The thing about depression is that it’s a wound. Severe depression compromises specific areas of your existence, not (necessarily) all areas. Like a ship that has been hit by a torpedo and is rapidly taking on water, certain compartments of life have to seal up and shut down.
For many people, it does get so bad that they can’t even get out of bed. That happens but rarely does it stay that bad for long and for most people, it never gets quite that severe. But that does not make it any less excruciating.
The clinically depressed person is walking through a haze, similar to a hangover or the flu, with specific areas of their day to day life being cordoned off from them. They’re unable to fully experience those areas of life and in many cases, unable to engage in those activities at all… it’s just too painful.
If it’s the galley that’s been hit, then guess what? No kitchen service is available. If it’s crew’s quarters, then nobody gets to sleep in a bed. If it’s the engine room… real problems will rapidly ensue.
A person with one missing eye can still see out of the other. A person with a broken foot can still put weight on the other foot. Someone who has a broken bone can still laugh at jokes or play a board game with a friend. Similarly, someone who is suffering from depression will seem entirely normal in many ways. You might notice that they seem sad. But you might not notice anything at all.
They might seem perfectly functional and happy. That’s because they’re putting on a good show, trying to make it through another day. Strong people loathe the idea of “putting their burdens on others”, especially those they love. But strong people experience trauma, too. No one is immune from the often horrific things that life throws at us.
Predictable Chaos
But the changes in brain brain chemistry that are what doctors refer to as clinical depression are in fact a wound, caused by repeated trauma. Bad things happen to all of us. At some point in your life, you will experience something that puts you into a serious “depression”, in the loose definition of the term. Your brain starts dropping off sharply in the “feel good” chemicals, like dopamine, norepinephrine, oxytocin and serotonin. You literally experience a type of constant, nagging hunger… but not for food. You hunger for certain chemicals in your brain.
You hunger for the hunger that you used to feel for life.
You hunger for the basic satisfactions that you used to take for granted.
It can sometimes get so bad that it becomes literally impossible to feel the normal desires for things you usually enjoy, like food, sex, entertainment and so on. Ice cream becomes meaningless and your favorite show is nothing but noise that you would rather not have to hear. Sleep is your new hobby. Silence is the new black. Or maybe you barely sleep at all. Maybe you gorge yourself on food or television or sex, just trying to get that brief fix, so you can feel happy for ten minutes before you crash again.
Everyone gets sad. The occasional bout of “the blues” is part and parcel of life. You lose a friend, a job or a relative. You move and then decide that you hate the new city or house you’re in. But you get over it… it’s what people do, you heal and you bounce back.
If something else really traumatic happens in six months, your brain once again starts spitting out the happy chemicals that help you enjoy the little things in life. The problem is that now… your brain has recognized a pattern. The brain uses neural pathways to go about its business and once those pathways are diverted, it takes more than just positive self-talk to restore them to proper order.
The Corks Bob Back Up
If you’re life situation gets better and it stays better, there might not be any issue. Our brains and bodies are one, single system and they’re usually quite adept at helping us equalize and stabilize, through even the most terrible traumas. The brain and the human spirit are absolutely magnificent things, capable of seemingly miraculous healing.
But if you have three or four major events, all timed out at roughly the same intervals (whether it’s six months, a year or even three years), then you have an accidental pattern that your brain now thinks that it’s supposed to run. It takes over and runs this new sequence, all on its own.
Trauma #1, happens. Then, a year later, Trauma #2. Trauma #3 comes along the next year and Trauma #4 happens in six months or a year after that.
So, wanting to be a strong person, you dig in and you do everything you know how to do to get past it. At some point… say, a year from there, you’re thinking (logically, consciously) that you should be doing better by now. You gave yourself time to heal. You thought positively, you exercised and you ate right. You “should” feel happy.
In fact, now things are going really well for you, on the surface. You got closer to being out of debt, the relationship is better, you got that promotion, maybe your skill level at your favorite hobby has improved. But you just DON’T feel happy and you’re not sure why. Sometimes, you barely feel anything at all. And when you do feel something, it’s usually something unpleasant, like tired, achy or lonely. There’s a sense of despair or boredom or constant, low-level anxiety. You did all the stuff but you’re just not getting the satisfaction that was promised by your sought-after goals.
It’s because your brain has come to believe that it’s supposed to be acting like it did, about this time, a year ago and a year before that.
Yes, having a bad attitude is unhealthy. That type of negative outlook can cause depression. But a bad attitude is a choice. Having depression, that results from multiple, traumatic life experiences, is NOT a choice. Being lazy is not cool. But people suffering with clinical depression are NOT lazy. They’re wounded.
Just like an excellent soldier can still get shot or step on a landmine, people experience life troubles that they did not bring upon themselves, through bad decisions. It’s even worse when there are some experiences that were not their fault and some that were. Why? Because the depressed person will often focus on the ones that they were responsible for. But who among us hasn’t done something stupid that caused us a lot of heartache?
Trauma is sometimes the result of what happens to others. A healthy, empathetic person is deeply, profoundly bothered by the suffering of others, especially family, loved ones, friends and pets. But even the suffering of total strangers will register as trauma, in the mind and heart of a kind and compassionate human being. Only sociopaths, Cluster B personality types, are completely unmoved by the suffering of others.
If you’ve never experienced Major Depressive Disorder (maybe you’re reading this for a friend or loved one), just think of how you feel when you see a news report about violence against an innocent child, a woman or an animal. Recall the way you felt on Sept. 11th and you saw the Twin Towers coming down. Now, imagine that several events took place that impacted you even more than those things, because you were right there, in real time, living each moment of it. It wasn’t on TV, it was inescapable. If you can have PTSD from something you saw on television, something that didn’t even happen to you, personally, then you can certainly have long-lasting, severely debilitating effects from stuff that did happen directly to you.
Fever
The company of friends doesn’t fix depression. Drugs, booze, sex… nothing fixes it. Certain things might bring relief temporarily, due to the chemical highs they produce. But once that high wears off, you’re right back in the deep end of the soup bowl. Sure, you might lie in bed for days, weeks or even months on end, getting up only to use the bathroom and eat something once or twice a day.
But you might also be up and working two or even three jobs. You might be pretending to laugh at the jokes people tell you and making up fake excitement about this or that, because you’re tired of people asking you if you’re alright, especially since you don’t know, yourself. You may find yourself acting like you’re really excited about that new thing that’s about to happen, when really, you’re dreading even having to talk about it, much less actually doing it.
You might even become cruel. Sometimes, the way of dealing with the pain becomes passing it on to others. This doesn’t happen in most cases but it can. Depressed people might temporarily have fits of anger and say things that they later regret. If you’re foot is already broken and someone steps on it, even accidentally, you may just bite their head off.
If you or someone you know is struggling with depression, be extra patient and gentle with the situation and allow for some mistakes. You do not have to suffer any unfair abuse. But you can firmly and lovingly say something like “I know you aren’t yourself, right now. I know you didn’t really mean that. But it wasn’t fair or kind and I didn’t deserve that remark. We’ll talk about it later, after you’re feeling better.”
Most people will never know the INCREDIBLE feat of strength that it took for that person to NOT shoot themselves or take a fistful of pills, to end the excruciating emotional pain. And I don’t mean to imply that anyone who commits suicide is weak. Actually… far from it. They simply carried the weight as far as they could, with the tools that they had at the time. When the pain being experienced becomes greater than the resources a person has to bear it, this is often the dismal result.
The only thing that I know to say to someone in that position is… if you’re just too damned stubborn to quit, then it might just get better… even if only by accident. But suicide is a permanent solution to a (possibly) temporary problem.
I only say possibly temporary, because I understand how the severely depressed person can’t wrap their injured mind around the idea that “Of course I’ll feel happy again, soon enough!”
Rope
That idea is foreign and often, they’re in so much distress that it feels insulting. “If you knew how miserable I am, you wouldn’t mock me by insisting that this is just going to get better.” Of course, it won’t “just get better”… they’re going to need help, skill sets, probably medicine and a lot of support… and time.
But even if you say all that, the chronically depressed mind will be extremely hesitant to feel the same optimism for itself that you, the healthy friend or loved one, feels for them. So, I don’t ask them to believe that it’s going to get better. Instead, I ask them not to rule out the possibility of feeling happy again in the future. That’s usually far more believable for them and it’s usually enough to keep them from checking themselves out.
People in the worst throws of this type of suffering start looking for anything that resembles rope. It can be used to climb out of the pit and it can be used to hang yourself. Either way, it’s useful stuff.
The real trick is in figuring out where to find your rope and how to use it properly. The best way is to use it to climb out of the hole. A far less desirable way is to make a noose with it.
And to the person who is so far gone, disappeared down that rabbit hole of depression, that they see nothing in front of them but perpetual night, either use of the rope seems perfectly acceptable.
They’re doing their best to navigate through the stupor of severe depression. So, they can’t discern the obvious differences between these two extremely different directions. That’s because severe depression is a type of temporary brain damage. They have moved outside the realm of logic and into a place where they can no longer differentiate between a sandwich and a sledgehammer.
It’s not a question of which use of their rope makes more sense. It’s merely a question of which rope will arrive sooner. Suicide looks (in the moment) like an escape from the constant, agonizing, emotional pain. The severely, chronically depressed person has been swimming upstream in a river of pain for so long, that the noose is perfectly believable.
The healthy person knows that you can tie evenly spaced knots in a piece of rope and use it to climb up out of the hellhole you’re in. But to the clinically depressed person, that just seems more like a pipe dream. They no longer believe that they can be happy. Too many unhappy days have convinced them of this and the compromised brain function, due to lack of the happiness chemicals, only reiterates this negative idea.
Muscle Memory
A lazy person wants to avoid discomfort. The depressed person isn’t lazy, they’re just slogging through huge waves of despair. These feelings don’t necessarily even have a cause. The feelings are “just always there” and so, the person begins to understandably believe “This is just who I am.”
They’re just trying to move on to the next day. That… is NOT laziness. That… is STRENGTH. They’re trying to get each leg out of the mud so they can take the next few steps. It should be admired, not criticized. It takes every resource inside a person to help them decide to stand up and try again, just one more time.
Obviously, it’s not healthy or productive to praise someone for dealing with depression, if they are not doing everything they can to remedy it. The depressed person must seek treatment and do the things that it takes to get better. However, trying to berate them into doing so is counterproductive, at best and disastrous, at worst. All a loved one can do is say “We’re here for you. There’s help. Let’s go see your doctor. Let’s get some good food and vitamins into you. Let’s go for a walk. I know you don’t feel like it but it’s what we’ve got to do or else it won’t get better.”
If you’ve ever had an old junker car or a broken down lawnmower, you know certain tricks you use to get it started. It takes longer than every other machine on the block but eventually, it will start. You utilize these tricks, just to get yourself to work or to go make some healthy food. You rely on habit and muscle memory. But the thing about severe depression is… at a certain point… nothing works. Nothing.
At those times, you have to rely on stupidly simple ideas, ideas like “OK, I am not going to cut my wrists. Instead I am going to sleep”. Instead of taking a bottle of pills (something, by the way, which is far more likely to give you permanent brain damage, than it is to actually kill you), you decide to get up and make a cup of tea. And even these little, seemingly insignificant decisions will carry you through a few more hours and a few more days and a few more months. And little by little, you get there.
I can’t stress enough that clinical depression feels very much like starving to death, only it’s in your head, not your belly. Imagine being insatiably hungry… inside your skull.
That’s what clinical, chemical depression feels like. It’s slow and agonizing and you don’t even know what it is that you’re hungry for. Everything you look at is stupid or broken or it’s something you truly desire that seems a million miles away. Every idea that you have for how to make things better seems insurmountable, a fool’s errand, doomed from the start.
That’s because there’s simply
no gas left in the tank.
A car will not run without gasoline and a human (or animal) brain will not function properly without those happy chemicals.
Smart, Stupid Brain
The drugs used to treat depression are typically called things like serotonin re-uptake inhibitors. What that means is that the brain is still producing those happy chemicals, the seratonin, dopamine, oxytocin, etc. But it’s spitting them back out, way too fast. This is a perfectly normal, human reaction to stress. It’s not a sign of weakness or genetic inferiority. It happens to all of us.
On an evolutionary level, this ejection of the happy chemicals makes a tremendous amount of sense. It is the brain’s way of telling you that there is a major problem and one that must be dealt with, immediately. Otherwise, you might be perfectly happy while the tiger is getting closer and closer to you. This chemical reaction is designed to get you to notice that you don’t feel good, anymore. That way, you take steps to rectify the problem and then you get to feel good again. Genius, right? Yes. Except for the fact that it doesn’t allow for situations that you can do nothing about. If something is outside of your control, how are you supposed to fix it?
It doesn’t help if you’re a seven year old child who is being abused on a regular basis. It doesn’t help if you break your leg and then in nine months, you lose a family member and then in another six months, your boyfriend cheats on you and leaves you. There’s no exception clause in the brain, for “acts of God” or bad luck. The mind and body (which are one, unified system) only understands this message:
- There’s an unusual amount of stress. Therefore, you don’t get to feel any joy or pleasure.
- When the stress goes away, then (and only then)… you can have your pleasure back…
Well… MAYBE you can have it back.
There’s more to it than that. There’s chemistry and chemistry is complicated. I don’t know about you but I found chemistry to be the most challenging class I took in college. The chemistry of your physical brain doesn’t necessarily follow the emotional beliefs that you have, about what ought to be the case. You can believe that you should feel good. But if the proper chemicals aren’t there, it ain’t happening and it doesn’t matter what anyone thinks about that or how hard you try to “be tough”.
There is a huge amount of peer-reviewed, scientific research that backs up what I’m saying here. If you don’t think that clinical depression is real, if you think it’s just an excuse that weak people use to get people to feel sorry for them, well then… you probably believe a lot of other, really stupid shit, as well.
Don’t believe me? That’s fine. Don’t take my word for it. Here’s one of our brightest scientists, Stanford University Professor, Robert Sapolski, speaking on the subject and the evidence behind it.
The type of unhappiness caused by the unavoidable, unfortunate events in life (the ones that we all experience) can be safely referred to as one of two things:
trauma – major events
and
sadness – lesser but still disappointing events
People who are around you can’t really be certain about how much certain events have impacted you. They can assume, they can guess, but they’re not in your head. They really don’t know. If they assume that what was trauma to you was only worthy of being called sadness, then they might regard you as being weak. But that’s not how it is. If enough traumatic and sad things happen to you, back to back, in a relatively short period of time, your brain quits making the happy juice. It’s that simple.
Clinical depression is defined by the MAYO Clinic as:
Major Depressive Disorder: A mental health disorder characterized by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life.
Garden variety sadness is to clinical depression, what scattered showers are to a hurricane.
It takes real strength to withstand that brutal, day to day beating of being unable to experience the ordinary everyday joys. Especially when you know they’re real… you used to feel them. It’s a truly strong person who doesn’t give in, curl up and die. How many times do you think Robin Williams decided NOT to kill himself… before the pain he felt became too intense and he could no longer bear it for even one more day? Personally, I would guess that it was probably hundreds of times, maybe even thousands, I don’t know.
But see, that’s the thing… I don’t know. Only he knew. And that’s why I’m not going to be a self-righteous asshole and presume that I do. Because I DON’T. And neither do you. Neither does anyone else.
Everybody gets sad once in a while. But that’s not even in the same ballpark as clinical depression. And if you think that someone dealing with severe, clinical depression is just being weak or they’re just having a bad attitude, then you’re wrong.
And if, after reading all of this, after watching the video presentation (given by one of the smartest guys on the planet), you still insist that this is all just about being “headstrong” or “tough”, then you… are an idiot… and you can go fuck yourself.
Depression is a wound. It hurts (right up there, inside your actual brain) just as bad as any kidney stone or dislocated knee (and I can tell you from personal experience that those things hurt like a bitch). But you’ll never see this pain. You’ll never be able to point to the scar and say, “See? That’s what’s causing my pain.”
It’s invisible pain, silent pain. Then again, cancer isn’t usually visible from the outside and last I heard, it’s still killing people. Aneurysms usually aren’t something you know you have, until a doctor tells you that it’s an aneurysm that damn near killed you. You don’t see a heart attack until it’s already happening. These things regularly cause people to suffer and they regularly kill people, too.
What To Do
If you’re struggling with depression, then you need help. Please get help. Don’t just try to “tough it out”, because it doesn’t work. That’s like expecting to drive a car with no gas in the tank on willpower, alone. Cars run on things like gas in the tank, oil in the engine, water in the radiator, brake fluid in the brake system and electricity in the battery. They DO NOT operate on willpower.
Brains are organic, chemical machines that require specific things, like oxygen, water, blood, electrical impulses, dopamine, serotonin and so on. If the depression has become so bad that you can’t function in essential areas of life, such as work and family, then you almost certainly need medication.
Unfortunately, the medications suck. They ALL have side effects. But stick with the process until you find the medication that has the fewest side effects. Or maybe you find one that has minor side effects that you feel can live with, stuff that is far more preferable than the misery of depression.
And if you think you are stable enough to come off your meds… PLEASE… do it incredibly SLOWLY! You have to scale down over a course of three to six months… not just three to six weeks.
The backlash of coming off of antidepressants too quickly will almost always cause suicidal thoughts and behaviors.
As far as the social stigma of depression, you have to just do your best. Be strong about dealing with intolerant people who think they know you, when they really don’t have the first clue. Think about this way: what kind of an asshole do you have to be, to harass someone who is suffering? If they’re harassing you about depression, then just be happy that you’re not that shitsicle.
You ARE strong. You made it this far. Don’t listen to the detractors. They’re not your real friends or your real family. Your real friends and family are the ones who take the time to fully educate themselves on what you’re suffering with.
Know Who You’re Dealing With
Your true friends and loved ones don’t say overly simplistic things, like “Yeah, I get it, you’re sad. But about WHAT? Your wife left? Hell, my wife left me. I got over it! Your dog died? I had three dogs die. I got over it. Jesus, buddy… man up!”
Your real friends don’t say stupid shit like “Just go do something fun. You’ll feel better!” No, your real friends ask if you’re going to your counselor regularly and if you’re making certain to take your medication and if there’s something they can do to help. They check to see that you’re eating well and they do it quietly, so they don’t make you feel like a child. There’s no condescending attitude about it. And if they say anything about you needing to just pull yourself up and try harder or anything like “You’re not doing your best”… they can fuck off.
If someone has gone fourteen days without food, you don’t say to them “Come on, push! Put your back into it!” They don’t respond with “Oh, sorry!” and suddenly just put a hundred more pounds of pressure into it. If they’re that weakened by hunger, they just keel over. A severe depressive episode is every bit as disabling as insulin shock is to a diabetic. They can’t just “push through”, they’re sick, they’re physically compromised. They have to get well first. Then, they can push just as hard as you can.
And if someone has clinical depression, you don’t say “Turn that frown upside down” and expect them to go “Hey, you’re right!”. It doesn’t work that way. And if you think that it does, well then, you’re an idiot and you can go fuck yourself.
The person with clinical depression is actually already pushing harder than you are. Because they’re doing daily battle with a highly persuasive devil. They’re pushing through an interminable and thoroughly confusing argument, going on inside their own mind, one that tells them “There’s nothing here for you. This world belongs to them. You don’t belong here. Do yourself a favor and end it now, because it’s only going to get worse”.
Deficit
Unless you’re wrestling with clinical depression… no, you don’t have to deal with anything even remotely as bad as that. You probably feel purposeful in your basic movements. You likely see light at the end of the tunnel. You are probably able to actually, truly BELIEVE that you are going to succeed, if only you do the right things, in the right order.
You probably believe that getting up and cleaning the kitchen is going to make a difference in your life. A severely depressed person sees no purpose whatsoever in doing those things. They might muddle through those activities… but they don’t really believe that it will matter in any way.
The depression sufferer is flying a four engine plane with three engines gone. They’re scaling up a cliff with a backpack full of bricks and cuts on their hands. They ARE strong. And if you recognize that, then you are, too. And if you don’t recognize their strength, then I have already said a few times what you can go do with yourself.
Ransom Note
The good news is that there are lots of things that you can do to get your life back together and not only survive but also feel joy. It takes more than just medication and talk therapy, though.
It takes a rabid commitment to stay alive and make as many small, constructive, healthy decisions as possible.
You’re going to need help from friends (REAL friends) and you’re going to need to be incredibly gentle with yourself and you have to ignore everyone who is telling you that you’re weak or lazy. If they were wearing the three hundred pound backpack that you are, they would not be as excited about charging up the next hill, either.
You need some outside help, as well and while I cannot guarantee help, I’m happy to try.
Tour of Duty
There’s a reason why soldiers are rotated out of active combat duty after no more than 13 months at a time. It’s called Shell Shock, Battle Fatigue or PTSD. At least a third of all military personnel and civilians who experienced intense battles in war end up with some sort of serious emotional trauma that haunts them.
Living with depression is a day to day grind and you have to be strong, because there is no end to your tour of duty, unless you make radical changes to your lifestyle.
Slugging it out in the trenches is no fun. You’re strong and you will seek the help you need. And you won’t stop until you find it.
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Well put, and thank you.