by Doctor Science
In honor of the darkest day of the year (in the Northern Hemisphere) (when I started writing this), I'm going to give some advice relevant to a post that's currently going around tumblr:
The problem with a history of depression and anxiety is that you can never know if you're "just having one of those weeks" or if you're sliding back down into those places you swore you'd never go again.This is not actually true. As someone with >more depression-mileage than most on tumblr (as in, diagnosed and dealing with it for more than 20 years), I can say that no, you *can* know if you're "just having one of those weeks" or if it's more serious.
This advice is for people who've already been diagnosed with depression or depression+anxiety, gotten a bit better, and now wonder if they're relapsing, just having a bad week, or whether they're in a situation where feeling depressed is the normal human thing to do.
1. Have you been taking all your medication? Without a weekly pill caddy or something similar it's probable that you'll miss some of your meds, because (in addition to normal human forgetfulness) depression and anxiety make a person forgetful and easily confused. And, as my husband says, "when you miss your medication *we all do*."
2. If you're starting to feel Really Bad again, especially if it's anxiety, you need to step back and drop something you're trying to do. This is one area where it's really good to have a spouse, partner or other very close friend to monitor you and give you permission to have a "mental health day".
3. Although online friends are great and can be life-saving, you *really* need someone who physically sees you and talks to you to keep an eye on your mood -- it's too easy to fake being OK if you text communicate by text alone, or even by (audio) phone. I'd like to hear from you-all if you think Skype or other video calls are significantly harder to fool.
4. What I call Big-D Depression really does, for me, *feel* different from "normal" depression: the kind you get after the death of someone close, or a terrorist attack, or other seriously depressing event.
Now, not everyone's experience of depression is the same. Allie Brosh of Hyperbole and a Half describes her Depression as losing the ability to feel *anything*, which is boring and horrible:
As I've described it before:
For me, it's really painful, in a very physical way -- it feels like wearing a lead vest, so that every breath requires exertion and stress. And yes, it is *intensely* boring -- boring and painful, the worst combination. And it stretches out in front of you, forever, nothing but pain and crushing boredom as far as your imagination can reach.My point is that your personal Depression may feel more boring or more painful, but it will differ in both degree and in kind, in "taste" or quality, from the kind of depression you feel from grief or a breakup or a war. There will be a "flavor" that you can get to know, that may warn you when you're starting to slide in that direction. And *that's* when you talk to someone (your partner, your doctor) about adjusting your circumstances and/or meds to keep you from sliding all the way down.
It's like, the doctors all say that one problem with high blood pressure is that it is "silent", you can't tell when you have it. I've been being treated for HBP for quite a few years now (10, maybe? I can't remember), such that my BP is usually around 120/80. Maybe because I've had periods when I've had to check my BP frequently (with a home monitor), I can now feel when my diastolic pressure gets above 90 or so. It's a distinctive pressure/dizziness, too subtle for me to recognize before I got the home monitor and had used it for a while. But now, I can detect "silent" HBP -- or that I have bad sinus congestion, it's not a perfect system.
But, my point! and I do have one! is that you can learn to pay attention to your body, including your mind, enough to not be blind-sided by your own emotional weather. The downside is that you learn not to take your own emotions at face value: just because something feels awful or devastating doesn't mean it really deserves that emotional intensity. Maybe it does, but I, at least can't rely on there being a strong correlation between significance and emotion.
I don't know how much my skepticism about my own emotions carries over to other people. It probably has to, to some extent, but I don't feel that I *despise* people because they feel things strongly. Instead, I try to cut people more slack -- as I hope they cut it for me -- because I know from my own experiences how emotional responses can be very real, but still illogical or disproportionate to the thing to which they're attached.
As for the quote I started with, it talks about
sliding back down into those places you swore you'd never go again.But what you can never do is swear you'll never go there again. That would be like swearing you'll never have a relapse of any other illness. Depression & anxiety aren't *choices you make*, they're chronic illnesses, and need to be treated as such: with respect, but nothing more.
Here comes the sun.
I agree, you can tell. My own experience going up and down depending on whether I could afford my SAMe enabled me to clearly identify the sort of thinking that went on during depressive episodes. A kind of logical spiral that I didn't otherwise engage in.
Posted by: Brett Bellmore | December 23, 2013 at 09:27 AM
"For me, it's really painful, in a very physical way -- it feels like wearing a lead vest, so that every breath requires exertion and stress. And yes, it is *intensely* boring -- boring and painful, the worst combination. And it stretches out in front of you, forever, nothing but pain and crushing boredom as far as your imagination can reach."
I can attest to that. And I have relatives who know immediately when they are about to slide into it.
I've taken a med for relatively short periods of time in the past when things became clinical, but no longer do (that'll be enough with the rolling of eyes, people).
Mainly because, I think, that when I came to myself at the mid-point of my life (no, it's always been that way) of a dark wood where the straight way was lost, I found some sort of perverse compensatory contentment in the beauty of the wood itself and the crooked path looping back on itself, and the occasional Beatrice, because it was a crack of light between two eternities of darkness, as Nabokov wrote, or maybe just a practical joke without a point, which is merely amusing, and if amusement is all I get between now and the extinguishing of the light, then that's O.K.
Here comes the sun.
I like George's formulation but Paul's and John's bipolar "It's getting better all the time (it can't get no worse)" will be my epitaph.
Posted by: Countme-In | December 23, 2013 at 10:33 AM
Have any of you all read Hyperbole and a Holf? It started out as a blog and is now a book. Very funny, with charming illustratins but with one of the scariest and most insightful first hand descriptions of depression that I have ever read.
Posted by: Laura Koerbeer | December 23, 2013 at 10:35 PM
humans have a very complex nervous system, which is prone to a lot of weird frailties. and just to raise the ante, we have a capacity for self-reflection, which means we get to observe ourselves being complicated fragile and weird.
we might be the only beings who can suffer while contemplating themselves suffering. yay for us. :(
i'm inclined to agree that there's a palpable difference between spiraling down the rathole of clinical depression, and just having the plain old blues. the clinical thing not only puts you in the hole, it robs you of the tools to dig yourself out.
and yeah, there are meds that can fix that, and if you need 'em, take 'em and don't look back. life's too short as it is.
in the meantime, here on the northern side of the axial tilt, as of about a day or two ago, we're heading back into the light. so. yay.
in the spirit of that, and inspired by the count's comment, a brief musical offering.
may it lift your spirits.
Posted by: russell | December 24, 2013 at 12:28 PM