What if depression does not depend on dire external circumstances?

April 4, 2022 | 05:07 pm PT
Duong Huong Tra Writer
I was 15 and in ninth grade. It's an age where there is some leeway to do stupid things, but I overdid it. I tried to kill myself.

That year, I graduated from middle school. My test scores were not high. I failed to get the literature major course in the school I wanted, while my friends got into top schools. Overwhelmed by shame and guilt towards my parents, I decided to end my life with 50 sleeping pills.

After consuming the pills, I lapsed into a half-awake state. I was still aware of my surroundings but couldn't wake myself up. Panicking, I called my father and fortunately he managed to rush me to the hospital in time. By the time the doctors cleaned out my bowel, I had fallen completely unconscious.

When I finally woke up, my mother and brother were beside me.

I was fortunate. Unfortunately, many people are like me and decide to end their lives at a very young age. Whatever the "direct" cause of this decision is – a failed relationship, a poor school performance or some such thing – this is never the root cause. I did not understand this at the time I tried to commit suicide.

I had always felt that I was a useless, throwaway person who did not deserve to live.

It was only much later when I was in my thirties that I could, with doctors' help, come to terms with what happened and why.

When someone decides to end it all, everyone thinks that it is a psychological problem. But why is it that out of all the young people that are disappointed with their studies or relationships, only a small minority think of destroying themselves? Humans have a natural desire to live and if that is subverted, pathological factors need to be considered.

Today, I can recall that when I was a student, I used to feel sad very often. My house was in Hanoi's Thanh Cong area, so I would go often to the Giang Vo Lake by myself and sit there for hours, eyes glazed over. I constantly felt tired of life. There was no need for a particular "cause" like failing exams... the sadness was already inside me. This sadness has been growing over the years.

Still later in life, marital breakdowns triggered a persistent, heavy and terrifying depression. A leading doctor at Bach Mai Hospital's mental health department explained the situation and helped me understand that negative external factors were the "exogenous" causes of depression. There were "endogenous" factors – things that already existed within, genetic or otherwise innate.

The doctor's explanation helped me look back at my old self – at the sadness that had already existed "endogenously" within me even as a school-going child; and it only needed an "exogenous" impact to turn into potentially fatal actions.

Studies by the National Institute of Mental Health at the Bach Mai Hospital show that 25 percent of the population have experienced depression in their lives. The most severe cases typically have very strong endogenous factors, particularly suicides. That’s why parents should pay close attention to their children for the smallest clues. Symptoms such as frequently feeling sad, withdrawing, avoiding social interactions, frequent fear, panic or unusual outbursts of anger could all be signs of endogenous depression.

Every day, these children have to struggle hard to endure themselves, to fight the bottomless pit threatening to swallow their minds. Every incident, no matter how small, can be the straw that breaks the camel's back. At times of such chaos and confusion, any criticism or scolding from a parent could be catastrophic. Comparing the abnormality of the child with the normality of other children could also have very heavy consequences. For people with endogenous depression, external stimuli cause pain far greater than for normal people.

Such people also experience loneliness frequently. I had always felt I was redundant from a very young age. The loneliness kept growing and eventually became fear and even panic. In such cases, it is dangerous for parents to be workaholics and leave their children alone in their own worlds. These children need a lot of time from their parents, two or even three times more than normal children.

Inadequately, I once wrote that a depressed person was like "a lost soul wandering in the frozen realm of ghosts." It is a feeling of pain and loneliness words can't describe.

Depression is a serious illness that demands a lot of time and effort from loved ones. It is very difficult to understand exactly what people with depression feel and experience, regardless of age. Those by the patient's side should accept the extent of the patient's condition and let them express themselves instead of judging or lecturing them.

"I wish I wasn't born so I don't have to suffer," I heard my 12-year-old son say. It put my guard up. I have since noticed that he has several symptoms of inherited endogenous depression. Even though I am still struggling with persistent illness, I know I have to live and stay strong to help my children deal with it. It sounds obvious, but it needs to be stressed that the love of people around us is the best remedy for endogenous depression.

*Duong Huong Tra is an author. The opinions expressed are her own.

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