Wednesday, August 13, 2014

Depression unhinges you from reality

When you find out someone died of cancer, do you wonder how they could have hurt their loved ones by doing that? Do you suspect they took the coward's way out? Do you think, "But he had it all: money, marriage, great kids, a successful career. Why would someone like that develop cancer and die?"

No, I doubt you'd respond like that to a death by cancer, but those are the reactions that many people have to a suicide.  In the United States some form of mental illness affects about one in five people, but Americans remain in heavy denial about it. We'd rather believe someone is an incomprehensible jerk than accept that he had an emotional disorder. We prefer that view because we feel great prejudice against the mentally ill, assuming that they're violent and dangerous. This reflects our ignorance. People who live with bipolar disorder, schizophrenia, chronic depression and other mood disorders are no more violent than anyone else. If we're dangerous to anyone, it's to ourselves.

I've struggled with depression for decades. I suspect my first depressive episodes were in high school, but I didn't receive a clinical diagnosis until my mid-30's. I actually felt relieved to learn what my problem was. So that was why I felt so hopeless and angry all the time: I was depressed. I willingly began the process of working with a psychiatrist to find out what prescription drugs worked for me. As the months went by and we figured out what helped, the gloom gradually lifted until I stopped thinking I'd be better off dead. Eventually, I even regained cheerfulness and enjoyment of life.

Since then I've gone up and down, even while on medication. For some people, depression is caused by prolonged stress, grief, loneliness or other life circumstances. But for those of us with chronic depression or depression as part of bipolar disorder, it doesn't need a trigger at all. Like other chronic conditions such as migraines, back trouble and insomnia, sometimes we can point to a reason that the problem has come back and sometimes we can't. It just is.

If someone tells you, "I've got a bad cold," you don't ask, "Why?" But that's what those of us with depression often hear. If I say, "I'm depressed today," friends often want to pinpoint a problem that can be fixed. They don't understand that my depression isn't a feeling; it's a mood disorder. It means my chronic condition has flared up and all I can do is manage the symptoms.

One thing (of many) that's difficult about living with depression is that everyone thinks they know what it is. Because everyone's had a bad day or felt gloomy about something, they think they've been depressed. We misuse the term. If someone notices a scratch on their car, they might say, "Well, that's depressing," when what they mean is that it's sad or discouraging or angering. But those are emotions. Depression isn't an emotion. Depression is a host of symptoms that are bigger than an emotional reaction to a single thing.

Depression is not an emotion. People responded to Robin Williams' death with sadness, grief, and feeling devastated. Those are emotional responses. In contrast, hearing about Robin didn't evoke any emotions for me, but made me think about times when I wished my life would end. Late in the day I began to think that if an incredible person like Robin Williams could pack it in, then what am I doing here? By evening my eyes glazed over and my mindset shifted into that familiar I'm-here-but-I'm-not. Instead of going home for dinner, I lay on a park bench and tried not to be me. I wanted out of my skin, out of my brain, out of my existence. Getting up and walking felt too hard. Being felt too hard.

For me, those are symptoms of depression. Fortunately, they didn't last and by morning I felt better. Like many other people, I used to think depression just meant feeling bad. I thought depression meant I needed some happy pills so I could stop crying and wanting to die. It wasn't until I got married that I realized that depression is also delusional. Only in close relationship with someone else did I get some perspective on what my mind was doing when depression took over.

Depression actually changes the way I perceive reality. People can say nice things to me all day long, but I won't hear them. Any external encouragement gets drowned out by the opinions that live in my head. So what if I'm pretty? I'm clearly a loser who can't get a man to love me. So what if I'm smart and funny? I can't even cheer myself up. So what if people enjoy my company and love to be around me? If I were really worth anything I'd have a better job/be thinner/be married/be capable of getting through a damn day without falling apart. When I'm depressed, I envy dead people who have been excused from the table and no longer have to worry about anything. When I'm depressed, I want to curl up and sleep until I become someone else. I hate myself. Looking in the mirror shows me a fat, ugly person no one could ever want. When I'm depressed, I resent ever having been born.

The delusion gets worse when death starts to look like a great idea. It's been over a decade since the last time I felt that way, but let me tell you: wanting to die was NO indication that I'd stopped caring about my friends and family. Wanting to die didn't mean putting my needs before theirs. In the delusion of suicidal depression, death looks like it meets the needs of all concerned. Sounds crazy, doesn't it? It sounds completely nutjob to think your family or kids will be happier without you, right? Sure it does because you're not in the grip of depression. But death really does look like the perfect solution when your perception of reality has become completely twisted by your mood disorder.

Depression doesn't mean having a bad day and suicide doesn't mean you've decided you're more important than the people who might be affected by your death. Suicidal depression includes believing that everyone will be better off without you, that you just don't matter much, that your death will actually make the world a better place. That level of depression means your existence has become nothing but your pain and the pain you believe you're causing others. Major depression means becoming someone who doesn't believe their life is worth much.

Unless you know what bipolar disorder or depression are like from experience, don't judge anyone's actions while they're in it. Americans must learn more about mental illness, especially as it affects more and more people with every generation. It can cause an unhinging from reality that leads to devastating decisions because the person isn't in his right mind. The millions of people who suffer from mood disorders need understanding and much more support than we usually get. It's just as inappropriate to hold a mentally ill person responsible for their suicide as it is to hold someone responsible for their death from Alzheimer's disease. Both suffer from conditions beyond their control.


David A. Parker said...

Thanks Regina - all important points.

Regina Rodríguez-Martin said...

Thanks, David. I hope readers share this post far and wide. Americans are desperately in need of a deeper understanding of mental illness.

Anonymous said...

This is incredibly right on and expressed so well. Thank-you.


Rhonda Armstrong said...

Both my mother and son suffer from depression and both can be suicidal at times. I must admit that quite often I don't understand why they are so sad because their lives are not that bad. And most of the time I don't have enough patience with my son because I feel like he has everything he could want so why be depressed.
After reading your blog I think I have a better understanding now than ever before.
Thank you

Regina Rodríguez-Martin said...

Sherry - thank you! I really appreciate all feedback on my posts, and of course positive is always good.
Rhonda - I'm very, VERY glad if my post has given you more insight into what your son is going through. Thank you for being open to more information so you can understand.

Lee Reilly said...

I love how you've managed to use everyday language and simple similes to write about something that people try to avoid looking at... having a cold, being excused from the table, lying on a park bench and trying "not to be me." I think you've contributed something important by being so down-to-earth. Thank you.

Anonymous said...

Hello Regina,

This is the best explanation of depression I have read and I am 62 and have had a lifetime of living with depression off and on since childhood. I am going to copy it to have on hand to give to others who need and want a better understanding of this. You know, even I have a better understanding of myself and my life after reading it. Thank you.


Regina Rodríguez-Martin said...

Thanks, Lee!
Anonymous - I'm honored that you're going to use my post to help explain depression to others. Really honored.

livelearn said...

Thank you. I needed to read this. It has given me some understanding, but I still have a long way to go. I am afraid that I have been guilty of wanting to tell someone afflicted with chronic depression, "Snap out of it!" Clearly, you can't just switch it off.