1 00:00:03,952 --> 00:00:07,814 "I felt a Funeral, in my Brain, 2 00:00:07,838 --> 00:00:10,216 and Mourners to and fro 3 00:00:10,240 --> 00:00:13,043 kept treading -- treading -- till [it seemed] 4 00:00:13,067 --> 00:00:15,386 that Sense was breaking through -- 5 00:00:15,836 --> 00:00:17,581 And when they all were seated, 6 00:00:17,605 --> 00:00:19,579 a Service, like a Drum -- 7 00:00:19,603 --> 00:00:23,055 kept beating -- beating -- till I [thought] 8 00:00:23,079 --> 00:00:24,845 my Mind was going numb -- 9 00:00:25,831 --> 00:00:29,970 And then I heard them lift a Box and creak across my Soul 10 00:00:29,994 --> 00:00:33,029 with those same Boots of Lead, again, 11 00:00:33,053 --> 00:00:36,046 then Space -- began to toll, 12 00:00:36,070 --> 00:00:40,177 As [all] the Heavens were a Bell, and Being, [but] an Ear, 13 00:00:40,201 --> 00:00:43,260 and I, and Silence, some strange Race, 14 00:00:43,284 --> 00:00:45,864 wrecked, solitary, here -- 15 00:00:46,493 --> 00:00:49,646 [And] then a Plank in Reason, broke, 16 00:00:49,670 --> 00:00:52,987 and I fell down and down -- 17 00:00:53,011 --> 00:00:55,662 and hit a World, at every plunge, 18 00:00:55,686 --> 00:00:58,245 and Finished knowing -- then --" 19 00:01:00,198 --> 00:01:03,012 We know depression through metaphors. 20 00:01:03,680 --> 00:01:07,365 Emily Dickinson was able to convey it in language, 21 00:01:07,389 --> 00:01:09,704 Goya in an image. 22 00:01:10,238 --> 00:01:14,833 Half the purpose of art is to describe such iconic states. 23 00:01:15,997 --> 00:01:19,851 As for me, I had always thought myself tough, 24 00:01:19,875 --> 00:01:21,677 one of the people who could survive 25 00:01:21,701 --> 00:01:24,024 if I'd been sent to a concentration camp. 26 00:01:24,614 --> 00:01:27,279 In 1991, I had a series of losses. 27 00:01:27,676 --> 00:01:29,174 My mother died, 28 00:01:29,198 --> 00:01:31,300 a relationship I'd been in ended, 29 00:01:31,324 --> 00:01:35,244 I moved back to the United States from some years abroad, 30 00:01:35,268 --> 00:01:37,982 and I got through all of those experiences intact. 31 00:01:38,617 --> 00:01:41,516 But in 1994, three years later, 32 00:01:41,540 --> 00:01:45,282 I found myself losing interest in almost everything. 33 00:01:46,059 --> 00:01:49,935 I didn't want to do any of the things I had previously wanted to do, 34 00:01:49,959 --> 00:01:51,419 and I didn't know why. 35 00:01:51,987 --> 00:01:56,548 The opposite of depression is not happiness, but vitality. 36 00:01:57,127 --> 00:01:58,571 And it was vitality 37 00:01:58,595 --> 00:02:01,558 that seemed to seep away from me in that moment. 38 00:02:02,231 --> 00:02:05,908 Everything there was to do seemed like too much work. 39 00:02:06,597 --> 00:02:08,034 I would come home 40 00:02:08,058 --> 00:02:11,386 and I would see the red light flashing on my answering machine, 41 00:02:11,410 --> 00:02:13,950 and instead of being thrilled to hear from my friends, 42 00:02:13,974 --> 00:02:15,163 I would think, 43 00:02:15,187 --> 00:02:17,782 "What a lot of people that is to have to call back." 44 00:02:18,368 --> 00:02:20,930 Or I would decide I should have lunch, 45 00:02:20,954 --> 00:02:23,691 and then I would think, but I'd have to get the food out 46 00:02:23,715 --> 00:02:25,477 and put it on a plate 47 00:02:25,501 --> 00:02:29,365 and cut it up and chew it and swallow it, 48 00:02:29,389 --> 00:02:32,723 and it felt to me like the Stations of the Cross. 49 00:02:33,286 --> 00:02:37,419 And one of the things that often gets lost in discussions of depression 50 00:02:37,443 --> 00:02:39,501 is that you know it's ridiculous. 51 00:02:39,801 --> 00:02:42,744 You know it's ridiculous while you're experiencing it. 52 00:02:42,768 --> 00:02:44,657 You know that most people manage 53 00:02:44,681 --> 00:02:46,971 to listen to their messages and eat lunch 54 00:02:46,995 --> 00:02:48,901 and organize themselves to take a shower 55 00:02:48,925 --> 00:02:50,143 and go out the front door 56 00:02:50,167 --> 00:02:51,795 and that it's not a big deal, 57 00:02:51,819 --> 00:02:54,961 and yet you are nonetheless in its grip 58 00:02:54,985 --> 00:02:58,422 and you are unable to figure out any way around it. 59 00:02:58,990 --> 00:03:03,212 And so I began to feel myself doing less 60 00:03:03,236 --> 00:03:05,522 and thinking less 61 00:03:05,546 --> 00:03:06,861 and feeling less. 62 00:03:07,829 --> 00:03:09,567 It was a kind of nullity. 63 00:03:10,049 --> 00:03:12,044 And then the anxiety set in. 64 00:03:12,567 --> 00:03:16,259 If you told me that I'd have to be depressed for the next month, 65 00:03:16,283 --> 00:03:19,522 I would say, "As long I know it'll be over in November, I can do it." 66 00:03:19,546 --> 00:03:20,792 But if you said to me, 67 00:03:20,816 --> 00:03:24,129 "You have to have acute anxiety for the next month," 68 00:03:24,153 --> 00:03:26,472 I would rather slit my wrist than go through it. 69 00:03:26,496 --> 00:03:28,054 It was the feeling all the time 70 00:03:28,078 --> 00:03:30,282 like that feeling you have if you're walking 71 00:03:30,306 --> 00:03:33,827 and you slip or trip and the ground is rushing up at you, 72 00:03:33,851 --> 00:03:36,563 but instead of lasting half a second, the way that does, 73 00:03:36,587 --> 00:03:38,468 it lasted for six months. 74 00:03:38,492 --> 00:03:41,421 It's a sensation of being afraid all the time 75 00:03:41,445 --> 00:03:44,430 but not even knowing what it is that you're afraid of. 76 00:03:45,057 --> 00:03:47,668 And it was at that point that I began to think 77 00:03:47,692 --> 00:03:51,452 that it was just too painful to be alive, 78 00:03:51,476 --> 00:03:54,036 and that the only reason not to kill oneself 79 00:03:54,060 --> 00:03:56,755 was so as not to hurt other people. 80 00:03:57,295 --> 00:04:00,176 And finally one day, I woke up 81 00:04:00,200 --> 00:04:02,397 and I thought perhaps I'd had a stroke, 82 00:04:02,421 --> 00:04:04,915 because I lay in bed completely frozen, 83 00:04:04,939 --> 00:04:06,864 looking at the telephone, thinking, 84 00:04:06,888 --> 00:04:10,427 "Something is wrong and I should call for help," 85 00:04:10,451 --> 00:04:12,162 and I couldn't reach out my arm 86 00:04:12,186 --> 00:04:14,428 and pick up the phone and dial. 87 00:04:14,801 --> 00:04:18,852 And finally, after four full hours of my lying and staring at it, 88 00:04:18,876 --> 00:04:20,140 the phone rang, 89 00:04:20,164 --> 00:04:22,543 and somehow I managed to pick it up, 90 00:04:22,567 --> 00:04:25,495 and it was my father, and I said, 91 00:04:25,519 --> 00:04:28,965 "I'm in serious trouble. We need to do something." 92 00:04:29,528 --> 00:04:34,219 The next day I started with the medications and the therapy. 93 00:04:35,352 --> 00:04:39,555 And I also started reckoning with this terrible question: 94 00:04:39,579 --> 00:04:41,683 If I'm not the tough person 95 00:04:41,707 --> 00:04:44,207 who could have made it through a concentration camp, 96 00:04:44,231 --> 00:04:45,719 then who am I? 97 00:04:45,743 --> 00:04:47,604 And if I have to take medication, 98 00:04:47,628 --> 00:04:51,541 is that medication making me more fully myself, 99 00:04:51,565 --> 00:04:53,783 or is it making me someone else? 100 00:04:53,807 --> 00:04:57,267 And how do I feel about it if it's making me someone else? 101 00:04:58,101 --> 00:05:01,005 I had two advantages as I went into the fight. 102 00:05:01,585 --> 00:05:04,256 The first is that I knew that, objectively speaking, 103 00:05:04,280 --> 00:05:05,877 I had a nice life, 104 00:05:05,901 --> 00:05:07,762 and that if I could only get well, 105 00:05:07,786 --> 00:05:10,986 there was something at the other end that was worth living for. 106 00:05:11,010 --> 00:05:13,827 And the other was that I had access to good treatment. 107 00:05:14,343 --> 00:05:17,792 But I nonetheless emerged and relapsed, 108 00:05:17,816 --> 00:05:20,327 and emerged and relapsed, 109 00:05:20,351 --> 00:05:23,345 and emerged and relapsed, 110 00:05:23,369 --> 00:05:25,309 and finally understood 111 00:05:25,333 --> 00:05:29,254 I would have to be on medication and in therapy forever. 112 00:05:29,769 --> 00:05:30,936 And I thought, 113 00:05:30,960 --> 00:05:33,746 "But is it a chemical problem or a psychological problem? 114 00:05:33,770 --> 00:05:37,703 And does it need a chemical cure or a philosophical cure?" 115 00:05:37,727 --> 00:05:39,854 And I couldn't figure out which it was. 116 00:05:39,878 --> 00:05:41,978 And then I understood that actually, 117 00:05:42,002 --> 00:05:45,989 we aren't advanced enough in either area for it to explain things fully. 118 00:05:46,013 --> 00:05:49,340 The chemical cure and the psychological cure 119 00:05:49,364 --> 00:05:51,038 both have a role to play, 120 00:05:51,062 --> 00:05:55,036 and I also figured out that depression was something 121 00:05:55,060 --> 00:05:57,284 that was braided so deep into us 122 00:05:57,308 --> 00:06:00,996 that there was no separating it from our character and personality. 123 00:06:01,552 --> 00:06:06,014 I want to say that the treatments we have for depression are appalling. 124 00:06:06,038 --> 00:06:07,641 They're not very effective. 125 00:06:07,958 --> 00:06:09,728 They're extremely costly. 126 00:06:09,752 --> 00:06:12,249 They come with innumerable side effects. 127 00:06:12,273 --> 00:06:13,710 They're a disaster. 128 00:06:14,027 --> 00:06:18,694 But I am so grateful that I live now and not 50 years ago, 129 00:06:18,718 --> 00:06:21,638 when there would have been almost nothing to be done. 130 00:06:21,662 --> 00:06:24,045 I hope that 50 years hence, 131 00:06:24,069 --> 00:06:26,091 people will hear about my treatments 132 00:06:26,115 --> 00:06:29,783 and be appalled that anyone endured such primitive science. 133 00:06:30,885 --> 00:06:34,127 Depression is the flaw in love. 134 00:06:35,441 --> 00:06:38,558 If you were married to someone and thought, 135 00:06:38,582 --> 00:06:42,292 "Well, if my wife dies, I'll find another one," 136 00:06:42,316 --> 00:06:44,565 it wouldn't be love as we know it. 137 00:06:45,364 --> 00:06:49,931 There's no such thing as love without the anticipation of loss, 138 00:06:49,955 --> 00:06:55,511 and that specter of despair can be the engine of intimacy. 139 00:06:56,204 --> 00:06:59,035 There are three things people tend to confuse: 140 00:06:59,059 --> 00:07:02,148 depression, grief and sadness. 141 00:07:02,966 --> 00:07:06,305 Grief is explicitly reactive. 142 00:07:06,329 --> 00:07:09,210 If you have a loss and you feel incredibly unhappy, 143 00:07:09,234 --> 00:07:10,909 and then, six months later, 144 00:07:10,933 --> 00:07:14,018 you are still deeply sad, but you're functioning a little better, 145 00:07:14,042 --> 00:07:15,827 it's probably grief, 146 00:07:15,851 --> 00:07:19,586 and it will probably ultimately resolve itself in some measure. 147 00:07:19,610 --> 00:07:22,415 If you experience a catastrophic loss, 148 00:07:22,439 --> 00:07:23,741 and you feel terrible, 149 00:07:23,765 --> 00:07:26,554 and six months later you can barely function at all, 150 00:07:26,578 --> 00:07:29,092 then it's probably a depression that was triggered 151 00:07:29,116 --> 00:07:31,299 by the catastrophic circumstances. 152 00:07:31,648 --> 00:07:34,818 The trajectory tells us a great deal. 153 00:07:35,196 --> 00:07:38,556 People think of depression as being just sadness. 154 00:07:38,580 --> 00:07:40,751 It's much, much too much sadness, 155 00:07:40,775 --> 00:07:42,526 much too much grief 156 00:07:42,550 --> 00:07:44,659 at far too slight a cause. 157 00:07:45,470 --> 00:07:48,255 As I set out to understand depression, 158 00:07:48,279 --> 00:07:50,926 and to interview people who had experienced it, 159 00:07:50,950 --> 00:07:54,743 I found that there were people who seemed, on the surface, 160 00:07:54,767 --> 00:07:57,980 to have what sounded like relatively mild depression 161 00:07:58,004 --> 00:08:00,742 who were nonetheless utterly disabled by it. 162 00:08:01,297 --> 00:08:03,710 And there were other people who had what sounded 163 00:08:03,734 --> 00:08:06,796 as they described it like terribly severe depression 164 00:08:06,820 --> 00:08:08,560 who nonetheless had good lives 165 00:08:08,584 --> 00:08:11,290 in the interstices between their depressive episodes. 166 00:08:11,885 --> 00:08:15,850 And I set out to find out what it is that causes some people 167 00:08:15,874 --> 00:08:18,103 to be more resilient than other people. 168 00:08:18,127 --> 00:08:21,343 What are the mechanisms that allow people to survive? 169 00:08:21,652 --> 00:08:24,850 And I went out and I interviewed person after person 170 00:08:24,874 --> 00:08:26,850 who was suffering with depression. 171 00:08:26,874 --> 00:08:29,065 One of the first people I interviewed 172 00:08:29,089 --> 00:08:33,943 described depression as a slower way of being dead, 173 00:08:33,967 --> 00:08:36,301 and that was a good thing for me to hear early on 174 00:08:36,325 --> 00:08:39,432 because it reminded me that that slow way of being dead 175 00:08:39,456 --> 00:08:41,736 can lead to actual deadness, 176 00:08:41,760 --> 00:08:43,717 that this is a serious business. 177 00:08:43,741 --> 00:08:46,130 It's the leading disability worldwide, 178 00:08:46,154 --> 00:08:48,236 and people die of it every day. 179 00:08:49,184 --> 00:08:52,903 One of the people I talked to when I was trying to understand this 180 00:08:52,927 --> 00:08:56,788 was a beloved friend who I had known for many years, 181 00:08:56,812 --> 00:09:01,265 and who had had a psychotic episode in her freshman year of college, 182 00:09:01,289 --> 00:09:04,091 and then plummeted into a horrific depression. 183 00:09:04,115 --> 00:09:05,754 She had bipolar illness, 184 00:09:05,778 --> 00:09:08,265 or manic depression, as it was then known. 185 00:09:08,289 --> 00:09:12,074 And then she did very well for many years on lithium, 186 00:09:12,098 --> 00:09:15,247 and then eventually, she was taken off her lithium 187 00:09:15,271 --> 00:09:17,082 to see how she would do without it, 188 00:09:17,106 --> 00:09:19,057 and she had another psychosis, 189 00:09:19,081 --> 00:09:23,441 and then plunged into the worst depression that I had ever seen 190 00:09:23,465 --> 00:09:26,282 in which she sat in her parents' apartment, 191 00:09:26,306 --> 00:09:29,578 more or less catatonic, essentially without moving, 192 00:09:29,602 --> 00:09:31,515 day after day after day. 193 00:09:31,943 --> 00:09:35,427 And when I interviewed her about that experience some years later -- 194 00:09:35,451 --> 00:09:38,552 she's a poet and psychotherapist named Maggie Robbins -- 195 00:09:38,576 --> 00:09:41,622 when I interviewed her, she said, 196 00:09:41,646 --> 00:09:45,165 "I was singing 'Where Have All The Flowers Gone,' 197 00:09:45,189 --> 00:09:48,086 over and over, to occupy my mind. 198 00:09:48,555 --> 00:09:51,351 I was singing to blot out the things my mind was saying, 199 00:09:51,375 --> 00:09:56,135 which were, 'You are nothing. You are nobody. 200 00:09:56,159 --> 00:09:58,090 You don't even deserve to live.' 201 00:09:58,691 --> 00:10:01,097 And that was when I really started thinking 202 00:10:01,121 --> 00:10:02,475 about killing myself." 203 00:10:03,193 --> 00:10:07,103 You don't think in depression that you've put on a gray veil 204 00:10:07,127 --> 00:10:10,491 and are seeing the world through the haze of a bad mood. 205 00:10:11,001 --> 00:10:13,991 You think that the veil has been taken away, 206 00:10:14,015 --> 00:10:15,619 the veil of happiness, 207 00:10:15,643 --> 00:10:17,580 and that now you're seeing truly. 208 00:10:18,247 --> 00:10:21,007 It's easier to help schizophrenics who perceive 209 00:10:21,031 --> 00:10:25,005 that there's something foreign inside of them that needs to be exorcised, 210 00:10:25,029 --> 00:10:27,355 but it's difficult with depressives, 211 00:10:27,379 --> 00:10:30,181 because we believe we are seeing the truth. 212 00:10:31,040 --> 00:10:32,585 But the truth lies. 213 00:10:33,987 --> 00:10:35,961 I became obsessed with that sentence: 214 00:10:35,985 --> 00:10:38,117 "But the truth lies." 215 00:10:38,435 --> 00:10:40,875 And I discovered, as I talked to depressive people, 216 00:10:40,899 --> 00:10:43,471 that they have many delusional perceptions. 217 00:10:43,815 --> 00:10:45,553 People will say, "No one loves me." 218 00:10:45,577 --> 00:10:46,789 And you say, "I love you, 219 00:10:46,813 --> 00:10:49,311 your wife loves you, your mother loves you." 220 00:10:49,335 --> 00:10:52,696 You can answer that one pretty readily, at least for most people. 221 00:10:53,124 --> 00:10:55,290 But people who are depressed will also say, 222 00:10:55,314 --> 00:10:59,361 "No matter what we do, we're all just going to die in the end." 223 00:10:59,385 --> 00:11:01,614 Or they'll say, "There can be no true communion 224 00:11:01,638 --> 00:11:03,000 between two human beings. 225 00:11:03,024 --> 00:11:05,408 Each of us is trapped in his own body." 226 00:11:05,805 --> 00:11:07,425 To which you have to say, 227 00:11:07,449 --> 00:11:08,928 "That's true, 228 00:11:08,952 --> 00:11:12,460 but I think we should focus right now on what to have for breakfast." 229 00:11:12,484 --> 00:11:14,645 (Laughter) 230 00:11:14,669 --> 00:11:16,314 A lot of the time, 231 00:11:16,338 --> 00:11:19,312 what they are expressing is not illness, but insight, 232 00:11:19,336 --> 00:11:21,867 and one comes to think what's really extraordinary 233 00:11:21,891 --> 00:11:25,023 is that most of us know about those existential questions 234 00:11:25,047 --> 00:11:27,091 and they don't distract us very much. 235 00:11:27,428 --> 00:11:29,250 There was a study I particularly liked 236 00:11:29,274 --> 00:11:33,017 in which a group of depressed and a group of non-depressed people 237 00:11:33,041 --> 00:11:35,765 were asked to play a video game for an hour, 238 00:11:35,789 --> 00:11:37,409 and at the end of the hour, 239 00:11:37,433 --> 00:11:41,043 they were asked how many little monsters they thought they had killed. 240 00:11:41,067 --> 00:11:45,052 The depressive group was usually accurate to within about 10 percent, 241 00:11:45,076 --> 00:11:46,647 and the non-depressed people 242 00:11:46,671 --> 00:11:51,125 guessed between 15 and 20 times as many little monsters -- 243 00:11:51,149 --> 00:11:52,300 (Laughter) 244 00:11:52,324 --> 00:11:54,076 as they had actually killed. 245 00:11:55,945 --> 00:11:59,161 A lot of people said, when I chose to write about my depression, 246 00:11:59,185 --> 00:12:02,650 that it must be very difficult to be out of that closet, 247 00:12:02,674 --> 00:12:03,983 to have people know. 248 00:12:04,007 --> 00:12:06,276 They said, "Do people talk to you differently?" 249 00:12:06,300 --> 00:12:08,379 I said, "Yes, people talk to me differently. 250 00:12:08,403 --> 00:12:10,165 They talk to me differently insofar 251 00:12:10,189 --> 00:12:12,856 as they start telling me about their experience, 252 00:12:12,880 --> 00:12:14,691 or their sister's experience, 253 00:12:14,715 --> 00:12:16,356 or their friend's experience. 254 00:12:16,729 --> 00:12:18,927 Things are different because now I know 255 00:12:18,951 --> 00:12:23,056 that depression is the family secret that everyone has. 256 00:12:23,715 --> 00:12:27,341 I went a few years ago to a conference, 257 00:12:27,365 --> 00:12:29,796 and on Friday of the three-day conference, 258 00:12:29,820 --> 00:12:32,825 one of the participants took me aside, and she said, 259 00:12:32,849 --> 00:12:39,098 "I suffer from depression and I'm a little embarrassed about it, 260 00:12:39,122 --> 00:12:40,964 but I've been taking this medication, 261 00:12:40,988 --> 00:12:44,102 and I just wanted to ask you what you think?" 262 00:12:44,126 --> 00:12:46,746 And so I did my best to give her such advice as I could. 263 00:12:46,770 --> 00:12:51,257 And then she said, "You know, my husband would never understand this. 264 00:12:51,281 --> 00:12:54,549 He's really the kind of guy to whom this wouldn't make any sense, 265 00:12:54,573 --> 00:12:56,697 so, you know, it's just between us." 266 00:12:56,721 --> 00:12:58,273 And I said, "Yes, that's fine." 267 00:12:58,733 --> 00:13:00,592 On Sunday of the same conference, 268 00:13:00,616 --> 00:13:02,492 her husband took me aside, 269 00:13:02,516 --> 00:13:03,830 (Laughter) 270 00:13:03,854 --> 00:13:05,615 and he said, "My wife wouldn't think 271 00:13:05,639 --> 00:13:07,950 that I was really much of a guy if she knew this, 272 00:13:07,974 --> 00:13:11,732 but I've been dealing with this depression and I'm taking some medication, 273 00:13:11,756 --> 00:13:14,181 and I wondered what you think?" 274 00:13:14,205 --> 00:13:16,495 They were hiding the same medication 275 00:13:16,519 --> 00:13:19,894 in two different places in the same bedroom. 276 00:13:19,918 --> 00:13:21,116 (Laughter) 277 00:13:21,140 --> 00:13:24,078 And I said that I thought communication within the marriage 278 00:13:24,102 --> 00:13:26,150 might be triggering some of their problems. 279 00:13:26,174 --> 00:13:28,666 (Laughter) 280 00:13:30,593 --> 00:13:32,156 But I was also struck 281 00:13:32,180 --> 00:13:35,698 by the burdensome nature of such mutual secrecy. 282 00:13:36,141 --> 00:13:38,002 Depression is so exhausting. 283 00:13:38,026 --> 00:13:40,972 It takes up so much of your time and energy, 284 00:13:40,996 --> 00:13:42,527 and silence about it, 285 00:13:42,551 --> 00:13:44,808 it really does make the depression worse. 286 00:13:45,276 --> 00:13:46,485 And then I began thinking 287 00:13:46,509 --> 00:13:48,832 about all the ways people make themselves better. 288 00:13:48,856 --> 00:13:51,317 I'd started off as a medical conservative. 289 00:13:51,341 --> 00:13:53,975 I thought there were a few kinds of therapy that worked, 290 00:13:53,999 --> 00:13:55,444 it was clear what they were -- 291 00:13:55,468 --> 00:13:56,968 there was medication, 292 00:13:56,992 --> 00:13:58,659 there were certain psychotherapies, 293 00:13:58,683 --> 00:14:01,104 there was possibly electroconvulsive treatment, 294 00:14:01,128 --> 00:14:03,717 and that everything else was nonsense. 295 00:14:03,741 --> 00:14:05,669 But then I discovered something. 296 00:14:05,693 --> 00:14:07,326 If you have brain cancer, 297 00:14:07,350 --> 00:14:10,538 and you say that standing on your head for 20 minutes every morning 298 00:14:10,562 --> 00:14:11,715 makes you feel better, 299 00:14:11,739 --> 00:14:14,717 it may make you feel better, but you still have brain cancer, 300 00:14:14,741 --> 00:14:16,814 and you'll still probably die from it. 301 00:14:17,387 --> 00:14:19,673 But if you say that you have depression, 302 00:14:19,697 --> 00:14:22,037 and standing on your head for 20 minutes every day 303 00:14:22,061 --> 00:14:24,257 makes you feel better, then it's worked, 304 00:14:24,281 --> 00:14:26,722 because depression is an illness of how you feel, 305 00:14:26,746 --> 00:14:28,076 and if you feel better, 306 00:14:28,100 --> 00:14:30,659 then you are effectively not depressed anymore. 307 00:14:31,112 --> 00:14:33,199 So I became much more tolerant 308 00:14:33,223 --> 00:14:35,611 of the vast world of alternative treatments. 309 00:14:35,936 --> 00:14:38,248 And I get letters, I get hundreds of letters 310 00:14:38,272 --> 00:14:41,082 from people writing to tell me about what's worked for them. 311 00:14:41,106 --> 00:14:44,671 Someone was asking me backstage today about meditation. 312 00:14:44,695 --> 00:14:48,367 My favorite of the letters that I got was the one that came from a woman 313 00:14:48,391 --> 00:14:51,312 who wrote and said that she had tried therapy, medication, 314 00:14:51,336 --> 00:14:53,166 she had tried pretty much everything, 315 00:14:53,190 --> 00:14:56,096 and she had found a solution and hoped I would tell the world, 316 00:14:56,120 --> 00:14:59,692 and that was making little things from yarn. 317 00:14:59,716 --> 00:15:02,609 (Laughter) 318 00:15:02,633 --> 00:15:04,169 She sent me some of them. 319 00:15:04,193 --> 00:15:06,223 (Laughter) 320 00:15:06,247 --> 00:15:08,112 And I'm not wearing them right now. 321 00:15:08,136 --> 00:15:09,286 (Laughter) 322 00:15:09,845 --> 00:15:12,336 I suggested to her that she also should look up 323 00:15:12,360 --> 00:15:15,766 obsessive compulsive disorder in the DSM. 324 00:15:16,979 --> 00:15:19,669 And yet, when I went to look at alternative treatments, 325 00:15:19,693 --> 00:15:22,121 I also gained perspective on other treatments. 326 00:15:22,605 --> 00:15:25,323 I went through a tribal exorcism in Senegal 327 00:15:25,347 --> 00:15:27,336 that involved a great deal of ram's blood 328 00:15:27,360 --> 00:15:29,398 and that I'm not going to detail right now, 329 00:15:29,422 --> 00:15:31,422 but a few years afterwards I was in Rwanda, 330 00:15:31,446 --> 00:15:33,343 working on a different project, 331 00:15:33,367 --> 00:15:35,952 and I happened to describe my experience to someone, 332 00:15:35,976 --> 00:15:37,135 and he said, 333 00:15:37,159 --> 00:15:39,617 "Well, that's West Africa, and we're in East Africa, 334 00:15:39,641 --> 00:15:41,898 and our rituals are in some ways very different, 335 00:15:41,922 --> 00:15:43,223 but we do have some rituals 336 00:15:43,247 --> 00:15:46,047 that have something in common with what you're describing." 337 00:15:46,071 --> 00:15:47,238 And he said, 338 00:15:47,262 --> 00:15:50,473 "But we've had a lot of trouble with Western mental health workers, 339 00:15:50,497 --> 00:15:53,115 especially the ones who came right after the genocide." 340 00:15:53,139 --> 00:15:55,189 I said, "What kind of trouble did you have?" 341 00:15:55,213 --> 00:15:58,965 And he said, "Well, they would do this bizarre thing. 342 00:15:58,989 --> 00:16:01,037 They didn't take people out in the sunshine 343 00:16:01,061 --> 00:16:02,550 where you begin to feel better. 344 00:16:02,574 --> 00:16:05,726 They didn't include drumming or music to get people's blood going. 345 00:16:05,750 --> 00:16:07,656 They didn't involve the whole community. 346 00:16:07,680 --> 00:16:10,916 They didn't externalize the depression as an invasive spirit. 347 00:16:10,940 --> 00:16:15,953 Instead what they did was they took people one at a time into dingy little rooms 348 00:16:15,977 --> 00:16:17,358 and had them talk for an hour 349 00:16:17,382 --> 00:16:19,526 about bad things that had happened to them." 350 00:16:19,550 --> 00:16:21,593 (Laughter) 351 00:16:21,617 --> 00:16:24,986 (Applause) 352 00:16:25,010 --> 00:16:27,439 He said, "We had to ask them to leave the country." 353 00:16:27,463 --> 00:16:30,405 (Laughter) 354 00:16:30,429 --> 00:16:33,007 Now at the other end of alternative treatments, 355 00:16:33,031 --> 00:16:35,126 let me tell you about Frank Russakoff. 356 00:16:35,150 --> 00:16:40,852 Frank Russakoff had the worst depression perhaps that I've ever seen in a man. 357 00:16:40,876 --> 00:16:42,845 He was constantly depressed. 358 00:16:42,869 --> 00:16:44,314 He was, when I met him, 359 00:16:44,338 --> 00:16:48,144 at a point at which every month, he would have electroshock treatment. 360 00:16:48,168 --> 00:16:50,719 Then he would feel sort of disoriented for a week. 361 00:16:50,743 --> 00:16:52,522 Then he would feel okay for a week. 362 00:16:52,546 --> 00:16:54,640 Then he would have a week of going downhill. 363 00:16:54,664 --> 00:16:57,254 And then he would have another electroshock treatment. 364 00:16:57,278 --> 00:16:58,851 And he said to me when I met him, 365 00:16:58,875 --> 00:17:01,240 "It's unbearable to go through my weeks this way. 366 00:17:01,264 --> 00:17:02,711 I can't go on this way, 367 00:17:02,735 --> 00:17:04,845 and I've figured out how I'm going to end it 368 00:17:04,869 --> 00:17:06,202 if I don't get better." 369 00:17:06,226 --> 00:17:10,328 "But," he said to me, "I heard about a protocol at Mass General 370 00:17:10,352 --> 00:17:13,574 for a procedure called a cingulotomy, which is a brain surgery, 371 00:17:13,598 --> 00:17:15,867 and I think I'm going to give that a try." 372 00:17:15,891 --> 00:17:19,184 And I remember being amazed at that point to think that someone 373 00:17:19,208 --> 00:17:22,205 who clearly had so many bad experiences 374 00:17:22,229 --> 00:17:24,365 with so many different treatments 375 00:17:24,389 --> 00:17:27,429 still had buried in him, somewhere, enough optimism 376 00:17:27,453 --> 00:17:29,238 to reach out for one more. 377 00:17:29,760 --> 00:17:33,957 And he had the cingulotomy, and it was incredibly successful. 378 00:17:33,981 --> 00:17:35,593 He's now a friend of mine. 379 00:17:35,617 --> 00:17:38,942 He has a lovely wife and two beautiful children. 380 00:17:38,966 --> 00:17:41,891 He wrote me a letter the Christmas after the surgery, 381 00:17:41,915 --> 00:17:43,080 and he said, 382 00:17:43,104 --> 00:17:45,707 "My father sent me two presents this year, 383 00:17:45,731 --> 00:17:48,258 First, a motorized CD rack from The Sharper Image 384 00:17:48,282 --> 00:17:49,680 that I didn't really need, 385 00:17:49,704 --> 00:17:51,941 but I knew he was giving it to me to celebrate 386 00:17:51,965 --> 00:17:55,214 the fact that I'm living on my own and have a job I seem to love. 387 00:17:55,635 --> 00:17:58,876 And the other present was a photo of my grandmother, 388 00:17:58,900 --> 00:18:00,376 who committed suicide. 389 00:18:00,955 --> 00:18:03,860 As I unwrapped it, I began to cry, 390 00:18:03,884 --> 00:18:05,741 and my mother came over and said, 391 00:18:05,765 --> 00:18:08,757 'Are you crying because of the relatives you never knew?' 392 00:18:09,162 --> 00:18:12,710 And I said, 'She had the same disease I have.' 393 00:18:13,242 --> 00:18:15,854 I'm crying now as I write to you. 394 00:18:15,878 --> 00:18:19,165 It's not that I'm so sad, but I get overwhelmed, 395 00:18:19,189 --> 00:18:21,386 I think, because I could have killed myself, 396 00:18:21,410 --> 00:18:24,838 but my parents kept me going, and so did the doctors, 397 00:18:24,862 --> 00:18:26,692 and I had the surgery. 398 00:18:26,716 --> 00:18:28,798 I'm alive and grateful. 399 00:18:29,531 --> 00:18:34,132 We live in the right time, even if it doesn't always feel like it." 400 00:18:35,856 --> 00:18:37,775 I was struck by the fact that depression 401 00:18:37,799 --> 00:18:42,805 is broadly perceived to be a modern, Western, middle-class thing, 402 00:18:42,829 --> 00:18:46,960 and I went to look at how it operated in a variety of other contexts, 403 00:18:46,984 --> 00:18:49,175 and one of the things I was most interested in 404 00:18:49,199 --> 00:18:51,114 was depression among the indigent. 405 00:18:51,138 --> 00:18:52,686 And so I went out to try to look 406 00:18:52,710 --> 00:18:55,463 at what was being done for poor people with depression. 407 00:18:55,487 --> 00:18:57,614 And what I discovered is that poor people 408 00:18:57,638 --> 00:19:00,166 are mostly not being treated for depression. 409 00:19:00,190 --> 00:19:02,864 Depression is the result of a genetic vulnerability, 410 00:19:02,888 --> 00:19:06,238 which is presumably evenly distributed in the population, 411 00:19:06,262 --> 00:19:07,975 and triggering circumstances, 412 00:19:07,999 --> 00:19:11,753 which are likely to be more severe for people who are impoverished. 413 00:19:11,777 --> 00:19:15,280 And yet it turns out that if you have a really lovely life 414 00:19:15,304 --> 00:19:16,886 but feel miserable all the time, 415 00:19:16,910 --> 00:19:18,696 you think, "Why do I feel like this? 416 00:19:18,720 --> 00:19:19,989 I must have depression." 417 00:19:20,013 --> 00:19:22,149 And you set out to find treatment for it. 418 00:19:22,173 --> 00:19:24,105 But if you have a perfectly awful life, 419 00:19:24,129 --> 00:19:25,872 and you feel miserable all the time, 420 00:19:25,896 --> 00:19:28,906 the way you feel is commensurate with your life, 421 00:19:28,930 --> 00:19:30,785 and it doesn't occur to you to think, 422 00:19:30,809 --> 00:19:32,346 "Maybe this is treatable." 423 00:19:32,370 --> 00:19:35,572 And so we have an epidemic in this country 424 00:19:35,596 --> 00:19:38,254 of depression among impoverished people 425 00:19:38,278 --> 00:19:40,850 that's not being picked up and that's not being treated 426 00:19:40,874 --> 00:19:42,822 and that's not being addressed, 427 00:19:42,846 --> 00:19:44,917 and it's a tragedy of a grand order. 428 00:19:45,219 --> 00:19:46,819 And so I found an academic 429 00:19:46,843 --> 00:19:50,068 who was doing a research project in slums outside of D.C., 430 00:19:50,092 --> 00:19:53,235 where she picked up women who had come in for other health problems 431 00:19:53,259 --> 00:19:55,014 and diagnosed them with depression, 432 00:19:55,038 --> 00:19:58,110 and then provided six months of the experimental protocol. 433 00:19:58,134 --> 00:20:00,439 One of them, Lolly, came in, 434 00:20:00,463 --> 00:20:02,736 and this is what she said the day she came in. 435 00:20:03,069 --> 00:20:07,634 She said, and she was a woman, by the way, who had seven children. 436 00:20:07,658 --> 00:20:10,443 She said, "I used to have a job but I had to give it up 437 00:20:10,467 --> 00:20:12,682 because I couldn't go out of the house. 438 00:20:13,134 --> 00:20:15,074 I have nothing to say to my children. 439 00:20:15,447 --> 00:20:17,929 In the morning, I can't wait for them to leave, 440 00:20:17,953 --> 00:20:21,155 and then I climb in bed and pull the covers over my head, 441 00:20:21,179 --> 00:20:23,054 and three o'clock when they come home, 442 00:20:23,078 --> 00:20:24,520 it just comes so fast." 443 00:20:24,544 --> 00:20:26,838 She said, "I've been taking a lot of Tylenol, 444 00:20:26,862 --> 00:20:29,365 anything I can take so that I can sleep more. 445 00:20:29,389 --> 00:20:33,386 My husband has been telling me I'm stupid, I'm ugly. 446 00:20:33,410 --> 00:20:36,164 I wish I could stop the pain." 447 00:20:36,935 --> 00:20:39,531 Well, she was brought into this experimental protocol, 448 00:20:39,555 --> 00:20:41,746 and when I interviewed her six months later, 449 00:20:41,770 --> 00:20:45,995 she had taken a job working in childcare 450 00:20:46,019 --> 00:20:50,069 for the U.S. Navy, she had left the abusive husband, 451 00:20:50,093 --> 00:20:52,116 and she said to me, 452 00:20:52,140 --> 00:20:54,395 "My kids are so much happier now." 453 00:20:54,419 --> 00:20:57,101 She said, "There's one room in my new place for the boys 454 00:20:57,125 --> 00:20:59,012 and one room for the girls, 455 00:20:59,036 --> 00:21:01,375 but at night, they're just all up on my bed, 456 00:21:01,399 --> 00:21:03,987 and we're doing homework all together and everything. 457 00:21:04,011 --> 00:21:05,685 One of them wants to be a preacher, 458 00:21:05,709 --> 00:21:07,602 one of them wants to be a firefighter, 459 00:21:07,626 --> 00:21:10,326 and one of the girls says she's going to be a lawyer. 460 00:21:10,350 --> 00:21:12,554 They don't cry like they used to, 461 00:21:12,578 --> 00:21:14,388 and they don't fight like they did. 462 00:21:15,144 --> 00:21:17,969 That's all I need now, is my kids. 463 00:21:18,826 --> 00:21:20,771 Things keep on changing, 464 00:21:20,795 --> 00:21:25,171 the way I dress, the way I feel, the way I act. 465 00:21:25,909 --> 00:21:29,710 I can go outside not being afraid anymore, 466 00:21:29,734 --> 00:21:33,222 and I don't think those bad feelings are coming back, 467 00:21:33,246 --> 00:21:36,182 and if it weren't for Dr. Miranda and that, 468 00:21:36,206 --> 00:21:39,728 I would still be at home with the covers pulled over my head, 469 00:21:39,752 --> 00:21:41,605 if I were still alive at all. 470 00:21:42,097 --> 00:21:45,603 I asked the Lord to send me an angel, 471 00:21:45,627 --> 00:21:47,404 and He heard my prayers." 472 00:21:50,308 --> 00:21:53,288 I was really moved by these experiences, 473 00:21:53,312 --> 00:21:55,827 and I decided that I wanted to write about them 474 00:21:55,851 --> 00:21:58,668 not only in a book I was working on, but also in an article, 475 00:21:58,692 --> 00:22:01,271 and I got a commission from The New York Times Magazine 476 00:22:01,295 --> 00:22:03,414 to write about depression among the indigent. 477 00:22:03,438 --> 00:22:04,675 And I turned in my story, 478 00:22:04,699 --> 00:22:08,159 and my editor called me and said, "We really can't publish this." 479 00:22:08,668 --> 00:22:09,827 And I said, "Why not?" 480 00:22:09,851 --> 00:22:11,922 And she said, "It just is too far-fetched. 481 00:22:11,946 --> 00:22:15,609 These people who are sort of at the very bottom rung of society 482 00:22:15,633 --> 00:22:17,648 and then they get a few months of treatment 483 00:22:17,672 --> 00:22:20,045 and they're virtually ready to run Morgan Stanley? 484 00:22:20,069 --> 00:22:21,585 It's just too implausible." 485 00:22:22,013 --> 00:22:24,594 She said, "I've never even heard of anything like it." 486 00:22:24,618 --> 00:22:27,071 And I said, "The fact that you've never heard of it 487 00:22:27,095 --> 00:22:29,198 is an indication that it is news." 488 00:22:29,907 --> 00:22:33,930 (Laughter) 489 00:22:33,954 --> 00:22:37,293 (Applause) 490 00:22:37,317 --> 00:22:39,434 "And you are a news magazine." 491 00:22:39,950 --> 00:22:43,010 So after a certain amount of negotiation, they agreed to it. 492 00:22:43,034 --> 00:22:46,920 But I think a lot of what they said was connected in some strange way 493 00:22:46,944 --> 00:22:50,525 to this distaste that people still have for the idea of treatment, 494 00:22:50,549 --> 00:22:52,407 the notion that somehow if we went out 495 00:22:52,431 --> 00:22:55,254 and treated a lot of people in indigent communities, 496 00:22:55,278 --> 00:22:57,134 that would be exploitative, 497 00:22:57,158 --> 00:22:58,856 because we would be changing them. 498 00:22:58,880 --> 00:23:02,687 There is this false moral imperative that seems to be all around us, 499 00:23:02,711 --> 00:23:04,819 that treatment of depression, 500 00:23:04,843 --> 00:23:07,118 the medications and so on, are an artifice, 501 00:23:07,142 --> 00:23:09,465 and that it's not natural. 502 00:23:09,489 --> 00:23:12,432 And I think that's very misguided. 503 00:23:12,456 --> 00:23:15,789 It would be natural for people's teeth to fall out, 504 00:23:15,813 --> 00:23:19,001 but there is nobody militating against toothpaste, 505 00:23:19,025 --> 00:23:20,495 at least not in my circles. 506 00:23:21,915 --> 00:23:23,159 People then say, 507 00:23:23,183 --> 00:23:26,444 "But isn't depression part of what people are supposed to experience? 508 00:23:26,468 --> 00:23:28,200 Didn't we evolve to have depression? 509 00:23:28,224 --> 00:23:29,975 Isn't it part of your personality?" 510 00:23:29,999 --> 00:23:32,438 To which I would say, mood is adaptive. 511 00:23:32,462 --> 00:23:35,539 Being able to have sadness and fear 512 00:23:35,563 --> 00:23:37,469 and joy and pleasure 513 00:23:37,493 --> 00:23:41,248 and all of the other moods that we have, that's incredibly valuable. 514 00:23:41,272 --> 00:23:43,186 And major depression 515 00:23:43,210 --> 00:23:46,572 is something that happens when that system gets broken. 516 00:23:46,596 --> 00:23:48,200 It's maladaptive. 517 00:23:48,224 --> 00:23:49,839 People will come to me and say, 518 00:23:49,863 --> 00:23:52,665 "I think, though, if I just stick it out for another year, 519 00:23:52,689 --> 00:23:54,542 I think I can just get through this." 520 00:23:54,566 --> 00:23:57,090 And I always say to them, "You may get through it, 521 00:23:57,114 --> 00:23:59,304 but you'll never be 37 again. 522 00:23:59,733 --> 00:24:03,442 Life is short, and that's a whole year you're talking about giving up. 523 00:24:03,982 --> 00:24:05,133 Think it through." 524 00:24:05,694 --> 00:24:08,342 It's a strange poverty of the English language, 525 00:24:08,366 --> 00:24:10,450 and indeed of many other languages, 526 00:24:10,474 --> 00:24:12,844 that we use this same word, depression, 527 00:24:12,868 --> 00:24:16,582 to describe how a kid feels when it rains on his birthday, 528 00:24:16,606 --> 00:24:20,965 and to describe how somebody feels the minute before they commit suicide. 529 00:24:21,495 --> 00:24:24,501 People say to me, "Well, is it continuous with normal sadness?" 530 00:24:24,525 --> 00:24:27,632 And I say, in a way it's continuous with normal sadness. 531 00:24:27,656 --> 00:24:29,830 There is a certain amount of continuity, 532 00:24:29,854 --> 00:24:31,791 but it's the same way there's continuity 533 00:24:31,815 --> 00:24:34,021 between having an iron fence outside your house 534 00:24:34,045 --> 00:24:35,465 that gets a little rust spot 535 00:24:35,489 --> 00:24:38,087 that you have to sand off and do a little repainting, 536 00:24:38,111 --> 00:24:40,939 and what happens if you leave the house for 100 years 537 00:24:40,963 --> 00:24:44,762 and it rusts through until it's only a pile of orange dust. 538 00:24:45,082 --> 00:24:46,935 And it's that orange dust spot, 539 00:24:46,959 --> 00:24:48,724 that orange dust problem, 540 00:24:48,748 --> 00:24:51,334 that's the one we're setting out to address. 541 00:24:52,040 --> 00:24:54,254 So now people say, 542 00:24:54,278 --> 00:24:56,957 "You take these happy pills, and do you feel happy?" 543 00:24:56,981 --> 00:24:58,171 And I don't. 544 00:24:58,594 --> 00:25:01,562 But I don't feel sad about having to eat lunch, 545 00:25:01,586 --> 00:25:04,427 and I don't feel sad about my answering machine, 546 00:25:04,451 --> 00:25:06,649 and I don't feel sad about taking a shower. 547 00:25:07,324 --> 00:25:09,927 I feel more, in fact, I think, 548 00:25:09,951 --> 00:25:12,357 because I can feel sadness without nullity. 549 00:25:12,704 --> 00:25:16,910 I feel sad about professional disappointments, 550 00:25:16,934 --> 00:25:19,218 about damaged relationships, 551 00:25:19,242 --> 00:25:20,759 about global warming. 552 00:25:21,114 --> 00:25:23,815 Those are the things that I feel sad about now. 553 00:25:23,839 --> 00:25:26,549 And I said to myself, well, what is the conclusion? 554 00:25:26,573 --> 00:25:29,110 How did those people who have better lives 555 00:25:29,134 --> 00:25:31,664 even with bigger depression manage to get through? 556 00:25:31,964 --> 00:25:34,115 What is the mechanism of resilience? 557 00:25:34,583 --> 00:25:36,545 And what I came up with over time 558 00:25:36,569 --> 00:25:39,395 was that the people who deny their experience, 559 00:25:39,419 --> 00:25:41,435 and say, "I was depressed a long time ago, 560 00:25:41,459 --> 00:25:43,230 I never want to think about it again, 561 00:25:43,254 --> 00:25:44,548 I'm not going to look at it 562 00:25:44,572 --> 00:25:46,595 and I'm just going to get on with my life," 563 00:25:46,619 --> 00:25:51,217 ironically, those are the people who are most enslaved by what they have. 564 00:25:51,241 --> 00:25:53,439 Shutting out the depression strengthens it. 565 00:25:53,780 --> 00:25:56,470 While you hide from it, it grows. 566 00:25:57,185 --> 00:25:59,723 And the people who do better 567 00:25:59,747 --> 00:26:04,300 are the ones who are able to tolerate the fact that they have this condition. 568 00:26:04,324 --> 00:26:08,196 Those who can tolerate their depression are the ones who achieve resilience. 569 00:26:08,516 --> 00:26:10,128 So Frank Russakoff said to me, 570 00:26:10,152 --> 00:26:13,874 "If I had a do-over, I suppose I wouldn't do it this way, 571 00:26:13,898 --> 00:26:17,366 but in a strange way, I'm grateful for what I've experienced. 572 00:26:17,390 --> 00:26:20,714 I'm glad to have been in the hospital 40 times. 573 00:26:21,023 --> 00:26:23,634 It taught me so much about love, 574 00:26:23,658 --> 00:26:26,579 and my relationship with my parents and my doctors 575 00:26:26,603 --> 00:26:30,149 has been so precious to me, and will be always." 576 00:26:30,772 --> 00:26:32,674 And Maggie Robbins said, 577 00:26:32,698 --> 00:26:35,663 "I used to volunteer in an AIDS clinic, 578 00:26:35,687 --> 00:26:38,677 and I would just talk and talk and talk, 579 00:26:38,701 --> 00:26:42,734 and the people I was dealing with weren't very responsive, and I thought, 580 00:26:42,758 --> 00:26:45,254 'That's not very friendly or helpful of them.'" 581 00:26:45,278 --> 00:26:46,518 (Laughter) 582 00:26:46,542 --> 00:26:48,160 "And then I realized, 583 00:26:48,184 --> 00:26:50,327 I realized that they weren't going to do more 584 00:26:50,351 --> 00:26:52,834 than make those first few minutes of small talk. 585 00:26:52,858 --> 00:26:54,897 It was simply going to be an occasion 586 00:26:54,921 --> 00:26:57,870 where I didn't have AIDS and I wasn't dying, 587 00:26:57,894 --> 00:27:00,772 but could tolerate the fact that they did 588 00:27:00,796 --> 00:27:02,011 and they were. 589 00:27:02,503 --> 00:27:05,646 Our needs are our greatest assets. 590 00:27:06,202 --> 00:27:10,367 It turns out I've learned to give all the things I need." 591 00:27:12,160 --> 00:27:16,021 Valuing one's depression does not prevent a relapse, 592 00:27:16,045 --> 00:27:18,682 but it may make the prospect of relapse 593 00:27:18,706 --> 00:27:22,219 and even relapse itself easier to tolerate. 594 00:27:23,004 --> 00:27:26,662 The question is not so much of finding great meaning 595 00:27:26,686 --> 00:27:29,257 and deciding your depression has been very meaningful. 596 00:27:29,281 --> 00:27:33,272 It's of seeking that meaning and thinking, when it comes again, 597 00:27:33,296 --> 00:27:36,613 "This will be hellish, but I will learn something from it." 598 00:27:37,487 --> 00:27:39,727 I have learned in my own depression 599 00:27:39,751 --> 00:27:41,949 how big an emotion can be, 600 00:27:41,973 --> 00:27:45,033 how it can be more real than facts, 601 00:27:45,057 --> 00:27:47,786 and I have found that that experience 602 00:27:47,810 --> 00:27:50,678 has allowed me to experience positive emotion 603 00:27:50,702 --> 00:27:53,601 in a more intense and more focused way. 604 00:27:54,222 --> 00:27:57,805 The opposite of depression is not happiness, 605 00:27:57,829 --> 00:27:59,139 but vitality, 606 00:27:59,163 --> 00:28:02,118 and these days, my life is vital, 607 00:28:02,142 --> 00:28:04,434 even on the days when I'm sad. 608 00:28:04,823 --> 00:28:07,938 I felt that funeral in my brain, 609 00:28:07,962 --> 00:28:12,502 and I sat next to the colossus at the edge of the world, 610 00:28:12,526 --> 00:28:16,413 and I have discovered something inside of myself 611 00:28:16,437 --> 00:28:18,501 that I would have to call a soul 612 00:28:18,525 --> 00:28:22,038 that I had never formulated until that day 20 years ago 613 00:28:22,062 --> 00:28:25,363 when hell came to pay me a surprise visit. 614 00:28:26,841 --> 00:28:30,654 I think that while I hated being depressed 615 00:28:30,678 --> 00:28:33,180 and would hate to be depressed again, 616 00:28:33,204 --> 00:28:35,267 I've found a way to love my depression. 617 00:28:35,894 --> 00:28:40,077 I love it because it has forced me to find and cling to joy. 618 00:28:40,681 --> 00:28:44,270 I love it because each day I decide, 619 00:28:44,294 --> 00:28:45,683 sometimes gamely, 620 00:28:45,707 --> 00:28:48,252 and sometimes against the moment's reason, 621 00:28:48,276 --> 00:28:50,415 to cleave to the reasons for living. 622 00:28:50,978 --> 00:28:54,655 And that, I think, is a highly privileged rapture. 623 00:28:55,076 --> 00:28:56,332 Thank you. 624 00:28:56,356 --> 00:29:00,357 (Applause) 625 00:29:00,381 --> 00:29:01,532 Thank you. 626 00:29:01,556 --> 00:29:03,928 (Applause)