Jo,

I will definitely jump over to Amazon shortly. Thanks for the recommendation.

Your question is great and is really at the heart of something that needs to be determined: can someone with a diagnosis of severe Major Depressive Disorder make rational decisions about his or her life?

My answer would be that it is possible but that, if the decision reached is one involving death, the rationality would need to be affirmed by one (or even three) competent people.

I don't know if I can explain why, in even some of my darkest hours, I believe that I can make rational decisions... sometimes; and also believe that If I am doubtful of my lucidity, my sanity, then I know that I am not capable of making "right-minded" decisions.

It goes back to the old conundrum – does the crazy man know that he's crazy? Some do and some don't. I have yet to meet, however, a person so deep into depression that they didn't know that they were depressed, even without knowing the reason. We're no flavor of bipolar. We don't enjoy schizophrenia. I am psychotic but not delusional (this time). Even when I was delusional I had doubts. I have severe anxiety but when I actually had a heart attack I didn't fear impending death so I know, now, that even my absolute worst full-blown panic attack isn't going to kill me.

Next year I 'celebrate' my thirtieth anniversary of being treated for depression and anxiety. During that time I had some good years – about three straight in a row – and four horrible years, 1999-2002 and this past year. 1997 to the present – 18 years – have all been cruel.

I've coped. I've had varying degrees of help during the past 18 years but even in the horrible years I've had to make, I have been forced to make, life changing and life threatening decisions on my own. I have never been as utterly alone in my life than for the past three years. During the past, oh, ten months there have been days when I have only been able to make it to the bathroom but not to the kitchen so I have not eaten. I have a grave fear of soiling the bed because I know that my caregiver would report it and if it occurred again I would have to return to a nursing home.

I am rambling, as I do.

The short answer to your question is that, even in a shroud of darkness and pain, I am aware of when I can and when I cannot make a rational, well reasoned decision. I am hearing a single voice at the moment, from my kitchen. I do not need to wheel into the kitchen to verify that it isn't real; I know that it isn't real. It has only been lately that I have found them bothersome. Wow. It's now the voice of Natalie Merchant singing but the only word that I caught was "brother" and, just now, "one day." Still able, currently, to make a logical decision.

I'm getting a bit tired and sleepy. I've been that way while writing but am rapidly losing the battle. I'm going to look at the book now.

Thanks.