THE EXPERIENCE OF DEPRESSION: "ON MY BAD DAYS . . . IT'S LIKE FALLIN' INTO A DARK CAVE."
Judy was able to convey the quality of her struggle with depression very clearly. Her first-person account was articulate, and this enabled her to provide a sense of what her subjective experience had been like. Judy tended to speak about her difficulties with depression in terms of “mental illness.” When I asked her how far back she could remember feeling depressed, she said, “I’m not sure what age the mental illness came in . . . uhm in my life, but I know freshman year, I tried to commit suicide, around Christmas time in my bedroom by hanging myself. That really didn’t work.” Judy did not dwell on this painful experience, nor did she elaborate extensively on this suicide attempt. She did state that she had made various suicide attempts throughout her life and that there were still moments when it was a struggle to remain invested in living. Judy’s depression began very early on in her life, and she explored in great detail some of the painful emotional experiences she had during her childhood.
In seeking out the origin of her depression, Judy recalled having difficulties as early as four years of age. “I know that I also have very severe learning disabilities and speech disabilities that really didn’t help because at the age of four I was not even speaking, anything and my parents took me to all sorts of specialists . . . including a neuronal pediatrician.” This doctor sent a letter explaining his assessment to Judy’s parents. In the letter, which was never discussed with Judy directly, “was a debate . . . saying it was either a weak tongue muscle or it could just be emotional.” Regardless of the potential physiological causes, a retreat from language or a refusal to enter it can also be a symptom of emotional distress (Casey, 2001; Kristeva, 1989; Rogers, 2006).
Kristeva (1991) describes a sense of all-encompassing alienation that can occur in depressive states. When a person internalizes this sense of alienation, of feeling foreign to him- or herself, what is left is a feeling of psychological homelessness, of not belonging anywhere. This can result in a retreat from communion, an alliance with silence that, while maintaining the relational schism that helped to create it, is at least a silence that does not further alienate the individual with mismatched words and inaccurate meanings. It is possible that this is one of the reasons for Judy’s childhood silence, and for the later separation she made from her family. Judy may have retreated from language at this very young age in order to protect herself from further mis- recognition and abuse. In this way, by embracing an excruciatingly painful sense of alienation, Judy was able to protect herself, at least for a while, from something worse. This sense of separation continued into the social realm as Judy got older, and it contributed to her depression. Judy explained,
Growing up I really had noooo, really friends, uhm . . . and, my neighborhood in grade school in high school uhm, I did have a lot of emotional problems in high school. My depression could have started there. I’m not really sure. Uhm, which came first, the chicken or the egg?
When asked to describe how she feels when she is depressed and what she does to cope with these feelings, Judy replied, “On my bad days, my dark days . . . it’s like fallin’ into a dark cave. I don’t want to be bothered. There are times I could get either very angry or very lonely or very sad. I don’t want to be bothered by anybody or anything. I want to be le- left alone.” At times, the darkness got so bad that it would threaten to engulf Judy, which sometimes prompted her to want to cause herself physical harm. When I inquired about her suicidality and what was going through her mind when she made attempts to take her own life, Judy explained:
Uhm, I wanted to end the pain. . . . When you when you self-cut, it doesn’t necessarily mean that you want to . . . commit suicide. When you physically cut, it’s just to stop the emotional pain inside. It’s just a temporary, fix. But the emotional pain gets back. Uhm, after years of therapy, I don’t self-cut anymore. Back growing up in grade school—this may sound gross—you take the bottom of your foot . . . I used to eat and peel away the whole . . . skin and make it bleed.
Self-injury provided a temporary relief from unbearable emotional pain. Physical pain can serve as a distraction from emotional anguish, or it can feel like a satisfying culmination of inner suffering expressed physically. Sometimes, the pain can create feelings of aliveness in individuals who have dwelled too long with a sense of deadness or numbness; it is a way to finally feel something. It also provides a sense of control; rather than harm being inflicted externally, the individual can control the type, extent, and duration of pain experienced, and in this way test his or her personal thresholds for tolerating pain. In a sense, self-cutting is an exercise in building resilience to suffering. Pipher (1994) states that self-injury in teenage girls can be seen as a commentary on the culturally inflicted pain they are experiencing, that it can be seen as a protest against psychological death. Judy wasn’t able to explain what caused her to peel the skin off of her foot any more than she was capable of explaining the intense psychological distress she was enduring. It is likely because she did not have any means of symbolizing her inner pain that she felt compelled to act in this self-destructive manner. Her behavior was a physically enacted symptom of the psychological assaults she was experiencing. Judy also recalled engaging in other forms of self-injury as a young child. “I used to lay in bed and with this thing (an object), in grade school, I used to constantly punch this eye (she pointed to her eye) out.”
Judy attributed many of her difficulties to the way she “was raised from childhood.” She said her upbringing had instilled in her a tendency to have extremely distorted perceptions: “It has a lot of irrational fears, a lot of extreme black and white, all or nothing thinkin’, it is where I have to do a lot of reality testing.” The need for reality testing is a natural response to being brought up in a boundary-l ess environment that is completely devoid of structure, consistency, clear rules, and limitations. These qualities provide for a person the sense of being held and contained. Without them, interpersonal worlds blend together and it is difficult to know where another person ends and one’s self begins. As a result, Judy often felt very isolated as a child. This feeling was further exacerbated by the fact that she was frequently the only one of her siblings to be specifically excluded from conversations about significant family events.