If Everyone’s Depressed, What Makes My Sadness Special?
Making meaning of misery, and making peace with how you cope.
I’ve been given Sertraline in the hopes of buffering some of my sadness. It is sitting atop an unopened box of birth control (another new addition) and Clobazam, prescribed for the adjustment period. I have yet to take it.
Wracking my brain for an answer, I can come up with a handful. I want to share a drink with loved ones without worrying about contraindications. Summer is approaching and I don’t want to be weighed down by side effects on top of the sweltering heat that looms. The end of the year is in sight, and I should be able to bite the bullet until then; once I am ‘free’, I will be able to sleep for months, write to my heart’s content, and sequester myself as I see fit. My executive dysfunction is bad enough as it is, so an SSRI with side effects impacting memory, however short-term, seems nefarious, at least in my mind’s eye. I want to ‘fix it’ myself. I want to will myself into the realm of being okay.
Disorders run into one another like streams trudging towards a river. Plug one hole and the water will find an alternate route. One of the main manifestations of my anxiety is whether or not things impact my health, namely my brain and my fertility. Long-term use of psychiatric medication does not bode well overall; brain damage, the development of other symptoms, and physical health are all impacted by the chemicals we crave — and often need — to placate parts of our psychic pain. Additionally, shame and aforementioned executive dysfunction have bred such indecisiveness and self-doubt that nowadays I crumble when ordering an Uber. So, what does one do when the helping hand appears transfigured into a talon? Take the plunge, knowing that you may be scarred (by your own anxieties or novel medication-related anomalies), or run the other way, realising that the same outcome could be true of the alternative path?
I have had forays with depression since I was about 11. Entering adolescence amidst various forms of personal turmoil, the only way my unidentified autistic self could claim any public display of emotion beyond my tough exterior was to become ‘emo’, to claim pain as an active mask as opposed to a passive consequence of circumstance. I panned towards hurt. I allowed myself to steep in what I thought was unfounded misery, clung to it, let it subside, and became subsumed once more whenever an external event was able to ‘cause’ sorrow. I felt validated by ‘clinical depression’ as a terminological absolute. There was a name for this ocean. Medication was a desirable solution to my problems — all of my problems, of course. This desire was met with reluctance by my caregivers — in hindsight, rightfully so.
This whole conundrum shows my never-ending paradox: I am simultaneously ahead of and lagging behind my self-concept. I craved diagnoses. But now that I have one (or some, depending on whether or not one counts passing comments, scores on self-assessments, or my own identifications of ‘disorder’), I pathologise myself less, or at least differently, in terms of my traits. This tendency rings true in the context of medical intervention, which, once placed firmly in my grasp, liquifies and slithers away from its former pedestal whenever it is offered and not begged for.
I want to be a psychologist, and psychiatry scares me. Its teeth seem sunken into every facet of my shortcomings, though currently only in theory. What I wrote before about pathologising myself less is not entirely true. I definitely compartmentalise my behaviour in terms of what cluster of traits I may tend towards on any given day. The difference is that now I can identify and intellectualise what exactly I am ashamed of, as well as where it comes from, as opposed to just labelling and commiserating. During intimate pauses, ‘Sorry if I seem distracted, ADHD-brain is floating away, but I promise I’m here.’ When I burst into tears at an inopportune moment, ‘Sorry I’m crying, I’m just really depressed at the moment, but thank you for listening.’ Daily, ‘I don’t know what’s wrong with me, but I feel like I’m falling apart.’ Still over-apologetic, still stuck in diagnostic language much to my ideological chagrin.
In this vein, I have a love/hate relationship with ‘depression’ as a concept, especially given the last eighteen months of global uncertainty and chaos. Mortality glares at you some days, and barely bats an eye on others. The threat of death and its by-products — of everything coming to a grinding halt once again — weighs down upon all of us. What is more, is functionality or lack thereof being tied to productivity. We know this. Capitalism eats our souls for breakfast, et cetera. This is coming from someone whose family has benefited from capitalism (and the requisite trappings of white privilege) to the point where I have attended a private school, can aim to do a Master’s with minimal stress of financial unavailability, and have been systemically allowed to take up more space than many others. I got my first car a few days ago, a seemingly ecstatic moment in anyone’s life. One filled with privilege and expectance. And yet I had an on-and-off breakdown for over three hours afterwards. Cocooned by new car smell and late afternoon sunbeams, the atmosphere seemed stuck in my throat. Singed my eyes. I am barely afloat amidst the carnage, can safely say that I have been consistently unravelling for over two and a half years, and I am one of the ‘lucky ones’.
This made me wonder: who isn’t depressed nowadays? I posted the PHQ-9 on my story and asked people to submit their results to me anonymously. Some have a clinical diagnosis of depression and/or other related maladies, some are medicated, and others have no clinical validation of their sadness.
The thresholds regarding the severity of depression in terms of the PHQ-9 are as such:
- Normal (0–4)
- Mild (5–9)
- Moderate (10–14)
- Moderate to Severe (15–19)
- Severe (20–27)
Nine people responded to my poll. Below is my first-year psych student summation of the results:
Most scores were ‘Severe’ in terms of their categorisation, and only one score fell into mild. I am a baby and statistics are not my forte, but seeing the numbers in front of me made my logical little brain buzz. This proves that my friends are sad, and not much else.
Like a good trauma baby, I am currently reading Bessel van der Kolk’s The Body Keeps The Score (in addition to Ottessa Moshfegh’s My Year of Rest and Relaxation, both of which are making me feel seen re: perpetual exhaustion and feeling stuck in sadness). I gifted it to myself for Christmas, albeit two months early. According to that which I’ve read so far, trauma equals long-term ills (a.k.a. Not Vibes), including but not limited to: chronic fatigue, relational difficulties, dissociation, hypervigilance, anxiety, disordered sleep, and depression. My relation to Trauma™️ as an integral component of my life and self has seen what can only be described as exponential growth over the last two years. This has been further accelerated by my cognisance of what I now understand to be autistic burnout.
Autistic burnout and depression feel like cousins in their occupation of my ‘functionality’. Hallmarks of autistic burnout are dysregulation, lack of motivation, lower executive and general functionality, hypersensitivity, withdrawal from the world, fatigue, and a decreased ability to ‘mask ‘, whilst hallmarks of depression are persistent sadness, lethargy, hopelessness, dysregulated sleep, dysregulated appetite, poorer concentration, anhedonia, guilt, and urges to destroy oneself. Discourse suggests that these two states of being are mutually exclusive, or that depression can be felt as a part of autistic burnout but not as an entity to be conflated with the latter. As an overall sadsack and autistic adult who is experiencing both of these things simultaneously, I disagree with the discourse. If autism carves variance into every aspect of existence, it is fair to say that autistic depression is related to one’s status regarding the spectrum. Presently, my days consist of feelings of suffocation. Everything is sticky. Too much. Too loud. And yet the only escape I can tolerate at times is doom-scrolling or writing, wincing at the blue light and cognitive effort those activities involve. I know I am approaching overstimulation station when my skin prickles itself and my eyelids sting. Whatever depression I am wallowing in, that fire is an overwhelming component, only instead of coming in waves following over-exertion, it stubbornly remains, a slow burn that clouds my vision and comfort for days on end. Depression and burnout, autistic or otherwise, share exhaustion and regression as common themes to their manifestations. In my understanding of these states of being, both often come about as a result of the onslaught. This onslaught could entail sensory, relational, or traumatic elements. I refuse to believe that sadness sprouts from nothingness.
Maybe that is why I am hesitant to take the antidepressants. Outside of my first- and second-hand experiences with episodic pitfalls of psychiatric intervention and its motivations, I do not wish to pathologise a justified response to the turmoil of my universe. Can I not just be tired in peace?
The last three years have been action-packed, so to speak. My grandmother died. My parents split from their partners. I had a brush with death. I was misunderstood and medicated for three months, the process of which scooped out the contents of my skull and threw them off a cliff. I navigated a complex situationship that felt like a supernova. Concurrently, I got a girlfriend. I finished high school in 2020 (need I say more?). Of the eight subjects I did, I matriculated with seven distinctions and one 79 despite drowning in the pain of unmasking and relational trauma. I was violated. I got an autism diagnosis. I started my degree. I got a part-time job. I learnt to drive. I was cheated on. I left an abusive situation feeling survivor’s guilt and a hollowness in my centre akin to implosion. Whilst this was unfolding into further chaos, I fell in love with a boy from my university after an adolescence of exclusively homosexual behaviour and identity. I have de facto moved in with him. We get lunch together at the same place a few times a week, kiss each other’s foreheads and noses whilst imbued by burnout and fatigue, eat cheese and crackers like our contentment depends on them (which, of course, it does). I passed my driving test. I get stuck in traffic by myself. Adulthood is in sight.
It is a wonder that the regularly scheduled guttural bleating didn’t burrow its way into my daily routine sooner. The bough has certainly broken in that respect. Rightfully so. I oscillate between accepting the deluge and feeling okay about my fragility related to its contents and wanting to ram myself into a wide-open space, kick myself for allowing stacks upon stacks of seemingly trivial happenings to impact me as forcefully as they have. Either way, I am the eye of the storm. There is nothing more indulgent than feeling sorry for yourself. Pain holds allure and depth, material to revisit long after you have emerged from its murky depths. Within this indulgence lies the myth of individuality. The need to feel special. No one else could possibly be filled with as much misery as you. But, as I have said vis-à-vis everyone is depressed, the lonely immersion into one’s own ‘illnesses’ and their ‘cures’ (e.g. depression and SSRIs, ADHD and stimulants, etc.) can only help so much, surely. 5% of adults are said to be depressed. That’s 395 million people. Even by clinical standards, you are not special!
As many of the advocates that traipsed through this electronic ether before I have said, community is key. I don’t know if I want community in the traditional sense — loads of people to talk to, support groups, direct communication — but I know that trawling through forums in the early hours of the morning, a cup of tea and pressure hug from my beloved, and reading accounts of people whose lamentations align with mine makes me feel less alone. Summer is going to grace me with good books and laughter and relief. Right now, I will ride this wave sans a chemical buffer, whether or not I end up dabbling in medicalised equilibrium at some point in the future, holding no judgement for those who want or need something of the sort. In the writing of this, I have ruminated on the fluctuations of the entropy and wherever I happen to drift. This piece has given me a sense of tranquillity in the uncertainty of this suspension, because, in moving through states of desperation, dissociation, sadness, exhaustion, inspiration, and neutrality, I have realised that being miserable is okay. I am going to be okay. We are all going to be okay.
This post was previously published on Patreon.
