If you clicked on this post, I’m gonna guess you did because maybe depression has touched your life in some way. Either you’ve been diagnosed with it, think you might have it, or you know somebody who does and you’re concerned. Before we get into this, just to be clear, I’m not that kinda doctor. That is to say, I’m not a psychologist or psychiatrist. I’m a person who was diagnosed with depression as a 20something, and I’ve spent a lot of time studying and trying different ways of managing it, some good, some not so good. This is what I’ve learned.
When I say depression, I’m referring to Major Depressive Disorder, meaning it is severe, comes in episodes, and I have had multiple weeks- to months-long episodes, including one that required a hospital stay when I was in grad school. And yes, that means I was suicidal. Being suicidal is a symptom of depression. Those thoughts happen. It’s just a fact. I’ve learned to dismiss or redirect them. It wasn’t easy.
Medication? Check. I’ve been on just about every antidepressant you can name, as well as a couple of mood stabilizers, and one ADHD drug. Why so many? Because everybody’s different, and for a couple of years my doctor kept throwing drugs at my brain to see what worked. There were a lot of side effects. Some rather unpleasant. But that’s kinda how it goes until you find the right neurochemical cocktail. Currently, I am on a combination of three drugs, two at relatively high doses, and that has been the combo that has helped me manage for the last several years, with a few adjustments here and there.
And y’all are like, “But wait, Prof – you’re like… a happy person. What do you mean you have depression?” Well I mean, yeah, so I have this mental illness. It’s chronic, but I have learned over the years to manage it like people learn to manage their diabetes or cholesterol. I’m okay for the most part and yes, generally happy. Not that I am ecstatically exploding with joy with rainbows shooting out my ass every day (I mean, who is?). Sure, I still have my bad days and even full-on depressive episodes every few years or so, but I have also developed strategies to deal with it.
People often wonder where depression comes from, like “Why me?” Others see it as a personal failing. I used to. But I don’t anymore.
My experience tells me that a combination of factors causes depression. For me it’s at least partly hereditary. There’s a history of mental illness and substance abuse in my extended family. I was also raised in a staunchly religious environment and subject to an enormous amount of daily negative messaging from a young age, particularly of a homophobic nature. So it could also be partly post-traumatic. Then again, I was putting frowny faces on the suns of my little-kid drawings when I was six years old, so who really knows how or when it started for me? I don’t think it ultimately matters.
People ask me sometimes what depression feels like. I can only speak for myself, but here’s what I tell them: Have you ever lost someone very close to you – either a devastating break-up, a divorce, or because they passed away? For me it’s exactly that sense of loss and dread and soul-sucking finality for which there is no remedy. Except if you lose someone close to you, you grieve and it’s horrible, but there comes a time sooner or later when you feel relatively okay again. Healthy grieving is finite.
A symptom of depression for me is the sense of time having stopped. That soul-sucking void feels like it will never end. It feels infinite and bottomless.
It’s precisely the infinite and bottomless nature of depression that drives people to suicide. You are convinced it will never end, will never get better. You feel doomed to despair. This is your reality. Forever. You dismiss any memory of happiness in the past as momentary delusion. The despair is the only thing that feels real.
It’s important to understand that this nearly unshakable belief is a symptom itself.
And you may start thinking you’re crazy because there’s either no discernible cause for your symptoms, or the initial trauma is long gone.
As a young adult I self-medicated with weed and alcohol. I don’t recommend this coping mechanism. Maybe you can get away with it, but I could not. Alcohol, however fun it is when you’re a little buzzed, is a depressant. It contributes to poor sleep, messed-up blood sugar, dehydration, and hella hangovers, all of which make depression worse. For me it also proved habitual. Once I took a drink I could never stop at one, or sometimes ten, so I eventually had to kick it to the curb in no uncertain terms.
When I was first diagnosed at age 22, my doctor put me on Prozac. A friend of mine describes Prozac as putting out a candle with a firehose. That is fairly accurate in my experience. My depression was more like a raging brushfire than a candle, but Prozac flattened me. It made me physically incapable of stress, which is good if you’re suicidal. But it’s not good if you need to be productive and have, like, deadlines.
I want to reiterate that different antidepressants affect different people in different ways, so your mileage will vary. All SSRI-class drugs flatten my personality, but they saved my life at one time, so I’m not going to knock them. Between death and Prozac, I’ll take Prozac, thanks. I recommend medication of some sort if you need it. I will never equivocate on this.
Eventually, I weaned myself off of Prozac and began a desperate self-improvement program. I took up running, martial arts, went vegan, and in a sense tried to outrun my depression. But within a couple of years I began to nosedive slowly and then very fast. And I crashed hard. That’s when I ended up in the hospital. I had to take a semester off from grad school.
Being out of school meant my insurance got cut off, so picture mid-20s me, drugged out to the gills and just out of the hospital, on the phone with my department chair yelling, “I may be crazy, but I’m not stupid. Nobody told me y’all would cancel my insurance. We’re gonna have to figure something out!” I had a $6500 hospital bill in my hand and zero means to pay it. You bet I was going to raise hell. They gave me dissertation hours even though I wasn’t done with coursework yet. That was the beginning of learning to advocate for myself out of necessity. This is an important skill.
Somehow my insurance got reinstated. Somehow I taught two classes. I remember stumbling around the classroom in a drugged-up, dizzy fog, but the student evaluations turned out okay, so yay? The only time I left the house other than teaching was to go buy Cheerios or take my dog Henry to the dog park. He saved my life too. He knew I needed his help.
I spent that semester, the whole year in fact, figuring out how to live. It was clear now that I couldn’t go unmedicated, that I had this thing that was going to be with me, presumably forever, and I had to stop fighting that fact.
In the hospital, we got asked in every therapy session, “What are you going to do differently so that you don’t end up back here?” I honestly had no idea at first.
For weeks after the hospitalization I spent most of my time reading, sleeping, and waiting for my next medicine dose or doctor or therapist’s appointment. All I ate was Cheerios with soymilk. That was all I could muster the will to eat.
The band I was in, the Hussies, replaced me with a new bass player. I was very hurt and told our lead guitarist how badly in a very long e-mail. She wrote back and said a bunch of things, but all I remember is, “You can sit at home and wait for your medicine to work, or you can live your life.” It was like getting cold water dashed in my face. It made me angry. But it was also true.
I remembered what they had asked us in the hospital and started making little adjustments in my life after that. As tiny as opening the shades to let the sun shine into my room, or as big as adopting new habits. When the radio played maudlin music, I changed the station rather than let it depress me more. I took up meditation, started attending the Zen center near my place. I started back at martial arts training. I set up reminders to take my medicine when I was supposed to. I started occasionally eating foods other than Cheerios with soymilk. I forced myself to take showers and brush my teeth.
All of these were huge accomplishments at the time, when my instinct was to stay on the couch wishing I was dead and never interacting with anyone. While on the couch, I did what I had always done when I had encountered an obstacle in life. I read every book on the topic I could find, looking for different ways to deal with my depression.
Here is what I discovered about depression:
- A big part of the pain of depression is the energy you expend trying to pretend you don’t have it. Trying to look normal. Fuck normal.
- We also cause ourselves a lot of pain by pushing depression away, “No, I hate this. Why me? This is terrible” and so forth. That energy could be used towards recovery.
- The kind of depression I have will never be cured, but it can be managed. And I have a lot of control over that.
- No one’s going to give me a medal for surviving this shit. The medal is getting to feel okay.
- I get to define what “okay” means.
If you’ve had MDD or know someone who has, you know this shit is not romantic. There is nothing of artistic merit about having depression. It mostly just sucks. It’s barely being able to do things like basic everyday tasks, getting exhausted from taking a shower or opening mail. You are indecisive, get no joy out of anything, cry at the drop of a hat, get irritated at the drop of a hat. A weird one for me is that I talk more slowly and haltingly, and my body hurts. I am prone to fits of rage, which, if you know me, is definitely not me. And it can drive all but your most supportive loved ones away from you – maybe even the supportive ones too – which of course compounds the whole thing.
It is like being stuck in a dark room, and you can’t find the door or the light switch. You just exhaust yourself looking and looking.
Ultimately I found that feeling okay had to be my number one priority. Not in-this-moment gratification type okay, but in a larger sense. Choices that point the way out of depression rather than reinforce it.
I will always be on medication, but that alone doesn’t get me to “okay.” It gets me to “suicidal is not the default setting” or “not in immediate danger of getting sucked into the void.” Both of which are good, but not what I wanted for my life. I wanted to be happy. That doesn’t come naturally to me like it might to some people, but I learned to make adjustments.
To reach “okay,” I have to be vigilant, both about what I do, but also what I don’t do. I’ve slowly engineered my life over the years to support my attempt to be okay, and for the most part I’ve been successful.
Here is what I have to do if I want to be okay. These are my non-negotiables:
- take my medication daily, at around the same time every day
- avoid sugar and crap
- don’t drink alcohol or use narcotics
- get toxic people out of my life asap, or minimize my exposure to them if I can’t get rid of them (this includes online)
- be willing to cut out negative influences, at least temporarily, such as the news or social media if they get too toxic
- pet and talk to all animals
- be hydrated
- notice stuff that’s good and allow myself to experience wonder
- tell the truth
- say “no”
- say “hi” to people at work and say nice things to them
- talk to someone if I feel like I’m going over the edge
The following are things that are extremely helpful, but I don’t do all of them all the time. The more of them I do, though, and the more regularly, the better I feel. Sometimes to the extent that I surpass “okay”:
- go for walks
- regularly practice meditation or other mindfulness-type things
- get at least a little sun exposure
- make up funny songs
- if possible, lift some weights
- take hot baths
- eat a bunch of vegetables, the less processed, the better
- eat healthy fats like avocados or nuts (they’re good for your brain)
- not give a shit if my definition of “okay” is dorky or uncool or in some way unacceptable to others
- quote song lyrics (especially old school hip-hop) at every possible opportunity
- watch things that are positive
- sing in the car
Now, like I said, I’m not a doctor-doctor, and some of this shit sounds admittedly Pollyanna-ish, but I don’t care. Because it has worked for me. Maybe your toolkit is different. Maybe this all sounds like “oh my God more shit to put on my to-do list, fuck off!” I get that. There are times when I’d say the same. But you don’t have to do all of them, or any of these specific things. Please keep in mind that I have compiled this list over the course of years based on my own personal trial and error. I don’t do all of them all the time.
The most important to me in all this has been the understanding that “there are no sacred cows.” I became willing to rethink anything in my life that was contributing to my depression. Yes, even coffee. And girlfriends. And friendships. This remains an ongoing process, and it changes as the world around me changes, as my schedule changes, as my relationships evolve.
The silver bullet is that there is no single silver bullet.
I have to be willing to come at my depression from every direction, or at least as many directions as I can at any given time. And to have realistic expectations as to what that can be at any given time.
Hey wait, isn’t it boring to give up a lot of fun stuff like sugar and alcohol? Well, for one, maybe you won’t have to. Everyone is different. And I function more optimally without those things. Maybe they don’t affect you as much. It’s just worth being willing to question the role your habits play in your overall enjoyment of life, not hanging on to them because you’re hooked by the moment’s distraction they offer.
And guess what? Actually it is fun. I have a lot of fun, like, on a daily basis. I’m actually open to more kinds of fun now than I used to be.
The important thing I want you to get from this is that you can recover. You have at least some control over your recovery. Nothing good can come from untreated depression. Or anxiety. Or bipolar. Or other mental illnesses. You can do things that will change your default setting, even if only a little. And it is 1000% worth the effort.
For some reason, I see online forums of young people who seem to stay stuck in non-recovery from mental illness, almost encouraging each other not to get help. New Agey types sometimes eschew “western medicine” because… I don’t know actually. I personally enjoy not being dead and prefer not to let the ideology-du-jour get in the way of my continued existence.
There is nothing “strong” or beneficial about not getting help. Yes, finding the right doctor and the right medicine can be hard. Therapy isn’t always a party. Yes, there are dumb people who still believe there is a stigma to getting mental health assistance. And yes, taking steps to get better can feel uncomfortable. As Buffy says, “The hardest thing in this world is to live in it. Be brave. Live.” That’s what I want for you.
You deserve that. To live. You deserve to be more than just functional. You deserve to feel okay. To reach whatever “optimal” looks like for you. To be happy. To feel wonder and joy and normal sadness and the full healthy range of human emotions. Feeling better is possible, even if it doesn’t seem like it right now.
If you think you may need help, here’s a good place to start.