“Are you spiraling?” my husband might ask, as I express that it’s been a hard day and all I want to do is go to bed. If you’re a regular reader, this phrase might be familiar to you: the concept of the “depression spiral” has worked its way deeply into my personal lexicon of mental illness descriptors. I think it works so well because it captures so accurately the momentum that depression can gain as it whirls around a person, sucking him or her closer and closer to the edge and eventually down into a deep, dark hole of apathy, sadness, hopelessness.
This is part one of a few entries I’m planning to write about the spiral. There are at least three big aspects of this thing for us to face down together, so I’m planning to address the following, in separate posts:
1. What it is this so-called spiral, and how do you manage to keep getting yourself sucked into it?
2. What’s it like inside?
3. How the hell do you get out?
So, here we’ve got part one. Bear with me, please, because we’re going to back our way into the twisty depths of depression by way of a sillier, more mundane analogy. I think it works, so I hope you do too.
Let’s talk about feelings, okay?
My mom has always told me that I “feel things very intensely.” Beginning in the fifth or sixth grade I began to fill notebooks with angsty, pained, (and painful to read) poems about love and loss (in all the wisdom I could muster from my 12-year-old heart). I have a distinct memory of my high school self becoming so consumed with a book on a family camping trip that I talked to no one until I finished it, and cried inconsolably for hours after I was done (in my defense, though, it was a really sad book). But I couldn’t put the book down, rejoin the real world, and walk away from how deeply it made me feel.
Then, when I began counseling in college and we had started exploring a diagnosis of depression, my therapist asked if I had always “tended toward the melancholy.” While that’s not a particularly flattering way to think of oneself (“why yes, I do identify closely with Eeyore, thank you for asking!”), I thought back on my notebooks and on my general outlook and had to admit that, at times, I did.
This tendency to see things with a bit of an overcast tone, on top of a propensity for feeling any kind of emotion intensely, means that I easily become sad -- and then, quickly, very sad. In a person with healthy coping skills and emotional regulation, this kind of sadness, whether from a book or a movie, or from a personal disappointment, or a tragic current event on the other side of the world, can be a passing feeling that might be remedied by a long walk, a talk with a friend, or a journaling session. But in my own experience with with depression, that kind of sadness -- the kind that should be faced and handled as a part of a healthy emotional life -- can trigger a deeper, more disturbing emotional response. For me, at least, the regular everyday sadness of life’s normal events can be like giving my depression a foothold in my soul, a place for it to grab on and take root.
So as I sank deeply into my depression over the past year or two, I began to avoid certain things that I knew would make me sad. I’ll read a crime thriller at the drop of a hat, but pushing myself to read something that had more emotional depth became off-limits. I can only see this in retrospect -- but I spent a good couple of years reading more far-fetched mysteries and police procedurals than I can count, while ignoring books I’d long wanted to read by favorites like Toni Morrison or John Updike because I was scared of what those beloved writers might make me feel. Likewise, I turned away from movies or TV shows that skew toward the tragic and opted either for sitcoms or, again, crime dramas. I passed by articles in the news that looked interesting and thought-provoking because they were about current events or social conditions that would make me feel sad about the state of the world.
I feared that if I allowed myself to feel unhappy in response to an appropriately sad stimulus, my depressive symptoms would take hold, that I would allow the weight of my illness to pull me further down into the spiral of despair that I experience when I am having an episode of major depression. (This spiral will be the sole subject of a future post, I promise. It will be fun.) I couldn’t let myself do it. It felt like too big a risk to give my depression even a fleeting chance to worm its way deeper into me.
I must state here that this is an observation I am making about myself only, and in retrospect only. I know that many people with depression seek out sad music or other media or news to validate their feelings and to feel less alone in their sadness. Personally, I avoided it at all costs. There’s no right way to experience mental illness (again, more on this another time).
But as I am growing and learning about self-care and becoming well, I’m working on learning the appropriate ways of dealing with normal emotional responses to sad things. I recently watched a speech that made me cry. I knew it would make me cry, and feel sad, and I was tempted to go to bed before it came on, but my husband encouraged me not to miss it and so we watched it together. (Coping skill #1: have someone with you for moral support.) I did cry, and I did feel sad, but then afterwards it felt okay. I did not feel the long, spindly fingers of depression reaching up from the depths of the spiral to grab at me. My husband showed me cat videos that made me smile. (Coping skill #2: laugh at things that are funny.)
And tonight, as I’m writing, we’ve decided to go see “Manchester-by-the-Sea,” a film set in my hometown (woot!) that is supposed to be excellent and also incredibly sad. I have asked myself, and my ever-patient husband, several times this week: “Why do we want to go see something so sad?” And also, “How am I supposed to choose to go do something for ‘fun’ that I know is going to make me cry?” Again, I imagined that after watching it I would come home in tears, emotionally wrecked and feeling devastated about fictional characters to whom fictitious sad things happened. (Coping skill #3: remember that sometimes sad things are not real.)
But I have decided, in a slow but clearly evolving way, that I am not going to be someone who misses out on life experiences like weeping at the end of an outstanding novel, or crying through a touching, phenomenally-acted film, or mourning with the people of another country who have just survived a terrible earthquake, just because it will make me have feelings. Feelings are okay. Feelings are real and raw and sometimes they hurt, and if you are mentally ill then a lot of the time they hurt, but part of life is learning to feel things as they come over you, and deciding what to do with them, and absorbing them into your human experience so that they make you a better, more insightful, more compassionate person. (Coping skill #4: remind yourself that feelings are allowed as part of your human experience.)
On hard days, or in the midst of a depressive episode, there can be wisdom in choosing to filter out some of the things that cause sadness and despair. But on healthy days, through the ins and outs of life, finding my footing as an emotionally healthy person, capable of feeling and gauging and processing my response to life, is one of the best ways to learn self-care and to grow in my understanding and capacity to care for others.
So, in that spirit, I’m headed to the movies -- with a pack of tissues.
As I mentioned in a previous post, I’ve been in a bit of a slump the past couple of weeks. I wouldn’t call it a rut, not a downward spiral, but definitely a downturn in my mood and energy. I’m not talking about the kind of desperate, gnawing sadness that I’ve described before, not a string of really terrible, hopeless days, but more of just a low-level, doing-the-bare-minimum, getting-by kind of depression. The low moments are not as painfully low as they are on a truly awful day, but the high moments don’t feel as happy and carefree as they should (and do) when I’m completely well. I’m a little more able to get out of the house and put a smile on my face, it’s just still hard to feel like I’m glad that I’ve done so.
It’s impossible for me to tell when a slump is coming. It just happens, as I slowly realize that I have been stringing together days and days of “blah.” My body might ache a bit more; I’m more prone to headaches and stomachaches; and I sleep a lot. (For example: last night was the first night in two weeks that I was not in bed before dark.) Over the weekend I slept and slept and slept. I got up for a few hours and then went back to bed after dinner, finding it difficult to think of a reason to stay up. If I couldn’t sleep, I escaped into a crime novel and read until my eyes closed. And then I slept some more.
Sometimes I sleep like this because I’m genuinely fatigued. I took a day off from work, using sick time to try to sleep off the misery and exhaustion I was feeling. It didn’t help, but back to work I went the following day. I fought my way through the rest of the week, doing my work, taking moments here and there to check in with my husband about how I was feeling. I tried to just let the depression sit with me through my days; I was functioning but feeling a constant, dim kind of melancholy. Sitting with even just that faint sadness all the time is really, really tiring. So I sleep.
Other times, I sleep like this because I just don’t feel like there is anything more important or more interesting to do. I let the pile of clean laundry sit unfolded. I let the dust gather around the jewelry and toiletries overcrowding my dresser. I notice that the shower curtain liner is starting to mildew. I just let it all go. None of it feels more important than being horizontal, in my bed, away from the nagging world. So I sleep.
Slumps like this can last for days, weeks, even months, for me. I function, get through work, cook some occasional meals, but mostly I just use my energy to get by. Socializing is hard, even with my closest friends and family. I want my husband home but when he’s nearby I get irritated with him for no reason. As soon as I push him away I want him back in the room with me (I’m sure this is maddening, but he takes it all in stride, thank God). I cancel plans so I can rest, or sleep, or hide, and then I feel guilty about canceling plans, so I spend energy using positive self-talk to remind myself that I’m not well and I need to take care of myself. That’s exhausting too, so then I go to bed. Again.
If you see me during a slump, you might not even know I’m having one. Upon starting this blog, several people close to me let me know that they would have had “no idea” that I suffer from depression if they weren’t told. I guarantee they have all seen me during a time like this, probably not on a horrible day, but during a bit of a hard time. I have learned to smile and, if not engage, at least quietly observe what’s going on around me and try look interested (rather than grimacing at the negative thoughts in my head, or muttering under my breath for the monster to pipe down). The good thing about slumps is, while they take a lot of energy to get through and they are damned persistent, at least they don’t suck all the happiness out of a moment. I can still get in a genuine smile here and there. I’m learning that it’s better than nothing.
So, slump or no, I try my best to be present for the important moments in life. I can name birthday dinners, reunion trips with college friends, weddings, even parties that I have hosted myself that have all occurred during a rough patch. I show up. I look the part. It’s okay. I can acknowledge happy occasions and wonderful people. The deep, sustaining joy in knowing that God is good and life is beautiful is not gone from my mind and my heart; I just am less equipped during these moments to fully experience and express happiness in all its shapes and sizes. I have still made the memories, still witnessed the events, still been present in the moment. At the time, I might feel like all I’m doing is mucking my way through the swampy waters of depression, the exultant world around me hazy and out of focus; but I try to remember that what I’m doing is being here. I’m living. Maybe the happiness won’t be as big, as uproarious, as full in my heart as I want it to be; but I’m here, where the happiness is, and that’s more than worth slumping through.
Yesterday was Mother’s Day, and Saturday night as I made preparations to celebrate the following day with my wonderful mom I found myself thinking back to Mother’s Day of last year. We had a big celebration with the entire extended family on my mom’s side -- each of her five siblings, most of their spouses, their children (my cousins), and even their children were there. We gathered around a long, long table in one of my grandmother’s favorite restaurants in Greensboro, North Carolina, and showered my Gram with cards and gifts and -- her favorite, I suspect -- a lot of hugs, kisses and family time with her kids, grandkids and great-grands.
Without context, this sounds like the kind of Mother’s Day memory that should make anyone smile; and yet, as I reminisced while driving home from dinner with my husband Saturday night, I caught tears running down my cheeks. I couldn’t make them stop.
The context is this: my grandfather, the patriarch of a family of six children, the husband of my grandmother for 65 years, had passed away in March 2015, and we held his memorial service on Mother’s Day weekend of that year. We celebrated my grandmother that weekend after we mourned her husband; and to say that “the whole family” was there is a half-truth, because my Papa was not there, and we felt his absence like none other (even and especially, perhaps, when the check came and he was not there to fight doggedly to take it away from my aunts and uncles).
And, for more context: in March of this year, my beautiful, strong, sarcastic and loving grandmother passed away as well. That giant family Mother’s Day lunch we all celebrated a year ago was to be her last. Mother of six, grandmother of 13, great-grandmother of 13 (I think? And with more on the way, and one already named in her honor): gone from us, with no warning. My mother, who was visiting, said goodbye to her mom at 9:00 in the evening and watched Gram make her way to the great hall of the retirement home to “say hey to the girls playing dominoes.” By the time my mom arrived to pick her up late the next morning, Gram had been found, quietly passed on, sitting in her recliner. There was still an indent on her pillow from having slept in her bed the night before.
At one point during the aftermath of my grandmother’s death, my brother asked how I was doing and I told him the truth: “Well… I guess I would say that grieving on top of having depression is like a pretty big kick in the crotch.” I stand by that description still. I told him I felt like I was wading through cement, like every tiny action of daily life took an enormous amount of energy to complete. What I didn’t tell him is that some days it felt less like wading and more like drowning.
Grieving while depressed is, I think, its own special kind of misery. You are already a person who, as my college therapist described it, “tends toward the melancholy” -- or more accurately put, who experiences chemical imbalances that cause you to feel sad, tired, empty, apathetic. Add to that a life-changing event, a loss that most mentally healthy people find difficult, or painful, or maybe even soul-crushingly awful, and it’s no wonder you begin to feel that you are drowning under the weight of grief and emptiness and loss. I try not to use any of these words lightly -- I don’t want them to lose their meaning -- but in the months following Gram’s death I really found myself fighting desperately to crawl out from under the weight that was pressing down on my heart and my mind. I certainly grieved when I lost my grandfather the previous year; but he had been sick and weak for a long while, and his hearty, soul-warming laugh had been absent for so long, that I had a chance to come to terms with losing him and I was able to say goodbye. This -- this sudden phone call from my mother, her quiet words: “Gram is… gone,” this sudden emptiness in a part of my life that had been so joyously full of love and support and gratitude: how was I supposed to cope with this?
I looked at pictures. I spoke at her memorial service. I reminisced with my husband, my brother and parents, my cousins; I did all of the right grieving things. I knew she was no longer suffering -- from skin cancer, from diabetes, from arthritis, from the depression that I think she too experienced during parts of her life -- but I could not make my own pain and sadness abate. I missed her; I wished I had visited her sooner (I had planned for this coming summer); thinking of losing her made me miss my grandfather terribly, all over again. I remember crying in my therapist’s office, telling her how bad my depression had gotten. I had been doing better over the past couple of months, but now I couldn’t get out of bed. I didn’t want to work. I was cancelling plans, avoiding seeing people I loved, trying so hard to climb out of the pit of despair I felt I was in, I told her, “and I just don’t know what else there is to do.”
While I believe I had gone through my five stages of grief and accepted that she was gone, really gone, and without a goodbye, I was still desperate for help recovering from this loss. When my therapist offered to add a prescription for Abilify to my current medication to help me “for a few weeks,” I eagerly accepted. But the medication didn’t help, and the side effects were, for me, intolerable. I stopped taking it as soon as I could and, slowly, in my own time, I began to come to terms with having lost two people who had shaped my life so deeply and meaningfully. I was able to feel more gratitude than sadness. I still waded my way through the cement of depression during that time, and some days I still do, but I’m going to choose to feel thankful that I am able to feel enough to grieve, rather than feeling completely empty of emotion. I’m going to make my way through the muck of grief with depression and try to be glad, because my depression will not take away my ability to grieve the people I have loved so profoundly. My mental illness may have taken many things from me, but it will not take that.
I could imagine that after all this reading, you could be wondering whether I’ve experienced any of the emotional symptoms of depression -- the sadness, the emptiness, the apathy -- or just the physical symptoms of fatigue and malaise that I’ve described up to this point. I’ve decided to take a break from the chronological telling of my story to address this, as the mental and emotional piece of depression is incredibly important and in many ways, I think, harder to understand.
The truth is that I experienced a great deal of frustration, loneliness and sadness leading up to my diagnosis, but once I found out what was wrong, a lot of that went away for a good couple of years. In the past 2 or 3 years, however, the emotional piece of the disease has taken a much stronger hold on me, and I’ve gone from having days of feeling easily worn out or just plain exhausted to being completely debilitated by a deep, aching, empty feeling that penetrated the core of who I had always known myself to be.
I honestly want to try to describe this pain without being melodramatic or overly emotional, and yet -- if you have never experienced how depression can worm its way into your soul and hurt, constantly, until you’re so tired of hurting that you feel nothing -- I can understand that it may seem that way. All I ask is that you read with an open mind and try to understand with an unbiased heart.
Imagine you wake up in the morning and you feel as though, overnight, your heart has sunk into the pit of your stomach and stayed there, throbbing, until it becomes a dull but persistent ache that has spread to your entire body. Maybe it’s raining and you have a dentist appointment later that day, or maybe it’s a warm sunny day and you have plans to spend it in your favorite place with friends: it doesn’t matter. The entire world looks ominous through the lens of the depression that has taken hold of you. Whatever lurks beyond the door of the bedroom doesn’t feel safe. Sitting up and swinging your feet out of bed feels insurmountable, not because of the mind-numbing fatigue you feel but because it just hurts inside. Just pushing yourself up to turn off your alarm makes all of your insides clench with discomfort and fear. You dread the moment your partner wakes up or comes into the room because you know he or she will realize immediately that it is a bad day. Looking at another person makes you want to burst into tears because the internal hurt you are feeling is so strong and you dread passing that on to another human being.
This kind of sickening, draining sorrow is so exhausting and so remarkably unique in its misery (often and especially because there is no discernable reason behind its appearance in your life) that it seems like you can’t possibly get through a day (never mind a week, or a month, or a year) feeling this way. Mostly you want to go to sleep and stay there, preferring unconsciousness to pain, but if you can’t do that then you start to think of ways to stop hurting. The only times I have ever had thoughts of self-harm, which thankfully last only seconds for me and upon which I have never acted, occur when I am in the depths of feeling this way. I am grateful to say that aside from these fleeting thoughts, I have not struggled with this horrible manifestation of my disease. But I do understand why seeking a physical release for the internal agony can be tempting. I jiggle my legs incessantly, I scratch bug bites too hard and for too long (one of them scarred), I pick at my cuticles. I count down from 100 over and over again in my mind. And when there is no more energy for any of this, I go blank. My husband reports watching me stare at the walls, eyes glazed over, responding to nothing, for minutes at a time. I guess I would say that during these times I am hurting less, because I have completely shut off from caring about anything, and yet I know it’s scary and unsettling for anyone to see how deeply apathetic I feel toward everything in that moment.
This is some of what depression has been like for me over the past couple of years. A spell like this can last a few hours, a full day, or several days in a row. It can be combined with intense anxiety or it can take over all on its own. Sometimes I’ll have just one bad day in the middle of a great month. Sometimes I’ll have a few good days in the middle of a mostly-bad month. The unpredictability is scary and infuriating, and can make it hard to make or keep plans. So when a friend that may be struggling with depression cancels on you last minute, or is evasive and noncommittal, or shows up and seems completely disengaged -- I hope that, maybe, you’ll think of this post and feel somewhat better enabled to comprehend what they’re going through. Be patient, ask what you can do to help, and love them the best you know how.