Dear Nick and Nora:
You’ve reached Stage IV — depression — and you feel alone in your search for who you are, and you wonder who you are about to become. It is the worst of times and also the best of times — but only the worst can be felt. Our friend Susan described one of depression’s central characteristics when she said, “I can’t shake it.” It takes its own time. One hopeful thing I can tell you is that, like the other emotional stages you’ve experienced, this one is transient. It has a beginning, a peak and a decline.
In this letter I’m going to tell you a story about myself and about the kind of topic we’ve always stayed away from during our 50 years of friendship. Then I’ll tell you about a resource that could be useful to you at this time in your lives.
Any story that begins, “When I fell out of the tree …” identifies the speaker as a dope, at best. Nevertheless, you know that five years ago I fell out of a tree and broke several ribs and punctured a lung. Broken ribs hurt, and my naïve belief that modern medicine could manage all pain was dispelled. As long as I remained absolutely still and tolerated very unpleasant side effects the pain was “managed.”
The worthless drug I was given to take home taught me the true meaning of the verb “to writhe.” My prescriptions increased in potency until the doctors prescribed a semi-synthetic opioid called Dilaudid, which is used as an alternative to morphine.
The dose was a 4-milligram tablet every six hours. My doctor told me to use as little as possible and that I would have an unpleasant experience when I stopped taking it. Over a period of two months I had no problem reducing the amount I took from one 4-gram tablet four times a day to only one half of a tablet a day.
In a recent Canadian podcast, a psychiatrist described himself as “having a rather melancholic temperament, which doesn’t mean that I don’t experience pleasure and joy, and, hopefully, a sense of humor.” I identified with that description. I also identified with what the doctor said next. “I know sadness, melancholy, angst, apprehension, worry and similar, normal experiences that give richness and depth to our lives while serving as a mainspring for creativity.”
He concluded with, “I have personal knowledge of the profound difference between these experiences and serious depressive illness, which destroys.” Dilaudid gave me a taste of what I think he meant by “serious depressive illness.” It is similar, too — and yet absolutely different from — what you are experiencing as a part of grief.
I stopped taking the half pill on a Saturday. When I awoke the next day, I found myself at the bottom of a deep well from which there was no possible escape or rescue.
I tried not to think. When I did, the only thoughts I had were about how useless and worthless I was and always had been. That abstract idea was concretized by endless examples of events and actions from the past that streamed through my mind filtered by this new perspective — a perspective that insisted that my involvement always produced negative results and had negative effects on everyone I contacted.
I knew this thinking was an effect of the withdrawal from Dilaudid; however, that didn’t help because I believed I was having an epiphany from hell, and the withdrawal from Dilaudid was simply leading me to what was true and undeniable. For six days I was alone with this new information and yet, at the same time, I was clinging to Mary whenever she was around. I have a low tolerance for clinging people, and I had become one of them. At times I felt as if I was drowning or might start to drown, and Mary was the life preserver. I knew she could barely tolerate my behavior, but I couldn’t stop.
This continued for six days. The feelings intensified the first three days and slowly subsided during the last three days. Even though I believe I had experienced what the doctor on the podcast described as “serious depression” (utterly different from previous episodes of melancholy, sadness, angst, apprehension and worry), I cannot imagine how anyone could endure it for longer than I did — and yet many, many people do.
The point is that the melancholy, sadness, angst, apprehension and worry you will no doubt experience during this Stage IV of your grief is terrible, and as Susan said, you won’t be able to “shake it” until it’s ready to leave in its own time. But these are normal experiences that will ultimately “give richness and depth to your lives” and will be a “mainspring for creativity.”
What I’m saying is that true despair is similar but qualitatively different and much worse, and it is destructive. I doubt that you’ll fall into this well. If you do, you’ll know it, and you’ll know that you need help to get out of it. As long as you have not fallen into this particular well you can indulge in your misery and embrace your suffering.
. . .
When he died, my friend Joe Lodge was the longest sitting judge in California and perhaps in the United States, and over time he came to love what he was doing. Joe was different from almost all other judges and lawyers I know in that he had a deep and abiding interest in the essence of abstract ideas that attempt to explain the world as we perceive it. He had been a philosophy major in college and was a philosopher for most of his life.
We must have been talking about a problem of mine when he told me that (like other judges) he had hundreds of law books in his chambers but only two that were not about law. They were the Columbia Desk Encyclopedia and Existential Psychotherapy by Irvin Yalom, who is a psychiatrist and professor emeritus of psychiatry at Stanford University. Joe valued the book so highly because it rounded up many of the philosophical ideas he’d been pondering for years and then put them to work.
Yalom’s premise is that there are four “existential tasks” that everyone must deal with in order to be a full and psychologically healthy adult. His second premise is that most, if not all, mental illness is the result of a failure to come to terms with one or more of these unavoidable issues.
I don’t know how right or how wrong Yalom’s ideas are, but like Joe, I found them soothing. You get an entire lifetime to accomplish four tasks, which sounds achievable. You might think that Yalom’s project is stupid and no one could prove you wrong, but if it sounds interesting, right now might be your last best chance to do some of that work. Yalom’s Big Four existential issues are:
» Aloneness. Everyone is essentially alone, and there are many experiences we must have by ourselves; death is one of them.
» Purpose. What is your life for?
» Death. You are going to die and so is everyone you love.
» Freedom and the responsibility that comes with it. This one is difficult for me to understand, but I think he is saying that freedom of mind carries with it a responsibility to find and assume the best attitude toward what we encounter both inside and outside ourselves.
In the next letter I’ll start with “aloneness.” Anyone who is paying attention to what’s happening to him or her during a divorce knows that being alone is different from knowing you are alone no matter how you wiggle and dance to avoid it. The most valuable things I know about aloneness I learned from two suffering teenagers, and I feel obliged to share what they taught me whenever there is someone who might be interested in listening.
Like depression and despair, these are subjects we’ve been able to avoid in conversation for 50 years. I’m going to try to change that.