Depression and Identity Politics

I was talking with a friend the other night about self-identification, and the way diagnoses can become a huge part of how we view ourselves.  I got to thinking about how I define myself in relationship to my depression, which is an illness.

I do define myself by a number of identity traits that are or are not inherent.

So, for examples, I consider myself a Jewish person.  Jewish first, person second, not because my personhood is necessarily subordinate to my Judaism, but because my Judaism informs such a huge part of my life that it's only reasonable the adjective should come before the noun.

I am a woman, or, following on the prior paragraph, a female person.  For that matter, I'm a cisgendered female person.  Again, the vast majority of my outlook on life, the decisions I make, are based from a cisgendered female perspective.

To make certain I'm not leaving those parts of myself that are privileged unmarked, I am a white person.  At the same time, I am a person of Russian and Polish descent.  And here we see where the "person" comes first.  My whiteness defines me because it inherently defines my experience in relation to others.  My heritage does not.  It is a part of me, it does not encompass me.

I am a writer, because I am driven to write, because I write in my head, because writing is something I could not live without.  I am a person who plays bridge, a person who swing dances, because I do those things, but the world would go on turning for me were they to disappear from my life.

Which begs the question: am I a depressive, or am I person with depression?  I like to think it's the latter.  I like to think that the illness does not control so much of me that it comes before my rational, even normative--to a degree--thought process.

People with cancer are not cancerous, or "cancer people."  People with asthma generally do not define themselves as asthmatic in terms of personality, in terms of what drives them as people.  Obviously, these are not direct parallels, since, outside of brain cancer, neither of these illnesses affects the mind, and how our mind works is so often how we define ourselves as human beings.  Still, the fact remains, it is not considered healthy to define ourselves by our physical maladies, and yet it seems to be no surprise to people when persons with mental illnesses see that as a driving force for our personalities.

I argue that they are certainly part of us.  Perhaps even a significant part.  But I also argue that we, like people with MS or Lupus or Crohns, are doing our best to get along despite the presence of the disease.  It informs our personalities, it should not define them.

To wit: we are not mentally ill persons; we are people suffering from mental illnesses.

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.