Depression: An Insider's Guide

 

"When you're depressed you don't control your thoughts, your thoughts control you. I wish people understood that."

--Anonymous

A few days ago, a friend and I had a talk about Depression (not The Depression). Her 20-year-old daughter has it, has had it for a long time, and my friend doesn’t really get it. She tries to understand, and certainly offers whatever care she can, but she doesn’t follow exactly what her daughter is going through. It’s often an invisible disease. We can’t see it by looking at someone’s scar or cast but must rely on their behavior and what they might tell us in conversation.

Finally there has begun a public conversation about it and other mental health issues, which is fantastic. Still, most people don’t really understand what it means to suffer with this disease. Most of us know someone who has it – a spouse, a child, a sibling, a friend. Most of us know someone who has it – a spouse, a child, a sibling, a friend. We want to give this loved one sympathy but there is also an element of frustration in not knowing how they are feeling. Truly feeling. We see someone who seems to have everything – a happy marriage, a good childhood, a nice house, a rewarding job. What can she possibly be sad about? Why is he always down in the dumps? Can’t she just be grateful for what she has and look at the positive side of things? Maybe we hear that someone has committed suicide, and we’re confused – but she seemed happy?...Contrary to popular belief, depression is not simply feeling sad.

My friend has shown this frustration with a bit of eye rolling at not really understanding how her daughter feels. I’ve seen that frequently – loved ones try to be sympathetic and be gentle with that person. But they can’t show true empathy because they don’t actually get it. As my friend talked about her daughter’s issues, I interjected to explain a few things from my perspective, because I, too, have it. I was shocked at how surprised --and thankful -- she was with what I told her. I was equally shocked to find out she had no idea I have it, because we talk about everything. For those of us who want to cover it up, it truly can be invisible to others.

With this conversation I had a sort of epiphany. I only now realize that there must be many people out there who are similarly frustrated, curious, and sad at not understanding or being able to help someone they know who is dealing with this. After the reaction from my friend, I decided to tell what it’s really like, at least as far as my brain is concerned.

I have an autoimmune disease that causes Depression; I was diagnosed with my illness almost 30 years ago, so I’ve suffered at least that long. Probably longer as I remember feeling “down” as a teen and my dad had “moods”, so I imagine I got some of it from his side of the family. As an adolescent I remember often feeling out of sorts – which could be explained as being a hormonal teenager. I recall watching my best friend who seemed happy almost all the time, unless she had a good excuse to be otherwise. I always wished I could be “happy go lucky” like her. To say it stinks to have to live with this is a vast understatement.

Some people can have it for a few months and then the affliction “goes away” over time, or with the right medications. Another friend of mine who also has Depression told me she feels it coming at 10 am in the winter months, will take some prescriptions at noon and it’s fine again until 10 am the next day. I don’t think it’s that way for most of us. There are plenty of sufferers who cannot even get out of bed. I fall somewhere in between: I never go off my meds, and even with that help it never quite goes away; it wanes somewhat so I know the drugs are working, but it’s always there. If I run out of my prescription, I can feel a shift downward within hours. Nothing bad will have happened necessarily but a heaviness begins. I start to ask myself, “What is wrong with me?” Additionally, if my autoimmune disease flares up, I know how I will soon be feeling mentally. Conversely, if I’m suddenly feeling blue, I know a flare up of my autoimmune is coming to my body. My disease is a chronic illness, so I occasionally go into total remission, but the sadness is never very far off. I have learned to recognize the depression signs that often welcome in the rest of the disease.

These days we are lucky to be able to talk about it. I guess when “Prozac Nation” came out in the 1990s it became clear how widespread it has become, and it sort of gave permission to talk about it. Years ago (as in pre-1950) it wasn’t seen officially as a medical condition, but more of an affliction or even “nuisance”. As we look on our experiences of Covid, mental health has become a large focus of the effect of the pandemic and the experience of quarantine. I haven’t talked to many people about it because I feel shame, even though our idea of it as a disease, like diabetes, has become accepted.

Abraham Lincoln and Winston Churchill are two well known people to have had depression. In Lincoln’s time it was known as “melancholia”. Women with it (often now known as PMS) that seemed impossible to live with were often committed to asylums and mental institutions, even when this affliction only hit them a few days a month. Winston Churchill was very aware of his disorder and referred to it as his “black dog”. I’ve always seen it as my “grey cloud” as that is what it feels like, all sadness and darkness hanging over me.

Depression can sneak up on you. I’m often completely submerged in it before I realize what’s happening. It’s almost like another personality takes over. She says awful things to me:

You’re a piece of shit.

No one loves you.

You are such a loser.

The thing is, I’ve had this disease for so long, I have finally learned to recognize its appearance and remind myself: DON’T BELIEVE IT.

That’s the key: to those who have it, you absolutely CANNOT believe what your brain is telling you. That feels insane. Ignore the “no one cares about you” and “you’re pathetic”. Remember that this will pass. That voice is very powerful, and hard to distinguish from reality. It is so easy to be convinced that the voice is coming from YOU, the you that is familiar and rational. It’s odd to convince yourself that your brain has been temporarily hijacked. It sounds crazy, you don’t REALLY have a split personality, and you are not having a breakdown. You are under temporary attack from a (sort of) stranger. And you are not alone in your suffering.

To those who don’t have depression, this inner conversation is false, but you need to understand how real it feels!! It’s easy to be overtaken by this dominant voice. It’s like a strong adversary – sneaky and eviI. When in the middle of an episode, it seems so real, so convincing, so true. It’s difficult to separate the angel from the devil on your shoulders. In the depths, it feels absolutely hopeless. There seems to be no future and the world seems to look better off without you. Bad things tend to pile up – you’re feeling awful and then every little thing – like a bad hair day or a crabby child – only adds to the feeling and seems like proof of your world being lost. This sounds overdramatic, but I assure you, it really feels this way. You feel like you aren’t contributing and you have no value. Your mind goes to the worst places and it’s hard to know what’s true. It feels like the whole world is against you. One can see how some suicides happen because this voice feels so authentic and powerful. All you can think about is how you feel, being very self conscious. The mean voice is so loud that you can’t help but be self-absorbed. When you are feeling normal again you look back at the craziness you felt and wonder how it came to be. Then it happens again.

I absolutely hate that I’ve spent so much of my life feeling this way, struggling, feeling so self-conscious, and so sad. The world is an amazing place, and I can’t stand the fact that sometimes I have difficulty seeing that. I was with another friend a few months ago and someone on TV said something about everyone feeling suicidal at times. My friend was taken aback and said, “I’ve never felt suicidal.” YOU’RE KIDDING, I thought. I can’t count the times I’ve thought about it. But I am confident that I would never do it. I could not hurt my family like that, break my mother’s heart, leave my kids to be scarred for life. IT WILL PASS. THINGS WILL BE BETTER TOMORROW. Luckily the rational part of me that refuses to be tricked by Depression takes over. Some, however, have it worse than me, and maybe their false inner voices are stronger.

Personally, when I feel bad, I tend to hide under my rock, to recede from public if I don’t feel well. I don’t want to be out with friends and be a sad sack. Who wants to be around someone constantly complaining about their life, or just moping in the corner? Observers probably see it as so much drama. When I feel better, I re-emerge. Being real with people is important, but if all you can think about is the bad stuff that’s going through your brain, it feels better to disappear for a bit and not subject your friends to this negativity. I’m always surprised when someone tells me they had no idea I felt this way because I am so conscious of that part of myself. I guess most of the time I hide it pretty well. The worst of it usually only lasts a week or two. I hate taking medication – depression pills on top of autoimmune medicines. However, I am so thankful that they are available. For those who say that I just need to “get it together” or to “get a life”, I wish it were like that. Believe me I’ve tried – on a regular basis I journal, get plenty of sleep, cuddle with my dog, paint, meditate, do yoga, talk it out, see a therapist, take a walk, get out in nature, show gratefulness, take deep breaths, volunteer – all the things that are proven to reduce stress. Those practices help but certainly don’t remove the sad feelings. Sometimes when it comes on it’s like the awareness you feel after you’ve had a few glasses of wine. You know that your brain is working differently, and you really have no choice but to follow the thoughts. You can’t control it during that time. My autoimmune (and therefore Depression) flare ups are caused by stress, short term and long term. I think mine is pretty much continuous because I’ve been under chronic stress for many years (health, death, finances, jobs, divorce, assault, etc.). Everyone deals with stress differently. If you’re thinking I need to figure out some ways to reduce my stress, believe
me, I’ve tried (see above). And I do everything I can to take stressors out of my life. This is just how my body works. Moreover, I had a fantastic childhood and remain very close with my family members, so it isn’t something I’ve repressed. It is a chemical misfunction in my body. I can feel my thoughts change when I run out of my medicine. This is when I remind myself not to be ashamed, because this problem isn’t caused by any action I’ve taken, but simply the way my body works.

There is often surprise when someone with depression is “discovered” or talks about having the disease, because there is still a certain amount of shame that comes with it (for some of us). Sufferers become competent at faking it even when this feels unusually tiresome, and why some of us recede for a bit. I don’t like feeling out of control of my emotions and self. If I knew that more people really understand what a depressive goes through, maybe I wouldn’t feel such shame. When someone catches me on a really bad day, I assume it’s clear to them how I’m feeling and what my problem is. Part of that reasoning is that with this disease all you can think about is how you feel, so it’s assumed that everyone else sees what’s so obvious to me.

Why can’t we all just be real with one another?? Unfortunately, most people are so concerned about their own lives and what they are going through that they don’t have the space to devote themselves fully to a depressive person’s issues. And maybe they are afraid of becoming depressed as well, hanging out with this person. As someone with the illness, it seems simpler to put on a positive face while everybody goes about their business. From there Depression makes it easy to conclude that no one really cares – isn’t this proof that I’m worthless?

There are physical symptoms of depression as well– one is fatigue, horrible fatigue. Desire to sleep. No appetite. Crying all the time. A general not caring about health and hygiene – nothing feels important. Except going back to bed or laying on the couch and listening to the horrible voices. I feel fortunate to be able to fulfill most of my responsibilities, albeit with a frown.

To those who are Depression caretakers: I understand how tiring it is. You feel like you’re walking on eggshells. My divorce is partially because he got tired of dealing with it. Tell your loved one how much they are valued and how lovable they are. Remind them that the evil voice is wrong. Tell them you understand they aren’t to blame. Hug them and make them aware of your love. Above all, let them know that you are thinking of them. If you don’t know what to say, tell them, “I don’t know what to say,” – the idea that someone out there sees you helps. Finally, know that it will pass.