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Show Holiday season brings depression continued the next day and into the next night. He finally awoke at midnight. mid-night. "Scrooge did a lot of sleeping," says Christensen. "Again, this comes early in the story where the disturbances have just begun. If Scrooge continued con-tinued this sleep pattern over a period of more that two or three weeks, or if his dreams so disturbed him that he could not sleep at all, I would suspect depression A noticeable change in sleeping habits could also signal depression. When the story begins, Scrooge has a bowl of gruel. This meal may be small because he is excessively frugal about paying for food, because he has a head cold or both. 'Lots of older people eat less, which poses a challenge in evaluating the eating patterns of older people within the context of depression," said Christensen. "A surprising number of seniors commit suicide by refusing to eat or care for themselves. I do not like the loneliness and isolation of Scrooge's life nor his eating pattems-but they have been the same for years. ' "He has not withdrawn from life as a result of emotional changes; he withdrew as a fairly young man because he focused his emotions on money," he continues. "Nevertheless, Scrooge remains in a high-risk age group for depression. His isolation and eating patterns should have been monitored by his nephew." The last two signs could be loss of energy and feelings of worthlessness or guilt. Scrooge begrudges everyone a day off for Christmas and clearly works as hard as his poor clerk. "The story describes great fatigue at certain points. But on balance, Scrooge appears to have stamina and energy," Christensen says. "I would not say the fatigue he experienced indicates depression." During the holidays, a number of people openly declare that they do not intend to celebrate the season. Some simply do not enjoy holiday preparations, prepara-tions, and, as a rule, never involve themselves in the traditional activities. Others may state that the upcoming holiday is "off limits" because the year has been difficult and they do not feel there is any reason to celebrate. Holidays bring stress-pressure to do more socially, eat more, drink more and buy more. Those who seem to disdain the frenetic nature of the holidays holi-days may, in fact, be wiser or less responsive to social pressures. Or, they may be depressed. While perfectly healthy reasons do exist for not celebrating, concerned friends and loved ones should not miss signs of serious emotional distress masked by the Scrooge-like "Bah, humbug!" Indeed, examining Ebeneezer Scrooge in Charles Dickens classic A Christmas Carol may shed some light on depression and its symptoms. Dr. Dan Christensen, medical director and depression expert at The Western Institute, a 90-bed psychiatric hospital clinically managed by the University of Utah's Health Sciences Department of Psychiatry, says Scrooge's "answers" to a depression checklist are quite revealing. For example, one common symptom of depression is a loss of interest in things once enjoyed. Despite a bleak beginning, Scrooge's later boyhood and young adult years were filled with good people and idealism. Transported back to his boyhood by the Ghost of Christmas Past, Scrooge sees inside the home of his master to whom he apprenticed, and spoke of his generosity and kindness. Then Scrooge relived his wife's parting words, "I have seen your nobler aspirations fall off, one by one, until the Master Passion, gain, engrosses you." Dr. Christensen notes, "It appears that Scrooge changed his goals as a young man. While he lost interest in some of the things that motivated him early in life, this is not the same loss of interest experienced by depressed people." "Society generally does not approve of the choices Scrooge made placing material success above any and all human relationships relation-ships but that soes not make him depressed," he continues. "Instead, Scrooge could be considered depressed if he lost all interest in his counting house suddenly, say within the last year or 1 8 months. The second sign of depression could be an inability to concentrate or think. At the story's beginning, Scrooge arrived at his gloomy suite of rooms after a long day of work. Instead of the door knocker, however, he saw the face of his dead partner, Marley-to whom he had not given a thought in seven years until that afternoon. Scrooge believed he saw a "locomotive hearse going on before him in the gloom." He sat down to a bowl of gruel and "the disjointed fragments of his thoughts." He saw Marley's face all around him in the tiles around the fireplace and coming through the door. "This passage does not provide enough information to base a judgment on Scrooge's state of mind," Christensen points out. "It is difficult to determine de-termine whether Scrooge may be having trouble thinking clearly or just ex-i ex-i periencing a bad day. Depressed people have disordered thoughts andor difficulty concentrating over a period of weeks. In detecting depression, it is important to note the amount of change in the individual's thought patterns pat-terns and during what period of time the change has occurred. Another sign might be recurring thoughts of death or suicide or a wish to die. Scrooge's vision of a haunted Marley clearly is about death and a ' tormented afterlife. Marley's chains represent the things he did not accomplish ac-complish on earth for mankind. Christensen says, "It appears that Scrooge fears dying and its consequences rather than wishing to die." "Depressed people feel that there is little reason to continue living or that life is too painful for them. On the other hand, Scrooge simply feels afraid of ghosts and anything to do with death." The fourth sign of depression is overwhelming feelings of sadness or hopelessness. When the Ghost of Christmas Past transports Ebeneezer back to his boyhood, he begins sobbing. While he experienced a grim early childhood, he was rescued by an older sister and grows up to apprentice himself to a man he remembers as generous and kind a role model. "Scrooge, when sad, responds as anyone would to a bad memory. One could not call this a depressed reaction," notes the depression expert "Sad times do occur and must be acknowledged, Scrooge responded happily to the scenes where his master, family and employees joyfully celebrate. Depressed people, often 'stuck' in a sad or hopeless state, find it all but impossible im-possible to react to positive events. " Another sign might be sleeplessness or oversleeping. Scrooge after his visit from Marley fell into a deep sleep. It continued through that night, 1 |
