In her heart-rending and strange essay in Sunday's Times Magazine, writer Daphne Merkin describes a depression so isolating that it made her envy the anorexia patients hospitalized with her.
Merkin has been in the news lately for her involvement with the Madoff scandal (her brother funneled money into Madoff's scheme), but her essay, "A Journey Through Darkness," covers more personal territory. She says she feels "as if in exiting the womb I was enveloped in a gray and itchy wool blanket instead of a soft, pastel-colored bunting," and that she was first hospitalized at age ten "because I cried all the time." The recent bout of depression that forms the focus of her essay was so severe that she not only lost thirty pounds but developed psychomotor retardation, moving slowly and speaking in a flat voice.
As obvious as these symptoms seem, Merkin was frustrated with how un-obvious her disease was. She writes,
The real question was why no one ever seemed to figure this grim scenario out on her own, just by looking at you. This was enraging in and of itself - the fact that severe depression, much as it might be treated as an illness, didn't send out clear signals for others to pick up on; it did its deadly dismantling work under cover of normalcy. The psychological pain was agonizing, but there was no way of proving it, no bleeding wounds to point to.
Because it lacks "bleeding wounds," Merkin feels, her illness doesn't seem real — even in comparison with other mental illnesses. Of the anorexia sufferers at her hospital, she writes,
They were clearly and poignantly victims of a culture that said you were too fat if you weren't too thin and had taken this message to heart. No one could blame them for their condition or view it as a moral failure, which was what I suspected even the nurses of doing about us depressed patients. In the eyes of the world, they were suffering from a disease, and we were suffering from being intractably and disconsolately - and some might say self-indulgently - ourselves.
But, as Carrie of ED Bites points out, "people with eating disorders are blamed for their illness, when it is even seen as an illness. Eating disorders are generally seen as some sort of failure—if not the sufferer, then clearly her parents." It's tempting to judge Merkin for assuming the anorexics have it easier, but one of the saddest things about the essay is how her illness isolates her even from other mental health patients, how she constructs a moral hierarchy of disease and puts herself at the bottom. The unfortunate reality is that, in society's moral hierarchy, all mental illness still lies at the bottom, too often ignored or dismissed as self-indulgence. This is changing, but Merkin's piece shows how deep the stigma still goes, and how difficult it is for those stigmatized to advocate for themselves — especially when their disease makes them feel that they are "a failure. A burden. Useless. Worse than useless: worthless." While Merkin's envy certainly seems misplaced, the blame for this belongs not with her but with her disease — and with the society that sometimes fails to recognize how real and serious this disease is.