I’m in a bad mood today.
Robin Williams died, and it was sad in the distant way that any celebrity or far-removed acquaintance’s death is sad.
And then the internet chimed in.
Post after post of “it’s selfish” was met with the far more insidious psycho-babble that’s so dangerous to actual sufferers of depression.
My bad day comes as a relief, a reprieve from a solid month of anhedonia. So thank you for making me angry, Internet. Let me return the favour by telling you why you should shut the fuck up about depression.
The absolute, No. 1, worst thing you can say about depression, in my books?
“Depression is … ”
Depression is 100% different for every person. A lot of symptoms overlap but they change from hour to hour. And if you use “anhedonia” to describe depression I will seriously consider punching you in the face because just as many people experience it as an overwhelming array of emotions. Heck, I vary between bouts in anhedonia and crushingly strong feelings. Someday psychologists will get their shit together and enforce calling it “mood disorder syndrome” or some shit and that day can’t come fucking soon enough but that still doesn’t even come close to conveying the variety of coping mechanisms that people use to try to get through it.
So say there’s around 10 continua on which symptoms of depression are expressed, i.e. sleeping too much/not sleeping enough, eating too much/not eating enough, physical pain/numbness, anhedonia/overemotion etc. etc. etc.
THEN you have to factor in the coping mechanisms that can also take place on those continua or apart, for example is the person avoiding sex/being promiscuous because it’s a symptom of their depression or is it part of their attempt to try to deal with it? And how much of a feedback loop is that creating in the depressive cycle? Because whatever else depression is it’s also a fucking mix of brain chemistry, personality, self-talk and behaviour loops.
The moral of the story is DON’T FUCKING TELL ME WHAT DEPRESSION IS OR IS NOT UNLESS YOU’RE MY FUCKING SHRINK.
Speaking of which, the second most insidious thing you can say regarding depression is …
I hope it’s patently obvious that getting help is the most daunting of all tasks when you’re depressed. Filled with some combination of self-hatred and the aforementioned complete lack of feeling, it often doesn’t occur to you that you’re worthy of help. And if it does occur to you, you fight it. And if you fight it, you get even more fucking exhausted than you already were. And 50 million people tweeting it in response to a high-profile suicide doesn’t move the fucking mountain any closer to Moses.
But wait, it gets worse.
Psychological help is fucking HARD. TO. GET. There is currently an 18-month wait list for a publicly funded psychologist in Winnipeg. You can pay $150 an hour for private treatment, and IF you have a good job your insurance will MAYBE cover six sessions of that, which is enough time to cover maybe the depth of how bad you feel, not solutions. You can go to the free group therapy sessions and sit next to a bunch of smelly whiners and/or deeply mentally ill people, all of whom you will empathize with (if you still have the capacity), many of whom will scare you, but none of whom are particularly interested in helping you deal with your problems (though they have lots of opinions on medication).
You can go to the ER and say you’re suicidal. What a fucking joke. Two years ago I spent the night in HSC ER with a close family member because they didn’t have a place to put them DESPITE (redacted).
And I haven’t heard good things about the availability of psychologists at the new dedicated mental health centre. Even for attempted suicides. They also no longer pick people up so you have to drag the person fucking down there.
Let’s not even talk about how hard it is to get in a room with one of the like 20 psychologists in the province because I predict that would cause you to join me in my curled-up ball on the floor and I don’t want anyone else in there.
“Talk to someone.”
Are you volunteering to step up? Because in my experience as a friend and family member of depressed/mentally ill people and as one myself, you have a few venting sessions before it gets to be a little much. And a few venting sessions does not a cure make. A few years into the mental health issues of the aforementioned ER visitor I would screen their calls, have a quick cry and a shot of bourbon, and call back. So if you’re volunteering, that’s what you’re signing up for.
Say you do score a psychologist, either by managing to not kill yourself for the 18-month wait, or by forking out the $600 a month.
Say they aren’t a complete piece of shit. (Many of them are.) Say they aren’t a cheerleader who wants to rah-rah-rah you through your problems. Say they *will* listen when you claim they’ve misdiagnosed you. Say they don’t sigh and look sad every time you relay some absolutely heartbreaking thing that just happened to you. Say, by some miracle, they let you take the focus off your fucked-up past and put it on your moderately fucked up present.
Say you don’t lose access to the psychologist by sleeping/being unable to go outside through several of the appointments. (Which, duh, happens all the time.)
Then you’re looking at, real talk, three to six of the worst months of your life while you talk through your shit. And when that’s over you’re just on the fucking ROAD to recovery.
Most psychologists in Winnipeg at least aren’t even trained in behaviour modification so right now we’re still just wallowing and hoping for the best.
“It’s a brain chemical issue”/“Think of it like cancer”
The “cancer” line has to be the worst fucking thing you can say. Do you honestly think I don’t wake up every morning wishing I could take the cancer out of some mentally healthy person’s body, because then at least SOMEONE could be happy?
But that leads us to pills. Yes, a small percentage of people find success through some pharmaceutical intervention. More will find it through a combination of pills and talk therapy, perhaps with some behaviour modification thrown in.
What they always seem to forget are the side effects. Sexual dysfunction: Not fun. Worse is the fuzzy state that can persist for months, years until you get the balance right. And then you’re looking at a fucking lifetime of calibrating that balance and having issues every time you want to change it/there’s a new drug/you lose your psychologist access/you lose your health plan/you decide you don’t want to keep taking pills every day for the rest of your life. And believe me, coming OFF the pills is the worst part of the whole enterprise.
And that’s how depression is not like a physical illness (except, OK, cancer): There is no such thing as a cure.
“It’s just a phase”/“You’re going to get through this”
Many of us have family histories of mental illness as well, and it drives home the point that it’s never going to end. It will get better, and it will get worse again. It will be managed well, and it will be managed poorly. Over and over.
“When you feel better, you’re going to … ”
… Probably kill yourself. Real talk, most suicides happen NOT when people are at their absolute lowest (that’s a non-mental-health suicide, like ’cause you lost all your millions) but rather as they’re starting to climb back up the ladder. So yeah, you just went through fucking months and years of hard work to get back and now you finally have enough energy to actually go out and buy the fucking gun and enough motivation to point it. I know this. So don’t fucking tell me what I’m going to do when I’m better.
So obviously this gets thrown around a lot in regards to suicide and I mean everyone and their dog will argue against it but really suicide is selfish, in the same way driving a car is selfish, because it’s THE EXPEDIENT WAY TO SOLVE YOUR PROBLEM, at a cost to others that includes the pain of your death and/or climate change.
Depression is inherently selfish too.
If you read all this and are still like OK I want to help someone let me tell you to LEAN IN TO THE SELFISH.
If it’s a friend or family member that’s suffering, let them do their thing. They are WORKING HARD to pull through and as long as they are aware you love them they will make some sort of a sign if they need help. Depression is inherently isolationary so reminding them all the time that they’re there to talk may just cause guilt/more pain/stabby feelings so don’t fucking push it. Let them be selfish.
Similarly, you need to be selfish too. If the person is having a negative impact on your life it’s OK to take steps to mitigate that. Like me with the pre-phone bourbon. Eventually I said, “look, loved one, I am struggling to help you right now. I am going to call your piece of shit psychiatrist and tell him to be nicer to you so you don’t have to talk to me about these details I would rather not know about (redacted).”
Outsource the fucking problem by buying books like Feeling Good (my personal favourite) and deal with the ways that YOU are contributing to the person’s depression because you goddamn well are. Read the book and then try to argue you’re not.
Take steps in your own life to be happy and model happiness. Put your own goddamned oxygen mask on first.
Feed the person a goddamned healthy meal.
And STFU until they ask you for help.
“How are you feeling today, sweetie?”
What did I JUST say?
Depressed people like being patronized about as much as non-depressed people.
If I tell you that “I have bad allergies today” or “sorry I was getting sleepy so I had to leave the party” then decide whether you need to probe into that or whether it’s now YOU who’s being selfish.
Here’s a thought: ASK the person what they want and skip the one-size-fits-all answers.
For me, the main thing is to BE HAPPY WITH ME WHEN I’M HAPPY. Don’t remind me how two days ago I was curled up on the couch with ice cream that I’m allergic to or ask why I haven’t painted the house yet. Just be my normal friend if it happens to be a day I can be your normal friend.