Coping with a Genetic Disposition for Depression

A Therapist Comes to Terms with Her Family's History of Depression

Martha Manning

My family is haunted by depression. My mother can trace it back in her family at least six generations and it's in my father's family, too. When it hits, it hits hard. We don't get "down in the dumps," we get lost in the pits. Some people find themselves or are found, others get lost forever. The melancholies, nerves and breakdowns of my ancestors landed them in sanitariums, rest homes or in upstairs rooms from which they never emerged. Treatment involved the state-of-the-art interventions of the time cold packs, electric current, sedating drugs. Sometimes people got better. Sometimes they didn't.

Understanding the legacy of depression in a family requires more than genetic mapping, family diagrams, or symptom checklists. Each of us is the product of a complex weaving of genes and expectations, biochemistry and family myths, and the configuration of our family's strengths, as well as its vulnerabilities. To truly appreciate the complexity of the weave, we have to sort out the contributions of individual threads to the overall design.

My own memory of being haunted by depression extends back to my great-grandmother who lived into her nineties and died when I was about 10. As I began to put things together about the relationship between my grandmother and her mother, I started to wonder whether the dulling of self I sometimes experienced, and its power to contaminate energy and joy, played leap frog with the generations hopping over my great-grandmother and landing on my grandmother, leaping over my mother and crashing down on me.

My mother had a no-nonsense approach to unhappiness. Stay busy, think of someone worse off than yourself, offer it up for the souls in Purgatory. At the pediatrician's office when two or three of us lined up with our bare asses vulnerable to imminent medical intervention, one of us invariably burst into loud and contagious tears, protests and screams. I remember more than once my mother leaning over and whispering, "If you must cry, cry quietly."

Early on, I considered myself flawed in a way that she wasn't. Unlike my mother, I had difficulty with what she calls "compartmentalizing." She could quickly extricate herself from awful feelings; I became mired in them. By my mid to late teens, I began to struggle with the variability of my moods, something that the steamroller approach to life I had learned from my mother could not control. I wondered which woman, my mother or my severely depressed grandmother, was the preview of my future.

In retrospect, I see how that pattern repeated itself with my therapist-husband when I was depressed, as we sat on the bed or at the table and he tried to get me to articulate what was wrong. Anyone who has ever been seriously depressed knows that that task is as daunting as asking a lame man to tap dance. In addition, it leads to mutual frustration, anger and, ultimately, helplessness. It was only when we both gave up the expectation that my husband could somehow "cure" me that we moved from pseudo therapy to true support. Instead of reaching out with well-intentioned "therapeutic" interventions, he shifted to questions like, "What would help right now?" My therapist was always willing to include Brian in our sessions and, even though they were not present, to recognize Brian and my daughter, Keara, not only as my support system but as people who were suffering also.

But my depression continued despite insight, despite a good marriage, despite a child I dearly loved. I finally agreed to try antidepressants and was horrified when my psychiatrist recommended imipramine, the same medicine my grandmother had used in her late seventies, with moderate success, but difficult side effects. My psychiatrist must have registered the horror on my face. He reassured me that he always chooses as the first antidepressant a drug that has worked with other family members.

He was right. The medicine helped quickly and dramatically. It lifted a lifelong weight off my back and made me wonder, "Is this how regular people feel?" But like many people who take psychotropic medications for significant periods of time, I struggled with questions like, "Why can't I do this on my own?" or, looking at the tiny pills, I wondered, "Is this all that stands between hell and me?"

Fortunately my psychiatrist and I already had a strong therapeutic relationship. Yet despite the benefits of the antidepressant, I still feared that I was destined to be my grandmother, a fear no drug could erase. I didn't want her resignation, her helplessness, her just-be-low-the-surface bubbling anger or her genuine and horrible suffering. I also didn't want to have the impact that she had on her family, particularly on my mother. I did not want my daughter to take on the yoke of responsibility and resent me for it.

In addition to support, the therapy focused on developing an understanding of the commonalities I shared with each woman, appreciating aspects of our shared legacies as some of the things I most valued in myself. I also had to articulate the differences between myself and each of them. I worked to understand that depression did not negate me, it just made my life different and difficult hopefully, for a limited amount of time, and that no one genetically, biologically or psychologically is the blueprint for anyone else. Being haunted is not the same as being cursed.

This blog is excerpted from “The Legacy". Read the full article here. >>

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Topic: Anxiety/Depression

Tags: antidepressants | coping with depression | depression | drugs | family | psychiatrist | success | teens | therapist | therapy

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