Integrated into the story of The Bell Jar by Sylvia Plath is a "case
history" of a depression patient, from it's subtle beginnings to it's
terrifying consequences to it's shaky resolution. On the subject of this
depression, there is an article written by William Styron which, in the course
of describing his own dealings with the disease, he compares it to cancer. It is
my own firm opinion that this assertion is perfectly valid, and it can be shown
through careful analysis of the causes and effects of both depression and cancer
that this is so. In addition, using The Bell Jar as an example of a case of
depression, we will see how this comparison makes clear sense. First, we must
address the nature of cancer and its effect on the individual bearing it's
weight. Cancer is the result of a mutation of the genetic material of a cell,
resulting in the lack of some inhibiting factor which would otherwise restrict
the uncontrolled reproduction of this cell. As a consequence, this cell
reproduces without bound, generating a cluster of cells which are reproducing
uncontrollably, and which use the resources of the body to an extent beyond
their proportional allotment. Eventually, the requirements of the tumor exceed
the body's ability to provide, and the individual dies. Treatment of cancer
includes surgery, the use of chemotherapy, and the use of radiation therapy.
Surgeons removing a tumor make every attempt to remove as much of the affected
tissue as possible, because the presence of even a single, properly placed cell
left after surgery could result in a second bout with the cancer. Chemotherapy
entails exposing the cancer to a barrage of chemicals which are toxic, in the
hope of poisoning it to death. Unfortunately, these chemicals, which are toxic
to the tumor, are also toxic to the patient. Chemotherapy results in a plethora
of serious negative side effects for the patient, even for all of it's ability
to fight the disease. Radiation therapy works by the same premise as
chemotherapy, but instead of chemicals it is radiation that is used to try and
destroy the cancer. Interestingly enough, often it is radiation which generates
the mutation in the genetic material of the cell which causes the cancer, and
yet it is possible to treat the cancer with radiation (exposure to certain
chemicals can cause cancer too, resulting in the same paradox relating to
chemotherapy.) Now, these treatments for cancer can be related to treatments for
depression, as we will see shortly. Important to any discussion of cancer is a
consideration of it's causes. Because of the statistical nature of genetic
mutations, which are the cause not only of cancer but of evolution, more
spontaneous, natural genetic mutations must be negative than advantageous. Some
of these negative mutations result in cancer. These natural mutations (another
paradox) are caused by sunlight, chemicals in food, and normal biological
processes occurring in the cell. In all cases of cancer except for a select few,
the victim has nothing to do with the cause of the cancer. Obvious exceptions
include the use of tobacco and the careless exposure of one's skin to the sun.
These situations are ones where the victim is wholly responsible for their
condition, though we can still maintain compassion and make medical attempts to
remedy their problem. One other issue relating to cancer which needs to be
addressed is that of pain related either directly to the cancer, or to its
treatment. In many cases of cancer, the patient is in great pain. Often this
pain results from the cancer itself, though many times the treatment
(particularly chemotherapy and radiation therapy) results in pain and sickness.
Doctors are permitted to prescribe pain medication, and in some states cannabis,
to alleviate this pain, though many times they are reluctant to prescribe pain
medication for extended periods of time (or cannabis at all) because of a fear
of raising the suspicions of local or federal drug enforcement agencies. In
general, however, the pain of a cancer patient can be satisfactorily soothed,
though rarely entirely relieved. A similar discussion of depression is necessary
to thoroughly understand the situation, and begins as follows. Depression is a
disease of the mind relating directly to the levels of certain chemicals in the
brain. The most integral of these chemicals is called seratonin, and it affects
the brain's way of perceiving the world around it. Low levels of seratonin
result in a morbid, somber perception of the world, and is an invariable feature
of depression. Simply put depression is a disease which causes the afflicted
individual to feel hopeless, to seem to lack a reason for living, and generally
to lose the joie du vie which normally accompanies everyday life for the rest of
us. Without doubt, each of us suffers from "the blues" on an occasion,
but this only serves to illustrate another key aspect of depression: it's
lingering nature. The normal doldrums for the rest of us will last a day or a
week, while depression affects its sufferers for months or years. Indeed, with
our own sense of the strain resulting from a few "down" days, we can
get an impression of the incredible strain associated with a year-long bout with
depression. However, this chemical aspect of depression is perhaps the least
important one. Depression is a disease which usually has a source unrelated to
the chemicals in the brain, and it is a combination of these two sides of the
depressed coin that results in the disease. An event or a situation in a
person's life can generate enough despair or sadness to generate susceptability
to depression. This event can be the loss of a loved one, through death or other
means, or a financial situation, or the loss of a job, or the inability to
complete a certain task. Indeed, this particular event, whatever it may be, has
a stronger influence over the development of depression than any chemical.
Treatment of depression comes from two directions. First, the use of
pharmaceutical products is often prescribed by those in the medical community
responsible for treating patients suffering from depression. The general intent
of these drugs is to increase the levels of seratonin in the brain, as this is
the root of depression. So with higher levels of seratonin, the ground is
fertile for a recovery. But the use of drugs is only one aspect of the treatment
of depression. In the same way that any chemical imbalance in the brain is less
influential over the development of depression than an event generating
inordinate sadness, the therapy intended to help the patient deal with that
event is more important in the treatment of depression than any drug.
Psychiatrists and psychologists are trained to provide patients with
psychological tools to deal with these root problems so that the patient himself
becomes able to deal with the problem, and so in a way cure himself. Comparing
here depression to cancer, this particular method of treatment is akin to the
doctor helping the lung cancer patient stop smoking after the cancer has
receded. Indeed, these psychological tools are of value to the patient even
after the depression has ended, in order to prevent a relapse, much as the
cessation of smoking is necessary to prevent a relapse of the lung cancer. Now,
in The Bell Jar, we have Esther who is in the midst of a summer in New York
working for a magazine. It is difficult for us to see why she, while
experiencing an educational and invigorating summer, could become afflicted with
a serious depression. It is interesting to note that in the face of such
apparently good fortune one could develop such a sad disease. One particularly
interesting passage in the novel which relates directly to this discussion
occurs when Esther goes with Buddy to the hospital and is watching a slide show.
"One slide I remember showed a beautiful laughing girl with a black mole on
her cheek. 'Twenty days after that mole appeared the girl was dead,' the doctor
said, and everybody went very quiet for a minute and then the bell rang, so I
never really found out what the mole was or why the girl died." (p.51-52)
Indeed this mole is reminiscent of a cancer, and it is interesting to note that
the mole is never explicitly explained. Much as depression is a disease shrouded
in mystery, and often times one never finds out what is wrong with an afflicted
individual before they die of the disease, cancer can come and kill with such
swiftness that it has all come and gone before any note is taken. Another
pertinent passage in the novel which describes a similarity between cancer and
depression comes when Esther goes to visit Buddy in the tuberculosis clinic.
"`Don't worry,' Buddy laughed. `I'm not positive.' 'Positive?' 'You can't
catch anything.'" (p.75) Although this particular passage is in reference
to tuberculosis, it is an accurate description of both cancer and depression.
Neither of these disorders can be contracted from another individual, and so
treatment of them is simplified by one degree. Because an doctor can treat a
depressed patient without concern that his own state of mind might become
depressed, he can conduct the treatment with more fervor and intensity. This is
certainly a positive aspect of both cancer and depression (yet two more
paradoxes) because of the implications for treatment and the lack of need for
concern in those close to the patient. One last example of a link between cancer
ad depression exists in Esther's consideration of her preconceived notions about
her psychiatrist, Dr. Gordon. "Then he would lean back in his chair and
match the tips of his fingers together in a little steeple and tell me why I
couldn't sleep and why I couldn't read and why I couldn't eat and why everything
people did seemed so silly, because they only died in the end." (p.105) Now
the importance of this passage exists in the perception maintained by Esther
about the insignificance of everything, given that people eventually die and go
into the ground. Now, in a patient's dealings with his own cancer or depression,
this is a consideration that must be made again and again. For an individual
suffering from cancer, the simple answer is that he would die eventually anyway
without the cancer, he is going to die with the cancer, so why not go ahead and
finish the job himself? The parallel simple answer for the individual suffering
from depression is that she will die someday anyway, and since she is in such
pain as it is now, why not take her own life now. Unfortunately, this logic is
exactly that logic the depression spends its entire existence struggling to
instill in its victims, and it is precisely the train of thought which is to be
avoided by a patient. For if a patient succumbs to this logic, he is trading the
beauty of the stars and the joy of a mug of hot tea and the love of a child for
utter nothingness. In conclusion, we can see how the similarities between cancer
and depression run deep, and how the same logic used to analyze cancer from a
pseudo-medical point of view can also be used to consider depression. We can see
that an individual suffering from depression is no more responsible for her
situation than another individual suffering from breast cancer, and so a
depression patient should be treated accordingly. Most importantly, however, in
the last example, we see how an individual who submits to either disease may as
well have never lived at all, because of the essential aspects of life he comes
to neglect.