Rise II: It’s Time To Talk About Depression
August 3, 2018 § 3 Comments
Over a year ago, I published a blogpost about anxiety in which I wrote about the stigma surrounding mental illness and described what anxiety is like for those who might not understand it.
The response I got blew me away. For weeks afterward, friends, coworkers, volunteers, family, and even Internet strangers told me how they too managed to live with anxiety, that they felt like someone else understood their struggle. I had included tons of resources and – judging by the responses – they seemed to help my readers as much as they had helped me.
That blogpost and its subsequent reactions only furthered the thought I had when I first wrote it, which was that we as a society need to talk more about mental illness.
Mental illness – which the American Psychiatric Association defines as a health condition related to changes in thinking, behavior, and/or emotion – is stigmatized even today. One common misconception about mental illness is that it doesn’t really exist; people with one of the many illnesses are either making them up, trying to get attention, or not trying hard enough to be ‘normal.’
Without getting into scientific articles about psychiatric reviews or necessary diagnoses (which do exist, if you are so inclined to look them up), mental illness is real. Just as a physical disease affects the human body, mental illness affects arguably the most important part of our physical buildup: the mind. Most importantly, they are treatable.
One of those mental illnesses is depression.
This is probably a good place for me to post ***TRIGGER WARNING*** so those of you who don’t want to read about depression can go somewhere else.
It’s difficult to find a place to start. I wasn’t really sure what exactly I wanted to say when I began this, other than having a general desire to a) explain depression to those who might not understand it; and b) provide help and resources for those who live with it.
I initially kicked things off by writing the sentence: “Depression is an incredibly personal journey.” My intention was to dive a little bit into my experience with depression that occurred during a good portion of my teen years and arose again several months ago.
And that description didn’t seem right, because journey gives the idea that depression is a heroic quest, during which the hero is saddled with a task only he/she can accomplish through action and heartbreak and bravery and the triumph over evil in the end. Like depression is a means to finding one’s true self and going on the adventure of a lifetime.
Then I wrote: “Depression is an incredibly personal odyssey.” That gave the impression of a heavier, scarier, darker version of a journey, which seemed a bit more fitting.
But even that wasn’t right. An odyssey is a lot more complicated than a journey (especially in The odyssey, where complexity is usually synonymous with dumbassery), but it still gives the impression that things happen. Friend and foe are met. Battles are won and lost. Lessons are learned. Tasks are accomplished. Odysseus comes home to his family.
With depression, there is nothing.
Emptiness.
Darkness.
In the last post, I likened anxiety to a Something. Depression is a Nothing.
Sometimes, you get both. If you’re among the 50% of individuals with depression who also have anxiety (Morin, 2018), the Nothing is punctured only by the ebb and flow of the Something – a harrowing, terribly unpredictable path.
Depression alone is a mental illness that affects 300 million people all over the world (World, 2018). In the United States alone, 16.2 million people suffer from depression and every year, 44,000 of them commit suicide (Morin, 2018). Suicide is the second leading cause of death for people aged 15-24 and the tenth leading cause of death for everyone in the U.S. (Morin, 2018).
And yet there’s still a stigma around depression. People feel the urge to hide it, to push it down, to put forth an image to the world that they’re fine, everything is fine. Only one in five people with depression receive treatment “consistent with current practice guidelines” while 37% receive none at all (Morin, 2018).
Some people wait years before getting help. Some people don’t know help exists. Some people don’t know what they have is treatable.
And then we get stories like this one.
Or a close friend or a relative or a neighbor or a coworker is gone without warning.
Or maybe – just maybe – one night, from the depths of the long-lived Nothing in your mind comes the thought that you would be better off dead.
Over the past few months I have seen a number of stories and posts about the seriousness of this disease, and we need to continue to bring depression into the limelight. Not so we can glamorize it, not so we can make #IHaveDepression a trend on Twitter.
So we can understand and combat it.
Not everyone understands what it is we’re understanding and combating here. That is why I’m writing this, a Part Two to my last post, if you will.
And as was the case with Part One, I don’t want to write this.
I need to.
I lived with depression for over three years, from the time I was fifteen to nearly eighteen years old.
Then, several months ago, my mental health once again spiraled almost completely out of control.
Some days, all I could do was curl up in my bed and stare at the wall.
Functioning as a human being became a nightmare. Every day I could barely do my job or keep my little household running. Saying words to people in a way that made sense, walking around on my own damn feet, even getting out of bed in the morning became suffocatingly, painfully difficult.
And those were the days that thoughts I’d had when I was sixteen came billowing back, unwanted, unannounced, into my brain:
There’s no point to any of this.
Nothing matters.
I don’t matter.
When my alarm went off in the morning, I would wake up feeling heavy. After days, weeks, a month, I couldn’t feel anything but that weight. Honestly, some mornings the only thing that got me out of bed was knowing my two cats and my horses relied on me.
I spiraled for many reasons, none of which need to be writen here.
And one night six, seven weeks ago ago, the whisper returned.
The whisper that came from the Nothing that took over my life then and was creeping back now.
The whisper that I’d heard when I was sixteen, when I’d Googled where to buy guns and at what part of the head one should aim.
And that night, I knew I needed help.
Part of the way I deal with things is by pondering them and then writing about them, preferably in storytelling-format with lists and charts and figures and references and color coordinated bullet points. That’s the type-A perfectionist in me. My professors loved my papers in college almost as much as I loved writing them.
And so this post is just as much about compiling a detailed explanation of depression from the point of view of someone who is currently fighting it as it is about offering some resources for those who might want them. (Spoiler alert, to rid you of any concern right away, I am getting professional help in addition to sitting over here making my lists.)
I’m not the only one who has gone through this, far from it. And before I went through it, I certainly didn’t understand it.
And so, we go to the part of this post where – hopefully – I pass on some facts about depression that will better explain its seriousness and complexity, sans color coordination. There are charts and references, though.
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1. Depression and sadness are not synonyms.
In the same mindset that stress and anxiety are not synonyms, it is important to understand that sadness is not one and the same with depression.
Depression does not mean extreme misery all the time. At least, not after a while.
See, when you’re falling into a depression, at first you feel things too much and all at once. You have too many feelings and processing them is a challenge, if not an impossibility.
And suddenly, at the peak of when you should be feeling all the feelings, you don’t.
You shut down.
You lose your ability to feel. To care.
You feel hollow, empty, void of any direction or purpose.
I wish I could make that sound less melodramatic, but there’s no other way to explain that depression is the true essence of Nothing.
Sadness is a temporary feeling that is a normal reaction to a situation. Depression is not normal. It is longer-lasting, deeper, and accompanied by feelings of poor self-image, being overwhelmed, or feeling a general hopelessness – all of which is hidden behind a mask.
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2. There are several causes – and signs – of depression.
I won’t get into details of brain chemistry here or anything like that. Suffice to say that depression strikes people in different ways and for different reasons, and sometimes that reason is – seemingly – no reason. Certainly some people are more susceptible to it than others based on their experiences or genetics. But it is important to understand that anyone can experience the following:
Anyone can also experience any of the following known factors that can contribute to depression (taken from PowerofPositivity.com)
- substance abuse
- poor self-image
- isolation or rejection
- being overworked
- compassion fatigue
- trauma or grief
- physical health conditions
The point here is that – similar to other diseases – depression manifests itself for different reasons, and in different ways, for everyone.
More on this later, but I find it important to note here that it can be extraordinarily difficult to detect signs of depression in other people.
At the end of this blogpost are tons of resources and among them is an article or two about how to catch signs of depression from friends or family. I encourage you to read them.
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3. I don’t want to write this one.
*** Trigger warning: suicide ***
Skip down to number four if you need to.
I’m just going to say it. Suicide is a card that’s either in your hand or facedown on the table when you have depression.
In the past few months, suicides have struck the news with alarming proximity. Everybody knows someone – or knows of someone – who is deceased due to suicide.
And I always hear the same question from everybody left to pick up the pieces after they are gone: “Why??”
Here’s my answer to that question. And I’m sorry to go here, really. But it needs to be said.
People suffering from deep depression don’t want to kill themselves. They just don’t want to be alive anymore.
A drug addict doesn’t want to shoot up heroin. An alcoholic doesn’t want to take another gulp of vodka. They want – need – to fuel their body’s craving.
It’s a means to an end.
If depression gets bad enough, suicide might be viewed in a similar way.
It’s not that we want to die.
It’s that if we don’t get help, if we don’t pull ourselves back or get pulled back from the Nothing, we don’t want to live.
As George Washington says to Alexander in Hamilton: “Dying is easy, young man. Living is harder.”
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4. Your “just be happy!” attitude is insulting and hurtful.
I get it. People mean well. They want to help and not comprehending how depression works can lead to some ill-placed advice or insensitive comments.
I’m here to say, any insistence on us turning a magic switch to become sunshine and rainbows is about as tactful as dangling a piece of candy over the head of a five-year-old and insisting he reach up to grab it.
Of course the five-year-old is going to jump up as high as he can with his arms in the air. He wants the candy. But like the child, those with depression are physically incapable of accomplishing a task at hand, be that eating a Snickers bar or suddenly becoming joyous and cheerful.
When I was a teenager, back before I knew what I had was depression, I remember getting so frustrated for not being able to turn a dial in my brain at the request of my family and be happy. “What’s the matter with you?” I heard. “Stop feeling sorry for yourself.”
If I was ever pressed for more detail about what was wrong – be it from my family or others – I could only come up with the description of feeling empty. And the number of times I’ve been told – then and now – that maybe I just need to try essential oils, or do yoga, or meditate, or eat clean, or exercise, or start a gratitude journal, or smile (just smile!), or volunteer at a food bank, or take a bath, or focus on the positive….
Yes, all of those are great contributors to a healthy, positive lifestyle. I’m not denying that. But – depending on the cause – depression requires more aggressive treatment that can range from many types of therapy to many types of medication. You wouldn’t tell a diabetic to go smell flowers rather than take her insulin. You wouldn’t tell someone in a coma to snap out of it.
Please don’t tell us to just be happy. Trust us, we would if we could.
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5. We feel like a burden on others.
This is as straightforward as it gets here. Because we feel like our mess of non-emotions is a burden on others, we feel the need to hide depression from our loved ones, strangers, the world.
For me, part of that desperation to hide depression was denial. See, if I admitted something was wrong, then I would have to face it head on.
Also, because parts of society are lacking of understanding about depression, it is a hell of a lot easier sometimes to just swallow back the Nothing. Sometimes it’s a hell of a lot easier to let someone think they’ve helped, when in reality all they’ve done is cheerfully informed you that you just need to see the sunshine and rainbows.
Here’s the main takeaway: don’t assume. Ever. You’d be surprised what lurks beneath the surface in a lot of people.
And I’ve found that usually, those who seem like they have it all together are the ones falling apart.
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6. Asking for help isn’t just hard, sometimes it feels impossible.
In June, on the same night I admitted to my husband that I didn’t want to be alive anymore (which took more out of me than I could describe), I agreed that I needed help and promised him on the spot that I would make a call to an EMDR therapist, one my boss had recomended.
I didn’t call for almost a week after that night. Every day my husband asked if I’d done it and I made excuses.
Finally, one late afternoon he came into our room where I was laying in bed, staring at the wall, and asked if I’d called.
“No,” I said.
“You should call her now.”
“It’s a quarter to five. She’ll be in a session or on her way home.”
“Why don’t you leave a voicemail?”
“I’d rather call during her regular hours.”
“She’ll get back to you if you leave a voicemail.”
“I’ll call tomorrow.”
Silence. Then, gently, lovingly, from him:
“You said you would call.”
He wouldn’t call for me. He could support me, he could encourage me to do it, but if I wanted to get help, I had to be the one to ask for it.
My hands shook and my heart rate rose as I finally picked up my phone and dialed. I swallowed the lump out of my throat and tried to steady my voice as I left a voicemail for the therapist. She called back half an hour later and after talking for a long time, we scheduled my first appointment for within the week.
And when I sat down in the waiting room to fill out the paperwork on the morning of my first session, blinking back tears, it took all my courage to not run out the door as fast as I could.
Here’s why it’s hard to ask for help: the only way out is through.
Getting help means we have to wade through the darkness and confront it. The way out is painful and terrifying.
We don’t know how long it’s going to take. We don’t know what we’re going to face.
Help us get help. Be understanding. Be insistent. Be gentle. Help us be brave.
Which leads me to this:
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7. Please don’t give up on us.
We are doing the best we can.
~
The hardest thing I’ve ever done in my life is live when I’ve wanted to die.
I wish I could soften that, somehow make it less shocking or upsetting.
But I want you to know – yes, you – that if you have ever felt this way, you are not alone.
Since the end of June, I’ve been going to an EMDR therapist weekly as well as making some changes in my daily life that are turning the consuming Nothing into a manageable Nothing.
But help looks like a number of things. Because depression is different for everybody, as you can imagine, there’s no one-size-fits-all treatment plan available.
The first thing – the most important thing – is this number.
1 (800) 273 – 8255
It’s easy for me to say please call this number if you are having thoughts of suicide. It’s easy for me to say that is the first step towards recovery.
I know it’s hard.
Be brave.
Remember, you are a worthwhile investment.
If therapy is an option for you, please know there are many types available. This is a great infographic that breaks them all down. To repeat what they say, please consult a trained professional to determine what therapeutic route would be best for you.
Remember, you are a worthwhile investment.
Help also looks like self care. One little change in your day that makes something easier, or brings in a little bit of brightness. Maybe it’s telling someone no. Maybe it’s canceling plans. Maybe it’s eating a piece of chocolate cake.
Whatever it is, as long as it’s not physically or mentally harmful to you, do it.
Remember, you are a worthwhile investment.
And while I can’t find an infographic on medication, please know that antidepressants help millions of people around the world. If it is an option for you, contact a mental health professional or your doctor to better discuss what is available.
Remember, you are a worthwhile investment.
~
In the same fashion that I didn’t know how to start this, now I don’t know how to end it.
I titled Part One to this “Rise” after this song. I was surprised by how much I loved it, given I’m not a fan of the artist’s usual work (sorry, Katy!). But the song holds a great deal of personal meaning to me as I heard it for the first time in August of 2016 when my anxiety worsened for the first time in years.
I listened to it all through those hard months. I hummed it while I powered through the last semester of my master’s degree. I sang it to my mare in her dying days. I think it to myself now as I struggle to found her legacy.
I listen to it again now – with a new challenge in front of me – and find such power in the chorus. Maybe you will, too.
When the fire’s at my feet again
And the vultures all start circling
They’re whispering, you’re out of time
But, still I rise.
This is no mistake, no accident
When you think the final nail is in, think again
Don’t be surprised
I will still rise
If you’re been reading this, and have thought to yourself you relate to something I’ve written, please know you are not alone. Please know that someone is here for you to stand in your corner while you fight. Whether we’ve met in person or only know each other via the Internet, whether we are good friends or acquaintances, I care about you.
Rise. Keep going.
One of my favorite books has a quote by which I live:
“The weakest step toward the top of the hill, toward sunrise, toward hope, is stronger than the fiercest storm.” ~ Joseph Marshall III.
Sometimes it’s easy to consider one step in the right direction a measly, useless little effort. That’s what the Nothing wants you to think.
But the truth is, you don’t have to be looking at the top of the hill. You don’t have to make a heroic charge towards sunrise. You don’t even have to have an abundance of hope. Only a scrap will do.
Just take one more step. Just a little one.
That step is stronger than you know. You are stronger than you know.
Rise. Keep going.
Remember, you are a worthwhile investment.
You are enough.
You are always enough.
Rise.
And keep going.
Don’t be surprised
I will still rise
~
SOURCES
HERE are facts and statistics (used in part for this blogpost) from The Anxiety and Depression Association in America.
The American Psychiatric Association breaks down what mental illness is HERE.
For those looking for easier reads, my personal favorite post about depression is from Allie Brosh of Hyperbole and a Half. Her comics are so articulate and acurate, with a little humor attached, and it is very informative. Here is both PART ONE and PART TWO.
THIS ARTICLE shares some ways you can help a loved one with depression. Similarly, here are 15 SIGNS SOMEONE IS SUFFERING FROM DEPRESSION what NOT to say to someone with depression and what to SAY INSTEAD.
THIS ARTICLE discusses the important distinction between depression and sadness.
Finally, HERE is the website for the Suicide Prevention Lifeline.
CITED WORKS
Morin, A. (2018, March). How Many People Are Actually Affected by Depression Every Year? Retrieved from https://www.verywellmind.com/depression-statistics-everyone-should-know-4159056
World Health Organization. (2018, March). Depression. Retrieved from http://www.who.int/news-room/fact-sheets/detail/depression
Shorts and Snippets 
Oh, my dear and cherished friend Alexis, I so appreciate your strength in writing this blog. Just reading this reminds me, I and others are not alone in this maddening disease. I am here for you, or anyone else that suffers from the darkness of depression, to talk to at any time of the day or night. We will rise!! Know that you are loved by me and so many others.
Always, your friend
Holly
thanks for this! depression is now widely talked about but still, narrowly accepted, few understands really, a must read! would like to share this! 🙂
Excellent…every word true.