Travelling through the Dark Wood of Depression

Apr 8, 2013

I haven’t “read” Dante’s Inferno since high school (thank you SparkNotes) but might be inclined to after reading David Blistein’s new memoir that borrows its title from the famous work. David’s Inferno is the emotional, and often humorous, story of one man’s journey through the dark woods of his own depression.

Just as Dante traveled through hell, purgatory and paradise, David too has voyaged through his own circles of hell. Depression had been a longtime companion of his, but for a two-year period beginning in 2005, it reared its monstrous head and consumed him. Those two years served as the driving force behind the book.

So why return to such a dark period of his life?

There was a need to understand what he had experienced and what he had gone through: Why had his diagnosis changed? Why were there so many names for those diagnoses? What does therapy really do? How had he changed as person? How had his relationships changed?  

As a result, his memoir becomes more a personal exploration and discovery rather than simply a retelling of a two-year period of his life. While his nearly 8,000-mile, cross-country expedition in his 1990 Volkswagen pop-top camper takes readers on the literal journey, descriptions of his interactions and experience with various forms of alternative therapy, medications, spirituality, creativity and diagnoses (and a pretty thorough scientific debrief on how the brain works in relation to mental illness) grants readers an inside look into the many topics—as well as the many unanswerable questions—that a person experiencing a mental illness faces.

David acknowledges that each person’s experience with depression may be different. Some may not wish to reexamine their own journey, some may not be able to find humor in their story, but he reminds readers that each person’s story is as important as the next; that each person has their own mythic journey to share, even if it won’t be included in the pantheon of literature.

David was kind enough to speak with NAMI recently about his memoir and remind us that even after travelling through hell, Dante’s work in the end was called The Divine Comedy.

NAMI: How did the decision to use Dante’s Inferno as a parallel to your personal story come about?

Blistein: To be honest, it began as a bit of a lark. I needed a name for my blog and David’s Inferno seemed like a good one. Especially since Dante’s Inferno begins with Western literature’s most famous description of a nervous breakdown: “Midway through the journey of our life, I found myself in a dark wood, for the straightforward path had been lost.”

After signing the book contract, I thought I should “give Dante his due” by writing some essays that drew parallels between my experience and his hell, purgatory and paradise. I soon realized that—theology aside—Dante was just another guy in search of the truth; and, correspondingly, that every person’s journey is as noble and mythic as his. This can be very empowering for people with major depression. It reminds us that our experience is as important a part of the human condition as happiness.

During the peak of your depression you took a cross-country trip. What did those nearly 8,000 miles help teach you?

To paraphrase Teddy Roosevelt, “It takes a fast horse to outrun the black care.” So I certainly learned that a 1990 VW van isn’t fast enough to outrun agitated depression! It also proved just how chemical my condition was, because it was with me wherever I went, whatever I did. Even when telling stories and laughing with old friends.

Major depression can make you feel so worthless, so impotent. Surviving that trip showed me that I still had some personal power; that I could still slay some dragons within and without. I was, frankly, proud as well as relieved that I survived, which gave me some confidence for the months ahead.

You mention the impact that the name of an illness or diagnosis can have (and you pick your favorite). How does being referred to by a certain string of words impact you?

The fact that I was given so many different diagnoses made me realize just how individual my experience was. Seeing that my doctor was also trying to find his way through my dark wood helped me feel less like a “failure” when a treatment or medication didn’t work. In other words, I was a partner in my treatment, not some helpless patient.

There’s a humorous analogy you use in your book about what it’s like experience depression as opposed to just sadness: “… sadness is like finding yourself at the bottom of a steep hill that you know well … Depression, however, is like finding yourself at the bottom of a real steep hill that you’ve never climbed before. You don’t know the road or how steep it gets. Turns out it’s not even paved. You have your road bike instead of your mountain bike. The shifting’s screwed up so you can’t get into the lowest gears. The tires are worn smooth and you don’t have any replacement tubes. Or a pump. Oh yeah, I forgot: a bunch of drunk kids drove up the road the night before and threw empty beer bottle out the window, shattering glass all over the place.” Why do you use humor to describe such a difficult experience here and throughout your book?

I can’t help it! It’s part of my nature…even in extremis.

I learned early on that humor is a very effective form of self-medication. And, just as importantly, that comedy can be as illuminating and instructive as tragedy.

Still, I’ve wondered if I would have wanted to read this book when I was in the midst of my breakdown. Or would I have thought, “How can this guy make light of what I’m going through? Has he forgotten how much it hurts?” So I’m relieved that many people who are currently suffering have told me that the book gives them hope. I suspect that’s because, as long as it’s grounded in kindness, humor makes difficult subjects a little less scary…and releases a few endorphins at the same time.

And, let’s not forget, Dante’s excruciating journey was ultimately called The Divine Comedy.

There was a very insightful moment in the book when you make a distinction between a break up, a breakdown and ultimately (and hopefully) a breakthrough. How does mental illness fit into that equation?

If you’re lucky, they’re all part of the equation. Without putting too fine a point on it, I’d say that in crisis, your mental/emotional/physical balance breaks down—your internal systems just don’t work the way they used to. Being healed means restoring that balance.

At the same time, your way of relating to the world breaks up. While a little scary, this offers the possibility of a real break through in which you can become free of old patterns of thought and behavior that have held you back.

Some people suffer debilitating mental illness for decades without ever really having a breakthrough. That doesn’t mean they failed in some way. They’re just on a different journey. That’s one of the most important messages in the book.

Why did you choose to include fairly detailed scientific information on how the brain functions (synapses, neurotransmitters, etc.) in your book?

I’m naturally curious about things—some might say obsessively so. I spent most of my business career as a copywriter. And, whether I was writing about computers or ball bearings, I was determined to explain things in terms laypeople could understand.

In this case, I was driven to understand what was going on “up there.” I had thought I was an informed patient. But the more research I did, the more I realized how little I understood. Who knew there were 15 different serotonin receptors? Or the difference between a serotonin precursor and a reuptake inhibitor? Or the significance of half lives? I sure didn’t. And, yet, facts like these explain so much. As I say in the book, if doctors want informed patients, we might as well give them a run for their money!

I still find the subject fascinating.

You’ve experimented with a lot of different methods of treatment in your life, including many alternative methods not as widely used in Western culture. What are your views on those forms of therapies?

There are no “magic bullets.” Some people respond to herbs and meditation. Others to talk therapy and acupuncture. Others to medication and exercise. Most forms of mild hands-on work (massage, acupuncture, Reiki, craniosacral) seem safe and effective—whether as primary or adjunct treatments. I found all of them helpful, although none provided lasting relief.

On the other hand, while nutritional therapies—whether herbs, vitamins, amino acids or even homeopathics—can be lasting cures, it’s important to be a bit careful, especially when combined with meds. For example, amino acids and SSRIs both affect the serotonergic system, but in different ways. They could potentially cancel out or double the effect of one another. Professionals on both sides of the medical equation are learning about these interactions but have a long way to go. I’d encourage folks to tell practitioners everything you’re taking, for the sake of future patients as well as yourself. 

How were you able to maintain the health of your marriage even when you were in your darkest moments? How did your wife help you throughout those difficult times?

My wife did a lot more of the maintaining than I did! She has had her own experiences with severe depression so she had a good idea what I was going through. It also helped that we weren’t facing a lot of day-to-day challenges at the time—we weren’t worried about where the next meal was coming from.

More importantly, she didn’t try to “fix me.” She didn’t get swept up in the drama of the thing. She was there to accompany me on the journey but didn’t impose.

I did do my best to keep her out of harm’s way. I remember waiting for her to leave for work so I could get in the shower and start screaming. (In the book I refer to my trip across the country as, in part, respite care for Wendy.)

It’s been five years since the final dates mentioned in the book, which spoke about your ongoing recovery. How has the road been since 2007?

I’ve been on the same medications since then with very minor adjustments in dosages. I also take nibbles of one of the milder benzodiazepines as needed. At first, every few weeks and then months, I’d sense that all-too-familiar feeling of darkness arise in my throat and start spreading up to my head and down to the pit of my stomach. It’s hard not to panic at those moments. In some cases, all it took was a good workout to move past it. In other cases, I’d go home, take a little anti-anxiety medication and lie very still for a while. But I haven’t even had an episode like that in more than six months.

In the last six years, my mom died, our daughter was married and our first grandchild was born. I was able to experience the full range of grief during the former and joy during the latter. I’m a lucky guy.

David Blistein is a novelist and essayist, and former advertising agency executive whose writing is the culmination of a lifelong pursuit of wisdom, transcendence and humor. His works-in-progress include books and blogs that present unconventional perspectives on nature, psychology, spirituality and writing. He lives with his wife, Wendy O’Connell, in Southern Vermont.