Saturday, October 22, 2011

Living with depression

This is something I really haven’t given much thought to. If you were to look back at this blog, which constitutes pretty much all my thinkin about depression since I started it, you’d probably find that around 75% of it are posts featuring me whining about my self-diagnosed chronic depression, around 20% about one or another alternative cure I’ve considered, 5% about miscellaneous stuff, and the remaining 37% about how bad I am at math. But, actually coping with depression, living day after day with this dark companion, is something that I’ve avoided altogether both in my head and on this blog, at least as an explicit topic of conversation. I’ve been so concerned about how much it sucks and how great it will be when I get over it that I’ve missed the obvious. To quote Jack Nicholson’s line, “What if this is as good as it gets?” What then? How have I coped and survived until now and how will I continue to do so?

A few weeks ago, I got an email from a teenager in Australia. Let’s call him Tom. He is also depressed. It appears to be chronic and he’s getting help. He’s not hiding it and, under the Australian health-care system, he has access to real help. So good so far, right? He emailed me because he felt that I, being someone more than twice his age with roughly the same set of problems, could provide some insight that the best of his counselors haven’t so far. To paraphrase because I didn’t ask permission to quote him, he basically had two questions based on the single premise that, since he seems to be stuck with this depression thing for life: 1) Is it really worth it to go on? 2) If so, then how does he cope with it because all the meds and counseling in the world, though they can help, might never make it really go away.

I didn’t ask his permission because I didn’t know if I would respond at all. I’m still not sure, as I type this sentence, if I can come up with something worth saying. I’ve been pretty flummoxed since I got his email. Given that I’ve never really considered question 2, it gave me a lot to think about. How have I coped? Do I really know or do I plod through the day, fearful of the alternative? I’m still not entirely sure.

Let’s tackle question 1 first. We’re talking about suicide although he never said it. It’s something to talk about. Most professionals and patients seem to treat suicide as the no-no, hush-hush alternative that we must never speak of or even allow ourselves to consider. I don’t really have a problem with it, I really don’t. Who’s to say that a person in a severe depressive episode is in any less pain than something who’s body is failing from a terminal disease. Your conclusion about whether or not someone in the latter situation should be given the ability to kill herself may be different from mine but, in the post-Kevorkian world, I think that we can all agree it’s something that should be considered and discussed. Ah, you say, depressive episodes pass and the person has the chance at life beyond it. True, but a life punctuated by random, unpredictable depressive episodes may be too much for one to deal with. Ultimately, the moral positions on suicide are not unlike abortion – they are too wrapped up in personal ethics, religious beliefs and societal mores for there to be a clear, universal answer. I believe it should be a personal choice. I do not consider someone who commits suicide to be immoral or even wrong. (The exception in my mind is when one commits suicide when he has obligations, financial or otherwise, to his friends or family. It is condemnable to leave behind someone to clean up the mess that he was too cowardly to clean up himself.)

But, none of that really addresses Tom’s question, does it? Is it worth it to go on? Here’s the answer that seems to have evolved in my life. Yes, for the most part, it’s worth it to go on. I have more good days than bad and, most of the time, I’m hopeful about the future. I’m also curious about the future; I really want to know how things will turn out. It seems a little silly to base my mortality on seeing the plot through but it works for me, somehow. I’m also damn scared of killing myself. At my lowest moments, the thing that kept me from doing the deed can only be described as pure cowardice. So, is it worth it to go on? As I said before, so far, for me, it beats the alternative.

Okay, then, on to Tom’s second question. How to cope with it? This is the bit that really stymied me. I really don’t know how I’ve coped. As I turned this question and the answers I could think of over in my head I began to realize that I was writing a commencement address – seek your happiness, be true to yourself, love your family, blah, blah, blah. Like I said, Tom’s a teenager and he’s set to graduate soon enough. I’ll leave the platitudes for the C-list actor who happened to graduate from Tom’s high-school and gives that speech the year he graduates.

So, I tried harder to come up with real answers. The thing about depression is that it is our problem. It is fairly well defined and we kind of have a list of things it does to us. However, everyone has problems, right? I heard of a study a few years ago that says that babies and toddlers feel the same level of anxiety over their little dramas as we adults do. It seems silly to consider that a missing toy leads to the same amount of stress as trying to figure out how to pay the utilities on a limited budget but, apparently, it does. My point is that I think humans tend to look for and focus on points of tension in our lives. We depressives are lucky in a twisted way in that we know the source of our tension and we sort of know what to expect from it. Other people with a different set of less definable problems are trying to deal with them as best as they can. I’m not sure if I’m making my point very clearly here or if I even really had one to begin with. Let’s move on.

As I’ve stumbled through life, I seem to have settled to two key points that guide me.

The first is to know your depression. This means that it’s important to learn when depression is making you feel a certain way or real life circumstances are. Rage, anxiety and sadness are all occasional symptoms of depression. They are also symptoms of the human experience. Whenever you feel extreme emotions, take a beat and try to identify if it’s a result of real life or some meaningless, internal storm. I’ve lost friends and alienated family members over not being able to tell the difference. Innocent comments can be misinterpreted when observed through a depressive filter and turned into insults.

My second best bit of advice is never blame your depression. I’m talking about both externally and internally. Externally is easy. Just don’t do it. Never use your depression as an excuse for your actions. If you are an ass to your best friend because you misinterpreted an innocent comment while you were having a particularly low day, don’t say you did it because you are a depressive. Your depression might have influenced you but final decision to lash out was yours. Apologize, hope he accepts it and move on. This isn’t to say that you never talk about your depression – your friends might be a great source of support for you - just don’t rely on it as an excuse for your bad actions.

More importantly, never tell yourself that you acted a certain way or made a bad decision because of your depression. Once again, depression might have influenced you but, ultimately, you are responsible for what you do. Blaming depression becomes a crutch, relieving you of all responsibility and that can become a vicious cycle: I’m even more depressed now because my life sucks because I made bad decisions because I was depressed at the time so now my decisions are going to be even worse and my life will suck all the more. Depression may be a part of who you are until the day you die but never let it define who you are.

I tried to avoid platitudes but that last sentence came dangerously close, didn’t it.

So, Tom, there’s my answer. I’m sorry it took so long but you really threw me on that one. You gave me a lot to think about and I hope I gave you a little insight, too. Best of luck, brother!

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