CHAPTER 2: WHAT IS DEPRESSION?

The first ten million years were the worst. And the second ten million years, they were the worst too. The third ten million years I didn’t enjoy at all. After that I went into a bit of a decline.

MARVIN THE ANDROID FROM DOUGLAS ADAMS’S THE RESTAURANT AT THE END OF THE UNIVERSE

WHAT IS A MOUNTAIN?

Easy, right? We know what a mountain is. A child of five knows what a mountain is—even if he’s lived in Kansas all his life. If I look outside my window in Colorado Springs, I see dozens, and it’s not like they’re hard to discern. They literally stick out.

At its simplest, a mountain is just really tall dirt.

But mountain isn’t as easy to define as you’d think.

There’s no such thing as a “typical” mountain. Some explode on the surface of the earth like a pimple; others are squished out of the ground like Play-Doh through a preschooler’s fingers. Mount Everest is more than 29,000 feet high. Australia’s Mount Wycheproof is less than 500. Mount Fuji looks different than Denali. Technically, Hawaii’s Mauna Kea is the world’s tallest mountain—nearly a mile taller than Everest, in fact—but less than 14,000 feet of it sticks out above the sea. And then, there’s a question of what makes a mountain at all. Why is that particular lump of dirt and rock a mountain, and not a hill? Are a mountain’s qualifications different in Colorado (which has lots of big lumps of dirt) than, say, Great Britain? (Scotland’s Ben Nevis is the tallest point in the UK at 4,413 feet. But if I stood in downtown Colorado Springs—which in many spots, by the way, is as flat as a dinner plate—I’d have to dig down about 2,000 feet to hit the equivalent of Ben Nevis’ summit.)

There’s no guarantee that even a pretty impressive peak will actually earn its mountain badge. Colorado may be officially home to fifty-three “fourteeners” (mountains that are more than 14,000 feet high).[1] But dedicated hikers argue this point with ardor, vigor, and—sometimes—weapons. Some will say we have fifty-two fourteeners. Or fifty-eight.[2] Or maybe seventy-four.[3] It all depends on how you quantify not just the peak’s height, but the elevation of the land (called a saddle) between two adjacent 14,000-foot peaks. If a saddle’s too high, a pair of perfectly serviceable mountains officially turns into a two-headed granite monstrosity.

And knowing what a mountain looks like doesn’t do justice to the actual experience of climbing one. Most fourteeners have false summits—peaks that God seemingly created to just break hikers’ hearts a little. (“What?” I’ve said more than once. “We’re not at the top?”) And even if they’re fairly straightforward, getting to the top can be brutal. The higher you go, the thinner the air gets. By the time you hit timberline—the line above which trees dare not grow—your heart feels like it’s as big as a cow’s and seems like it’s beating as fast as a chipmunk’s. Your lungs expand and contract like a bullfrog throat, even though it feels like there’s precious little oxygen to fill them. Your head grows lighter, your legs get heavier, and every step becomes an exercise of pure, stubborn will.

Depression’s a little like a mountain. Only without the view.

Like a mountain, most of us think we know what depression looks like. And in part, most of us sorta do. But defining it gets pretty tricky pretty fast. In fact, if you ever hear someone say theatrically “I’m sooooo depressed,” chances are pretty good that she isn’t. The hallmark of depression isn’t always feeling really sad: When it gets bad, it’s about your inability to feel much of anything.

At its most basic, experts define depression through a collection of recognizable symptoms, which include:

Every depressed person will exhibit at least some of these symptoms, but they by no means need to have them all. Not every depressed person is suicidal (thank goodness). Not everyone has trouble concentrating. Lots of depressed people lose weight, but for me, the allure of lemon meringue pie is typically too strong for that. (Curse you, variable depressive symptoms!) All these symptoms can vary in degree and intensity too. And to raise the difficulty level higher, most of those symptoms are shared by other conditions, diseases, and even personality traits.

Take, for instance, one of the telltale indications of depression: lethargy. This might be the condition’s biggest calling card and one of its most crippling symptoms—and perhaps the biggest reason why depression (according to the World Health Organization) is a leading cause of disability worldwide.[5] Depressed people have a hard time getting out of bed, much less doing something meaningful with their time. “I am in that temper that if I were under Water I would, scarcely kick to come to the top,” wrote Romantic-era poet John Keats.[6] In the teeth of a particularly severe depressive episode, some of the afflicted don’t have the energy to eat (thus the weight loss). Taking a shower, to the depressive person, feels not just pointless, but nigh impossible. (And shampooing? Don’t get me started.) For the depressed person, the phrase “life’s burdens” feels less like a nice cliché than a literal 1970s-era Chevy that you have to carry around everywhere.

In his book The Noonday Demon: An Atlas of Depression, Andrew Solomon said that depression, at its worst, sapped his ability to do anything. He had no thoughts of killing himself because the act itself would have just required too much effort.[7] It’s a sentiment echoed by the former TV talk show host Dick Cavett, who has struggled with depression most of his life. “Perhaps the saddest irony of depression is that suicide happens when the patient gets a little better and can again function sufficiently.”[8]

But in those who suffer from a less severe case, depressive lethargy can look an awful lot like, well, just being lazy. And naturally, being lazy can be mistaken for depression. Friends and family members might not recognize the difference. I’m not sure I can even tell the difference at times. If I spend four hours playing a video game, am I depressed? Or am I just feeling particularly shiftless and looking for ways to avoid writing a book about depression?

The same goes for lots of the symptoms on the depressive docket: Insomnia could be a sign of depression, or it could be the result of a particularly stressful day, too much coffee, the time of year, or any number of factors. You might be depressed if you have trouble making decisions . . . or you might just be indecisive. Suicidal ideation is one of the most alarming symptoms of depression, but not every person who tries to kill him- or herself is actually depressed.

So, yeah, depression is confusing, and it comes with a host of misconceptions. So perhaps as we begin this discussion, we should not start by trying to define what depression is, but to say what it is not.

It is not ordinary sadness. Sadness is a very normal and very healthy reaction to life’s pits and rinds. Oh, depressive people can be quite sad, of course, but that’s not what makes them stand out. If we break up with someone or we lose out on a job we really wanted or someone lets us down, we should be sad about that. I can get pretty mopey even when the Denver Broncos lose a football game (though admittedly, as I write this in 2019, I’m getting more used to it all the time). But that’s not depression.

It is not grief—even though grief can look very much like depression. Yes, when we grieve over the death of a parent or child or friend, we can feel that our own lives are over. We can sink into a state wherein it’s almost impossible to do much of anything. And honestly, someone doesn’t need to die for us to experience it. The loss of a relationship can knock us flat. The loss of a job can send us reeling. I think, in a way, we can even grieve the loss of our children when they head off to school and start their own lives.

But again, grief is normal and, in its own strange way, a gift of sorts. When we grieve, it means that we have loved. Our pain speaks to the depth of that love. And eventually, even our sadness may help to remind us how blessed we were to have them in our lives in the first place. The grieving process is a journey—not an easy one, but one that has a destination, a place where joy tempers sadness and loss, and where you can remember what was with a bittersweet fondness.

Depression can look like a Sisyphean form of grief—one in which you push through those terrible emotions but feel like you’ll never push past them. It’s not a trek through sadness and despondency, but a treadmill, where you’re grinding through the same emotions again and again.

I like how Solomon contrasts grief and depression in The Noonday Demon: “Grief is a humble angel who leaves you with strong, clear thoughts and a sense of your own depth. Depression is a demon who leaves you appalled.”[9]

Speaking of demons . . .

It is not sin (in itself). Some Christians believe that depression is simply a symptom of a lack of faith and God’s promises. Get right with the Lord, they say, and your mental angst and anguish will melt away like so much snow. And I understand that on some level. We’re a people who believe in purpose and answered prayers. It’s not that we think that life will be easy. But the Bible tells us that God has given us all the tools we need to push through life’s torments and trials. The pessimism that seems such an integral part of depression can feel, to some, like a rejection of that confidence. Oh ye of little faith.

But when we dig into the workings of the brain, we learn that depression is less about faith and more about science—even if the science itself is still unfolding.

We are creatures with wildly complicated operating systems, and a dizzying number of factors feed into this state of melancholia. Some are biological: Scientists have found, for instance, that the brain’s hippocampus is smaller in some women who suffer from depression.[10] Research suggests that some depressed people may have faulty neurotransmitters—the process through which our nerve cells communicate with each other.[11] Most scientists believe that there’s a genetic component at work too: “Heritability is probably 40 to 50 percent,” according to an article from Stanford Medicine, “and might be higher for severe depression.”[12] Past trauma, such as physical or sexual abuse, can increase the likelihood of suffering from depression. Certain medications can too. Life events can, of course, be massive triggers. But a lot of times, people can get depressed for little or no apparent reason at all.

Will scientists ever understand the brain sufficiently to define the causes of depression as definitively as they diagnose strep throat today? I doubt it. And honestly, I hope not. I like a little mystery in my life. I like the fact that each human mind is a little like a perpetually unfolding, ultimately inscrutable continent, where even those of us who live there find new hills and valleys all the time. To understand the human brain the way we might a car engine . . . well, that just seems to rob our lives of a little magic.

And it’s not as if the Bible promises a life free of mental anguish if we just pray a little bit harder. Everyone from Job to Moses walks through some desperately dark times in their lives. The Psalms sometimes scream in mental anguish. And while ancient Israel didn’t have a lot of qualified psychologists to diagnose the mental maladies of the poets, plenty seem to read like depression to me. Take this snippet from Psalm 88:

I am a man who has no strength,

like one set loose among the dead,

like the slain that lie in the grave,

like those whom you remember no more,

for they are cut off from your hand.

You have put me in the depths of the pit,

in the regions dark and deep.

Your wrath lies heavy upon me,

and you overwhelm me with all your waves.

PSALM 88:4-7

The psalmist prays plenty, but still feels no relief. “Why do you hide your face from me?” he cries in verse 14. If depression is the product of too little faith, it seems like we’re in fine company.

It is not a bad mood that can be cured with good intentions. In days gone by, depression might have been seen less as “mental illness” and more “mental weakness.”

And while we better understand depression now, that sense of weakness still soaks into the discussion. Feeling sad? Mopey? Cheer up. Get over yourself.

I used to work for a professional rodeo organization, and perhaps the rodeo cowboy’s philosophy can be summed up in two words: Cowboy up. It’s a pretty good philosophy in most respects, and I think a lot of us feel that way when we’re faced with someone who’s depressed—and sometimes, even when we deal with it ourselves. Cowboy up, we think. Get on your feet. Pull yourself together. When the going gets tough, the tough get going. I could fill the rest of this book with well-meaning clichés, inspirational exhortations, and plain ol’ kicks-in-the-keister.

But for those dealing with depression, it’s not always so easy. For those convinced that the whole world is a gray, empty place, no pep talk or candy gram—no matter how peppy the talk or how candy-laden the gram—will give it the color and meaning needed.

And yet.

While depression is none of those things, it can have elements of all of these things. Sadness is often a symptom of depression. Grief can trigger depression. Our own sin can spawn feelings of worthlessness and hopelessness and separation from God—all of which can make us very depressed indeed.

And you know what else? Sometimes a candy gram or kick-in-the-keister is what we need to move forward.

What is depression? It’s complicated, that’s what.

Its causes are myriad and not fully understood. Its symptoms can vary wildly from person to person. While it comes in a handful of recognized types (mild to severe, episodic to chronic, seasonal, postpartum, etc.), it melds and morphs to fit each of us like its own awful glove. Typical depression? There’s no such thing. It can show up in as many forms as the people who suffer from it. More, perhaps. I know that, over the years, depression has looked and felt different for me. Depression, like faith, is intensely personal. But if I dared express the condition in general terms—what it feels like—I’d agree with a comparison Andrew Solomon makes in The Noonday Demon: It feels like static.[13]

I grew up in a long-ago, far-away time when entertainment was a rudimentary thing, not far removed from Punch-and-Judy shows. We had television, but no streaming services to cue up, no DVR’ed episodes to fast-forward through. My parents didn’t even have cable—an absence I’m still a little bitter about. No, our television had a set of rabbit ears and just a handful of local stations.[14] Some of those stations would come in pretty clearly. Turn the rabbit ears just so, and the reception was almost as good as you could get on cable. But when I tried to watch NBC (an ancient electronic destination called a broadcast network), the picture was always marred at least a little by static—electronic insects that would swarm and circle under the glass. Some days you could see the picture relatively clearly: The insects would blur the images a bit, pushing and pulling and muting the color in their black-and-white dance, but you could still tell what you were watching. A cat looked like a cat. A house looked like a house. You could even pick out different people.

But other days, you’d lose the picture almost entirely. You knew that something was underneath the static: You could see, however dimly, outline and shade. But was it a cat? Could it be a horse? Hard to tell. And no matter how much you turned the rabbit ears or thwacked the side of the TV (that really did work sometimes), the picture never got better. And even as the picture grew fainter, the sound seemed louder—a harsh hiss cutting through the dialogue and music. You had to turn the sound way up to hear the dialogue.

At its worst, that’s what my depression can feel like: that channel on a bad day. Life fades under a sea of insects. The real world retreats against an assault of half-seen, mostly imagined fears and doubts, even as the noise around you grows louder. No matter how hard you try to find that picture underneath, you can’t see it for the insects—or, at least, you can’t see it enough for the image to mean much of anything.

But here’s a funny and frightening thing. Even as depression (and its sister illness, anxiety) warps the world around you, it serves as an amplifier for all the gunk inside you. Your insecurities, your suspicions, your guilt, your pain. Tim Sanford, a counselor for Focus on the Family who’s dealt with his own bouts of depression, tells me that depression never creates the feelings of sadness and unworthiness that are so common; it just makes them bigger and badder and nigh impossible to quiet and ignore. Imagine, for a moment, that your negative emotions and thoughts are stuffed in a closet somewhere in your psyche. Picture them as pots and pans, kazoos, maybe a drum or cymbal or two. You open the door and look at them now and again, maybe shuffling them around the closet and, if you’re lucky, throwing some of them out sometimes.

Depression’s the toddler who’s just learned to open doors. He’ll pull out all those negative feelings and play with them—tossing pot lids down the stairs, beating the drums through the halls, playing the kazoos at three in the morning. The noise is unrelenting. And if you do somehow manage to gather all those emotions, throw ’em back in the closet, and slam the door again, depression won’t let the door alone.

The din inside grows as the music outside diminishes. You lose your ability to filter what’s really important with the clanging, banging sound of your own anxieties and shame and sadness.

I’ve heard that the ability to filter is one of the secrets to our ability to live and succeed. Our environments are such rich places—so filled with countless sights and sounds and smells and sensations—that our minds are constantly winnowing down all that information into what we actually need to be aware of, what we need to know.[15] We’re filtering out sensations constantly, which makes a muddy world feel clearer, more consumable, and thus more manageable. We need those filters in place to operate well. And if we lose them, we run the risk of being unable to operate at all.

I wonder if the same is true of our own thoughts and feelings, too. Perhaps to thrive, we need to filter our more negative emotions—not filter them out, because then we’d just have other problems, but sift and strain them to a more manageable level. Perhaps depression and anxiety is simply what we call it when those filters aren’t working the way they should. We’re flooded with an amplified sense of our own faults and stressors and the horror of everything. And in the wake of the flood of internal inputs—the need to swim in so many directions at once—you stop trying. You’re no longer in control; your affliction controls you. You and the static you feel are indistinguishable. You see nothing. You feel nothing. You are nothing.

I’ve only been down that “nothing” path a couple of times in my life, but it’s an interesting sensation. I remember feeling particularly anguished one night in college—pouring out my soul to my (surely bewildered) girlfriend in the car, parked by a cornfield. I can’t remember exactly what was going through my mind at the time, but there was sure a lot of it: The insects were buzzing that night. Flooding. And then, suddenly, it felt like I’d gone under. I was so filled with the static and I was empty. My life seemed to drain away, like water in a tub. I felt like a hollow drum with not even enough energy to beat my skin and boom.

I didn’t feel sad or angry or happy or relieved, though there was a curious, cold peace. I was a dead man blinking.

I think maybe we all feel that sense of emptiness sometimes when we’re grieving a loved one or mourning a treasured relationship. We cry and wail and tear at our sackcloth and, eventually, there are no more tears. We’re left cool and hard until God, in His infinite love, gives us a transfusion of humanity again.

But some people who suffer from depression can feel this way for weeks, even months. It overwhelms you and, like a giant mosquito, sucks you dry—depleting even your desire to scratch. It takes everything you are and everything you want to be, leaving you unable to give or receive, to do or even feel. The insects take over. And unless you do something, they’ll pull you down . . . one way or another.

That’s not my experience often. I’m one of the happier depressed people I know, in fact—a melancholy optimist. But even today, when I feel like I have some control over my darker moods, I still can feel like I’m watching that channel: that channel on a good day, admittedly, but a channel that still stirs with understated static. The joy I might otherwise feel is just a bit muted. My ability to deal with the world around me is ever so slightly impaired, requiring a bit more effort. Staring at the picture behind the insects requires more concentration. And depression runs through my psyche, beating its drum.

Depression is the microbrew of mental health: bewilderingly diverse and oddly trendy. In fact, if you look at the stats, depression is on the rise with pretty much every demographic you can think of.[16] But it does seem to visit certain types of people more than others.

It’s more likely to affect women than men—twice as likely, in fact. Experts point to a variety of reasons for this gender disparity: Hormones can play a huge factor during puberty, menopause, and during and after giving birth. Women tend to deal with more inequity at work and, frankly, more work and pressure at home. Culturally, the average woman has to deal with more stress than the average man, as the women in my life often tell me. But men are also less likely to seek help for depression than women, which means they’re inherently diagnosed less often.

Folks who care for others in their jobs tend to be more likely to be depressed too.[17] Nursing, teaching, social work, and caring for both youth and elderly are all on the list of most “depressing” careers (though I’d imagine that many working in those fields would also say they’re among the most rewarding, too). Creative types—artists, actors, and, yes, writers—tend to experience depression at higher rates than others. In fact, according to Health.com, this is the job category most likely to be associated with major depression in men.[18]

And while depression is no discriminator, youth and the aged have some greater risk factors that can feed the condition. More than one in six teens have already experienced at least one severe mental disorder in their lives, according to the National Alliance on Mental Illness.[19] Adults aged eighteen to twenty-five reportedly think about suicide more than any other age group.[20] And while the elderly are not particularly prone to depression (in fact, many studies suggest you get happier as you age[21]), rates go up depending on how healthy they are and how isolated they feel. And because seniors are expected to slow down, depressive lethargy might go unrecognized—leading to depression that goes untreated.[22]

Location may have an impact on depression as well, as strange as that sounds. In the United States, people who live in rural environs suffer slightly more than those who live in cities.[23] (Oddly, a 2004 study found the opposite to be true in Canada.[24]) Cloudy, rainy Seattle is often said to be the suicide capital of the US, but a study published in Social Science & Medicine found that it wasn’t even in the top ten.[25] Sunny Las Vegas tops that onerous list, followed by my home, Colorado Springs. Western and southern states seem to have higher rates of mental illness than those in the Northeast or Midwest. Six of the seven states with the country’s highest suicide rates are clustered around the Rockies.[26] The outlier—Alaska—has its own fair share of mountains. Experts say that lots of factors play into why the west and south have higher rates of suicide, including regional attitudes toward mental health care and adequate access to that care. But might even altitude be a factor in depression? Some believe so.[27]

This past summer, some friends and I decided to hike Mount Quandary, one of Colorado’s fifty-three, or fifty-eight, or seventy-four fourteeners. While experts consider it a fairly easy fourteener to climb, there’s really no such thing. Quandary’s challenge is its dramatic rise in altitude—about 7,000 feet in six miles. The grade is so steep that, in places, you’re not hiking a trail: You’re climbing stairs. And when you’re already starting at 11,000 feet, each stair feels about two feet high.

One of the hikers was a college student, fresh back from a year at sea level in California. Most of us were huffing and puffing as we started the hike, but he was suffering more than the rest of us. About a half mile in, he sat down and stared at me with wide eyes. “Is it all like this?” he said.

Aside from all the biology and genetics and demographics of depression, there’s one simple fact that makes the condition so insidious: Life is hard enough as it is, and depression makes it harder. And in the teeth of it, it seems that life and depression are one—and that as long as you have the former, you’ll walk with the latter. Each step saps your strength, and you know the next step will feel heavier than the last. You struggle even to breathe. You try to enjoy the wonderful world around you, but you’re so tired. So tired.

Is it all like this? You ask. And the depression whispers in your soul, Yes. Yes it is.

But depression, as I’ve learned, lies.

While scientists still study and debate the causes of depression, the condition is treatable. Just as the condition has no single cause, it has no single cure. Counseling can be incredibly helpful. (The ministry I work for, Focus on the Family, has counselors on staff able to talk with you if you call their helpline at 1-855-771-HELP.) Support groups can provide community in what can be a terribly isolating condition. Medication can be a huge tool in stilling the static—in restoring the brain’s equilibrium and keeping it that way. According to the Depression and Bipolar Support Alliance, up to 80 percent of people who are treated for depression are successfully helped through a combination of medication and counseling.

But depressed people need help outside the doctor’s office too. This most intimate of diseases shrinks, like a vampire exposed to a cross, from our most intimate resources: Friends. Family. Faith. These have been instrumental in helping me deal with my own issues. Because depression can sap your strength and will, sometimes you need to lean on others.

But there are limits.

At the very end of 2003’s The Lord of the Rings: The Return of the King, Frodo Baggins and his loyal friend, Samwise Gamgee, find themselves on a mountain—the ominously and appropriately named Mount Doom. Frodo carries the Ring of Power, an incredibly evil (and slightly sentient) piece of jewelry that slowly destroys everyone who wears it. Frodo and Sam are on their way to cast it into the mountain’s fires—getting rid of it forever. And Frodo, as the story’s “Ring Bearer,” must carry the Ring alone. But as he carries it, the Ring’s original owner and maker, the terrible Sauron, seems to spiritually come ever nearer.

While I don’t think anyone has ever compared the Ring to depression, its impact on Frodo feels, at times, strangely similar. Over the course of the story, that Ring has slowly sapped much of Frodo’s strength and will and joy—becoming more alive than Frodo is himself. And here, on the rocky slope of Mount Doom, Frodo can no longer walk. He falls to the fire-torn ground, his face scarred and marred by grime.

Sam comes alongside and tries to encourage Frodo by reminding him about the Shire, their home—about the good, precious, beautiful things in life. The birds, the flowers, strawberries with cream.

“Do you remember the taste of strawberries?” Sam asks.

“No, Sam,” Frodo answers weakly. “I don’t recall the taste of food. Nor the sound of water. Or the touch of grass. [I’m] naked in the dark. There’s nothing. No veil. He’s with me in the wheel of fire! I can see him with my waking eyes!”

“Then let us be rid of it, once and for all,” Sam says. “Come on, Mr. Frodo. I can’t carry it for you—but I can carry you!”

It’s a beautiful, powerful scene. And in the context of our subject, the story offers a sense of hope to those of us who are carrying our own depressing burdens. If our strength gives out, we may have people in our lives who can come alongside and lift us up—even carry us for a time.

But alas, depression isn’t a metal ring we can just rip off and chuck into a volcano. If it was, this book would be a whole lot shorter. The burden we carry is inside us. And eventually, it’s up to us to deal with it. No amount of counseling or medication or the support of family and friends will save us in spite of ourselves. We must find the will to do our part.

Depression is as varied as the people who have it. And, as such, the ultimate cure for depression may be just as variable. But in the following pages I’ll share with you what I’ve experienced and what I feel I’ve learned.

I hope that you—those who struggle with depression, and those who care about someone who struggles with it—can find a little hope and, maybe, a little help. Or, at the very least, you’ll feel less alone. I can’t carry you, but we’re on this mountain together.