Depression, the secret we share | Andrew Solomon

Translator: Alicia Ferreiro Reviewer: Carme Paz

"I felt a Funeral, in my Brain,

"Sentín un funeral no meu cerebro,

and Mourners to and fro

e os parentes ían e viñan

camiñando, camiñando ata que, pareceu,

kept treading -- treading -- till [it seemed]

que o sentido crebaba totalmente.

that Sense was breaking through --

And when they all were seated,

E cando todos estiveron sentados,

a Service, like a Drum --

unha liturxia, como un tambor,

kept beating -- beating -- till I [thought]

comezou a bater, a bater ata que pensei

que a miña mente adormecía

my Mind was going numb --

And then I heard them lift a Box and creak across my Soul

E logo oínos erguer o caixón e renxer a través da miña alma

with those same Boots of Lead, again,

coas mesmas botas de chumbo, outra vez,

e o espazo comezou a tanxer,

then Space -- began to toll,

Coma se os ceos fosen unha campá, e a existencia só un oído,

As [all] the Heavens were a Bell, and Being, [but] an Ear,

and I, and Silence, some strange Race,

e eu, e o silencio, unha raza estraña

desfeita, solitaria, aquí.

wrecked, solitary, here --

[And] then a Plank in Reason, broke,

E entón un baleiro na razón, rompeu

and I fell down and down --

e caín máis e máis abaixo

e dei cun mundo, a cada mergullo,

and hit a World, at every plunge,

and Finished knowing -- then --"

e acabei sabendo, daquela"

We know depression through metaphors.

Coñecemos a depresión a través de metáforas.

Emily Dickinson foi capaz de expresalo con palabras,

Emily Dickinson was able to convey it in language,

Goya in an image.

Goya, nunha imaxe.

A metade do propósito da arte é describir estes estados icónicos.

Half the purpose of art is to describe such iconic states.

As for me, I had always thought myself tough,

Canto a min, sempre me vin como unha persoa dura,

one of the people who could survive

unha das que poderían sobrevivir

if I'd been sent to a concentration camp.

se me enviasen a un campo de concentración.

In 1991, I had a series of losses.

En 1991, sufrín unha serie de perdas.

My mother died,

A miña nai morreu,

a relationship I'd been in ended,

rematou a relación na que estaba,

I moved back to the United States from some years abroad,

volvín para os Estados Unidos despois duns anos no estranxeiro

and I got through all of those experiences intact.

e pasei por estas experiencias intacto.

But in 1994, three years later,

Pero en 1994, tres anos despois,

I found myself losing interest in almost everything.

atopeime perdendo o interese en case todo,

non quería facer nada do que antes si quería,

I didn't want to do any of the things I had previously wanted to do,

and I didn't know why.

e non sabía o porqué.

The opposite of depression is not happiness, but vitality.

O contrario da depresión non é a felicidade, senón a vitalidade.

E era a vitalidade

And it was vitality

that seemed to seep away from me in that moment.

a que se esvaecía para min naquel momento.

Todo o que había para facer era demasiado traballo.

Everything there was to do seemed like too much work.

I would come home

Volvía á casa

e vía pestanexar a luz vermella do contestador

and I would see the red light flashing on my answering machine,

and instead of being thrilled to hear from my friends,

e en vez de aledarme por saber dos meus amigos,

I would think,

pensaba:

"Vaia morea de xente á que lle teño que devolver a chamada"

"What a lot of people that is to have to call back."

Or I would decide I should have lunch,

Ou decidía que tiña que comer

and then I would think, but I'd have to get the food out

pero despois pensaba: teño que coller a comida,

and put it on a plate

poñela no prato

and cut it up and chew it and swallow it,

e cortala e mastigala e tragala,

and it felt to me like the Stations of the Cross.

e sentía que eran as estacións do Viacrucis.

E algo que a miúdo se esquece ao falar de depresión

And one of the things that often gets lost in discussions of depression

is that you know it's ridiculous.

é que ti sabes que é absurdo.

You know it's ridiculous while you're experiencing it.

Sabes que é absurdo mentres o experimentas.

You know that most people manage

Sabes que a maioría da xente é quen

to listen to their messages and eat lunch

de escoitar as menxases e xantar

and organize themselves to take a shower

e organizarse para ducharse

and go out the front door

e saír pola porta

e que non é gran cousa,

and that it's not a big deal,

and yet you are nonetheless in its grip

e aínda así estás nas súas gadoupas,

and you are unable to figure out any way around it.

e es incapaz de idear unha saída.

And so I began to feel myself doing less

Así que comecei a sentir que facía menos

and thinking less

e pensaba menos

and feeling less.

e sentía menos.

It was a kind of nullity.

Era unha especie de nulidade.

E despois chegou a ansiedade.

And then the anxiety set in.

If you told me that I'd have to be depressed for the next month,

Se me dis que teño que estar deprimido o próximo mes,

I would say, "As long I know it'll be over in November, I can do it."

diría: "Se está rematado en novembro, podo facelo."

But if you said to me,

Pero se me dis:

"You have to have acute anxiety for the next month,"

"Tes que ter ansiedade aguda durante o próximo mes"

Preferiría cortar as veas antes de pasar por iso.

I would rather slit my wrist than go through it.

It was the feeling all the time

Era sentir continuamente

coma cando vas andando

like that feeling you have if you're walking

and you slip or trip and the ground is rushing up at you,

e esvaras ou tropezas e o chan achégase a ti,

but instead of lasting half a second, the way that does,

pero en vez de durar medio segundo como é,

it lasted for six months.

dura seis meses.

It's a sensation of being afraid all the time

É a sensación de estar sempre asustado,

but not even knowing what it is that you're afraid of.

pero sen sequera saber de que estás asustado.

E foi nese punto cando comecei a pensar

And it was at that point that I began to think

that it was just too painful to be alive,

que estar vivo era sinxelamente demasiado doloroso,

and that the only reason not to kill oneself

e que a única razón para non suicidarme

era non ferir outra xente.

was so as not to hurt other people.

And finally one day, I woke up

E finalmente un día espertei

and I thought perhaps I'd had a stroke,

e pensei que quizais sufrira un ataque,

because I lay in bed completely frozen,

porque estaba na cama totalmente inmobilizado,

looking at the telephone, thinking,

mirando o teléfono, pensando:

"Something is wrong and I should call for help,"

"Algo vai mal e debería chamar para pedir axuda"

and I couldn't reach out my arm

e non podía estirar o brazo

and pick up the phone and dial.

e agarrar o teléfono e marcar.

And finally, after four full hours of my lying and staring at it,

E finalmente, despois de catro horas deitado mirándoo

the phone rang,

o teléfono soou,

e dalgún xeito conseguín contestar

and somehow I managed to pick it up,

and it was my father, and I said,

e era o meu pai e dixen:

"Teño un problema serio, Temos que facer algo."

"I'm in serious trouble. We need to do something."

The next day I started with the medications and the therapy.

O día seguinte comecei coa medicación e a terapia.

And I also started reckoning with this terrible question:

E tamén empecei a considerar esta terrible cuestión:

If I'm not the tough person

Se non son a persoa dura,

who could have made it through a concentration camp,

que podería sobrevivir a un campo de concentración,

entón quen son?

then who am I?

And if I have to take medication,

E se tiña que tomar medicación,

is that medication making me more fully myself,

esa medicación facíame ser completamente eu,

or is it making me someone else?

ou convertíame noutra persoa?

And how do I feel about it if it's making me someone else?

E que me parecía se me convertía noutro?

Tiña dúas vantaxes nesta travesía.

I had two advantages as I went into the fight.

The first is that I knew that, objectively speaking,

A primeira é que eu sabía que, falando obxectivamente,

I had a nice life,

tiña unha boa vida,

and that if I could only get well,

e que se era capaz de poñerme ben

there was something at the other end that was worth living for.

había algo ao final polo que valía a pena vivir.

E a outra é que tiña acceso a un bo tratamento.

And the other was that I had access to good treatment.

Pero aínda así saín e recaín,

But I nonetheless emerged and relapsed,

and emerged and relapsed,

e saín e recaín,

e saín e recaín,

and emerged and relapsed,

e finalmente entendín

and finally understood

que tería que medicarme e ir a terapia para sempre.

I would have to be on medication and in therapy forever.

And I thought,

E pensei:

"But is it a chemical problem or a psychological problem?

"Pero é un problema químico ou psicolóxico?

And does it need a chemical cure or a philosophical cure?"

E precisa dunha cura química ou unha cura filosófica?"

And I couldn't figure out which it was.

E non fun quen de saber a resposta.

And then I understood that actually,

E logo entendín que en realidade

non estamos tan avanzados nesas áreas como para explicalo todo.

we aren't advanced enough in either area for it to explain things fully.

Tanto a cura química como a cura psicolóxica

The chemical cure and the psychological cure

both have a role to play,

teñen un papel que cumprir,

e tamén souben que a depresión era

and I also figured out that depression was something

algo entretecido tan profundamente en nós

that was braided so deep into us

that there was no separating it from our character and personality.

que non se podía separar do noso carácter e personalidade.

I want to say that the treatments we have for depression are appalling.

Quero decir que os tratamentos para a depresión son terribles.

Non son moi efectivos.

They're not very effective.

They're extremely costly.

Son moi caros.

They come with innumerable side effects.

Teñen innumerables efectos secundarios.

Son un desastre.

They're a disaster.

Pero estou tan agradecido por vivir agora e non hai 50 anos,

But I am so grateful that I live now and not 50 years ago,

when there would have been almost nothing to be done.

cando non se podería facer case nada.

I hope that 50 years hence,

Espero que dentro de 50 anos,

a xente oia falar dos meus tratamentos

people will hear about my treatments

e se arrepíe de que alguén soportara unha ciencia tan primitiva.

and be appalled that anyone endured such primitive science.

Depression is the flaw in love.

A depresión é a imperfección do amor.

If you were married to someone and thought,

Se estás casado con alguén e pensas:

"Well, if my wife dies, I'll find another one,"

"Ben, se a miña muller morre, atoparei outra"

non sería amor tal como o coñecemos.

it wouldn't be love as we know it.

There's no such thing as love without the anticipation of loss,

Non existe o amor sen a anticipación da perda,

and that specter of despair can be the engine of intimacy.

e o espectro da desesperación pode ser o motor da intimidade.

Hai tres cousas que a xente tende a confundir:

There are three things people tend to confuse:

depresión, dor e tristeza.

depression, grief and sadness.

Grief is explicitly reactive.

A dor é explicitamente reactiva.

Se sofres unha perda e te sentes moi infeliz,

If you have a loss and you feel incredibly unhappy,

e logo, 6 meses despois,

and then, six months later,

you are still deeply sad, but you're functioning a little better,

estás aínda moi triste, pero xa empezas a funcionar mellor,

probablemente sexa dor,

it's probably grief,

and it will probably ultimately resolve itself in some measure.

e probablemente se resolva por si mesma en certa medida.

If you experience a catastrophic loss,

Se experimentas unha perda catastrófica,

e te sentes fatal,

and you feel terrible,

and six months later you can barely function at all,

e seis meses despois case non podes funcionar,

then it's probably a depression that was triggered

probablemente se desencadeou unha depresión

polas circunstancias catastróficas.

by the catastrophic circumstances.

The trajectory tells us a great deal.

A traxectoria dinos moito.

A xente pensa na depresión simplemente como estar triste.

People think of depression as being just sadness.

It's much, much too much sadness,

É moita, moita, demasiada tristeza,

much too much grief

moita, demasiada dor,

at far too slight a cause.

por algo tan lixeiro.

As I set out to understand depression,

Cando comezaba a comprender a depresión

e a entrevistar persoas que a sufriran,

and to interview people who had experienced it,

I found that there were people who seemed, on the surface,

atopei que había xente que tiña a primeira vista o que parecía

to have what sounded like relatively mild depression

unha relativamente leve depresión

e que estaban aínda así totalmente incapacitados por ela.

who were nonetheless utterly disabled by it.

And there were other people who had what sounded

E había outra xente que parecía ter,

segundo a describía, unha depresión grave

as they described it like terribly severe depression

who nonetheless had good lives

que tiña porén boas vidas

in the interstices between their depressive episodes.

nos intervalos entre episodios depresivos.

And I set out to find out what it is that causes some people

E comecei a descubrir o que causaba que certas persoas

fosen máis resilientes que outras.

to be more resilient than other people.

Cales son os mecanismos que lle permiten á xente sobrevivir?

What are the mechanisms that allow people to survive?

And I went out and I interviewed person after person

E saín entrevistar unha tras outra

who was suffering with depression.

persoas que estaban sufrindo depresión.

One of the first people I interviewed

Unha das primeiras ás que entrevistei

describiu a depresión como un xeito máis lento de estar morto

described depression as a slower way of being dead,

and that was a good thing for me to hear early on

e para min foi unha boa cousa oílo ao principio

because it reminded me that that slow way of being dead

porque me recordou que ese xeito lento de estar morto

can lead to actual deadness,

pode levar a unha morte real,

that this is a serious business.

que é un asunto serio.

It's the leading disability worldwide,

É o líder mundial da discapacidade,

e a xente morre diso cada día.

and people die of it every day.

One of the people I talked to when I was trying to understand this

Unha das persoas coas que falei cando intentaba entender isto

was a beloved friend who I had known for many years,

era unha querida amiga coñecida desde había moitos anos,

and who had had a psychotic episode in her freshman year of college,

e que sufrira un episodio psicótico no primeiro ano da facultade

e que despois caeu de golpe nunha depresión terrible.

and then plummeted into a horrific depression.

Tiña síndrome bipolar,

She had bipolar illness,

or manic depression, as it was then known.

ou enfermidade maníaco-depresiva, como se dicía daquela,

And then she did very well for many years on lithium,

e foille moi ben co litio durante moitos anos,

e logo, co tempo, quitáronlle o litio

and then eventually, she was taken off her lithium

to see how she would do without it,

para ver como estaba sen el,

e tivo outra psicose

and she had another psychosis,

e logo caeu na peor depresión que vin na miña vida,

and then plunged into the worst depression that I had ever seen

in which she sat in her parents' apartment,

durante a que sentaba no apartamento dos pais

more or less catatonic, essentially without moving,

mais ou menos catatónica, basicamente sen moverse,

day after day after day.

día tras día tras día.

And when I interviewed her about that experience some years later --

E cando lle preguntei sobre esta experiencia anos despois,

-é unha poeta e psicoterapeuta chamada Maggie Robbins-

she's a poet and psychotherapist named Maggie Robbins --

when I interviewed her, she said,

cando a entrevistei, díxome:

"I was singing 'Where Have All The Flowers Gone,'

"Estaba cantando 'A onde foron as flores'

unha e outra vez para ocupar a mente.

over and over, to occupy my mind.

I was singing to blot out the things my mind was saying,

Cantaba para bloquear as cousas que dicía a miña mente,

which were, 'You are nothing. You are nobody.

que eran 'Non es nada. Non es ninguén.

Non mereces nin vivir.'

You don't even deserve to live.'

And that was when I really started thinking

E aí foi cando de verdade comecei a pensar

en suicidarme".

about killing myself."

Durante a depresión non pensas que che puxeron un veo gris

You don't think in depression that you've put on a gray veil

e que ves o mundo a través dunha néboa de mal humor.

and are seeing the world through the haze of a bad mood.

Pensas que che quitaron o veo,

You think that the veil has been taken away,

o veo da felicidade,

the veil of happiness,

and that now you're seeing truly.

e que agora ves a verdade.

É máis fácil axudar esquizofrénicos que perciben

It's easier to help schizophrenics who perceive

que hai algo alleo dentro deles que precisa ser exorcizado,

that there's something foreign inside of them that needs to be exorcised,

pero é difícil cos depresivos,

but it's difficult with depressives,

because we believe we are seeing the truth.

porque cremos que estamos vendo a verdade.

Pero a verdade mente.

But the truth lies.

I became obsessed with that sentence:

Obsesioneime con esa frase:

"But the truth lies."

"Pero a verdade mente"

And I discovered, as I talked to depressive people,

E descubrín, ao falar con persoas deprimidas,

that they have many delusional perceptions.

que teñen moitas percepcións ficticias.

People will say, "No one loves me."

Eles diranche "Ninguén me quere"

And you say, "I love you,

e ti dislles "Eu quérote,

your wife loves you, your mother loves you."

a túa muller quérete, a túa nai quérete".

You can answer that one pretty readily, at least for most people.

Podes contestar sen problemas polo menos a maioría da xente.

Pero a xente deprimida tamén che dirá:

But people who are depressed will also say,

"No matter what we do, we're all just going to die in the end."

"Tanto ten o que fagamos, ao final imos morrer."

Ou dirán: "Non pode haber auténtica comunión

Or they'll say, "There can be no true communion

between two human beings.

entre dous seres humanos.

Cada un está atrapado no seu propio corpo"

Each of us is trapped in his own body."

To which you have to say,

Ao que tes que responder

"That's true,

"Iso é certo,

but I think we should focus right now on what to have for breakfast."

pero creo que agora deberiamos centrarnos en qué imos almorzar".

(Laughter)

(Risos)

A lot of the time,

Gran parte do tempo,

what they are expressing is not illness, but insight,

o que expresan non é tristura, senón perspicacia,

and one comes to think what's really extraordinary

e isto lévame a pensar que é extraordinario

is that most of us know about those existential questions

que a maioría de nós coñece estas preguntas existenciais

sen que nos distraian moito.

and they don't distract us very much.

Había un estudo que me gustaba especialmente

There was a study I particularly liked

in which a group of depressed and a group of non-depressed people

no cal a un grupo de xente deprimida e a un de xente non deprimida

se lles pide que xoguen a un videoxogo durante unha hora,

were asked to play a video game for an hour,

and at the end of the hour,

e ao final desa hora,

they were asked how many little monsters they thought they had killed.

preguntábaselles cantos monstruíños pensaban que mataran.

O grupo deprimido normalmente acertaba cunha marxe dun 10 por cento,

The depressive group was usually accurate to within about 10 percent,

e o grupo de non deprimidos

and the non-depressed people

guessed between 15 and 20 times as many little monsters --

supoñía entre 15 e 20 veces máis monstruíños

(Risos)

(Laughter)

dos que realmente mataran.

as they had actually killed.

A lot of people said, when I chose to write about my depression,

Moita xente dixo, cando decidín escribir sobre a miña depresión,

que debía ser moi difícil expoñerse así,

that it must be very difficult to be out of that closet,

to have people know.

que a xente o soubese.

They said, "Do people talk to you differently?"

Dicían: "A xente fálache distinto?"

I said, "Yes, people talk to me differently.

e eu dicía: "Si, a xente fálame distinto.

They talk to me differently insofar

Fálanme distinto desde o momento

as they start telling me about their experience,

en que comezan a falarme da súa experiencia,

or their sister's experience,

ou da experiencia da súa irmá,

or their friend's experience.

ou da experiencia do seu amigo.

Things are different because now I know

A cousas son diferentes porque agora sei

that depression is the family secret that everyone has.

que a depresión é o segredo familiar que todo o mundo ten.

I went a few years ago to a conference,

Hai uns anos fun a unha conferencia

e o venres da conferencia de tres días

and on Friday of the three-day conference,

one of the participants took me aside, and she said,

unha das participantes levoume á parte e díxome:

"I suffer from depression and I'm a little embarrassed about it,

"Teño depresión e dáme un pouco de vergoña,

but I've been taking this medication,

pero estiven tomando esta medicación,

and I just wanted to ask you what you think?"

e só quería preguntarche que opinas".

And so I did my best to give her such advice as I could.

Así que me esforcei en darlle o mellor consello que puiden.

And then she said, "You know, my husband would never understand this.

E entón díxome: "Sabes? o meu home nunca entendería isto.

He's really the kind of guy to whom this wouldn't make any sense,

É o tipo de persoa para o que isto non tería sentido,

so, you know, it's just between us."

así que, xa sabes, que quede entre nós."

And I said, "Yes, that's fine."

E díxenlle: "Si, está ben."

On Sunday of the same conference,

No domingo da mesma conferencia,

her husband took me aside,

o seu home chamoume á parte

(Laughter)

(Risos)

and he said, "My wife wouldn't think

e díxome "A miña muller non me vería

that I was really much of a guy if she knew this,

como o home que son se o soubese

but I've been dealing with this depression and I'm taking some medication,

pero estou loitando cunha depresión e estou tomando esta medicación

and I wondered what you think?"

e preguntábame que opinabas".

They were hiding the same medication

Estaban agochando a mesma medicación

in two different places in the same bedroom.

en dous sitios distintos do mesmo cuarto.

(Laughter)

(Risos)

E díxenlle que pensaba que a comunicación no matrimonio

And I said that I thought communication within the marriage

might be triggering some of their problems.

podía estar desencadeando algúns dos problemas.

(Laughter)

(Risos)

But I was also struck

Pero tamén quedei abraiado

by the burdensome nature of such mutual secrecy.

pola incómoda natureza do segredo mutuo.

A depresión tamén é extenuante,

Depression is so exhausting.

Requíreche tanto tempo e enerxía,

It takes up so much of your time and energy,

and silence about it,

e o silencio ao respecto

it really does make the depression worse.

realmente empeora a depresión.

E despois comecei a pensar

And then I began thinking

about all the ways people make themselves better.

en todos os xeitos cos que a xente se sente mellor.

I'd started off as a medical conservative.

Comecei como un conservador da medicina.

Pensaba que un par de tipos de terapia funcionaban,

I thought there were a few kinds of therapy that worked,

it was clear what they were --

estaba claro que o facían,

there was medication,

estaba a medicación,

there were certain psychotherapies,

algúns tipos de psicoterapia,

there was possibly electroconvulsive treatment,

estaba posiblemente a terapia electroconvulsiva,

e todo o demais non tiña sentido.

and that everything else was nonsense.

But then I discovered something.

Pero entón descubrín algo.

If you have brain cancer,

Se tes un tumor cerebral

e dis que facer o pino 20 minutos cada mañá

and you say that standing on your head for 20 minutes every morning

makes you feel better,

fai que te sintas mellor,

it may make you feel better, but you still have brain cancer,

se cadra faino, pero segues tendo un tumor cerebral,

and you'll still probably die from it.

e probablemente vaias morrer igual.

Pero se dis que tes unha depresión,

But if you say that you have depression,

and standing on your head for 20 minutes every day

e que facer o pino 20 minutos cada día

fai que te sintas mellor, entón funcionou,

makes you feel better, then it's worked,

porque a depresión é unha doenza de como te sentes,

because depression is an illness of how you feel,

and if you feel better,

e se te sentes mellor,

entón efectivamente xa non estás deprimido.

then you are effectively not depressed anymore.

Así que me volvín moito máis tolerante

So I became much more tolerant

of the vast world of alternative treatments.

co amplo mundo dos tratamentos alternativos.

And I get letters, I get hundreds of letters

E recibo cartas, recibo centos de cartas

from people writing to tell me about what's worked for them.

de xente que me conta o que lles funcionou.

Alguén me preguntou hoxe entre bastidores, sobre a meditación.

Someone was asking me backstage today about meditation.

My favorite of the letters that I got was the one that came from a woman

A miña carta favorita, entre as que recibín, era dunha muller

who wrote and said that she had tried therapy, medication,

que escribiu e me dixo que probara terapia, medicación,

she had tried pretty much everything,

que probara case de todo,

and she had found a solution and hoped I would tell the world,

pero atopou a solución, e quería que eu llo dixese ao mundo,

e era facer cousiñas de fío.

and that was making little things from yarn.

(Laughter)

(Risos)

She sent me some of them.

Envioume algunhas.

(Laughter)

(Risos)

And I'm not wearing them right now.

E non as levo postas agora mesmo.

(Laughter)

(Risos)

I suggested to her that she also should look up

Suxerinlle que debería mirar tamén

trastorno obsesivo compulsivo no DSM.

obsessive compulsive disorder in the DSM.

And yet, when I went to look at alternative treatments,

E así, cando miraba os tratamentos alternativos,

I also gained perspective on other treatments.

gañaba perspectiva respecto aos outros tratamentos.

I went through a tribal exorcism in Senegal

Pasei por un exorcismo tribal en Senegal

that involved a great deal of ram's blood

que incluía bastante sangue de año

and that I'm not going to detail right now,

e do que non vou dar detalles agora mesmo,

but a few years afterwards I was in Rwanda,

pero uns anos despois estaba en Ruanda,

working on a different project,

traballando nun proxecto distinto,

and I happened to describe my experience to someone,

E resulta que lle describín a miña experiencia a alguén,

and he said,

e díxome:

Ben, iso é o oeste de África, estamos no leste

"Well, that's West Africa, and we're in East Africa,

and our rituals are in some ways very different,

e os nosos rituais son distintos nalgúns aspectos,

but we do have some rituals

pero temos algúns rituais

that have something in common with what you're describing."

que teñen algo en común co que describes."

E dixo:

And he said,

"Pero temos moitos problemas cos traballadores occidentais de saúde mental,

"But we've had a lot of trouble with Western mental health workers,

especialmente cos que viñeron tralo xenocidio."

especially the ones who came right after the genocide."

E dixen: "Que tipo de problemas tedes?

I said, "What kind of trouble did you have?"

E díxome: "Ben, fan cousas moi estrañas.

And he said, "Well, they would do this bizarre thing.

They didn't take people out in the sunshine

Non levan a xente ao sol,

cando comezan a estar mellor,

where you begin to feel better.

They didn't include drumming or music to get people's blood going.

non inclúen percusión ou música que fai que o sangue se mova.

They didn't involve the whole community.

Non implican toda a comunidade.

They didn't externalize the depression as an invasive spirit.

Non externalizan a depresión como un espírito invasor.

Instead what they did was they took people one at a time into dingy little rooms

En vez diso, o que fan é levar a xente unha por unha a uns cuartiños sórdidos

and had them talk for an hour

e teñenos falando unha hora

about bad things that had happened to them."

sobre as cousas malas que lles pasaron."

(Laughter)

(Risos)

(Applause)

(Aplausos)

Díxome: "Pedímoslles que marchasen do país."

He said, "We had to ask them to leave the country."

(Laughter)

(Risos)

Now at the other end of alternative treatments,

Na outra esquina dos tratamentos alternativos,

deixádeme falarvos de Frank Russakoff.

let me tell you about Frank Russakoff.

Frank Russakoff tiña probablemente a peor depresión que vin nun home.

Frank Russakoff had the worst depression perhaps that I've ever seen in a man.

He was constantly depressed.

Estaba continuamente deprimido,

He was, when I met him,

Estaba, cando o coñecín, nun punto no que

at a point at which every month, he would have electroshock treatment.

cada mes recibía un tratamento de electroshock.

Sentíase desorientado unha semana,

Then he would feel sort of disoriented for a week.

Then he would feel okay for a week.

despois sentíase ben unha semana,

Then he would have a week of going downhill.

despois tiña unha semana de caída,

And then he would have another electroshock treatment.

e despois recibía outro tratamento de electroshock.

E cando o coñecín díxome:

And he said to me when I met him,

"It's unbearable to go through my weeks this way.

"É insufrible pasar as semanas deste xeito,

non podo seguir así,

I can't go on this way,

and I've figured out how I'm going to end it

e xa sei como vou acabar

if I don't get better."

se non melloro.

"But," he said to me, "I heard about a protocol at Mass General

Pero -díxome- oín falar dun protocolo no Mass General

for a procedure called a cingulotomy, which is a brain surgery,

para unha cirurxía chamada cingulotomía que é unha operación cerebral,

and I think I'm going to give that a try."

e creo que o vou tentar."

And I remember being amazed at that point to think that someone

E lembro estar fascinado nese momento ao pensar que alguén

who clearly had so many bad experiences

que claramente pasou por tantas malas experiencias

with so many different treatments

con tantos tratamentos diferentes

still had buried in him, somewhere, enough optimism

aínda tivese nalgún sitio do seu interior o optimismo

to reach out for one more.

suficiente para buscar outro máis.

And he had the cingulotomy, and it was incredibly successful.

E pasou por esta cirurxía e tivo moito éxito.

He's now a friend of mine.

Agora é amigo meu,

He has a lovely wife and two beautiful children.

ten unha esposa adorable e dous preciosos fillos.

He wrote me a letter the Christmas after the surgery,

Escribiume unha carta o Nadal posterior á operación

and he said,

e díxome:

"O meu pai mandoume dous regalos este ano,

"My father sent me two presents this year,

First, a motorized CD rack from The Sharper Image

primeiro, unha torre de CD automática de The Sharper Image

that I didn't really need,

que eu non precisaba,

but I knew he was giving it to me to celebrate

pero sei que ma estaba dando para celebrar

the fact that I'm living on my own and have a job I seem to love.

que eu vivise só e tivese un traballo que parecía encantarme.

And the other present was a photo of my grandmother,

E o outro regalo, era unha foto da miña avoa,

who committed suicide.

que se suicidou.

As I unwrapped it, I began to cry,

Cando o desenvolvín, comecei a chorar,

and my mother came over and said,

e veu a miña nai e díxome:

'Are you crying because of the relatives you never knew?'

"Estás chorando por parentes que non coñeciches?"

e eu díxenlle: "Tiña a mesma enfermidade ca min".

And I said, 'She had the same disease I have.'

Choro agora mentres che escribo.

I'm crying now as I write to you.

It's not that I'm so sad, but I get overwhelmed,

Non é que estea triste, senón sobrecollido.

I think, because I could have killed myself,

Porque creo que eu puiden suicidarme

but my parents kept me going, and so did the doctors,

pero meus pais termaron de min, e tamén os doutores

and I had the surgery.

e a cirurxía.

I'm alive and grateful.

Estou vivo e agradecido.

We live in the right time, even if it doesn't always feel like it."

Vivimos no momento correcto, aínda que ás veces non o pareza."

I was struck by the fact that depression

Estaba sorprendido porque a depresión

is broadly perceived to be a modern, Western, middle-class thing,

é maiormente percibida como unha cousa moderna, occidental, da clase media,

and I went to look at how it operated in a variety of other contexts,

e fun mirar como funcionaba nunha variedade de contextos,

and one of the things I was most interested in

e unha das cousas que máis interese me causou

was depression among the indigent.

foi a depresión entre os indixentes.

Así que intentei saber

And so I went out to try to look

at what was being done for poor people with depression.

que se facía polas persoas pobres con depresión,

And what I discovered is that poor people

E o que descubrín foi que as persoas pobres

are mostly not being treated for depression.

maioritariamente non son tratadas para a depresión.

A depresión é o resultado da vulneralidade xenética,

Depression is the result of a genetic vulnerability,

which is presumably evenly distributed in the population,

que en principio está distribuída igualitariamente entre a poboación,

and triggering circumstances,

e as circunstancias desencadeantes,

which are likely to be more severe for people who are impoverished.

que adoitan ser máis graves para a xente empobrecida.

And yet it turns out that if you have a really lovely life

E aínda así resulta que se tes unha vida estupenda

but feel miserable all the time,

pero sempre te sentes miserable

you think, "Why do I feel like this?

pensas: "Por que me sinto así?

I must have depression."

Debo ter unha depresión."

E decides buscar un tratamento.

And you set out to find treatment for it.

Pero se tes unha vida desastrosa,

But if you have a perfectly awful life,

e sénteste miserable todo o tempo,

and you feel miserable all the time,

the way you feel is commensurate with your life,

o teu sentimento concorda coa túa vida,

and it doesn't occur to you to think,

e non se che ocorre pensar,

"Maybe this is treatable."

"Se cadra isto pódese tratar."

And so we have an epidemic in this country

Así que temos unha epidemia neste país

of depression among impoverished people

de depresión entre persoas empobrecidas

that's not being picked up and that's not being treated

que non se detecta, que non se trata

and that's not being addressed,

e que non se aborda,

and it's a tragedy of a grand order.

e é unha traxedia de gran magnitude.

Así que atopei una académica

And so I found an academic

who was doing a research project in slums outside of D.C.,

que facía un proxecto de investigación nos arrabaldes pobres de D.C.,

onde seleccionaba mulleres que foran por outros problemas de saúde

where she picked up women who had come in for other health problems

and diagnosed them with depression,

e eran diagnosticadas de depresión

e proporcionáballes seis meses baixo o protocolo experimental.

and then provided six months of the experimental protocol.

Unha delas, Lolly, veu

One of them, Lolly, came in,

and this is what she said the day she came in.

e díxome isto o día que veu.

She said, and she was a woman, by the way, who had seven children.

Díxome, e era unha muller que, por certo, tiña sete fillos.

She said, "I used to have a job but I had to give it up

Díxome: "Tiña un traballo, pero tiven que deixalo porque

because I couldn't go out of the house.

non era capaz de saír da casa.

Non tiña nada que dicirlles aos meus fillos.

I have nothing to say to my children.

In the morning, I can't wait for them to leave,

Pola maña, estou desexando que marchen,

and then I climb in bed and pull the covers over my head,

para meterme na cama e tapar a cabeza coas mantas,

e as tres, cando volven,

and three o'clock when they come home,

chegan tan rápido".

it just comes so fast."

She said, "I've been taking a lot of Tylenol,

Díxome: "Tomaba moito Tylenol,

anything I can take so that I can sleep more.

calquera cousa coa que puidese durmir máis,

My husband has been telling me I'm stupid, I'm ugly.

o meu marido dicíame que era estúpida, fea.

Oxalá puidese parar a dor".

I wish I could stop the pain."

Well, she was brought into this experimental protocol,

Ben, trouxérona a este protocolo experimental,

and when I interviewed her six months later,

e cando a entrevistei seis meses despois,

she had taken a job working in childcare

tiña un traballo coidando nenos

para o exército americano, deixara o marido violento,

for the U.S. Navy, she had left the abusive husband,

e díxome:

and she said to me,

"Os meus fillos son moito máis felices agora."

"My kids are so much happier now."

She said, "There's one room in my new place for the boys

Dixo: "Hai un cuarto na miña nova casa para os rapaces

e un para as rapazas,

and one room for the girls,

pero pola noite, saltan á miña cama,

but at night, they're just all up on my bed,

and we're doing homework all together and everything.

e facemos os deberes xuntos e todo.

Un deles quere ser predicador,

One of them wants to be a preacher,

one of them wants to be a firefighter,

outro quere ser bombeiro,

and one of the girls says she's going to be a lawyer.

e unha das nenas di que vai ser avogada.

They don't cry like they used to,

Xa non choran como antes,

and they don't fight like they did.

nin pelexan como facían.

Iso é todo o que preciso, os meus fillos.

That's all I need now, is my kids.

Things keep on changing,

As cousas seguen cambiando,

the way I dress, the way I feel, the way I act.

como me visto, como me sinto, como actúo.

I can go outside not being afraid anymore,

Xa podo saír sen ter medo,

and I don't think those bad feelings are coming back,

e non creo que eses malos sentimentos vaian volver,

e se non fora pola doutora Miranda e isto,

and if it weren't for Dr. Miranda and that,

estaría aínda na casa, coas mantas enriba da cabeza,

I would still be at home with the covers pulled over my head,

if I were still alive at all.

no caso de estar aínda viva.

Pedinlle ao Señor que me enviase un anxo,

I asked the Lord to send me an angel,

and He heard my prayers."

e escoitou as miñas pregarias."

I was really moved by these experiences,

Estaba realmente conmovido por estas experiencias,

and I decided that I wanted to write about them

e decidín que quería escribir sobre elas,

not only in a book I was working on, but also in an article,

non só no libro que escribía senón tamén nun artigo,

and I got a commission from The New York Times Magazine

así que me encargaron da revista New York Times,

escribir sobre a depresión entre os indixentes.

to write about depression among the indigent.

And I turned in my story,

E entreguei a miña historia,

and my editor called me and said, "We really can't publish this."

e o meu editor chamoume e díxome: "Non podemos publicar isto."

And I said, "Why not?"

E díxenlle: "Por que?"

And she said, "It just is too far-fetched.

E díxome: "É demasiado rebuscado.

These people who are sort of at the very bottom rung of society

Esta xente está como no máis baixo da sociedade

and then they get a few months of treatment

e cun par de meses de tratamento

and they're virtually ready to run Morgan Stanley?

xa están virtualmente listas para manexar Morgan Stanley?

It's just too implausible."

É demasiado imposible."

Díxome: "Nunca oín nada igual."

She said, "I've never even heard of anything like it."

And I said, "The fact that you've never heard of it

E díxenlle: "O feito de que nunca o oíras

é un indicativo de que son 'noticias'."

is an indication that it is news."

(Laughter)

(Risas)

(Aplausos)

(Applause)

"And you are a news magazine."

"E vós sodes unha revista de noticias."

So after a certain amount of negotiation, they agreed to it.

Despois dunha serie de negociacións accederon.

Pero penso moito en que o que dixo estaba dalgún xeito conectado

But I think a lot of what they said was connected in some strange way

to this distaste that people still have for the idea of treatment,

co desprezo que a xente aínda ten pola idea do tratamento,

the notion that somehow if we went out

a noción de que dalgún xeito se saímos

and treated a lot of people in indigent communities,

e tratamos moita xente en comunidades de indixentes

sería un tipo de explotación,

that would be exploitative,

porque os estariamos cambiando.

because we would be changing them.

There is this false moral imperative that seems to be all around us,

Hai un imperativo da falsa moral que parece rodearnos,

that treatment of depression,

de que o tratamento da depresión,

the medications and so on, are an artifice,

os medicamentos e demais, son un artificio,

e que non é natural.

and that it's not natural.

And I think that's very misguided.

E eu penso que é un erro.

It would be natural for people's teeth to fall out,

É natural que á xente lle caian os dentes,

but there is nobody militating against toothpaste,

pero non hai ninguén militando contra a pasta de dentes,

polo menos non nos meus círculos.

at least not in my circles.

People then say,

A xente di:

"Pero a depresión non é algo que se supón que hai que experimentar?

"But isn't depression part of what people are supposed to experience?

Didn't we evolve to have depression?

Non evolucionamos para ter depresión?

Isn't it part of your personality?"

Non é parte da personalidade?"

To which I would say, mood is adaptive.

Ao que debo dicir, o humor é adaptable,

Being able to have sadness and fear

ser quen de sentir tristura e medo,

and joy and pleasure

e alegría e pracer,

and all of the other moods that we have, that's incredibly valuable.

e todos os outros estados de ánimo que temos, é incriblemente valioso.

And major depression

E unha depresión grave

is something that happens when that system gets broken.

é algo que ocorre cando o sistema creba.

It's maladaptive.

É falta de adaptación.

A xente virá e dirame:

People will come to me and say,

"I think, though, if I just stick it out for another year,

"Creo, aínda así, que se aguantara outro ano,

I think I can just get through this."

podería superalo."

And I always say to them, "You may get through it,

E sempre lles digo: "Quizais o superaras,

pero nunca volverás a ter 37 anos.

but you'll never be 37 again.

Life is short, and that's a whole year you're talking about giving up.

A vida é curta, e é un ano enteiro do que estás a falar.

Think it through."

Pénsao ben."

It's a strange poverty of the English language,

É estraña a pobreza da lingua inglesa,

and indeed of many other languages,

e de feito de moitas outras linguas,

that we use this same word, depression,

que utilizamos a mesma palabra, depresión,

to describe how a kid feels when it rains on his birthday,

para describir como se sente un neno cando chove no seu aniversario,

and to describe how somebody feels the minute before they commit suicide.

e para describir como se sente unha persoa o minuto antes de suicidarse.

People say to me, "Well, is it continuous with normal sadness?"

A xente dime: "Ben, é unha continuación da tristeza normal?"

And I say, in a way it's continuous with normal sadness.

E eu digo, en certo modo, é unha continuación da tristeza normal.

There is a certain amount of continuity,

Hai un certo grao de continuidade,

but it's the same way there's continuity

pero é o mesmo tipo de continuación

between having an iron fence outside your house

entre ter un valo de ferro arredor da casa

que ten un puntiño de ferruxe

that gets a little rust spot

that you have to sand off and do a little repainting,

que tes que lixar e pintar un pouco

e o que sucede se abandonas a casa 100 anos

and what happens if you leave the house for 100 years

and it rusts through until it's only a pile of orange dust.

e se enferruxou tanto que só é unha morea de po laranxa.

E é esa morea de po laranxa,

And it's that orange dust spot,

that orange dust problem,

ese problema do po laranxa,

that's the one we're setting out to address.

o que estamos tentando abordar.

E agora a xente di:

So now people say,

"You take these happy pills, and do you feel happy?"

"Tomas estas pastillas da felicidade, e xa es feliz?"

And I don't.

E non.

But I don't feel sad about having to eat lunch,

Pero non me sinto triste por ter que xantar,

and I don't feel sad about my answering machine,

e non me sinto triste polo contestador,

and I don't feel sad about taking a shower.

e non me sinto triste por ter que ducharme.

De feito, penso que sinto máis,

I feel more, in fact, I think,

because I can feel sadness without nullity.

porque podo sentir tristeza sen sentir nulidade.

I feel sad about professional disappointments,

Sintome triste polas decepcións profesionais,

about damaged relationships,

polas relacións danadas,

e polo quecemento global.

about global warming.

Esas son as cousas polas que me sinto triste agora.

Those are the things that I feel sad about now.

And I said to myself, well, what is the conclusion?

E díxenme a min mesmo, cal é a conclusión?

How did those people who have better lives

Como conseguiu esta xente que ten vidas mellores,

aínda con peores depresións, seguir adiante?

even with bigger depression manage to get through?

What is the mechanism of resilience?

Cal é o mecanismo da resiliencia?

And what I came up with over time

E o que aparecía continuamente

was that the people who deny their experience,

era que a xente que nega a experiencia,

and say, "I was depressed a long time ago,

e din "Tiven depresión hai moito tempo,

I never want to think about it again,

e non quero volver pensar nela,

I'm not going to look at it

e non quero mirala,

and I'm just going to get on with my life,"

simplemente vou seguir coa miña vida",

ironically, those are the people who are most enslaved by what they have.

ironicamente, son as persoas que están máis escravizadas polo que teñen.

Silenciar a depresión refórzaa.

Shutting out the depression strengthens it.

While you hide from it, it grows.

Mentres a escondes, medra.

E a xente que mellor o fai,

And the people who do better

are the ones who are able to tolerate the fact that they have this condition.

e a que é tolerante co feito de ter esa condición.

Aquela que pode aceptar a súa depresión, é quen acada a resiliencia.

Those who can tolerate their depression are the ones who achieve resilience.

So Frank Russakoff said to me,

Frank Russakoff díxome:

"Se tivese que facelo de novo, supoño que non o faría deste xeito,

"If I had a do-over, I suppose I wouldn't do it this way,

but in a strange way, I'm grateful for what I've experienced.

pero dun modo estraño, estou agradecido pola experiencia.

I'm glad to have been in the hospital 40 times.

Estou contento por ter que estar 40 veces no hospital.

Ensinoume tanto sobre o amor,

It taught me so much about love,

and my relationship with my parents and my doctors

e a miña relación cos meus pais e doutores,

has been so precious to me, and will be always."

foi tan valiosa, e sempre o será".

And Maggie Robbins said,

E Maggie Robbins dixo:

"I used to volunteer in an AIDS clinic,

"Adoitaba ser voluntaria nunha clínica de SIDA

and I would just talk and talk and talk,

e simplemente falaba e falaba e falaba

and the people I was dealing with weren't very responsive, and I thought,

e a xente coa que trataba non era moi receptiva, e pensaba:

'That's not very friendly or helpful of them.'"

'Isto non é moi amable nin útil pola súa parte'

(Laughter)

(Risos)

"And then I realized,

"E despois deime de conta,

I realized that they weren't going to do more

deime de conta de que non ían facer máis,

than make those first few minutes of small talk.

que eses escasos primeiros minutos de conversa.

It was simply going to be an occasion

Ía simplemente ser un momento

where I didn't have AIDS and I wasn't dying,

no que eu non tiña SIDA e non estaba morrendo,

but could tolerate the fact that they did

pero podía aceptar o feito de que eles si o estiveran,

and they were.

e estábano.

Our needs are our greatest assets.

As nosas necesidades son os nosos maiores activos.

Resulta que aprendín a dar todo o que preciso."

It turns out I've learned to give all the things I need."

Valorar a depresión propia non evita unha recaída,

Valuing one's depression does not prevent a relapse,

pero pode facer a perspectiva dunha recaída

but it may make the prospect of relapse

and even relapse itself easier to tolerate.

e mesmo a recaída máis fácil de aceptar.

A pregunta non é tanto atopar un gran significado

The question is not so much of finding great meaning

and deciding your depression has been very meaningful.

e decidir que a túa depresión tivo moito significado.

It's of seeking that meaning and thinking, when it comes again,

Está en buscar ese significado e pensar, cando volve:

"This will be hellish, but I will learn something from it."

"Isto vai ser infernal, pero vou aprender algo."

I have learned in my own depression

Aprendín da miña propia depresión

how big an emotion can be,

o grande que pode ser unha emoción,

how it can be more real than facts,

como pode ser máis real que os feitos,

e descubrín que esta experiencia

and I have found that that experience

has allowed me to experience positive emotion

me permitiu experimentar emocións positivas

in a more intense and more focused way.

dun modo máis intenso e máis centrado.

The opposite of depression is not happiness,

O oposto á depresión non é a felicidade,

but vitality,

senón a vitalidade,

and these days, my life is vital,

e estes días, a miña vida é vital,

aínda nos días que estou triste.

even on the days when I'm sad.

I felt that funeral in my brain,

Sentín ese funeral no meu cerebro,

and I sat next to the colossus at the edge of the world,

e senteime preto do Coloso, no bordo do mundo,

and I have discovered something inside of myself

e descubrín algo dentro de min

that I would have to call a soul

que debería chamar alma

that I had never formulated until that day 20 years ago

que nunca formulara ata ese día hai 20 anos

cando o inferno me fixo unha visita sorpresa.

when hell came to pay me a surprise visit.

I think that while I hated being depressed

Creo que aínda que odiaba estar deprimido

and would hate to be depressed again,

e que odiaría estar deprimido de novo,

atopei un xeito de amar a miña depresión.

I've found a way to love my depression.

I love it because it has forced me to find and cling to joy.

Ámoa porque me obrigou a buscar e aferrarme á alegría.

I love it because each day I decide,

Ámoa porque cada día decido,

ás veces valentemente,

sometimes gamely,

and sometimes against the moment's reason,

e ás veces contra a lóxica do momento,

to cleave to the reasons for living.

pegarme ás razóns para vivir.

And that, I think, is a highly privileged rapture.

E iso, creo, é unha grande e privilexiada alegría.

Grazas.

Thank you.

(Aplausos)

(Applause)

Grazas.

(Aplausos)

Thank you.

(Applause)