This is a copy of an insightful article my therapist gave me to read over and pass on to my friends and family. I have highlighted and italicized areas that most resonate with me and my experiences.
Depression: From the Inside Out
By Carol Bailey
(excerpted from the Mood Disorders Association of Metro Toronto Handbook)
It is difficult, perhaps impossible, to fully comprehend the feelings and thoughts of someone who is clinically depressed if you have not experienced mood disorder yourself. Yet, some degree of understanding is necessary to help you respond to a depressed relative or friend in an appropriate and supportive way. Some degree of understanding also helps to alleviate the frustration and guilt you may feel when all your best efforts to improve the mood of your relative or friend don’t work.
It is unfortunate that the same word – depression – is used to describe both a normal mood experienced by everyone at one time or another and a serious form of mental illness. It certainly confuses the issue. Nevertheless, the two do share a common starting point that our journey into darkness begins.
Everyone knows what it feels like to be sad and even emotionally crushed by life events. Virtually everyone has felt the pain of losing a loved one through death or separation. Virtually everyone has experienced the devastation of a broken heart at the end of a romantic involvement. Virtually everyone has experienced the pain of failure and disappointment. We certainly all know what sadness and small “d” depression feels like.
Clinical depression often starts out the same way. You feel sad, you feel blue. You cry (or feel like crying) more easily, your appetite is affected – you eat more than usual, or don’t eat as much. Your concentration is off a bit, you don’t feel like socializing. You feel sorry for yourself. Often a major disappointment or loss started you on your way, although with clinical depression, sometimes you start to feel down for no particular reason.
It’s at this point that the two depressions start to part company. The aching pain of profound sadness, almost palpable, is, if anything, heavier and deeper. You begin to realize that the pain is more severe than it should be – that whatever caused your depressed mood does not merit the depth of the pain you feel. You begin to feel out of control – that dark tentacles of depression are spreading through you, taking over, and you can’t do anything about it. You start to feel like you are no longer you.
Feelings of dread, self-disgust and shame overwhelm you. You feel weak and helpless. You start to hate yourself for being so weak and out of control. And you can see no light at the end of the tunnel. You see your unbearable pain stretching endlessly into the future. You can no longer remember what “normal” feels like.
Your thinking slows down, almost to a crawl. It becomes difficult to concentrate and to remember details. You have trouble understanding the meaning of words on the printed page. You start to feel stupid. You struggle with the simplest decision – it takes enormous effort and sometimes you just give up – you do nothing because you can’t make a decision.
Your physical energy levels drop. You often feel physically and emotionally exhausted. You have to gear yourself up to just get out of bed in the morning. Sometimes, in spite of your best efforts, you just can’t get up. You just can’t. And the mornings are usually the worst. That brief interval between the sleeping and the waking state – that instant when you realize where you are and what is happening to you – comes back as an overwhelming shock. You feel as if a load of bricks had been dumped on your chest – the wind knocked out of you. You are terrified and you want to retreat back into the protection of sleep. Sleep becomes your safe place – your only way to escape the pain. You pull the covers over your head because you are afraid of the pain.
When you do manage to drag yourself out of bed and get yourself dressed, you find that you have lost interest in everything. The depression wraps you in a thick, heavy blanket. Nothing gives you pleasure; you can’t laugh; you can’t feel joy. Food, when you can get it down, is tasteless. You could sit for hours watching hilarious videos and not crack a smile, although your logic tells you the movie is funny and you should be laughing.
You feel separated from everything and from everyone as if a great translucent force field was keeping you out and isolated. When people talk to you, you often feel as though they were a million miles away – at the far end of a giant telescope. And even when you feel well enough to play a game or sport, you feel like a robot, as if you were just going through the motions. Sometimes you feel like you are invisible.
Although the depression tends to lift somewhat as the day goes on, depressed feelings come in waves – suddenly washing over you with no warning. At these moments you feel particularly helpless, like a small twig being tossed around on a stormy sea.
When you are depressed and feeling out of control, you don’t like yourself. You know you are a burden to others. You know that people don’t feel comfortable in your company. So you avoid people, you withdraw. You feel disgusted with yourself and your weakness. You begin to think about suicide.
When you are depressed, you do not think of suicide as the “easy” way out. You think of suicide as the only way out of an unendurable living hell. When you are depressed you do not think of suicide as a “permanent solution to a temporary problem”. You think of suicide as the only solution to an agonizing existence that feels permanent. When you are depressed, you think of suicide as the only way to free your loved ones and your friends from the heavy burden you impose on them – and from the shame. You truly believe that the world would be a better place if you were not in it.
People can’t understand how you feel. Many think you are weak, selfish, lazy. Many think you want to feel depressed. You feel totally, starkly alone – as alone as any human being has ever felt. You don’t deserve to feel any better. You don’t deserve to live. You’ve reached bottom…
And then one day, you pick up a newspaper and you can understand what the words say. You hear a joke and you actually smile. You find it easier to get up in the morning. You still feel bad, but you have more and more moments when you feel almost human. And then, suddenly, you realize that your mood is back to normal. The rest of your life, however, probably isn’t. You have a lot of cleaning up to do, a lot of repairing. You need all the help and understanding you can get.
Living with someone who is depressed is an ordeal that only those who have been there can truly appreciate. Your best efforts to help your relative or friend feel better either have no effect at all or seem to aggravate the situation. How, then, should you respond?
It is essential to understand that your relative’s or friend’s mood is beyond their personal control. When you remind the depressed person that s/he has everything to live for, that other people have much more serious problems, you are just reminding them of something they already know – that their mood is out of control and inappropriate. You are just reminding them that they are weak and reinforcing the guilt they already feel.
The fact is, there is nothing you can say to banish the depression. You can, however, relieve some of the pain and provide comfort simply by being there – simply by listening to your friend or relative when they most need you – simply by letting the depressed person know that you care and that s/he is a worthwhile person who is needed and loved.
Try to understand that the person you know is still there, under the veil of depression. Try to understand that their withdrawal is in no way a rejection of you or other family remembers and that their lack of response does not reflect a lack of will power or a weak constitution. Your loved one is ill. The brain chemicals (or neurotransmitters) that regulate mood are out of balance – it is both that simple and that complicated.
Mood disorder is a tough thing to live with, whether directly or indirectly. I used to blame myself and the people who couldn’t understand me. I don’t anymore. I do my best to let people know that it has nothing to do with selfishness or a lack of will power or a desire to wallow in self-pity. A mood disorder is a trip I would rather not take. When it happens, all I ask is that you understand I’m not a voluntary tourist [on this scary vacation]. Don’t blame me, [don’t blame yourself], don’t blame anyone. Let’s, once and for all, banish the negative stereotypes to the history books where they belong.
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