Sunday, January 6, 2013

"Is once a week regular?"

"I never knew what depression was.  I knew that 'I'm kind of sad today...I'm kind of blue today,... the Reds lost.'  I knew that.  This I'm telling you you get on an elevator and the bottom drops out.  You can't stand looking at the sunlight.  You can't wait to get back in bed at night. You're shaking.  You're shivering.  I went through this for about 6 months..."  David Letterman as interviewed by Oprah Winfrey on 1/3/2013

I was out of the country for a couple of years back in the 1970s.  When I got back my younger brothers were watching David Letterman's day time TV show.  Since then I have watched him on a fairly regular basis.  Late night TV watchers often have their favorites and I there are clearly preferences based on personality differences and interview style among the various late night talk show hosts.  Letterman's reputation includes a the fact that he has a fairly quiet life style and few people seem to know the details of his private life.  This year he became a Kennedy Center honoree for his lifetime of achievement in the entertainment industry.

He was interviewed recently, first by Alec Baldwin for his public radio show Here's the Thing and earlier this evening by Oprah Winfrey for her interview series Next Chapter.  In both cases, he discusses his depression, how it affected him and even describes his understanding of why the neurotransmitters dopamine and serotonin  may be important:

I was amazed by it. I was amazed by the chemical mechanism in your brain that can just drop you like that. And then somebody told me that, "You know what, we’re given these chemicals, these serotonins and dopamine and so forth, because if we didn’t have them, the world would scare the crap out of us." I don’t know if that’s true or not, but when I was depressed it made sense."

In the interview with Baldwin he acknowledges taking an antidepressant ("small dose of an SSRI").  In the interview with Oprah, she asks if he is seeing a psychiatrist "regularly".  He replies" "Is once a week regular?" and after that initial joke goes on to describe weekly sessions that have as the goal personal self improvement or bringing his behavior in line with the person he always thought that he was.

I liked these interviews for several reasons.  Dave's matter of fact presentation of depression, how severe it was and the way it impacted his life was striking.  In a few sentences he was able to contrast it with sadness related to disappointments in life and explain how it allowed him to empathize with people.  Prior to experiencing depression himself he was likely to consider depression something that you should just get over on your own: "Go do some push-ups and you’ll feel better." .  He describes both medical treatment of depression and psychotherapeutic treatment.  His primary care physician was instrumental in referring him for treatment.  He also discussed the overall goal of his current psychological therapy.

I am sure that in the days that follow, the networks will have their medical consultants out there with some talking points on depression.  A discussion of depression as a risk factor for coronary artery disease might be one example.  For the sake of this post, he communicated the problems at several levels very well in just a few sentences and I hope that people get to see and listen to these interviews.

George Dawson, MD, DFAPA

Alec Baldwin.  Here's the Thing Transcript of David Letterman Interview June 18,2012.  (depression segment starts 2/3 of the page down).

Oprah Winfrey.  Next Chapter Transcript of David Letterman Interview January 6, 2013. (depression segment starts 2/3 of the second page down).

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