I’d like to add that we write about depression from time to time because depression often results from long term, unremitting anxiety disorders. More often than not, people who become depressed had pre-existing problems with anxiety. Parenthetically, the author of the NY Times article did not express concerns about anxiety.

I’ve never been able to figure out how a social phobic is supposed to get better when everything says you need a support group to improve, but you can’t have a support group because you’re a social phobic.

I so agree with what you’ve written. As a CBT therapist, I felt so sad reading that article in the New York Times. While severe depression like the author’s is probably never going to go away, a good CBT therapist could, at the very least, help Ms. Merkin accept that she will have future bouts with depression and make some plans about what she will do when they occur.

@ Jude If someone has social phobia, a first good step would be to go to an individual therapist to help plan a gradual introduction for meeting more people. This would not necessarily be a support group for social phobics–it could include some social skills training to be practiced in multiple settings.
@ Susan. So, true, a relapse prevention program includes a relapse expectation. Thanks for your comment!

I have had depression for years, since I was 20 years old. I’m 37 now. I tried many therapists and many psychiatrists. The form of depression I have had been treatment-resistant. As CBT and other therapies have helped, they would not get me out of depression. Many medications did not work, though one did partially for awhile and then quit. I kept trying more medications. I would not go as far as getting elctro-convulsive therapy until I tried everything I could. By the time I reached that point, it was too risky to do so because I had already had brain damage from having had a stroke and depression-induced memory problems. There was still hope – VNS therapy. Of course, I had to fight the insurance to get coverage for the procedure and the adjustments afterward. My depression was it’s worst in the months before I won the fight with my insurance company. The night in the hospital after I had the VNS pulse generator implanted, I was awed by the journey that I had up to that point. It took so much fight just to live and stay alive. I wonder if I had not been born with disabilities if I would have fought as hard as I did.

Some people can keep fighting like I did, but many people cannot afford to pay for that. Many don’t have the strength to fight like I did for their right to have humane and effective treatments for this disorder. There is still a stigma of having a mental disorder. Fighting the stigma of having a disability helped me to fight the stigma of having a mental illness.

While there is hope, depression blinds us from that. It erodes our ability to keep going. It drowns our personalities. Over time, it drowns our will to keep on going. Your article is a lovely rope to those of us who can’t see because some don’t have anyone to throw them that rope.

Oh, yes. I forgot to mention that I am doing better now, thanks to the VNS therapy. I know this is not a cure. I will always have this condition. It is manageable now, and hopefully, it will be for the rest of my life.

I’ve been actively fighting depression my entire adult life (I am almost 50 now). I am on 3 antidepressants and a mood stabalizer and underwent over 20 ECT treatments a few years ago (it helped pull me out of a depression so severe I could not work). I see a very good therapist 2 to 4 times per month and my psychiatrist every 30 days. I spend most of my disposable income on psychiatric treatment/medication and only recently cleared up the debt from ECT. I have found that mental health coverage is never as good as straight medical insurance and I am apalled by the cost of my medications. I accept that I have a chronic condition that I may well have to endure for the rest of my life. I might be able to shed therapy eventually, but every time I stop taking my meds I end up irrational and suicidal, sometimes hearing voices telling me to kill myself immediately. I know the voices are hallucianations, but enduring them is hell. So I keep working full time to keep a roof over my head and to keep my mental health in check. I hope there are programs in place to help me when I am too old to work, because I sure haven’t been able to save much for retirement.

Thank you Donia for your comments. You have offered readers another possibility to battle depression. Hopefully there will be more developments in the future. Take care.

Donia: I have a friend who has had the same experience that you have (all the anti-depressant meds including MAOI’s & adding Abilify & ECT’s & also has had VNS…)

She is 60 now & has had the unrelenting depression for at least 25 yrs. She has tried numerous therapies (individual, CBT, DBT, all sorts of different methods & philosophies). Someone previously mentioned learning coping techniques for when the depression RETURNS between episodes; hers has NEVER LEFT. It has been continuous.

I absolutely am amazed at her strength in seeking out help as much as she has. She has such a hard time even getting out of bed, opening the mail… Her house is a wreck; taking a shower is a major ordeal.

She can’t make a phone call. I call her to check on her & usually she is in tears. Her children don’t want her grandchildren “exposed” to her & don’t let her visit or ever come to her house as it is really a total overwhelming mess. She does not have any energy to clean…

I pick her up & take her to a monthly support group; otherwise, she would not hardly be around other human beings except for the medical professionals she has sought out trying to get some relief.

She says she is “just existing”, but it seems hopeless for her. She blames herself as all these meds & techniques have failed to help her. She reads about these success stories & then she never has a good response to anything.

It is hard to offer hope at this point.

I suffered from misdiagnosed & therefore incorrectly treated bipolar disorder from 15 yrs. old (1st suicide attempt) until the age of 48. Then it took a full year of trial & error & enduring awful side effects of meds to get the right combo to alleviate my symptoms of severe depression, anxiety & delusional thinking–but I was able to be helped. Finally…my mother also had bipolar & did end up dying by suicide when I was a teenager as the treatments available to her were not able to help her.

It breaks my heart to see my friend having this horrible quality of life.

I’m 55 now & even though my life was hell pretty much until middle-age, at least I’ve had a better quality of life now; experienced some joy & see what “normal” people experience & take for granted.

I struggled with depression my whole life- it was not constant but never far. I was suicidal for decades- off and on- until SSRIs were developed.

I have struggled. hard. long. and I am absolutely intent on having it have been worth it. Lots of folks have battles- most even have struggles in life with health or addiction or whatever. My battle has been depression- i have seen it as a monster pulling me under the sea- but i have fought and fought. at times (a lot of times before SSRIs) – the goal was to stay alive- now I’m ok and on some days happy. I am 55 and I INSIST on having some fun after all this. I’m on the right amount of meds FINALLY have an ok job, bought a little tiny condo- have good neighbors- in other words- a regular person. I still do not trust. But I feel like i am here to say that the battle can be fought- and you can triumph over depression. I know I can’t say I will never be that way again- but today I feel ok- and I have a lot to be grateful for. I just INSIST on having all the pain and fight I’ve put in be worth the trouble. So, I hope that you will keep the goal in the front of your mind and never ever give up- if I can more or less do it anyone can- i spent many many years in deep depression. i’m ok. i feel decent- even good. part of it is realizing how lucky i am to have stuff I have- and just to look on the good side- to INSIST on that. I INSIST on believing I have a future that will be good.
I really want to go to do the stuff I didn’t do because I was encased in depression. I want to go to the beach and boardwalk, maybe live near an ocean. that is my dream- and someday I WILL! I totally believe that “impossible” things can be possible one step at a time. Do I sound like a cliche. Or like the Dorothy in the Wizard of Oz (I do believe, I do I do I do) Sorry! I have come to KNOW that I will have and deserve good things- instead of bad things, suffering and pain.
Good fortune, happy trails and never ever ever give up. I have a cousin who did- and I want to be the other better choice. to live

The writers above offer clues as to how complex depression can be. Those who call it a chemical brain inbalance are overly simpliyfying a disorder with multiple etiologies. Depression can be brought on genetically, fed by trauma, difficult childoods, culture, or accident. Just like depression has multiple beginnings, the ending of depression can require multiple attempts. There are options out there, fight until you fee better.