Mental health is an area where the suffering is frequently increased by shame. Many people who struggle with anxiety or depression or ADHD develop a sort of secret life where they “pass for normal” daily while feeling like simply maintaining is a struggle. In many cases this fear of exposure is founded in reality, whether the fear is about social acceptance or maintaining employment. There’s a lot at stake for people who are already facing big challenges and announcing to the world that you might be a little weak and vulnerable is risking much for very nebulous gain.
There has a been a thaw over the last few decades in public acceptance where it has truly become less of a stigma and better understood. But these improvements are far from universal and I think it’s deep in the human character to want to appear strong. Perhaps it’s even a need to feel strong. Psychologically it’s easy to imagine that “coming out” to others, especially when feeling overwhelmed would be a terrible humiliation. The worst thing would be to have the external world completely reflect your inner struggle and support the idea that you are “damaged goods”. In this light, not telling others could be in a sense, healthy. The problem is that this denial and hiding is very isolating and it often extends to family and friends. The person who can afford it least, is sunk into a very lonely secret struggle.
It’s not that I think my writing or perspective is essential to anyone but I would like to raise my hand as one more person daylighting the reality of the struggle. I have ADHD and anxiety and exist somewhere on the gray zone of the autism spectrum. In my youth I suffered from periodic crippling depression. I’ve learned some hard lessons about it and have managed to stay out of its grip for over 20 years. But it is a permanent vulnerability, I have to be watchful and proactive. I am not a mental health professional and I am not claiming universal accuracy in my characterization of depression, but for the kind I had and for the kind I have seen in many friends over the years I think I have something to say worth hearing.
As a person who has dealt with a lot of depression and has escaped it I would say: Depression is a hostile takeover. Depression is a looping fugue state and there are things depressed people do that maintain the depression. Depression tells you that soul gargling misery is your new life. Depression watches you like an abusive jealous spouse to make sure you don’t see any other feelings.
Sadness is completely different. Sadness is normal and healthy and contemplative. You do not despise life when you are sad or even grieving. Your relationship to life isn’t fouled, poisoned and stuck; it is simply a place in the natural flow of our emotional range of motion and it is mostly appropriate when it arises.
What I know of depression is that it begins as a cascade effect and that it ultimately requires the victim’s cooperation to complete its circuit.
One danger signal was a kind of impatient bitter anger flaring up accompanied by feelings of unfairness. But for me, the thing that started the cascade was saying to myself: “It doesn’t matter” Or “I give up”. Which is followed by “this always happens to me” which is followed by more sad mice nibbling in increasing waves of amplitude. This sequence is a spiral staircase downward with a sudden trap door at the bottom. Once through this trapdoor, depression is a steady state. It’s not a mood, it’s a place. It’s as if a neurological/ emotional tipping point has been crossed.
In my experience, once here depression has certain visceral feelings, literally gut feelings . An odd sensation in my stomach begins and a strange sense, sickly pleasurable, of the intensity of it along a background sense of marveling at how awful it is. There are waves and troughs, screeching self loathing, and pits of sodden despair. Shame is everywhere, and a horror of being seen. One makes brave attempts to look normal with red eyes and a cracked expression. It truly is an altered state, a nightmarish one.
And all the while, the voice of your worst enemy on a concentration camp loudspeaker hammering you down and mocking your attempts to lift yourself up.
This used to happen to me two or three times a year with disastrous results. It was like a kind of weather that blew in and stayed a while and blew over though some unknown mechanism. Later I began to learn about the biochemical aspects of it, and later still I came to notice the voice and the key phrases that were the predictable opening chords. To my astonishment, I was an active participant in the process by speaking the lines and opening doors deeper and deeper inside me to my worst enemy. This is not blaming the victim, this is mindfulness. This is learning that it’s better not to walk into that giant hole over there.
I do require medication to even my playing field, I have a biochemical vulnerability . But the psycho-dynamics of thought are half the battle. You must actively reject this enemy, you must tell it that things DO matter and you DON’T give up and that this DOESN’T always happen to you. Fight. Fight for your life. This is your moment to save yourself.
But it is a different challenge for friends and family: There is a fine line between being a loving listener and being an enabler for this. Listen lovingly but don’t over indulge the misery. Likewise, don’t mock or get caught denying your friends assertions of misery. Do not bother listing solutions to problems. You cannot win them over with words. A depressed person is a virtual district attorney, prosecuting hope. You can tell them that depression is a poison and that while that poison is in their system there is no solution to their problems. That no matter what they are thinking the problem is, the REAL problem preventing work on any other IS the depression.
The first thing you have to do is look for opportunities to do things that tend to break the person’s bond to depression. Enjoyable exercise, or a game that requires losing yourself in focus and attention or doing something that actually is meaningful and helpful for someone else. In a perverse way, when we are depressed we are grotesquely full of ourselves and the quickest way to happiness and health is the kind of disappearing we do when really engaged by things outside of ourselves. In depression “WE” fill the lens. We can’t escape ourselves. But when joyful we become JOY and our personal agenda becomes a faint background issue. Life problems are real but depression is a loop, a misery fugue state, and the loop can really only be broken by times and experiences that allow people to escape it long enough to remember and reclaim their normal lives.
A Kind of Summary
- Sadness welcomes relief, depression denies relief. It’s a kind of monomania or idée fixe.
- As such, direct attempts to help through talk will be hijacked by a global sense of hopelessness. The conversation will become a platform for editorializing on behalf of despair.
- Depression asserts a kind of dominance and territoriality. It is defensive.
- Depression interferes with information processing. Memory, reaction time, problem solving and perception are all negatively affected.
- The most effective simple steps for depression relief are activities that make the person forget themselves for a bit. Often the person will need to be “tricked” into these activities because they will reject doing something “Because it will make you feel better.” Every time the person forgets to be miserable the depression loosens its grip a bit. It’s best not to point out that they are feeling better too soon.
- In depression the person is deeply isolated and essentially out of relationship with other people. They are stuck in a hall of mirrors.
- Perhaps because of this, doing some good for another person is often incredibly therapeutic. You might ask a depressed friend to help you with something and get them out of the house and performing an activity that one can lose themselves in.