A few days ago I came across Allie Brosh's recent post about depression, which has to be one of the best descriptions of depression ever made. What impressed me so much about it was that I believe someone who had never experienced a similar mental illness could read it and begin to get an understanding about what true clinical depression is like. I say I "believe" because, while I don't talk about it much (certainly not in my blog) I have experienced depression firsthand, many, many times.
Here is one thing I think I can say definitively: it is not possible to truly understand clinical depression unless you've experienced it. But for those of you who've never experienced it, please don't let that stop you from trying. That is why I'm straying from my norm and dedicating this blog post to an attempt to describe my experience with depression and anxiety.
One of the hardest things to overcome when you are suffering from depression is the prevailing attitude that surrounds you from all sides: that your illness is somehow your fault. Don't get me wrong - there are certainly people out there who derive a perverse kind of pleasure from being miserable; there are those who dwell needlessly on unpleasant things and bad memories. I think everyone has, at least once in their lives, been in a place where they just needed to "man up" and "get over it." I know I have! But clinical depression is an entirely different matter.
In the eight years or so since I first received professional help for my mental illness, I've been lucky; I haven't had to think about it too much. A combination of therapy, Dharma practice, and, yes, medication have enabled me to live my life as "myself." I think of my "real" self as someone with a lot of joie de vivre. I take a lot of pleasure in daily life, in my creative endeavors, and in being with people (and animals) I love. I am one of the lucky ones - I've found a treatment that works for me.
Everyone's experience with mental illness is different; for me, depression and anxiety were inextricably linked. I don't think I've ever experienced one without the other. I find that analogies are helpful when describing something as abstract as mental illness, so I've come up with a couple of analogies that describe my experience.
Depression: The Jar
Imagine, all of a sudden, that a great big jar drops out of nowhere and lands right on top of you, trapping you like a bug. You can see out, though it's kind of blurry, and the people around you can see in. Maybe at first it's not so bad - it's uncomfortable, but there's still plenty of air, and you can see out. You can still go about your life with some normalcy, so you figure it'll just go away.
Gradually, however, you start to lose oxygen. The glass starts to cloud up and you can see less and less. You're struggling to breathe and to see and you realize you have to get out or you'll die. So you start to panic, banging on the glass and screaming, but for some reason no one else can hear you.
That may be the worst thing of all: nobody else can see that you're stuck in a jar. They don't even believe it's there when you try to tell them. You try to explain that you're stuck and you're suffering and you don't know how to fix it, and they insist that it's all in your mind and you should just snap out of it. Eventually, you realize no one around you is going to help because no one believes you have a problem that you yourself can't fix.
So what do you do? Keep banging on the glass, even though you know you can't break it? That's getting harder and harder, because more and more, you're struggling to breathe. So do you lie down, close your eyes, and try to shut everything out - the jar, the people, the world around you - hoping someone will notice you now you've stopped fighting?
Anxiety: The Chasm
Say you find yourself standing right on the edge of vast, dark chasm. You can't see the bottom but you know it's miles deep, and you can feel the cold subterranean air rising from the depths. And you can't walk away from it. You can turn your back to it, try not to look at it, try to focus on other things, but it's impossible when you can feel your feet teetering on the edge, and one wrong step will send you plummeting.
Understandably, you're afraid. The fear of falling is with you constantly. Sometimes it's a small, nagging worry, sometimes it's sweat-drenching, nausea-inducing terror, but it's always there, making it very hard to focus on anything else.
And, like the jar, no one else seems to know it's there. Or if they do, they don't see why you're so bothered by it. "Just don't think about it" is the common response when you confess your fear to someone else. But how do you not think about it? The chasm is huge and dark and freezing cold and it's waiting to swallow you whole. How do you live with it?
Like I said, I'm one of the lucky ones. Therapy helped some, Dharma practice helped some, but the real treatment came in the form of something I'd been resistant to all my life - antidepressants. Antidepressants were for people who couldn't deal with the ups and downs of life. But eventually I came to the painful realization that without medication, there might never be any more ups, only downs.
So, reluctantly, I followed my therapist's recommendation and gave medication a try. And I was shocked, because I had forgotten what it was like to have a normal emotional life. A small dose of Prozac every day, and all of a sudden, I was a normal person again. I had ups, I had downs, but it was all okay. It was like the color had returned to life. It was like the jar had finally been lifted and I could breathe fresh air again. And the chasm? It was just a little crack in the earth.
Since that time, I've had a few lapses back into my old illness, but overall I've been very fortunate. Not everyone who suffers from depression can find a medication that works for them - in fact, some will make things even worse. There are those who spend their lives in the constant struggle for normalcy. Nothing, it seems, can help them.
My treatment might not work for me forever. I could always lapse again, this time long-term. But at least for now, I can choose not to be anxious about it.