You can call it a defect in my personality, but my first instinct after learning of the recent shooting in Newtown, CT and reading the frenzied responses was to make light of those responses. Not the heartfelt expressions of sympathy or sadness, but the immediate calls for arming the school officials (I did read at least one response that stated this never would have happened if the principal, teachers, and lunch lady would have had guns on them). I have only the smallest feeling of shame for jumping back into levity so soon after a tragedy. What else could I do?
This horrific event has brought up two big issues: gun control and mental illness. I have some opinions on both of them, but one clearly weighs on my mind more than the other. So if you’re looking for a discussion about gun control, I merely direct you to The Onion, which said it better than I ever could. Today I want to talk about mental illness and how it is perceived in our country and perhaps the world. I don’t want to talk about it in terms of policy. In fact, I can sum up my opinion in one sentence: Everyone should have access to quality mental healthcare, and anything less is indicative of a society’s gross inadequacy. Instead, I want to talk about it in very personal terms, and I want to focus on the only type of mental health issue that I really feel qualified to discuss. I want to talk about depression, how to deal with it if you are suffering, and how to help somebody you know who is suffering. Because fortunately, there are many correlations between how we can approach the many types of mental illness, and understanding one facet can open up the understanding of many.
Let me get this out of the way first. I have struggled with depression for at least ten years. I say at least, because I probably suffered from it before that, but was unaware of it. While it’s something that I still deal with from time to time, a combination of therapy and medication has allowed me to overcome it to the extent that I am able to be consistently happy and productive. I’ll never forget the moment when, after treating it directly for several months, I had the epiphany that I am capable of being happy and feeling good about myself and my life. Until that point, I had resigned myself to leading an unhappy life, since that was “just the way it is.” Having been up and down with depression over the years, I feel like I’m an expert in knowing what the symptoms are, and more importantly knowing how the symptoms feel.
While there aren’t many absolutes in how different people experience depression, there are three components I have found in my experience that seem to define it best: isolation, hopelessness, and self-loathing. That brings us to one of the more peculiar and distressing components about it, which is that it is an illness that hinders you from helping yourself. The feeling of isolation makes it hard to reach out and connect with someone who can help you. The hopelessness makes it feel like there’s no point in getting help, since the problem can’t be solved. The self-loathing tells you that getting better is not something you deserve. In that sense, your mind is pitted against your best interests, and it is far too easy to be pulled in, unable to escape.
The self-loathing aspect of it is particularly disturbing to me. I was able to recognize that I was feeling terrible about myself. And I was also able to recognize that those feelings and the way they manifest are repulsive to other people, and to myself as well. If you’ve ever spent time around someone who is depressed, their self-denigration and lack of motivation can be off-putting and downright infuriating. My reaction was often to spare my close friends the discomfort of being near me, since that way I couldn’t alienate them. I ended up just pushing them further away by not bringing them into my life.
Here’s where our cultural approach to mental illness can be harmful. I find a pervasive attitude in our culture that equates depression with weakness or lack of will. A clinical diagnosis of depression is far less tangible than a diagnosis for something like diabetes or cancer, so it’s too easy to treat it as something non-existent or, pardon the expression, all in your head. As I stated above, the nature of depression is that you often feel that you don’t deserve to get better. So if you believe that you’re not good enough to get better, and the voices in American culture are telling you that you’re not strong enough to “snap out of it,” the feelings of self-loathing get compounded and can lead to someone hurting themselves.
So let me be blunt about this. Depression is real. If you cannot fathom how or why someone could be depressed, you are exceedingly fortunate. But just in the same way that you needed extra help with algebra while some of your peers sailed right through it, different people experience life differently. It is narrow-minded to think that just because you don’t experience it that it doesn’t exist.
If someone in your life is experiencing signs of depression, such as hopelessness, aversion to social situations, or persistent sadness, there are a few things you can say and do to help them in their situation. First of all, listen as best as you can. Let them understand they’re being heard and that you’re sympathetic to how they’re feeling. This is not the time to be problem-solving. I remember being told during a particularly low point that I just needed to get out more, which was not only wholly unproductive, but hurtful. I wanted to ask the person, “you actually think I don’t want to get out more? You think I like feeling like this?” Listen and empathize. Probably the most helpful thing that can be said is a sincere, “that sounds like it’s really hard.” It can be good to follow it up with, “it’s ok. You’re going to be able to feel better. You won’t always feel this way.” Again, offer support, but don’t push any solutions at this point unless specifically asked.
I say listen as best as you can, because in our relationships with friends, families, and partners, we have complex roles. We go out and have good times with our friends; we experience complex family dynamics with our relatives; we entwine intimacy into our relationships with our partners. Whereas it’s important in these roles to provide support for our loved ones, at a certain point it can harm our relationships as well. Sometimes in listening to the issues our loved ones are dealing with, our own desires and roles can get muddled in the process. As a listener, you need to be aware of how their issues are affecting you also, and you need to be able to catch the breaking point before it hurts either of you. Sometimes that means saying at some point, “It sounds like you’re having a lot of difficulty right now. Would you consider talking to a third party about it?”
To me, the purpose of a therapist is to provide the support and help you need without any of the dual roles that come with friends, families and partners. For someone who has never seen a therapist before, the act of talking to someone about your problems, coupled with the isolation, hopelessness, and self-loathing inherent in depression, can be paralyzing. It also doesn’t help that because the existence of mental illness is often challenged, the visiting of a therapist to help find a solution is often perceived as a pseudo-science. In suggesting finding a therapist, I have found it helpful to not be pushy, but to be casual and be clear that this is a potential solution to the problems the person is having. It can take time for someone to come around to the idea that this might be good for them. With one close friend, we talked about it on and off for about two years before she decided it was worthwhile to try.
Medication for depression also seems to be a controversial subject, though I’m not sure why. You have hyperthyroidism? You take medication for it to make life bearable. I have depression? I take medication for it to make life bearable. No one is challenging the sufferer of hyperthyroidism to deal with it, or telling them that if they just worked a little harder they’d be able to overcome it. The truth is that there are drugs that help me, so I take them. It’s not a sign of weakness, and it’s not an indication that I’m covering up my problems. When a friend recently made the statement about someone she knew, “well, she’s on anti-depressants, so you know she’s not doing well,” I was disheartened and actually insulted. Shouldn’t it be: “well, she was feeling depressed, so she found the motivation and strength to do something about it.” Yes, I’m sure drugs are often over-prescribed, but sometimes they’re also just “prescribed.”
Finally, if you are suffering from depression, I also say this is real, in that it is something that is actually taking place in your brain. I believe you when you say you’re feeling alone and lost and you don’t think that it can ever get any better. I understand and I empathize, but I also know from experience that it is possible to find a way to not feel this way. Things can get better, your life can change, and misery does not have to be the constant backdrop of your life. With the help of the loved ones in your life, you can find a therapist, a medication plan, a diet, an outlook, or whatever it takes to have the rich and satisfying life that you deserve. That we all deserve.