The Depressed Have Rights Too  Tony Giordano

Anyone who has suffered with a disorder such as depression knows all too well that the ordeals extend well beyond the devastating symptoms of the illness itself. The misinformation and stigma surrounding the illness unnecessarily add to the suffering of victims who just want a fair chance to obtain needed healthcare, make a living and lead a decent life.

I have experienced nearly every type of problem a depressed person can encounter. My condition has been misdiagnosed. I was given a number of treatments that were ineffective. I was prescribed medications that were ineffective or produced side effects as bad as depression itself. I tried ten different medications. My recovery was delayed and my illness prolonged. I had to go on disability leave twice. I exhausted my disability benefits. I lost two good jobs as a result of depression, essentially destroying my career. I had difficulty finding a job and changed careers. I had to see five different therapists and four psychiatrists before achieving substantial recovery. I faced limitations on my healthcare due to having an emotional rather than physical illness. I couldn’t afford the type of treatment that would have most expeditiously treated my illness. I couldn’t afford to maintain my family’s lifestyle. My marriage was severely strained by the prolonged duration of my illness.

And, what’s perhaps most surprising but also most significant, my situation is not unlike that of millions of others.

The Travesty of Mental Healthcare

To further illustrate the shameful state of affairs in mental healthcare, I should add a few significant details about my story. It turned out that depression alone was not my problem. Only after two years of therapy and medication did I learn that there was much more to my condition, and these issues surfaced at my own prompting based on what I had read about the causes of depression. None of the therapists or psychiatrists I saw raised these issues.
I was reading “Healing the Child Within” by Charles Whitfield, an extraordinary book that examines the link between mood disorders such as depression and severe emotional trauma during childhood. I was struck by how similar my symptoms were to a disorder that Dr. Whitfield contends is far more common than the medical community acknowledges, and which can affect a person years or decades after the trauma. My symptoms actually aligned closer with this condition than with depression. It is post traumatic stress disorder (PTSD). Emotional or mental trauma can affect children much more severely than adults and produce a type of chronic shock that disrupts and inhibits emotions. This produces a vulnerability to stresses that occur later in life, which can lead to depression. But PTSD produces serious symptoms of its own—emotional numbness, hyper-vigilance, irritability, moodiness, and withdrawal, to name a few.

When I volunteered this information, my therapist seemed largely unfazed while confirming that I had probably had PTSD, since, he argued, the treatment would be essentially the same as that for depression. He knew my history, that as a young child I witnessed countless incidents of rage, verbal abuse and threats of violence by an alcoholic father directed at my mother, my only parent who showed me any love, warmth and approval. These raging incidents could go on for hours, and they didn’t stop for a decade. I became petrified and numb.

In order to heal the wounds and recover from a mood disorder, you need to understand what happened to you. Psychoanalyst Alice Miller has sold millions of books making this point, but caregivers evidently aren’t getting the word. I absolutely needed to know the whole truth about what made me what I am, and I was incredulous with disappointment that I didn’t know earlier about something as significant as PTSD.

There’s more. I described to all my caregivers a number of strange symptoms I experienced most of my life— being easily distracted, difficulty concentrating, inability to follow simple instructions, quickly losing focus while driving or reading, excessive daydreaming and fantasizing. Everyone has these experiences from time to time, but mine were continual and pervasive. They defined me. One time not too long ago I thought I might have ADD, then I thought it might be bipolar. I knew something was wrong.

Once again, I stumbled upon some telling information when I was reading about mood disorders-- my symptoms were an awful lot like a condition called dissociative disorder. This too can result from severe trauma. At some point, often in childhood, a person can disconnect from reality as a defense mechanism, because it’s so painful and unbearable. In the face of severe, repeated trauma, the disconnection can become a permanent part of personality. A few weeks into my sessions with a new therapist, number five I believe, I asked if my symptoms could indicate dissociative disorder. This therapist, who I like a lot and feel very confident in, suspected I might have this condition and gave me an assessment.

In spite of my suspicions, I didn’t really expect to be diagnosed with another disorder this late in my treatment. But, it turned out I did in fact have a moderate degree of dissociation, enough to present serious challenges.

I’m 55 when I learn this, about two and a half years into psychotherapy and medication over two separate episodes. I feel a sense of satisfaction hearing this because it explains a lot of things, like who I am. But I’m understandably upset and frustrated that it wasn’t found much earlier. For one, an implication is that I’ll probably require yet another type of treatment.

Now I know that it’s not at all unusual for a person to have a complex of conditions including PTSD, depression and some degree of dissociative disorder. Knowing all this is critical if for no other reason than it relieves the destructive guilt I’ve felt that I was inferior, weak, and responsible for my own inability to be “normal.” I shouldn’t worry anymore about being normal because it’s not possible to lead anything approaching a normal life with these conditions, at least not in our society.

Fighting Back

For the record, and to attest to the ability to endure these ordeals, I somehow managed despite these handicaps to do OK with my life, at least until things started unraveling. Depression “officially” struck pretty late in my life, although I always carried the vulnerability and the symptoms of severe traumatic wounds. It appears that dissociation is a condition I’ve had my whole life. Prior to my depression, I managed to get a masters degree from an Ivy League college, have a 25 year career in market research culminating in an executive position, and enjoy a 33 year marriage and three wonderful children. Now it’s all falling apart.

I grieved for awhile, but I’m doing alright now. I’ve been knocked down so many times I can’t count anymore. And when I’m down, I don’t always get up right away. But I do get up, I’ll always get up, and I hit back. My last employer didn’t understand my depression or show any compassion or tolerance; now, after a few conversations with my lawyer, they’re happy to part with a handful of money to shut me up. No one should tolerate discrimination.

I’m just warming up. I plan on doing a lot more fighting.

Unfortunately, most people are too busy with their own lives and their own problems to pay attention to these arguments and learn the truth about depression. Leadership is needed, strong, enlightened leadership. You would think that policymakers could help lead the way in dispelling myths and reforming policies that unfairly restrict the rights victims of mood disorders have or should have in the realms of jobs and healthcare. It’s time we recognize the reality of mood disorder, end the stigma and discrimination, and come out of the dark ages in the handling of these horrible but treatable illnesses.

Finally, on a positive note, let’s look at the powerful economic arguments, which typically trump any moral argument. The costs of improving diagnosis and care for mood disorders will be more than made up by savings in terms of reduced disability, improved productivity, and lower medical costs for treatment of the many diseases that depression leads to if not treated properly. Doing the right thing is even better than “free.” It will save money in the long run, which apparently is of more concern than saving people.

I’ve given up hoping for understanding or compassion. Just give us the medical treatment we deserve, allow us a rightful chance to hold a job and lead a decent life, then you can leave us alone.

Tony Giordano a 25 year career in consumer market research until depression struck. He currently teaches part-time at Rutgers University and is writing a book about his experiences. You can contact him at giordano.fh@verizon.net.

Depression  |  People Tell Their Stories  |