Category Archives: therapy

December 2, 2023 · 8:33 pm

Sharing The Joy

by Lillian Csernica on December 2, 2023

I am delighted to announce that I’ve written 200 pages of my new nonfiction book, Keep Getting Up. If you’ve spent some time following my adventures here, you’ll know my life is complicated. It’s not easy getting through my days. I have gone on doing so, so my friends encouraged me to write a book about how I keep on keeping on. Resilience. That’s the magic word.

Resilience is the process and outcome of successfully adapting to difficult or challenging life experiences, especially through mental, emotional, and behavioral flexibility and adjustment to external and internal demands.
American Psychological Association

Plunging into National Novel Writing Month with a nonfiction project was a challenge. This is my ninth year, and in all the previous years I’ve written fiction. What’s more, this nonfiction would be about me, about my daily life and its impact on my mental health. I have a psychiatrist who prescribes the medications for my clinical depression and insomnia. I see a therapist once a week for Cognitive Behavioral Therapy. I rely heavily on their support to keep practicing the techniques that have brought me a long way toward resilience.

In order to create some structure for the book, I wrote out what could be termed a “trauma timeline,” a list of every single year of my life and any traumatic events that took place during it. For example, when I was eleven years old, my parents got divorced, which meant my mother and I moved to a new apartment. I had to go to a new school away from all the people I’d spent five years with in elementary school. My parents had no sense of self-restraint when it came to complaining about each other in front of me. That was a very rough year.

I am of an age now to have enough distance and perspective on life with my nuclear family. I can’t help laughing when I hear that term. More than once there was the emotional equivalent of a mushroom cloud rising above my house. My father was an alcoholic. My mother was a narcissist. My sister…. Well, the less said there the better. My brother is fine. Good career, wonderful daughter, a great guy. I’m the baby of the family, so the trickle down economics of passive aggression tended to hit me rather hard.

Telling my own story my own way is quite an adventure. Heaven only knows what insights await me as I go through the editing process!

The Imp Of The Perverse

by Lillian Csernica on October 5, 2023

In 1845, Edgar Allan Poe wrote a story that explored in fictional form concepts that would later be examined in the works of Sigmund Freud and Carl Jung. The title of the story, The Imp Of The Perverse, has passed into the English language as a turn of phrase referring to self-destructive urges or behavior. Poe himself describes it this way:

“We stand upon the brink of a precipice. We peer into the abyss—we grow sick and dizzy. Our first impulse is to shrink away from the danger. Unaccountably we remain… it is but a thought, although a fearful one, and one which chills the very marrow of our bones with the fierceness of the delight of its horror. It is merely the idea of what would be our sensations during the sweeping precipitancy of a fall from such a height… for this very cause do we now the most vividly desire it.“

As I mentioned in yesterday’s blog, when I was a teenager I had a strong curiosity about all things supernatural. I read a lot of books, both fiction and nonfiction. I watched a lot of movies, both documentary and total make-believe. All of this research and exploration churned inside my mind and gave rise to this poem, published by editor Emerian Rich on HorrorAddicts.Net.

EVIL SIRENS SWEETLY SINGING

Wake to the world of the darkness

Wake! To the world of the Night.

Burn with the fires of Hecate

Ache with the Devil’s delight.

Live in the land of Jung’s Shadow

Dance in the mind’s shady gloom

Dive into Charon’s black waters

Swing on the bellrope of Doom!

Hark to the Muse of the Lethe

Smash sanity’s last painful shard

Revel with your nightmare secrets

Give voice to the soul’s darkest bard.

Cry with your soul’s hundred voices

Fling wide the crypt in your heart

Bathe in the hungers within you

Damnation is only the start!

Staying The Course

by Lillian Csernica on February 14, 2023

Hello, folks. I hope you are all safe and well. I’ve been doing my best to keep on keeping on.

One of the biggest challenges a writer can face is the problem of chronic pain. Back in the days when I was younger and stronger, I was in a car accident that damaged my left knee. I can still walk, thank God, but time has taken its toll. My right knee has been taking up the slack ever since the accident. The result is Degenerative Joint Disorder in both knees.

Chronic pain is exhausting. It sucks away all energy and the power to concentrate. It makes sleep difficult and medication necessary. I know that my writing is different now than it was when I first began selling my work and seeing it published. That is so frustrating. If not for the pain, maybe I could write more and write better. Maybe I could endure the endless labor of online self-promotion more successfully. I am a mother of two boys, so what little time and energy I have to write is precious to me. Chronic pain robs me of that.

And yet…. The need to write continues. The desire to publish continues. Compulsive behavior? Maybe, but for me it’s a good thing. On the bad days when I just don’t have it in me to do the work, I ask myself, “How bad do you want this?” Days go by so fast now, running into months and years. There is no “later.” There is no “tomorrow.” If I don’t get something done right now, today, when will I get it done? It’s so hard. When I can’t stand up, when I can’t walk across the room, it seems impossible.

That’s when doing it matters the most.

Yes, there are times when I cut myself some slack and accomplish whatever I can actually manage to do that day. There are times when I look at my To Do list and just start laughing. As Dirty Harry once said, “A man’s got to know his limitations.” I interpret that statement not as knowing what you can’t do, but knowing how much or how little you can do on that particular day. It’s the habit of making the effort that matters. If I don’t bother to make the effort, it gets easier and easier to just leave the work for some other day.

Dorothy Parker once said, “I hate writing. I love having written.” That sums it up. The labor of writing feels dreadful, but the satisfaction of knowing you did the work is immense. My favorite unit of writing is a twenty minute free write. Keep that pen moving. Just get the words down. The great part about free writes is the way I can just keep plowing forward, and not stop to think until the timer goes off. Then I get to bask in the pleasure of having written.

In the past week I sent three short stories out to market. Write, edit, submit. Rinse and repeat. Yes, my body aches and my mind get worn out, but I won’t give up. Each moment of success adds to all the ones that have come before it.

2 Comments

Filed under creativity, Depression, doctors, editing, Family, fantasy, Fiction, frustration, Goals, historical fiction, publication, Self-image, Small business, therapy, Writing

Tagged as #arthritis, #chronicpain, #commitment, #success, #writinglife, mental-health, writing

May 18, 2022 · 12:02 am

Gathering My Thoughts

by Lillian Csernica on May 17, 2022

I enjoy writing by hand. I keep a personal journal along with writing first drafts in my work notebook. As satisfying as this is, there are two drawbacks to this approach. First, if I’m doing a timed free writing session where the goal is to blow past the internal editor, I often can’t read my own handwriting afterward. Second, I then have to spend the time typing in all those pages. That makes a drastic difference in terms of getting stories polished and out to market.

Last week I decided to plow through all the notebooks I’ve been piling up. That meant organizing the ideas and random scenes and large chunks of developing stories. I was delighted to discover quite a few I’d forgotten about writing. This prompted me to indulge in two of my favorite activities: shopping at the Dollar Tree and buying office supplies. Here’s the new binder for the various bits and pieces related to my Kyoto Steampunk stories.

I’ve got more stacks of notebooks to go through. That means more binders, more dividers, and the hunt for more stickers and whatnot to do the decorating. Dollar Tree, here I come!

R is for Relaxation

by Lillian Csernica on April 21, 2022

As you may have gathered from some of my previous posts, my life is rather stressful. Finding reliable methods of relaxation is essential. Here are a few of my favorites.

Watching the wildlife

Various members of the local wildlife community who turn up in my back yard. I live on an acre of land with a creek that runs along the southern property line. The wildfires in California caused such a loss of habitat I’m happy to see the critters show up here. The regulars include ravens, crows, ducks, wild turkeys, woodpeckers, and two dozen species of songbirds. Squirrels both red ad gray live in the trees on both banks of the creek. There are two skunks who snuffle around late at night. Once in a while I’ll see a ‘possum.

Coloring books

Entangled Night Skies from Creative Haven uses Angela Porter’s wonderful designs. It takes some work to color in all the separate elements of each page, but it’s well worth it. There’s no particular deadline, so I can go at my own pace and linger over the colors I enjoy the most.

Bad ghost chaser movies

I find these entertaining if only because they’re so predictable. Ignoring all the warnings. Blowing off that creepy sense of being watched. The lights flickering. Will the problem be in the attic or the basement? The popularity of paranormal investigation movies has given me the opportunity to gain some insight into other cultures. Scandinavia, India, Poland, Turkey, France…. All over the world, things go bump in the night!

2 Comments

Filed under #atozchallenge, bad movies, Blog challenges, nature, therapy, Writing

Tagged as #animals, #art, #backyard, #birds, #coloring, #ghost, #haunted, #lighthouse, #paranormal, #spring, #waterfowl

April 20, 2022 · 10:37 am

Q is for Quandary

by Lillian Csernica on April 20, 2022

Lexico.com defines quandary as “A state of perplexity or uncertainty over what to do in a difficult situation.” This is a perfect description of the difficulties I’ve faced when trying to balance a career as a professional writer with being the mother of two special needs boys.

In 1993 I joined the Science Fiction and Fantasy Writers Association as an Active Member. In 1998 my older boy Michael came into the world at only 23 weeks. That he survived the next three and a half months in the hospital is nothing short of miraculous. The writing I accomplished during that time consisted mainly of the notes I kept in pretty hardback journals, documenting Michael’s growth, his tiny but meaningful milestones, the tests and surgeries and growing list of medications. Once Michael was allowed to come home, life became crowded with doctor appointments and physical therapy sessions. I tried to make the best use of the time available, editing manuscripts while in transit to the various appointments.

In 1998 John came along. Now I had two babies to care for. At that time it was just me while my husband was at work during the day. This is when I developed the habit of writing at night after the boys were asleep. Not the best plan when I wasn’t getting much sleep anyway. John was getting better and better at climbing out of his crib. At age two Michael developed seizure disorder, so I lived with one ear listening for any strange sound that might indicate John had escaped or Michael might be in distress. It’s very difficult to achieve the state of creative trance necessary for writing when one’s attention is constantly divided.

When Michael turned three and was eligible for the Early Start program, one of the benefits was nursing care. Thanks to the RNs who helped out and the support of my family, I wrote Ship Of Dreams. Getting that manuscript research took two solid years, then writing it meant daily labor. I suffered a disk crash that cost me two months’ work. (Words of wisdom: “Finish it!” and “Back it up!”) I found a literary agent who sold the book to a publisher. I’d been having some success with selling short stories and writing nonfiction pieces.

This might sound wonderful, and it was, but it meant struggling against my own fatigue, emotional exhaustion, and what I later learned were the symptoms of PTSD. When your brain already feels like dead coral, it’s almost impossible to summon up the energy needed to string words together. By that I meant just making sense when you’re talking to another person, never mind the effort required for creative writing. How was I going to keep writing? How was I going to complete projects, edit them, and do the marketing work?

There have been many times when I’ve wanted to “do it later.” As many wise people have said, later never comes. Today is tomorrow. I asked myself, “How badly do you want this? How badly do you want to work toward a Hugo, a Nebula, a World Fantasy Award?” The answers to those questions drove me to find ways to do the work even while attending doctor appointments, during hospital stays for Michael, and then facing John’s difficulties.

John had been hitting all the developmental milestones up until age four. We knew he had speech delay. The speech therapist was the first one to suggest we get John evaluated by a neurologist. The neurologist diagnosed John with Autistic Spectrum Disorder. At that time I knew nothing about “autism” other than the really drastic examples most people think of when they heard that word. Mind you, this was twenty years ago when a lot less was known about neurodiversity. I was in shock, frightened, depressed, and overwhelmed. Managing Michael’s care was already a complex challenge. Now John’s doctor and therapist appointments would have to be shoehorned into an already tight schedule. How on earth was I going to maintain a writing career when I couldn’t even manage a regular night’s sleep?

So I learned how to write whenever I had a few minutes. Free writing. Word sprints. Call it what you will. These bursts of writing are manageable, fun, and can be fit into a car ride, sitting in a waiting room, while having a meal in the hospital cafeteria. It’s not always comfortable, and it’s not easy, but practice promotes adaptation. I’ve written a total of seven novels and quite a few short stories. Now that some family issues and the first shock of the pandemic have settled down somewhat, I hope to move forward with editing and polishing these novels.

Living in today’s world makes it even harder to maintain a creative life. So many of us have had to take on the role of caregiver to a family member. Believe me when I tell you it’s essential to carve out some time for yourself, and for your creative work. Somewhere in your waking hours there will be fifteen minutes, thirty minutes, maybe even a whole hour. Use it. Sit down and take a good look at your daily schedule. You may find you have more time than you realize, it’s just a matter of making choices about what you spend that time doing.

Creative success. How badly do you want it?

4 Comments

Filed under #atozchallenge, autism, Blog challenges, creativity, doctors, editing, Family, Fiction, frustration, Goals, historical fiction, hospital, memoirs, mother, neurodiversity, parenting, publication, research, science fiction, special education, Special needs, specialists, therapy, worry, Writing

Tagged as #ASD, #autism, #cerebral palsy, #choices, #dilemma, #qundary, #seizure disorder, #self-care, #time management, #writing

April 15, 2022 · 11:40 pm

M is for Mystery

by Lillian Csernica on April 15, 2022

I love a good mystery novel. Few things offer me the escapism and fine writing and entertaining guesswork of an excellent mystery. These are some of my favorites:

Artists In Crime by Dame Ngaio Marsh

This was the first Inspector Alleyn novel I read. While clearly upper crust and possessed of impeccable manners, Alleyn brings a very pragmatic approach to his investigations. By that I mean he lets the suspects think he’s playing along with their nonsense while he seizes the available opportunities to gather the information he needs. Among the artists involved in this crime is Agatha Troy, a famous painter who captures Alleyn’s heart while he’s trying to figure out if she’s the one he has to arrest for murder. As the sixth case in the series, this story presents Alleyn in a new light with a depth of characterization that compelled me to read all thirty-two of his adventures.

The Murder At The Vicarage by Agatha Christie

The first of the Miss Marple novels, in this story I discovered the world of the quaint little English village and what a fierce combination of deceit, resentment, and violence seethes just below its proper public face. A cranky, abrasive churchwarden is shot in his office at the vicarage. A total of twenty-one characters dilute the main story a bit with subplots, but the red herrings do keep you guessing. The characters are so realistic and well-drawn I can read this book again and again.

The Redbreast by Jo Nesbo

Nordic Noir is quite a reading experience. Scandinavian landscapes, brooding police protagonists, and crimes of dark and twisted violence. I admit I wasn’t prepared for that last one. Even so, the brilliance of the writing and the intensity of the characters make for a thrilling read. Harry Hole is the Norwegian detective in Jo Nesbo’s series.

The Fifth Elephant by Sir Terry Pratchett

There’s trouble brewing in Uberwald, a dark, spooky country where power is split between the vampires, the werewolves, and the Low King of the Dwarves. A new Low King is about to take charge in a turn of events that will affect the reins of power all over the Disc. Lord Ventinari intends to protect the interests of Ankh-Morpork and its allies by sending Commander Sam Vimes of the City Watch. Vimes also happens to be a Duke, which makes him the perfect copper for the diplomatic mission. Vimes is anything but diplomatic, guaranteeing a bumpy time will be had by all. The plot concerns a theft that leads to murder surrounded by lies, lies, and more lies. Great stuff!

The Big Sleep by Raymond Chandler

Philip Marlowe’s first novel-length case takes him from blackmail and a gambling den to drugs, murder, and madness. General Sternwood hires him to solve the problem plaguing his younger daughter Carmen. The cynical way way General Sternwood talks about both Carmen and his elder daughter Vivian as corrupt and “having all the usual vices” signals just how far down such high class socialites can fall. The movie version starring Humphrey Bogart and Lauren Bacall is excellent, directed by John Huston with William Faulkner himself working on the script. Hollywood did sanitize the story a bit. For the complete story with every sordid detail, read the book!

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Filed under #atozchallenge, artists, Blog challenges, classics, Fiction, historical fiction, memoirs, nature, publication, research, romance, therapy, Writing

Tagged as #crime, #mystery, #suspense, Agatha Christie, Dashiell Hammett, Discworld, Jo Nesbo, Ngaio Marsh, Sir Terry Pratchett

April 14, 2022 · 2:27 am

L is for Love

by Lillian Csernica on April 14, 2022

LOOKING FOR LOVE

The older I get, the more I realize how much I don’t know. Take love, for example. I don’t know much more about what love really is than I did when I was in elementary school. For me, love started out being this big exalted dream of perfect happiness, perfect harmony, and total devotion to each other. I think I got that from reading fairy tales. (Disney movies also have a lot to answer for.) Then I listened to what older girls said about their boyfriends. I got the impression that having a boyfriend was one of those Rules for Living that showed everybody else you knew what you were doing.

One night when I was nineteen years old, it was so bitterly cold my body heat wasn’t enough to warm up the sheets and blankets. I lay there alone, shivering and miserable, thinking if only I had boyfriend. If only I could find a boyfriend to keep me warm, inside and out. The intense desire to avoid another night like that one prompted me to do some pretty stupid things. As I look back at that cold night from the perspective of fifty-plus years, I can see that I could have saved myself all kinds of trouble if I’d just bought an electric blanket.

Ever since I met my first crush when I was in the grade, I thought the right guy was the solution to all my needs and problems. I don’t know how I got this idea. It must have been all those fairy tales, because I certainly didn’t learn it from my family. My grandparents got divorced twice and married three times. (It’s true. I have photos of two of the weddings.) My parents divorced when I was eleven. My older sister never has married. My brother had to divorce his first wife. Why on earth did I think attaching myself to some boy who probably had even less of a clue than I did would somehow result in that magical state called “true love”?

When I was on the debate team in college, the first rule was “Define your terms.” That way both the Affirmative and the Negative teams knew exactly what the Affirmative team meant by the resolution being debated. When it comes to the search for love, I think the same rule should apply. After all, the statement “I love you” can have several different meanings and those meanings often depend on context. Matchmakers, dating services, and our best friends all ask the same question, “What are you looking for in a partner?” This is where it starts to get really complicated. Does the resulting list of characteristics represent the idealized image of the person whom you want to fall in love with? Or does it represent the person whom you want to fall in love with you? Are you really looking for a healthy relationship based on mutual give and take, or are you looking for a human transitional object that will soothe your insecurities and pay for your evening entertainment?

At this point in my life, I can see that wanting this perfect person to fall in love with me meant more than just having a boyfriend so I could go out on dates. It meant proving to the world that I had achieved the ultimate validation, the concrete emotional evidence that I wasn’t a loser, I wasn’t the last person chosen during schoolyard games. I wasn’t cold, alone, and miserable anymore. That’s what I hoped. Life hasn’t worked out that way.

Right now there’s all that Easter candy out there on the shelves. Most of it is chocolate. As adults, we know which brands are better than others. We know how to compare them and get the most value for our money. This skill comes from time, maturity, and a lot of taste-testing. Kids are different. When it comes to chocolate, kids don’t care. In the Dollar Tree you can find the phrase “chocolate-flavored” on many of the Easter items. There’s no actual cacao, just a lot of artificial colors and flavors. Unfortunately, the same can be said of some people. In the quest for love, some of us who crave True Love, the Real Thing, can become so desperate they will settle for the off-brands that are cheap, flashy, and artificial. It’s so hard to resist the temptation for a quick fix that will silence those nagging cravings and insecurities. It took me a while to learn the importance of patience, of saving up for the quality chocolate and the quality people.

My mother had her opinions about my boyfriends. When I was in middle school and awash in all kinds of hormonal angst over whether or not I’d ever get a boyfriend, Mom said I was “boy crazy.” Accurate, if not all that flattering or sympathetic. Years later, after I’d graduated high school and had spent some adventurous years working the Renaissance Faires, Mom managed to sum up both the quality and the quantity of my efforts to find love: “Well, at least you won’t wonder what you might have missed out on.” Once again, neither flattering nor all that sympathetic. Thanks, Mom.

So now that I’m a woman of a certain age, do I really know any more about love than when I first started dating boys? I’ve been married for thirty-four years come July, but that’s less of a testament to romantic love than to maintaining a stable home life for my sons. In a world of uncertainties, I know three things for sure: I love my sons, I love my cats, and I love really good dark chocolate.

9 Comments

Filed under #atozchallenge, Blog challenges, cats, chocolate, Depression, dreams, fairy tales, Family, Fiction, frustration, Goals, love, marriage, memoirs, mother, perspective, romance, school, therapy, worry

Tagged as #adolescence, #divorce, #happiness, #hope, #loneliness, #love, #soul mate, relationship

April 11, 2022 · 3:04 am

J is for Jokes

by Lillian Csernica on April 11, 2022

What do you get when you cross a rabbit with shellfish?

An oyster bunny!

Did you hear about the cowboy who was all wrapped up in brown paper?

He was arrested for rustling.

How does the snowman commute to work?

Bicycle (By icicle!)

Why did the two 4s skip dinner?

Because they already 8!

What kind of tree can fit in one hand?

A palm tree!

Did you hear about the first restaurant to open on the Moon?

It had great food, but no atmosphere.

Two windmills are standing on a wind farm. One asks, “What’s your favorite kind of music?”

The other replies, “I’m a big metal fan.”

6 Comments

Filed under #atozchallenge, Blog challenges, Humor, therapy

Tagged as #bicycle, #humor, #jokes, #oysters, #silliness, #windmills

April 9, 2022 · 2:56 am

I is for Insomia

by Lillian Csernica on April 9, 2022

When I was a teenager I loved to sleep. Stay up late, sleep late, linger in bed, the very definition of a layabout. Science now tells us teenagers need a lot of sleep because they’re growing both physically and mentally. Adolescence takes a heavy toll on the body and the mind. I’ll vouch for that. Living through middle school meant two of the worst years of my life. Sleep as a method of escaping reality became a coping mechanism. I had what the psychologists refer to as “peer problems.” I grew up alone due to my brother and sister both leaving home when I was only seven years old. Now I was in middle school, twelve years old, and my parents had just gone through a really messy, bitter divorce. The divorce meant Dad was gone and Mom had to go back to work, so I was a latchkey kid before the term had been invented. I was miserable. I could escape that only when I was sleeping.

For somebody who liked to sleep so much, how did I develop all three forms of insomnia associated with clinical depression? It’s been a long and stressful road from twelve to fifty-six, and life wasn’t exactly all rainbows and unicorns when I was a little kid. Just to be clear, let me explain the three separate forms of insomnia:

1. I have difficulty getting to sleep.

2. I have difficulty staying asleep.

3. If something wakes me up, I can’t get back to sleep.

Do I take medication for insomnia? Oh yes. Does the medication I take work? Yes and no. If I avoid caffeine, don’t eat the wrong foods and don’t eat too late in the evening, take my pills on an empty stomach and then go straight to bed, I might have an even chance of actually dozing off in a reasonable amount of time. All of that is referred to as good “sleep hygiene.” In general, my sleep hygiene is poor. I stay up too late. That’s when the house is quite enough for me to write. I watch exciting mysteries or detective shows or supernatural movies on TV. Many of these self-defeating behaviors are tied into my depression. Some nights I’m just too agitated to sleep and the medication makes no difference at all. Then there’s the problem of my body’s tendency to acclimate to medication within about four months. Am I still depressed? Oh yes. Will I ever be cured? There is no cure for Major Depressive Disorder. There is only support through medication and therapy, along with healthy living habits and a determination to keep on climbing up out of the darkness.

I know these things for sure:

Sleep deprivation makes depression worse and causes weight gain.

Depression will make weight gain worse.

Weight gain will make depression worse.

See how easy it is to get stuck in the labyrinth with no way out? The answer is sleep. When I’m asleep, my body is restoring itself and my mind processes what’s going on at various levels of my consciousness. That processing is essential. Picture your mind as one big file drawer. When you get enough sleep, all the files are in the right order and new material gets filed and cross-referenced appropriately. When you don’t get enough sleep, information gets filed incorrectly, memory doesn’t work right, and if the sleep deprivation goes on long enough, what you end up with is that file drawer yanked out, turned upside down, and everything dumped on the floor in an impossible mess. Sometimes the mess is so bad you have what the psychiatrists refer to as a “psychotic break.”

Bear in mind I’m talking about myself here. Different people need different amounts of sleep. Newborns do very little but eat and sleep. Teenagers need a lot of sleep not because they’re lazy but because of their mental and physical growth rates. Older people might not need as much sleep as people in their thirties or forties. Your mileage may vary. All I know is I need more sleep than I get, and that’s partly due to my own bad habits. It’s important to be aware of that. The more control I have over the causes of my depression, the more I can fight it. The more I keep up the fight, the more often I win. It’s when I forget that I can stand up against the depression that it takes over. Fatigue, chronic pain, the endless stress of two special needs children, and the pandemic make it very difficult to keep moving forward. Cognitive Behavioral Therapy is my friend.

Right now I’m sitting here at 1:30 a.m. It’s been another long day in a long week. Before I go to sleep, I will write down at least three good things that happened today. I will light that candle and keep it lit against the darkness of depression.