![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
Entry tags:
I've been talking a lot about depression recently
You know, since I declared war on depression at the end of January, one of my friends has gotten her doctor to change her meds to some that worked better, one friend has decided that he has had a depression problem all his life and is going to find a therapist to start working on it, and one has decided that she deserves to have Nice Things in her life and not have everyone dump on her all the time.
I'm kinda happy about that, y'know?
Anyway, because I've been talking about it, I decided I'd write a little about what depression is like for me.
The first thing I want to do is to distinguish between three things which can all be called "depression", may externally look similar, but which are fundamentally different.
They are sadness and melancholy, situational depression, and clinical depression.
When I talk about the thing which I have, which I consider my enemy, which I consider to be an evil and pernicious disease -- I'm referring ONLY to that third one.
"Sadness" is a normal and healthy part of life. In fact, I'd argue that, if you CAN'T feel sad when it's appropriate to feel sad, THAT is a problem. The lack of sadness may, sometimes, be a problem in itself. We people, we have emotions. And they are all part of being alive. Contentment is a good one, and I think that there are people who can feel that most of the time. It's a feeling of reasonable peace at the world, that there's nothing particularly going on bad. If your baseline emotion is "contentment", I think that would mean you have a pretty good life.
From that baseline, we can feel other things. There are all sorts of lists of emotions that people can feel -- when I was in kindergarten, I think we were given the idea of three emotions -- sadness, happiness, anger. I think that an emotionally healthy person can move out of their default "contentment" state when something happens to make them happy, or sad, or angry, and return back to contentment when it is appropriate to do so.
Some people list emotions including anger, disgust, surprise, fear, joy, and sadness. (Aristotle lists, as emotions, anger, calmness (an opposite of anger), friendship, enmity/hatred, fear, shame, kindness, pity, indignation, envy, and emulation -- but his list was made for a specific purpose: it consists of emotional states that an orator can excite in an audience in order to get them to do or not do things, so it's not really relevant here, which is why it's in parenthesis. Because it's cool, even if it is irrelevant.)
If a person feels sadness, that is not depression. It is sadness. If a person feels unreasonable sadness, overwhelming over a long period of time -- in my opinion, that may well be a condition that needs treatment -- but it's not the same thing as what I call depression.
Then we have "situational depression." And understanding situational depression is the first step to understanding what I consider clinical depression to be.
I think that situational depression is a necessary part of the human mind. I think that it is there for a reason. I think it's a circuit-breaker.
If you experience a deep, deep loss, something shocking, something that changes the entire landscape of your world, something will break. This loss could be a death of someone who was a deep part of your emotional life, a loss of a job which was a framework to how you lived, a disillusionment with a belief that you held and built ideas and ways of living around. A beloved pet who formed a great part of your emotional support, a community which you were entwined with.
If you lose something like that, something breaks. Your world has changed.
I believe that, when that happens, our emotions shut down for a while. We go off-line. The operating system crashes. Whatever analogy you use -- something in us dies to keep the rest of ourself from being destroyed by it.
We feel shock, which numbs us, and the numbness continues and shuts us down. We are empty inside, with nothing. After a while, we may gain some basic functioning, but we remain empty. And, eventually, we find a degree of stability in our new life, we can afford to feel again, and our emotions "wake up" again, or come to life, or are reborn, or come online -- however we want to look at it.
And that's situational depression. Something that our minds do to protect us from the abyss of having our world torn apart, until our world may be repaired. It is necessary, like a scab, or a scar. It is a form of "damage" that prevents worse damage.
Human societies develop rituals around this process. For instance, in the earliest stages of this situational depression, when the emotions have shut down, it may have taken most of our basic ability to care for ourselves with it. So we feed people. The vast flowering of casserole dishes that appear after a funeral are a healthy and necessary way in which a society helps an individual go through this process.
We Jews have a fairly involved ritual, which I rather like, and I feel works fairly well.
In the immediate aftermath of a death, the mourners stay at home, often with mirrors covered, often sitting on the floor, often in a darkened room. They do not bathe, they do not cook. People come by and sit with them, in silence unless the mourner WANTS to talk. And people bring food.
There is no expectation that a mourner will be able to manage even the most basic of tasks during this first stage . They are too empty, and too shocked by being empty. They may feel INTENSELY for short periods of time, and may then go back to basic emptiness.
After about a week, it is expected that the mourners may be able to get back to really basic level functioning -- but they are not expected to be able to feel pleasure, and so do not go to parties or other happy events. It's just considered to be not fair to them -- most likely, they're STILL basically empty inside.
After a month or so, though, it is expected that they will be able to feel again. At THAT time, they will be able to cry for their loss, and feel happiness when happy things happen, and anger, and all the other parts of emotional life.
And that is how situational depression is supposed to work, I think. You feel empty and unable to even care for yourself; you learn to care for yourself, but are still empty; and finally, your life is stable enough that you can feel again. Perhaps there might be medical ways to shorten the period of situational depression, but, even if there are, why would you want to? It's performing a useful function -- protecting people until their world can heal.
So.
What of clinical depression?
I think that there are four kinds of diseases: something is in your body that oughtn't be there, something is missing from your body that ought to be there, and your body is doing something that it is designed to do, but is Doing It Wrong, and your body is harming itself thereby.
Things that could be in your body could be parasites, or toxins. A virus, or a microbe, or a heavy metal of some sort. Things that could be lacking could be a vitamin, a hormone, or something like that. And then, of course, your body could Do Something Wrong -- as mild a thing as using its sneezing defenses against innocuous things, such as ragweed pollen, or as serious as deciding that your own internal organs are invading parasites and attacking them.
I think that clinical depression is this last.
I think that clinical depression is when your mind has decided to activate the "situational depression" kinds of defenses, but based on no loss. And since the activation was based on no loss, nothing you gain can get rid of it.
Depression, for me, has nothing to do with sadness. If I can feel sad, it is a sign to me that my bout of depression is passing. I relish the feeling of sadness -- it lets me know I am emotionally alive. Sadness is vastly preferable to depression.
Depression is the absence of feeling. It is the absence of the ability to feel. To the extent that I CAN feel anything, it's muted, far-off, like a feeling being felt by someone else.
When I'm depressed, I cannot feel happy, that is true -- but I also cannot feel sad, angry, disgusted, or afraid. Not much, anyway.
You know why more depressed people don't commit suicide? Because we can't be bothered. There may be no point in living, but there's no point in dying, either.
And we DO have physical feelings, like hunger, and cold, and so forth, although they're muted. We might not bother to put a blanket over ourselves if we're cold, but then again, we might. We might not bother to eat, but then, we might.
For me, as far as eating goes, if I ate sugar, the blood sugar spike as the glucose hit felt remarkably close to emotion, so that's what I do when I'm depressed -- I eat junk food, because it's as close as I can get to feeling an emotion.
Other people do self-injury, like cutting, or burning themselves. It doesn't really work, but it does come close. I've tried it; I think the "chocolate" thing works better. For me, the glucose hit works better than the adrenaline hit.
I suspect that there are other drugs which do similar things.
Alcohol, by the way, does the opposite: it doesn't make you feel anything, but it gives you an excuse for not feeling anything. You don't feel anything, but you can fool yourself into believing that you DO have emotions somewhere, but it's just that they are hiding behind the alcohol.
This is why I have such incomprehension when people ask questions like, "What do we lose when we medicate people out of depression?"
Answer: absolutely nothing. Clinical depression has absolutely no upside. Situational depression DOES have a purpose, and an upside, but that's not clinical depression. And sadness, and melancholy, are VERY important -- but they have no more to do with depression than happiness does. Depression is as far from sadness as it is from joy.
Hell, depression isn't even BLEAK. Bleakness is when you look at the world around you, and see no future. In depression, you can't even get THAT far. You're just hollow.
I'm kinda happy about that, y'know?
Anyway, because I've been talking about it, I decided I'd write a little about what depression is like for me.
The first thing I want to do is to distinguish between three things which can all be called "depression", may externally look similar, but which are fundamentally different.
They are sadness and melancholy, situational depression, and clinical depression.
When I talk about the thing which I have, which I consider my enemy, which I consider to be an evil and pernicious disease -- I'm referring ONLY to that third one.
"Sadness" is a normal and healthy part of life. In fact, I'd argue that, if you CAN'T feel sad when it's appropriate to feel sad, THAT is a problem. The lack of sadness may, sometimes, be a problem in itself. We people, we have emotions. And they are all part of being alive. Contentment is a good one, and I think that there are people who can feel that most of the time. It's a feeling of reasonable peace at the world, that there's nothing particularly going on bad. If your baseline emotion is "contentment", I think that would mean you have a pretty good life.
From that baseline, we can feel other things. There are all sorts of lists of emotions that people can feel -- when I was in kindergarten, I think we were given the idea of three emotions -- sadness, happiness, anger. I think that an emotionally healthy person can move out of their default "contentment" state when something happens to make them happy, or sad, or angry, and return back to contentment when it is appropriate to do so.
Some people list emotions including anger, disgust, surprise, fear, joy, and sadness. (Aristotle lists, as emotions, anger, calmness (an opposite of anger), friendship, enmity/hatred, fear, shame, kindness, pity, indignation, envy, and emulation -- but his list was made for a specific purpose: it consists of emotional states that an orator can excite in an audience in order to get them to do or not do things, so it's not really relevant here, which is why it's in parenthesis. Because it's cool, even if it is irrelevant.)
If a person feels sadness, that is not depression. It is sadness. If a person feels unreasonable sadness, overwhelming over a long period of time -- in my opinion, that may well be a condition that needs treatment -- but it's not the same thing as what I call depression.
Then we have "situational depression." And understanding situational depression is the first step to understanding what I consider clinical depression to be.
I think that situational depression is a necessary part of the human mind. I think that it is there for a reason. I think it's a circuit-breaker.
If you experience a deep, deep loss, something shocking, something that changes the entire landscape of your world, something will break. This loss could be a death of someone who was a deep part of your emotional life, a loss of a job which was a framework to how you lived, a disillusionment with a belief that you held and built ideas and ways of living around. A beloved pet who formed a great part of your emotional support, a community which you were entwined with.
If you lose something like that, something breaks. Your world has changed.
I believe that, when that happens, our emotions shut down for a while. We go off-line. The operating system crashes. Whatever analogy you use -- something in us dies to keep the rest of ourself from being destroyed by it.
We feel shock, which numbs us, and the numbness continues and shuts us down. We are empty inside, with nothing. After a while, we may gain some basic functioning, but we remain empty. And, eventually, we find a degree of stability in our new life, we can afford to feel again, and our emotions "wake up" again, or come to life, or are reborn, or come online -- however we want to look at it.
And that's situational depression. Something that our minds do to protect us from the abyss of having our world torn apart, until our world may be repaired. It is necessary, like a scab, or a scar. It is a form of "damage" that prevents worse damage.
Human societies develop rituals around this process. For instance, in the earliest stages of this situational depression, when the emotions have shut down, it may have taken most of our basic ability to care for ourselves with it. So we feed people. The vast flowering of casserole dishes that appear after a funeral are a healthy and necessary way in which a society helps an individual go through this process.
We Jews have a fairly involved ritual, which I rather like, and I feel works fairly well.
In the immediate aftermath of a death, the mourners stay at home, often with mirrors covered, often sitting on the floor, often in a darkened room. They do not bathe, they do not cook. People come by and sit with them, in silence unless the mourner WANTS to talk. And people bring food.
There is no expectation that a mourner will be able to manage even the most basic of tasks during this first stage . They are too empty, and too shocked by being empty. They may feel INTENSELY for short periods of time, and may then go back to basic emptiness.
After about a week, it is expected that the mourners may be able to get back to really basic level functioning -- but they are not expected to be able to feel pleasure, and so do not go to parties or other happy events. It's just considered to be not fair to them -- most likely, they're STILL basically empty inside.
After a month or so, though, it is expected that they will be able to feel again. At THAT time, they will be able to cry for their loss, and feel happiness when happy things happen, and anger, and all the other parts of emotional life.
And that is how situational depression is supposed to work, I think. You feel empty and unable to even care for yourself; you learn to care for yourself, but are still empty; and finally, your life is stable enough that you can feel again. Perhaps there might be medical ways to shorten the period of situational depression, but, even if there are, why would you want to? It's performing a useful function -- protecting people until their world can heal.
So.
What of clinical depression?
I think that there are four kinds of diseases: something is in your body that oughtn't be there, something is missing from your body that ought to be there, and your body is doing something that it is designed to do, but is Doing It Wrong, and your body is harming itself thereby.
Things that could be in your body could be parasites, or toxins. A virus, or a microbe, or a heavy metal of some sort. Things that could be lacking could be a vitamin, a hormone, or something like that. And then, of course, your body could Do Something Wrong -- as mild a thing as using its sneezing defenses against innocuous things, such as ragweed pollen, or as serious as deciding that your own internal organs are invading parasites and attacking them.
I think that clinical depression is this last.
I think that clinical depression is when your mind has decided to activate the "situational depression" kinds of defenses, but based on no loss. And since the activation was based on no loss, nothing you gain can get rid of it.
Depression, for me, has nothing to do with sadness. If I can feel sad, it is a sign to me that my bout of depression is passing. I relish the feeling of sadness -- it lets me know I am emotionally alive. Sadness is vastly preferable to depression.
Depression is the absence of feeling. It is the absence of the ability to feel. To the extent that I CAN feel anything, it's muted, far-off, like a feeling being felt by someone else.
When I'm depressed, I cannot feel happy, that is true -- but I also cannot feel sad, angry, disgusted, or afraid. Not much, anyway.
You know why more depressed people don't commit suicide? Because we can't be bothered. There may be no point in living, but there's no point in dying, either.
And we DO have physical feelings, like hunger, and cold, and so forth, although they're muted. We might not bother to put a blanket over ourselves if we're cold, but then again, we might. We might not bother to eat, but then, we might.
For me, as far as eating goes, if I ate sugar, the blood sugar spike as the glucose hit felt remarkably close to emotion, so that's what I do when I'm depressed -- I eat junk food, because it's as close as I can get to feeling an emotion.
Other people do self-injury, like cutting, or burning themselves. It doesn't really work, but it does come close. I've tried it; I think the "chocolate" thing works better. For me, the glucose hit works better than the adrenaline hit.
I suspect that there are other drugs which do similar things.
Alcohol, by the way, does the opposite: it doesn't make you feel anything, but it gives you an excuse for not feeling anything. You don't feel anything, but you can fool yourself into believing that you DO have emotions somewhere, but it's just that they are hiding behind the alcohol.
This is why I have such incomprehension when people ask questions like, "What do we lose when we medicate people out of depression?"
Answer: absolutely nothing. Clinical depression has absolutely no upside. Situational depression DOES have a purpose, and an upside, but that's not clinical depression. And sadness, and melancholy, are VERY important -- but they have no more to do with depression than happiness does. Depression is as far from sadness as it is from joy.
Hell, depression isn't even BLEAK. Bleakness is when you look at the world around you, and see no future. In depression, you can't even get THAT far. You're just hollow.
types of depression
And of course, real people aren't as simple as two little boxes. My depression is mostly atypical: I crave carbohydrates when depressed and can be cheered up temporarily (leading to me becoming addicted to video games as I feel happy while playing the game as it blocks out all the negative thoughts in my head). The problem is that during depression, my baseline mood has drifted downwards. So it's easy for me to feel bad because only a small surge of badness is enough to push my mood down to the troughs, the lowest possible mood - but it would take a VERY SERIOUSLY happy event for me to feel even mild contentment, due to starting so far below zero. And the positive mood doesn't last - I'll feel happy because I'm having fun with my friends, but as soon as my friends go away, I'm back to myself and my thoughts again. I have comorbid anxiety, which brings with it the irritable features more like melancholic depression, and anger. Like the melancholic depressive I'll have trouble getting to sleep and will still be awake at 4am worrying about stuff, but I have the atypical feature of sleeping for many, many hours once asleep. (Part of my trouble with falling asleep is "natural" insomnia that I've had my whole life, part is delayed sleep phase syndrome, the rest is due to the fact that I have nightmares when depressed and would rather like to avoid them by not going to sleep at all. I also tend to self-medicate with bright lights, which can reduce the body's ability to act on melatonin.) When depressed, I have times of not looking after myself because I don't have enough energy to do things like cook proper meals or wash, and times of not looking after myself as a form of self-punishment - "I'm a bad, weak person, and I don't deserve to be clean". Following therapy, the latter is now very rare for me - I've learned that my brain chemistry beats me up enough without needing to add to it :)
I also have a strong psychotic component from hormonal stuff. Every time I have ever intentionally self-harmed was on day 23 of my period, when my progesterone:oestrogen ratio is highest. And the majority of times I have unintentionally hurt myself (e.g. by falling off stepstools or down the stairs) have been during the window of day 22-day 25. In general, my ability to think, reason & co-ordinate my physical presence all get screwed up by the wonky brain chemistry that results from the hormone spike.
[comment too long, continued in next post]
Re: types of depression
Re: types of depression