More Thoughts on Depression and Amyloidosis

Over the last month or so since we learned about Mom's postmortem diagnosis of amyloidosis, I've continued to wrestle with whether these physiological changes to her brain led to her suicide or whether it was depression. 

In many ways, having a brain-related diagnosis made her death simpler to explain and easier for most to accept. People are visibly relieved when we say Mom had a disease that caused proteins to build up in her brain; her death was not due to "just depression."

Although mental illness is less of a taboo subject now than in previous eras, as a society we still seem to struggle with the idea that depression or any other psychiatric condition is truly a disease since it is also classified as a mental health disorder. The American Psychiatric Association states, "Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act." When someone is suffering from a disease such as asthma, cancer, arthritis, or pneumonia, we don't blame the person. We never expect someone with asthma to "just get over it," because we understand their difficulty breathing is not a personal failure but an illness. While one can use an inhaler to mitigate the symptoms, the asthma is not cured. 

However, we rarely view someone with depression as having a disease or illness. Many people seem to think that depression is when someone is sad and they simply need to try harder, exercise more, eat healthier, focus on the positive, or get over it. While taking prescribed medication, eating a healthy diet, getting adequate sleep, and exercising can help, they do not cure the illness. Mom used to say she wished depression caused a rash or fever, any externally verifiable evidence that ones' body was not operating as it should. 

When we tell people that Mom did everything she could to get better, it's almost as if we need to convince others that she exhausted all possibilities. As if otherwise her suicide may be seen as a personal failing or acting in a moment of weakness. We also tell people she tried everything so they don't feel like they should have done more. 


Mom had walked through times of depression before, utilized a variety of strategies, and managed the disease. This time was different and she knew it. Whether she believed she had early onset dementia or a brain tumor, we know she did not think she could ever get better. And we now know that no amount of interventions could have fixed her brain because it was full of amyloid proteins.

So did she take her own life because of depression or amyloidosis? Currently, I think it's both. The amyloidosis greatly diminished any benefit from the multitude of interventions she tried. If she'd "only had" depression, her own history shows interventions help and she likely would not have fallen into this deep a pit of despair. If she'd "only had" amyloidosis, she would have seen the cognitive decline but it likely would not have been paired with the hopelessness. 

Even though it appears that, at least in Mom's case, her death was not due to "just depression," clinical depression alone can cause someone to take their own life. Even when they try everything to get better. 

More information about depression:
Depression - Why the Disease Label Matters
Why is Depression a Disease? Quora
Depression - CDC
What is Depression?
Depression Not Just A Mental Illness; It's A Systemic Disease That Affects The Entire Body

Comments

Susan said…
What was going on turned out to be a complex and tangled interweaving, but I think you have figured this out and explained it just right.

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