Writers and Depression

On an afternoon in September of 1994, I sat by myself with a razor blade in my hand. Outside, the weather was hot and still. But in my head a storm raged. Dozens of disordered voices howled in the wind of that storm. Most of them were of the opinion that my work had no value; that I would never succeed as a writer, and thus would never realize my most cherished dream; that the pain of my existence had made me a liability to myself and to my family; and that I would be better off dead. Luckily, the voice I heard most clearly as I held the razor poised above the veins of my wrist was that of my young son, asking me to think about what his life would be like without a mother. I put the blade down and cried, unable to do what I had intended, but finally convinced that I was seriously ill and needed help.

The name for the condition is clinical depression. During the year of my recovery, I was surprised yet somehow comforted to discover that depression is one of the most common human ailments. Almost everyone becomes clinically depressed at least once. Over half the general population will experience two or more episodes of serious depression during a lifetime. Statistics gathered in a recent article in Scientific American* indicate that the incidence of clinical depression among writers and artists may be as much as ten times greater than that among the general population. The incidence of suicide is as much as eighteen times greater. Why should this be the case? What exactly is depression? And what can we, as individuals who are apparently more vulnerable than most, do to protect ourselves from the specter of this often fatal illness?

The most common symptoms of depression are:

Isolation. Loss of interest in activities and friends. A sense of being trapped inside yourself. You may develop an aversion to answering the phone or the doorbell, or to greeting acquaintances if you pass them on the street.
A major change in sleeping patterns. Are you sleeping more than usual, or do you find that you go to sleep easily but awaken during the night and can't get back to sleep? Anecdotal evidence suggests that many writers suffer from frequent insomnia. But if your insomnia gets much worse than usual, this, too, can be a sign of depression.
A generalized inability to take pleasure in life. This can include loss of interest in food, or obsessive consumption of it. A secondary symptom is unintentional weight loss or gain of more than ten pounds in a short period of time. It can also include loss of interest in sex.
Inability to concentrate. This can manifest as a pattern of dropping things, frequent accidents while walking or driving, and so forth. It can also show up as a feeling of confusion, or inability to make decisions.
Loss of hope. If your prospects for the future seem unremittingly bleak, be suspicious.
Self-medication. You may be unable to shake the conviction that you need alcohol, marijuana, cocaine, or other nonprescription drugs in order to cope with life.

Scientists are still debating the question of why writers seem particularly prone to depression. Some feel that the underlying cause may be genetic. But it's also possible that the cause is more mundane. Some of the everyday aspects of writing may contribute to depression.

It takes a lot of courage to be a professional writer, though this fact is rarely acknowledged. Producing a book, a story, or a poem is emotionally similar to becoming a parent. We put so much of ourselves into our work that it's hard to separate ourselves from it, even after we've finished it and sent it out into the world to be judged by others. So it's easy to get confused about whether an editor is rejecting your story or you personally. The steady drum of rejection slips is a part of life for every writer, even the most successful. The courage it takes to deal with rejections and keep going may fail us at times. Without courage, we become fair game for depression.

Another occupational hazard for writers is the solitary nature of the profession. We spend a lot of time sitting alone with only our thoughts for company; it's difficult to get work done under any other circumstances. The average writer doesn't swim in the luxurious stream of external feedback that most human beings enjoy. Most of the decisions we make about our work and its quality we make on our own. There may be periods of time during which the only feedback we have is a string of editorial rejections. Even after we achieve regular publication, we must sometimes grapple with harsh reviews, critical inattention, or indifferent treatment from publishers. It's not socially acceptable to complain too much about these unpleasant aspects of the business, so the tendency is to internalize them--to take them to heart, and believe that they mean the worst. Without frequent reality checks--perspectives from a number of other people--it's possible to get stuck in the endless! loop of our own doubts and get further and further from the truth without realizing it.

There are several things a writer can do to keep depression at bay, or to dig out from under it once it descends. First, realize that the body and the mind are an interdependent system. Staying emotionally healthy is always easier if you feel good physically. My own dance with depression was complicated by the the chronic pain of a degenerative disease. I know from firsthand experience that once I felt better physically, the climb back to a normal outlook on life became considerably easier.

If you habitually overuse common drugs such as alcohol, nicotine, or even caffeine, make an effort to cut down. (Be careful to withdraw from nicotine and caffeine gradually, though, as sudden withdrawal can actually add to depression!) These substances can cause various physical discomforts ranging from nausea to respiratory difficulties. They can also contribute to perceptual distortions and mood swings. Pay attention to your diet. Eating regular, well-balanced meals will make you feel better in every way. Try to keep regular hours. They don't have to be normal. But they do have to stay about the same from day to day, and they should include adequate rest. Last but not least, try to get some aerobic exercise each day. It doesn't have to be much and it doesn't have to be particularly strenuous. Even as little as twenty minutes of cycling or brisk walking daily will benefit your overall health in a big way.

To alleviate isolation, cultivate the friendship of other writers. Having other writers to talk to can help you keep a healthier perspective. One note of caution here, though. Be careful about participating in a workshop or critique group while you're depressed. Inept or unnecessesarily harsh criticisms can exacerbate the problem.

There will probably still be times when the dark curtain of depression comes down in spite of your best efforts to stay healthy. According to Gene Grossman, a family therapist who has practiced for over twenty years in the San Francisco Bay Area, it takes resilience to overcome depression, and resilience can be learned to some degree. He recommends several valuable texts for writers who are learning to cope with depression: Darkness Visible: A Memoir of Madness, by the renowned novelist William Styron; Learned Optimism, by Martin Seligman; and How to Want What You Have, by Timothy Miller, Ph.D. In addition to these, I have found Nathaniel Branden's book The Six Pillars of Self Esteem, and Julia Cameron's The Artist's Way very helpful.

Finally, if you're too ill to help yourself and the task of fighting the darkness seems insurmountable, don't hesitate to get professional help. I ended up looking at that razor blade because I thought it would be a humiliating admission of weakness if I went to see a therapist. I had a lot of "good" excuses. It would cause my family pain and embarrassment. It would cost too much money. The only thing a therapist could do would be to prescribe anti-depressants, which would probably rob me of the will to write. I should have asked myself what would hurt and embarrass my family more, my seeing a psychiatrist or my committing suicide. I should have realized that drug therapy is just one of many possible paths out of depression's jungle. And the expense of therapy is not as great as I feared. Most insurance policies cover at least some of the expenses associated with treatment of acute conditions such as clinical depression. If you have no insurance, there are many th! erapists who work on a sliding rate scale, based on the patient's ability to pay.

There are hundreds of good moments in every single day. Noticing them and celebrating them on paper is part of what makes us writers. If you stop being able to see them, take action. It may save your life.

* The article referred to is Kay Redfield Jamison's "Manic Depressive Illness and Creativity," which appeared in the February 1995 issue of Scientific American

"Writers and Depression" © 1995 by Nancy Etchemendy. All rights reserved. May not be reproduced or distributed without the author's written permission. Permission is granted only for posting on the World Wide Web at http://www.horror.org/, though hyperlinks to the article at this URL are encouraged.

Nancy Etchemendy lives in the San Francisco Bay Area with her husband, John, and their son Max. Her short stories for chidren and adults appear regularly in magazines and periodicals worldwide. She is the author of four novels for young readers, including The Power of Un, currently available at bookstores and online booksellers. Her writing earned her a Bram Stoker Award in 1999.