What does it mean to be depressed?
Questions and answers. Mostly answers.
Before we begin: this is not an attempt to provide answers for all forms of depression. I can only speak for myself.
You look cheerful, why do you keep insisting you are depressed?
It is a conditioned defence mechanism, my so-called cheerfulness and humour. I wish I can go around looking all morose and glum, but I have learned very early on in life that it keeps people away, and as much as I like to be alone sometimes, being alienated from society is akin to physical pain. Also does Catherine Zeta Jones look bipolar? Does this list of people look mentally ill? Do you know Abraham Lincoln was suicidal?
“They often wear what we call ‘the mask of depression,’ which helps them put on a more acceptable face to the world,” she said. “But behind that mask there is a terrible struggle going on. There is a stigma about depression and oftentimes the laughter distracts from feelings of weakness.” — source
Why do you seem like you’re able to go on with your life like everyone else?
I have moderate high functioning depression or dysthymia interspersed with major depressive episodes, depending on context and season. I am lucky enough that I am so good at managing it now that I hardly have a major depressive episode where people can’t get out of bed or muster the will to live, but what it means is that it still takes herculean effort to be functioning like everyone else. I am a lot less resilient to common stressors and I need to maintain a monastic lifestyle in order just to feel normal.
…but the other day you were so full of energy?!
…but what you don’t see is the crash after, where I need to hibernate for days to recover. Or you don’t see the days before when I am hyper-careful about preserving my energy so I can turn up and be present.
How about work? You seem to have done a lot.
Fortunately and unfortunately, work is like a drug to me. I used work to numb my feelings and avoid feeling existential despair. I am trying to uncondition my addiction to work after coming into awareness that I was working hard just to be seen.
There are quite a few visibly successful people I know who survive on therapy and medication — just because we don’t talk about it doesn’t mean it is not there.
People are starving in [x], there are a ton of people with lives worse than yours. You shouldn’t feel depressed.
I genuinely feel terrible and I spend a lot of time thinking about how to make the world more equitable. I know I am privileged compared to many other people. However, I have no control over how my nervous system is wired. It is a complex neurological condition, with genetic causes. Making me feel guilty about my existence is not going to make my nervous system auto-magically rewire itself.
Heritability is probably 40–50%, and might be higher for severe depression.– source
Have you tried [xyz]?
If it is out there in the world, I have tried it. If I am not trying it or haven’t tried it, I have my reasons. Since lack of motivation is a symptom of depression — the neurotransmitters affected in depression is the same ones that controls motivation — it is a challenge to just be alive, much less do [xyz]. What has worked for me is simply the time and space to try different cocktails on my own terms.
Is there hope at all?
I honestly don’t know. I have found some liberation in acceptance that it will always be there. Reading the stories of Abraham Lincoln and Charles Darwin greatly inspired me. There are good periods and terrible ones. There is also an argument that depression is an evolutionary mechanism which is somewhat comforting to me.
“Laboratory experiments indicate that depressed people are better at solving social dilemmas by better analysis of the costs and benefits of the different options that they might take.”
— Scientific American: Depression’s Evolutionary Roots
What does it really mean to be depressed?
Neurologically, it means my nervous system is somehow unable to function. The neurotransmitters involved in depression is imbalances in serotonin, norepinephrine, and dopamine:
The neurotransmitter serotonin is involved in regulating many important physiological (body-oriented) functions, including sleep, aggression, eating, sexual behavior, and mood…Another line of research has investigated linkages between stress, depression, and norepinephrine. Norepinephrine helps our bodies to recognize and respond to stressful situations. Researchers suggest that people who are vulnerable to depression may have a norepinephrinergic system that doesn’t handle the effects of stress very efficiently…Dopamine plays an important role in regulating our drive to seek out rewards, as well as our ability to obtain a sense of pleasure. Low dopamine levels may in part explain why depressed people don’t derive the same sense of pleasure out of activities or people that they did before becoming depressed. — source
There are also psychological factors that exacerbate the depression. The current state of the world is not helping, for example. Some childhood wounds still trigger me as though they happened yesterday. Does the neurological imbalance causes the psyche to malfunction, or is it the wounded psyche that causes these imbalances? Nobody knows.
Personally, it also means that I use so much of my energy just trying to function that I hardly have a surplus for anything else. So please forgive me if I fade into silence.
…but you have so much time to write, read and tweet?!
These are all things I do to survive. Having an asynchronous community is really important for me because I have no energy to have too many synchronous interactions. So I still appreciate the emails, texts, tagged posts, whatever. I may not have the capacity to respond at times, but it really makes a difference to me.
What can we do for you, or a fellow depressed friend?
Everyone is different. For me, I appreciate the space given. I have the tremendous luck to have people who are there for me when I show up, and somehow still linger around without expectations when I disappear into my own despair. Acknowledgement of the suffering is also helpful, instead of trivialisation or denial. Since the neurological system is in charge of our emotions, it cannot be subject to logic and rationality. We cannot think away our depression, even though it is commonly termed as a mental illness. It is very much a physical illness as much as any other dysfunctional organ.
Why are you writing this?
When I get another “you don’t look depressed” comment, instead of unending despair, perhaps I could forward this to the relevant party. I am pretty sure I am not the only one who wants to scream into the ether when such a impactful condition is not being honoured as part of who we are. Maybe there are some people who prefers not to be associated with their condition, but I very much feel that this has shaped so much of my life and who will I be without my brain? I should at least have a choice to let myself be identified with my condition and be acknowledged for it.
In all honesty, I am also hoping my loved ones would read this and stop harbouring the hope that I can be any different, or stop asking me when am I going to return to my old life.
I do a lot because I am trying everything I can to feel like I can be alive. If I choose to help with something, it is because I feel like if I cannot make much use of my own existence, perhaps it could be of use to someone else. Everything I do and who I am, is a consequence of my neurological makeup. To deny this, is to deny the person I am.
I have also spent tremendous amount of energy trying to shield people from my darkness, precisely because I care. But doing that has its costs. Moving forward, I just wish to be more honest even if there are consequences I have to suffer. I just want to make life more liveable for myself, and that means I have to stop putting other people’s feelings ahead of mine.
I am just trying to be alive, that is all.
