I apologize for my sporadic postings. Besides being physically sick, which is weird in and of itself because I’m constantly fatigued but am peppered with headaches, joint pain, and muscle aches throughout the day in addition to the infection that came back, and I’m also struggling a little bit with depression.
I surprise myself sometimes at how candidly I can speak about BPD and eating disorders, but depression is a different beast. I’ve been so proud, happy, and most of all, grateful that I haven’t been dealing with much of it since last November. Now though, I am kind of falling back into it and it’s a little scary (and honestly, embarrassing) to admit. I know why it’s happening now and at least that’s something. I’m again in a weird limbo phase of no longer a college student, but I haven’t begun my next chapter which will really start when I move in a few weeks.
Summertime is also my most difficult season because of my body image issues. I know I’m not alone in this but it is SO HARD to see “blog talk” and advertisements and such that’s all about running (I really RARELY see bloggers who are “healthy living bloggers” that don’t run) or exercising 5x a week, losing weight, how to cut calories without sacrificing flavor, etc. I think my idea of healthy living and the blog world’s idea of healthy living are just not the same, which is why I’ve decided to stop reading the more popular “HL” blogs that I’ve been following for a while. It’s unusually hard to do this, especially since “blogger” is kind of my primary identity right now.
It’s interesting to me how depression is the most difficult of my “issues” to talk about and I’ve been thinking for days how I wanted to approach the topic on my blog. After all, not only have I lived through a few serious bouts of depression, I just spent the last four months studying depression through a philosophical lens, and now I’m learning about it from a spiritual perspective. If I’m being honest, I know a lot more about depression than I care to, and most of it is from first hand experience.
You can read anything and everything about depression but unless you go through it, you won’t be able to really understand. I imagine the same thing is true for things like cancer and pregnancy. How foolish would it be of me to claim that I know anything about what it’s like to go through either when it’s never happened to me? I think that the reason that depression is one of the more shamed mental illnesses is because although it’s easy to throw around the phrase, “I’m depressed” when you really mean sad, bored, etc., many people perceive it as laziness and not trying hard enough. In other words, it’s a choice.
“I’m suicidal” is not a phrase that’s thrown around as casually as “I’m depressed” and for good reason, but depression is often not taken seriously or loved ones and supports get so frustrated that they can’t help the person suffering that they just don’t know what to do anymore. It is an incredibly difficult thing to go through, no matter what role you play.
According to the World Health Organization, depression affects nearly 121 million people worldwide every year and is among the leading causes of disability (source). Suicide is the 3rd leading cause of death of those between the ages of 15 and 24, and the 11th leading cause of death in the U.S., while homicide is 15th (source). So basically we have this global mental health crisis with millions of people suffering from depression, and although I don’t have any statistic to back this up, I’d be willing to say a fair percentage of those suffering also have co-morbid disorders such as a mood disorder (like Bipolar), personality disorder (like BPD), eating disorder, or substance abuse problems.
However, and here is where I might get a lot of disagreement, the WHO says that, “Antidepressant medications and brief, structured forms of psychotherapy are effective for 60-80 % of those affected and can be delivered in primary care” (source). Ok so yes, on the one hand, who am I to question the WHO? (Yeah, I had to use the abbreviation) I mean of course if a statistic says that half to most of those with depression can be helped by antidepressants and “brief, structured forms of psychotherapy”, then that must be true, right? To be fair, the WHO also says “fewer than 25 % of those affected (in some countries fewer than 10 %) receive such treatments. Barriers to effective care include the lack of resources, lack of trained providers, and the social stigma associated with mental disorders including depression” (source).
To me there seems like a big discrepancy between the two statements and I have to say (understanding that my own bias created by my own experiences and study of depression undoubtedly impacts this) that I believe the World Health Organization grossly underestimates or at least does not acknowledge the complexities involved in depression. This is not just a psychological illness that can be treated with some pills and “brief, structured” therapy (whatever that vague phrase is supposed to entail). This is a problem with philosophical, biological, sociological, and epistemological roots and without looking at a person as a whole, as someone with predispositions, a history, and a unique, complex life, we are just treating the symptom and not the cause. It’s like taking medication for chronic migraines without trying to find out why you are getting migraines in the first place.
These statistics fail to show for how long an individual must be on medication, if there are relapses (which there often are), the quality of life (does someone go from being depressed to being on a pill and getting a little therapy and then being completely happy and “normal”?), that there is a spectrum of depression (some people experience mild depression while others experience major depressive episodes lasting months or years with suicidal thoughts and possibly actions), as well as how many of those that are “effectively treated” never have problems with depression again. And what does “effectively treated” really mean? They certainly don’t attempt to define this, leaving it open to a lot of (mis)interpretation.
There’s so much more on this topic that I have to say, but I think I’ve said enough for now. It’s too important of an issue to me to just encapsulate in one post, but from my own experience and from my own research, the most important thing I think people need to know about depression is that:
1) It’s not laziness
and
2) It’s a whole lot more complicated than we are told and than what we think (both the illness and the recovery from it)
If you have made it to the end of this post, I thank you for staying with me. I know this is kind of a wave of information, thoughts, arguments, etc.
I hope you all have a great night and remember to treat yourself kindly.
{ 9 comments… read them below or add one }
Great post, Alex. I have a friend whose medications stopped working…and it’s been painful to watch the cycling on and off new medications and treatments in the hopes something will work…watching it has reminded me how insidious depression can be.
I’ve definitely had times in my life where I was “depressed” according to the textbook description (withdrawn, unable to concentrate, changes in appetite, feelings of hopelessness)…and I thought that was awful (and saw a therapist), I also know I was able to do all the things I needed to do (go to work, run errands), so when I think about the people who are affected to the point that they *can’t* function, I can’t imagine how painful that must be.
Thank you so much, Zo! Medications are incredibly tricky and SO frustrating. I’m sorry your friend is going through that, I can definitely empathize. I’m also sorry to hear that you went through times of depression and it’s still incredibly difficult to go to work and live life when you’re depressed. There’s this great quote by Viktor Frankl that says something like “the pain of human suffering is absolutely relative” so no matter what you are going through, it fills up your heart like a gas chamber (an interesting analogy coming from a man who survived four concentration camps). I hope I didn’t come across as saying that my pain was greater than anyone else’s. What I meant to say was that no matter what you are going through or how “deep” (for lack of a better word) your depression is, it impacts your life in a dramatic way. I hope I’m making sense. Thank you for your thoughtful comment and as always, for following my journey.
Oh, no. You didn’t come across as saying yours was “greater”…just that it’s hard to qualify/quantify the pain…I just know that in those moments where I felt I wasn’t handling things well, I would remind myself that at least I could get out of bed….it wasn’t so much to minimize my pain as to remind myself that I wasn’t totally overwhelmed/engulfed by it…and what that comes down to, I’m not sure…
Ah yes, another post I seriously adore. This is all so true and needed to be said. IT was so hard strangely for me to admit I was depressed and not the peppy all together Alex I tried so hard to maintain. I think depression was only exacerbated by my ED but stuck around longest. I hate saying it because people just think oh your sad all the time, just do things that make you happy If only it were that easy. The HL world is kind of hard to be part of when you are actively trying to recover because there are a lot of disordered eating and such around it. True but hard to admit. I needed to hear this today. I also hate to hear that you are feeling sick still, hang in there Alex, always thinking of you!
Hi Alex! Aw, thank you so much for the nice compliment! It’s nice to know someone else can relate to the fact that admitting depression is hard to do. Oh and I definitely agree that an eating disorder makes it worse, because if your brain and body are just trying to survive, there’s really no chance depression can get better because all the energy goes towards sustaining life, not increasing the quality of it.
It is SO frustrating when people say that- “Do the things that make you happy” or “Forget about the sad stuff, don’t think about it.” Really? Do people not think we’d be in this position if we had thought of that? I think that’s another misconception about depression, but I also think sometimes people say that as a last resort comment because they just don’t know how to help and wish they could. It’s all so very complicated and the stigma and lack of real discussion about the topic just furthers ignorance and stigma. People generally don’t want to talk about depression and that needs to change.
Thinking of you as well and hope you had a great graduation ceremony and a safe trip to MA! (my future home!)
I discovered your blog yesterday, and have really REALLY enjoyed reading it. I absolutely ADMIRE your courage in sharing this journey with others. It is hard enough to navigate recovery, no matter what the obstacles are or specific challenges, much less to bare your soul and publish your feelings, heart, thoughts and reality. Seriously, I can’t emphasize enough how admirable and courageous this is- it’s exactly because of feeling the fear and walking through it anyway, that is so amazing. Not fearless, but inspiring for feeling fear- and continuing on the journey, in spite of it (because of it- ?).
This post really resonates with me, as I know the internal process of “avoiding” facing the depression- did it for SO many years. When my silent, dark “partner” goes back into the shadows, and stays away, it is almost like there is this part of me that is always anxious, waiting for the other shoe to drop (when will it show up again?) I have to consciously remind myself that I have stayed ahead of the depression, kept it at bay, through very hard work, taking my medication, and being conscious of the reality that my chemistry set just will, well, go offline. While I want to and do all I can to try to prevent this, that having to even admit that my diagnosis (MDD with GAD) was “true” probably was the most difficult hurdle to clear. Once I had cleared that one, the rest were relatively “easier”. And, I have been at this now for 12 years. They are still much better years than all the years I needed treatment and didn’t get it, until I no longer had the option to avoid it. I know all this, and still think at times, well, I don’t have it as hard as my friends with [insert other diagnosis here]. Comparing is not good, but it is my way of trying to also not over dramatize my own situation- just respect in general, that lots of people are struggling. All of our pain is “legitimate”, and like you said about cancer, one probably never knows and can only surmise, until it happens to you.
You have eloquently summarized what it is like to have depression- and I especially related to the confusion most have about this mood disorder, and the overall stigma and unfair “just get over it” cavalier, throw away attitudes and comments so many people seem to have and make. It is so very ironic to me that these folks don’t seem to understand how insidious it is to be inside a depressed mind, which ONLY wants to feel “that” way- to be “normal”- to navigate life the way others do, so seemingly effortlessly. Or, at least without constant fear of cracking under pressure, stress and debilitating mood. I have been to the deepest depths, and in many ways, I know I have this new found, more clear “understanding”. I have survived suicidal ideation (which I thankfully, and again, ironically, lacked the effort and physical ability to act on – so exhausted and bed ridden by depression, I lacked an ability to carry through on my darkest thoughts. That probably sounds harsh, but I have accepted my dark sense of humor and how it helps me to find humor in the harsh cruelty of life sometimes- it is what it is. Laughing at it helps me).
I know what it means to not only slowly crawl out of the deepest, darkest pit I wasn’t even capable of imagining before I hit the bottom of it, and be healthy again. I also know what it means to survive the heart breaking loss and grief of two friends who did not survive their struggle, and completed suicide. I hope, beyond hope, that it has taught me greater compassion. I know it has enabled me to help others, and begin to educate others (I’m always the one people call now, when they want to talk about suicide. Weird, huh? Still, it seems like an important responsibility, and I am always about encouraging the honest, open dialogue).
I still work very hard on my internal dialogue, and behavior modification; I am now conquering other challenges (I quit smoking and drinking on May 8- YAY me!).
It is so important to share these realities, and not be fearful of what others think. I think – and you have expressed this in other posts- that when we are our authentic, true selves, we found out who the authentic, caring souls are along the way, that are capable of simply letting us be who we are, feeling as we feel. We also learn not to put any weight or importance on the others who just aren’t capable of that, and let them recede from and out of our lives. That is probably one of the greatest gifts of my experience in aging- as time passes I truly care less and less about “what would others think?” and all those non-healthy, non-enriching thoughts and neuroses.
I have found that by refusing to play into the stigma language, I know I have helped others open their minds to understanding mood disorders are diseases, and if nothing else, they should be grateful they “just can’t imagine” what it is like to have a broken brain. But, also try to not condemn those who are struggling. As I say- “If you saw a person walking down the road with a severe compound fractured arm, wouldn’t you immediately respond with concern and attempt to get them medical treatment? Why then would you not have the same impulse for someone who is struggling with a mental health issue?”
The organization Bring Change to Mind is truly great! If you are interested, I bet they would love to have your contribution here (but that is very personal, and of course, your call/decision): http://bringchange2mind.org/page/s/story
Wishing you a speedy recovery from this infection and that you feel better soon- keep resting (I struggle with this- look at me giving out all the advice!, but truly, it is so important- you seem to have a good grasp on how much that is true), and keep that pup right by your side. My two black lab mutt mixes were KEY partners in recovery!
Thank you for the gift of your blog, and testament, truly. I will continue reading and be in cheering you on from cyberspace mode!
Wow, thank you SO much for this comment and for stopping by my blog, Uppity Gal. I definitely cannot do the comment justice in a one response but I am and continue to be so grateful for your incredibly thoughtful and kind response. I’m so glad to hear that you are a fellow stigma-fighter and I identified with SO much of what you said, especially being the one who is able to talk about difficult things like suicide. I think one of the problems is that it isn’t talked about enough until tragedy strikes and that compounds the tragedy. Out of the silence we must come in order to start healing this world in which so many are hurting in a not-so-obvious way.
I will definitely check out the organization Bring Change to Mind and I appreciate you bringing it to my attention. Again, I am very grateful you stopped by and took the time to write me such an incredible comment, full of wisdom and beautiful compliments that I very much appreciate. Have a great day and I hope you will continue to stop by! Thank you!
Couldn’t have said it better myself.
Thanks Amanda! Good to hear from you! Hope you are doing well!
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