I apologize for this being a week late. My sister was doing her first half-Iron distance triathalon last week, and for those of you who aren't familiar, spectating that kind of event is an endurance test in and of itself.
In any case, as promised, the flip-side of my last blog post: or, what TO do as the friend/family member of someone suffering from severe clinical depression. Sticking to the five number format, since it worked well last time and I like symmetry.
5. Take care of yourself. I'm willing to bet this seems self-evident, but only from the outside looking in. It is incredibly easy to lose sight of self-care when being a support system for someone who is spiraling. Self-care is a lot of things. It is eating right, it is sleeping enough, it is physical activity, but most significantly, in this situation, it is the ability to say no, to look to others for help.
I had two friends once, and one was a depressive. She was a self-harmer, and I'm pretty sure she had borderline personality disorder. The other friend was someone who had never really dealt with self-harm and the threatened potential of something worse. Both women were young at the time, and the support-friend got to the point where she was the ONLY support for the self-harming friend.
Support-friend wasn't sleeping enough, was very worn down and at one point, I asked, "When Other Friend asks you to come over or if she can stay with you, do you feel like you can say no?"
And after a long moment, she shook her head, "No."
Trying to get help while depressed is hard. It sucks. It often doesn't work quickly, so it seems like all the effort was pointless. If you allow yourself to become the sole support system for someone who is depressed, that person may very well take advantage (knowingly or unknowingly) and use your support until YOU are the one whose health is suffering.
Learn to say, "No, I cannot help you right now," and to put yourself first. Realistically, unless you are taking care of yourself, making sure that you are steady and grounded, you're not able to help us anyway, you're just creating an enabling loop.
4. Encourage us to get help and to KEEP AT the things that are helpful. This, obviously, ties in with the last one. Here's the thing about depression: when we're in a depression cycle, we have neither the energy nor the mental strength to seek out aid on our own. We don't believe it will help. Many of us have been and been and been to professionals to no real advancement or change.
We still need it. Not only because professionals are the best suited to know when we need to be put in a hospital and make that choice dispassionately, but because they are paid to take care of us, and therefore are an essential part of the support system.
When we're doing well, we often tell ourselves (and others), "Oh, I don't need that right now."
When we're doing well is EXACTLY when we need to be working on it. It's when we have the best ability to do so. Chances are, though, that we won't unless encouraged.
What's more is, we probably won't stick with it unless we see support from our friends and family. Asking a person who is depressed what she's getting out of her therapy sessions? An absolute no. Saying, "Hey, I really think you're doing better at __________ since you've been in therapy,"? Go for it.
This is the same (maybe even more so) for meds. A lot of people seem to think psych meds are the same as say, cold meds, where once you start feeling better, you can get off of them and your body will take care of the rest. That's not how it works. These meds are more like something you would take for an auto-immune condition, or something else chronic.
A lot of people DO get off their meds when they start feeling better and then spiral back because the improvement stemmed from the meds fixing the problem. Psych meds are often a lifelong deal for people with depression. Being meds positive is a HUGE help, since there's already a stigma on mental illness and using meds for them. Not to mention, every one of these meds comes with a barrel of possible side effects and the probability of long-term liver or kidney damage.
I avoided meds for SEVEN YEARS for lots of reasons, but definitely among them was the idea that taking them made me weak, that "now we just prescribe a pill for everything" and I didn't really need them. I needed them. I still need them. And I still hate that I need them. The last thing I need is people making me feel like I'm weak/stupid/bad for taking them.
Finally, we also need to be encouraged to build up community. Whether this is through support groups, or hobbies where we meet other people, the more community we have, the more help YOU have when things get bad. Community is essential. If there's a way to help us create some, even if it's just having a few dinner parties and trying to introduce us to people you think might make good friends? In the long run, that's going to be better for everyone involved. You will have people to turn to for support and support for us can be diffused among a larger group of persons.
3. Aid in good habits. This is a little like four, but slightly different in that this is talking day-to-day behaviors. So, for example, depression tends to breed a lot of "side effect" conditions, such as eating disorders, insomnia, agoraphobia, etc.
For example, let's say your friend's problem is agoraphobia, in the sense that she refuses to leave her hosue. Create a standing "date night." This is important: be the one to drive, to pick the place and be ready to have to do the work of basically dragging her with you over protests. But do it. Make sure she gets out of the house, even if it's only for an hour.
If the problem is compulsive overeating? Do activities that don't involve food or at least involve healthy foods.
Help us to live in clean and safe environments. Maybe this means coming over on a Saturday and making us sort out our closets with you, if you're good at that kind of thing. Maybe this means helping us to find a cleaning company, if financially viable.
Get us to exercise. Physical movement helps with the depression, even if we don't want to do it. If the weather's nice, get us to take a walk around our neighborhood. Or maybe find a yoga workout online that can be done inside, together. Just something to get our blood flowing.
Like I said last week, do not do these things FOR us, do them WITH us. And if you cannot get us to leave our house/help with tiny things/etc.? Call our doctor. Let a professional handle the situation.
2. Listen. Listening is hard. It's hard to just take in a flood of "I hate my life," and not try to help, not try to make us see where there's a flaw in our "logic," but here's the thing: you can't help, not in the big picture of actually clearing up the depression, and our logic is flawed because our brain is misfiring. No amount of arguing is going to change that. Chances are we KNOW our logic is flawed and it doesn't matter, because we cannot emotionally feel that.
There's a comic of one person having a panic attack, and another person says, "Calm down," and then the person panicking says, "It worked!" When put into stark relief that way, we can all see how ridiculous a comment like that is, when someone's brain is telling her to panic. It's the same with depression. You can tell us to "cheer up," or "think positively," or that the "past does not define the future," or that "hope exists," and you're basically just talking to yourself. And probably making us feel like you weren't listening or you are dismissing the way we feel.
But listening to us, listening and just saying, "man, that sucks," or, "can I hug you?" or "I'm here," any of those things, it may not make it BETTER for us, but it doesn't make it worse and it does remind us that there is someone out there who cares enough to just let us be who we are, mental illness and all.
It's not fun for the person listening, believe me, I get it, I've been that person more than once. And it feels helpless and sometimes really eye-rolly. But to the person to whom you're listening? It feels like, for once, someone is actually HEARING us, and we don't get a lot of that.
1. Be persistent/annoying. My best friend texts me every day. Every single one. Without fail. And most of the time I'm kind of like "yeah, I'm here, yeah." But on those days where I'm holding onto things with broken fingernails and the skin of my teeth? That grounding moment is huge. It says, "Hey, there's someone out there who would be really upset if you did what you want to do right now."
Bug us. Sometimes, we're probably going to be dicks about it, wanting to be left alone to ruminate, let the depression marinate. It is very seductive in that manner. Be that third wheel. Disrupt our date, bring pizza we didn't ask for, and a board game.
Try to do it in a way the person in question handles well. I'm best at text and email, so that's what most of my friends do. They'll call in a pinch, but I don't like being on the phone, so they try and avoid that. Other people like that voice connection, or, if you're near, maybe they'd sometimes prefer actual face to face. You have to determine what works best for you and your loved one.
I recently saw an article about how people disappear in times of grieving to "give the mourner space." Except that, in most cases, what the mourner needs most is a community of support, rather than "space." Depressives are the same way. We put off vibes that we want to be left alone, and maybe some of us even really do, but we shouldn't be. We need to have people showing they care, making sure we're responsive, and generally just pecking at us until our brain lets up and we settle into a remission phase.
Saturday, September 27, 2014
Saturday, September 13, 2014
Some Basic Don'ts
I know, I'm supposed to balance the Dont's with the Dos. But, a) Don'ts with depression are easier, and more universal, and b) relax, next week's edition is on the Dos. I've got to maintain a little mystery, right? Keep you coming back for more? Or something.
Again, I really cannot speak for all persons with depression. This is more about me and all the people I've known with the condition than the world at large. But pronouns are tricky and not always as varied as I might desire.
I am going to do five of these, since that's a nice, round number.
5. Do not take it personally if I don't seem terribly present.
As I've talked about in this note, depressives are taught early--and later internalize--that our tendency to be "sad" means we are self-involved. This often creates a defense mechanism which turns us into people who automatically de-prioritize ourselves. As such, when we are at all, even just a little bit able to be, chances are we're going to be the best person in your life for listening, empathizing, and trying to support you.
If you notice we've stopped really paying attention, say, we're nodding our heads but not responding the way we normally might, chances are a few things are happening. Depression robs people of the ability to concentrate. It might be taking us all our energy just to focus. It's also possible that we don't have the energy to care at that time. This is NOT personal. It's not even close to personal.
We have stopped caring about OURSELVES. We have stopped caring about everything that previously made us happy. In my case, when I get to this point, if I COULD care about anything, it would be what's going on with my friends and family. But I'm so far beyond that, it's generally all I can manage just to be physically listening/hearing.
You don't have to stop talking. Just be compassionate if the response you usually get is unavailable. And don't get mad because we can't be the person you need right at that moment. At least in my case, I'm trying as hard as my little heart can manage. Also, getting mad isn't going to get you what you need or want. In my case, it's going to mean I withdraw emotionally from you long term, because I have learned you have no ability to consider my emotions, and because the last thing I have the ability to do at that moment is say, "Hey, I need you to realize I'm having a hard time right now and that doesn't mean I don't care about you."
4. Do not let us disappear.
This is a hard one. Especially if the depressive you know and are trying to be there for is an introvert. Because that person NEEDS time alone to even have a chance of functioning in the rest of her life.
If the person is an extrovert, don't mess around: make sure that person is going out with you, even if you have to provide rides, or set up hanging out at her house with some friends. This latter is a good way to handle an introvert if you cannot get her to come out: take food to her place. It allows her the safety of her surroundings, and means that she's eating. Depression can cause emotional over-eating, but it can also cause a complete lack of interest in food, ESPECIALLY if it has to be made.
I am someone who's really awesomesauce at making myself eat when depressed and last night I had a bowl of cereal and an apple for dinner because I couldn't rustle up the mental energy to actually figure out a meal plan and enact it.
A sub-tip to number four is, if you get to her house and basic things, such as taking out the trash, laundry, etc., need to be done, help. DO NOT do it for her. Unless you physically cannot drag her out of bed--in which case, call someone stronger than you, put her in your car, and take her to the nearest hospital--have her participate in some way. It can be small. You can have her sit down and sort the laundry. Or walk with you to the curb with the trash cans. Anything. But force her to take part in her own life. I am not saying this is easy. She might be a total crab-ass at you. Or say terrible things. Or cry hysterically.
Get her some water or Gatorade, and make her participate in her own life anyway.
At the VERY least, call or text and check in with her. Suicide happens, in my experience, when people reach a crucial clusterfuck nebula of two points: the sense that things are hopeless, cannot get better, and things will always be this terrible and painful, and that the world, even the people in it who love us, is better off without us, and things will be easier for everyone that way.
This is possibly the most important point of this post: nobody can stop another person from committing suicide. At the end of the day, it is the person who takes that step's choice. That said, letting a person know you care day in and day out, even if it's just by saying "hi, thinking of you," can go a long way toward slowing or even halting the cycle of "nobody needs me" thoughts.
If you can--and being the friend to someone suffering from depression is grueling, so if this means too much mental and emotional energy on your part, just don't--occasionally find a reason WHY you care about that person to mention. It doesn't have to be epic.
A friend recently told me she needs me to hang on because she learns things from me. That's an A++ reason. Any reason that's real will help. It won't FIX anything, but it will help.
3. Do not expect miracles from medication and therapy.
Speaking of fixing...
In some people, these steps do cause miracles. And if that happens to someone you love, be thankful, because miracles are rare and precious. But if what you get out of that person is instead two days out of the week that are better than they were before? Or the ability to communicate frustration where she could not before? Take that and run. And be proud when those moments happen. Let the person KNOW you are proud, not only for the progress, but for being willing to get help, to try different things, when, frankly, it's one of the hardest things.
On Thursday, I went to my prescribing doc. He really wishes I would go to the hospital, because I have hit the space where I genuinely have no capacity to believe life will get better than it is right now, and I have no interest in continuing on in this space. Or, as I said to my therapist when she asked me if I planned on doing another triathalon, "The thought of being alive long enough to do that is depressing."
I won't go to the hospital because I cannot afford it, either financially or time-wise, and because all it would mean is a bigger mess when I come out the other side. Additionally, I have a bunny who just got an ear infection, and I'm the only person who can take care of her the way she needs. My bunnies are actually my last line of defense. I remind myself regularly that nobody is going to take an almost nine year old and almost seven year old bunny and really pay attention to them and love them if I'm not around.
So, instead, my doc doubled my dosage. If this doesn't work, the next step is putting me on a THIRD anti-depressant, co-currently. Being honest, I sincerely doubt any of this will even take the edge off. Changing meds hasn't worked the last two times we've done it. I don't think it will now. I don't think going to therapy is doing anything, because I've reached the point where there's nothing more to say: something I straight up told my therapist this week. And that's the disease. It tells me, in no unclear manner, that nothing I do will help, that things will always be like this.
And I believe it, because I have no other choice. But I go to therapy and doctors because I know its the right thing to do. If you know a depressive who constantly goes and does the work, at her worst, she's not doing it because she believes it will change anything. She's doing it because she's supposed to. Hug her and tell her she's doing a great job and you're proud of her for keeping it up, even when it seems hopeless. Because, trust me: it does.
2. Do not let us go silent.
This is another hard one. For me, talking, really talking, when I'm like this, is a chore. I'm tired of hearing my own voice in my head. I don't have anything new to say. I don't want to pretend to be happy. Silence is my best option.
Which is why, once a week or so, it's important that someone find a way to get me to talk, even if I am saying the exact same thing. Things haven't gotten better for me in two years. They're unlikely to anytime in the foreseeable future. I'm not going to have a lot that's new and interesting to say.
Ask leading questions and listen anyway.
It's like this: I may be tired of hearing my voice in my head, but that's not going to shut it up. And a lot of the poisonous shit it says? Is just plain better getting released. When someone overdoses, we pump her stomach, because "better out than in." Depression is the experience of constantly overdosing on hopelessness without any affirmative action on one's own part. Someone's gotta go in and make us bring it all up every once in a while, because just like the drugs, if not as immediately, it will kill us.
1. Do not, do not, do NOT, EVER, say the words "things could be worse," or "just cheer up," or any variation thereof.
I actually get that for some people this helps. Those people are not chemical depressives.
Have you ever broken a limb, or had a bad flu, or cut yourself deep enough to need stitches? Out of curiosity, did thinking positive thoughts about getting better hasten your healing process? Because, if it did, you might have either mutant or angelic powers, and you should consider a career in televangelism, or something.
I can think all the positive thoughts I want. Realistic ones, even. Ones like, "I write well and research like a boss and have a really interesting professional and academic background: someone has to hire me sooner or later." Or, "Lots of people meet life partners much later in life, things are just taking their time." I can repeat them in front of the mirror every morning. I can use them as a meditation, whatever. My BRAIN does not believe them. Because my brain does not function correctly. Much like a broken arm, the essential function of my brain is in a state of disrepair and works on a basis of limited functionality. The difference is, fixing a broken arm is a decently exact science at this time. Fixing my brain? Not so much.
As far as the "things could be worse" approach, let me quote something I saw on tumblr, the font of all true wisdom. (That is a lie.)
"In breaking news, the person in the worst situation on planet earth was finally found and THAT person is allowed to be sad. No sads for anyone else, though, ever."
Like I said, I realize that for non-clinical depressives, this sometimes helps. I've met people who find it useful to think about the fact that they could, say, not have a home, or be going hungry, or be physically ill. And I envy the crap out of those people. Man, if I could make myself better by thinking about all the things that could be worse? I'd be the world's happiest chickadee.
For a moment, though, let's take it for granted that I don't actually want to be so miserable all the time that I would rather be dead. And from there, let's take the logical step that if it were that easy for me to feel better, I'd have already fixed the problem. I talk in this note about how, not only is using this approach unhelpful, it's DANGEROUS. It tends to cause a guilty reaction, which will not only make me stop talking--see point number two, this is NOT a good thing, it doesn't mean I feel better, it means I've been made to feel like my pain does not matter--but will stay with me, and very possibly trigger a cycle of even worse feelings of worthlessness than are usually an issue.
A sub-suggestion here is, "things will get better"? Also not helpful. I cannot convince myself of this. You telling me it? Feels dismissive, even if it is not intended to be. And again, it makes me feel foolish for not being able to make my brain believe it, makes me feel like I should stop talking, like I should go away. Away away.
So what DO you say to a person who's depressed? *grins slyly* Come back next week, mes amis.
Again, I really cannot speak for all persons with depression. This is more about me and all the people I've known with the condition than the world at large. But pronouns are tricky and not always as varied as I might desire.
I am going to do five of these, since that's a nice, round number.
5. Do not take it personally if I don't seem terribly present.
As I've talked about in this note, depressives are taught early--and later internalize--that our tendency to be "sad" means we are self-involved. This often creates a defense mechanism which turns us into people who automatically de-prioritize ourselves. As such, when we are at all, even just a little bit able to be, chances are we're going to be the best person in your life for listening, empathizing, and trying to support you.
If you notice we've stopped really paying attention, say, we're nodding our heads but not responding the way we normally might, chances are a few things are happening. Depression robs people of the ability to concentrate. It might be taking us all our energy just to focus. It's also possible that we don't have the energy to care at that time. This is NOT personal. It's not even close to personal.
We have stopped caring about OURSELVES. We have stopped caring about everything that previously made us happy. In my case, when I get to this point, if I COULD care about anything, it would be what's going on with my friends and family. But I'm so far beyond that, it's generally all I can manage just to be physically listening/hearing.
You don't have to stop talking. Just be compassionate if the response you usually get is unavailable. And don't get mad because we can't be the person you need right at that moment. At least in my case, I'm trying as hard as my little heart can manage. Also, getting mad isn't going to get you what you need or want. In my case, it's going to mean I withdraw emotionally from you long term, because I have learned you have no ability to consider my emotions, and because the last thing I have the ability to do at that moment is say, "Hey, I need you to realize I'm having a hard time right now and that doesn't mean I don't care about you."
4. Do not let us disappear.
This is a hard one. Especially if the depressive you know and are trying to be there for is an introvert. Because that person NEEDS time alone to even have a chance of functioning in the rest of her life.
If the person is an extrovert, don't mess around: make sure that person is going out with you, even if you have to provide rides, or set up hanging out at her house with some friends. This latter is a good way to handle an introvert if you cannot get her to come out: take food to her place. It allows her the safety of her surroundings, and means that she's eating. Depression can cause emotional over-eating, but it can also cause a complete lack of interest in food, ESPECIALLY if it has to be made.
I am someone who's really awesomesauce at making myself eat when depressed and last night I had a bowl of cereal and an apple for dinner because I couldn't rustle up the mental energy to actually figure out a meal plan and enact it.
A sub-tip to number four is, if you get to her house and basic things, such as taking out the trash, laundry, etc., need to be done, help. DO NOT do it for her. Unless you physically cannot drag her out of bed--in which case, call someone stronger than you, put her in your car, and take her to the nearest hospital--have her participate in some way. It can be small. You can have her sit down and sort the laundry. Or walk with you to the curb with the trash cans. Anything. But force her to take part in her own life. I am not saying this is easy. She might be a total crab-ass at you. Or say terrible things. Or cry hysterically.
Get her some water or Gatorade, and make her participate in her own life anyway.
At the VERY least, call or text and check in with her. Suicide happens, in my experience, when people reach a crucial clusterfuck nebula of two points: the sense that things are hopeless, cannot get better, and things will always be this terrible and painful, and that the world, even the people in it who love us, is better off without us, and things will be easier for everyone that way.
This is possibly the most important point of this post: nobody can stop another person from committing suicide. At the end of the day, it is the person who takes that step's choice. That said, letting a person know you care day in and day out, even if it's just by saying "hi, thinking of you," can go a long way toward slowing or even halting the cycle of "nobody needs me" thoughts.
If you can--and being the friend to someone suffering from depression is grueling, so if this means too much mental and emotional energy on your part, just don't--occasionally find a reason WHY you care about that person to mention. It doesn't have to be epic.
A friend recently told me she needs me to hang on because she learns things from me. That's an A++ reason. Any reason that's real will help. It won't FIX anything, but it will help.
3. Do not expect miracles from medication and therapy.
Speaking of fixing...
In some people, these steps do cause miracles. And if that happens to someone you love, be thankful, because miracles are rare and precious. But if what you get out of that person is instead two days out of the week that are better than they were before? Or the ability to communicate frustration where she could not before? Take that and run. And be proud when those moments happen. Let the person KNOW you are proud, not only for the progress, but for being willing to get help, to try different things, when, frankly, it's one of the hardest things.
On Thursday, I went to my prescribing doc. He really wishes I would go to the hospital, because I have hit the space where I genuinely have no capacity to believe life will get better than it is right now, and I have no interest in continuing on in this space. Or, as I said to my therapist when she asked me if I planned on doing another triathalon, "The thought of being alive long enough to do that is depressing."
I won't go to the hospital because I cannot afford it, either financially or time-wise, and because all it would mean is a bigger mess when I come out the other side. Additionally, I have a bunny who just got an ear infection, and I'm the only person who can take care of her the way she needs. My bunnies are actually my last line of defense. I remind myself regularly that nobody is going to take an almost nine year old and almost seven year old bunny and really pay attention to them and love them if I'm not around.
So, instead, my doc doubled my dosage. If this doesn't work, the next step is putting me on a THIRD anti-depressant, co-currently. Being honest, I sincerely doubt any of this will even take the edge off. Changing meds hasn't worked the last two times we've done it. I don't think it will now. I don't think going to therapy is doing anything, because I've reached the point where there's nothing more to say: something I straight up told my therapist this week. And that's the disease. It tells me, in no unclear manner, that nothing I do will help, that things will always be like this.
And I believe it, because I have no other choice. But I go to therapy and doctors because I know its the right thing to do. If you know a depressive who constantly goes and does the work, at her worst, she's not doing it because she believes it will change anything. She's doing it because she's supposed to. Hug her and tell her she's doing a great job and you're proud of her for keeping it up, even when it seems hopeless. Because, trust me: it does.
2. Do not let us go silent.
This is another hard one. For me, talking, really talking, when I'm like this, is a chore. I'm tired of hearing my own voice in my head. I don't have anything new to say. I don't want to pretend to be happy. Silence is my best option.
Which is why, once a week or so, it's important that someone find a way to get me to talk, even if I am saying the exact same thing. Things haven't gotten better for me in two years. They're unlikely to anytime in the foreseeable future. I'm not going to have a lot that's new and interesting to say.
Ask leading questions and listen anyway.
It's like this: I may be tired of hearing my voice in my head, but that's not going to shut it up. And a lot of the poisonous shit it says? Is just plain better getting released. When someone overdoses, we pump her stomach, because "better out than in." Depression is the experience of constantly overdosing on hopelessness without any affirmative action on one's own part. Someone's gotta go in and make us bring it all up every once in a while, because just like the drugs, if not as immediately, it will kill us.
1. Do not, do not, do NOT, EVER, say the words "things could be worse," or "just cheer up," or any variation thereof.
I actually get that for some people this helps. Those people are not chemical depressives.
Have you ever broken a limb, or had a bad flu, or cut yourself deep enough to need stitches? Out of curiosity, did thinking positive thoughts about getting better hasten your healing process? Because, if it did, you might have either mutant or angelic powers, and you should consider a career in televangelism, or something.
I can think all the positive thoughts I want. Realistic ones, even. Ones like, "I write well and research like a boss and have a really interesting professional and academic background: someone has to hire me sooner or later." Or, "Lots of people meet life partners much later in life, things are just taking their time." I can repeat them in front of the mirror every morning. I can use them as a meditation, whatever. My BRAIN does not believe them. Because my brain does not function correctly. Much like a broken arm, the essential function of my brain is in a state of disrepair and works on a basis of limited functionality. The difference is, fixing a broken arm is a decently exact science at this time. Fixing my brain? Not so much.
As far as the "things could be worse" approach, let me quote something I saw on tumblr, the font of all true wisdom. (That is a lie.)
"In breaking news, the person in the worst situation on planet earth was finally found and THAT person is allowed to be sad. No sads for anyone else, though, ever."
Like I said, I realize that for non-clinical depressives, this sometimes helps. I've met people who find it useful to think about the fact that they could, say, not have a home, or be going hungry, or be physically ill. And I envy the crap out of those people. Man, if I could make myself better by thinking about all the things that could be worse? I'd be the world's happiest chickadee.
For a moment, though, let's take it for granted that I don't actually want to be so miserable all the time that I would rather be dead. And from there, let's take the logical step that if it were that easy for me to feel better, I'd have already fixed the problem. I talk in this note about how, not only is using this approach unhelpful, it's DANGEROUS. It tends to cause a guilty reaction, which will not only make me stop talking--see point number two, this is NOT a good thing, it doesn't mean I feel better, it means I've been made to feel like my pain does not matter--but will stay with me, and very possibly trigger a cycle of even worse feelings of worthlessness than are usually an issue.
A sub-suggestion here is, "things will get better"? Also not helpful. I cannot convince myself of this. You telling me it? Feels dismissive, even if it is not intended to be. And again, it makes me feel foolish for not being able to make my brain believe it, makes me feel like I should stop talking, like I should go away. Away away.
So what DO you say to a person who's depressed? *grins slyly* Come back next week, mes amis.
Sunday, September 7, 2014
Some Housekeeping
One of my favorite essays in the world is "Axiomatic," by the late Eve Kosofsky-Sedgwick. At its most stripped bare, the point of the essay is this: assume nothing. I try to live my life by that approach. I fail a lot. But I try.
As such, I want to set up some basics here, so that when I say certain things, at least some of the guess work that might be inherent gets taken out.
1. I am in no way, shape, or form, a psychological or psychiatric professional. I did not so much as take Psych 101 at any point in my education. I have no social work background, or any type of work that might enable me to call myself an "expert" on the topics I'm speaking on in this blog. This all about personal experience and observation, absolutely nothing else.
2. I experience this world through the filters and privilege and lackthereof. This is to say: I am white, cisgendered, middle-class, American, a native-English speaker, able-bodied, thin, decently attractive by societal standards, and highly educated. All of those afford me privileges that both "normalize" me, at the same time as giving me chances others are not allowed, chances I might not even realize I've been given. Alternately, I am female, occupy a strange space between pansexuality and asexuality--which I generally describe as "queer" for simplification reasons--I am Jewish, and I have a chronic auto-immune disorder as well as the serious depression, generalized anxiety disorder, and avoidant attachment disorder diagnoses. These aspects of selfhood help me to see exactly how privilege operates, if they do not always give me the ability to see every aspect of it. (As a sidenote, it is because I am female and cisgendered, and for no other reason, that I will use female pronouns in this blog as the universal.)
3. Although I use the tags "mental health" and "mental illness" in this blog, let me be specific: this blog is about depression. Not bipolar disoder, not borderline personality disorder, not any other mental illness in the world. I do not suffer from those. Do I know people with them? Yes. Do I think that gives me the right to speak to them? Nope, not even just a little tiny miniscule bit. Depression is a mental illness or a mental health issue, hence I feel justified using those tags. But this blog is not meant to be a broad-spectrum mental illness discussion spot, please do not read it expecting such.
4. I want to set up some definitions. Again, see point one, these are not technical. They are definitions I've built up through common sense, and a lot of therapy--the receiving end. But these are three terms that I see confused and misused a whole wooly bunch, and in order to talk about depression-related topics, I need to separate them and clarify how I will be using them.
Sadness: Sadness is an emotion. It is in relation to something happening to a person that causes the emotion. It can be about loss or grief or fear. It can be confusing, and weirdly, it can be wonderful. Some important things about sadness are this: one, it is a real, justified response to something that has happened to a person, two, with time, it will go away--it might be a lot of time, depending on the cause--but it will resolve, and three, it can often be mutually exclusive from forms of depression.
Wait, what?
Yes. This is vital to understand: depression can be something so removed from sadness, that quite literally the person suffering from it cannot even reach a place where she can feel sadness, which is about connection to things. Sadness is, first and foremost, an emotion, and depression pushes a sufferer to a place where emotion is beyond them, ALL that exists is the depression.
Circumstantial Depression: Like the term would suggest, circumstantial depression is depression triggered by things that are happening to a person. I use the word "trigger" specifically. A trigger is not a cause. A cause has a causal relation, i.e., "my cat died, this makes me sad." Triggers are buried minefields. Yes, they CAUSE the reaction, but there's not an obvious A to B to C that can be uncovered and pointed out. For instance, a woman I once knew has PTSD from childhood sexual abuse. Her episodes are triggered by algebra for reasons she was later able to determine, but it's not as if the two had an obvious connection. Triggers are psychological, and therefore not always self-evident.
Circumstantial depression is usually caused by a type of "cascade failure" in life. For example, a quick series of major losses can trigger circumstantial depression. That does not make the depression about the losses themselves, but more about what a person might read as those losses saying about her.
Circumstantial depression is the baby brother to clinical/serious depression, and, IF THE PERSON HAS THE BRAIN CHEMISTRY FOR IT, can trigger a serious depression episode. (Sadness can do this as well, although it is less likely.) If the person does NOT have that brain chemistry, circumstantial depression WILL resolve, so long as the community of the person suffering from it are supportive, rather than suggesting that if the person would just cheer up/relax/do this/do that. Circumstantial depression, like serious depression, causes suicidal thoughts and ideation, and people in the midst of it can be driven there by surrounding factors. Circumstantial depression looks almost identical to serious depression, but because it is environmentally-based rather than brain-chemistry based, with help and the right community, can be conquered and has the possibility of not returning.
Serious/Clinical Depression: Here is the single biggest differentiator between the first two terms and this last one: serious or clinical depression is the result of a chemical misfire of the brain. Yes, it CAN be triggered by environment and circumstance. It can also be triggered by a depressive's brain firing the wrong damn signal one day, and deciding to every single long dreary day after that.
Unlike the other two, which might--note my prevarication--be resolvable without intervention, serious/clinical depression requires treatment. There are some people who swear by so-called alternative therapies, such as acupuncture. There are others for whom meds are the only option. There are people like me who would have sworn meds were at least a stabilizing option who find that not even those work, and further methods have to be explored. But depression does not get better just because someone "should" be happy. It does not get better because a person "works hard enough."
It gets better--if it does--because the person finds the solution that kicks her chemical balance back into being. And I have yet to meet a single depressive who managed that by thinking positive thoughts. Depression, like, say, migraines, is real. Migraines don't go away because you don't want them to happen. They go away because you realize that caffeine is causing them, and you take yourself off all caffeine, so as not to have that chemical interaction in your body. They go away because your doctor finds the right pain medication to hold them off. Or maybe, sometimes, they don't go away, and that's just something you have to live with for the rest of your life.
Serious/clinical depression has no time frame and, at this time in medical science, has no surefire cure. And it has one purpose: to kill the person whose mind it has infiltrated. Depression steals hope, steals belief, steals the bright moments of reality. It steals and it lies and it cheats until it kills its intended target.
People who survive depression--by living long enough to die of some other cause--like people who survive other fatal diseases, survive because they fight with the ferocity of trapped rats and because, frankly, they are lucky enough to somehow be spared. We do not know why some people survive and others do not. We do not know why some can be "cured" or at least placed in remission, and others cannot. Mostly, those of us who live with it just know that it is our enemy. And it tells us that in fact, it is not an external enemy at all, but really who we are. That we, ourselves, are the ugliness and fear and terror and hopelessness. That we are the weapon cutting away at ourselves.
And so, when the outside world tells us the same? A lot of us hear. A lot of us listen. A lot of us destroy what we have come to understand as nothing more than a weapon, a device of destruction. We destroy ourselves.
The depression takes another life, tallies it to its win count, and laughs.
THAT is what defines serious/clinical depression.
As such, I want to set up some basics here, so that when I say certain things, at least some of the guess work that might be inherent gets taken out.
1. I am in no way, shape, or form, a psychological or psychiatric professional. I did not so much as take Psych 101 at any point in my education. I have no social work background, or any type of work that might enable me to call myself an "expert" on the topics I'm speaking on in this blog. This all about personal experience and observation, absolutely nothing else.
2. I experience this world through the filters and privilege and lackthereof. This is to say: I am white, cisgendered, middle-class, American, a native-English speaker, able-bodied, thin, decently attractive by societal standards, and highly educated. All of those afford me privileges that both "normalize" me, at the same time as giving me chances others are not allowed, chances I might not even realize I've been given. Alternately, I am female, occupy a strange space between pansexuality and asexuality--which I generally describe as "queer" for simplification reasons--I am Jewish, and I have a chronic auto-immune disorder as well as the serious depression, generalized anxiety disorder, and avoidant attachment disorder diagnoses. These aspects of selfhood help me to see exactly how privilege operates, if they do not always give me the ability to see every aspect of it. (As a sidenote, it is because I am female and cisgendered, and for no other reason, that I will use female pronouns in this blog as the universal.)
3. Although I use the tags "mental health" and "mental illness" in this blog, let me be specific: this blog is about depression. Not bipolar disoder, not borderline personality disorder, not any other mental illness in the world. I do not suffer from those. Do I know people with them? Yes. Do I think that gives me the right to speak to them? Nope, not even just a little tiny miniscule bit. Depression is a mental illness or a mental health issue, hence I feel justified using those tags. But this blog is not meant to be a broad-spectrum mental illness discussion spot, please do not read it expecting such.
4. I want to set up some definitions. Again, see point one, these are not technical. They are definitions I've built up through common sense, and a lot of therapy--the receiving end. But these are three terms that I see confused and misused a whole wooly bunch, and in order to talk about depression-related topics, I need to separate them and clarify how I will be using them.
Sadness: Sadness is an emotion. It is in relation to something happening to a person that causes the emotion. It can be about loss or grief or fear. It can be confusing, and weirdly, it can be wonderful. Some important things about sadness are this: one, it is a real, justified response to something that has happened to a person, two, with time, it will go away--it might be a lot of time, depending on the cause--but it will resolve, and three, it can often be mutually exclusive from forms of depression.
Wait, what?
Yes. This is vital to understand: depression can be something so removed from sadness, that quite literally the person suffering from it cannot even reach a place where she can feel sadness, which is about connection to things. Sadness is, first and foremost, an emotion, and depression pushes a sufferer to a place where emotion is beyond them, ALL that exists is the depression.
Circumstantial Depression: Like the term would suggest, circumstantial depression is depression triggered by things that are happening to a person. I use the word "trigger" specifically. A trigger is not a cause. A cause has a causal relation, i.e., "my cat died, this makes me sad." Triggers are buried minefields. Yes, they CAUSE the reaction, but there's not an obvious A to B to C that can be uncovered and pointed out. For instance, a woman I once knew has PTSD from childhood sexual abuse. Her episodes are triggered by algebra for reasons she was later able to determine, but it's not as if the two had an obvious connection. Triggers are psychological, and therefore not always self-evident.
Circumstantial depression is usually caused by a type of "cascade failure" in life. For example, a quick series of major losses can trigger circumstantial depression. That does not make the depression about the losses themselves, but more about what a person might read as those losses saying about her.
Circumstantial depression is the baby brother to clinical/serious depression, and, IF THE PERSON HAS THE BRAIN CHEMISTRY FOR IT, can trigger a serious depression episode. (Sadness can do this as well, although it is less likely.) If the person does NOT have that brain chemistry, circumstantial depression WILL resolve, so long as the community of the person suffering from it are supportive, rather than suggesting that if the person would just cheer up/relax/do this/do that. Circumstantial depression, like serious depression, causes suicidal thoughts and ideation, and people in the midst of it can be driven there by surrounding factors. Circumstantial depression looks almost identical to serious depression, but because it is environmentally-based rather than brain-chemistry based, with help and the right community, can be conquered and has the possibility of not returning.
Serious/Clinical Depression: Here is the single biggest differentiator between the first two terms and this last one: serious or clinical depression is the result of a chemical misfire of the brain. Yes, it CAN be triggered by environment and circumstance. It can also be triggered by a depressive's brain firing the wrong damn signal one day, and deciding to every single long dreary day after that.
Unlike the other two, which might--note my prevarication--be resolvable without intervention, serious/clinical depression requires treatment. There are some people who swear by so-called alternative therapies, such as acupuncture. There are others for whom meds are the only option. There are people like me who would have sworn meds were at least a stabilizing option who find that not even those work, and further methods have to be explored. But depression does not get better just because someone "should" be happy. It does not get better because a person "works hard enough."
It gets better--if it does--because the person finds the solution that kicks her chemical balance back into being. And I have yet to meet a single depressive who managed that by thinking positive thoughts. Depression, like, say, migraines, is real. Migraines don't go away because you don't want them to happen. They go away because you realize that caffeine is causing them, and you take yourself off all caffeine, so as not to have that chemical interaction in your body. They go away because your doctor finds the right pain medication to hold them off. Or maybe, sometimes, they don't go away, and that's just something you have to live with for the rest of your life.
Serious/clinical depression has no time frame and, at this time in medical science, has no surefire cure. And it has one purpose: to kill the person whose mind it has infiltrated. Depression steals hope, steals belief, steals the bright moments of reality. It steals and it lies and it cheats until it kills its intended target.
People who survive depression--by living long enough to die of some other cause--like people who survive other fatal diseases, survive because they fight with the ferocity of trapped rats and because, frankly, they are lucky enough to somehow be spared. We do not know why some people survive and others do not. We do not know why some can be "cured" or at least placed in remission, and others cannot. Mostly, those of us who live with it just know that it is our enemy. And it tells us that in fact, it is not an external enemy at all, but really who we are. That we, ourselves, are the ugliness and fear and terror and hopelessness. That we are the weapon cutting away at ourselves.
And so, when the outside world tells us the same? A lot of us hear. A lot of us listen. A lot of us destroy what we have come to understand as nothing more than a weapon, a device of destruction. We destroy ourselves.
The depression takes another life, tallies it to its win count, and laughs.
THAT is what defines serious/clinical depression.
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