Disclaimer: this post is heavily personal, and not exactly cheery. It's also probably the most honest thing I will ever post on this blog, and easily the least emotionally-restrained. It has a lot of not-well-known info about me and my life that I've never been comfortable sharing. Depending on who you are and how well you know me, it may change the tenor of our interaction, and not necessarily for the better. Stop here if you aren't okay with that, or think I wouldn't be.
Still reading? Alright, you've been warned.
This post is about the effects and truths of depression and related mental illnesses, from a first- and second-hand perspective. I'll start by going over why I have whatever knowledge I do, since otherwise I'd just be talking out my ass. Then I'll go over the most important things to remember about this kind of stuff, basically a fact-or-myth about dealing with depression. I'll finish up with some opinions about more general handling of mental health issues, because what's a blog without opinion?
I've never told this to anyone without a medical degree, but in March 2012 I was diagnosed with mild-to-moderate depression. Though this was aggravated by a borderline case of anaemia, there's some evidence to suggest I've been dealing with depression since I was a pre-teen, most notably some hereditary predisposition and, oh yeah, the fact that I'm still suffering from it. Mild-to-moderate depression is basically what we'd call "high-functioning" if I were an alcoholic: it doesn't strongly affect how I go about my day-to-day life (usually), but it can still lead to significant problems down the road. What it basically boils down to is
- little or no motivation to do pretty much anything
- extremely low social energy at times
- tendency towards self-defeating thought processes
- a few other things I won't discuss here because my blog is public
(I don't want to even fathom the number of people who read that section and went, "Oh. That explains a lot.")
Why did I never tell anyone? Well, have you met me? Do I seem like the type to ask outside myself for help? Do I seem like the type to stop and admit that something is wrong?
I guess I'm doing my best to change that, now. (This post might not stay up forever.)
"But Jacob," you might say if you skipped the rest of this section, "you talk about severe depression later on. Surely you can't be as informed about that."
I'd respond with this ever-so-slightly more public information. In October 2010, I started dating a wonderful woman named Monica Post. This was somewhat against my better judgement because, while I was almost certain that I was madly in love with her, I was more certain that she was severely depressed, because I'd been one of the people to help her out of a particularly low point. Later we found out that she had Bipolar Disorder, an illness that is characterized by unpredictable shifts between periods of mania (over-confidence, delusions of grandeur, hyperactivity, hallucinations, psychosis, and general emotional instability) and periods of depression (which I described above, except stronger). In a move seen by those who knew as uncharacteristically mature and brave (I don't share this belief), I stayed by her for a little over three years, through the best times and the worst.
I really wish I didn't have to write in past tense. Monica died just under 4 months ago.
Aside:I've never openly written on this subject without some level of control over my audience. My level of "handling it" fluctuates from day to day. On the better days, I want the subject as far away from me as possible. On the worse ones, I'm not strong enough to write about it. This blog post is partially me saying, "Fuck that. I'm stronger than this." (Before you agree with me, keep in mind that I had to write this section in private because I'm shaking like a poorly-built house on a fault line.)
So uh yeah. Life experience is a bitch.
(Or as close to facts as I can get)
First and foremost, something I feel should always be mentioned: depression is mostly about chemical imbalances in the brain. If there's anything that bugs knowledgeable people the most, it's when people say to just "Get over it." Seriously, fuck you. That's like telling a person in a wheelchair to just get up and walk.
Now let's go over some treatment methods. The "simplest" treatment is psychotherapy, or, if you're in a lazy work of fiction, "lie down on a couch with a guy who looks like Freud and talk about your mother." The current main school of thought is Cognitive Behavioural Therapy, which focuses on harmful thought processes and destructive emotional responses. I say "main", but from what I've experienced I could also easily say "only," because I've never seen any other kind of psychotherapy suggested. In programming terms, CBT (as it's almost always abbreviated) is debugging your mind: constantly thinking, "Why did I think that? Where did that emotional outburst come from? Why am I so affected by this?" Luckily, most people are better at this than
gdb, since it's been shown to be fairly effective on anything short of severe depression (not to mention many other kinds of mental illness.) Hell, I'd say depression-free people can even benefit from it from time to time.
But sometimes it just doesn't work. You'd be surprised at how self-defeating a person with depression can be, and sometimes it's just too deeply-rooted in their thought process to be dislodged like that. Or it just takes too much energy, and depression takes enough away on its own. For that, medication is the next best thing.
Remember how I said depression is mainly chemicals? See, brains are hard. There's so much that can go wrong, and, even when it looks like the same thing is wrong in two people, they may not be helped by the same thing. Again, in CS-y terms, it's like supporting an Android app on every phone: there are so many subtle differences in hardware and the implementation of software that a bugfix on one platform is nowhere near guaranteed to work on all others. Hell, it might make things worse. That's why there are so many anti-depressants out there, and that's why some people spend their entire life finding the right one. (Ignore the implications of the wording. That's not what I meant.) Prozac might work for you, or it might make you more suicidal. Effexor might make you a little brighter, or it might numb your emotions. Cymbalta might make you more stable or (also likely) less. But, of course, SSRIs don't work that fast, so you won't know until 4 weeks in, and by then you'll be experiencing all the negative side-effects, and you'll probably go through withdrawal if it turns out it wasn't even working. Then you just repeat the process the next time you can see your psychiatrist, because, wow, it looks like they're booked through until December.
Sorry, that's a bit of a raw nerve. Back on topic...
There are more extreme cures and fixes than medication and thought-correction, but I won't go into them here because I won't be able to write about them while staying in a stable frame of mind. There are also less-extreme things that help. A huge factor, for instance, is proper physical health. I've noticed personally that it's easier to handle my symptoms when I've been keeping up a healthy routine of diet and exercise (though maintaining that through an episode isn't easy, to say the least). Obviously this isn't a cure, since the episodes still happen, but it has been shown to improve the stress reaction, which I think is the most important factor in getting through it. (Source) To put this in nerd-terms, this goes about as far towards computer performance as keeping your fan free of dust: it won't fix a crashed hard-drive, but it'll help out at times.
Where to begin?
Let's start off at the obvious: please treat people with depression (and any other mental illness) as people. Like, they aren't animals in a zoo or something, nor are they that mask of tragedy that hangs along its creepy-smile companion over every middle school drama department. They have just as much depth to their emotional state as any other person, and they really don't like to be labelled. I know the party-line is always about "removing stigma," but I feel like a lot of people who talk like that do very little to actually remove it, and in some ways actually further it.
On that note, the idea of a "mental health rally?" Stop. The last thing a depressed person wants is to be reminded of it in public. Further, you're making a social event for people with no energy for social activity. How does that make sense? Making people aware of resources available to them is one thing. Pointing out what's wrong in a public setting is another.
If you're having trouble, see a therapist at least once. I'm not saying to sign up for 10 sessions, just see if it helps and go from there. If you want a resource on CBT for some self-study, I found Mind over Mood to be pretty helpful.
Lastly, don't suffer in silence. Don't wait 10 years to tell your family you think something is wrong. Maybe don't blog about it, but talking to someone, anyone, will help, trust me. I'm probably pushing the blog-barrier again, but that's one of the things I miss most, which is likely why I'm writing about it now, as opposed to months ago.
Happy 3rd post! I'm going to go sit in my room for a while.