Decline into depression
QUESTION:
JC (44 year-old man)I am a 44-year-old executive who owns his own consulting business. I was married once for not quite three years, have no kids, and have been divorced for nearly 12 years. My upbringing was pretty normal and middle class for its time: Dad owned a retail business, Mom stayed home; Janice and I went to school. I was skipped past all of first, and part of second, grades, and completed university when I was just 20 years old. I have been working ever since.
In June 1996, my father died; mother died in January 1999; I started the business in April 1999; and in May 1999, my younger sister (only sibling) was diagnosed with brain cancer and died in July, 1999. I have no other family, other than some distant cousins I've not seen in decades. I have seriously considered suicide three times in my life... Once as an 18 year old while at university; once in my late 20s; and am now, at times, suicidal. I have not had what by any reasonable definition of the term a "girl friend" for 10 years, have not slept with anyone in seven, and stopped dating three years ago. I have one close friend, who lives 700 miles away, and another good friend who lives 350 miles away.
In my own city, I have no real friends or acquaintances, although when I moved here nine years ago I joined organizations, became active in arts or social service groups, gave parties and dinners in my home, all in an unsuccessful effort to meet people and make friends. I stopped doing this a few years ago after growing tired of entertaining the city and never being invited back, or being asked to join others when they go out or do things.
My interests include baseball and golf. But the baseball season is ending for the winter, as is golf. My primary social contacts in the summer are visiting with neighbors across the fence; I've invited them to BBQs in my yard, but seldom if ever have been asked to their homes. I've lost interest in doing much of anything besides trying to build my business, and watching TV in the evening or on weekends. I haven't read a book in two years, and dropped my magazine subscriptions because I never opened them. I don't like music or going to films because I have a congenital hearing loss in one ear (90%) and so the sound is just noise to me. I lost interest in sex partially because I was tired of being OK enough to take women on, say, trips but not to bed. Besides, it occurred to me that the screwing I'd get wasn't worth the screwing I got, so to speak.
I have had therapy from time to time, largely for depression although last year it was for grief at having lost my entire family in such a short period of time. But it has been largely ineffective as I continue to see myself (based on my experience as an adult) as ugly as a tick - I taught myself to look at what I am doing when I shave or tie a tie, not at who's doing it because I can't stand to look at myself in a mirror - not worth being friends with, and not having much value to myself or anyone else. On the plus side, I do know that I am smart, creative, empathetic and understanding. Hope this isn't too much background.
Here are my questions:
- Is it possible to come to grips and accept the fact that I am [a] unappealing and [b] not worth being with without becoming depressed about it? I've been trying to commit "emotional suicide" for decades, and believe that if I can't learn how to be emotionally dead, the roller coaster of depression will eventually lead me to a real suicide.
- How can I adapt to living totally alone?
- How can I avoid the depressions, which are not clinical, and without using medication? I will not go on anti-depressants such as Prozac because of their reputation and the lingering side effects. Besides, I haven't been to a physician since I was 16 (a medical was required for admission to university) and don't have a family doctor.
ANSWER:
Susan Maroto,
Dear JC,
I'm going to tackle your questions one by one:
JC
Is it possible to come to grips and accept the fact that I am [a] unappealing and [b] not worth being with without becoming depressed about it? I've been trying to commit "emotional suicide" for decades, and believe that if I can't learn how to be emotionally dead, the roller coaster of depression will eventually lead me to a real suicide.
Susan
My question to you is, why would you want to come to grips and accept those "facts"? You certainly don't have to. I would much rather see you transform your view of yourself so that you view yourself as both appealing and as someone worth being with. When you start to see yourself as appealing and worth being with, you will subtly change how you act towards others and they too will begin to see you in that light.
The fact that you're able to identify some positive qualities about yourself - smart, creative, empathetic and understanding - is a good starting point. Surely someone who has those qualities is (or can be, once other factors such as your entrenched depression are addressed) appealing to others.
Something else is preventing you from connecting with others in the way that you want. Right now, the depression is a big part of what's in the way. Previously, it sounds like you habitually chose women who didn't value you or view you in a romantic light. That's hard, and it sounds like you resent the way women "used" you as a way to get vacations or other treats - and rightfully so. But patterns such as continually choosing the wrong people can be changed, especially if you're willing to consciously work on changing the pattern with the help of a good therapist. Maybe your prior therapists weren't the right match for you in terms of personality, style, or technique - it may help to interview several before committing to one.
Yes, you have been committing "emotional suicide," and THAT is what could lead to an actual suicide if you don't get help soon. But learning how to be "emotionally dead" is neither desirable nor feasible- you can't make painful emotions go away because you don't want to have them anymore. But what you can do is to LEARN from your painful emotions. Emotions are basically a feedback mechanism that let us know what is and isn't working in our lives. In your case, your unhappiness and despair are telling you that you have been too isolated for too long, and that "toughing it out" with lots of work and television isn't changing your basic unhappiness - it isn't getting to the root of the problem. In your consulting business, I bet you advise clients to change their strategy if what they're doing isn't bringing the results they desire - and it's no different with working out one's personal life. The fact that you are so unhappy does not mean that the right decision is to end your life, but it does signal that it is time for a change, and NOW.
Here are some phone numbers I would like for you to have: 1 800 784-2433 is a crisis hotline number - please call if you are feeling like you are edging closer to actually taking those pills at any time. 1 404 245-3900 is a number for the Suicide Information and Education Center.
JC
How can I adapt to living totally alone?
Susan
Loneliness and isolation are a big part of the pattern of depression you described, so it's no surprise that you don't feel 'adapted' to living alone. Humans weren't designed to be completely on their own - we all need others. Perhaps it would help to try to make contact with others in settings other than work. You could try a support group for depression (1 (800) 367-6274 is a national referral network for self help groups, which are usually free or very low cost). It can help a lot to realize that you are not alone with your problem, that others suffer from depression, and that IT DOES GET BETTER. As you heal from your depression and establish connections with others, living alone won't be so difficult because living alone will no longer mean being so alone.
JC
How can I avoid the depressions, which are not clinical, and without using medication? I will not go on anti-depressants such as Prozac because of their reputation and the lingering side effects. Besides, I haven't been to a physician since I was 16 (a medical was required for admission to university) and don't have a family doctor.
Susan
You may not be able to totally avoid the depressions - all people experience the full range of emotions, including sadness and anger, from time to time. But you can certainly get to a point where the depressions are not constant and are not having such a huge impact on your life. If you completely refuse medication, it may be more difficult. This depression has been 26 years or more in the making (based on your first feeling suicidal at 18 years old) and it is not likely to resolve overnight. While you don't indicate what led you to feel suicidal at 18, my guess is that whatever it is was never fully resolved and it therefore resurfaced at the other times you mentioned. Perhaps you experienced too much pressure being advanced quickly through school, and your social and emotional development was hurried past your readiness level because of your academic progress. This type of hurrying can result in people not having a good foundation in communication and relationship skills.
You don't mention why you won't go to a doctor, but it's always a good idea to go for a physical to rule out any physiological basis for your depression. (It doesn't really hurt anything to go - if you don't like what the doctor suggests or prescribes, you're not obligated to take his or her advice.) Some people who are reluctant to take medications benefit from herbs such as St. John's Wort - but this herb can have side effects also and you would be wise to talk with a medical professional before trying it.
Part of the problem at this point is that you have been depressed for so long, you most likely can't really remember what it is like to feel good - so it is hard to imagine why it would be worth it to stick it out through the painful parts of the process you are going through. People benefit from a range of methods (some people gain help from supportive friends or family, through their religion, through meditation or other spiritual pursuits), and you have to choose according to what "feels right" for you. Therapy is a wonderful tool for helping people with problems such as what you describe, and it is highly effective with depression. I can't urge you strongly enough to pursue it again, and to keep shopping for a right therapist to work with.
Good luck and take care -
Sincerely,
Susan Maroto, LCSW
This question has been answered by Susan Maroto. She is a Licensed Clinical Social Worker working out of Mount Laurel, New Jersey. She uses an eclectic approach to holistic healing, mind-body relationships, life transitions, depression, and anxiety.For more information visit: http://www.therapywithsusan.com/