Lingering Depression By Laura L. Smith, Ph.D.

I read a well written, moving article in the Sunday NYT magazine section about a woman with severe, unremitting depression. Although the ending offered a small bit of hope, the piece induced in me the feeling that depression has a life of its own, and that those of us who try to help people with depression are mostly powerless bystanders. Daphne Merkin, the author writes, “What’s more, after a lifetime of talk therapy and medication that never seemed to do more than patch over the holes in my self, I wasn’t sure that I still believed in the concept of professional intervention.”
At first, I thought that writing about that piece could be dangerous, that anything I wrote would be construed as me not understanding the depth and darkness of real depression. But then, I thought that stance would be cowardly and fighting depression takes courage. So here goes.
I find myself wondering why people who live in New York City (and write about depression) seem to have such poetic yet intractable depressions. Okay, some of my favorite people live in or come from NYC; but really, sometimes it seems to me that those that venture west appear more able to plod through life than those remaining in the dark canyons and gray skies of NYC.
On a more serious level, I also wonder why so many people persist in getting therapy that does not seem to be working. If you are in therapy for a “lifetime” and are not getting better, ask for a referral! Do so again if the new therapy doesn’t seem to be doing you any good after a few months. There are literally thousands of practitioners, especially in New York that offer empirically validated treatments for depression such as cognitive behavioral therapy. And finally, if you are getting medications that are not helping you, talk to, and yes, complain to your doctor (but please don’t abruptly discontinue without talking to your doctor).
I write this because I have studied many hundreds of research articles that show people who receive cognitive behavioral therapy for depression, whether mild or severe, can and usually do recover. Other successful treatments for depression or even severe personality disorders (which commonly accompany prolonged depression) include interpersonal therapy, schema focused therapy, and mentalization based therapy.
I have witnessed many people who suffer from severe, protracted depression get better. And I know that pessimism (often caused in part by the disorder of depression), is not a helpful stance to take. So, don’t totally discard rose colored glasses. My message is one of hope. Please, if you are feeling depressed, hopeless, or helpless, there are treatments that work. Look for them and keep looking if need be.
At the same time, my heart goes out to the author of the article in the New York Times. Clearly, she has suffered from a deep seated depression that to date has lingered in the background of her entire life. I only want to say to her and you, “Don’t give up; keep plugging away. There are powerful reasons to maintain hope.”

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Laura L. Smith, Ph.D. is a clinical psychologist who specializes in the assessment and treatment of adults and children with obsessive compulsive disorder, as well as personality disorders, depression, anxiety, ADHD, and learning disorders. Dr. Smith is a widely published author of articles and books to the profession and the public, including: Obsessive Compulsive Disorder For Dummies, Seasonal Affective Disorder For Dummies, Anxiety and Depression Workbook For Dummies, Depression For Dummies, Overcoming Anxiety For Dummies, Hollow Kids: Recapturing the Soul of a Generation Lost to the Self-Esteem Myth, and Why Can’t I Be the Parent I Want to Be?

Ex-POW in Iraq war recalls nightmares, depression

By KIMBERLY HEFLING, Associated Press Writer Kimberly Hefling, Associated Press Writer – Wed Feb 3, 9:34 am ET

WASHINGTON – Shoshana Johnson survived gunshot wounds to both legs and 22 days as a prisoner of war in Iraq. Life wasn't so easy when she came home, either.
In a new book out this week, the 37-year-old single mother describes mental health problems related to her captivity and tells how it felt to play second fiddle in the media to fellow POW Jessica Lynch, who was captured in the same ambush.
"It was kind of hurtful," the former Army cook said in a telephone interview with The Associated Press. "If I'd been a petite, cutesy thing, it would've been different."
Johnson, the nation's first female black prisoner of war, said she felt she was portrayed differently because of her race, either by media outlets that chose not to cover her experience or those who portrayed her as greedy when she challenged the disability rating she was given for her post-traumatic stress disorder.
While the story of Lynch, then 19, remains firmly in the nation's collective memory from the 2003 U.S. invasion of Iraq, far less attention has been paid to Johnson, then 30, and four male soldiers from the 507th Maintenance Co. from Fort Bliss, Texas, who also survived captivity.
Johnson was rescued by Marines, about two weeks after Lynch's rescue. Months after returning home, Johnson left the military and today is enrolled in culinary school. She lives in El Paso, Texas, with her 9-year-old daughter.
Johnson's book, "I'm Still Standing," is being released in time for Black History Month. Johnson said she hopes that by telling her story, she can set the record straight and bring attention to mental health issues affecting veterans.
The day of the 2003 ambush, Johnson and Lynch were among 33 U.S. soldiers in a convoy that got lost in Nasiriyah en route to Baghdad. Their journey, Johnson said, was hampered by broken-down vehicles and malfunctioning equipment. Eleven were killed — including Johnson's friend Army Pfc. Lori Piestewa.
Johnson asked to be medically discharged from the military in part because she felt other soldiers resented her over the attention her POW status attracted.
She's also struggled with depression and nightmares. At times it was so bad, she writes, that her daughter, who was 2 at the time Johnson was captured, asked Johnson's parents, "Why is Mommy crying all the time?"
In 2008, she checked herself into a psychiatric ward for a few days.
"Even when I came home, I didn't think I'd ever get better. I didn't think the issues I had would ever ease," Johnson said in the interview. "But as time goes on and I stick with my therapy, it has gotten easier, and I know if I keep on the right track, I'll be OK."
It was hard at first to admit to having PTSD, she said, because she thought of it as something that happened to Vietnam veterans.
"When they started throwing out that word when I came home, I was like, no, that's not me," Johnson said.
Today, Johnson is training to be a pastry chef so she can make wedding and birthday cakes.
"It would just be nice to be able to celebrate those special moments with people," she said. "After everything that's gone on, I think those kinds of moments are very special."
After successfully fighting to receive improved disability benefits stemming from her PTSD, she was later asked to serve on the Veterans Affairs Department's panel on minority affairs.
She speaks proudly of the other POWs in captivity with her and keeps in touch with them. She said they schedule annual POW exams — the Defense Department is studying the effects of captivity — at the same time in Florida so they can see each other.
Contrary to speculation, Johnson said she was never angry at Lynch or jealous of her.
"Jessica is my friend," Johnson writes. "I was her friend before the ambush and I'm still her friend now."
One of the most brutal things Johnson endured was a captor grabbing her chest. She tells in her book of mobs of Iraqi people coming to view her as a vehicle she was in traveled from town to town, with one villager slapping her and another spitting on her. But while the men endured beatings during the captivity, she said she was treated better.
She describes acts of kindness, too, by the Iraqis. One doctor operated on her legs, which she credits with allowing her to keep them. Another doctor early in her captivity whispered to her that a woman Johnson assumed was Lynch was alive, which provided comfort.
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On the Net:
Book site: http://www.simonandschuster.com/
Army account of attack on 507th Maintenance Co.: http://tinyurl.com/ylcm5e6