Monday, August 17, 2020

Concerning Depression

Hello. I am The Great and Mighty Nobody and I suffer from depression. In fact, I have what’s called major depressive disorder (MDD) - also known as clinical depression. Now, I know what you’re thinking, but it didn’t come about in the wee hours of November 8, 2016, nor on January 20, 2017. (Although, those two dates didn’t help matters.) In fact, living with depression has been part of my daily routine for over a decade. Now, as enjoyable as that may sound, after struggling with it for well over 4000 days, I can assure you that it is not. Suffering from MDD is downright awful. Any morning I wake up and decide to face the world is a victory.

According to the World Health Organization (WHO), depression is the leading cause of disability worldwide.1 In 2017 alone, the National Institute of Mental Health estimates that 17.3 million Americans over the age of 18 suffered at least one major depressive episode that year.2 Employing a bit of mathematics, that’s one out of every twelve adults in the US, which means it is likely you know one or more persons suffering from depression at any one time. (And maybe more so as the US continues its skirmish with the Covid-19 pandemic.3)

I’m not sure how many people know, or suspect, I have MDD. There are only a few people I openly speak to about it. Not out of embarrassment or shame, but simply because it’s not something I often want to talk about. When I see or talk to people, I want to enjoy myself, and blathering about my depression isn’t my idea of a good time. That notwithstanding, it is important to discuss from time to time, not only because one should, but because it helps people to better understand me. For I’ve found, if you haven’t experienced a depressive episode, it is very difficult to understand someone who has.

Depression can be frustratingly crippling. It permeates nearly every aspect of one’s life. It affects you mentally and physically, wreaking havoc on mind, body, and soul. In essence, depression can lock you in a personal prison from which it can be difficult to escape. My goal today is to convey to you just how crippling it can be.

The best analogy I can conjure is that of getting caught in quicksand while on a jungle safari. At first, you don’t think there is anything wrong. Sure, the people you trusted to accompany you on this crazy adventure are slowly moving away from you, failing to notice that you’ve fallen behind, but you assume after taking a break to catch your breath, you’ll easily catch up. Eventually, however, you realize the problem is larger than you originally believed. Your people are still visible, but they’re moving farther away, and though you’d really like to join them, doing so will be difficult with your feet ankle-deep in viscous sand.

At this point, you feel slightly embarrassed. Your entire party walked this same path yet you’re the only one who stepped in it. You consider yelling out for help but realize that might be overly reactionary.  “Okay,” you think to yourself, “this is no big deal. I’ve been in scrapes in my life and I’ve navigated my way out of them. How different can this be?” Yet, no matter how much effort you put in or what tactics you employ, you sink deeper.

Eventually, you begin to panic. You know wriggling around only makes it worse but you can’t help yourself. With the quicksand up to your knees, things are starting to become unbearable. Finally, you call out. A few members of the group hear you and wander back. At first they’re confused about the situation. They have no idea how you’ve gotten yourself into this mess, and moreover, having never been caught in quicksand, they have no idea how to help. Some offer words of encouragement:

“You can do it.”
“You’re a strong person, I know you’ll get through this.”
“You can do anything you put your mind to. I’ve seen you do it.”

Others say rather different things:

“I’m not sure what you want me to do.”
“Look around you. Everywhere you look there are things you can grab onto. Just pull yourself out.”
“Suck it up, buttercup.”

In different circumstances, these things might be helpful, but considering you’re up to your hips in quicksand, they are not. You understand that, in their own way, each person is trying to be helpful. Nonetheless, you’re sinking, and hope is waning. Your head tells you to scream out, “Why the @#&!$ are you all just standing there? Help me!!!” but your heart says, “Let the people go on ahead. They have busy lives to lead and it would be unfair of you to burden them with your silly insecurities.” And, without being specifically asked for assistance, that’s what they do.

Consequently, you find yourself belly button deep with only your own devices to rely on. Normally, this wouldn’t be a problem, but with the pressure the quicksand is exerting on your body and the mental stress the whole situation is causing, your mind is failing to work properly. Your thoughts have quickly become disorganized. When you do finally think of something, you second guess yourself over and over again. You think, “Okay, I will just reach over and grab that vine. It’s securely wrapped around the branch of that tree so I shouldn't have any problems pulling myself free.” Unfortunately, that’s when your head starts messing with you. “You could grab that vine, but what if pulling on it causes the branch to break and the branch strikes you on the head? That would only make matters worse. Also, is it really a vine? How many movies have you seen where someone grabs a vine in the jungle and, in reality, it’s a large snake? Then, not only would you be stuck in quicksand, but you'd be cast in an unwatchable J Lo/Ice Cube vehicle as well!” (Frankly, I'm not sure which is worse.)

You’re aware these thoughts are irrational, yet they cause indecision, and that indecision causes you to be pulled deeper into the mire in which you’re stuck. And it just becomes a vicious cycle from which you cannot remove yourself.

If I beat that analogy to death, forgive me. But, to be honest, it’s a fair assessment of what living with depression feels like. I’m not necessarily speaking for others, yet I wouldn’t be surprised if some might agree. If my quicksand analogy was confusing, let me offer you another, much shorter glimpse, into the brain of one with MDD. This is something I wrote a few years ago that might help you understand the mindset of someone deep in the throes of melancholia.

I cannot picture the future. When I look ahead there is nothing. Not even a blank canvas that I hope to fill with my dreams and desires. I imagine when others look ahead, they see themselves walking/living beside a significant other, making a change in the world, growing contentedly old. But I see nothing. There is no future. It’s just today and tomorrow and they look exactly the same. Nothing exciting, interesting, or hopeful exists in either day. No matter how hard I try, I can paint no portrait of the future me. It’s simply black on black, void of anything good or decent. And that is what I have left to look forward to. To most of you, that probably sounds sad and pathetic, but for me, it's worse than that. It’s heartbreaking. I don’t want it to be that way, it just is. That is what each day is like for me; a futile attempt to discover meaning in the nothingness of my life.

For an even shorter summary, watch this 10 second clip from the movie People Places Things starring Jemaine Clement.*#

 



Forgive me if all of that was a bit morose. It is no easy task to honestly explain the struggles one faces on a daily basis when trying to manage their depression. And that’s what most of us who have depression are doing - managing it. On any one day, the symptoms someone may experience include:

  • Feelings of sadness or hopelessness
  • Anger, frustration, or irritability
  • Lack of interest in normal activities (even those they enjoy)
  • Sleep issues (either lack or excess of)
  • Lack of energy and motivation
  • Weight gain or loss
  • Anxiety or restlessness
  • Feelings of worthlessness, guilt, or self-blame
  • Trouble with mind-related tasks: memory, concentration, focus
  • Thoughts of suicide or self-harm
  • Seemingly unrelated physical issues4

It’s almost never all of these at once, but it’s usually a combination. Of course, there are ways to combat depression. Therapy, medication, mindfulness, exercise, and an improved diet can assist in alleviating depressive symptoms.5 Having said that, for many people, it can be a long road to wellness. Depression can’t be cured - the goal is remission.6 Take it from me, after battling with this mood disorder for over a decade, even temporary remission would be welcome. Other than four months in 2016, when I walked from Plymouth Rock, MA to South Bend, IN, there have been astonishingly few days I haven’t been fully aware of the existence and persistence of my depression.

I don’t imagine reading this post was nearly as interesting or provoking as the others I’ve written this year, but it is by far the most personal. For the last 12 months, I’ve been going to therapy, and more recently, started trying different medications. I've been attempting to form new neural pathways and to rewire old ones in my brain. However necessary, it is a task that is both laborious and tedious, thus, fraught with its own difficulties. I admit I haven’t been very successful. It is exceedingly difficult, but I must remind myself, if I still possess the desire to try, there might still be hope yet.

If you know anyone suffering from depression, or you suspect might be, be empathetic. Be supportive. It is a debilitating condition. I’m not asking you to give them a pass if it begins affecting the lives of others negatively, but a little understanding goes a long way.

Ultimately, the only way out of depression and into remission is through one’s own efforts. If someone doesn’t take the steps needed to improve their own situation, anything you might do to help will come up short. Yet, providing understanding and support is helpful. Listening can be more important than providing solutions. And, in my heavily biased opinion, a hug can be the most comforting act in all the world. Just wear your mask!

Also, this may be cliche, but it's vital - if you or someone you know is in crisis and needs immediate help, call the National Suicide Prevention Hotline at 1-800-273-TALK(8255) or go to their website https://suicidepreventionlifeline.org/


1 https://www.who.int/news-room/fact-sheets/detail/depression

2 https://www.nimh.nih.gov/health/statistics/major-depression.shtml

3 https://www.massgeneral.org/news/coronavirus/depression-on-rise-during-covid-19

4 https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007

5 https://www.mayoclinic.org/diseases-conditions/depression/diagnosis-treatment/drc-20356013

6 https://www.healthline.com/health/can-you-cure-depression#7

People Places Things, a 2015 Beachside Films Production, Written & Directed by Jim Strouse 


# Very few of you have seen this movie. Watch it. It’s good. You can trust me. I don’t know much, but I know movies. And, if you like this one, contact me. I would be overjoyed to provide you with other titles you might want to check out.

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