Saturday, October 22, 2011

Living with depression

This is something I really haven’t given much thought to. If you were to look back at this blog, which constitutes pretty much all my thinkinhttp://www.blogger.com/img/blank.gifg about depression since I started it, you’d probably find that around 75% of it are posts featuring me whining about my self-diagnosed chronic depression, around 20% about one or another alternative cure I’ve considered, 5% about miscellaneous stuff, and the remaining 37% about how bad I am at math. But, actually coping with depression, living day after day with this dark companion, is something that I’ve avoided altogether both in my head and on this blog, at least as an explicit topic of conversation. I’ve been so concerned about how much it sucks and how great it will be when I get over it that I’ve missed the obvious. To quote Jack Nicholson’s line, “What if this is as good as it gets?” What then? How have I coped and survived until now and how will I continue to do so?

A few weeks ago, I got an email from a teenager in Australia. Let’s call him Tom. He is also depressed. It appears to be chronic and he’s getting help. He’s not hiding it and, under the Australian health-care system, he has access to real help. So good so far, right? He emailed me because he felt that I, being someone more than twice his age with roughly the same set of problems, could provide some insight that the best of his counselors haven’t so far. To paraphrase because I didn’t ask permission to quote him, he basically had two questions based on the single premise that, since he seems to be stuck with this depression thing for life: 1) Is it really worth it to go on? 2) If so, then how does he cope with it because all the meds and counseling in the world, though they can help, might never make it really go away.

I didn’t ask his permission because I didn’t know if I would respond at all. I’m still not sure, as I type this sentence, if I can come up with something worth saying. I’ve been pretty flummoxed since I got his email. Given that I’ve never really considered question 2, it gave me a lot to think about. How have I coped? Do I really know or do I plod through the day, fearful of the alternative? I’m still not entirely sure.

Let’s tackle question 1 first. We’re talking about suicide although he never said it. It’s something to talk about. Most professionals and patients seem to treat suicide as the no-no, hush-hush alternative that we must never speak of or even allow ourselves to consider. I don’t really have a problem with it, I really don’t. Who’s to say that a person in a severe depressive episode is in any less pain than something who’s body is failing from a terminal disease. Your conclusion about whether or not someone in the latter situation should be given the ability to kill herself may be different from mine but, in the post-Kevorkian world, I think that we can all agree it’s something that should be considered and discussed. Ah, you say, depressive episodes pass and the person has the chance at life beyond it. True, but a life punctuated by random, unpredictable depressive episodes may be too much for one to deal with. Ultimately, the moral positions on suicide are not unlike abortion – they are too wrapped up in personal ethics, religious beliefs and societal mores for there to be a clear, universal answer. I believe it should be a personal choice. I do not consider someone who commits suicide to be immoral or even wrong. (The exception in my mind is when one commits suicide when he has obligations, financial or otherwise, to his friends or family. It is condemnable to leave behind someone to clean up the mess that he was too cowardly to clean up himself.)

But, none of that really addresses Tom’s question, does it? Is it worth it to go on? Here’s the answer that seems to have evolved in my life. Yes, for the most part, it’s worth it to go on. I have more good days than bad and, most of the time, I’m hopeful about the future. I’m also curious about the future; I really want to know how things will turn out. It seems a little silly to base my mortality on seeing the plot through but it works for me, somehow. I’m also damn scared of killing myself. At my lowest moments, the thing that kept me from doing the deed can only be described as pure cowardice. So, is it worth it to go on? As I said before, so far, for me, it beats the alternative.

Okay, then, on to Tom’s second question. How to cope with it? This is the bit that really stymied me. I really don’t know how I’ve coped. As I turned this question and the answers I could think of over in my head I began to realize that I was writing a commencement address – seek your happiness, be true to yourself, love your family, blah, blah, blah. Like I said, Tom’s a teenager and he’s set to graduate soon enough. I’ll leave the platitudes for the C-list actor who happened to graduate from Tom’s high-school and gives that speech the year he graduates.

So, I tried harder to come up with real answers. The thing about depression is that it is our problem. It is fairly well defined and we kind of have a list of things it does to us. However, everyone has problems, right? I heard of a study a few years ago that says that babies and toddlers feel the same level of anxiety over their little dramas as we adults do. It seems silly to consider that a missing toy leads to the same amount of stress as trying to figure out how to pay the utilities on a limited budget but, apparently, it does. My point is that I think humans tend to look for and focus on points of tension in our lives. We depressives are lucky in a twisted way in that we know the source of our tension and we sort of know what to expect from it. Other people with a different set of less definable problems are trying to deal with them as best as they can. I’m not sure if I’m making my point very clearly here or if I even really had one to begin with. Let’s move on.

As I’ve stumbled through life, I seem to have settled to two key points that guide me.

The first is to know your depression. This means that it’s important to learn when depression is making you feel a certain way or real life circumstances are. Rage, anxiety and sadness are all occasional symptoms of depression. They are also symptoms of the human experience. Whenever you feel extreme emotions, take a beat and try to identify if it’s a result of real life or some meaningless, internal storm. I’ve lost friends and alienated family members over not being able to tell the difference. Innocent comments can be misinterpreted when observed through a depressive filter and turned into insults.

My second best bit of advice is never blame your depression. I’m talking about both externally and internally. Externally is easy. Just don’t do it. Never use your depression as an excuse for your actions. If you are an ass to your best friend because you misinterpreted an innocent comment while you were having a particularly low day, don’t say you did it because you are a depressive. Your depression might have influenced you but final decision to lash out was yours. Apologize, hope he accepts it and move on. This isn’t to say that you never talk about your depression – your friends might be a great source of support for you - just don’t rely on it as an excuse for your bad actions.

More importantly, never tell yourself that you acted a certain way or made a bad decision because of your depression. Once again, depression might have influenced you but, ultimately, you are responsible for what you do. Blaming depression becomes a crutch, relieving you of all responsibility and that can become a vicious cycle: I’m even more depressed now because my life sucks because I made bad decisions because I was depressed at the time so now my decisions are going to be even worse and my life will suck all the more. Depression may be a part of who you are until the day you die but never let it define who you are.

I tried to avoid platitudes but that last sentence came dangerously close, didn’t it.

So, Tom, there’s my answer. I’m sorry it took so long but you really threw me on that one. You gave me a lot to think about and I hope I gave you a little insight, too. Best of luck, brother!

This blog post contains a sponsored link.

40 comments:

Jen said...

I hope it's not rude to chime in, but I really appreciated that you had the guts to talk about suicide. I'm a mental-health professional and I am NOT ALLOWED to compassionately, objectively, and openly discuss suicide. If the client hurts themselves and I didn't report it (which may impact things like their release from the hospital, their being allowed to go back to school, etc), the family can sue and I will lose everything. License, job, career, finances, everything. It drives me up the wall because suicide needs to be discussed without triggering a firestorm of consequences. Any smart person will keep their mouths shut in the healthcare environment.
Thank you for talking about it.

But also as a mental-health professional, I have to say this: be very clear what constitutes "responsibilities" that should rule suicide out. I have worked with a number of family survivors. A lot don't get over it. Depression can convince you that they are better off without you - try to see past the depressive filter. I once spent over an hour crouching on the floor next to a man so literally crushed by his daughter's suicide that he couldn't stand up. This was years after he lost her.

I'm not trying to preach from on high here - just trying to make sure that those who read this blog know about the aftermath. It's ridiculous to expect someone suffering from severe depression to be as brave as they have to be. Sometimes it might help to know that by being so brave, you're sparing others terrible suffering.

I'm speaking in platitudes too. Sorry. Feel free to delete my comment if you feel it's unhelpful.

The Pursuit of Happiness said...

Thanks, Jen. This is interesting and helpful. Clearly, my view of suicide is a bit naive.

Anonymous said...

Really insightful post- and really difficult email for someone to write, and for someone else to read and then answer. Suicide- well, it's very much out there, isn't it? It definitely doesn't exist, but then again, it's so scary to broach. Eight years ago I attempted said subject in a way that us usually effective and also considered particularly violent (won't say how...I definitely don't want to give anyone any ideas here). Regardless, as fast as I was treated at the normal hospital ( by people who were clearly pissed at me- can't blame them there for acting like I was wasting their time) I was sent to a mental hospital and I can tell you now-there was zero sympathy there by the staff. I practically had a staff member there spit at me and yell at me. Horrible. And then I saw my parents....they came every day for their allotted time and were wonderful, but to see the pain it caused them then, and frankly, how it still affects how they treat me today (kid gloves, mostly) breaks my heart sometimes. Then there's my siblings, who had a really hard time knowing what to do/ forgiving me/ being scared for me: it would have destroyed my family. Friends? Well, not many stuck around for that. People don't "feel sorry" when you commit suicide- they get pissed off and/ or so terribly sad and affected. It isn't your life you're taking but the lives of the people around you. I've rebuilt, restructured, gotten "better", etc. But I'll never be able to get private health insurance outside of marriage :) and I'm fortunate that I have. Sometimes (not always...) but most of the time, yes, it's worth it. The alternative is not.

Melanie said...
This comment has been removed by the author.
Melanie said...

Ray,
I am so glad you addressed using depression as a crutch/excuse.

I used to argue with my counselor over this subject over and over. I REFUSED to give myself excuses for my actions because of my "mental issues". Finally we got to a place where we saw eye to eye. No...my depression was NOT an excuse for my behavior BUT...it was a fact! I WAS DEPRESSED! So...he allowed me to see that I needed to forgive myself for the wrongs I had done and the way I had behaved (towards my husband and children), make restitution for those mistakes and try to move on. It made a world of difference. I was able to let go of the guilt attached to things and try and make them better.

I also LOVE this: "Depression may be a part of who you are until the day you die but never let it define who you are."

Thanks for this post.

Hilarity in Shoes said...

Great post. I used to think that everyone kept the idea of suicide in their back pocket, in case things became too painful for too long, but I've come to understand that my belief is heavily influenced by being passed through my poor serotonin-deprived brain.

As far as not using the big D as an excuse, I think the challenge is a little more complicated--for me, anyway. It's understanding how depression affects your life and behavior and learning to manage it so that it doesn't negatively affect other people.

Not using it as an excuse is good advice, but I think it's helpful to draw a bright line between letting yourself off the hook for bad behavior born from depression and admitting that depression impacts your behavior and that it's your responsibility to correct that.

love?! said...

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love?! said...

ps.: i quoted you! i hope that's okay with you!

love?! said...
This comment has been removed by the author.
noch said...

i empathize everything you said here
i go through the same thoughts in my head all the time as i struggle with my depression and suicidal ideations

Anonymous said...

I've lived with depression my whole life _ I'm now 52_ and the only answer I have about going on and not ending it - is just like with any chronic illness bad bouts do pass. Life does go on and sometimes if you just concentrate on taking the next breath before you know it it's tomorrow and then the day after that and all of a sudden the sun is shining again.
I don't think anyone who has suffered from a real depressive bout doesn't think about suicide. Depression is PAINFUl - but not permanent. Just like you would for any flare up of an illness get treatment, take care of yourself (like you would someone you really loved - pretending can work) and take one breath at a time.
It's worked for me.

Robyn Wheeler said...

Hi!
I just wanted to say thanks, for posting such a well thought out post from someone actually experiencing depression. It can be hard to hear from professionals and friends about how to cope with something they themselves don't suffer from.

Look forward to more posts!

Goth Girl said...

I use depression as an excuse all the time, i know its wrong but its just so easy, it justifys all my actions, and i dont really know how to be normal and do normal things depression might as well make itself useful

Diaz said...

hello.
First of all I would like to tell you that I am very impressed on how open you dare to speak about your feelings. I think it is at least one step in the right direction: talk about it - don't swallow the pain.
Although I am not depressive myself I still feel I can relate a lot to you - in fighting an inner challenge. One that prevents me from moving on and live the life I want to live.
I've been diagnosed with burnout syndrome 2 weeks ago and try to work through it with my blog http://burning-noticed.blogspot.com. I'd love to know what you think of it.
Anyhow, I will come back soon to find out how you are doing... Until then: All the best! Be strong...

Jen said...

I wrote a reply that somehow didn't post, sorry. I don't think your view is naive at all. It's rational and it's thoughtful. And you're stepping up right where the mental health system gets all worthless and pathetic.

Anonymous put my concerns better than I did :).

jv61 said...

Ray, thank you for starting this discussion. I have struggled with depression most of my adult life, and have thought about suicide many times, wondering whether life with all its difficulties was worth living. At times the indecision paralysed me and kept me from making changes that could have improved my life.

To make a long story short, I made a concsious decision to assume that life was worth living and that suicide was not an option. I didn't really believe it at first, but I acted as if I did. "Fake it till you make it", as they say.

That was in 2004, and it worked. Thinking that way became a habit, and I haven't had any suicidal thoughts since then. I have started a new career, had relationships and generally gotten on with my life.

I'm not saying this is a cure-all for suicidal urges, but it worked for me.

Anonymous said...

I live with a severly depressed person. I also have had issues over the years. I have found lately that my depression is getting worse. I have seen my spouse get hooked on the drug train and they take 9 different drugs. I will not take any drugs. I left all that behind in my teenaged years. I am 54 and have been married for 36 years. I take my vows seriously. When I went for theropy the theropist suggested I leave my spouse. I cant and wont do that but I cant keep living the way I do. I do not see a future that I want to be a part of. I feel trapped, miserable and dont want to keep going. The only thing that keps me here is I have to take care of my spouse cause they havent left the house in 4 years.

kaye said...

I had my first severe suicidal episode in 1982. Since then I've learned enough to be happy most of the time, although it's not perfect. I beat myself up over this at times, but I also accept now the reality that depression is a chronically relapsing condition. That is the nature of the illness - however happy I feel at any given time, I may become depressed again. I try to focus on using the things that work for me (writing down the good things, bright light, exercise, changing distorted thoughts, diet, planning activities esp pleasure, setting and working on goals, paid work, activities that put me in 'flow', such as writing)on a regular basis so they become my default position. I also keep a watchful eye for signs that I might be going downhill and take action to stop it. (I write about what I do to maintain my happiness on my blog at www.habituallyhappy.blogspot for anyone who actually reads this comment and wants to hear more!)

So my personal answer to question 2 'how will he cope with chronic depression?' is something like - try a whole bunch of things, find what works for you, and find ways to keep doing those things. Also - the happiness you create might not be perfect but it's much better than being chronically depressed!

In answer to question 1/ is it worth it going on? I guess my answer is - I'm still here. I almost died from a suicide attempt in 1996. I've been suicidal at times since but never acted on it again. I guess a big part of the reason for that (apart from the happiness I experience, which makes life much easier) is that when recovering from the attempt (which doctors thought I wouldn't - that's how severe it was) I had an overwhelming feeling that I was here for a purpose and my work wasn't finished yet. I've never lost that feeling. Even though I'm bedridden a lot of the time with a chronic physical illness, I focus on my goals, my sense of purpose, and that's what keeps me going on the bad days. The combination of happiness and meaningful goals is what gets me through, makes it worth it.

Luanne said...

Thanks for your blog. It's really very difficult to talk about depression, especially about suicide. It's a very delicate subject and I really admire how your cope up with these.

Again, thanks

Das said...

It hurts to read this post =(
Very much so.
As you, I do not have the courage to commit suicide AND I am afraid of what might come next (I'm not religious, but what if?) AND last but definitely NOT least: I don't want to hurt the people I love most.
=(

David Wayne McCannon said...

I have attempted suicide more times than I can remember. My life is some much better now. Times are hard and I do need work like many others as well. Drugs, ECT, and other Psychiatric treatments never were effective for me. I have not taken any medications over the last year, and my relationship with Jesus Christ keeps me going. I have wrote about my story on my WordPress Blog Called Safety in Counsel. Have a Merry Christmas! David

kiivibo said...

just stumbled upon your site when looking for a depression web-blog to empathize with during my depressive episodes. i'm not exactly sure if this is a good coping mechanism for me--to be reading about the inner workings of a depressed person. It's not any offense to you; I just don't know what I expect to get out of reading things I can empathize with--like whether it makes me feel better that other people out there feel the exact same way or it makes me feel worse because we're all caught in this downward vortex of self-pity and loathing. But regardless of whether or not reading this helps me get out of the rut, I do enjoy your entries. Much thanks.

erza mae lirica said...

Wow, this is one of the greatest blog posts I've read. I admire your bravery to talk about suicide, as it is a very difficult topic to discuss. I pray for better days for you.

Daniel said...

Great post. I just got started blogging about my depression.
http://danielandtheblackdog.blogspot.com/

Ann Maria said...

Thank you for your blog. I'm struggling today and am really sick of it. I always want to beat my depression once and for all but I think the answer is just keep trying things. Right now I'm going to love myself,tell the depression to f--- off, have a glass of wine, play loud music Whatever. Thank you for your blog. Are you still posting?

Joyce Batens said...

Thank you for sharing your story. I agree with you that it is important to know your depression and to not blame it. I have learned a lot of ways to help treat my own depression through the helpful website http://onlineceucredit.com/edu/social-work-ceus-dy . I recommend anyone with depression looking to help themselves to check this website out.

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Horror Movie Medication said...

I'm 25, and trying to deal with my depression which is quite crippling. I am getting medicated and working with a therapist, but I also discovered something else that helps me personally. Check it out at my new blog.

http://horrormoviemedication.blogspot.com/2013/02/why-horror-helps.html

keep up the good fight.

Horror Movie Medication said...

I'm 25, and trying to deal with my depression which is quite crippling. I am getting medicated and working with a therapist, but I also discovered something else that helps me personally. Check it out at my new blog.

http://horrormoviemedication.blogspot.com/2013/02/why-horror-helps.html

keep up the good fight.

Horror Movie Medication said...

I'm 25, and trying to deal with my depression which is quite crippling. I am getting medicated and working with a therapist, but I also discovered something else that helps me personally. Check it out at my new blog.

http://horrormoviemedication.blogspot.com/2013/02/why-horror-helps.html

keep up the good fight.

Raven's Haven said...

I agree with the platitude...don't let it define us. I also agree with "Horror", though not by the same means. Identify what might be triggering an episode, then Divert. Isn't diversion what works best, besides meds of course? Ha. I'm a Believer, so I have the positive influence of Christ and prayer. I immerse myself in things and places I love (if I can move). I stay out of my head as much as possible during bad days. I just started writing again (blog of course) and this helps too. Best of everything!

Anonymous said...

Thanks

Chelsea Sawyer said...

Really great piece. I used to feel the same way but not anymore. It would be a same to admit I once thought of suicide too but realized that there's more to life than what I have experienced. Meds didn't work for me but the support I got from my family and friends helped me get through it. I did natural depression treatment. Thanks for this. Great read!

Joyless said...

how can I tell my story, hoping it may help me

Joyless said...

I am 67 years old and have been mostly sad all of my life. I have everything that any person my age could possibly want, monetarily and with family. I've been in therapy for 25 years and on every possible medication. I'm so sick of it. My family is unaware because I'm such a good pretender. I really have 2 me's and I like the fact that everyone thinks i'm happy.
Is there anyone else out there that feels that way

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