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?