Posted by: Beverly Davidson, LMSW | August 14, 2014

The Black Hole of Depression

So much to say – a beloved actor and caring, benevolent man has passed at his own hands, falling prey to the tunnels of darkness. So much has been written already about him, and about the horrors of depression. Calls to raise awareness, reduce stigma, and increase treatment are being championed all around the media and blogosphere. But will we rise?

I have been thinking these last few days of all the people, both personally and professionally, I have known who have struggled with such illnesses. I have been flooded with many memories of conversations I have had over the years, mostly with clients, on what it is like to have a debilitating brain disease such as depression. I shudder at some of the response I gave during my early years of practice. So much I did not know, so much I did not understand.
I think about some of the times I have asked my clients about their illness and what it is like for them. Here are some answers I have remembered. Some are so haunting they have stuck with me for years. I try to never forget their answers so I will always have compassion the next time I meet someone who is suffering and feeling so utterly alone.

What is depression like for you?
“It’s like a black hole you can’t crawl out of, it’s neverending, and it is blinding.”
“It is paralyzing, my body aches, my heart hurts, and my head spins. It just won’t stop.”
“Sometimes the drugs help, a lot of times they do, but then there is that day they don’t. Then it is darkness all over again. And then less hope.”
“People tell me to just be happy and pick myself up by my bootstraps. But it it feels like I can’t even get my boots on.”
“I have bipolar. The highs are fantastical. I feel so alive. Then the lows come. It is worse than being dead.”
“I feel like I can’t move. I can feel it coming on, and I can’t stop it. I pray, I tell it to go away, I beg. It just doesn’t go away.”
“I just want it to end. I have tried every med there is. I just don’t think there is any point.”
“I am just sick and tired of being sick and tired. My hope is almost gone. Without that what is there?”
“I try so hard to make it stop. I worry about my family. I do think sometime they’d be better off without me. I have no joy. I have nothing to give.”

What, I ask you, do you say to such pain?

What about therapy? Have you tried that?
“Yes, but therapy is mostly talking. I have nothing inside of me. I feel nothing. I am nothing. What is there to talk about?”
“Why would I talk to someone about how I feel? No one can change how I feel, and I wouldn’t want to be a burden on someone, even a stranger, for how desperate my soul is.”
“Therapy works for awhile. Just like the meds. Then it comes back. It always comes back.”

These truths are real, and there are no easy answers.

These are real-life statements from people who I have known. People of different socio-economic and racial backgrounds, not just the poor and uneducated. Their voices periodically linger in the back of my mind, and even more so this week. I have known two people who have taken their own lives. They were severely depressed, and struggled with addiction. But so did many other people I have worked with over the years. I do not know what sets them apart from all the others I have known with mental illness. I don’t think anyone will ever know. Why him? Why not her? It makes sense if she did it? But him, no way? The truth is we just don’t know the inner workings of someone’s mind, even in spite of their outside persona. A person’s inner soul is so immensely private, that likely a very select few ever see it. This I do know. Depression, bipolar disorder, schizophrenia, any of the “mental illnesses” are insidious and complicated diseases, and anyone who suffers from them need our compassion and understanding, even during death, for a person to take his or her own life, he must have been suffering greater psychic pain than any average person will ever, ever know. Be kind, in life, and in death.

It does continue to make me wonder what we can do.

One thing that comes to mind is that we need to reframe the discussion. Why are we calling depression, bipolar, addiction, or schizophrenia a mental illness? These are physical illnesses that are due to atypical brain chemistry. When you call something a mental illness, there is an implication that a person is at fault and there is some kind of character flaw. With that belief, it is easier to blame the person and villify him as a defective human. When we can blame a person, there is no collective responsibility for humanity or compassion. Is that what we have come to?

When a person has diabetes, they have a pancreas that is not functioning properly. When a person has asthma, they have lungs not functioning properly. If a person dies of an asthma attack, is he blamed and characterized as being at fault? Unlikely. When a person has depression, their brain is not functioning properly. The pancreas and the lungs and the brain are all organs, and organs we all need to survive. Diabetes, heart disease, lung disease all are treated with scans and tests of the organ responsible for the disease. “Mental” illnesses are the only illnesses whose organ, the brain, is not routinely scanned or evaluated to determine appropriate treatment. I once met with a psychiatrist for my own struggles with anxiety, and he said that psychiatry is more an art versus a science, and so we experimented with different medications to see what worked. Would that type of experimentation happen with heart disease?

I am not intimating that the medical profession is at fault for the evaluation and treatment of “mental” illness. In fact, no one is, but we all are. I am suggesting, however, that if we remove the term “mental” from these illnesses, and just call them physical illnesses, less stigma would be attached to the individuals who suffer so greatly from such pain. Less blame translates into more compassion and kindness…..and that leads to better treatment overall.

I am grateful I have never suffered from the black hole of depression. No one deserves to have such suffering. To all those who struggle, may you find peace and compassion.



  1. Thank you Bev.

  2. Very nice, i have seen that black hole and to this day i dread ever going back.

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