Slowly — too slowly — our culture is beginning to understand that depression isn’t just one person feeling blue because their life sucks. It’s a health issue with causes and effects that can be treated and ameliorated. The human brain is, by far, the most complex, complicated organ in our bodies. It’s also the organ we understand the least. Inside our skulls, 100 billion nerve cells (neurons) [are] interconnected by trillions of connections, called synapses. On average, each connection transmits about one signal per second. Some specialized connections send up to 1,000 signals per second. Our synapses work like digital circuits; they’re either open or closed. If they’re open, electrical currents can travel across them — and information moves right along with the current. “Somehow… that’s producing thought,” says Charles Jennings, director of neurotechnology at the MIT McGovern Institute for Brain Research. As ethereal as our thoughts feel, they probably have a physical form — some kind of encoding sequence “burned into” storage areas of our brains. These storage areas — dispersed across our grey matter — link up as we think associatively — connecting immediate stimuli to memories of similar stimuli.
In a happy world where only happy thoughts filtered into our brains, our brains would (one hopes) process only happiness and happiness is all we’d feel and “know”. Alas, Life doesn’t work that way. Even getting through a morning can produce the full gamut of thought possibilities. Some Life experiences leave behind more than just their physical imprint on our neural networks They leave behind darkness. Depression.
If happy thoughts produce lightness in our heads, depression produces its opposite. And, mind you, just like with cancer, there’s more than one kind of depression. Not all darkness is created equal. What Shakespeare called “the slings and arrows of outrageous fortune” can leave scars on our bodies and in our minds. I was sexually assaulted twice when I was fourteen by the religious director at the synagogue where my family belonged outside of Baltimore. The second instance was especially harmful because (having kept the secret that first time), I believed I was therefore responsible for there being a second time. Somehow, this information imprinted deeply into my brain — not just that it happened but that it happened for a complicated reason for which I was responsible. That’s a lot of abstraction spread across various parts of my brain. But, that abstraction became my darkness — and that darkness haunted me even though I denied its existence.
When does a terrible incident transition into depression inside our brains? What causes that depression to “metastasize” from “sad thoughts” into increasingly self-destructive behavior? I treated this memory of being sexually assaulted like a secret only I (and my attacker) would or could know. That’s why there was a second time, remember? Despite being sexually assaulted once, I said nothing, told no one. That must have been the case — from my attacker’s point of view — since he still had a job and wasn’t in jail. As I walked in the door that second time, he knew he was safe — and knew he could do it again. So, he did.
This particular memory — this collection of information plus perspective plus all other associations connected to it — behaved exactly like a slow-moving cancer. Plenty of other bad memories become “cancerous” in that they interfere with your life in potentially fatal ways. Just like our immune system regularly deals with low level cancers all the time, our brains find ways of, if not healing the cancerous thoughts, at least containing them and the damage done. Talk therapy went a long way toward mitigating a lot of the depression caused by my sexual assault. Unfortunately, until I dealt with that cancer directly, I was never going to put my cancer into remission.
In my case, this “thought cancer” destroyed my ability to relate to other people with confidence. It’s not that I didn’t or couldn’t trust them, it’s that I had a secret that they could never know — and if they didn’t know that secret about me, they couldn’t possibly know “me”. This put me on an emotional island I didn’t even know I was on. I had friends but never close friends; that is, they felt closeness to me that I couldn’t feel toward them because, down deep, I couldn’t understand why they’d want to BE my friend when, the dark, dirty truth was, I was undeserving of anyone’s friendship. Because of what I did.
Three days before Christmas 2016 — my cancer suddenly metastasizing at an even more alarming rate — I came within literal inches of killing myself. My darkness, my thought cancer, had blocked out all perspective. I had become convinced that my family and friends — my community — would go on same as it was just fine without me. That would not have been the case at all, certainly not with my wife and kids. But, that’s the insidious thing about “thought cancer”. Like a tumor does, depression becomes part of the architecture. The body starts feeding it blood — like it belonged there. The tumor’s essence flows into you and, like a virus, sets about turning you into it.
In my case, I convinced myself that because I’d been sexually assaulted, I deserved every other rotten thing that happened. Including death. Talk about bullshit.
My path out of the darkness and back up into reality began with talk therapy. Acknowledging the need for help was essential to both getting help and being helped. But, I was still keeping that secret from myself — literally denying that such a thing had ever happened to me. I needed even more help — that was my suicide attempt. I had feared mood stabilizers because of the reasons above: we have a “guestimate” understanding of how our brains work but an even bigger gap in understanding how exactly these drugs work in our individual brains. I grew up in a medical family; my dad was a surgeon. I know the culture. I know that my GP doesn’t have a background in these meds — not their fault. Most likely, they’d prescribe whatever the last Big Pharma rep left behind last time she visited and handed out samples. I wanted to deal with my depression while leaving my hypomania alone mostly (that’s where my creativity resides — I’m bi-polar too) and had found lamotrigine (lamictil). The anecdotal information available while I was Googling back in 2014 and 2015 was scant compared to now. At higher doses (I’ve since researched), lamotrigine can impact one’s hypomania. But, I got lucky.
Boy, did I get lucky. Immediately after my attempt — knowing I needed more help than just talk therapy — I drove straight to my GP and told them everything. I told them what happened — but not why because I didn’t know that yet. I told them I’d researched lamotrigine. My GP (and the head doctor — I got a lot of attention) whipped out their smart phones to look it up for themselves. By that point, they’d asked me three times if perhaps I should be hospitalized. I assured them that if trying medication didn’t help then, yes — I’d agree to be hospitalized. They wrote the script.
I went hope, told my family what I was planning — they signed off on it (they were even more desperate than I was that I get help) and I took my first 25 milligram dose. That’s when luck really kicked in. Within 36 hours at that minimal dose, I levelled. I literally felt the darkness lose its power to control me.
My rage was explosive back then. Though usually self-directed, my rage could just as easily be pointed at something stupid I heard on the radio or LA traffic. I don’t remember what set it off that time but the rage erupted in my gut and began to funnel upward with increasing velocity. I was quite prepared for it to hit my throat and — per usual — explode out of me in waves of angry, vituperative spew. But, this time, just as the rage went to explode, instead, it dissipated like a soap bubble popping. I knew I had felt this incredible anger but, just when I expected to really FEEL it? Nada. It was gone except for the (already) fading memory of it.
This was liberating! After the exact same thing happened again several hours later, I understood exactly how the mood stabilizer was stabilizing my moods.
With my depression no longer in charge — no longer able to derail me and my emotions, I could begin the real process of healing. In my case, I could begin to address the eight thousand kiloton gorilla sitting on my chest: my secret.
Long story short: I did confront my secret and confronting it hurt like a mofo. But, confronting that secret — talking about it finally — took away literally all its power over me. Writing about it was even more healing.
I haven’t removed my darkness, I’ve disempowered it. It still lurks within and it knows the power it has over me. If this was “cancer” cancer, I’d change my diet to keep it at bay or alter my lifestyle as necessary. Thought cancer requires the same pro-active measures.
I don’t think for two seconds that I’ve “beaten” this thought cancer. I’ve just figured out how to live with it — and find happiness while living with it. That’s the good news on the subject: there is hope. Lots and lots of it.