Beyond 101: Depression: The Other Stuff
This article is part of a series on going deeper with mental health and wellness. Disclaimer: I am not a medical doctor. Please seek any needed medical advice through your preferred medical professional.
Depression is an illness comparable in course and treatment to any other chronic medical condition. It isn’t a mood, a state of mind, or an emotion. I often think we should call it something else, like intermittent hypoenergetic disorder. That makes it sound more official and less like a thing you might feel when your favorite band breaks up. (Distant, mournful sobbing for Great Big Sea).
Major depressive disorder is an illness with many associated symptoms. If you’re diagnosed with depression, it’s important to be mindful of symptoms other than feeling sad. The more you can be aware of, the more you can address through treatment. What I’m about to list are not necessarily on the official list for clinical depression. Rather, they are a group of anecdotally related symptoms I often see when I see depression. Look for the following:
- Marked low energy
Depression can feel like the weight of a thousand elephants sitting on your limbs. Getting up to get ready for work can seem difficult. You can become physically tired easier. You may sleep more (or you may find you have a ton of fatigue but have trouble sleeping). When we think of depression, we think of the mood-related symptoms but this low energy is a physical symptom of a physical illness. Just like we become fatigued and need rest when we have a cold, we become fatigued when we have depression. The danger is that the fatigue becomes chronic and seems to linger on and on.
As with most things that help depression, the very thing you don’t want to do can often aid with this low energy issue. Exercise, in particular, can make a noticeable positive impact on overall energy levels. You only need a little movement every day, like walking or yoga. Like other chronic conditions, mindful movement seems to help the symptoms. (See your doctor for any concerns about starting an exercise regimen)
- Pac-Man Syndrome
Many people like to say that depression lies. While I agree, I see it a little differently. The problem with depression isn’t as much that it lies outright but that it tells the truth in such a malicious way that it may as well be lying. When I talk about this, I call it Pac-Man syndrome.
Look at Pac-Man:
Imagine life’s experiences fitting into the full circle of Pac-Man’s body. We know that life contains lots of good things and bad things (a pile of each, you might say). Depression narrows the focus of truth down to only the parts of life contained within Pac-Man’s mouth. A small sliver of the whole truth is all a person with depression gets to see, hear, and experience.
A person without a mood disorder need only talk to a person with depression to see this in action. It’s commonly called “yeah, but” syndrome: Anything you can say, depression can say more negatively. Depression can show you the bad side of any situation. Depression can tell you how something great is going to turn sour. Depression will have a beautiful meal and only remember that the waiter made a comment that might have been about its weight. Depression will receive a gift and only feel the shame that it didn’t reciprocate (rather than the more holistic experience of joy, excitement, being loved, and guilt for not reciprocating).
Depression, in short, is a real boner killer to be around. Imagine being around it all the time. Imagine never being able to escape the narrow view of life that it allows. Now you know why telling a person with depression to “look on the bright side” is an asinine thing to say. They literally can’t; it’s physiological. You might as well tell a person with a broken arm to lift their arm and shake it around until the bone is healed by magic.
One way through this is to frequently and passionately practice mindfulness. Truly a depressed mind needs to be forced to see the whole picture (not the bright side but all of Pac-Man). The depressed mind needs to be re-taught how to see all the things. The good news is we have science that tells us mindful practice can help lay down new pathways in the brain. We can change our brains just as we can set and cast a broken bone to help it heal. Here’s a list of mindful resources available right now, online, for free.
Why Pac-Man (which is kind of a stupid analogy) and not a pie chart? Well:
- Memory Issues and Decision-Making Trouble
Depression makes thinking difficult. I like the Pac-Man analogy because it sticks in the brain, and brains on depression can be slippery. A person’s decision-making skills become mired down, the brain’s processing speed slows, and everything that used to be simple—going grocery shopping or planning a vacation—seems insurmountably difficult.
These changes can happen slowly, so a person with depression might not notice their difficulties increasing until they are deep within them. By then, the faulty thinking of depression will allow them to believe that they are to blame for their troubles. Depression will tell you you’re not suffering from an illness, you’re just stupid or lazy or useless or whatever.
Imagine if we treated someone on chemo like that. Downtrodden? Forgetful? Struggling to do life stuff? These make sense when a person is being pumped full of poison and fighting a deadly illness. Depression is an imbalance of chemistry in the brain—something up there is not working correctly. A person with depression is, in essence, chemically compromised. Depression is sometimes deadly. Depression is a serious illness like any other. Just because we can’t take a picture of it right away does not mean it isn’t real. (Incidentally, we can take a picture of it.)
Help for this can come in various ways. One way, I think, is in shame resilience work. If depression is an illness, there is no shame in being limited by it. If we can beat back shame and go after it with empathy and sharing our stories, we can come a long way toward accepting what can be done and what can’t in any given day.
Depression causes people to shrink away from their lives. Apathy is a well-known symptom of depression, and it is pervasive. Slowly over time, people with depression will carve away at their social time, their recreational time, their self-care time, and anything that requires effort. Relationships suffer, either through open conflict or through the disappearing act depression casts over someone’s life.
Life starts to look like the small sliver of truth depression shows a person: short, brutal, and nasty. What might have been untrue at first becomes true–friends stop calling, job difficulties can increase, and self-care disappears. A person feels physically unwell and perhaps unable to address things like exercise, healthy foods, mindfulness and getting medicated if necessary. Who wants to read a self-help book on shame when they’re feeling that tired, forgetful, and low?
The obvious answer for help is the right one here–expand. It will feel wrong and tiring and useless. Do it anyway. The depressed brain is terrible at knowing what’s good for it. A lunch with a friend may cost a lot in energy, but the net gain can be worth it. Expand, take up space, push back, and be sure to rest.
A word on moods, since I am discussing a mood disorder. Depression does not mean sad. It can run an entire course in someone’s life and never make them feel sad. It means illness and can affect mood symptomatically. A person with depression might be frequently angry or stop caring altogether (apathy again) or spend all day crying but not feel sad, or they might be anxious and nervous all the time. Sometimes depression is like having a dimmer switch on emotions—a person can feel happy, sad, angry, lonely, but they feel everything at a distance or in a muted fashion.
In short, depression is less a feeling and more of an effect on feelings—a nasty one, generally.
What I want people to walk away with here is an understanding that major depressive disorder is a complex illness that affects many parts of someone’s life. Having depression is like having any illness: There are good days and bad days; there are treatment breakthroughs and setbacks. Nothing means failure, and nothing about depression is related to a person’s personality, worthiness, or awesomeness. Depression is an illness, not a personality. Act accordingly.