Depression thy name is Gozer

     Managing Depression is one of those things that is so hard because you have to stay ahead of your own brain. Enough outside sources are telling you it isn't a real thing, or that you can think your way out, bounce back, all these fables... So there's this denial you feel when it starts to come back. You fight desperately to be "okay" when it finally reaches the point that you just AREN'T and there's no point trying to lie about it anymore.

Then you feel guilty for admitting you're depressed (Why aren't you able to shake it off?), and you feel guilty 'pandering' to your depression by 'letting it' alter your plans and lifestyle.
But Depression is a disease. When you have a chronic lifelong condition like Depression, sometimes you need to stop. Rest. Recover.
It isn't easy. It feels like failing and being a disappointment, but you have to take your health seriously. Especially your mental health.

Depression makes you way more vulnerable to all kinds of negative emotions. Just like some illnesses make you more vulnerable to a cold or infection, you have to try to quarantine yourself. You have to try to avoid the bad, the sad, and the painful.
I got to thinking about this as I tried to self quarantine the other night.
Sometimes no matter how hard you try, your depression is determined to ruin your night, you might even see it coming, but you can't quite stave it off.
It reminds me of the epic battle in the first Ghostbusters. They blast at Gozer the demon (evil god?) and she disappears.

But she isn't gone. She's waiting, listening, searching for weakness. (Depression sometimes feels unhappily similar to demonic possession. The bastard disease knows what buttons to push.)

...Then the voice comes. "Choose the form of your destructor."

The human brain is a logical center paired with an emotional center, so many time when the emotional center is out of whack, logic steps in to find or create some sort of logical rationale or reason for all that pain and sadness.
So when the tide of sadness rises up, suddenly your brain starts looking for a REASON, a justification, and if there ISN'T a reason, it'll make shit up. It'll dig through your mind to FIND a reason to be sad.

Choose the form of your destructor. What should we be sad about tonight? Abandoned puppies? Current failings and guilt? Childhood insecurities? Memories of past humiliation or loss? That one thing that someone said that you KNOW they didn't MEAN anything by but it hurt and it's stuck in your brain forever? Or perhaps the spectre that someday you, or your loved ones, will die.
Spin the wheel. Pick a poison.

The problem is when we justify the pain we ultimately magnify it. What started as a burst of random sadness and depression, that might have gone away, we fed it into the blackest parts of our memories and fears, and now it starts a cycle of fault-finding, unhappiness and guilt. We dig up old wounds that still hurt, and that pain makes it worse. It's a spiral you have to force yourself out of. And that's not always easy.

I'd like to end this on some cheerier note about how you have to 'cross the streams' to revert the sadness and climb out of the hole... But I can't trivialize depression with some cliched 'easy answer' ending. There is no easy answer. Sometimes the hole is relentlessly deep... but short lived, a canyon that you eventually climb right out of. Sometimes its shallow but seemingly endless. It's not 'that bad' but it's never 'great' either. You just can't seem to feel joy like other people do. And sometimes it's pit after pit after pit to where you start to think the next one will for sure be full of man-eating tigers and you won't make it out alive.

(I was going to put a death pit of tigers sketch here. I opted for cute tigers instead. You're welcome.)

But you keep going. Just keep going. Build a cycle of good thoughts to help pry you out of a painful spiral. Remember people that love you. Look at cute animals. Read happy books, watch funny shows, remind yourself of seasons and holidays and hobbies that you need to see and do again. Find a reason to keep breathing. Then sleep, and wake up sometime later, and keep breathing some more.
You are stronger than you may ever believe. You are a fighter. Just keep going. It will get better.

Mental Health: The Invisible Stigma

The Invisible Stigma

Recently I read an article, frankly it was a rather superficial piece, on mental health, published originally in a Mommy Magazine, but it got enough interest that it was republished online via CNN. The interesting thing about it, is that my first immediate reaction upon reading it the first time was outrage. I reposted the article along with a diatribe. This isn't anything new, I have some of the most interesting discussions when I get irate about something, but this time something unique happened.

Over the course of the day when different people saw the link, I got two very polarized responses. The first, irate agreement with my annoyance, the second was polite confusion trying to pinpoint what exactly had struck me so wrong. It was the second response that made me think. I reread the article, trying to pinpoint the exact phrases that set me off, and they were there, but it was a subtle game. The article never directly said anything pointed, in fact it was the very calm, nonspecific nature of the piece that made it all the more frustrating, and all the more difficult to combat.

I'll bring back a link to the article, and discuss my arguments about it at length further on, but first a little background on me, and the experiences that have affected my perception.

I was diagnosed 'depressed' at seventeen. This didn't come as a surprise to anyone, I'd known I was unhappy, and frankly sick of fighting an endless battle with my sadness, apathy, and loneliness. It was back in 02, and even though more and more people were learning about depression, aware that it existed, and the TV and magazine ads for prozac had already started making the rounds, it was still something no one really wanted to admit happened to them.

I had a lot of reasons to be depressed. In addition to the dramas of adolescence I'd been fighting a long hard battle with another invisible disease, Ulcerative Colitis, that left me dangerously underweight, exhausted, wary of everything I ate, and frequently in the hospital. The thing is, depression doesn't care if you have a reason to be depressed, reasons just make it all the more difficult to fight it. Getting diagnosed with depression was a relief, it gave my problem a name and a description of ways to combat it. Like my other disease, not knowing what was killing me was far worse than giving it a name.

The irony in my struggle is that if I told people I was depressed and taking antidepressants as a teenager, they had no argument with that. For most it was something so indefinable, that they didn't bother to question it, they just accepted it. No, the irony was in the way people reacted to my actual physical disease. I had UC. I was diagnosed by doctors through many, many tests. I went through many courses of medication. I had a doctors note requiring teachers to forgive my absences because sometimes I was in the hospital, sometimes I just couldn't get out of bed. But when I did go to school, it was such a relief to see my friends, I preferred to act like nothing was wrong. I joked with friends, goofed around, and tried to have a normal school experience.

Some people couldn't accept that. Teachers, especially, couldn't grasp the idea that I could be deeply ill, and yet joke with my friends during class. They assumed I wasn't trying hard enough to do their coursework, some seemed to assume I was outright 'faking' a disease to get attention. I was deliberately failed by one teacher, despite my A on the final exam. Another teacher refused to give me a letter grade, and only supplied a 'course completed' stamp that got me out of her class without contributing to my GPA. Passive aggressive punishment for having a legitimate disease.

I am far more bitter about the experiences I had at the hands of adults, I admit. There were other incidents with students, more petty and cruel, but I don't expect better from teenagers. Stupidity at sixteen is almost required. It was the people that should have known better. Those that should have been past such petty judgments, those are the wounds that I remember.

It was situations like this that made me all the more sensitive to meta-messages. All the things you read between the lines, all the cruelty and subtle emphasis you make clear without ever saying a word. I think many people who become depressed are more sensitive to the opinions of others. Many of these people are highly intelligent, artistically inclined, and clever enough to see through the fronts others put up.

This might make them too sensitive, maybe even paranoid at our most insecure, seeing daggers in every sigh, and judgment in every silence. But we aren't stupid, and when we say people judge us for our 'mental disorders' we aren't wrong.

I was fortunate to know, quite acutely, that I was depressed, and I needed help when I first sought it. It made it easier to accept the diagnosis, but it didn't mean it was easy to stay there. Depression is like a cancer, you can beat it back, and sometimes go for a long time free of it, but there's no guarantee that it will stay gone, and all too often it comes back. To make matters worse, it might not be just depression. It might be anxiety caused by stress factors that you can predict, or panic attacks that come on violently for no reason. You could be diagnosed depressed, but actually suffer from a manic depression where half the time your unable to sleep, sit still, or stop chasing a dream, then you crash and fall into a pit of despair and lethargy. Mental disorders are tricky to face, hard to diagnose, and even harder to treat long term without difficulty.

Yet, if given half the chance, I'm sure almost everyone you know can tell you a 'solution' to your problems. Everyone has been sad, or unhappy at some point, but not everyone has been depressed. The fact that so many people believe sadness, mourning, or normal unhappiness is equal to clinical depression is one of the hardest logical fallacies for both depressed and 'normal' people to overcome.

If I have an ugly infected boil on my toe, it takes a special kind of person to give me advice on how to cure it, let alone someone who'll want to talk about it at all. Yet if you say you're "depressed" for most people they assume it's your way of asking them to 'fix it', and they'll try. (Sometimes I wish Depression had a fancier name. I think I'll start calling mine 'Johnson's Apathy'. If I tell people I'm on medication to cure my Johnson's Apathy maybe they'll stop telling me how I can quit my pills and just take a vacation instead.)

People who have fought the battle for their mental health, especially people who are willing to talk about it openly, have all dealt with the oftimes crushing advice on how to get better. "Just try to cheer up." "Maybe you need more sunlight." "Maybe you need more vitamins." "When I'm sad I just…" "If your so stressed, you should take some time off." "You need to get out more." "You need to relax more." "Get a hobby." And the far worst one, the one that so few actually say, but we can read it loud and clear between the lines. "Maybe it's all in your head." "Just stop being that way."

Passive aggressive, condescending, sometimes well meant, but all the more painful, the advice from people who've never truly understood mental disorders all carries the same stigma, "I'm fine. So what is so wrong with you?"

People with depression aren't seen as 'sick', they're seen as weak, unmotivated, not 'really trying' to get better. The burden of the judgment can be a weight that crushes you, especially when you're already deeply convinced that you cannot escape your flaws. Someone who is depressed, but afraid to be labeled 'mentally ill', will run from that stigma. Sometimes until it kills them.

I am fortunate. I know that my depression is a physical chemical imbalance that I need medical help to manage. I know my depression is not a sin, a personal flaw, a choice or a weakness. I know that I cannot always help the sadness that swallows me whole, and that when that happens, my job is to get support, see my Doctor, and remind myself that it will get better. You know what, even though I know all that with the same certainty that I know the sun will rise… When I am depressed, it doesn't stop me from hating how I feel, hating who I become, and feeling like a burden and a failure to my family.

Knowing that depression is a disease I can fight, with proper medication, therapy, and support of friends and family is the rope I need to climb out of the pit that depression throws me into. Having the certainty that I will keep fighting, and this is not my fault is all the difference in the world sometimes.

This is why a fluff piece in amagazine offended me so much. (Specifically titled, "Xanax Makes Me a Better Mom") The article began with a 'depressed' mother who went off her medication and 'cured' her depression with moments of solitary meditation, the article ended with a 'depressed' mother who's daughter said 'she feels sad' (An early sign of depression, though in a child it's contingent on a LOT of factors, like duration, severity, frequency, before deciding it's an actual concern.) so the Mother's conclusion from her daughter's sadness was to go off her medication and try to deal with her disease (and her potentially depressed 6yo) unmedicated.

Basically looking at the structure of the article, if you begin a news piece with a statement about using alternative (to medication) methods to combat depression, then end that piece with a similar statement about getting off the pills and reconnecting with life, the position of those two pieces make them your strongest 'argument'. Thus, the article is saying "American parents are over-medicated and need to stop taking pills in order to better experience life".

This is why I found the article a bit offensive. If you also look at the statements they included in the article statistics from the CDC stating one in ten people are on antidepressants, include a therapist who thinks people just want a pill to deal with normal feelings in life, and a snippet from a psychologist who says taking pills without seeing a therapist is never going to fix the problem. Even though they couched all this language in fuzzy anecdotes about parenting and interviews with parents on medication, their implication is clear. "You don't need a pill. You just need to get over it."

The stigma is right there, wrapped in statistics, and couched in anecdotes. "They fixed their depression. Why can't you?" "You don't need medication." "People just want a pill to deal with normal sadness." The words are there, "It's just easier to take a pill." along with the implication, you are weak for needing a pill to survive your illness. You are a failure for 'not facing' your depression and getting over it. You are broken.

If someone is depressed an already hating themselves then all they see from these words is not an offer of help, or an observance of the medical possibilities for getting better, instead they just see how they can't fall into the fallacy of the over-medicated society.

The thing is, there are probably a great many people who are not clinically depressed, but have had a rough time, get on a dose of pills to get through it, and never think to stop. There are probably many people who would benefit from therapy to deal with traumas and triggers in their life that still effect them today. There are even people who are depressed, but choose to face it without medication because they feel they know what they're doing and they know the risks.

The problem isn't if people are taking too much medication, or if it's the wrong medication. The problem is that we don't bother to learn what depression is, how to help, and what to do to support those who have it. Instead we assume the media is to blame, that people are taking pills they don't need, and no one has a legitimate illness.

Doing that just takes us backward, and leaves us marginalizing mental illness, reducing it to 'an illusion' and stranding the legitimately sick people without aid, and without the understanding they desperately need. Depression is a captor, it takes your mind, it tears down your confidence, it divides you from your ability to judge rationally who you are, and if what you’re feeling is normal. If everyone who isn't depressed learns to think it's all a lie… then who will be there to help the person who can't help herself?

Every article that boosts the stigma that mental illness isn't 'really a disease' does damage to the way people perceive mental illness, and each other. My biggest fear is that too many people will believe that lie, and those of us who need help will be left to die by inches, imprisoned in our own minds.

When Depression Helps you Set up Camp and Stay There

I wrote about my depression a few weeks ago.  Many people were hugely supportive, and all those kind words helped.

I am not all better. I still haven't seen a Doctor, and it's really just a self-defeatist attitude, and a almost Freudian forgetfulness that makes it that much easier to procrastinate. Thing is, I'm not miserable all the time.  I'm not unhappy all the time.

I had an amazing birthday. I was already having a good day,  then so many friends sent me birthday wishes through twitter and Facebook that it made the day that much more wonderful. I was really surprised, and grateful, that so many people stopped long enough to type a few words. the whole week went by in a blur.
I am lucky to have friends, who at the very least, are there to tweet and text almost any time of day. I'm lucky to have a fantastic family, a husband who is incredibly perfect for me. A beautiful daughter who is very well behaved, despite inheriting her mother's tendency toward weirdness. I have tons of extended family there to talk, to help, to support me.
I am so very fortunate to have all of these things.

Yet it doesn't fix my brain. It doesn't keep the depression from creeping in and making me unhappy in spite of all the things I am grateful for. Sometimes the very nature of depression makes it easier to be angry with myself, because I should be enjoying my life. I should be happy with what I have, and I shouldn't waste so much time on mindless pursuits that I'm only doing to stave off the weariness.

I compared depression to being lost in the swamps. The thing about being stuck in the mire, is that everytime you fall in the quicksand, nearly drown in the bog, or get mauled by an alligator, you have to retreat. You lose ground, you lose time. Instead of being able to push forward with your life, you feel like you're never making progress.

For me, it starts to become a pattern, the depression creeps up and mires me in place, and after so many tries to do something ambitious, to succeed, and after so much failing, it's easier to not try anything. That's one of the things I hate the most.

If the job is easy, perhaps tackling a load of laundry, or baking a tray of cookies, I'll take it one, and then congratulate myself on the small achievement. Then because I did something, that becomes justification to do nothing else. It'd be different if what I was attempting actually took my out of my comfort zone, or required a real commitment, but I don't do those things when I'm down.

I've set up a camp on a small piece of 'safe' land in the swamp.  I never try anything big. I avoid leaving the house except when I have to.  I avoid offering to help/socialize/interact with people, and I completely avoid tackling any creative project that requires real effort and passion. It becomes a sort of wall, and if I stay within it, then maybe just maybe I won't wind up failing, I won't wind up trying anything that might fail, and so I won't fail myself.

I don't want to drown in the swamp. So rather than trying to swim, I'll just avoid going near the water.
This is the stage of depression, this form of self limiting behavior, that's so easy to get stuck in. Even people who don't think they are depressed, don't think they've ever been depressed get trapped here. You aren't really happy. You aren't miserable, but you aren't enjoying life either.  It creeps in, and you tell yourself all the little lies: that you never really wanted to try for that dream, or that you never really cared for the friends you've lost touch with. You aren't really hurting, you aren't really sad, you're just existing.

Sometimes I wonder how much of my life I wasted just letting life pass me by because the depression and my own insecurity kept me from trying. I wonder how many of those years where I didn't really do all that much are actually a product of me becoming complacent in my own apathy.

Let me make sure I explain. It's okay to have a life where you stay at home, work on your own hobbies and enjoy a quiet life. There is nothing wrong with a peaceful life. What matters is what you feel about your life. Sometimes I feel like I'm failing in some way because I'm NOT a stepford wife. I don't have a clean house and I'm perpetually disorganized and I just don't care if clutter piles up. But having a clean house or a perfect kitchen isn't what makes me happy. If you are legitimately happy and satisfied in your life then you aren't camping in the swamp.

I'm not in the swamp because I want to be here. I'm here because I'm afraid to leave right now. I hate the voice in my head that is constantly shooting down my hopes. I hate the crippling uncertainty that makes me feel convinced that my next attempt at anything meaningful will fail. I hate the fact that life starts to become a meaningless blur. So many days that don't matter, weeks and months that go by without me doing anything outside my very small circle of what makes me ...not happy... but safe. I hate the tired weariness that comes with it. The sleep disruptions, the irritability.
I'm going to get help. I'm going to get out. I don't want to live here anymore.

I just hope that if you read this and see yourself, or if you know someone else who might be helped by this, that you're willing to share it with them. Help them get out. Its so very easy to believe, when your depressed, that you don't really deserve to be happy, and that nothing will get you there.
Just because you got lost in the swamp doesn't mean you should settle in to live there. There is more to life than settling for misery. Please, if you feel the same way, get help. Tell a friend, tell a doctor, call a hotline and if you can't get out of the swamp on your own, your friends can be the rescue team that shows you a way out.

Hang in there. It will get better.
Liz