I am depressed, but that's not really the problem, is it?

I cannot stop thinking about all the losses in my life.

Published May 18, 2006 11:40AM (EDT)

Dear Cary:

You probably get a million letters like this, but I am sad all the time and I'm not sure I can cope with it much longer. In 1997, my mother died unexpectedly at the age of 52. I was 27. A few years later, my brother and I had a falling out, and I haven't spoken to him since. (In fact, I can't even find him; I've tried!) Last year, my wife of 11 years and I divorced through every fault of my own. Two months later, my best friend of 25 years died very unexpectedly (age 39). Since his death, I have not stopped, even for a second, feeling like bursting into tears.

At 36, my life has more or less been nothing but a series of self-inflicted catastrophes, and I've been depressed for nearly as long as I can remember, stretching back into my early adolescence. I mention that just to avoid sidetracking into that area. Yes, I'm a depressive person who has never really sought assistance for that problem (and really cannot because of an ongoing lack of medical insurance). But what I'm really concerned about now is the feeling of sadness and loss for not only my friend and my mother but also my brother and ex-wife, all people I loved who are, for one reason or another, now gone from my life.

Everything I do, everything I see, everything I enjoy reminds me of one of them, and it cripples me. Emotionally, that is. Mentally, physically, I've been going through the motions: Since my mother's death, I've accomplished a lot both artistically and professionally. But the aggregate losses I've suffered are catching up with me, and I'm beginning to feel like I just can't take it anymore. I have no family, no one close, and I am finding no joy whatsoever in life. I simply don't understand how I can go on without my family and without my friend. I can't see the point in going on without them and, really, don't want to go on without them.

But although I think about suicide a lot, I know that I must go on. So my question is this: How is that done? How does anyone do that? Since my divorce, I've begun considering converting to Judaism, and in the process of that examination, I've reencountered stories of Holocaust survivors. Not to equate anything I've gone through with that experience, but the fact that so many of them did go on (although some did not) after suffering such indescribable losses tells me that this is possible. But how?

Thank you,

Catchy-Name-That-You-Make-Up

Dear Catchy-Name-That-I-Make-Up,

Sorry I could not think up a catchy name, but your situation does not lend itself to catchiness. In short, my answer to you is that you find the help you need. You say you have accomplished a lot both artistically and professionally and yet cannot seek help for your depression because of "an ongoing lack of medical insurance." I believe that there is help available for you and that you can find it. Perhaps you believe that you are not entitled to such help. I believe you are, and I believe that you must assume that you are entitled to it in order to search for it with diligence and determination.

Surely it is a scandal that the United States has not yet found a way to ensure that its citizens have adequate healthcare. But that does not mean that enterprising people cannot get it if they set their minds to it. The key thing seems to be to make it a priority. Clearly in your case what is needed is treatment for depression. You readily admit that you are a depressive person, and yet, you say, what you are really concerned about is this feeling of sadness and loss. That is like saying that, yes, you are on fire but what really concerns you is all these flames licking about your person. You must get treatment for your depression. It is not about the events in your life that triggered it. It is about your depression itself.

This is something that I think you will come to see after embarking on the work that lies ahead. It will probably be slow going. You are now at the very beginning. For starters you must begin searching for treatment and a way to pay for it. Do not despair. There are ways.

How much are you willing to pay to be free of your suffering? Is there a dollar amount that can be placed on it? I hesitate to even speak of specific dollar amounts, for the relative value of dollars varies. But how much would you pay to live?

I have no great insight into the particularities and nuances of your condition. What is required first of all is the relentless determination to act and keep acting, to begin the long journey home. If you can get yourself in a course of treatment, you may have many insights along the way that will astound you and comfort you and terrify you and make you wise, sometimes all in the same moment. But you must begin.

Pick up the phone, call a hospital or clinic or even a friend or relative and simply say, "I am seeking treatment for my depression." Keep saying that. Eventually someone will direct you to the right place. Someone will say, "Come in and let's talk." Then you say, "What time? I will be there." Do it. As innocent humans beset with a multitude of troubles not of our making, we have the right to adequate medical care. It is a right, not a privilege. It is what you need. Demand it. Worry about the money later.

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