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 till 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, till I felt 00:00:22.315 --> 00:00:25.831 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 --> 00:00:43.284 and I, and silence, some strange race 00:00:43.284 --> 00:00:46.493 wrecked, 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 --> 00:01:19.587 As for me, I had always thought myself tough, 00:01:19.587 --> 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 --> 00:01:38.432 and I got through all of those experiences intact. NOTE Paragraph 00:01:38.432 --> 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, but 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 --> 00:02:54.985 and yet you are nonetheless in its grip 00:02:54.985 --> 00:02:58.737 and you are unable to figure out any way around it. 00:02:58.737 --> 00:03:03.236 And so I began to feel myself doing less 00:03:03.236 --> 00:03:05.326 and thinking less 00:03:05.326 --> 00:03:07.694 and feeling less. 00:03:07.694 --> 00:03:10.049 It was a kind of nullity. NOTE Paragraph 00:03:10.049 --> 00:03:12.415 And then the anxiety set in. 00:03:12.415 --> 00:03:14.694 If you told me that I'd have to be 00:03:14.694 --> 00:03:16.283 depressed for the next month, 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." 00:03:19.507 --> 00:03:20.623 But if you said to me, 00:03:20.623 --> 00:03:23.923 "You have to have acute anxiety for the next month," 00:03:23.923 --> 00:03:26.296 I would rather slit my wrist than go through it. 00:03:26.296 --> 00:03:28.078 It was the feeling all the time 00:03:28.078 --> 00:03:30.306 like that feeling you have if you're walking 00:03:30.306 --> 00:03:31.708 and you slip or trip 00:03:31.708 --> 00:03:33.593 and the ground is rushing up at you, 00:03:33.593 --> 00:03:36.311 but instead of lasting half a second, the way that does, 00:03:36.311 --> 00:03:38.249 it lasted for six months. 00:03:38.249 --> 00:03:41.281 It's a sensation of being afraid all the time 00:03:41.281 --> 00:03:45.057 but not even knowing what it is that you're afraid of. 00:03:45.057 --> 00:03:47.477 And it was at that point that I began to think 00:03:47.477 --> 00:03:51.476 that it was just too painful to be alive, 00:03:51.476 --> 00:03:54.060 and that the only reason not to kill oneself 00:03:54.060 --> 00:03:57.191 was so as not to hurt other people. NOTE Paragraph 00:03:57.191 --> 00:04:00.184 And finally one day, I woke up 00:04:00.200 --> 00:04:02.208 and I thought perhaps I'd had a stroke, 00:04:02.208 --> 00:04:04.939 because I lay in bed completely frozen, 00:04:04.939 --> 00:04:06.888 looking at the telephone, thinking, 00:04:06.888 --> 00:04:10.451 "Something is wrong and I should call for help," 00:04:10.451 --> 00:04:12.186 and I couldn't reach out my arm 00:04:12.186 --> 00:04:14.648 and pick up the phone and dial. 00:04:14.648 --> 00:04:18.802 And finally, after four full hours of my lying and staring at it, 00:04:18.802 --> 00:04:20.164 the phone rang, 00:04:20.164 --> 00:04:22.412 and somehow I managed to pick it up, 00:04:22.412 --> 00:04:24.212 and it was my father, 00:04:24.212 --> 00:04:27.365 and I said, "I'm in serious trouble. 00:04:27.365 --> 00:04:29.528 We need to do something." NOTE Paragraph 00:04:29.528 --> 00:04:32.856 The next day I started with the medications 00:04:32.856 --> 00:04:35.224 and the therapy. 00:04:35.224 --> 00:04:37.531 And I also started reckoning 00:04:37.531 --> 00:04:39.410 with this terrible question: 00:04:39.410 --> 00:04:41.483 If I'm not the tough person 00:04:41.483 --> 00:04:44.039 who could have made it through a concentration camp, 00:04:44.039 --> 00:04:45.679 then who am I? 00:04:45.679 --> 00:04:47.628 And if I have to take medication, 00:04:47.628 --> 00:04:51.335 is that medication making me more fully myself, 00:04:51.335 --> 00:04:53.754 or is it making me someone else? 00:04:53.754 --> 00:04:55.450 And how do I feel about it 00:04:55.450 --> 00:04:57.989 if it's making me someone else? NOTE Paragraph 00:04:57.989 --> 00:05:01.300 I had two advantages as I went in to the fight. 00:05:01.300 --> 00:05:04.280 The first is that I knew that, objectively speaking, 00:05:04.280 --> 00:05:05.901 I had a nice life, 00:05:05.901 --> 00:05:07.786 and that if I could only get well, 00:05:07.786 --> 00:05:09.224 there was something at the other end 00:05:09.224 --> 00:05:11.010 that was worth living for. 00:05:11.010 --> 00:05:14.052 And the other was that I had access to good treatment. NOTE Paragraph 00:05:14.052 --> 00:05:17.816 But I nonetheless emerged and relapsed, 00:05:17.816 --> 00:05:20.095 and emerged and relapsed, 00:05:20.095 --> 00:05:23.139 and emerged and relapsed, 00:05:23.139 --> 00:05:25.092 and finally understood 00:05:25.092 --> 00:05:27.336 I would have to be on medication 00:05:27.336 --> 00:05:29.632 and in therapy forever. 00:05:29.632 --> 00:05:32.006 And I thought, "But is it a chemical problem 00:05:32.006 --> 00:05:33.770 or a psychological problem? 00:05:33.770 --> 00:05:37.466 And does it need a chemical cure or a philosophical cure?" 00:05:37.466 --> 00:05:39.525 And I couldn't figure out which it was. 00:05:39.525 --> 00:05:42.002 And then I understood that actually, 00:05:42.002 --> 00:05:44.076 we aren't advanced enough in either area 00:05:44.076 --> 00:05:46.013 for it to explain things fully. 00:05:46.013 --> 00:05:49.260 The chemical cure and the psychological cure 00:05:49.260 --> 00:05:51.062 both have a role to play, 00:05:51.062 --> 00:05:54.805 and I also figured out that depression was something 00:05:54.805 --> 00:05:57.308 that was braided so deep into us 00:05:57.308 --> 00:05:58.927 that there was no separating it 00:05:58.927 --> 00:06:01.413 from our character and personality. NOTE Paragraph 00:06:01.413 --> 00:06:03.445 I want to say that the treatments we have 00:06:03.445 --> 00:06:05.990 for depression are appalling. 00:06:05.990 --> 00:06:07.817 They're not very effective. 00:06:07.817 --> 00:06:09.650 They're extremely costly. 00:06:09.650 --> 00:06:12.099 They come with innumerable side effects. 00:06:12.099 --> 00:06:13.888 They're a disaster. 00:06:13.888 --> 00:06:16.766 But I am so grateful that I live now 00:06:16.766 --> 00:06:18.576 and not 50 years ago, 00:06:18.576 --> 00:06:20.087 when there would have been almost nothing 00:06:20.087 --> 00:06:21.488 to be done. 00:06:21.488 --> 00:06:24.069 I hope that 50 years hence, 00:06:24.069 --> 00:06:25.926 people will hear about my treatments 00:06:25.926 --> 00:06:28.059 and be appalled that anyone endured 00:06:28.059 --> 00:06:30.885 such primitive science. NOTE Paragraph 00:06:30.885 --> 00:06:35.441 Depression is the flaw in love. 00:06:35.441 --> 00:06:38.582 If you were married to someone and thought, 00:06:38.582 --> 00:06:42.177 "Well, if my wife dies, I'll find another one," 00:06:42.177 --> 00:06:45.223 it wouldn't be love as we know it. 00:06:45.223 --> 00:06:47.173 There's no such thing as love 00:06:47.173 --> 00:06:49.817 without the anticipation of loss, 00:06:49.817 --> 00:06:52.401 and that specter of despair 00:06:52.401 --> 00:06:56.130 can be the engine of intimacy. NOTE Paragraph 00:06:56.130 --> 00:06:59.059 There are three things people tend to confuse: 00:06:59.059 --> 00:07:02.859 depression, grief and sadness. 00:07:02.859 --> 00:07:06.145 Grief is explicitly reactive. 00:07:06.145 --> 00:07:09.104 If you have a loss and you feel incredibly unhappy, 00:07:09.104 --> 00:07:10.737 and then, six months later, 00:07:10.737 --> 00:07:13.959 you are still deeply sad, but you're functioning a little better, 00:07:13.959 --> 00:07:15.687 it's probably grief, 00:07:15.687 --> 00:07:17.979 and it will probably ultimately resolve itself 00:07:17.979 --> 00:07:19.428 in some measure. 00:07:19.428 --> 00:07:22.179 If you experience a catastrophic loss, 00:07:22.179 --> 00:07:23.393 and you feel terrible, 00:07:23.393 --> 00:07:26.390 and six months later you can barely function at all, 00:07:26.390 --> 00:07:28.975 then it's probably a depression that was triggered 00:07:28.975 --> 00:07:31.449 by the catastrophic circumstances. 00:07:31.449 --> 00:07:35.081 The trajectory tells us a great deal. 00:07:35.081 --> 00:07:38.439 People think of depression as being just sadness. 00:07:38.439 --> 00:07:40.775 It's much, much too much sadness, 00:07:40.775 --> 00:07:42.439 much too much grief 00:07:42.439 --> 00:07:45.368 at far too slight a cause. NOTE Paragraph 00:07:45.368 --> 00:07:48.115 As I set out to understand depression, 00:07:48.115 --> 00:07:50.950 and to interview people who had experienced it, 00:07:50.950 --> 00:07:53.981 I found that there were people who seemed 00:07:53.981 --> 00:07:55.686 on the surface to have what sounded like 00:07:55.686 --> 00:07:57.748 relatively mild depression 00:07:57.748 --> 00:08:01.195 who were nonetheless utterly disabled by it. 00:08:01.195 --> 00:08:03.053 And there were other people who had what sounded 00:08:03.053 --> 00:08:04.365 as they described it 00:08:04.365 --> 00:08:06.616 like terribly severe depression 00:08:06.616 --> 00:08:09.431 who nonetheless had good lives in the interstices 00:08:09.431 --> 00:08:11.586 between their depressive episodes. 00:08:11.586 --> 00:08:14.271 And I set out to find out what it is 00:08:14.271 --> 00:08:15.874 that causes some people 00:08:15.874 --> 00:08:18.127 to be more resilient than other people. 00:08:18.127 --> 00:08:19.686 What are the mechanisms 00:08:19.686 --> 00:08:21.530 that allow people to survive? 00:08:21.530 --> 00:08:24.699 And I went out and I interviewed person after person 00:08:24.699 --> 00:08:26.874 who was suffering with depression. NOTE Paragraph 00:08:26.874 --> 00:08:28.825 One of the first people I interviewed 00:08:28.825 --> 00:08:30.706 described depression 00:08:30.706 --> 00:08:33.967 as a slower way of being dead, 00:08:33.967 --> 00:08:36.091 and that was a good thing for me to hear early on 00:08:36.091 --> 00:08:37.457 because it reminded me 00:08:37.457 --> 00:08:39.456 that that slow way of being dead 00:08:39.456 --> 00:08:41.491 can lead to actual deadness, 00:08:41.491 --> 00:08:43.495 that this is a serious business. 00:08:43.495 --> 00:08:46.154 It's the leading disability worldwide, 00:08:46.154 --> 00:08:49.184 and people die of it every day. NOTE Paragraph 00:08:49.184 --> 00:08:50.953 One of the people I talked to 00:08:50.953 --> 00:08:52.927 when I was trying to understand this 00:08:52.927 --> 00:08:54.595 was a beloved friend 00:08:54.595 --> 00:08:56.613 who I had known for many years, 00:08:56.613 --> 00:08:59.155 and who had had a psychotic episode 00:08:59.155 --> 00:09:01.059 in her freshman year of college, 00:09:01.059 --> 00:09:04.115 and then plummeted into a horrific depression. 00:09:04.115 --> 00:09:05.541 She had bipolar illness, 00:09:05.541 --> 00:09:08.184 or manic depression, as it was then known. 00:09:08.184 --> 00:09:10.228 And then she did very well 00:09:10.228 --> 00:09:11.936 for many years on lithium, 00:09:11.936 --> 00:09:13.311 and then eventually, 00:09:13.311 --> 00:09:15.271 she was taken off her lithium 00:09:15.271 --> 00:09:17.106 to see how she would do without it, 00:09:17.106 --> 00:09:19.081 and she had another psychosis, 00:09:19.081 --> 00:09:21.419 and then plunged into the worst depression 00:09:21.419 --> 00:09:23.291 that I had ever seen 00:09:23.291 --> 00:09:26.306 in which she sat in her parents' apartment, 00:09:26.306 --> 00:09:29.383 more or less catatonic, essentially without moving, 00:09:29.383 --> 00:09:31.865 day after day after day. 00:09:31.865 --> 00:09:35.082 And when I interviewed her about that experience some years later -- 00:09:35.082 --> 00:09:38.413 she's a poet and psychotherapist named Maggie Robbins — 00:09:38.413 --> 00:09:41.646 when I interviewed her, she said, 00:09:41.646 --> 00:09:45.030 "I was singing 'Where Have All The Flowers Gone' 00:09:45.030 --> 00:09:48.240 over and over to occupy my mind. 00:09:48.240 --> 00:09:51.375 I was singing to blot out the things my mind was saying, 00:09:51.375 --> 00:09:55.865 which were, 'You are nothing. You are nobody. 00:09:55.865 --> 00:09:58.691 You don't even deserve to live.' 00:09:58.691 --> 00:10:00.869 And that was when I really started thinking 00:10:00.869 --> 00:10:03.082 about killing myself." NOTE Paragraph 00:10:03.082 --> 00:10:04.990 You don't think in depression 00:10:04.990 --> 00:10:07.127 that you've put on a gray veil 00:10:07.127 --> 00:10:09.107 and are seeing the world through the haze 00:10:09.107 --> 00:10:11.001 of a bad mood. 00:10:11.001 --> 00:10:13.721 You think that the veil has been taken away, 00:10:13.721 --> 00:10:15.643 the veil of happiness, 00:10:15.643 --> 00:10:18.067 and that now you're seeing truly. 00:10:18.067 --> 00:10:21.031 It's easier to help schizophrenics who perceive 00:10:21.031 --> 00:10:22.842 that there's something foreign inside of them 00:10:22.842 --> 00:10:25.029 that needs to be exorcised, 00:10:25.029 --> 00:10:27.193 but it's difficult with depressives, 00:10:27.193 --> 00:10:31.040 because we believe we are seeing the truth. NOTE Paragraph 00:10:31.040 --> 00:10:33.987 But the truth lies. 00:10:33.987 --> 00:10:35.985 I became obsessed with that sentence: 00:10:35.985 --> 00:10:38.360 "But the truth lies." 00:10:38.360 --> 00:10:40.813 And I discovered, as I talked to depressive people, 00:10:40.813 --> 00:10:43.495 that they have many delusional perceptions. 00:10:43.495 --> 00:10:45.162 People will say, "No one loves me." 00:10:45.162 --> 00:10:46.813 And you say, "I love you, 00:10:46.813 --> 00:10:49.335 your wife loves you, your mother loves you." 00:10:49.335 --> 00:10:51.258 You can answer that one pretty readily, 00:10:51.258 --> 00:10:52.923 at least for most people. 00:10:52.923 --> 00:10:55.190 But people who are depressed will also say, 00:10:55.190 --> 00:10:56.895 "No matter what we do, 00:10:56.895 --> 00:10:59.168 we're all just going to die in the end." 00:10:59.168 --> 00:11:01.371 Or they'll say, "There can be no true communion 00:11:01.371 --> 00:11:03.024 between two human beings. 00:11:03.024 --> 00:11:05.600 Each of us is trapped in his own body." 00:11:05.600 --> 00:11:07.449 To which you have to say, 00:11:07.449 --> 00:11:08.770 "That's true, 00:11:08.770 --> 00:11:10.588 but I think we should focus right now 00:11:10.588 --> 00:11:12.484 on what to have for breakfast." 00:11:12.484 --> 00:11:14.669 (Laughter) 00:11:14.669 --> 00:11:16.338 A lot of the time, 00:11:16.338 --> 00:11:19.234 what they are expressing is not illness, but insight, 00:11:19.234 --> 00:11:21.891 and one comes to think what's really extraordinary 00:11:21.891 --> 00:11:24.825 is that most of us know about those existential questions 00:11:24.825 --> 00:11:27.115 and they don't distract us very much. 00:11:27.115 --> 00:11:29.274 There was a study I particularly liked 00:11:29.274 --> 00:11:30.954 in which a group of depressed 00:11:30.954 --> 00:11:32.855 and a group of non-depressed people 00:11:32.855 --> 00:11:35.478 were asked to play a video game for an hour, 00:11:35.478 --> 00:11:37.291 and at the end of the hour, 00:11:37.291 --> 00:11:38.942 they were asked how many little monsters 00:11:38.942 --> 00:11:40.806 they thought they had killed. 00:11:40.806 --> 00:11:43.018 The depressive group was usually accurate 00:11:43.018 --> 00:11:45.076 to within about 10 percent, 00:11:45.076 --> 00:11:46.547 and the non-depressed people 00:11:46.547 --> 00:11:50.092 guessed between 15 and 20 times as many 00:11:50.092 --> 00:11:51.834 little monsters — (Laughter) — 00:11:51.834 --> 00:11:55.945 as they had actually killed. NOTE Paragraph 00:11:55.945 --> 00:11:59.011 A lot of people said, when I chose to write about my depression, 00:11:59.011 --> 00:12:00.780 that it must be very difficult 00:12:00.780 --> 00:12:03.904 to be out of that closet, to have people know. 00:12:03.904 --> 00:12:06.104 They said, "Do people talk to you differently?" 00:12:06.104 --> 00:12:08.176 And I said, "Yes, people talk to me differently. 00:12:08.176 --> 00:12:10.090 They talk to me differently insofar 00:12:10.090 --> 00:12:12.880 as they start telling me about their experience, 00:12:12.880 --> 00:12:14.715 or their sister's experience, 00:12:14.715 --> 00:12:16.489 or their friend's experience. 00:12:16.489 --> 00:12:18.781 Things are different because now I know 00:12:18.781 --> 00:12:21.462 that depression is the family secret 00:12:21.462 --> 00:12:23.539 that everyone has. NOTE Paragraph 00:12:23.539 --> 00:12:27.167 I went a few years ago to a conference, 00:12:27.167 --> 00:12:29.820 and on Friday of the three-day conference, 00:12:29.820 --> 00:12:32.711 one of the participants took me aside, and she said, 00:12:32.711 --> 00:12:36.116 "I suffer from depression and 00:12:36.116 --> 00:12:38.885 I'm a little embarrassed about it, 00:12:38.885 --> 00:12:40.988 but I've been taking this medication, 00:12:40.988 --> 00:12:43.936 and I just wanted to ask you what you think?" 00:12:43.936 --> 00:12:46.770 And so I did my best to give her such advice as I could. 00:12:46.770 --> 00:12:48.490 And then she said, "You know, 00:12:48.490 --> 00:12:51.281 my husband would never understand this. 00:12:51.281 --> 00:12:53.854 He's really the kind of guy to whom this wouldn't make any sense, 00:12:53.854 --> 00:12:56.721 so I just, you know, it's just between us." 00:12:56.721 --> 00:12:58.507 And I said, "Yes, that's fine." 00:12:58.507 --> 00:13:00.616 On Sunday of the same conference, 00:13:00.616 --> 00:13:03.660 her husband took me aside, 00:13:03.660 --> 00:13:05.354 and he said, "My wife wouldn't think 00:13:05.354 --> 00:13:07.789 that I was really much of a guy if she knew this, 00:13:07.789 --> 00:13:10.255 but I've been dealing with this depression 00:13:10.255 --> 00:13:11.609 and I'm taking some medication, 00:13:11.609 --> 00:13:14.114 and I wondered what you think?" 00:13:14.114 --> 00:13:15.537 They were hiding 00:13:15.537 --> 00:13:17.752 the same medication in two different places 00:13:17.752 --> 00:13:20.397 in the same bedroom. 00:13:20.397 --> 00:13:22.418 And I said that I thought 00:13:22.418 --> 00:13:24.102 communication within the marriage 00:13:24.102 --> 00:13:26.116 might be triggering some of their problems. 00:13:26.116 --> 00:13:30.307 (Laughter) 00:13:30.307 --> 00:13:31.962 But I was also struck 00:13:31.962 --> 00:13:33.768 by the burdensome nature 00:13:33.768 --> 00:13:36.141 of such mutual secrecy. 00:13:36.141 --> 00:13:38.026 Depression is so exhausting. 00:13:38.026 --> 00:13:40.794 It takes up so much of your time and energy, 00:13:40.794 --> 00:13:42.298 and silence about it, 00:13:42.298 --> 00:13:45.029 it really does make the depression worse. NOTE Paragraph 00:13:45.029 --> 00:13:46.762 And then I began thinking about all the ways 00:13:46.762 --> 00:13:48.728 people make themselves better. 00:13:48.728 --> 00:13:51.167 I'd started off as a medical conservative. 00:13:51.167 --> 00:13:53.539 I thought there were a few kinds of therapy that worked, 00:13:53.539 --> 00:13:55.348 it was clear what they were -- 00:13:55.348 --> 00:13:56.992 there was medication, 00:13:56.992 --> 00:13:58.468 there were certain psychotherapies, 00:13:58.468 --> 00:14:00.913 there was possibly electroconvulsive treatment, 00:14:00.913 --> 00:14:03.588 and that everything else was nonsense. 00:14:03.588 --> 00:14:05.420 But then I discovered something. 00:14:05.420 --> 00:14:07.172 If you have brain cancer, 00:14:07.172 --> 00:14:08.644 and you say that standing on your head 00:14:08.644 --> 00:14:11.639 for 20 minutes every morning makes you feel better, 00:14:11.639 --> 00:14:13.153 it may make you feel better, 00:14:13.153 --> 00:14:14.741 but you still have brain cancer, 00:14:14.741 --> 00:14:17.030 and you'll still probably die from it. 00:14:17.030 --> 00:14:19.542 But if you say that you have depression, 00:14:19.542 --> 00:14:21.647 and standing on your head for 20 minutes every day 00:14:21.647 --> 00:14:24.131 makes you feel better, then it's worked, 00:14:24.131 --> 00:14:26.491 because depression is an illness of how you feel, 00:14:26.491 --> 00:14:28.100 and if you feel better, 00:14:28.100 --> 00:14:30.930 then you are effectively not depressed anymore. 00:14:30.930 --> 00:14:32.963 So I became much more tolerant 00:14:32.963 --> 00:14:35.888 of the vast world of alternative treatments. NOTE Paragraph 00:14:35.888 --> 00:14:38.272 And I get letters, I get hundreds of letters 00:14:38.272 --> 00:14:40.788 from people writing to tell me about what's worked for them. 00:14:40.788 --> 00:14:42.989 Someone was asking me backstage today 00:14:42.989 --> 00:14:44.452 about meditation. 00:14:44.452 --> 00:14:46.917 My favorite of the letters that I got 00:14:46.917 --> 00:14:48.391 was the one that came from a woman 00:14:48.391 --> 00:14:50.598 who wrote and said that she had tried therapy, 00:14:50.598 --> 00:14:52.985 she had tried medication, she had tried pretty much everything, 00:14:52.985 --> 00:14:55.822 and she had found a solution and hoped I would tell the world, 00:14:55.822 --> 00:14:59.634 and that was making little things from yarn. 00:14:59.634 --> 00:15:02.633 (Laughter) 00:15:02.633 --> 00:15:06.157 She sent me some of them. (Laughter) 00:15:06.157 --> 00:15:09.845 And I'm not wearing them right now. 00:15:09.845 --> 00:15:12.360 I suggested to her that she also should look up 00:15:12.360 --> 00:15:16.408 obsessive compulsive disorder in the DSM. NOTE Paragraph 00:15:16.408 --> 00:15:19.536 And yet, when I went to look at alternative treatments, 00:15:19.536 --> 00:15:22.444 I also gained perspective on other treatments. 00:15:22.444 --> 00:15:25.347 I went through a tribal exorcism in Senegal 00:15:25.347 --> 00:15:27.360 that involved a great deal of ram's blood 00:15:27.360 --> 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 afterwards I was in Rwanda 00:15:31.422 --> 00:15:33.180 working on a different project, 00:15:33.180 --> 00:15:35.976 and I happened to describe my experience to someone, 00:15:35.976 --> 00:15:37.736 and he said, "Well, you know, 00:15:37.736 --> 00:15:39.556 that's West Africa, and we're in East Africa, 00:15:39.556 --> 00:15:41.390 and our rituals are in some ways very different, 00:15:41.390 --> 00:15:43.403 but we do have some rituals that have something 00:15:43.403 --> 00:15:45.390 in common with what you're describing." 00:15:45.390 --> 00:15:47.053 And I said, "Oh." And he said, "Yes," he said, 00:15:47.053 --> 00:15:49.695 "but we've had a lot of trouble with Western mental health workers, 00:15:49.695 --> 00:15:52.452 especially the ones who came right after the genocide." 00:15:52.452 --> 00:15:54.779 And I said, "What kind of trouble did you have?" 00:15:54.779 --> 00:15:56.325 And he said, "Well, 00:15:56.325 --> 00:15:58.989 they would do this bizarre thing. 00:15:58.989 --> 00:16:00.874 They didn't take people out in the sunshine 00:16:00.874 --> 00:16:02.574 where you begin to feel better. 00:16:02.574 --> 00:16:05.668 They didn't include drumming or music to get people's blood going. 00:16:05.668 --> 00:16:07.510 They didn't involve the whole community. 00:16:07.510 --> 00:16:09.285 They didn't externalize the depression 00:16:09.285 --> 00:16:10.718 as an invasive spirit. 00:16:10.718 --> 00:16:13.349 Instead what they did was they took people 00:16:13.349 --> 00:16:15.977 one at a time into dingy little rooms 00:16:15.977 --> 00:16:17.320 and had them talk for an hour 00:16:17.320 --> 00:16:19.550 about bad things that had happened to them." 00:16:19.550 --> 00:16:25.010 (Laughter) (Applause) 00:16:25.010 --> 00:16:27.372 He said, "We had to ask them to leave the country." 00:16:27.372 --> 00:16:30.429 (Laughter) NOTE Paragraph 00:16:30.429 --> 00:16:32.873 Now at the other end of alternative treatments, 00:16:32.873 --> 00:16:34.908 let me tell you about Frank Russakoff. 00:16:34.908 --> 00:16:37.961 Frank Russakoff had the worst depression 00:16:37.961 --> 00:16:40.876 perhaps that I've ever seen in a man. 00:16:40.876 --> 00:16:42.869 He was constantly depressed. 00:16:42.869 --> 00:16:45.010 He was, when I met him, at a point at which 00:16:45.010 --> 00:16:48.168 every month he would have electroshock treatment. 00:16:48.168 --> 00:16:50.743 Then he would feel sort of disoriented for a week. 00:16:50.743 --> 00:16:52.546 Then he would feel okay for a week. 00:16:52.546 --> 00:16:54.246 Then he would have a week of going downhill. 00:16:54.246 --> 00:16:56.931 And then he would have another electroshock treatment. 00:16:56.931 --> 00:16:58.346 And he said to me when I met him, 00:16:58.346 --> 00:17:00.898 "It's unbearable to go through my weeks this way. 00:17:00.898 --> 00:17:02.405 I can't go on this way, 00:17:02.405 --> 00:17:04.669 and I've figured out how I'm going to end it 00:17:04.669 --> 00:17:06.226 if I don't get better. 00:17:06.226 --> 00:17:08.934 But," he said to me, "I heard about a protocol 00:17:08.934 --> 00:17:11.157 at Mass General for a procedure called 00:17:11.157 --> 00:17:13.183 a cingulotomy, which is a brain surgery, 00:17:13.183 --> 00:17:15.754 and I think I'm going to give that a try." 00:17:15.754 --> 00:17:17.708 And I remember being amazed at that point 00:17:17.708 --> 00:17:19.008 to think that someone 00:17:19.008 --> 00:17:22.229 who clearly had so many bad experiences 00:17:22.229 --> 00:17:24.088 with so many different treatments 00:17:24.088 --> 00:17:27.210 still had buried in him somewhere enough optimism 00:17:27.210 --> 00:17:29.760 to reach out for one more. 00:17:29.760 --> 00:17:31.940 And he had the cingulotomy, 00:17:31.940 --> 00:17:33.981 and it was incredibly successful. 00:17:33.981 --> 00:17:35.474 He's now a friend of mine. 00:17:35.474 --> 00:17:38.966 He has a lovely wife and two beautiful children. 00:17:38.966 --> 00:17:41.915 He wrote me a letter the Christmas after the surgery, 00:17:41.915 --> 00:17:43.104 and he said, 00:17:43.104 --> 00:17:45.511 "My father sent me two presents this year, 00:17:45.511 --> 00:17:48.113 First, a motorized C.D. rack from The Sharper Image 00:17:48.113 --> 00:17:49.534 that I didn't really need, 00:17:49.534 --> 00:17:51.631 but I knew he was giving it to me to celebrate 00:17:51.631 --> 00:17:53.359 the fact that I'm living on my own 00:17:53.359 --> 00:17:55.406 and have a job I seem to love. 00:17:55.406 --> 00:17:56.967 And the other present 00:17:56.967 --> 00:17:58.543 was a photo of my grandmother, 00:17:58.543 --> 00:18:00.795 who committed suicide. 00:18:00.795 --> 00:18:03.730 As I unwrapped it, I began to cry, 00:18:03.730 --> 00:18:05.610 and my mother came over and said, 00:18:05.610 --> 00:18:08.925 'Are you crying because of the relatives you never knew?' 00:18:08.925 --> 00:18:13.013 And I said, 'She had the same disease I have.' 00:18:13.013 --> 00:18:15.594 I'm crying now as I write to you. 00:18:15.594 --> 00:18:19.189 It's not that I'm so sad, but I get overwhelmed, 00:18:19.189 --> 00:18:21.410 I think, because I could have killed myself, 00:18:21.410 --> 00:18:23.113 but my parents kept me going, 00:18:23.113 --> 00:18:24.862 and so did the doctors, 00:18:24.862 --> 00:18:26.716 and I had the surgery. 00:18:26.716 --> 00:18:29.531 I'm alive and grateful. 00:18:29.531 --> 00:18:31.791 We live in the right time, 00:18:31.791 --> 00:18:35.670 even if it doesn't always feel like it." NOTE Paragraph 00:18:35.670 --> 00:18:37.567 I was struck by the fact that depression 00:18:37.567 --> 00:18:39.292 is broadly perceived to be 00:18:39.292 --> 00:18:42.829 a modern, Western, middle-class thing, 00:18:42.829 --> 00:18:44.981 and I went to look at how it operated 00:18:44.981 --> 00:18:46.984 in a variety of other contexts, 00:18:46.984 --> 00:18:49.103 and one of the things I was most interested in 00:18:49.103 --> 00:18:50.893 was depression among the indigent. 00:18:50.893 --> 00:18:52.674 And so I went out to try to look at 00:18:52.674 --> 00:18:55.254 what was being done for poor people with depression. 00:18:55.254 --> 00:18:57.412 And what I discovered is that poor people 00:18:57.412 --> 00:18:59.969 are mostly not being treated for depression. 00:18:59.969 --> 00:19:02.888 Depression is the result of a genetic vulnerability, 00:19:02.888 --> 00:19:06.046 which is presumably evenly distributed in the population, 00:19:06.046 --> 00:19:07.999 and triggering circumstances, 00:19:07.999 --> 00:19:09.902 which are likely to be more severe 00:19:09.902 --> 00:19:11.777 for people who are impoverished. 00:19:11.777 --> 00:19:14.204 And yet it turns out that if you have 00:19:14.204 --> 00:19:16.344 a really lovely life but feel miserable all the time, 00:19:16.344 --> 00:19:18.344 you think, "Why do I feel like this? 00:19:18.344 --> 00:19:20.013 I must have depression." 00:19:20.013 --> 00:19:21.936 And you set out to find treatment for it. 00:19:21.936 --> 00:19:24.029 But if you have a perfectly awful life, 00:19:24.029 --> 00:19:25.896 and you feel miserable all the time, 00:19:25.896 --> 00:19:28.722 the way you feel is commensurate with your life, 00:19:28.722 --> 00:19:30.446 and it doesn't occur to you to think, 00:19:30.446 --> 00:19:32.229 "Maybe this is treatable." 00:19:32.229 --> 00:19:35.365 And so we have an epidemic in this country 00:19:35.365 --> 00:19:38.278 of depression among impoverished people 00:19:38.278 --> 00:19:40.790 that's not being picked up and that's not being treated 00:19:40.790 --> 00:19:42.846 and that's not being addressed, 00:19:42.846 --> 00:19:45.046 and it's a tragedy of a grand order. 00:19:45.046 --> 00:19:46.534 And so I found an academic 00:19:46.534 --> 00:19:48.351 who was doing a research project 00:19:48.351 --> 00:19:50.092 in slums outside of D.C., 00:19:50.092 --> 00:19:53.089 where she picked up women who had come in for other health problems 00:19:53.089 --> 00:19:54.868 and diagnosed them with depression, 00:19:54.868 --> 00:19:58.134 and then provided six months of the experimental protocol. 00:19:58.134 --> 00:20:00.463 One of them, Lolly, came in, 00:20:00.463 --> 00:20:02.760 and this is what she said the day she came in. 00:20:02.760 --> 00:20:06.155 She said, and she was a woman, by the way, 00:20:06.155 --> 00:20:08.247 who had seven children. She said, 00:20:08.247 --> 00:20:10.898 "I used to have a job but I had to give it up because 00:20:10.898 --> 00:20:12.958 I couldn't go out of the house. 00:20:12.958 --> 00:20:15.186 I have nothing to say to my children. 00:20:15.186 --> 00:20:17.953 In the morning, I can't wait for them to leave, 00:20:17.953 --> 00:20:20.943 and then I climb in bed and pull the covers over my head, 00:20:20.943 --> 00:20:22.589 and three o'clock when they come home, 00:20:22.589 --> 00:20:24.390 it just comes so fast." 00:20:24.390 --> 00:20:26.630 She said, "I've been taking a lot of Tylenol, 00:20:26.630 --> 00:20:29.389 anything I can take so that I can sleep more. 00:20:29.389 --> 00:20:33.159 My husband has been telling me I'm stupid, I'm ugly. 00:20:33.159 --> 00:20:36.664 I wish I could stop the pain." NOTE Paragraph 00:20:36.664 --> 00:20:39.304 Well, she was brought into this experimental protocol, 00:20:39.304 --> 00:20:41.612 and when I interviewed her six months later, 00:20:41.612 --> 00:20:46.019 she had taken a job working in childcare 00:20:46.019 --> 00:20:49.824 for the U.S. Navy, she had left the abusive husband, 00:20:49.824 --> 00:20:51.906 and she said to me, 00:20:51.906 --> 00:20:54.275 "My kids are so much happier now." 00:20:54.275 --> 00:20:56.252 She said, "There's one room in my new place 00:20:56.252 --> 00:20:58.860 for the boys and one room for the girls, 00:20:58.860 --> 00:21:01.399 but at night, they're just all up on my bed, 00:21:01.399 --> 00:21:04.011 and we're doing homework all together and everything. 00:21:04.011 --> 00:21:05.684 One of them wants to be a preacher, 00:21:05.684 --> 00:21:07.384 one of them wants to be a firefighter, 00:21:07.384 --> 00:21:10.350 and one of the girls says she's going to be a lawyer. 00:21:10.350 --> 00:21:12.355 They don't cry like they used to, 00:21:12.355 --> 00:21:14.913 and they don't fight like they did. 00:21:14.913 --> 00:21:18.693 That's all I need now is my kids. 00:21:18.693 --> 00:21:20.605 Things keep on changing, 00:21:20.605 --> 00:21:25.798 the way I dress, the way I feel, the way I act. 00:21:25.798 --> 00:21:29.485 I can go outside not being afraid anymore, 00:21:29.485 --> 00:21:32.894 and I don't think those bad feelings are coming back, 00:21:32.894 --> 00:21:35.929 and if it weren't for Dr. Miranda and that, 00:21:35.929 --> 00:21:39.546 I would still be at home with the covers pulled over my head, 00:21:39.546 --> 00:21:41.895 if I were still alive at all. 00:21:41.895 --> 00:21:45.627 I asked the Lord to send me an angel, 00:21:45.627 --> 00:21:49.957 and he heard my prayers." NOTE Paragraph 00:21:49.959 --> 00:21:53.312 I was really moved by these experiences, 00:21:53.312 --> 00:21:55.851 and I decided that I wanted to write about them 00:21:55.851 --> 00:21:57.230 not only in a book I was working on, 00:21:57.230 --> 00:21:58.541 but also in an article, 00:21:58.541 --> 00:22:00.862 and so I got a commission from The New York Times Magazine 00:22:00.862 --> 00:22:02.878 to write about depression among the indigent. NOTE Paragraph 00:22:02.878 --> 00:22:04.494 And I turned in my story, 00:22:04.494 --> 00:22:06.090 and my editor called me and said, 00:22:06.090 --> 00:22:07.800 "We really can't publish this." NOTE Paragraph 00:22:07.800 --> 00:22:09.550 And I said, "Why not?" NOTE Paragraph 00:22:09.550 --> 00:22:11.855 And she said, "It just is too far-fetched. 00:22:11.855 --> 00:22:15.633 These people who are sort of at the very bottom rung of society 00:22:15.633 --> 00:22:17.337 and then they get a few months of treatment 00:22:17.337 --> 00:22:19.969 and they're virtually ready to run Morgan Stanley? 00:22:19.969 --> 00:22:21.823 It's just too implausible." 00:22:21.823 --> 00:22:24.028 She said, I've never even heard of anything like it." NOTE Paragraph 00:22:24.028 --> 00:22:26.562 And I said, "The fact that you've never heard of it 00:22:26.562 --> 00:22:29.562 is an indication that it is news." 00:22:29.562 --> 00:22:35.696 (Laughter) (Applause) 00:22:37.317 --> 00:22:39.811 "And you are a news magazine." NOTE Paragraph 00:22:39.811 --> 00:22:41.793 So after a certain amount of negotiation, 00:22:41.793 --> 00:22:43.034 they agreed to it. 00:22:43.034 --> 00:22:44.649 But I think a lot of what they said 00:22:44.649 --> 00:22:46.944 was connected in some strange way 00:22:46.944 --> 00:22:49.086 to this distaste that people still have 00:22:49.086 --> 00:22:50.549 for the idea of treatment, 00:22:50.549 --> 00:22:52.431 the notion that somehow if we went out 00:22:52.431 --> 00:22:55.127 and treated a lot of people in indigent communities, 00:22:55.127 --> 00:22:57.025 that would be an exploitative thing to do, 00:22:57.025 --> 00:22:58.667 because we would be changing them. 00:22:58.667 --> 00:23:00.700 There is this false moral imperative 00:23:00.700 --> 00:23:02.489 that seems to be all around us 00:23:02.489 --> 00:23:04.843 that treatment of depression, 00:23:04.843 --> 00:23:07.142 the medications and so on, are an artifice, 00:23:07.142 --> 00:23:09.314 and that it's not natural. 00:23:09.314 --> 00:23:12.163 And I think that's very misguided. 00:23:12.163 --> 00:23:15.695 It would be natural for people's teeth to fall out, 00:23:15.695 --> 00:23:19.025 but there is nobody militating against toothpaste, 00:23:19.025 --> 00:23:21.153 at least not in my circles. NOTE Paragraph 00:23:21.153 --> 00:23:23.655 And people then say, "Well, but isn't depression 00:23:23.655 --> 00:23:25.840 part of what people are supposed to experience? 00:23:25.840 --> 00:23:27.581 Didn't we evolve to have depression? 00:23:27.581 --> 00:23:29.488 Isn't it part of your personality?" 00:23:29.488 --> 00:23:32.234 To which I would say, mood is adaptive. 00:23:32.234 --> 00:23:35.563 Being able to have sadness and fear 00:23:35.563 --> 00:23:37.405 and joy and pleasure 00:23:37.405 --> 00:23:39.208 and all of the other moods that we have, 00:23:39.208 --> 00:23:41.272 that's incredibly valuable. 00:23:41.272 --> 00:23:44.319 And major depression is something that happens 00:23:44.319 --> 00:23:46.331 when that system gets broken. 00:23:46.331 --> 00:23:48.048 It's maladaptive. NOTE Paragraph 00:23:48.048 --> 00:23:49.620 People will come to me and say, 00:23:49.620 --> 00:23:52.388 "I think, though, if I just stick it out for another year, 00:23:52.388 --> 00:23:54.464 I think I can just get through this." NOTE Paragraph 00:23:54.464 --> 00:23:56.767 And I always say to them, "You may get through it, 00:23:56.767 --> 00:23:59.476 but you'll never be 37 again. 00:23:59.476 --> 00:24:02.026 Life is short, and that's a whole year 00:24:02.026 --> 00:24:03.982 you're talking about giving up. 00:24:03.982 --> 00:24:05.520 Think it through." NOTE Paragraph 00:24:05.520 --> 00:24:08.366 It's a strange poverty of the English language, 00:24:08.366 --> 00:24:10.474 and indeed of many other languages, 00:24:10.474 --> 00:24:12.692 that we use this same word, depression, 00:24:12.692 --> 00:24:14.497 to describe how a kid feels 00:24:14.497 --> 00:24:16.209 when it rains on his birthday, 00:24:16.209 --> 00:24:18.737 and to describe how somebody feels 00:24:18.737 --> 00:24:21.191 the minute before they commit suicide. NOTE Paragraph 00:24:21.191 --> 00:24:24.296 People say to me, "Well, is it continuous with normal sadness?" 00:24:24.296 --> 00:24:27.440 And I say, in a way it's continuous with normal sadness. 00:24:27.440 --> 00:24:29.640 There is a certain amount of continuity, 00:24:29.640 --> 00:24:31.597 but it's the same way there's continuity 00:24:31.597 --> 00:24:33.584 between having an iron fence outside your house 00:24:33.584 --> 00:24:35.261 that gets a little rust spot 00:24:35.261 --> 00:24:38.007 that you have to sand off and do a little repainting, 00:24:38.007 --> 00:24:40.654 and what happens if you leave the house for 100 years 00:24:40.654 --> 00:24:43.552 and it rusts through until it's only a pile 00:24:43.552 --> 00:24:44.786 of orange dust. 00:24:44.786 --> 00:24:46.959 And it's that orange dust spot, 00:24:46.959 --> 00:24:48.748 that orange dust problem, 00:24:48.748 --> 00:24:51.737 that's the one we're setting out to address. NOTE Paragraph 00:24:51.737 --> 00:24:53.977 So now people say, 00:24:53.977 --> 00:24:56.708 "You take these happy pills, and do you feel happy?" 00:24:56.708 --> 00:24:58.594 And I don't. 00:24:58.594 --> 00:25:01.416 But I don't feel sad about having to eat lunch, 00:25:01.416 --> 00:25:04.252 and I don't feel sad about my answering machine, 00:25:04.252 --> 00:25:07.097 and I don't feel sad about taking a shower. 00:25:07.097 --> 00:25:09.951 I feel more, in fact, I think, 00:25:09.951 --> 00:25:12.381 because I can feel sadness without nullity. 00:25:12.381 --> 00:25:16.728 I feel sad about professional disappointments, 00:25:16.728 --> 00:25:19.075 about damaged relationships, 00:25:19.075 --> 00:25:21.114 about global warming. 00:25:21.114 --> 00:25:23.839 Those are the things that I feel sad about now. 00:25:23.839 --> 00:25:26.573 And I said to myself, well, what is the conclusion? 00:25:26.573 --> 00:25:29.134 How did those people who have better lives 00:25:29.134 --> 00:25:31.688 even with bigger depression manage to get through? 00:25:31.688 --> 00:25:34.485 What is the mechanism of resilience? 00:25:34.485 --> 00:25:36.569 And what I came up with over time 00:25:36.569 --> 00:25:39.485 was that the people who deny their experience, 00:25:39.485 --> 00:25:41.517 the ones who say, "I was depressed a long time ago 00:25:41.517 --> 00:25:43.254 and I never want to think about it again 00:25:43.254 --> 00:25:44.496 and I'm not going to look at it 00:25:44.496 --> 00:25:46.386 and I'm just going to get on with my life," 00:25:46.386 --> 00:25:48.345 ironically, those are the people 00:25:48.345 --> 00:25:51.043 who are most enslaved by what they have. 00:25:51.043 --> 00:25:53.607 Shutting out the depression strengthens it. 00:25:53.607 --> 00:25:56.887 While you hide from it, it grows. 00:25:56.887 --> 00:25:59.747 And the people who do better 00:25:59.747 --> 00:26:02.346 are the ones who are able to tolerate the fact 00:26:02.346 --> 00:26:03.968 that they have this condition. 00:26:03.968 --> 00:26:06.438 Those who can tolerate their depression 00:26:06.438 --> 00:26:08.220 are the ones who achieve resilience. NOTE Paragraph 00:26:08.220 --> 00:26:10.003 So Frank Russakoff said to me, 00:26:10.003 --> 00:26:11.519 "If I had it again to do over, 00:26:11.519 --> 00:26:13.656 I suppose I wouldn't do it this way, 00:26:13.656 --> 00:26:15.620 but in a strange way, I'm grateful 00:26:15.620 --> 00:26:17.123 for what I've experienced. 00:26:17.123 --> 00:26:20.940 I'm glad to have been in the hospital 40 times. 00:26:20.940 --> 00:26:23.543 It taught me so much about love, 00:26:23.543 --> 00:26:26.383 and my relationship with my parents and my doctors 00:26:26.383 --> 00:26:30.772 has been so precious to me, and will be always." NOTE Paragraph 00:26:30.772 --> 00:26:32.698 And Maggie Robbins said, 00:26:32.698 --> 00:26:35.687 "I used to volunteer in an AIDS clinic, 00:26:35.687 --> 00:26:38.701 and I would just talk and talk and talk, 00:26:38.701 --> 00:26:40.514 and the people I was dealing with 00:26:40.514 --> 00:26:42.581 weren't very responsive, and I thought, 00:26:42.581 --> 00:26:46.542 'That's not very friendly or helpful of them.' 00:26:46.542 --> 00:26:48.184 And then I realized, 00:26:48.184 --> 00:26:50.311 I realized that they weren't going to do more 00:26:50.311 --> 00:26:52.698 than make those first few minutes of small talk. 00:26:52.698 --> 00:26:54.755 It was simply going to be an occasion 00:26:54.755 --> 00:26:57.633 where I didn't have AIDS and I wasn't dying, 00:26:57.633 --> 00:27:00.606 but could tolerate the fact that they did 00:27:00.606 --> 00:27:02.393 and they were. 00:27:02.393 --> 00:27:05.996 Our needs are our greatest assets. 00:27:05.996 --> 00:27:08.135 It turns out I've learned to give 00:27:08.135 --> 00:27:12.160 all the things I need." NOTE Paragraph 00:27:12.160 --> 00:27:13.851 Valuing one's depression 00:27:13.851 --> 00:27:16.045 does not prevent a relapse, 00:27:16.045 --> 00:27:18.706 but it may make the prospect of relapse 00:27:18.706 --> 00:27:22.924 and even relapse itself easier to tolerate. 00:27:22.924 --> 00:27:24.969 The question is not so much 00:27:24.969 --> 00:27:27.144 of finding great meaning and deciding 00:27:27.144 --> 00:27:29.171 your depression has been very meaningful. 00:27:29.171 --> 00:27:31.342 It's of seeking that meaning 00:27:31.342 --> 00:27:33.146 and thinking, when it comes again, 00:27:33.146 --> 00:27:34.786 "This will be hellish, 00:27:34.786 --> 00:27:37.487 but I will learn something from it." 00:27:37.487 --> 00:27:39.751 I have learned in my own depression 00:27:39.751 --> 00:27:41.764 how big an emotion can be, 00:27:41.764 --> 00:27:44.861 how it can be more real than facts, 00:27:44.861 --> 00:27:47.810 and I have found that that experience 00:27:47.810 --> 00:27:50.702 has allowed me to experience positive emotion 00:27:50.702 --> 00:27:54.222 in a more intense and more focused way. 00:27:54.222 --> 00:27:57.709 The opposite of depression is not happiness, 00:27:57.709 --> 00:27:59.163 but vitality, 00:27:59.163 --> 00:28:01.904 and these days, my life is vital, 00:28:01.904 --> 00:28:04.649 even on the days when I'm sad. 00:28:04.649 --> 00:28:07.962 I felt that funeral in my brain, 00:28:07.962 --> 00:28:09.986 and I sat next to the colossus 00:28:09.986 --> 00:28:12.233 at the edge of the world, 00:28:12.233 --> 00:28:14.322 and I have discovered 00:28:14.322 --> 00:28:16.173 something inside of myself 00:28:16.173 --> 00:28:18.306 that I would have to call a soul 00:28:18.306 --> 00:28:22.062 that I had never formulated until that day 20 years ago 00:28:22.062 --> 00:28:26.580 when hell came to pay me a surprise visit. 00:28:26.580 --> 00:28:30.678 I think that while I hated being depressed 00:28:30.678 --> 00:28:33.012 and would hate to be depressed again, 00:28:33.012 --> 00:28:35.756 I've found a way to love my depression. 00:28:35.756 --> 00:28:37.781 I love it because it has forced me 00:28:37.781 --> 00:28:40.550 to find and cling to joy. 00:28:40.550 --> 00:28:44.038 I love it because each day I decide, 00:28:44.038 --> 00:28:45.578 sometimes gamely, 00:28:45.578 --> 00:28:48.276 and sometimes against the moment's reason, 00:28:48.276 --> 00:28:50.854 to cleave to the reasons for living. 00:28:50.854 --> 00:28:54.977 And that, I think, is a highly privileged rapture. NOTE Paragraph 00:28:54.977 --> 00:28:58.960 Thank you. NOTE Paragraph 00:28:58.960 --> 00:29:02.096 (Applause)