Welcome to Back from the Abyss. I'm Dr. Craig Ecock.

I really like today's story for a number of reasons. First, our storyteller Rebecca

is smart and funny, and she invites us into her story with such a wise and vulnerable voice. And I also

love how Rebecca's story doesn't fit many of the common beliefs and tropes in psychiatry. Her story is one more piece of evidence

that addiction is not always about trauma. Her stories suggest that, rare as it is, there are

young children without trauma or severe stressors who are endogenously depressed. And finally,

her story is one more concrete piece of evidence that her purported DSM diagnosis of

quote-unquote major depressive disorder is a completely unhelpful and basically meaningless way to

think about her complex non-bipolar spectrum out of the bell curve depression. Rebecca describes

being born depressed, and this supposedly doesn't happen,

but hang on for the conclusion of this episode where I posit my theory for her birth-onset depression.

We can't understand Rebecca in any meaningful way by giving her a diagnosis of quote-unquote

major depressive disorder. As with all our patients, we can only understand

the depression if we understand the whole story. I was born the middle child of three children

with two brothers, one older, one younger. My mom often said that I came out of the womb depressed. She said she had never seen a

depressed baby before, but I was one. I wouldn't engage. I wouldn't smile. She said that what she

had ended up having to do to get me to react to the world is she would just carry me around and talk to me constantly. And she said,

finally, I began to smile and interact with people. But she always had this feeling that I was just like,

ugh, really, I had to be born into this life. Even though, you know, I was born into a family that was filled with love. My parents

were very family oriented. There was never any doubt in the world that I was wanted and loved.

I was always told I could be whatever I wanted to be. Yet what I wanted to be was just not really present.

And the only thing that I really connected with as a child was animals.

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