In the wake of Robin Williams’ death, the internet is rife with talk of depression. Depression is at best an insidious and poorly understood condition. There is enormous potential value in the current surge of awareness and discussion of this topic. But equally there is enormous potential for harm. For those suffering depression, there is hope that increased awareness may bring improvements to Mental Health Care systems, better accessibility, less stigma. But there is also despair that so many people are dismissive, callous, or simply don’t understand.
Here is my response to everyone out there, whatever their belief, position, or experience:
THERE ARE NO EASY ANSWERS.
I wish to address a few points that hit home for me. This is MY EXPERIENCE, it may not be yours. Everyone is different, everyone’s depression is different, everyone’s life, issues, circumstances, experience, etc is DIFFERENT.
THERE ARE NO EASY ANSWERS.
I have lived with depression for 25 years.
I have no official medical diagnosis, and until recently, never sought professional help.
At the age of 15, 10th grade, I began experiencing mood swings. At the height of their severity I could swing from a manic, hyperactive, literally bouncing off the walls high to a despondent, catatonic (www.healthline.com/health/depression/catatonic-depression) low in 15 minutes. Had I seen a doctor at that time I may have been diagnosed with bipolar disorder. But I did not see a doctor. I hid my problems from my family, my classmates, and most of my teachers. Only a couple close friends and one teacher saw what was happening.
i knew, rightly or wrongly, that my parents would not understand. That they would think it was “all in my head”, and tell me to “snap out of it”. I figured teachers would be the same. I struggled through daily life for a year, while my friends watched and removed sharp objects from reach. I got a job, and when the pressure and personal politics got too much for me to handle I quit, with the excuse that my schooling took precedence. I fell for the flattery of a much older man and found myself caught in a very unhealthy relationship.
I started cutting.
Then I got pregnant.
My baby, along with the influence of two perceptive teachers, probably saved my life. Being a 17 year old single mother was not easy, but my life now had purpose. It was my responsibility to care for this tiny, helpless, human being. I coped with my depression by focusing on my child.
Not that the depression ever went away. One of the coping tools that the professionals teach is distraction. Keep yourself occupied. Find things to do and be involved with which hold your interest and challenge you without being overwhelming. Depression makes you sedentary and insular, which, in turn, worsens depression. It’s a self-perpetuating cycle that is very difficult to break out of. I learned to recognize early signs of a downward slide and force myself to get up and do something while I still could.
Motherhood, finishing high school, my second child, beginning university at age 23, marriage, travel, work, horses, needlework, farming, tractors, books, writing, etc kept me relatively stable for more than 15 years. I still had down times. Periods of apathy. Times when I didn’t have the energy to care about anyone or anything. Sometimes the pressures of work or school were too much and I had to take time off. Sometimes the urge to run away and hide from the world was so strong I started looking up train schedules. But my husband was supportive, and my children and school were my anchors. And I coped.
Then my marriage ended in a terrible flood of events leading to criminal charges and jail (not for me). Over the next 5 years I gradually lost everything I had worked so hard for. My home, the farm, pets, most of my possessions, stability, safety, security. I no longer had the time or the funds to continue my part time education. I had two grown children leaving home, and two little children just starting their lives. All the control measures I had built so carefully into my life were gone.
Now I am back to coping day-to-day. Sometimes hour-to-hour. I cry, often, for little or no reason. I force myself out of bed every morning when I just want to stay unconscious and ignore the world. I try to avoid trigger points like news stories, personal confrontations, stress, fatigue, but it’s impossible unless I withdraw from life entirely. Last fall my babysitter claimed my partner was cheating on me with her. I spent a night in a padded cell in the local hospital under the care of a crisis nurse and a psychiatrist.
I am slowly trying to rebuild a stable platform on which to stand, but I now know all too well how fragile the structures of our lives really are. How can you trust your weight to relationships, jobs, finances, homes, social positions, etc which could be whipped out from under you in an instant? You can’t.
I have seen, in the past couple days, a number of well-meaning people stating that depression is treatable, that suicide is avoidable, that help is out there and all you have to do is ask.
I wish that were true. I wish it were that simple.
Truth is that Mental Health services and support are not readily available to many people. Standard treatments like antidepressant and anti-anxiety drugs are not effective for many people. Psychiatrists, psychologists, and councilors are few and overbooked. Family doctors are not well equipped to diagnose and treat mental illness.
As I said earlier, I spent a night in hospital last November. I was given a prescription for an antidepressant and sent home. I was told flat out that my options for follow up care were almost non-existent. My family doctor had previously prescribed an antidepressant for me. He put me on the full dose from day-one and told me to come back if I didn’t feel better in a month or two. The mental health equivalent of “take 2 aspirin and call me in the morning”. I lasted less than two weeks on the meds. I had a constant pounding headache, despondency, and stupidity. My brain shut down and I was unable to function on a daily basis. The psychiatrist told me that this is typical of family doctors trying to treat depression. Knowing my family doctor was not an appropriate resource for follow up care, the psych. suggested I check with Health Services at my university.
University Health Services has 1 psychiatrist on site once a month. (Same Dr. I saw at the hospital.) In order to see him, one has to first have one of the two physicians on staff for primary care (which would cause my family doctor to de-roster me and my kids), then go through the process of evaluation, primary treatment, tentative diagnosis, referral, etc. By which time the school year would be over.
A quick internet search for mental health services in my area is revealing. I found zero private practice psychiatrists, nine private therapists – only one of whom is listed as a psychologist, and all of whom must be paid for (supplemental health insurance may or may not cover this cost). There is a list of organizations (including local hospitals, public health, child protection agencies, local chapters of support groups for various disorders, addiction services, and places like Bethesda and Pathstones) which provide crisis lines, some counseling, and other services for a range of mental health issues as well as developmental disorders, physical impairments, etc. Some specialize in children, or behavioral or socials issues. All have long waiting lists. Some are not qualified to prescribe.
And it’s all very confusing and intimidating.
Some people will look at the last 5 paragraphs and see only a list of excuses and negative bias. They will say that if I cannot find the help I need, then I am not trying hard enough.
Which brings me nicely to my next point: the assumption that a depressed person wants and/or is capable of seeking help.
A large part of depression is apathy. When I hit the bottom I no longer care about anything, or anyone. I no longer respond to stimuli. All I know is my own internal pain. And all I want is for it to stop. I’m not the only one who experiences this:
From the comments on a HuffPost article about Robin Williams –
This is a misconception that always bothers me when people talk about depression.
It can lead to it, certainly; especially in severe cases as it was with Robin.
It’s like nothing has meaning and a pressure is always pressing harder and harder on your chest and throat, you want to cry out and explode in emotion but you just can’t. The pain is unreal, it’s like there’s no escape. Your brain is a torrent of thoughts and emotions which have no way to release.
It’s like a shaken bottle being shaken more and more to the point of it exploding but something just won’t let it even though it’s far past the point of bursting.
It’s like no one cares and neither do you, it’s so hard to be happy when going through a depressive episode. Even when people try to help you feel better something just won’t click in your mind. You know they’re there and they care but it doesn’t help.
It’s like nothing matters to you. There’s no reason to anything and if you happened to die you wouldn’t have a problem with it; you don’t necessarily want to die, you just wouldn’t mind if it happened..
I do deal with depression but luckily it’s not /so/ severe to where I can’t manage it.
I do enjoy my life and have many people who care about me and who I care about. Just occasionally things get bleak and very dark for reasons I don’t even understand, anything can trigger the depression.
You see someone with such a genuinely kind and loving soul who has struggled with this for so long. You can ask “How could it be so bad? Such a great career, a loving family. . .” – To which I respond, “You don’t understand.” And it is because of that. . . Those of us who experience those most brief of moments standing at the edge questioning the very facets of our being and whom or what ever we chose to believe in beyond this mortal coil. . . It’s because of that those who suffer from depression in any form choose to let go. And. . . It’s scary. I promise you, it is terrifying.