Depression – Part 1

Content Warning: depression, suicide, Covid-19, general 2020 unpleasantness.

Depression comes in many shapes and sizes, and all are equally valid. Just because one person’s depression only comes on during winter months doesn’t mean they suffer less than someone who has it year-round. I know one thing I struggle with is comparing scars — meaning: “I shouldn’t complain or seek help because other people are really suffering.” Just because someone else may have it worse doesn’t change the fact that you are still struggling, and deserving of help.

Something tells me I’m going to be writing that sentence a lot. It’s an idea that can be easy to forget when mental illness takes over.

Depression is a huge scary beast of a topic, so I’m going to try and break it up into manageable chunks. Here, I’m going to give an overview.

What Is Depression and Who Can Get It?

Depression is a mood disorder often resulting in a decrease of production or uptake of serotonin — the “happy chemical”. There are numerous causes, including but not limited to: family history, early childhood trauma, brain structure, substance abuse, and preexisting medical conditions.

It’s a very common mental health issue, one that almost everyone experiences at least once in their lifetime. However, being part of a marginalized community — such as being a Black or Indigenous Person of Color (BIPOC) or LGBTQIA+ — increases those numbers, and unfortunately the American healthcare system does little to help their suffering. In fact, Black adults are 20% more likely to experience emotional distress than White adults, but are much more likely to be misdiagnosed with schizophrenia than a mood disorder. Another alarming statistic: “Native and Indigenous American adults have the highest reported rate of mental illnesses of any single race identifying group.”
Additionally, these numbers have been on the rise since the covid-19 pandemic began (and with it, social unrest, police violence, and political chaos). Many people are experiencing depression for the first time, or their depression is getting significantly worse as we navigate this new and bizarre reality. The good news is: there is help.

Types of Depression

There are many many different types of depression, each one with its own criteria. Some of the more common ones include:

  • Major Depressive Disorder (MDD) – characterized by mood instability and feelings of hopelessness or worthlessness that lasts for longer than two weeks. This has many subtypes, depending on severity and duration. I’ve had this – and several subtypes – for most of my life.
  • Seasonal Affective Disorder (SAD) – colloquially referred to as “the winter blues”. This is most often seen in climates that have long, dark winters, and is characterized by feelings of hopelessness and sadness that dissipate as the seasons change. I’ve had this one since I was a teenager.
  • Persistent Depressive Disorder (PDD) – formerly referred to as “dysthymia”, this version of depression is more persistent, but the symptoms aren’t as severe. This is the second most common type of depression.
  • Peri- and Postpartum Depression – these are seen in people who are pregnant or those who have just given birth. Like with other types, it can be characterized with feelings of worthlessness, apathy, sadness, or irritability.

There are many other types, such as atypical, anxious-presenting, or melancholic features, and more. Most of these fall under MDD, but are worth looking into for specifics.

What Does It Look Like?

No two people will experience depression the exact same way. Men tend to feel more anger, women tend to experience more guilt, and children will often exhibit irritability and impatience. Atypical depression or PDD might have different symptoms. However, some universal feelings can be:

  • Feelings of worthlessness or hopelessness (“Why am I even trying? What’s the point of this? It’s not going to amount to anything; I’m just going through the motions.”)
  • A lack of interest in usual activities, or an inability to be productive
  • Chronic forgetfulness, fatigue, or “brain fog”
  • Inability to concentrate or make decisions (“I can’t decide what to wear so I’m not going to bother getting dressed.”)
  • Sleeping too much or too little (I get really bad insomnia when my depression hits)
  • Eating too much or too little (I lived on Red Bull and 1 muffin a day for four months)
  • Irritability, mood swings, feelings of sadness
  • Low self-esteem
  • Apathy – I feel like this one isn’t talked about enough. Depression isn’t usually “sad all the time”. It’s “I feel nothing at all ever; sadness would be a relief.” It’s emotional purgatory.
  • Recurring thoughts of death or suicide

There can also be physical manifestations, such as:

  • Headaches or migraines
  • Weight loss or weight gain
  • Muscle pain or stiffness; general “heaviness” of the body
  • Slowed movement or speech
  • Chronic exhaustion

Clearly, depression is no picnic. This is why it’s important to take people seriously when they say they are experiencing symptoms of depression, and not to trivialize this illness by saying things like, “I’m so depressed,” when you’re bummed out or disappointed. Depression is a condition as real as cancer, and can have serious consequences.

Often, someone experiencing depression will withdraw from social activities. Conversely, not having frequent positive interactions with others can cause symptoms of depression — which is one reason why so many people experienced it for the first time with the covid-19 pandemic.

From the outside, it can be hard to tell if someone is experiencing depression, especially if they’re high-functioning or good at hiding it. Many of the photos of me (when I bother to have my picture be taken) show me grinning and happy, but 7 out of 10 of them are when I’m going through varying stages of depression. The last photo of Robin Williams was of his laughter. Few people knew about Mac Miller’s mental illness beforehand. Depression can’t always be detected just by looking at someone.

What Can Be Done About It?

There are many options for those experiencing depression. But probably the first and most important thing to understand is this:

Your depression is happening toyou, it is not you.

I’ll get more into other mindsets in a later post, but this realization was so vital in helping me recognize that what my brain was telling me was a sickness, not me as a person. Especially since I’ve had it from such an early age, it was hard to tell what was Depression Voice and what was Me, because for much of my life those two were side-by-side. Realizing my mental illness was something I was experiencing, and not something I was as a person made such a big difference and was what helped me begin the road to recovery.

  1. Therapy

You’ll eventually get tired of me telling you how wonderful therapy can be, but seriously, having someone who knows how to handle the onslaught of emotions (or lack thereof) is so helpful. An unbiased third party who can help you differentiate between what you actually believe and what the depression is lying about can save your life. A person who can give you the tools to redirect and reframe troubling thoughts will make your future so much more manageable.

2. Medication

Honestly, meds are a whole huge topic deserving of an entire post, but the baseline is this: there are medications that help with depression; many of them are not habit-forming, and while some may have unpleasant side effects (sensitivity to light, inorgasmia, tremors, anxiety) they are worth looking into if you think you need more help than talking it out with a therapist.
It can be a pain to find the right drugs, and it’s a daunting, time-consuming task that you might find yourself reluctant to begin. However, if they keep the Depression Voice from getting too loud and can help you begin feeling better, it is well worth the effort.
Most importantly: there is no need to feel shame about taking medication. You take pain relievers for headaches and insulin for diabetes — your brain is an organ that sometimes needs medical help, too. As always, talk to your doctor and ask about anything that might be worrying you.

3. Social Safety Net

In times of physical distancing and continued uncertainty, it’s hard to maintain our friendships like we did before — not to mention if you have lost someone to Covid-19, caught it yourself, or lost your job or home because of it. There’s no getting around the fact that life looks different this year.
There’s also no denying that Skype calls aren’t the same as grabbing coffee with your friends, but weekly interactions with people who care about you can greatly improve your mood overall. As we settle into a new normal and navigate the chaos that is 2020, now is a good time to regularly check in on your friends and family, especially if you haven’t heard from them in a while.
Even before Covid, feelings of isolation were a primary reason for feelings of depression. Humans are social creatures, and we need our herd to stay happy. What’s worse is that depression can exacerbate feelings of isolation and being unwanted, which makes it that much harder to reach out. Having a good social group is more important now than ever before.

What Next?

I tend to write these posts on the fly and don’t really plan them out, so I’m not sure what I’ll write about next! For now, I hope you learned a little more about an illness that is frequently misunderstood, and have an idea of what to do if you’re experiencing it. As always, please reach out if you feel the desire to do so. I would be delighted to hear from you!

Always,
Erica Jane

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