Since I was 17 years old, I’ve been prone to bouts of debilitating depression, particularly in March. By my mid-twenties, mid-August joined the annual mix. In my thirties, the holiday season became a danger zone. Over the past few years, late February started feeling left out and joined the gang.
But even if you see the tsunami approaching, you can’t always outrun it.
Depression is a chronic mental illness. Like a migraine, it can be brought on by a circumstance or simply appear out of nowhere. Its severity can range from dull malaise to life-threatening. It is often progressive, which means that periods of depression tend to become longer and worse as one ages.
What started as a one-week occurrence in my teens now adds up to several episodes totaling two to three months of my year, every year, including days during which my capacity to function is nearly nonexistent.
Of course, life doesn’t stop. Mental health days off are not a thing, not really, especially when your business doesn’t run with out you or if you’re not paid unless you show up to work. Depression can be a wedge in any relationship and threaten the most routine of daily tasks, like getting out of bed or eating a square meal or changing out of pajamas.
There are treatments for depression, yes, but the fact is that we just don’t know enough about the brain yet to effectively manage it or prevent it, let alone eradicate it. The balance required for maintenance changes by person and it shifts throughout one’s life. Like diabetes or back pain, chronic mental illnesses require constant vigilance. They don’t get cured and then go into indefinite remission. Depression requires daily attention to stay under control.
The amount of time, energy, and attention I put into activities just to maintain “normal” is significant. These days, I spend between 10-20 hours per week on these activities and an average of about $450 per month including out of pocket health care. (Fortunately, some things I do overlap with other important wellness maintenance, like going to the gym or getting enough sleep.)
Things that work: exercise, meditation, lavish sleep, one on one time with authentic friends, getting into flow on a project, therapy, support groups, spiritual practice groups, volunteering, singing, dancing, nature.
Things that sometimes work but not reliably: gratitude lists, podcasts, prayer, movies, mini vacations, social gatherings, eating nutritiously, books, music.
Things that work for a moment but usually backfire: alcohol, drugs, excessive sugar, cigarettes, shopping for things I don’t need, overdoing it on caffeine, self-help gurus, sarcasm/cynicism, overconsuming media, all social media, and texting that guy I really shouldn’t be messing with anymore.
I spent many years heavily using most of that last list because, well, they worked. But dependence on things like wine or weed for escape eventually becomes its own problem, and increasingly dangerous.
Five years ago today, I divorced alcohol and drugs completely. In terms of instant mood adjustment, this seriously set me back. I feel ALL my feelings now, all the time and acutely. Learning healthier tools has meant a ton of work, including opening myself to difficult truths about the dark side of my coping mechanisms and stunted emotional maturity. Don’t get me wrong, it’s been a net positive. But it necessitates constant vigilance and consistent care.
Without the old shortcuts, I’ve had to double down on my mood management, incorporating tactics including therapy with a psychologist, medication with a psychiatrist, practical strategies with an addiction counselor, body work, moving across the country to have an easier lifestyle, support groups, mentors, journaling, nature, meditation, and avoiding triggers, all while figuring out who I am aside from the labels and trying to build a life and community that’s awesome enough to pull me through the worst slumps.
I’m not a psychiatrist; this is my own, inherently flawed and ever-evolving perspective on what works and what definitely does not. My personality is such that when I’m diagnosed with something, information makes me feel in control of it. Hence, I’ve devoured hundreds of books, academic studies, blogs, documentaries, and podcasts on the invisible illnesses with which I’ve been diagnosed.
But the irony is obvious: I am managing the dysfunctioning thing with the very thing that is not properly functioning.
Sometimes it works; sometimes it doesn’t. My best efforts at maintenance can be thrown off track by unexpected circumstances like a snowstorm or a shitty client or a romantic disappointment. That’s when I go to emergency mode, a combination of getting through the day at minimal capacity and leaning on my closest friends.
There’s no formula to getting out of a depressive episode. It’s a waiting game. One day, it just switches. Until then, you do your best, which may not look like very much.
I do know the #1 thing that doesn’t work: when people, including myself, respond as though the conditions with which I contend are merely a choice, a weakness, a character flaw, or nonexistent.
Here are the things we say to one another to be “helpful,” which in fact betray respecting mental illness as a medical condition which should be treated by medical professionals and evidence-based lifestyle modifications:
Make a gratitude list!
It could be worse!
Snap out of it!
Happiness is a choice!
Stop rehashing the past!
Everything works out for the best!
God never gives us more than we can handle!
Those are first-world problems!
I call this Spiritual Bullying – the act of directly or indirectly suggesting that someone be at another point on their personal spiritual or emotional path than where they currently are right now.
When it comes to mental illness, Spiritual Bullies insist that my mind functions in the same way as a healthy person’s, and that the tools or amount of effort it takes for them to feel joy is the same for me. It isn’t.
Believe me, I do it to myself too.
A therapist put it this way: I compare myself to others halfway through a five-mile race without acknowledging that I ran another 30 miles before the starting line.
Either mental illness is real or it isn’t. Most of us who try to be aware and compassionate agree that “we need to take mental illness seriously,” including sufficient access to treatment in our health care system, schools, and even workplaces. Yet, we undermine these conscious sentiments by treating those suffering from mental illness with much less compassion or active support than those suffering from a physical illness like cancer or Crohn’s, even though the effort it takes to push through the day might be just as daunting.
When I dip below the invisible line of okay-ness and into depression, I can only see the underbelly of everything. It is like being underwater. It is like seeing everything through shit-colored glasses. It is like every cell in my body has a weight inside it. I am tired. I am fatigued. I am on the verge of tears. I believe I am a burden to you. I do not feel hope. I am incapable of optimism on my own behalf. I believe the game is rigged against me. I am fiending for the tiniest hit of dopamine.
It is not a choice; it is chemical. The choice is only possible once I’m back above that line, and then it’s imperative to practice that long and ever-shifting list of self-care strategies that keeps me above water.
Of course, the worst bully of all is myself. I’m an Olympic archer when it comes to what Buddhists call “the second arrow,” making our suffering (the first arrow) worse by feeling terrible about it, shaming ourselves about it, or avoiding the pain altogether.
So, I keep trying to learn from my friends how to speak to myself more constructively and compassionately. Here are the things that are helpful:
I’m so sorry you’re going through this.
I love you.
I think you’re amazing.
You got through it last time so I know you’ll get through it again.
I still want to hang out with you even if you feel like you’re not at your best.
You’re right, it’s not fair.
You can call me anytime, even if you just want someone to listen.
You don’t have to be amazing today.
Thank you for sharing with me.
Or, just sit with me and breathe through it. Be patient while I feel the feelings, until they pass.
Artwork © Fiona Aboud