You are all on notice.

[xiphias]

Too many of my friends are in emotional pain. Now, some emotional pain is because of genuine loss, because people are in bad situations, because of real, external things that cause people to be in pain.

There's not a hell of a lot I can do about that, except be a shoulder to cry on, and to listen, and to express sympathy. And I want to do that for you.

But there are also a lot of people I love who are in emotional pain because of depression, and other internal effects that people carry with them.

I have decided that depression is my enemy. I hate it. I've started to make a good dent on killing it in my own brain, and I am now getting sick and tired of this evil enemy attacking my friends, too.

Depression, you are my enemy. I HATE you, and I hate to see you fucking with my friends. And so, I am YOUR enemy, too.

So, people I love -- when I see Depression attacking you, I'm going to get mad, and I'm going to start pushing you to take care of yourself and to destroy it.

If you are sad and upset because of grief and loss, that's not depression. If you are sad and upset because of loved ones who have died, that's not depression. If you are sad and upset because your life actually does, genuinely, suck, that's not depression.

But if the worm of depression is eating away your mind from inside? That's what I declare war upon.

Now, I don't care HOW you fight it, so long as it works. For some of you, taking B12 vitamins will work, because your brains just aren't producing enough of those B-complex vitamins, but, if you take supplements, your brain will be able to use them to make the seratonin and other neurotransmitters you need. If that works for you, that's fantastic.

Some of you will be able to control your depression through exercise. Your brain will be able to use the endorphins and other chemicals released in exercise to synthesize the chemicals it needs.

For some of you, that won't work. Some of you will need antidepressants. For some of you, selective seratonin reuptake inhibitors will work -- you make enough seratonin, but other parts of your brain that don't really need it are slurping it up before it can do its job. For some of you, those won't work, either. There are several classes of antidepressants. If one doesn't work on you, try another one.

Talk therapy might work for some of you. For others of you, it will do fuck-all. At least, before you're on drugs that help. Once your brain DOES have the chemicals it needs, THEN talk therapy will be useful, because, at that point, your brain will physically have the structures to be CAPABLE of not being depressed. At THAT point, you can start to learn how to not be depressed. But you physically CAN'T learn how to not be depressed when, in your brain, that whole part is just plain missing.

Being depressed isn't your fault. It's a physical disability. It is your brain physically not producing the chemicals that non-depressed brains have. In order to NOT be depressed, those chemicals need to be there, some way or another.

And it is just about impossible to get out of depression on your own. Those chemicals which are lacking? Those are the chemicals which would allow you to do things about getting out of depression -- and they're not there.

I have a wife who pushed me into treatment. And pushed me into different treatments, one after the other, until we found one that worked.

So, that's it. I want these motherf-ckling depressions OUT OF your motherf-cking brains. And I'm going to be yelling at each one of you to DO something about it, and if that thing isn't working, to DO SOMETHING ELSE, until you kill the depression.

Unless you don't want me to -- feel free to tell me NOT to do that. I'm not your parent. There are a couple people on my f-list that I AM in some sense responsible for, and you don't get to opt out of this (temima, I'm looking at you) -- but the rest of you can.

I just hate depression. I hate that it attacks my friends.

Comments

[navrins]

Hear, hear!

(Mind if I link?)

[xiphias.livejournal.com]

Please do.

[janetmiles.livejournal.com]

From your keyboard to G-d's monitor.

I haven't been able to kill my depression, but I can mostly control it with meds and periodic talk-therapy. You have my express consent to tell me if you perceive that mine is getting out of control.

And I need to find some way to start taking yoga again. That's good stuff, for me.

[ailsaek.livejournal.com]

Feel free. I have a few warning signs that I have logged in my brain to take seriously, but the problem is that it takes me a couple of days to notice the pattern. Also, it's really useful to have someone call bullshit on my various rationalizations.

[sarianna.livejournal.com]

Thank you.
I have a small bit of depression coupled with a whole lotta panic disorder. And this is wonderful encouragement to keep on fighting.
:')

[tylik.livejournal.com]

I applaud this.

I also wonder how much one can attack depression as an external thing, and how much one risks having deal with it as a shadow self through that approach. No real clue. I run up against that one sometimes, but my most closely analogous thing is the whole chronic pain / spine injury thing, and while being very damn proactive on both dealing with the pain and doing other things to keep my body healthy is very good, it's all too clear that this is my body, and it's the only one I've got. In many ways I'm more healthy and fit than most people I know, but there are still things that are not insignificantly broken.

[whuffle.livejournal.com]

*Applauds Wildly*

Anger and Passion are strong and powerful motivators. May they keep you strong enough to fight the battles inside of you and to wage war against the larger enemy you've named. Remember, names have power; you own this one because you know it's name.

[jehanna.livejournal.com]

Yay, well said.

(Approximately four years of the pink capsules and counting....)

[greenlily.livejournal.com]

*joins the chorus of applause*

When I started taking meds, red_queen's comment was the most helpful. She said, sometimes meds help you get out of your own way so you can do what you need to do. That kind of re-framed it for me, and helped me stop being so resistant to taking the blasted things.

Melrose has a new super hero...

[wargoddess.livejournal.com]

ANTIDEPRESSANT MAN!

>^,^<

.

[matociquala.livejournal.com]

I really appreciate that you are doing this. I think it's a good thing. I value you, and I adore your determination to do a good thing in the world.

And I think I need to opt out.

I'm bipolar. I know it. I do what I can to treat it, but I'm going to be bipolar all my life, and a certain amount of living with chronic illness is, well, learning what you can do and what you can't. And when I am going fifteen rounds with the brain chemicals, it doesn't help to be told I'm going fifteen rounds with the brain chemicals. It just makes me feel bitter and resentful and angry that I have this fucking chronic illness, and so.

But thank you.

[xiphias.livejournal.com]

That's why I included the "unless you don't want me to." 'Cause it's not useful for everyone, and I don't want to make things worse.

[matociquala.livejournal.com]

<3

[griffen.livejournal.com]

Please don't do that to me. Yes, some of my problem is depression, but there is nothing I can do to circumvent it when it happens. Antidepressants have all kinds of nasty side effects or reverse effects on me, and I am tired of trying one drug after another and going through the inevitable nasty side effects like mania, stuttering, rash breakouts, and narcolepsy.

I appreciate your anger, but I would feel it was directed at me if you yelled at me to do something about it, which would be counterproductive at best.

[xiphias.livejournal.com]

That's why I included the "unless you don't want me to." 'Cause it's not useful for everyone, and I don't want to make things worse.

[vito-excalibur.livejournal.com]

Yep! It sucks! Backup is good.

[plumtreeblossom.livejournal.com]

Amen!

I only get circumstantial depression, when circumstances truly suck, but I have many friends who live with chronic depression. I agree, it needs to be fought, not bowed to.

[anhelometuo.livejournal.com]

I agree, whole-heartedly.

Heh, one of my posts were a reminder of the hell I went through during it and to get over it.

And life seems to be going pretty well. (Minus the occasional day of remembrance.)

Good luck to all those who need it, because it takes a lot of effort, and a lot of time.

[asqmh.livejournal.com]

Thanks for posting. There have been times in the past when mine has been largely controlled. Right now, it's less so. But I feel the same way. And yes, feel free to tell me if I'm in piss-poor shape because while I may feel bad, I may also be blind to how bad it is. I had a medication interruption awhile back and I'm still trying to get stuff leveled out.

Anyway, thanks for saying what needs to be said.

[blairette.livejournal.com]

WOOOO! Go for it!
I am going to sit certain of my friends down and give them this almost exact same talk. And on my bad daysI am going to sit myself down, too.
Nice one. See, this is what LJ should be for!!

[zdenka]

Well said.

[dichroic.livejournal.com]

I'm really glad you included the opt-out provision. This was making me a bit uncomfortable until then. I'm not depressive at all (except of course normal sadness) but I decided a while back that I just won't put up with anyone yelling at me unless I give them that right implicitly or explicitly. (I.e. we're actually in an equal argument and both yelling or I've asked them to be my coach.) I think I'm another one for whom being yelled at or nagged would make things worse.

But I'm glad you're doing this for those it *will* help.

[msdirector.livejournal.com]

Bravo.

I'm one of those few(?)lucky people who was able to pull myself out of depression on my own. Perhaps it was not a true clinical depression - but after several years of the inability to deal with the world or do much of anything but lie on the couch, I can't help but believe it was. This was 30 years ago and I didn't even think of it being depression at the time (though I should have, having been a psych minor), but in retrospect I can't think of what else it could have been. It took a move to a different state (which may have triggered that "exercise makes endorphins") to start getting me out of it, followed by an absolute refusal to let myself fall back into my funk again, literally forcing myself to get up and get out and DO something. Obviously my problem was not a serious chemical imbalance, but the results were just as debilitating as if it were. Looking back, I'm astonished that I was able to pull out of it without help.

Would it have helped if someone had pushed me earlier to take the steps I ultimately did? I don't know. I tend to work better when I wait until I find my own motivation than when pushed since I tend to take perceived criticism personally and retreat further. But it sure would have been great if someone had actually recognized the symptoms and told me that there was actually something wrong and something I could do about it.

So, I, too, am glad you are doing this for those it will help. Just be positive in your approach... negativity just makes things worse.

[erin-c-1978.livejournal.com]

The thing I sometimes wonder is, how can I reliably tell the difference between my life sucking and mental illness making me think my life sucks (or making my life actually suck)? And if it really is the former and I'm just refusing to admit it, does it make me weak if I take antidepressants? How can a person tell the difference, especially if there is a certain amount of life suckage but possibly also depression in addition to and not solely resulting from life suckage?

Actually, this whole reply is probably my OCD showing more than my depression. Feh.

[xiphias.livejournal.com]

If it really is your life sucking, antidepressants won't help.

But talking to a clinician about it, and getting his or her opinion about if they're worth trying is a sign of strength, not weakness.

[dancing-kiralee.livejournal.com]

If it really is your life sucking, antidepressants won't help

I want to see the proof... not just claims by one of my friends, or even statements by medical personal; not even anecdotal evidence. I want to see the actual studies this statement is based on.

I'm sorry, but the medical profession has gotten into trouble with this in the past - I'm not going to just trust them because they say so.

Kiralee

[erin-c-1978.livejournal.com]

I suppose that basically sums it up. And the Luvox is helping, both with the OCD and the depression, at least in terms of giving me the mental space to get things done and enjoy life sometimes instead of contracting into a ball of anxious misery. It might help me deal better with crappy life stuff, but it doesn't make the crappy life stuff All Okay, because how could it?

Actually, one way I can tell the meds are helping is that I'm able to write something as reasonable as this instead of my usual written equivalent of a high-pitched wail of despair.

I strongly suspect that my depression is in part a reaction to my OCD -- I'm driven to PICK at things, mentally and physically, and the depression is my mind trying to tamp down the anxiety, but the cure is worse than the disease.

[xiphias.livejournal.com]

I strongly suspect that my depression is in part a reaction to my OCD -- I'm driven to PICK at things, mentally and physically, and the depression is my mind trying to tamp down the anxiety, but the cure is worse than the disease.

That makes a lot of sense to me.

I mean, you figure, depression has to, y'know, come from SOMEWHERE, right? I can think of three basic ways that diseases work: parasites, deficiencies, and something in the body that's supposed to do one thing screwing up and doing something else.

A virus, a bacterium, or something bigger like a tapeworm -- you can think of those all as parasites. The disease happens because making you sick somehow benefits some other critter.

A deficiency -- for some reason, humans (and guinea pigs) can't synthesize vitamin C. And our bodies need it to function. So, if we don't get that, we get scurvy.

One's own body screwing up and doing something it's not supposed to -- lupus would be a real dramatic example of this, where the immune system decides to go and attack the rest of the body. I think some cancers might be like this, too.

So, since there isn't, as far as I know, a "depression virus" or something like that, depression is probably in one of the other two categories. Or, y'know, it could be in BOTH those categories -- we lack something in our brains that is supposed to control and channel some function in the brain, and, without those controlling chemicals, whatever it is runs amok and forms depression.

At Arisia a year ago -- not this just past one, but the one before -- someone got an evening panel basically just to talk about some of the hypotheses he had come up with about depression. He was very clear that these were just hypotheses, but I found them interesting.

His question was -- "what if depression is, basically, an out-of-control version of something else, something that might be actually USEFUL?"

And he noticed that clinical depression mimics, in a few significant ways, parts of the early grieving process.

So he wondered if, in effect, we had a way to basically shut down our emotions, as, sort of, a circuit breaker, during periods where the feelings are too intense -- that we have some sort of reaction which allows us to react with numbness and then depression for a while, and THEN, after some of the emotions have cooled off a bit, feel them THEN.

And that clinical depression might be something in which this reaction gets out-of-control, takes on a life of its own, shows up without an external cause, and then won't go away in the time period that it's supposed to.

Again, this is just his hypothesis, but it's really an interesting one, isn't it? And it would dovetail with your experience -- the numbness that is like depression is supposed to be a reaction to emotional shock.

[(Anonymous)]

You haven't mentioned the theory I subscribe to, which is that some people learn self-destructive behaviors and patterns of thinking. Over time, these patterns, or other factors, like abuse or bad life situations, can mess up people's emotional response systems. Looking back on my family situation growing up, I'm not at all surprised at how I am now.

It doesn't help that people who get depressed often don't have people who can act as a support network, because they withdraw, or have personality traits which keep people from liking them. And I don't blame others for this -- I don't like spending time with other people who are discouragingly depressed either.

I'm not sure what to do about my issues. My mood has been ok recently, especially since I've found various ways to keep busy, but I still have very little motivation in life and few friends.

I've tried antidepressants and they don't do much except blunting my emotions. Talk therapy has been an utter waste, but I'm convinced it's because most therapists aren't very good at what they do. I don't understand what's supposed to happen in therapy, but whatever it is, it hasn't happened for me.

If you have any suggestions, I'd love to hear them.

[xiphias.livejournal.com]

The right antidepressant at the right dosage does not blunt emotions. Emotional blunting is a side-effect that means that you're on the wrong drug, or the wrong dosage. It's something that must be mentioned to a clinician -- it means that whatever you're on isn't working.

In general, I think that most people with clinical depression need a combination of three things: drugs, talk therapy, and behavior modification. I believe that the drugs have to come first, and once those are stable, you can go on to the other things.

I think that talk therapy won't work if there is clinical depression in the way, and that that is probably as much of a bar as incompetent therapists. That said, there ARE a lot of incompetent therapists -- but there are also some competent ones. You just have to be willing to go through a lot of ones who AREN'T a match before you find one who is. If after two or three sessions, nothing useful is happening, it's time to find someone else.

Family background fucks people up tons, too. But, personally, I think that long-lasting, chronic depression coming from being fucked up by family can be treated the same way as the sort that I have. I don't KNOW that, of course. But I think that, basically, being fucked up by family physicially breaks your brain, and that it then needs the drugs to survive.

I suppose I could also speculate that fucked-up families are ones where the parents have broken brains themselves, and they go ahead and genetically pass those along to their children, along with the fucked-up-ness itself.

So -- my suggestions are to find a COMPETENT doctor or other clinician -- RN, prescribing physician's assistant, whatever -- who is specifically trained in depression and wants to attack it with every weapon in the arsenal -- talk therapy, behavior modification, drugs, vitamins, exercise, Tibetian chanting, balancing your four humors -- EVERYTHING -- and will keep trying different things until they find what works for you.

To KNOW that this isn't your fault, any more than a clubfoot or color-blindness would be your fault. And to not give up.

[(Anonymous)]

I'm not convinced that it isn't my fault, since I often make bad decisions which make me feel emotionally worse (staying up all night, procrastinating, avoiding social contact, etc). And it doesn't matter whose fault it is if there's still no way of improving the situation.

[xiphias.livejournal.com]

Of course you're not convinced that it isn't your fault.

That is the most evil and pernicious thing that depression does: it convinces you that you did this to yourself. That IT'S not there -- YOU'RE doing it. It is an evil, evil disease, and this is precisely why I hate it so much -- because not only does it destroy you, it convinces you that you did it to yourself. It tells you that it's all your fault -- that you deserve it, that you are doing it, that if only you were a better person, this wouldn't be happening, that this is simply a case of you being lazy, or weak, and that if you were stronger, better, smarter, wiser, or just generally a good person, you wouldn't be doing this.

It's all lies.

It's all lies the depression tells you.

The depression lies to you, and tells you that it's your fault, and it gets inside your brain, and twists things around, and it makes you believe it.

It's not true. It's not at all true. But the depression fucks with you until you believe it anyway.

And that's why it's evil.

Staying up all night? Procrastinating? Avoiding social contact?

Those aren't causes of depression: they're results. They'e symptoms. Those are things the DISEASE does, not you. It just twists your mind around to convince you that it's you, and not it.

And there are ways of improving the situation. But you need help to get better. You can't do it alone, and you don't HAVE to be able to do it alone. Depression will try to tell you that you have to do it alone. It is lying to you. You need help -- friends, a support network, a good, competent doctor or other clinician, and, almost certainly, drugs.

[(Anonymous)]

I don't really like philosphy, so I feel uncomfortable saying this, but I have trouble believing that everyone who procrastinates or is socially isolated has a problem with their brain chemistry which requires drugs. My entire family is bad at getting things done and never did much socially, so I'm not surprised that I picked up the same patterns.

Everyone, depressed or not, should have a support network. The problem is getting one.

Another problem is finding an effective therapist. It's easy to say that if I just took some drugs it would allow therapy to start working, but if nothing is accomplished in a therapy session besides me complaining until time runs out even when I'm having a good day, I don't see what would ever happen.

Can anyone describe what exactly goes on in effective, productive therapy, where they ended up changing for the better? I know the obvious, vague stuff, about exploring your feelings and motivations and coming up with strategies and stuff. I feel like I do that all the time on my own, without any results, while I *didn't* discover anything in therapy and certainly never came up with any strategies. So I'd like to know the *details* of what happened in therapy and how it helped.

[xiphias.livejournal.com]

I'm sorry for not responding to this sooner: I was out all weekend.

I think your first point is right: clinical depression is ONE thing that can result in procrastination and social isolation, but is far from the ONLY thing that could.

Now, MY question, about the REST of your family, is, "are they generally content being loners and taking their time getting things done?" There's nothing wrong with being a loner, there's nothing wrong with being laid-back. If they're content with their lives, if it works with them, then there's no problem.

If it causes pain, then it IS a problem. And it sounds like it causes pain for you. Does it cause pain for the rest of your family, too?

I'd say that, for ME, at least, "productive" therapy is when the therapist and I can set specific, concrete goals for the time between then and our next meeting, things that I can work on, track, and come back and report how it worked out.

For instance, perhaps I could make a goal of "spend two hours working on my resume, and apply to three jobs per day." Or "go to the gym twice a week." Or something like that. Something concrete and measurable, some goal.

If I DON'T make that goal, then we look at WHY, at what happened emotionally or to my energy level, or what, that kept me from doing it. Without throwing blame around, doing our best to NOT have me feel guilty about it, but giving us a chance to look at what happened instead of what we intended to happen, figure out whatever that thing was, and start to come up with ways to work around it.

For me, anyway, useful therapy isn't about "how did I get this way," but rather about "what do I do from here".

Other people have different needs. There are people who have genuine traumas that they need to deal with -- in effect, they're dealing with so much emotional scar tissue that it's getting in the way. There are people who have irrational responses to situations, which they need to work through and understand in order to defeat.

But me, what I need is concrete plans and measuarable goals.

That is merely what works for me -- you may need something different.

But, as you can see, for ME, since I need measurable goals that I can attempt to do and then talk about what made it succeed or fail, I ALSO need drugs to allow me to have the chance to have it work. If I have so much emotional shit going on that I physically cannot get out of bed (I've been going through my LJ and tagging old entries, and I'm reading about how bad stuff used to be), then it's obvious that I cannot learn anything useful about why I didn't get to the gym twice this week -- I didn't get to the gym because I couldn't get out of bed. That's not useful.

So, for ME, I need drugs to get me to the point where I have a chance to do something, then therapy to help figure out things to do, and to discuss and analyze why I was or was not able to do them.

[ron_newman]

Just to be contrary, I'm going to link to today's Salon article: Don't be happy, worry. I'd be interested in hearing your response to this (or to the books that it reviews).

[browngirl.livejournal.com]

I think I might have broken my pledge to myself not to get into flamewars in my friends' journals, were it not for this line of the review: "There are severely depressed people out there; they need medical help." There are definetely problems with overmedication in US society, but the answer to them is not that depressed people just need to buck up and all psychiatric medicine is a moneymaking scam.

[temima.livejournal.com]

I told you a lot of things I was thinking about last night. Anyway, thank you for your support, if I didn't say it then.

And also, to continue our conversation a little bit, one other problem is that for me, 'what-ifs' can turn into either worry over things not yet happening, panic over too many options, or viable plans. I find that when I am depressed, 'what-ifs' can kill me.

[browngirl.livejournal.com]

I've been thinking about this, because. My answer keeps oscillating, which probably indicates just what it should be. But I wanted you to know I was thinking about it.

[xiphias.livejournal.com]

You were the other person besides Temima I was considering naming by name.

[browngirl.livejournal.com]

Oh, I know. *rueful smile, but a smile indeed*

*hugs you*

[dancing-kiralee.livejournal.com]

I hate not having information, and not being able to ask you about it and get an answer...

Right now, I don't know if, in the context under discussion, I fall into the category of "your friend." And, I can't ask... or, well, I can ask, but I'm not likely to get an answer (I've asked before, in relation to other contexts, and I didn't get an answer.)

I want to know because if I am your friend in this context, it's my responsibility to tell you what I want - whether I want to opt in or opt out. It's important because I get upset about how people treat me in this context (well, about how people treat each other on in this context generally, but I figure, for other people, if it's consensual I shouldn't put my nose in their business even if I don't agree with what they are doing.) Since I'm not always comfortable with the standard, expected, responses, and since I can get angry about it, it's up to me to let people know what I want... but without an answer to my question, it's hard to know if that's necessary or appropriate.

And that isn't the only question I have. What your describing isn't a single act, but a set of behaviors. It's a pretty good description, but there are some things it doesn't cover (and I wouldn't expect it to.) I can't say, for every potential act, whether or not you think it falls into this behavior set; for some acts, of course, it's obvious; but there are a few acts for which the answer is not obvious.

As I said, I don't expect your description, or any description, to cover every potential act. What is supposed to happen, is that people who think of acts whose position is unclear (are they or aren't they in the behavior set) are supposed to be able to ask questions and get answers from the relevant person.

I can't seem to ask you questions and get answers.

So this is the best response I can come up with under the circumstances.

For those things that are clearly in the behavior set you describe, I'd like , for the present, to opt out. I've put a lot of work into coming up with solutions that work for me, and I'm not interested in having the effectiveness of those solutions judged by you. Generally speaking, I don't want anyone but my closest friends judging those solutions. As the world is vast and complex and unpredictable, it may be that someday you will be one of the people I trust on this; but for the moment, I'd much rather you didn't try to do this for / to me.

However, there are some behaviors which may or may not fall into the behavior set you describe. Some of these are things I want you to do; in fact I'd be upset if a) you considered me your friend, and b) you were offering to do this for your other friends but weren't willing to do it for me.

Kiralee

re Antidepression Man, I'll opt out... mostly

[happyfunpaul.livejournal.com]

I'll request an opt-out, with a proviso...

My depression, thankfully, is pretty mild. I did try medications for a while, but the side effects were awful, and I no longer wish to try that route. I "get by" pretty well without medication, most of the time, by structuring my life in certain ways.

It doesn't always work; the past several months I've had many more depressive episodes than usual, probably because:

(1) My job keeps me so busy I lose sleep (the hope is that next year I will be a second-year teacher and it won't be so bad), and when I am that chronically tired, I may fall into a bad funk where Nothing Feels Any Good for 2 or 3 days, and

(2) Part of the positive structuring involves pre-planned social activities-- social interaction with friends perks me up but having to plan takes too much energy-- and I've had so little free time and energy that I don't get my necessary weekly dosage of friendstime. (Last night I slept through Psinging, for example.)

Now, assuming I don't have to do any planning and if I can spare the time, then being kicked to "get out of the house and be social" can be quite positive. So that's the proviso.

I suppose another proviso would be if I do keep my teaching job next year and the year after and yet I still am chronically run-down and falling into depression frequently. Then I'll have to get out, and someone might have to poke me to do that. But I think things will get better (as long as I can be re-hired for future years, which may not happen due to town budget problems).