This is a guest post by Rob Robinson. Used by permission.
Since I know that a number of my closest friends on here live with clinical depression and the attendant illnesses that derive from it, I thought it might be appropriate to post some thoughts on the matter, both for sufferers and non-sufferers. These are based on personal experience and also experience of working as a mental health lecturer, so they’re a mixture of life and theory.
What clinical depression IS – and what it isn’t….
Depression is not a lifestyle choice. It’s the most debilitating of illnesses and nobody chooses to suffer with it. The actual cause (as ever the medical profession is obsessed with finding a concrete, biological cause, and preferably one that can be treated with medication…) isn’t proven, though certain chemical imbalances in the brain are thought to occur in the sufferer. As with all mental illnesses, it engenders a great panic in medics because it can’t be ‘seen’ – it is diagnosed through observation, not scans or biopsies – and because it is a disorder of perception and thinking, both functions of the mind, and the mind happens to be contained within the brain, focus of research tends to treat it as a brain malfunction. The evidence for this is actually alarming sparse. Once the two clear physical conditions that might affect the brain – that is, organic disease such as Alzheimer’s, and trauma – where the organ has actually been damaged, as in taking a huge blow – are ruled out, then it all gets into a bit of a mushy grey soup as far as the most severe mental illnesses are concerned. Ironic, given that the brain might be described as mushy grey soup itself….
The characteristics of depression for the sufferer are dominated by reduction in affect, affect being the term used to describe mood. People who experience low mood for a short period or periods often self-diagnose with clinical depression. Often however they are wrong. Clinical depression is a much longer-term condition. The sufferer will gradually withdraw from any activity that once brought pleasure. This might seem perverse or even attention-seeking, but it isn’t. The individual cannot experience pleasure – and any attempt at doing so reminds them of their past, happier life. This feels so bad that withdrawal is actually a pretty sane and necessary thing to do, just to survive. Of course it becomes a vicious circle, as the sufferer is left increasingly alone with his thoughts, which are negative and pessimistic, and life becomes one of endless, dark reflection on past failures and missed opportunities.
Anxiety-Insomnia-Depression: the unhappy threesome
Anxiety is actually the engine that drives depression. Add in insomnia, which is a very common symptom of the illness, and you have the perfect unholy trinity of experiences to render life pretty untenable. Why is the depressive anxious? Well, you have to imagine a world that is suddenly full of threats. Not just the ‘normal’ ones, such as, say, fear of physical harm, intimidation, financial insecurity, loss of status or bereavement. But laughter, happiness, frivolity – all become a threat, too. An ever-present reminder of how you aren’t invited to the party any more. All the sufferer can do is set their expectations of life as low as possible, and reduce their status to one of mere existence. I describe it as like putting yourself on standby mode…the power is connected to the TV, but there’s nothing showing on the screen. Only the little red light glows to give any sign of life.
Anxiety leads the sufferer to become acutely aware of everything around them, and perceive threats where others do not. This state is known as hyper-vigilance. It’s incredibly enervating because you are constantly on the lookout – so withdrawal from life is easier to bear. Anxiety can also lead to chronic sleep disturbance, either insomnia or oversleeping. Hence the individual suffering with depression is frequently under attack from three sources…and as a wise general will shy away from fighting a war on two fronts, he will know the near-impossibility of winning one on three….
What doesn’t help…
“Cheer up! It’s not THAT bad!”
Yes, it is. Thank-you for making me feel even more of a failure.
“Just do something – ANYTHING – it’s bound to help”
You think I’m stupid as well, clearly. Like I haven’t tried that. It made things worse. I don’t attempt things because that way at least I can’t fail in doing them.
“You used to be fun! What happened to you?”
I died. Inside. I sincerely hope it doesn’t ever happen to you. In the mean time, please stop pushing me to make this emotional death, a physical one.
“For fuck’s sake stop being so full of self-pity!”
Thank you. You are clearly from another planet. Depression is NOT about self-pity, for the simple reason that to pity yourself you have to like yourself. And I really, really, do not like myself one little bit. Depression is about self-deletion. If I delete myself from the world, it will be a better place. And I will stop making those who still try to love me so unhappy.
“I know how you feel…”
No, you don’t. Depression is unique to every sufferer. And besides which, you are my friend. I don’t want you to know how I feel, because the only way you could do that is to feel like it yourself. And since I love you, I wouldn’t wish this on you in a million years. Or on anybody, really…
How to help…
Love. Understand, that you almost certainly CAN’T understand… Be patient. Don’t apply pressure. Don’t judge. Don’t harass. Don’t take to heart the things that the sufferer may say to you that hurt. Remember this is a person you love, who is still that person, but is in a bleak and isolated and terrifying place right now. They might seem a million miles away and be utterly lost to you. Please try, not to become lost to them. Try and see their depression as if they are taking Winston Churchill’s black dog for a very long walk. And keep a light on, waiting for them for when they get home.
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© Rob Robinson 2015
Image: Rob Robinson