Posts Tagged ‘depression’

  • Not recognized by mental health professionals as a valid (or “billable”) diagnosis.

And still, it is…

  • Feeling like you always have to prove to everyone that you are good enough
  • Isolating yourself because there is no one you can trust
  • Having explosive outbursts of rage at the store clerk because he forgets your receipt or your cat because she threw up on your carpet or your friend because she didn’t answer your text
  • Not remembering the reasons behind your anger or your sadness or your hopelessness
  • Cutting yourself to take the pain away
  • Being sure everybody is angry with you and saying bad things about you
  • Wishing you could die so there would be an end to your pain
  • Feeling guilty because you didn’t suffer “real” trauma
  • Never living, but just surviving day-to-day

Complex PTSD is all this, and much, much more.

  • Sleeping all day.
  • Not sleeping at all.
  • Having no appetite.
  • Eating everything in sight.
  • Going through the day with a smile on your face.
  • Feeling numb.
  • Dragging yourself through each day because that’s what others expect of you.
  • Always feeling like you are covered with a thick, scratchy, woolen blanket and huddled at the bottom of a well.
  • Not having enough energy to make a meal or do the dishes or vacuum the floor.
  • Hearing that this life is amazing and worth it and how you will see that if only you will exercise or get out more or volunteer somewhere.
  • Knowing that everyone is lying to you, knowing that you are really ugly and stupid and worthless.
  • Feeling like you’re walking through a suffocating blanket of mist and fog.
  • Needing to read the same page over and over in a book, and still not understanding what you read.
  • Sitting for hours on your couch, watching Andy Griffith reruns
  • Being told that your worse day is not nearly as bad as that stranger’s who was just diagnosed with cancer or the father who just lost his job and his house, even as you try to figure out how many pills it will take to kill you on that day you’ve chosen to be your last.


Depression is so much more than you think.

I usually try, a few times every year, to make a list of at least 25 things I’m grateful for.  It’s a good exercise to help us remember the really important things in life.  The things and people that sustain us, even when we may not be as mindful of them as we should. The past few years have been really tough, though; my attention has been pulled inward, trying to sort through the grief of many losses, deep depression brought about by repeated betrayals and confusing memories, and the general worries for an uncertain future.

But I decided to take some time on this day of thanksgiving to think about the one thing I am most grateful for in my life right this moment.  I’ve made a concerted effort in just the last couple of days to get back to living mindfully because I notice that it is then and only then when I find true peace and happiness.  And while I am so very thankful for my mom and the rest of my family, and for my cats ‘rissa and Silk, and wonderful friends, and so much more, I think I am most grateful today for all of the suffering I have endured.

Most people think of suffering in terms of major crises or traumatic events, but we all endure small amounts of suffering each day. Even if we lead a generally happy and content life, we may encounter disappointment when our expectations are not met, sadness when someone dies, or anger when things don’t go our way.  And of course, there are larger, more long-term issues that sometimes create more intense and chronic episodes of suffering: physical or emotional pain from chronic illness, living in abject poverty, or dealing with the aftermath of a catastrophic event are a few examples.

What I am discovering is that, for me, the suffering – as intense and unending as it has seemed at times – has been a necessary part of this journey and that there are a few things I can do along the way to ease its grip.  But that always I should be thankful for the gifts it has given me, for it has made me a person who is wiser, kinder, more understanding, more patient, and with greater empathy and compassion than before.

Even for those of us who live daily with the challenges of clinical depression and for whom death and suicide are dinner table conversation, Robin Williams’ suicide came as both shock and unexpected, immense loss.  As all of us work through what this means to each of us personally, and as a culture, though, it is my hope that his death will begin and sustain a serious dialogue on the critical issues surrounding clinical depression: its recognition, its treatment, the severe lack of balance in care vs. profit that exists in the mental health “industry” today, the gross misunderstandings that those who have not suffered from this illness carry with them, and finally, the end game – suicide.  That thing that nobody really wants to talk about but which is killing so many of us at an increasingly alarming rate every year.

Over the past couple of weeks, there have been countless articles and blog posts and television news stories about Robin’s death and just as many opinions and “professional” statements about the nature of depression and suicide.  Most, by far, have called depression an illness and suicide, in essence, an effect or product of that illness, an act committed “by the disease,” not literally, of course, but an implication that the individual has no control over the decision.  A few, though, have – boldly, cruelly maybe, and, with more support than one might think – suggested that suicide is 100% choice and that the person who commits this act is sinful or a coward or selfish.

Some examples of the latter:

When it comes to the issues of illness and health, people need for their questions to have black and white answers.  The medical community has established norms for blood pressure and pulse and the levels of all sorts of stuff in the body, which allows us to confidently say, “I have diabetes” or “my cholesterol is normal.”  Advances in CT and MRI allow radiologists to see and definitively diagnose cancers and microfractures and ligament tears.  But mental illness and the issues it presents lie in a space somewhere in-between, in a murky grey zone that most of society avoids like the plague.

Even the question of whether mental disorders like depression are actual illnesses has been up for debate in some circles. There’s been a lot of research, though, that connects brain functioning and even structure with behaviors, emotions, thoughts, and experiences associated with various disorders and provides strong enough evidence to the medical community that there is a separate and well-respected manual used as a guideline for identifying and treating mental illnesses: the Diagnostic and Statistical Manual of Mental Disorders, or DSM V.

Different types of depression affect individuals in various and unique ways.  Someone who is experiencing psychotic symptoms – delusions and hallucinations – as part of their depression will react differently to the world around them than will someone who  is not.   Similarly, someone whose depression is complicated by chronic physical illness, severe or repeated stressors, or loss will likely have a greater challenge in managing it than someone who does not have additional worries.

Suicide is, most often, a response to depression or another mental illness but it cannot and never should be viewed as the same experience for everybody.  People turn to suicide as a solution for a variety of reasons.   Most don’t truly want to die, but rather want to be free  from the intense, unbearable pain they are experiencing.  Depending on their circumstances, that might be emotional pain or it could be physical pain, or it could be both.  There may be other reasons.  Some illnesses have hallucinations and delusions as symptoms, and people who try to kill themselves are reacting to voices that tell them to do so or to the false belief that by doing so something positive will result.  Some people who are diagnosed with terminal illnesses kill themselves to avoid the debilitating effects, the financial or perceived emotional burdens on family of the disease. Others overdose accidentally on medication, either in a gesture intended as a call for help or as a purely unintended and unfortunate error.  The list of reasons go on.

It’s unfortunate that in our society suicide is often seen as a cowardly and selfish act, and even viewed as sinful by a great many “loving, forgiving” religious folk.  People who suffer from mental illness and grapple with thoughts of suicide, sometimes on a daily and chronic basis, are among the most courageous people I know.  It takes guts, not to mention a special kind of strength, to wake up to the kind of hell these people go through every day.  To suggest that a person is a coward for needing relief from a hell he cannot (or does not believe he can) escape, says more about the person standing on the outside than the one who has died.

And so it goes for the person who smugly calls him selfish.  On the surface, it seems reasonable. Take Robin Williams for example. He had a wife, children, millions of fans around the world that loved him.  His death truly affected a great many people.  And he had to know that it would, right? That by killing himself, he would be hurting a lot of people, including those closest and dearest to him.

Well, maybe.  And maybe not.  And NO ONE can answer that question, except him.

See, depression and other mental illnesses do strange things to our thinking.  When someone is considering suicide, he often thinks that he has no place in this world.  That family and friends would be better off without him.  That he’s a burden to others, and that if he died, everyone would get along much better, wouldn’t fight, wouldn’t have him to worry about.  Maybe even, that they wouldn’t even miss him if he were gone. Or that if he died, the financial problems could be resolved.  Depression skews our thinking.

I think that people use terms like “coward” and “selfish” and “sinner” because they are afraid and angry.  It is really hard for some to imagine how anyone could take their own lives, especially if that person is a productive member of society and has a loving family and close group of friends.  It forces people to reconsider what they thought was stable and sure, and to think about their own mortality.   It gives them an answer to a confusing situation that, a lot of the time, really doesn’t have one.  And it helps them compartmentalize what might have been a painful event.

It really doesn’t help anyone to call someone who died in such pain a coward or selfish or a sinner.  The only black-and-white with suicide is that when a person kills himself, he’s dead.  It may have been done on impulse, without thought; it may have been a measured choice, planned out in excruciating detail.  Judging people who are depressed or mentally ill and belittling them after they’ve died only spreads a message to others who are in a similar situation and perpetuates the problem.

Instead of judgment based on ignorance, we need more education, understanding kindness, compassion, and dialogue.  Robin Williams could be you.  Depression and suicide do not discriminate.