Depression

MANY ALCOHOLICS cease to suffer from depression after getting sober in AA. Others--and co-founder Bill W. was among them--continue to experience periods of deep despondency. When a member tells about his or her own depression in a meeting, there is usually at least one person in the group who is surprised to hear about it, and relieved to know that he is not alone.

Most depressed persons are convinced that no one could possibly understand how they feel, that they are solitary sufferers in a world populated by lunatics hysterically elated over nothing. If you are now a DP (depressed person), you do not need cheerful facts to intensify your sense of alienation. What you need is wretched, gloomy news, compatible with your present state of mind. Fortunately, just the right information is at hand. The National Association of Mental Health recently announced that fifteen percent of Americans aged eighteen to seventy-four suffer symptoms of serious depression. The NAMH even calls depression "the nation's number one mental health problem."

Now, there is no need for AA members to become outraged that our pet disease, alcoholism, has been kicked out of its number one position. Another national organization (not AA) still ranks alcoholism as the number one public health problem; depression is merely the number one mental health problem. Clearly, though, an alcoholic with a depression can consider himself among the elite "in" group--number one all around.

I had been sober in AA more than ten years when I was suddenly hit by that leaden, cut-adrift, listless, devastating state called depression. During my twenty-three years of drinking, I had cleverly escaped any prolonged period of gloom by grabbing a drink at the first sign of anxiety or sadness. Early in my AA life, I was fascinated and sympathetic toward fellow members who talked about their long-lasting low states of mind. I questioned them after the meetings and read Bill W.'s descriptions of his own recurrent periods of despondency. When I was hit by depression, I feel it was far more than coincidence that several of these same people called me to share their experience and understanding. Through such rallying around of fellow alcoholics, I was able to work my way out of it.

While preparing this piece, I came across a remedy for depression suggested many decades ago by Dr. Alfred Adler, one of the world's most eminent psychiatrists. This remedy is almost identical to the one Bill W. described as effective in his own case. I'm tempted to reveal it in the next sentence, but if I did, it probably wouldn't work. It would be rejected as too simple and at the same time too difficult.

Like a one-cylinder engine stalled at dead center, the depressed person has to be jiggled and rocked into action so that he can move again under his own power. Both infuriating and challenging is the suggestion of another psychiatrist, Frederic F. Flach, MD, in The Secret Strength of Depression. He holds that depression is necessary to jolt insecure, rigid individuals from the bondage of limiting habits of thought and to free "the vital elements of creativity."

To a depressed alcoholic, it's dirty pool to imply that his or her wretched state of mind may be preparation for a new high plateau of serenity and progress in the AA program. It's akin to the exasperating advice of friends and family members: "Cheer up!," "Snap out of it!," and "Stop feeling sorry for yourself." Such optimism is so blatant, so smugly obnoxious, that the sufferer is plunged even deeper into melancholy. If a depression did not usually render its victims incapable of constructive action, the advice to cheer up would result in hordes of cheerers-up getting a punch in the mouth.

I can look back and see that when I finally climbed out of that state of apathy eight years ago, I was indeed in a better frame of mind than before the slump. But I had assumed that the subjective sense of improvement was mere contrast--just as a pan of tepid water feels hot to a hand recently immersed in ice water. Further, in recalling the AA friends who came so quickly and so mysteriously unbidden to my aid, I can now recognize that they emerged from their periods of lowered self-worth with vastly increased ability to share with others.

The NAMH news item on the prevalence of depression sent me to the library to see whether recent books and magazines reflected the situation. They do. In the card catalog, I found the titles of twelve books dealing with depression, all published within the last two or three years. The titles all suggest various treatments and even "cures." Luckily, I wasn't depressed at the time, because not one of those books was on the shelves.

What about magazines? I consulted the Readers' Guide to Periodical Literature, which cross-indexes articles on virtually every subject from more than a hundred magazines. Starting with the earliest volume on the shelf, 1919, I looked up "Depression." No listing. The heading didn't appear until 1932, when it referred only to the financial slump. Not until World War II, when millions of men and women were in the armed services and families were scattered by defense work, did the guide begin using the word in its current sense. Even then, it directed the reader to see "Mental Hygiene," and such titles as "Lonesome and Lonely," "Gloomy Moods," and "Christmas Neurosis" were the rule.

I first found the word "depression" in the title of an article in the March 1957 issue of Science Digest: "Depression: Time Is the Cure." In 1960, another popular magazine on science announced an "Antidepression Cure." Five years later, the same publication, forgetting it had already proclaimed a chemical cure, was "foreseeing cures for depression in pills and injections." (No magazine seems to have a memory for anything. It's as though a new staff got out each issue, and the departing staff took the back files with them.)

In more recent years, magazine articles assure readers that depression can be cured, offering remedies such as self-help techniques or professional therapy, with or without medication. As in the case of alcoholism, cures are constantly being announced over the years, yet the number of sufferers continues to increase. Still, it cannot be denied that some depressed persons appear to respond to each of the various remedies: chemotherapy, professional counseling, improved (or changed) nutrition, travel--in fact, everything from high karate to high colonies. Also, some do not respond to any of these treatments.

My reading makes me realize how fortunate I was when depression hit me in 1967. I did not think of drinking again, nor of taking my life, even though day after day I sank deeper into my moody lethargy. External circumstances may have triggered this loss of self-esteem. A promising relationship with an attractive, intelligent, buoyant-natured AA friend had ended suddenly. A period of erratic employment justified some concern, but not panic. I canceled an invitation to speak at an AA convention in a Midwestern state. Why should those good people pay air fare and hotel expenses for an AA speaker who could not bring a convincing example of the joy of living a spiritual life in the Fellowship?

After nearly two weeks of this increasing depression, I began to get phone calls from AA members who had themselves suffered such moods. They told me they knew how I felt. They told me it would pass. They said, "I've been there, you know. Want to talk about it?" And nobody, bless them, said, "Cheer up." The uplifting effect of this concern was tremendous. It didn't yank me out of the doldrums, but it gave me a source of borrowed energy and incentive to force myself into action, to jolt myself off that "dead center."

One call was from a man who had told me, years before, of placing the muzzle of his .357 magnum pistol in his mouth. Hearing his calm recital of his own despondency and a warm chuckle as he assured me that "this, too, will pass" gave me hope and confidence. If this man could look back and laugh over his own periods of hopelessness, so could I! He and others shed new light on the part of Tradition Five that speaks of the AA group's "primary purpose--to carry its message to the alcoholic who still suffers." Not just the alcoholic who is still drinking, but the one who still suffers.

After four or five calls from fellow AAs, I began taking inventory. On my list of omissions and commissions were these: (1) I had let up on my daily exercise, a program of jogging a physician had put me on long before the activity became a fad; (2) I had drifted back into the habit of eating large amounts of pie and ice cream and had piled on weight--both blubber and hidden guilt; (3) instead of productive activity, I had lapsed into my earliest compulsion, acquired at the age of six--reading (an ideal rationalization for a writer, "enlarging my fund of general knowledge"--the same excuse I once gave myself for spending so much time in bars); (4) I attended only speaker meetings in AA, as a listener, avoiding discussion meetings where I would have to open up.

Along with calls from AA members came an invitation to speak at a meeting in a Los Angeles suburb, where I then lived. Stifling the phony-humility excuse that "I have nothing to offer right now," I accepted. So I got up in front of about fifty people, gave my name as an alcoholic, and said, "After ten years of AA sobriety, I am now in the middle of a depression, and I don't really have any reason for it." Then I poured out an account of my procrastination, my avoidance of productive activity, my compulsive eating and gluttonous reading. At each admitted defect, from the crowd came a burst of laughter--wonderful AA laughter that washes away shame, fear, guilt, and false pride--laughter that says, "Welcome back to the human race!"

Then I got to work. I resumed jogging. I cut out sweets. I forced myself to clear up accumulated details and became active again in Twelfth Step calls. In a matter of days after I started this effort, the depression lifted. It has not returned. The following year, the good AAs in the Midwestern state invited me back to speak at their convention, an expression of confidence and magnanimity I still cherish deeply.

A two-week depression may not rank as a true one to persons who drag through these bouts for months at a time, but it was real enough and miserable enough for me.

For purposes of comparison, I asked some Denver AAs what they do when a depression hits. A woman about sixty, sober twelve years, who now has bone cancer and who in addition has been a semi-invalid most of her life, gave this reply: "Depression? I'm so busy," she smiled, "I just don't have time to be depressed."

Well, she wasn't much help. I asked a member who has been sober for thirty-five years. He's a diabetic, and he admitted to frequent depressions, which in his case include a profound feeling of guilt from an unknown cause. "The only thing that works," he told me, "is to get busy at something. Go downtown. Look around. Be with people. I've got to force myself into it. It's rough."

Another friend, sober eighteen years, is convinced that vitamins and proper nutrition are the answer. A look at paperbacks at your newsstand or health-food store will show you literally dozens of expert opinions, all varied and some contradictory, as to what constitutes "proper nutrition." My friend has evidently discovered what is proper for her, however, for she radiates health and a cheerful, outgoing nature.

Of his own painful moods, our co-founder Bill W. wrote, "Sometimes, we become depressed. I ought to know; I have been a champion dry-bender case myself. While the surface causes were a part of the picture. . .the underlying causes, I am satisfied, ran much deeper.

"Intellectually, I could accept my situation. Emotionally, I could not.

"To these problems, there are certainly no pat answers. But part of the answer surely lies in the constant effort to practice all of AA's Twelve Steps." (As Bill Sees It, page 30)

Chemotherapy, diet, exercise, psychiatry, keeping busy, working the Twelve Steps--a baffling conglomeration of treatments and alleged cures. Perhaps now we're prepared to give serious attention to the remedy I mentioned earlier, prescribed many years ago by Dr. Alfred Adler to a depressed patient. The patient told the psychiatrist he would do anything to get rid of his suffering. Dr. Adler said he knew a method that would quickly banish the depression, but the cure was difficult, and so drastic that there was probably no point in mentioning it. Naturally, the patient begged for the secret. With sales psychology worthy of Dale Carnegie, Adler kept the patient waiting till the end of the session. Here is Adler's prescription, as related in Masks of Loneliness, by Manès Sperber:

"You can be healed if every day you begin the first thing in the morning to consider how you can bring a real joy to someone else. If you can stick to this for two weeks you will no longer need therapy."

Not much different from Bill's suggestion about a more intensive working of the AA Steps, is it? We make depression worse by regarding it as merely a penalty for slipping back into our old ideas of self-centeredness. If used properly, depression can goad us to achieve more emotional maturity and improve our understanding of God's will for us.