Into the Abyss
and Back

By Steven D.
Imparl

(Published
in Newsweek Japan,

December
4, 2002, pp. 54-55)

“Beep…beep…beep…beep,”
my alarm clock sounded on a sunny, clear morning in mid-October, 2001. A warm breeze
blew through the open window. Birds chirped happily in the backyard. Outside,
the day was starting very well.

There
was only one problem: I could not get out of bed. My brain simply could not be
bothered to tell my arms and legs to move. During the previous few months, I
had begun to dread the mornings and I did not want to face another day.
Although I love my work, the thought of going to my downtown Chicago office on
this particular day was positively horrifying.

Under
normal circumstances, I relished autumn days like this one. Now, I wanted to
hide under the covers and wait for the world to disappear.

My
low mood was not a surprise. For the previous three months, a strange fear—a
sense of impending doom—greeted me when I awoke in the morning. That fear
followed me through my waking hours like a lost black dog. I was having trouble
concentrating, working, and enjoying life.

Knowing
what lay ahead of me, I did not greet the day with my usual enthusiasm.
Instead, I found myself tumbling down a bottomless abyss from which there
appeared to be no escape. Indeed, at that point, I did not even want to escape.
I was content to continue my free fall into oblivion, unconcerned about such
mundane things as paying my bills, getting dressed, or even eating. A profound
apathy tainted everything in my life; I just did not care what happened.

Sure,
the economy was deteriorating all around me and I was highly anxious about
keeping new clients and trying to find new ones. Yes, I had been chronically
cranky, irritable, and restless. I hadn’t slept longer than 30 minutes at a
time for several months. I had broken off a relationship with a woman whom I
had loved deeply and to whom I had nearly become engaged.

I
found myself angry almost all the time. Although I am usually calm and fairly
even-tempered, lately, the slightest provocation could make my blood boil.
Once, while I was walking down the street at lunchtime, a man driving a small
red sports car in the snarled Chicago traffic blew his horn just a little too
long. I yelled at the driver and he yelled something back. Almost instantly, I
was shouting at him and ready—no, eager—to throw punches. I calmed
myself with a few deep breaths as the noisy man and his car disappeared into
the endless flood of vehicles. My response had been totally out of character; I
knew something was wrong and I didn’t like it.

On
top of this, I was working insanely long hours, yet accomplishing less and
less, despite all my effort. On weekends, I mostly laid on my bed, staring at
the ceiling. Spending time with friends was unbearable. I was contemplating
suicide with an alarming frequency, and I had plotted my demise in gruesome
detail. But no, I wasn’t depressed.

In
my one-man law practice, I counsel and represent small businesses, especially
Internet and e-commerce companies. I intentionally surround myself with fellow
entrepreneurs, in part, to boost my energy and mood. My work is interesting and
very rewarding. However, in the summer of 2001, I was turning away new clients
because I could not generate the enthusiasm to work for them. Consequently, my
income was dropping. As my income dropped, my mood sank, too. As my mood
worsened, my income fell further. A dangerous cycle had begun.

Because
all of these feelings and behaviors were so unusual for me, I started seeing a
therapist. The sessions were helpful, but something was missing. I mentioned my
frustration with the “missing” piece to my therapist, and he gently invited me
to consider medical treatment. For a few months, I balked at that idea. I told
him I was not “crazy” or “unstable,” and I resented any suggestion that I was.
I did not want to see a psychiatrist. Seeing a psychotherapist was bad enough,
but to see a psychiatrist implied mental illness, with its embarrassing baggage
of misconceptions and stigma.

Nevertheless,
on that October morning, I realized I had two options: try medications or kill
myself. Facing that grim Hobson’s choice, I contacted a psychiatrist that my
therapist had recommended and scheduled an appointment with her at the end of
the following week.

Arriving
at the psychiatrist’s office, I expected to meet a cold, disagreeable figure
who would delve into my earliest childhood memories, fill me with exotic brain-numbing
pills, and administer painful electric shock therapies when the former methods
failed to cure me. I was pleasantly surprised. The doctor was a friendly
middle-aged woman with a soft voice and a gracious demeanor. She asked a few
questions, but mostly let me talk. She listened intently and wrote a few notes.
After pausing for a moment, the good doctor smiled respectfully and told me I
was suffering from major depression.

I
was shocked. Me? Depressed? No way! I bristled at the doctor’s diagnosis. On
the surface, everything seemed to be going great. As a lawyer-businessman in my
late 30s, I had been blessed with success and interesting opportunities in law,
information technology, business, and writing. I had achieved most of the goals
I had set for myself professionally and personally. I had been happily
self-employed for seven years and had published a highly successful
three-volume book about Internet law. I was exploring some promising new
business ventures. My family was healthy. I had a lot of friends. How could I
be depressed?

Initially,
accepting that I had depression was extremely difficult. I felt weak and
inadequate, flawed and lazy. I concluded I must have had some terrible
character flaw to be feeling so awful. Because most things in my life were
going very well, a diagnosis of depression made no sense to me.

Nor
did I like the idea of taking pills for depression; in part, because I worried
they would change my personality or turn me into a zombie. I had read about
antidepressants. I knew that the process of prescribing antidepressant
medicines could be a matter of trial and error, and that doctors had only
“theories” about how those medicines worked, rather than facts. I was very
uncomfortable with the idea of medical treatment for depression because it
seemed so unscientific.

Further,
I had thought that depression was an illness that primarily affected women. In
the popular media, I had seen many depictions of depressed women, but never of
depressed men. As a guy who liked to be active and engaged in life, I felt
ashamed of a condition that threatened to bench me in the game of life at a
critical point in that game. Depression was too unmanly and, well, too
depressing to accept.

Since
I was paying my hard-earned money for the 45-minute visit with the
psychiatrist, I told her all of my concerns. I expressed my disbelief and asked
her how I could possibly be depressed. Patiently, my doctor explained that
depression is a physical illness as much as it is an illness of the mind. I
learned that most psychiatrists now believe depression results from an
imbalance of certain chemicals in the brain called neurotransmitters.
Encouragingly, the doctor said that depression usually responds well to
treatment. She also told me that a lot of people suffer from depression and
that there is no reason to feel ashamed of the illness. Becoming somber for a
moment, she cautioned that untreated depression could be fatal: as many as 15%
of depressed persons who do not receive treatment eventually kill themselves.

The
doctor prescribed a medication called EffexorXR®. I’d like to say that there
was a miraculous change the next day, but it didn’t work that way. In fact, for
the first few weeks, I felt nothing. I wanted to abandon the treatment. I
called my doctor, who suggested I be patient because antidepressants can take
several weeks to reach their full effect. I waited three months, punctuated by
regular visits with my doctor. Finally, after taking the medication for about
three and one half months, I began to feel consistently better and more like my
usual self.

A
year later, I am feeling much better. Most of my enthusiasm for life has
returned. Increasingly, I have moments of joy and a sense of direction and
purpose. My income is gradually rising, too, although it will take time to
recover the recent losses. I am developing a new Internet-based business,
actively networking with other professionals, and seeking new clients for my
law practice.

I
now realize that I did not have to suffer as long as I did or feel ashamed of
my depression. Effective treatments are available and offer us hope. I am the
living proof.