Depression - From the Inside Out

Someday I may regret sharing so much on the internet for just anyone to read, but when and if that day comes I will deal with it then by praying for new direction.  For now, however, sharing with transparency is the direction I continuously feel led to go so my simple prayer remains the same:  Dear Lord, please use my life and my experiences to help others see You in the midst of our messed up, crazy world.  Use what I have to help someone else with their load.  To You be the glory.

My world is one of depression.  Not sadness.  Not unhappiness.  Not glumness or melancholy.  Simply depression.

Okay, so maybe you don’t quite understand what I’m saying.  Maybe you generally see me as upbeat, or cheerful; playfully sarcastic, or even scrappy (I love that one!).  Maybe depression seems an odd choice since I seem fairly grounded, smile from the heart when talking about my children, set lofty goals for myself and typically meet them, and love to joke and play with friends.

Or… maybe perhaps you have known me for more years than either one of us wants to admit and that first sentence turned on a light bulb over your head as you suddenly thought, “Ooooohhh.  I get it now.”  Or worse yet, maybe you just started reading and thought, “Well, DUH!”  The odd mood swings in junior high and high school.  The silent quick escapes from dorm life in college.  The lone-wolf behavior at work or at Christmas parties or even at church functions.  

Or perhaps you’ve known me just long enough to fall somewhere in between those two places wondering how you missed this, but interested in connecting the dots because you see the possibility.  Thinking I seem normal enough - whatever that means.  That I don’t look sick.  Thinking I surely must be exaggerating or over-stating the issue in some way, but curious to know more because my initial statement has caught your attention and you can see how it might be true.  

Well, regardless of what you may or may not think about the first paragraph of this post, the truth remains the same.  My world is one of depression.   Even when I’m genuinely smiling from ear to ear, Depression is still close at hand.  Like an old friend – not always in the room, but too familiar to be forgotten and too ingrained to ever be separate.  Sometimes depression exists only as a memory; and sometimes it's an underlying feeling of foreboding, but it is always somehow present.

I live with depression.  I always have.  And I always will.  I don’t “suffer” from depression.  I’m not “a victim” of depression.  I might give you the verb “battle”, but I’m not a hostage of some mental illness or a survivor of some psychological disease.  I simply live with depression.  The same way I live with my gray hairs, my scarred eyelash line, and my ingrown toenails.  (Sorry, feet-hating people, please don’t be too grossed out by that comparison…)  Those things – gray hairs, scars and ugly toenails  - don’t make me bad, or change my value, or maybe really even matter to anyone but myself, but they do work together to help make me who I am and effect the way I present myself to the world.  And so does living with depression. 

You see, just like everyone else, I spend a lot of time trying to hide my “flaws” and convince people I am perfectly “normal” and just like them.  I color my hair, I purposely avoid mascara, and you feet-haters probably really appreciate my choice to avoid flip-flops.  But just like with everyone else’s flaws, disguising them, or otherwise downplaying them, doesn’t make mine go away.  My hair still grows in gray (which I am sure Clairol is thrilled to hear).  My eyelashes still don’t match and that scar isn’t going to go away over the next thirty-eight years any more than it has over the past thirty-eight.  And my big toes can hide inside my shoes all they want, even surgery couldn’t make them appear as if they’d never been affected by my family’s DNA.  And yet somehow trying to cover-up the flaws and downplay the differences seems so “natural” that we all do it.  

What is up with that?  Why is it so natural for us to try to hide things from each other?  Why do we feel the need to appear just like everyone else instead of embracing who we are?  And what does it mean in the bigger picture?  Especially when we are talking emotions and brain function rather than just gray hairs and facial scars.  Well, in my opinion, I think it means it is time to stop hiding and start talking.

|If you look to Merriam-Webster for the medical definition of depression you will find the following:

a (1) : a state of feeling sad (2) : a mood disorder marked especially by sadness, inactivity, difficulty with thinking and concentration, a significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness, and sometimes suicidal thoughts or an attempt to commit suicide

If you look to the same source for synonyms of depression you will find among others:

a state or spell of low spirit:  blues, dejection, desolation, despondency, dispiritedness, doldrums, dolefulness, downheartedness, dreariness, dumps, forlornness, glumness, heartsickness, joylessness, melancholy, mournfulness, oppression, sorrowfulness, unhappiness

And if you Google the word depression you will find things like:

Prescription options; symptom checklists; “signs, causes, and more”; multiple definitions of the word; and multiple associations and treatment centers related to the symptoms

And the connections go on and on…  “Depression” is a well-known term.  A commonly heard word in today’s general conversation.  It has various meanings and has come to be used rather flippantly to describe any sign of sadness or a bad mood, but where is the more human response to the word?  Where are the down-to-earth, one-on-one connections for those living life a bit differently than most others or those living with those people who just need to talk about differences?  Where is the comfort zone for asking real questions of real people and getting real answers, rather than just trying to connect dots in our heads while simultaneously hiding the very differences we’re trying to understand?

Truth be told, most of us are so used to hiding our flaws from each other that we don’t know when it’s okay to stop and we don’t feel comfortable asking for help when we need it out of sheer fear of being labeled “different”.  Throw in a few actual symptoms of true clinical depression - sadness, hopelessness, difficulty concentrating, feelings of dejection, perceived isolation – and it becomes even more difficult to cut through the fear and guilt and confusion and see potential pathways to help. 

Whether you see depression as a disease, a flaw, a state of mind, or even a lifestyle the fact of the matter is - it’s real.  People live with it.  People just like me.  People trying to live and interact like everyone else, but being held back by their own thoughts and emotions. 

Depression is tricky.  It can be controlled and yet it can be all-consuming.  It can be treated, but even when it’s not it can be masked and hidden quite efficiently.  And even when it is being treated, it can still give its input to the day.  Depression can be scary, but it can also be comfortable and well-worn.  It can be hard to understand, even harder to explain, and difficult to accept.  But of all the things depression is – It is not something to be ashamed of.  It doesn’t have to be in charge.  And NO ONE should be in the position of battling it alone.

According to The Depression Answer Book by Wes Burgess (2009), more than 18 million people in the United States live with the effects of major depression.  Eighteen million!  That’s a lot of people.  And yet how many deal with depression in secret or have never been able to put a name to it or have never sought sustainable help because they feel they cannot openly discuss their concerns without judgment?

Let me tell you something I’ve learned through my own history with depression - Depressed people cannot just “fix” themselves.  One of my favorite quotes from Dr. Burgess’s book is:  After all, if you’re just in a bad mood, people wonder why you cannot exert some effort and pull yourself out of it.  However, you usually cannot pull yourself out of major depression, it can be severely debilitating and too often results in death by accident or suicide.  People do not kill themselves because they are in a bad mood.  (pg 2)

People living with depression need help to get help.  They need a family member or a friend or a professional counselor who is willing to stand in the gap for them, to look beyond the surface.  To really engage rather than simply get frustrated with mood swings or consistent “I don’t know what’s wrong” answers.  They need someone who is willing to dig beyond the surface and really help them figure out what’s going on, even when the depressed person doesn’t know where to look.  Or perhaps, especially when the depression itself is making it hard to know what to do.

People living with depression need love – consistent, unconditional willing-to-help love.  They need support.  They need commitment.  They need a friend.   Someone willing to get involved beyond asking “What’s wrong?” or suggesting “You need to get help.”  Someone willing to be observant of cycles and symptoms, who understands the importance of empathic silences, who is able to mirror and validate difficult emotions, and who is willing to be a source of permanence. (Golant & Golant, What to Do When Someone You Love Is Depressed, 2007, pg 84) 

A few weeks ago a longtime friend of mine responded with a heartfelt, “I’m so sorry,” when she learned that I recently began taking an antidepressant.  I was very quick to tell her, “It’s okay.  I should have done it a long time ago.”  I’m not proud of the fact that I take daily medication to help manage my depression, but I’m also not ashamed to acknowledge the help I am receiving as it has helped make my life more fulfilling than I ever understood it could be.  I have never been one to take medication for anything and despite my current prescription I am still in no way an advocate for medication as I still resist taking even a simple aspirin or Benadryl, but the more I learn about depression and my own patterns and triggers the more I understand just how much control depression has had over my life for the past forty years.  And when I sit back and really put things in perspective, my biggest regret is that I was not in a position to have someone engage and help me find answers and direction sooner.

The truth is, I have been “medicating” my depression for most of my life; I just didn’t have the right prescription to acquire lasting long-term effects because I was “self-medicating” with people and activities.  For as long as I can remember I would self-analyze myself and then search for “answers”, trying to relate myself to depression checklists or definitions, but I never seemed to match up.  I’m not suicidal and never have been, thank God!  I don’t stay in bed all day and due to my Type A personality I get quite a lot accomplished despite by little friend.  But the reality remains – I attempted to combat depression on my own for a very, very long time.  

Music.  Checklists.  Exercise.  Work.  Relationships.  Avoidance of certain social situations… In my own little way I have always known on some level what my triggers are and I routinely (perhaps often subconsciously) found ways to combat or avoid them.  I just never understood that everyone didn’t live like that and I didn’t have to either.  And then, when I started to lose the consistency of those self-help treatments in my life – more kids, less music involvement, more deployments, less employment obligations, less time to exercise, removal of long-term friends, less interest from my spouse - my ability to control the depression I was self-medicating began to fall away as well.  

Little changes in the action would help here or there – a mission trip to China, new friends in a new neighborhood, a new Bible Study to plug into – but the underlying status quo remained the same.  My old friend, Depression, was still along for the ride.  Like an old sock – comfortable and worn and almost like a second skin.  Like glasses on top of my head that I didn't realize were still there. That word on the tip of my tongue that I just couldn’t grasp no matter how hard I tried to focus on it.  Always there.  Even when not center-stage.  Ever present and increasingly assertive even when I couldn’t quite pinpoint what was going on.

Chronic depression doesn’t go away.  It’s not just a bad mood that you will eventually get over.  It is an actual chemical imbalance in a person’s brain.  “It is an illness that directly impacts an individual’s entire being.  It alters and disrupts one’s mood, one’s thoughts, one’s body, and one’s behavior.”  (Golant & Golant, 2007, pg 28)  Yes, it can often be controlled with talk therapy and self-monitoring, but it also just as likely needs medication to aid in control as well.  For me, given the dark hole I found myself in last year after a lengthy onslaught of trigger situations, it has taken both counseling and medication to really get things under control and feel like I am the boss of my thoughts and feelings again rather than just along for the ride in life.  And even so, I am not “cured”.  

Like I said before, chronic depression doesn’t go away.  Thus the word chronic.  It is a part of who I am and always will be.  But that’s okay.  In some ways it really is like an old friend…  I wouldn’t know who I was without it and I wouldn’t have become who I am without its influence.  I have had some of my closest moments of communion with Christ because of it, and have written some of my most poignant poetry in the midst of it.  It has pushed me to stay active and it has driven me to learn more about myself.  But I also appreciate being in a place where my depression doesn’t control me and doesn’t negatively impact my family.  It’s never really gone, and there are days I still fear its power to manipulate as obvious triggers pop up here or there, but I also now know what I’m dealing with and have a solid base of support to which I can turn for help when things get rocky.  

Honestly, it is a bit scary to me that I somehow lived until the age of forty without ever being professionally diagnosed and provided aid in understanding and controlling what has been a part of my existence my entire life, but there are a lot of reasons for that.  The prime reason being I didn’t know any different.  It is hard to figure out for yourself what is setting you at odds with the world around you when there is nothing different about yourself today compared to yesterday.  It’s hard to diagnose yourself with any kind of struggle if you have never lived any other way.  But it also took someone willing to look at the bigger picture and say, “Hey, WE need to get you some help” to make change happen in my world.  And even that only came as a result of what some would consider a bout with double depression.  My own parents and siblings didn’t realize the extent of my lifelong experience with depression until someone from the outside helped me explain things to them, mostly for the same reason – they never knew me to be any different and I had never shared the details of my battle because I didn’t understand there was any other way.

Looking back it is easy to see the symptoms.  It is easy to see the tell-tale signs.  I have been provided the correct checklists to identify and manage the symptoms of depression I live with.  It is becoming easier to explain my depression-effected thought processes to others, to understand how depression impacted my daily life and relationships over the years, and how much control it has had over my self-worth, emotional and mental health, and general perceptions of the world around me.  But the key is that I am looking back with help and not just on my own, which helps my thoughts be more focused, allows me to be less self-deprecating, and generally assists my outlook in being more positive than it has been since all that self-medication stuff was last working effectively (many years ago...).

So, why have I shared all of this with you?  Well, basically, because I know I am not alone.  I am no longer alone in working through the differences that make me me, but I also know I am not the only one who has ever been on the other side and if there is one change I would make in this world it is that NO ONE would ever feel as alone as I have in my past.  You might define “alone” as having no one else physically present, but for a person living with depression it only takes the perception of being alone to trigger a complete avalanche of negative emotions, guilt, and/or hopelessness.  

So, I ask that you be aware and be on watch.  If you suspect someone you love might be battling depression, step up and step in.  Go beyond “What’s wrong?” and really investigate the big picture.  I’m not saying it’s going to be easy – trust me, I know it’s not.  Mystery and evasion is not intentional on the part of the depressed.  The very nature of depression will cause the depressed to resist intervention.  But once that life-giving gift of understanding and assistance is granted to a battler, the rewards in that person’s life are worth more than all the tea in China.

And what if it happens to be you?  What if it is you who is feeling alone?  Feeling different.  Reading self-help books on loneliness and isolation.  Searching out check-lists on behavior disorders wondering if you’ll ever find the perfect match.  Or perhaps you suspect you already found the answers you need, but are paralyzed by the idea of addressing them.  Perhap you feel as if this is just the best it can ever be… Please know YOU ARE NOT ALONE.   

Reach out.  Write a note if it’s too scary to share your thoughts aloud.  Do yourself the biggest favor ever and accept help when it’s offered.  Contact me if you want to.  I’m not a doctor, I can’t “fix” you, but I am more than happy to share my story and talk with you about yours.  I spent years thinking that if I just prayed more, worked harder, controlled myself better, made it through the next "situation", etc., etc., eventually things would get better because it was just my cross to bear at that time.  The truth is, NO ONE deserves to live with unaddressed depression, NO ONE should live with secrets of sadness, and NO ONE has to.

Yes, my world is one of depression.  But I am not alone and depression is not a taboo subject for me anymore.  Please don't allow it to be for you either.  Step up.  Step in.  Talk it out.  Get educated.  Ask questions.  Offer aid.  Accept help.  Live as God created you to – blessed and truly able to enjoy it.  Whether you live with depression or someone you love does, Depression doesn't have to define the situation.