 00:20:08,247 --> 00:20:10,898 "I used to have a job but I had to give it up because 506 00:20:10,898 --> 00:20:12,958 I couldn't go out of the house. 507 00:20:12,958 --> 00:20:15,186 I have nothing to say to my children. 508 00:20:15,186 --> 00:20:17,953 In the morning, I can't wait for them to leave, 509 00:20:17,953 --> 00:20:20,943 and then I climb in bed and pull the covers over my head, 510 00:20:20,943 --> 00:20:22,589 and three o'clock when they come home, 511 00:20:22,589 --> 00:20:24,390 it just comes so fast." 512 00:20:24,390 --> 00:20:26,630 She said, "I've been taking a lot of Tylenol, 513 00:20:26,630 --> 00:20:29,389 anything I can take so that I can sleep more. 514 00:20:29,389 --> 00:20:33,159 My husband has been telling me I'm stupid, I'm ugly. 515 00:20:33,159 --> 00:20:36,664 I wish I could stop the pain." 516 00:20:36,664 --> 00:20:39,304 Well, she was brought into this experimental protocol, 517 00:20:39,304 --> 00:20:41,612 and when I interviewed her six months later, 518 00:20:41,612 --> 00:20:46,019 she had taken a job working in child care 519 00:20:46,019 --> 00:20:49,824 for the U.S. Navy, she had left the abusive husband, 520 00:20:49,824 --> 00:20:51,906 and she said to me, 521 00:20:51,906 --> 00:20:54,275 "My kids are so much happier now." 522 00:20:54,275 --> 00:20:55,929 She said, "There's one room in my new place 523 00:20:55,929 --> 00:20:58,860 for the boys and one room for the girls, 524 00:20:58,860 --> 00:21:01,046 but at night, they're just all up on my bed, 525 00:21:01,046 --> 00:21:04,011 and we're doing homework all together and everything. 526 00:21:04,011 --> 00:21:05,684 One of them wants to be a preacher, 527 00:21:05,684 --> 00:21:07,384 one of them wants to be a firefighter, 528 00:21:07,384 --> 00:21:10,350 and one of the girls says she's going to be a lawyer. 529 00:21:10,350 --> 00:21:12,355 They don't cry like they used to, 530 00:21:12,355 --> 00:21:14,913 and they don't fight like they did. 531 00:21:14,913 --> 00:21:18,693 That's all I need now is my kids. 532 00:21:18,693 --> 00:21:20,605 Things keep on changing, 533 00:21:20,605 --> 00:21:25,798 the way I dress, the way I feel, the way I act. 534 00:21:25,798 --> 00:21:29,485 I can go outside not being afraid anymore, 535 00:21:29,485 --> 00:21:32,894 and I don't think those bad feelings are coming back, 536 00:21:32,894 --> 00:21:35,929 and if it weren't for Dr. Miranda and that, 537 00:21:35,929 --> 00:21:39,546 I would still be at home with the covers pulled over my head, 538 00:21:39,546 --> 00:21:41,895 if I were still alive at all. 539 00:21:41,895 --> 00:21:45,627 I asked the Lord to send me an angel, 540 00:21:45,627 --> 00:21:49,281 and he heard my prayers." 541 00:21:50,313 --> 00:21:53,312 I was really moved by these experiences, 542 00:21:53,312 --> 00:21:55,851 and I decided that I wanted to write about them 543 00:21:55,851 --> 00:21:57,230 not only in a book I was working on, 544 00:21:57,230 --> 00:21:58,618 but also in an article, 545 00:21:58,618 --> 00:22:00,755 and so I got a commission from "The New York Times Magazine" 546 00:22:00,755 --> 00:22:02,878 to write about depression among the indigent. 547 00:22:02,878 --> 00:22:04,494 And I turned in my story, 548 00:22:04,494 --> 00:22:06,090 and my editor called me and said, 549 00:22:06,090 --> 00:22:08,493 "We really can't publish this." 550 00:22:08,493 --> 00:22:09,412 And I said, "Why not?" 551 00:22:09,412 --> 00:22:11,779 And she said, "It just is too far-fetched. 552 00:22:11,779 --> 00:22:15,633 These people who are sort of at the very bottom rung of society 553 00:22:15,633 --> 00:22:17,337 and then they get a few months of treatment 554 00:22:17,337 --> 00:22:19,969 and they're virtually ready to run Morgan Stanley? 555 00:22:19,969 --> 00:22:21,823 It's just too implausible." 556 00:22:21,823 --> 00:22:24,028 She said, I've never even heard of anything like it." 557 00:22:24,028 --> 00:22:26,562 And I said, "The fact that you've never heard of it 558 00:22:26,562 --> 00:22:29,562 is an indication that it is news." 559 00:22:29,562 --> 00:22:35,696 (Laughter) (Applause) 560 00:22:37,317 --> 00:22:39,811 "And you are a news magazine." 561 00:22:39,811 --> 00:22:41,793 So after a certain amount of negotiation, 562 00:22:41,793 --> 00:22:43,034 they agreed to it. 563 00:22:43,034 --> 00:22:44,649 But I think a lot of what they said 564 00:22:44,649 --> 00:22:46,944 was connected in some strange way 565 00:22:46,944 --> 00:22:49,086 to this distaste that people still have 566 00:22:49,086 --> 00:22:50,549 for the idea of treatment, 567 00:22:50,549 --> 00:22:52,431 the notion that somehow if we went out 568 00:22:52,431 --> 00:22:55,127 and treated a lot of people in indigent communities, 569 00:22:55,127 --> 00:22:57,025 that would be an exploitative thing to do, 570 00:22:57,025 --> 00:22:58,667 because we would be changing them. 571 00:22:58,667 --> 00:23:00,700 There is this false moral imperative 572 00:23:00,700 --> 00:23:02,489 that seems to be all around us 573 00:23:02,489 --> 00:23:04,843 that treatment of depression, 574 00:23:04,843 --> 00:23:07,142 the medications and so on, are an artifice, 575 00:23:07,142 --> 00:23:09,314 and that it's not natural. 576 00:23:09,314 --> 00:23:12,163 And I think that's very misguided. 577 00:23:12,163 --> 00:23:15,695 It would be natural for people's teeth to fall out, 578 00:23:15,695 --> 00:23:19,025 but there is nobody militating against toothpaste, 579 00:23:19,025 --> 00:23:21,846 at least not in my circles. 580 00:23:21,846 --> 00:23:23,655 And people then say, "Well, but isn't depression 581 00:23:23,655 --> 00:23:25,840 part of what people are supposed to experience? 582 00:23:25,840 --> 00:23:27,581 Didn't we evolve to have depression? 583 00:23:27,581 --> 00:23:29,488 Isn't it part of your personality?" 584 00:23:29,488 --> 00:23:32,234 To which I would say, mood is adaptive. 585 00:23:32,234 --> 00:23:35,563 Being able to have sadness and fear 586 00:23:35,563 --> 00:23:37,405 and joy and pleasure 587 00:23:37,405 --> 00:23:39,208 and all of the other moods that we have, 588 00:23:39,208 --> 00:23:41,272 that's incredibly valuable. 589 00:23:41,272 --> 00:23:44,319 And major depression is something that happens 590 00:23:44,319 --> 00:23:46,331 when that system gets broken. 591 00:23:46,331 --> 00:23:48,048 It's maladaptive. 592 00:23:48,048 --> 00:23:49,620 People will come to me and say, 593 00:23:49,620 --> 00:23:52,388 "I think, though, if I just stick it out for another year, 594 00:23:52,388 --> 00:23:54,464 I think I can just get through this." 595 00:23:54,464 --> 00:23:56,767 And I always say to them, "You may get through it, 596 00:23:56,767 --> 00:23:59,476 but you'll never be 37 again. 597 00:23:59,476 --> 00:24:02,026 Life is short, and that's a whole year 598 00:24:02,026 --> 00:24:03,982 you're talking about giving up. 599 00:24:03,982 --> 00:24:05,520 Think it through." 600 00:24:05,520 --> 00:24:08,366 It's a strange poverty of the English language, 601 00:24:08,366 --> 00:24:10,474 and indeed of many other languages, 602 00:24:10,474 --> 00:24:12,692 that we use this same word, "depression," 603 00:24:12,692 --> 00:24:14,497 to describe how a kid feels 604 00:24:14,497 --> 00:24:16,209 when it rains on his birthday, 605 00:24:16,209 --> 00:24:18,737 and to describe how somebody feels 606 00:24:18,737 --> 00:24:21,191 the minute before they commit suicide. 607 00:24:21,191 --> 00:24:24,296 People say to me, "Well, is it continuous with normal sadness?" 608 00:24:24,296 --> 00:24:27,440 And I say, in a way it's continuous with normal sadness. 609 00:24:27,440 --> 00:24:29,640 There is a certain amount of continuity, 610 00:24:29,640 --> 00:24:31,597 but it's the same way there's continuity 611 00:24:31,597 --> 00:24:33,584 between having an iron fence outside your house 612 00:24:33,584 --> 00:24:35,261 that gets a little rust spot 613 00:24:35,261 --> 00:24:38,007 that you have to sort of sand off and do a little repainting, 614 00:24:38,007 --> 00:24:40,654 and what happens if you leave the house for a hundred years 615 00:24:40,654 --> 00:24:43,552 and it rusts through until it's only a pile 616 00:24:43,552 --> 00:24:44,786 of orange dust. 617 00:24:44,786 --> 00:24:46,959 And it's that orange dust spot, 618 00:24:46,959 --> 00:24:48,748 that orange dust problem, 619 00:24:48,748 --> 00:24:51,737 that's the one we're setting out to address. 620 00:24:51,737 --> 00:24:53,977 So now people say, 621 00:24:53,977 --> 00:24:56,708 "You take these happy pills, and do you feel happy?" 622 00:24:56,708 --> 00:24:58,594 And I don't. 623 00:24:58,594 --> 00:25:01,416 But I don't feel sad about having to eat lunch, 624 00:25:01,416 --> 00:25:04,252 and I don't feel sad about my answering machine, 625 00:25:04,252 --> 00:25:07,097 and I don't feel sad about taking a shower. 626 00:25:07,097 --> 00:25:09,951 I feel more, in fact, I think, 627 00:25:09,951 --> 00:25:12,381 because I can feel sadness without nullity. 628 00:25:12,381 --> 00:25:16,728 I feel sad about professional disappointments, 629 00:25:16,728 --> 00:25:19,075 about damaged relationships, 630 00:25:19,075 --> 00:25:21,114 about global warming. 631 00:25:21,114 --> 00:25:23,839 Those are the things that I feel sad about now. 632 00:25:23,839 --> 00:25:26,573 And I said to myself, well, what is the conclusion? 633 00:25:26,573 --> 00:25:29,134 How did those people who have better lives 634 00:25:29,134 --> 00:25:31,688 even with bigger depression manage to get through? 635 00:25:31,688 --> 00:25:34,485 What is the mechanism of resilience? 636 00:25:34,485 --> 00:25:36,569 And what I came up with over time 637 00:25:36,569 --> 00:25:39,485 was that the people who deny their experience, 638 00:25:39,485 --> 00:25:41,517 the ones who say, "I was depressed a long time ago 639 00:25:41,517 --> 00:25:43,254 and I never want to think about it again 640 00:25:43,254 --> 00:25:44,496 and I'm not going to look at it 641 00:25:44,496 --> 00:25:46,386 and I'm just going to get on with my life," 642 00:25:46,386 --> 00:25:48,345 ironically, those are the people 643 00:25:48,345 --> 00:25:51,043 who are most enslaved by what they have. 644 00:25:51,043 --> 00:25:53,607 Shutting out the depression strengthens it. 645 00:25:53,607 --> 00:25:56,887 While you hide from it, it grows. 646 00:25:56,887 --> 00:25:59,747 And the people who do better 647 00:25:59,747 --> 00:26:02,346 are the ones who are able to tolerate the fact 648 00:26:02,346 --> 00:26:03,968 that they have this condition. 649 00:26:03,968 --> 00:26:06,438 Those who can tolerate their depression 650 00:26:06,438 --> 00:26:08,220 are the ones who achieve resilience. 651 00:26:08,220 --> 00:26:10,003 So Frank Roussekoff said to me, 652 00:26:10,003 --> 00:26:11,519 "If I had it again to do over, 653 00:26:11,519 --> 00:26:13,656 I suppose I wouldn't do it this way, 654 00:26:13,656 --> 00:26:15,620 but in a strange way, I'm grateful 655 00:26:15,620 --> 00:26:17,123 for what I've experienced. 656 00:26:17,123 --> 00:26:20,940 I'm glad to have been in the hospital 40 times. 657 00:26:20,940 --> 00:26:23,543 It taught me so much about love, 658 00:26:23,543 --> 00:26:26,383 and my relationship with my parents and my doctors 659 00:26:26,383 --> 00:26:30,772 has been so precious to me, and will be always." 660 00:26:30,772 --> 00:26:32,698 And Maggie Robbins said, 661 00:26:32,698 --> 00:26:35,687 "I used to volunteer in an AIDS clinic, 662 00:26:35,687 --> 00:26:38,701 and I would just talk and talk and talk, 663 00:26:38,701 --> 00:26:40,514 and the people I was dealing with 664 00:26:40,514 --> 00:26:42,581 weren't very responsive, and I thought, 665 00:26:42,581 --> 00:26:46,542 'That's not very friendly or helpful of them.' 666 00:26:46,542 --> 00:26:48,184 And then I realized, 667 00:26:48,184 --> 00:26:50,035 I realized that they weren't going to do more 668 00:26:50,035 --> 00:26:52,698 than make those first few minutes of small talk. 669 00:26:52,698 --> 00:26:54,755 It was simply going to be an occasion 670 00:26:54,755 --> 00:26:57,633 where I didn't have AIDS and I wasn't dying, 671 00:26:57,633 --> 00:27:00,606 but could tolerate the fact that they did 672 00:27:00,606 --> 00:27:02,393 and they were. 673 00:27:02,393 --> 00:27:05,996 Our needs are our greatest assets. 674 00:27:05,996 --> 00:27:08,135 It turns out I've learned to give 675 00:27:08,135 --> 00:27:12,160 all the things I need." 676 00:27:12,160 --> 00:27:13,851 Valuing one's depression 677 00:27:13,851 --> 00:27:16,045 does not prevent a relapse, 678 00:27:16,045 --> 00:27:18,706 but it may make the prospect of relapse 679 00:27:18,706 --> 00:27:22,924 and even relapse itself easier to tolerate. 680 00:27:22,924 --> 00:27:24,969 The question is not so much 681 00:27:24,969 --> 00:27:27,144 of finding great meaning and deciding 682 00:27:27,144 --> 00:27:29,171 your depression has been very meaningful. 683 00:27:29,171 --> 00:27:31,342 It's of seeking that meaning 684 00:27:31,342 --> 00:27:33,146 and thinking, when it comes again, 685 00:27:33,146 --> 00:27:34,786 "This will be hellish, 686 00:27:34,786 --> 00:27:37,487 but I will learn something from it." 687 00:27:37,487 --> 00:27:39,751 I have learned in my own depression 688 00:27:39,751 --> 00:27:41,764 how big an emotion can be, 689 00:27:41,764 --> 00:27:44,861 how it can be more real than facts, 690 00:27:44,861 --> 00:27:47,564 and I have found that that experience 691 00:27:47,564 --> 00:27:50,702 has allowed me to experience positive emotion 692 00:27:50,702 --> 00:27:54,222 in a more intense and more focused way. 693 00:27:54,222 --> 00:27:57,709 The opposite of depression is not happiness, 694 00:27:57,709 --> 00:27:59,163 but vitality, 695 00:27:59,163 --> 00:28:01,904 and these days, my life is vital, 696 00:28:01,904 --> 00:28:04,649 even on the days when I'm sad. 697 00:28:04,649 --> 00:28:07,962 I felt that funeral in my brain, 698 00:28:07,962 --> 00:28:09,986 and I sat next to the colossus 699 00:28:09,986 --> 00:28:12,233 at the edge of the world, 700 00:28:12,233 --> 00:28:14,322 and I have discovered 701 00:28:14,322 --> 00:28:16,173 something inside of myself 702 00:28:16,173 --> 00:28:18,306 that I would have to call a soul 703 00:28:18,306 --> 00:28:22,062 that I had never formulated until that day 20 years ago 704 00:28:22,062 --> 00:28:26,580 when hell came to pay me a surprise visit. 705 00:28:26,580 --> 00:28:30,678 I think that while I hated being depressed 706 00:28:30,678 --> 00:28:33,012 and would hate to be depressed again, 707 00:28:33,012 --> 00:28:35,756 I've found a way to love my depression. 708 00:28:35,756 --> 00:28:37,781 I love it because it has forced me 709 00:28:37,781 --> 00:28:40,550 to find and cling to joy. 710 00:28:40,550 --> 00:28:44,038 I love it because each day I decide, 711 00:28:44,038 --> 00:28:45,578 sometimes gamely, 712 00:28:45,578 --> 00:28:48,276 and sometimes against the moment's reason, 713 00:28:48,276 --> 00:28:50,854 to cleave to the reasons for living. 714 00:28:50,854 --> 00:28:54,977 And that, I think, is a highly privileged rapture. 715 00:28:54,977 --> 00:28:58,960 Thank you. 716 00:28:58,960 --> 00:29:02,096 (Applause)