Some of you may have read this post on my old blog when I first published it 11/19/2010. I have made some revisions. Next week, I will post my list of activities that I have found effective for keeping my depression under control.
This post is specifically about some common unhealthy thought patterns that are a major impediment to recovery from depression. I used to embrace these fallacies myself and I recognize them in other depressed people, too. It took me eight years (without therapy) to realize these beliefs are false and counterproductive.
That said, I am not trying to discount anyone’s experience with clinical depression because I acknowledge that it’s real, and I have experienced it myself. I am only referring to unipolar depression here, since I have no firsthand experience with bipolar disorder. Everyone’s case is different, but these are based on observations from my own thoughts and experiences, including over 250 hours of service as a crisis counselor for a suicide hotline, and my observations of others. I’m not an expert, so take it or leave it.
This post is NOT about those of you who want to recover and are actually trying to, because you are taking care of yourself.
What I consider to be a “depression obsession” describes the people who come across a though they are almost proud to be clinically depressed, “messed up,” mentally ill, etc. They express a desire to get out of their living hell, to feel happy again, normal again. But some of their actions indicate they are holding on dearly to their depression.
These are the people who see “beauty in pain.” Their depression defines their life and who they are. You can usually identify the extreme ones from all the lists of hospitalizations, diagnoses (with insurance codes), and past and present medications (including doses) that they flaunt on their blog. (Perhaps their blogging behavior is different from their daily life, but posting something publicly on the Internet is indicative of a desire for someone else to see it.) They show it off, as if to say, “Look at all I’ve been through!”
I used to want to show off, too, that I was “messed up” and taking antidepressants. But I’ve learned that most people are not always accepting or understanding, especially when it comes to something as misunderstood as mental disorders. There are many people who will immediately pass judgment and think you’re crazy, unreliable, or even dangerous if they know you’re on psychotropic medication. The older I get, the more I see the importance of keeping personal issues separate from academic and professional work. (In fact, I felt quite hesitant to post this entry on my public site, but I decided to do it in hopes that some people can benefit from it.)
When I was in high school, I used to think I was special among my peers because I was clinically depressed. Later I figured out my next point, which is: Depression does not make you special. In the U.S. alone, an estimated 14.8 million adults suffer from major depressive disorder, and another 3.3 million have dysthymic disorder.1 One in eight adolescents are clinically depressed.2 How special is that? Everyone is unique (even when it comes down to the details of their problems). Why not try to cultivate your uniqueness in some other direction?
Being depressed does not mean you’re deep and meaningful–it just means you’re depressed. Yes, you tend to notice and have an appreciation for things that non-depressed people do not. You may be offended when people who have no idea about mental illnesses just don’t get it, and think that they’re shallow. But it’s still possible to be deep and introspective when you’re not depressed.
My guess is that people who have to go through some form of suffering or misfortune that they have no control over will start to come up with reasons for why the experience isn’t really so bad. (Such justification is known as cognitive dissonance.) After seeing what we’ve learned from it, we begin to see it as a privilege that only people who have suffered like us get to experience. Then the feelings of superiority may start to kick in. Those who have not been through such experiences look “simple” and oblivious in comparison. There is no doubt that there are many things that we will never truly understand unless we’ve been there ourselves, but I see such experiences as an opportunity for me to develop empathy for other people who are suffering.
Any “benefits” are not worth the cost. I used to think I was a better writer during my depressed moods. I wrote strange stories about depressed people, which impressed non-depressed people. At the time, I honestly did not want to let go of my depression because I did not want to lose my ability. Well, hanging on to it caused more harm in the long run.
Even if you can make a living from your artwork or writing, depression still results in lost productivity. You should know. I shouldn’t even have to bring out the statistic that every year $35.7 billion is lost in the U.S. due to depression significantly reducing productivity.3
There really is nothing deep, romantic, sexy, glamorous, cool, or special about being depressed. Depression also has negative affects on your physical health. Studies have found links between depression and heart disease, as well as depression and hippocampal atrophy. (The hippocampus is a brain structure that is crucial for learning and memory. Hippocampal volume has been found to be significantly reduced in depressed patients. The longer the duration of depression, the more atrophy.)
If you constantly use your depression as an excuse, and think you can’t do anything because of it, you will never get anywhere. Yes, it does affect functioning, significantly. But I’ve noticed that there are some people who have gotten so used to the excuse that they still use it even after they’ve started recovering, and it’s only going to hold them back. I made this mistake for the longest time, and I sometimes still catch myself falling for it. Yes, it’s difficult, but I keep reminding myself to face my fears. It’s the only way to grow. (This deeply ingrained habit will most likely take some—or a lot—of cognitive behavioral therapy to change.)
In writing all this, the main point that I’d like to get across is that we often do have more control over our mood disorder than we realize. For instance, I can usually sense a possible relapse, but I know there are things I can do to try to not let it get there. I can either make sure I get adequate sleep, some physical activity, time out of the house, and positive interactions with people, or I can stay up late doing nothing, continue to think negative thoughts, dwell on things that can’t be changed, withdraw from others, and stay curled up in bed all day. Even if my effort does not prevent a relapse, my attitude will help me work my way out of it earlier, before it gets real tough. I know that preventing relapse is not the same as trying to recover when you are in-a-ditch depressed, but what I am saying is that you can take active steps to make the best of your condition.
If you don’t think you can do it on your own, get a psychotherapist to help you. An effective therapist who practices cognitive-behavioral therapy will teach you how to recognize your cognitive distortions and evaluate the evidence for and against such negative automatic thoughts. The therapist can assist you in coming up with alternatives, instead of only letting you ramble on and on about your problems. This is not the same as giving advice. Having someone listen is important during times of crisis, but if you’re not in a crisis and come in week after week to talk about the same issues, but never work through them, they will remain there (until you do or die, whichever comes first). There are some problems that pills alone can’t solve. Although people who were treated with cognitive therapy and medication recovered more than people on a placebo did, those with cognitive therapy were less likely to relapse the after treatment was finished.5
I’ve heard many people say that sometimes it’s necessary to accept their depression instead of trying to fight it. I agree that acceptance is important, because acknowledging there’s a problem is the first step to dealing with it. However, I also believe there is no need to dwell on it. In fact, people who ruminate more will remain depressed for longer and with greater severity than those who do not.4 You’re a victim only as long as you think of yourself as one. I don’t like the word victim because it implies powerlessness. I remind myself: Don’t be a victim, be a survivor!
Knowing what it’s like to be clinically depressed, these words will most likely be met with resistance. Nothing could get through to me while I was under that cloud. I am NOT telling anyone to simply “snap out of it” because I know that’s not possible. My only hope is that this will lead to a change in attitude and a sense of empowerment, however slight they might be, and a start on the road to recovery.