You don’t need to be depressed! Just rent a funny movie. Or go and get yourself a massage.

August 3, 2011 12:18 PM

Ten things not to say to a depressed person and Ten supportive things I’m glad somebody said to me
posted by fearfulsymmetry (183 comments total)

Let's add "Are you Okay?" to the list of things never to say.

Because, if it needs to be asked, you already know what the answer is. Offer support instead.
posted by schmod at 12:22 PM on August 3, 2011 [4 favorites]

11. Anything.
posted by Potomac Avenue at 12:23 PM on August 3, 2011 [4 favorites]

Seriously though: "You should get some exercise!" is probably the worst cuz it's also like hey thanks I'm fat too. No I don't want to hear about Kettle Balls.
posted by Potomac Avenue at 12:24 PM on August 3, 2011 [34 favorites]

“But you can’t be depressed! You’re so confident/bubbly/jolly/self-assured (delete as applicable)!”

This one made finally getting myself treatment very, very difficult.
posted by sweetkid at 12:25 PM on August 3, 2011 [18 favorites]

People, quit being so negative. You all are some grumpy grumpkins. You need to get outdoors and spend some time in the sun. That'll fix ya.
posted by etc. at 12:26 PM on August 3, 2011 [17 favorites]

exercising outside in the sun you mean?
posted by caddis at 12:28 PM on August 3, 2011

Let's add "Are you Okay?" to the list of things never to say.

Let's not.

Using this phrase gives the person that was addressed a way out if they'd rather not talk to you and/or if they don't want your support.
Offering support instantly is both intrusive and assuming. You telling the person that you know they're not ok which means you're potentially stepping over a line of privacy they might want to maintain for at that moment.
posted by Hairy Lobster at 12:29 PM on August 3, 2011 [79 favorites]

I'm glad the first link makes it clear that there are an awful lot of crappy people manning hotlines and psychiatric care centers. All the dismissive "just call the hotline" or "just see a doctor" comments that one often receives are woefully ignorant of this fact.
posted by Gator at 12:30 PM on August 3, 2011 [7 favorites]

Are people more depressed because they have no sense of self worth in a world where you really don't have a special job to do that a hundred others couldn't do as well? Are they depressed because they have no real problems to overcome so the mind has to do something? Are they depressed because of medication? Are we over medicating our public?

Or perhaps there have always been as many people depressed as right now, it's just that the planet has an enormous population of humans that it did not have before, so the percentage of depressed people is greatly increased?

I'm more curious as to why so many people /are/ depressed, and why it seems that the more comfortable you are in your situation, the more depressed you get? (From observation. Very few extremely poor who have to overcome hardships daily "appear" to be depressed, or ever complain about it. Maybe the complaining is a luxury in itself?)

Is there a study on this at all, rather than how to cure depression in the individual?
posted by Malice at 12:31 PM on August 3, 2011 [3 favorites]

Should really be titled "10 things not to say to some depressed people." Pisses me off that depression is this "one size fits all" problem that can be fixed for all of us using the things that worked for you.
posted by seanyboy at 12:33 PM on August 3, 2011 [27 favorites]

The problem is that, along with actually being depressed, I get even more depressed right before my period, such that I can generally figure out when I'm about to get my (not particularly consistent) period if I suddenly am suicidal out of a clear blue sky.

This is quite different from depression, which doesn't magically lift in 2 days every time, but it feels the same.
posted by jeather at 12:33 PM on August 3, 2011 [11 favorites]

The problem is that, along with actually being depressed, I get even more depressed right before my period, such that I can generally figure out when I'm about to get my (not particularly consistent) period if I suddenly am suicidal out of a clear blue sky.

You're not alone in this. It has gotten particularly bad since I've been on birth control. (Ortho 7/7/7)
posted by Malice at 12:36 PM on August 3, 2011

I've got a history of depression. It took someone asking me (to my face) if I was actually depressed or just feeling sorry for myself to realize that not every personal misery needs to turn into a spiraling depressive episode. So, scratch #8 off the no-list for me. Number 6 counts double for me, because I have improved my life from next-to-nothing to having a partner much smarter than me, security in life, and a great career. None of these changes had any effect on my depression. Hearing from some asshole that my life is too good for me to be depressed just makes me frustrated.

On preview: laughing a little at Potomac Avenue's comment re: kettlebells. I'm an avid kettlebell trainee and it really helps my mood, but I would never recommend them to a person as therapy. I don't know that I would ever recommend anything to anyone regarding treating depression. It's such a personal thing. It's a part of you that might resemble its analogue in another person, but at the same time is so very different. There is no reason to think what works for me will work for you.
posted by Sternmeyer at 12:36 PM on August 3, 2011 [2 favorites]

Using this phrase gives the person that was addressed a way out if they'd rather not talk to you and/or if they don't want your support.

I usually go with "you sound like you're stressed out/ upset/ dealing with a lot of difficult stuff. Do you want to talk about it?"
posted by craichead at 12:36 PM on August 3, 2011

One of the few nice things about my time in LA (which was mainly marked by alternating fits of anxiety, boredom, depression and insomnia) was the group of people I met in my housing complex. Among other activities, we started RPing on Sunday nights. Now, I was unemployed, went to community college two days a week and spent 90% of the rest of the time on the couch in my apartment or in the midst of a 14-hour sleep session: a depression poster-boy, basically. Anyhow, my sleep cycle was completely broken, and it was around 3 PM on Sunday that I was into hour, I don't know, ten of being asleep, having gone to bed around 5 AM that very same morning. My girlfriend at the time comes into the bedroom to wake me up because "your friends are here."

That was weird because I really hardly ever had houseguests and didn't remember inviting anyone. So I come to the door in my bathrobe and there's my entire RP crew at the door. Turns out it's Sunday and I'm way the hell late.

"Come on, it's time to RP."
"It's cool, guys, I'll meet you over at the apartment."
"Nope. We're waiting right here."

I doubt they knew it, but that was one thing said to a depressed person that I'll always remember.
posted by griphus at 12:36 PM on August 3, 2011 [52 favorites]

Malice, what great suggestions to add to the first link!

Because clearly people with mental illness just aren't cut out for their cushy modern lives and have been made sick by society/a conspiracy by drug companies to make us believe that we need expensive medication.
posted by SpaceWarp13 at 12:37 PM on August 3, 2011 [5 favorites]

The Hairy Lobster is right. But texting "R U OK?" is still not the best way to open these lines of communication.
posted by hal9k at 12:37 PM on August 3, 2011

"Oh, snap out of it."
posted by Curious Artificer at 12:37 PM on August 3, 2011 [8 favorites]

Or perhaps there have always been as many people depressed as right now, it's just that the planet has an enormous population of humans that it did not have before, so the percentage of depressed people is greatly increased?

Or perhaps there have been as many people depressed as right now, but medical science has improved to the fact that we now know what to do about it, and understand that it is often a physical problem rather than someone just being "moody" or whatever.
posted by EmpressCallipygos at 12:39 PM on August 3, 2011 [5 favorites]

Let's add "Are you Okay?" to the list of things never to say.

Usually "Are you okay?" is the trigger for me to realize that it's time to sort stuff out. Sometimes I appear worse than I feel and I need a minor adjustment. Sometimes I'm in a bad spot and really haven't realized it until someone lets me know.

Still not okay. Getting better.
posted by Mister Fabulous at 12:39 PM on August 3, 2011 [2 favorites]

Malice, do you really think this stuff is new? My family tree is *full* of the same problems I have and then some. Go back a hundred years and you have random snippets. This woman never married and died alone in a crumbling house full of old newspapers. This man made a lot of *really* stupid business decisions over and over again, his whole life, and lost every penny he ever made.

I manage, even when I'm off meds, to feed myself, keep a roof over my head, that doesn't mean I'm okay. All of history is full of people who were miserable, mysteriously ill for years, prone to really awful impulse decisions, lazy bums who leeched off their families because they couldn't hold a job, whatever, and that's not even counting the people who soldier on and on without ever really complaining but also without being able to be happy.

I had an interesting conversation the other day with my grandmother, who in one breath wondered about all these kids with ADHD, and then went on about how she was never able to get anything done in school and she was always a mess "but she turned out okay" when she's legendary in the family for being late, disorganized, forgetful. The problems were still there before they had a name.
posted by gracedissolved at 12:40 PM on August 3, 2011 [73 favorites]

Those are some interesting issues you bring up, Malice. It is my impression that many Third World people have more pressing issues that take up their energy. On the other hand, the suicide rate among drought-stricken Indian farmers is horrifying.

Not to diminish the problem for those individuals who suffer from clinical depression, but it does call for some investigation into why industrialized countries whose most pressing problems have been ameliorated, if not solved, are home to so many people who take antidepressants. I'm sure some of you have given a lot more thought to this than I have, but it is hardly a new idea to look at the connection between illness of different kinds within the context of societal circumstances.
posted by kozad at 12:41 PM on August 3, 2011 [1 favorite]

“I don’t believe there’s such a thing as mental illness. People in developing countries like the one where I grew up just don’t have these sorts of problems.”

This one always sets me back in terms of making me feel guilty for being depressed. It makes Depression into a First World Problem, and puts me in the weird position of wishing I lived in one of those agrarian villages and at the same time feeling like I should be more grateful that I don't.
posted by gauche at 12:41 PM on August 3, 2011 [5 favorites]

Maybe the complaining is a luxury in itself?

Speaking out about mental illness is not complaining. Its as much a luxury as getting cancer treatment is or having access to any other medical service.
posted by SpaceWarp13 at 12:41 PM on August 3, 2011 [27 favorites]

It's true that giving advice is practically useless. It's also true that exercise is the single best way that I've found to refocus my attention and pull me out of depression, and it doesn't come with the long-term side effects of medication. We all know that immobility and self-loathing is an awful spiral. I find that changing the immobility is way easier than changing the self-loathing. But yeah, telling depressed people this never works out well.
posted by jwhite1979 at 12:42 PM on August 3, 2011 [4 favorites]

I think the problem so many people have relating/understanding truly depressed individuals is that they believe that they, too, have been depressed and bounced right back. Unfortunately, what they actually had was a short period of feeling down or blue because of some setback. They've not actually experienced the sort of life-long, whole-being depression that so many people suffer from and, really have no capability of understanding just how complete a life-fuck depression can be.
posted by Thorzdad at 12:43 PM on August 3, 2011 [42 favorites]

gracedissolved - yep plus all the people that self-medicated for depression and/or anxiety with alcohol.
posted by hydrobatidae at 12:44 PM on August 3, 2011 [2 favorites]

I love the exercise cure too. If I can't pull it together to stop crying, eat, get a shower, or leave the house I'm sure the gym is a completely realistic goal and my first priority.
posted by Space Kitty at 12:45 PM on August 3, 2011 [28 favorites]

and I think that's because in the past, even then, most folks HAD to get out of bed and go work/do something. No time to feel sorry about it, complain, sleep for 14 hours. That's what also what makes this feel like a first-world problem.
posted by k5.user at 12:45 PM on August 3, 2011

"Should really be titled "10 things not to say to some depressed people." Pisses me off that depression is this "one size fits all" problem that can be fixed for all of us using the things that worked for you."

Let's not throw out the whole of a good post based on a few minor flaws. Do you have anything constructive to contribute? What has worked for you?
posted by Eideteker at 12:47 PM on August 3, 2011 [4 favorites]

I suspect that the reason more people are depressed is that we're getting better at identifying the problem. What is currently a depressed person would have been--a few generations ago--that old weird uncle who muttered and drank himself to death at an early age. Prior to clinically-proven drugs that are not all that old, really, people were self-medicating with alcohol or opiates.

Or patent medicine, which were usually the same thing.
posted by fifteen schnitzengruben is my limit at 12:47 PM on August 3, 2011 [4 favorites]

That first link, times 10,000! One of the problems I kept running into was people saying "how can you be depressed again? You were just doing so awesome!!!". Turns out my "so awesome" periods were hypomania. These comments just made me feel worse.
Currently, a close friend thinks that I could ditch the lithium if I just got a personal trainer. Really. She just can't understand that I have an illness.
posted by Biblio at 12:48 PM on August 3, 2011 [2 favorites]

Severe depression runs in my family. I remember my grandma standing out in the garden watering her plants one evening and talking to the neighbor lady, Lahoma. Grandma had been feeling pretty low around that time and her emotions tend to be broadcast on her face loud and clear, so Lahoma was all, "Irene, are you okay? You seem down." Grandma replied that she wasn't really all that great, that she was having some issues with depression.

Lahoma blurted out, "Why, that's silly! You just need to buck up. Whenever I get a little blue, I just sing! I siiiiiiiiiing and sing and sing until the blues just up and fly away!"

That dumb woman is so lucky my grandma throws words before she throws fists.

I had an interesting conversation the other day with my grandmother, who in one breath wondered about all these kids with ADHD, and then went on about how she was never able to get anything done in school and she was always a mess "but she turned out okay" when she's legendary in the family for being late, disorganized, forgetful. The problems were still there before they had a name.

I was recently diagnosed with adult ADHD and had basically this same conversation with my own grandmother. She also busted out the "we probably should have had you tested for all this when you were a kid since you showed signs even back then, but you turned out okay so I guess all's well that ends well." Never mind the crushingly low self-esteem that comes with an undiagnosed neuro issue that makes people believe that you're lazy and stupid and worthless, never mind the multiple academic and career failures. Et cetera, et cetera, ad nauseum, ugh.
posted by palomar at 12:49 PM on August 3, 2011 [12 favorites]

"Y U NO :)????"
posted by rebent at 12:49 PM on August 3, 2011 [5 favorites]

I think a lot of these responses are because the person who is speaking to the depressed person feels like they need to help, or suggest an answer (with the exception of the moronic health care professionals detailed in the post). While they may come off as dismissive, they may genuinely feel like they are actually giving good advice and "helping".

Of course, it ain't that simple nor is the person actually looking for help. The person is looking for validation that they are not crazy, insane or just plain weird because they are depressed. They are looking for someone to look them in the eye and acknowledge that what they are going through is real, it's not "in their head" and it is a medical condition that needs treatment.
posted by Leezie at 12:49 PM on August 3, 2011

Severe depression runs in my family as well. I imagine many of the poets we know and love in history were depressed. I don't doubt it exists, but I'm more curious as to /why/ it exists. We are finding out slowly what causes certain types of cancers. What causes depression? Is it an imbalance in the brain? I've read conflicting reports on that. Is it external? Is it self inflicted? Is it environmental?
posted by Malice at 12:51 PM on August 3, 2011 [1 favorite]

Today, I am going to succeed at something, and fail at something. I accept that this will sometimes be the same exact thing, just at different times of the day.

Today, I am going to keep trying to be a better person, either as a result of, or in spite of, what I currently think.
posted by Debaser626 at 12:51 PM on August 3, 2011 [5 favorites]

Oh for Christ's sake, the "only rich people get depression" canard.

Poor people frequently deal with extreme and debilitating depression, ask literally ANY social worker. Oftentimes this results in homelessness, drug addiction, or alcoholism. Sure they get depressed "about" "real" problems and the rich get depressed over enui, but its the depression that makes the problems depressing, not the other way around. Our society grants the generally-but-not-always-supportive label of "depression" to those who can afford health insurance, but just because the poor don't get a sympathetic label doesn't mean they don't suffer just as much, if not more, from mental illness.

As for over-medication. Fear of this had me on and off pills for years. Medication doesn't work for everyone, and lifestyle changes can and do help a lot, but you have to make up your mind. Either go the medical route, find a good psychiatrist who you'll stick with during the inevitable times when generally effective medication stops working, and do everything they tell you to do without second guessing them based on some article you read somewhere, or go the natural route and make an active project out of your mental health that you work on every single day. (Or do both, but I wasn't able to do the latter without the former).

If you find a psychiatrist who will let you try drugs because you know someone they worked for or you read something about them somewhere, find another one. You're not an MD, if your psychiatrist is only there to let you write your own prescriptions, they're not worth a damn. And there's a whole lot of that going on.
posted by keratacon at 12:52 PM on August 3, 2011 [23 favorites]

and I think that's because in the past, even then, most folks HAD to get out of bed and go work/do something.

Or maybe they broke down completely, started to act strange and were "treated" to death for being possessed by evil spirits. Or maybe just forced to live at the lunatic asylums or poorhouse. It's a scary thought that people weren't depressed simply because the condition didn't "exist".
posted by Foci for Analysis at 12:52 PM on August 3, 2011 [11 favorites]

Some of the time, I really am confident/bubbly/jolly/self-assured/whatever – in fact, sometimes a bit too much so, and that’s a feature of my illness in itself. Most of the time, though, I’m not – I’m self-doubting, self-hating, anxious, and convinced I am a terrible person and that I am awful at my job. But in order to get by socially and in the workplace, I have to pull together some kind of functional persona to get through the day.

Wait, this isn't everybody? :(
posted by two or three cars parked under the stars at 12:54 PM on August 3, 2011 [8 favorites]

Wait, this isn't everybody? :(

Yeah, reading stuff like that makes me wonder whether I should get diagnosed or something.
posted by naju at 12:56 PM on August 3, 2011 [2 favorites]

+1 on the historical self-medication. Still goes on, to this day.

"I think a lot of these responses are because the person who is speaking to the depressed person feels like they need to help, or suggest an answer (with the exception of the moronic health care professionals detailed in the post). While they may come off as dismissive, they may genuinely feel like they are actually giving good advice and "helping".

Of course, it ain't that simple nor is the person actually looking for help. The person is looking for validation that they are not crazy, insane or just plain weird because they are depressed. They are looking for someone to look them in the eye and acknowledge that what they are going through is real, it's not "in their head" and it is a medical condition that needs treatment."

It's a great way to make my depression about you and your inability to fix me. I am not your challenge, and I don't particularly care that your self-worth depends on being able to fix me. (Shades of Male Answer Syndrome.)
posted by Eideteker at 12:57 PM on August 3, 2011 [6 favorites]

I've been depressed *even when I exercise regularly*. Exercise isn't this magic curative for depression, though I am sure it works for some people. There are many bad reasons to say "well, you'd feel much better if you got some exercise": you might not; if you're depressed, it's hard to get out and exercise; hey! it's your fault for being so lazy that you got depressed.
posted by jeather at 12:57 PM on August 3, 2011 [9 favorites]

and I think that's because in the past, even then, most folks HAD to get out of bed and go work/do something. No time to feel sorry about it, complain, sleep for 14 hours. That's what also what makes this feel like a first-world problem.

Um, I have bipolar and I still HAVE to get out of bed and go work/do something. Sometimes that's the problem, is that everything I have to do feels so overwhelming that I would literally rather be dead than deal with it. Sometimes, just taking a shower feels that way.
posted by Mrs. Pterodactyl at 12:58 PM on August 3, 2011 [23 favorites]

I love the exercise cure too. If I can't pull it together to stop crying, eat, get a shower, or leave the house I'm sure the gym is a completely realistic goal and my first priority.

Maybe the idea here is that it's more a preventative or maintenance plan, rather than an intervention. I know that, at least for me, when I am doing better and I'm exercising regularly I'm much less likely to have major depressive episodes and the dysthymic periods don't seem to last as long. Of course YMMV.
posted by BigHeartedGuy at 12:59 PM on August 3, 2011 [1 favorite]

I find it astonishing that in the 21st century basic mental well-being isn't taught to the citizenry of modern societies. Yes, mental health is very complicated and you probably cannot cure yourself if suffering from a serious problem, but imagine the social and individual benefits if we were taught the basics when in elementary school. I'm positive this is achievable, especially if it's treated like any other skill, say reading or maths, and taught in interdependent increments.
posted by Foci for Analysis at 1:00 PM on August 3, 2011 [3 favorites]

I so love my children for accepting me through the worst years. I was a ' functioning' depressive (which just meant I hid it well and kept my kids safe). I remember once I was laying on the couch for hours when my youngest came in to remind me to drive her to her drama class. She sat over me while I explained I was almost through the worst and I would get her there on time. I rambled on about how someday this 'cloud' thing was going to be discovered to have a real physical root - just like alcoholism - and people would be more accepting. She listened to me go on and on and then said, "Mom, can I use this for my monologue in class?"

Humor helps.
posted by Surfurrus at 1:01 PM on August 3, 2011 [9 favorites]

That dumb woman is so lucky my grandma throws words before she throws fists.

Grandma was holding a HOSE, for goodness sake. The potential was there!!
posted by ThePinkSuperhero at 1:03 PM on August 3, 2011 [7 favorites]

Also, not that any depressed person who this applies to WANTS to hear this, but quit drinking and quit smoking pot. It took me a very long time to be honest with myself about how counter-productive my self-medicating was. It's also impossible to tell if medication should be working if you're interacting it with other mind-altering substances, to say nothing of the chemistry of how blood alcohol affects the absorption of just about any drug into the system.
posted by keratacon at 1:04 PM on August 3, 2011 [11 favorites]

I love the whole thing about it being "just" hormones. Hormones drive any number of important biological functions and are known to affect emotional states and behaviors. "Just" hormones is like saying oh, you're tired, but it's "just" anemia.
posted by the young rope-rider at 1:06 PM on August 3, 2011 [23 favorites]

My unsupported impression is that depression is more survivable for rich people than for poor people who may lack a social/financial/medical safety net.

So perhaps it's not that rich people are disproportionately depressed, it might just be that people with depression who survive to live with it are disproportionately richer.

But I don't have any data to back that up.
posted by Salvor Hardin at 1:09 PM on August 3, 2011 [2 favorites]

It always pisses me off when Ask Metafilter answerers tell depressed people they should go out and volunteer for the needy.

Volunteering for the needy is fucking depressing.
posted by dunkadunc at 1:09 PM on August 3, 2011 [40 favorites]

I come from a depressed family full of alcoholics and prescription drug abusers. My mother started on antidepressants when I was a little kid, and that caused side-effects that doctors treated with other drugs. Within a few years she was on close to a dozen scripts, and by the time I graduated high school she was a full-blown alcoholic as well. That was about twelve years ago. Today she is struggling with the same things, but she also has the symptoms of Parkinson's, which I'm told often afflicts people who have been on antidepressants for a long time.

I'm sure antidepressants are helpful for some people, but I hate them. I believe they should be a last resort after natural treatments like exercise, journaling, and therapy have been tried extensively. I am well aware how hard it is to do these things when a person is depressed. Fear of turning out like my mother is probably the only thing that could have motivated me to do these things. They haven't been a cure-all, but they have made my life livable.
posted by jwhite1979 at 1:11 PM on August 3, 2011 [5 favorites]

Maybe the idea here is that it's more a preventative or maintenance plan, rather than an intervention.

I think that's great and I'm genuinely glad it works for you. For me, not being able to force myself to exercise* is just one more example of how I fail at life and proof that if I just worked a little harder maybe I wouldn't bring all this on myself.

You can see how that's counterproductive. Depression is an insidious evil motherfucker I wouldn't wish on my worst enemy.

*On top of forcing myself to be somewhat functional.
posted by Space Kitty at 1:11 PM on August 3, 2011 [9 favorites]

gracedissolved: "Malice, do you really think this stuff is new? Go back a hundred years and you have random snippets. This woman never married and died alone in a crumbling house full of old newspapers. This man made a lot of *really* stupid business decisions over and over again, his whole life, and lost every penny he ever made."

My go-to refutation for any nostalgia-based claim is to recommend a book called The Wisconsin Death Trip. Written by professor of literary journalism Michael Lesy, it's a collection of photos and news snippets gathered from one small town in Wisconsin at the end of the 19th century. It features all kinds of crimes and weirdness, from barn-burnings to casket photos of children and serves to thoroughly disabuse the reader of any nostalgia for long-gone eras.

It is also, obviously, not great reading material for people having problems with depression, unless it would be helpful to reinforce the knowledge that mental illness is not new or an affliction of the leisured classes.
posted by workerant at 1:12 PM on August 3, 2011 [12 favorites]

Wait, this isn't everybody? :(

Yeah, reading stuff like that makes me wonder whether I should get diagnosed or something.

A couple of years ago, I made a new friend. One of the interesting things for me in this friendship was that she reminded me so much of myself before I got treatment for my anxiety. In one half-hour period, for instance, she worried that we'd get kicked out of her hotel because she invited us to come swimming there with her and maybe it wasn't OK; tried to shush my 3-year-old who was making ordinary noises in the hotel room at 11 in the morning because she was afraid people in neighboring rooms would complain; described how she struggles endlessly to control her son's eating because she's so afraid he'll become fat; ranted for several minutes about her fair-skinned lover having gotten sunburned because "doesn't she think of us and what will happen to us if she gets skin cancer and dies?"; and so on. She was always like this: excessively worried, seeing worst-case scenarios, fretting out loud about future things that probably wouldn't happen.

The hilarious punchline to this was, an hour later, she told me that she had really enjoyed some writing I had done about my life. "You and I have so much in common," she said, "except, of course, that I don't have anxiety."

I was so busy staring at her in amazement that I didn't say anything. Maybe I should have. I know that I didn't realize how unnecessary all my own worrying and fear was until it started to improve--I thought everybody just had that same voice in their head all the time, because it had been a constant companion of mine for as long as I could remember, right back into childhood. Maybe I'm wrong about my friend, but to me she looks like the poster child for untreated anxiety.
posted by not that girl at 1:12 PM on August 3, 2011 [23 favorites]

I know there's no one-size solution, but almost all the no-nos on that list are the kind of things that work on my own depressive tendencies.

Severe suicidal depression runs deep in my family. My childhood was defined by my mom's battle with it, I lost several family members to it, and now I get to watch my sister handle this fun legacy. I can recognize the signs in myself, it's not just "the blues". But the thing is, IT IS all in my head. That's what mental illness is.

You know what else is in my head? Me. What works best against the cloud is exerting control. Bucking up, taking little baby steps to take care of myself (for me it's not so much exercise, but cleaning the house and making food ahead of time that works), getting my mind off my misery (my drug of choice is an insane work schedule) and counting my blessings is all part of a balanced treatment plan.

What really, REALLY doesn't work for me is pity, sympathy, kid gloves. Even validation. If I'm gonna beat this, I have to believe I have a modicum of control over it, and well-meaning people telling me "it's ok, it's a disease, you can't help it" or encouraging me to dwell at lenght on every little emotions work counter to that.

I guess my point is there's a difference between what this depressed person wants to hear and what really helps.
posted by Freyja at 1:17 PM on August 3, 2011 [4 favorites]

As far as I'm concerned, there's only one appropriate answer for someone who tells you they're depressed: "OK. Thanks for telling me. Let me know if there's anything I can do to help."
posted by LN at 1:19 PM on August 3, 2011 [4 favorites]

Malice:

Or perhaps there have always been as many people depressed as right now, it's just that the planet has an enormous population of humans that it did not have before, so the percentage of depressed people is greatly increased?

Just a technical point: the mere fact of overall population increase would not, itself, lead to a greater percentage of depressed individuals. It would, presumably, effect an increase in the total number of depressed people, but that's not the same as the ratio of depressed people to non-depressed people, which is what it sounds like you're saying.

I'm more curious as to why so many people /are/ depressed, and why it seems that the more comfortable you are in your situation, the more depressed you get? (From observation. Very few extremely poor who have to overcome hardships daily "appear" to be depressed, or ever complain about it. Maybe the complaining is a luxury in itself?)

So do you think it's a "first-world problem"? I think there's probably a case to be made that depression is connected to lacking a sense of social integration and meaningful activity, but it's important to be careful in this assertion, because it can seem to come awfully close to saying that external/concrete/socio-economic suffering is a prophylactic against depression, which would be a very perverse position to take.
posted by clockzero at 1:19 PM on August 3, 2011 [1 favorite]

Grandma was holding a HOSE, for goodness sake. The potential was there!!

I know, right? Sadly, Grandma is almost always a lady in her actions (although she sports a fierce trucker mouth during football season and rush hour), and would never dream of turning the hose on some ridiculous person, although she will definitely talk smack about that ridiculous person as soon as they are out of earshot. That's ladylike, don't you know.
posted by palomar at 1:20 PM on August 3, 2011

#12:

Me (depressed person): "I want to kill myself."

Most people: "Don't say things like that. Stop."

AHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH.
posted by Lutoslawski at 1:20 PM on August 3, 2011 [19 favorites]

I'm sure antidepressants are helpful for some people, but I hate them. I believe they should be a last resort after natural treatments like exercise, journaling, and therapy have been tried extensively.

I really, really don't want to be judgmental but this is actually something I would really like included on a list of things not to say to people who are depressed. It took me a long time to become comfortable with being on medicine and then even longer to accept that I'd never be able to stop taking it. This mindset and people saying things like this feel very hurtful to me and make me feel ashamed of something that I need to do in order to take care of myself. I'd rather not take medicine for this stuff but I recognize that it would be irresponsible not to. I'd prefer not to get into specifics but in general I think that if someone tells us that they're unwell or unhappy we should trust them. Don't make getting treatment harder for people who already find it difficult because they haven't journaled enough.
posted by Mrs. Pterodactyl at 1:22 PM on August 3, 2011 [84 favorites]

Wait, this isn't everybody? :(

You jest, but I honestly have a hard time wrapping my head around the idea that not everyone is at least as depressed as me, like I can't fathom what it must be like.
posted by Lutoslawski at 1:22 PM on August 3, 2011 [7 favorites]

I'm sure antidepressants are helpful for some people, but I hate them. I believe they should be a last resort after natural treatments like exercise, journaling, and therapy have been tried extensively.

What people who say things like this don't realize is that there is a point where there is really no possible way you can do any of those things without some meds first. Journaling? Exercising? Fuck, get me out of bed first. Then we can talk.
posted by Lutoslawski at 1:24 PM on August 3, 2011 [34 favorites]

Oh! Just remembered my absolute favorite anecdotal evidence that depression is neither new nor unique to the privileged.

Sleepy Man Blues by Bukka White. lyrics

I'm feelin' worried in mind, and I'm tryin' to keep from cryin'
I am standin' in the sunshine, to keep from weakin' down
I want somewhere to go, but I hate to go to town
Hate to stand around
posted by keratacon at 1:25 PM on August 3, 2011 [1 favorite]

"Oh, you're not really depressed."

Yeah. Thanks for that.
posted by lekvar at 1:27 PM on August 3, 2011

The funny thing about exercise is that if I can get into a solid exercise regimen, eventually I *do* feel like I'm equilibrating, such that I can't imagine why I ever stopped exercising; but if I haven't exercised for a while, getting back in the saddle seems like a Herculean task -- how did I *ever* do that? Etc. etc. Simply telling people to exercise often misses the point -- they *want* to exercise, but there are more fundamental problems preventing them from doing so.
posted by a small part of the world at 1:27 PM on August 3, 2011 [4 favorites]

How about, "So go ahead then. Do it."
posted by knoyers at 1:30 PM on August 3, 2011 [2 favorites]

"But look at how lucky you are!"

Yup. That really doesn't help at all.
posted by brundlefly at 1:30 PM on August 3, 2011 [2 favorites]

How about, "So go ahead then. Do it."

Please expand, what does this mean?
posted by sweetkid at 1:31 PM on August 3, 2011

"How about, "So go ahead then. Do it."

Please expand, what does this mean?

I think it means, "go ahead and kill yourself." Implying that otherwise, it's not really depression.
posted by daniel_charms at 1:33 PM on August 3, 2011

"I'm really disappointed. I didn't think you were this much of a drama queen."
posted by Vibrissa at 1:33 PM on August 3, 2011

I think it means, "go ahead and kill yourself." Implying that otherwise, it's not really depression.

That's what I thought, but hoping otherwise.
posted by sweetkid at 1:35 PM on August 3, 2011

"We all go through that".

I get the sentiment, that people are trying to offer sympathy based on a shared experience. But in and of itself, it's really not comforting.
posted by Solomon at 1:37 PM on August 3, 2011 [1 favorite]

Wait, this isn't everybody? :(

You jest, but I honestly have a hard time wrapping my head around the idea that not everyone is at least as depressed as me, like I can't fathom what it must be like.

I wasn't jesting.
posted by two or three cars parked under the stars at 1:38 PM on August 3, 2011 [1 favorite]

I know you’re taking your meds, but they’re not working for you, are they, sweetie?

Most effective spoken with a sneer and followed by canned laughter.
posted by stupidsexyFlanders at 1:41 PM on August 3, 2011 [1 favorite]

Another facet of the "go exercise" issue, for me, at least, is that sometimes when I start a new program or system or regimen I end up tipping over into mania. If I were to take my friend's advice I would run the risk of rapidly becoming an exercise evangelical, talking, blogging and posting excessively about x gym, or y method. I would live at the gym, decide to become a trainer myself and alienate everyone I knew who wasn't following my program. And then the chemicals in my brain would hiccup and I'd be back in bed wondering why the fuck I can't ever do anything right. I'd probably wait 6 months before canceling my gym membership, so I'd lose money in the process.
I'm currently pretty stable, so I hope this wouldn't happen, but damn have I gone through it before, with any number of things.
posted by Biblio at 1:46 PM on August 3, 2011 [4 favorites]

Major depression strongly linked to social conditions.

The linked study above shows little difference in the rates of depression between high-income and middle-to-low-income countries (14.6 percent lifetime rate vs. 11.1 percent, respectively).
posted by Unicorn on the cob at 1:50 PM on August 3, 2011 [1 favorite]

Also: the genetic link to depression.
posted by Unicorn on the cob at 1:52 PM on August 3, 2011

I'm fortunate in that my depression rarely if ever renders me suicidal. But I've noticed since getting treatment for my ADD, I'm more likely to be homicidal. When I'm not busy tripping myself up and can actually make some progress at the things I undertake, suddenly, the obstructions become incredibly frustrating. As my therapist put it, diplomatically, "You don't suffer fools gladly."

Shades of the few times in my life I've actually been given any kind of authority. I become some kind of horrible, magnificent bastard of a holy terror (I've heard Doctor Doom and Fieldmarshal Rommel). Those who serve under me work harder and more efficiently than they would for anyone else, but the rewards are as great. I ask a lot, but I give even more. I'm told it's a wondrous site to behold. But, you know, short of an impending apocalypse, no one should be subject to that kind of pressure.
posted by Eideteker at 1:54 PM on August 3, 2011 [2 favorites]

@Mrs. Pterodactyl.
1. For a long time I held the opinion that meds and therapy were evil and wrong and that someone who took them was avoiding themselves. Then I figured out my girlfriend was seriously anorexic and suicidal. Needless to say, in one bout resulting with a charcoal slurpee at the hospital, she solidified in my mind that meds were good for some people - and so was therapy. The whole experience was rough, it contributed to unsatisfied performance at work (my work was good, I just didn't feel it). I started to fantisize about running my car through the median on the interstate, and I dreaded going home. Finally I resigned from work and decided that cooking would be a better plan for me. I also thought my girlfriend was starting to act sane and reasonable while she was taking her meds - they seemed to work for some people. It was almost good, but she was far less of a girlfriend now and more of a roommate. She stablized and, after some odd behavior, I ended it. I often wonder if I had ended it earlier, if I would have never left engineering or cooked... or met my ex-wife... which brings me to point 2.

2. My ex wife and I had communications problems in our marriage that I didn't see, partially becayse I thought of her as a LICSW (she was), and so I always figured we were able to talk and that what we were saying to eachother was communicating... even though it didn't feel like it. The day after my (ex) wife's birthday, she told me she was leaving me. That was the day that I found out that I needed therapy now and I needed medication to survive the blindside I had just recieved. I knew this because I knew I couldn't process what was happening and I fell apart. Had I just gone with the counciling it would not have been sufficient. I would have been lost... and then I figured out exactly what you were saying.

3. Meds alone didn't fix things. Meds alone didn't make me feel better. Meds made me capable of handling the world enough so that I could reinterpret things, learn to reprocess things, and get my shit back together. I learned this: I will never judge someone reckless for having to take meds, but I will judge someone as reckless for not taking their meds when they should.

4. If you need to take meds every day for the rest of your life and it helps you be the best person you are - then honestly that's awesome - because we are a better community because you take your meds. If I ever find myself in a situation where I am faced with taking meds permanently in order to be a functional person - I will gladly take them every day, because I know that whatever it takes - it is worth it for recovery.

You are inspirational - don't ever forget that.
posted by Nanukthedog at 1:55 PM on August 3, 2011 [20 favorites]

It is my impression that many Third World people have more pressing issues that take up their energy.

Wow. Holy trivializing-mental-illness.

Look, mental illness happens in the third world just like anywhere else. Just like all the other mental permutations that cause people trouble are not less present in the gene pool (ie schizophrenia, autism) the hard lot of poorer people does not make them any less prone to things like depression. On the contrariwise it just makes life even harder for people who get stuck with say, subsistence farming -and- bipolar disorder.

About the only thing you can say for sure is that a depressed first worlder is more likely to ascribe their mood disorder to their brain chemicals because they have few other sources to blame, unlike the depressed third worlder who can say "I'm sad because I work in a sweat shop!" But with mood disorders like depression or anxiety, they often give you floating malaise that needs something to latch onto. Which is why one anxious person may explain that the world is going to end in an environmental collapse, while the other one thinks that everyone will laugh at them... and have the same symptoms of a panic attack while continuing to blame widely different causes.
posted by Phalene at 1:55 PM on August 3, 2011 [6 favorites]

Wow, sight. Can you tell I've been working on web site copy all day? *is going cross-eyed* >.<
posted by Eideteker at 1:56 PM on August 3, 2011

This article has always helped me a great deal with my depression. To me it speaks to the utter disconnect between appearances and reality, between the expectations of how a person ought to feel - if they are live a comfortable middle class life, if they have a beautiful family, if they are President of the United States - and how they might actually feel, due to chemistry

I am now the most miserable man living. If what I feel were equally distributed to the whole human family, there would not be one cheerful face on the earth. Whether I shall ever be better I can not tell; I awfully forebode I shall not. To remain as I am is impossible; I must die or be better, it appears to me.

If Abraham Lincoln was miserable and convinced of his own worthlessness, then surely I ought to at least reconsider my own self doubt.
posted by shaun uh at 1:56 PM on August 3, 2011 [9 favorites]

Don't Call it a Happy Pill

A myth, if not the myth about antidepressants is that they are “happy pills.”

Hearing this makes me want to punch people. Guess my happy pills aren’t working.

Seriously though, it doesn’t work like that. Sure, if you take a pill that’s not meant for you you might feel “up” but if it feels unnatural – well it is.

Antidepressants – the right antidepressants – get you to normal. Not rose-colored normal, not happy fluffy normal, not normal where all day long you are snuggled by tiny non-allergenic kittens, just normal.

This concept is hard to understand if you haven’t been there. People who don’t know what depression feels like don’t fully understand what not having depression feels like. Likewise those stuck in depression don’t know what not having it feels like either.

So let’s think of an example.

Ever had a sore throat? That oh my g-OW feeling that comes when you swallow? And it’s so painful that at a certain point you try to come up with ways not to swallow ever again, even if that means no food and almost certainly no sex life?

And then you’re better. And you can swallow. Just… swallow. No pain, no agony, no needing to spend minutes if not hours debating if a particular bite of food is really worth your time. You can just eat, and drink, and breathe.

That’s what the right antidepressant is like. Depression is an illness that makes you hurt, and when you beat it back it doesn’t make you hurt anymore. It takes the cloud away. It pulls back the spikes. It lets you be you again, good, bad, and all.

posted by tzikeh at 1:56 PM on August 3, 2011 [41 favorites]

and how they might actually feel.

Full stop. I managed to delete almost all of that extra clause! Next time I will succeed.
posted by shaun uh at 1:57 PM on August 3, 2011

I really, really don't want to be judgmental but this is actually something I would really like included on a list of things not to say to people who are depressed... Don't make getting treatment harder for people who already find it difficult because they haven't journaled enough.

I guess it's all in context of how this advice is delivered, whether it's a helpful opinion or a judgmental edict. As someone that experienced serious clinical depression I tried antidepressants for years to very ill effect but talk therapy, exercise, and other alternatives were the only things that actually helped.

Maybe the advice should be not "take these drugs" or "don't take these drugs" but, explore the full range of options, only settle for a legitimate medical professional that you're comfortable with (amongst psychiatrists, therapists, support workers, family doctors, and others), and be persistent. Your cure won't come in "a few weeks" when the pills/exercise/therapy starts to take effect. What's important is to focus on moving towards a continuously progressive better.
posted by artificialard at 2:00 PM on August 3, 2011 [1 favorite]

“Feeling sorry for ourselves, are we?” (General nurse, delivered in snotty tone of voice).

Hey, nurse. FUCK YOU!!!

Oh, and SHUT THE FUCK UP!!!
posted by ericb at 2:01 PM on August 3, 2011

The Hairy Lobster is right. But texting "R U OK?" is still not the best way to open these lines of communication.

Dear god no. That's like, what, 7 characters including spaces?

"Sup?" is so much better.
posted by formless at 2:02 PM on August 3, 2011

So I used to think I was depressed a lot when I was much younger, about 19 thru 22. But I wasn't, I was just dirt poor and living on my own thousands of miles away from where I grew up and most of my friends and family. I ended up reading a couple of self-help books and that did the trick for me. I got in my head the idea that happiness is not a state but a process and that was all I needed. Since then, I've been fine.

Until about two years ago. I got laid off. It was the second time I got laid off, so it wasn't that big of a shock, and I could see it coming from a year away. And it was after a very long career in a sector that I was no longer satisfied with, so I believed it was the best thing to happen to me. But after a couple of months on unemployment, looking for work and doing interviews, things dried up completely on this front and I was just sitting at home all day every day, staying up until 7AM and sleeping about five hours a day. I also wasn't eating too well, and probably drinking way too much coffee. That's when it hit me. I started getting panic attacks and suicidal thoughts. I felt trapped, and my brain kept trying to convince me that it was all pointless and I should just kill myself. Now, I don't have a suicidal bone in my body, as it were, so these thoughts, even in the midst of a panic attack, made no sense to me whatsoever. It seemed easier to understand the panic attacks, which was basically just a tight feeling in my chest, like it was hard to breathe. It was just physical symptoms. But the suicidal ideation was just so completely bizarre to me. The thoughts weren't coming from my rational mind. Basically, I had lost control of my brain.

And I finally understood. All those years of reading the DSM-IV, trying to figure out if I was actually depressed as a young man, and never really understanding if the description of symptoms applied to me or not. It now all made sense. I had always known that there was a real difference between rational depression and clinical depression, I just couldn't relate because I had never experienced that loss of control. After experiencing it, I finally had a point of reference, a way to relate to it. (Okay, maybe I don't get it completely. My description of my experience is just that: how I relate to what happened to me. I probably sound way off to people who've had to deal with this their entire lives, for which I apologize.)

The point of all this, is that I think most people who never experience clinical depression can only relate to those who suffer from it from the perspective of rational depression. They only know about how sometimes you can think yourself into feeling down and it really is easy enough to just distract yourself, do something you enjoy, and get yourself out of it. Since they have never experienced the real imbalance and lack of control of clinical depression, they just don't get it. Of course, another thing you probably don't want to say to a depressed person is that they should realize that others really just don't get it, and you should try to explain to them what you're actually going through, but it is something we should keep in mind as a society. We really need to help everyone understand that these kinds of disorders are physical problems with real and uncontrollable psychological manifestations that cannot be addressed with simple rational thinking and a bowl of your favorite ice cream. It would also help to staff hotlines with people who do get it, because the help line responses noted in the first link were so completely insensitive, they really defeat the purpose of those kind of things.
posted by effwerd at 2:06 PM on August 3, 2011 [17 favorites]

I suffer depression, social anxiety, and ocd. There are days I cannot get out of my own house because everything seems overwhelming. It's why I sometimes flake out on meetups I rsvp to.

It's very hard for my family to understand. I don't look sick. I'm not always frowning or sad. There are obligations and responsibilities to be met.

Somedays I wish their, "Jesus Christ, just get out of the house like a normal person," becomes the abracadabra phrase that sends me around my own block instead of into a spiral of self loathing and routines.

But you know what works best? When my sister or a friend come over and take me by the hand, make no demands or comment, and let me quietly trail along.

It's true you get further with kindness, whether word or deed.
posted by FunkyHelix at 2:10 PM on August 3, 2011 [10 favorites]

I think my favorite dumb thing was when I was 16 or so and over at a friend's house. I think he was playing me a Counting Crows album or something like that. Anyway, he turned to me and said, "You think you're depressed? Listen to this guy, this guy is really depressed. You're not nearly as down as this guy."

Well, yeah, I do think I'm depressed. I wasn't aware it was a competitive sport.

The same guy and some others tell stories about how they were depressed for long periods of time, until one day they just woke up and snapped out of it, with the implication that one day I'll do the same and then it'll be fine. It'd be nice, I guess. I don't think that's going to happen, though.

It's funny, though, I actually really don't like it when people tell me to call them any time or whatever. I'm almost certainly not going to, because when it comes to this bit of my life I don't really trust anyone to understand anything. So whenever people offer me help, all I can think about is how now I have to stop pretending for a while that we're actually friends, because I clearly won't rely on them at all and now I wish they'd just leave me alone. Depression is amusing.
posted by Errant at 2:14 PM on August 3, 2011 [2 favorites]

And sometimes when you're on
you're really fucking on.
And your friends they sing along and they love you.
But the lows are so extreme
that the good seems fucking cheap
and it teases you for weeks in its absence.
posted by khaibit at 2:23 PM on August 3, 2011 [4 favorites]

They forgot my favorite: You just need to find God.

I got that one from a well-meaning elderly relative, in a little motivational card, complete with some tacky blingy medallion of... something, I forget what.

Because when there is something seriously wrong in my brain's wiring, and I can't sleep, and everything hurts and I have no idea why, and I can't even get up the mental daring to go grocery shopping because it's full of people and they will all KNOW -- all I have to do is believe in God and it'll go away! He'll bop me over the head with a magic wand and, poof, all better!

My rather drastic turnaround after starting medication and therapy put an end to that sort of talk, at least in my presence, but I'm sure deep down she probably still thinks it happened because she asked God.

Rargh.
posted by cmyk at 2:25 PM on August 3, 2011 [3 favorites]

>> Wait, this isn't everybody? :(
>Yeah, reading stuff like that makes me wonder whether I should get diagnosed or something.

In a sense, it is like everybody. It might be because we don't really have specialized faculties for expressing that we're "really" depressed; we use what we have. Anxiety, fear, frustration and so on. And that's exactly why it's so difficult for most people to notice or understand depression. On the surface, there might not be much difference between someone being awfully stressed over something or someone being depressed. The main difference is that if one is depressed, it doesn't go away. In fact, it will begin to seem like the normal state of affairs. And you will never even consider the possibility that it might all be in your head, that you're not thinking straight; in fact, you believe yourself to be perfectly rational about everything.

Once you're out of it, you will probably still continue using the same stereotypes, the same thought patterns, the same models you did when you were depressed. I know that I certainly do. I still think about killing myself from time to time; I just can't help it. I can still think that I'm worthless; I still suffer from social anxiety. Yet I've learned that these are just models that I apply, not rock solid reality. I've started questioning them. I haven't stopped using them, but I have stopped unconditionally believing in them.
posted by daniel_charms at 2:25 PM on August 3, 2011 [5 favorites]

Personally I think anybody who was in my shoes and was happy would obviously be insane. Depression is sometimes rational.
posted by yesster at 2:41 PM on August 3, 2011 [7 favorites]

I like being asked "are you okay?" because it means at least I'm visible to someone. It makes me real again. Otherwise, I'm once again the kid sitting in the shadows.
posted by desjardins at 2:42 PM on August 3, 2011 [13 favorites]

Forget your troubles, common get happy etc.
posted by Postroad at 2:43 PM on August 3, 2011

Strange that we've been making serious progress on the treatment of depression with medication and therapy, but there still doesn't seem to be a glimpse of a cure for asshole.
posted by ODiV at 2:44 PM on August 3, 2011 [9 favorites]

"But you seem so calm." (many, many people)

"Have a shrimp cocktail." (my former therapist, oddly enough, repeatedly)
posted by The corpse in the library at 2:47 PM on August 3, 2011 [2 favorites]

The point of all this, is that I think most people who never experience clinical depression can only relate to those who suffer from it from the perspective of rational depression. They only know about how sometimes you can think yourself into feeling down and it really is easy enough to just distract yourself, do something you enjoy, and get yourself out of it. Since they have never experienced the real imbalance and lack of control of clinical depression, they just don't get it.

Of course, another thing you probably don't want to say to a depressed person is that they should realize that others really just don't get it, and you should try to explain to them what you're actually going through, but it is something we should keep in mind as a society. We really need to help everyone understand that these kinds of disorders are physical problems with real and uncontrollable psychological manifestations that cannot be addressed with simple rational thinking and a bowl of your favorite ice cream.

posted by effwerd at 5:06 PM on August 3

Thank you, effwerd, I was just going to post something similar.

I don't have depression, but a friend of mine does. Years ago, when I was ranting about another friend who seemed to be depressed and not snapping out of it, she looked me in the eye and said "That's why they call it a mental illness--because they can't snap out of it."

That's when it sank in for me. Well, sank it as much as it can for someone who's never been clinically depressed. The majority of the people in the world don't have experience dealing with and diagnosing a mental illness like depression. They aren't psychiatrists. They literally don't recognize clinical depression when they see it. They think you just have a case of the blues, and are offering advice on how to shake yourself out of it.

The blogger has it correct when she writes that many people use the term “depressed” in a loose, informal way, while people who've been diagnosed use it in a clinical sense. That adds to the confusion, and it leads well-meaning people to react inappropriately.

I can sympathize with the frustration that people with depression feel about the advice they receive and the comments that they hear. But from what I can see, that's basically blaming people for not being mental health professionals.

Someone once posted a comic here that showed a guy with a crushed hand, in obvious pain, and the thoughtless comments that people would make to him about it. The point of the comic was that having depression was like having a crushed hand--you wouldn't say such awful things to someone with a crushed hand, why would you say them to someone with depression? I can't help but think that if you had a crushed hand, you wouldn't be unhappy with your friends for not being surgeons and helping you, but somehow it's okay to be unhappy at them for not being psychiatrists and helping you.

I'm not letting folks off the hook, mind you. Many folks are bastards and wouldn't help you even if they could. And all people should know to ask 'What can I do to help?' But whenever this topic comes up, I can't help but think 'How are people supposed to know that you're clinically depressed (instead of just dealing with the blues), and the proper way to meet your needs?' Because from the outside looking in, the symptoms seem the same (barring actual suicide attempts).
posted by magstheaxe at 2:48 PM on August 3, 2011 [5 favorites]

As an aside, has anybody else been following the Slacktiverse Depression 101 section?

My own personal set-off is when people talk about meds.

I spent a large period of my teenage years convinced that drugs or therapy would both be a sign of admitting weakness or destroying my "true" self, in part because of a family that considered mental illness something to be endured rather than treated and in part because of the cultural narrative around "soma" and "happy pills" (YA lit was not my friend). As a result, I spent almost all of my teen and preteen years in a fog of surreal self-loathing brought on by a combination of normal adolescent imagination and crippling depression/anxiety. Even now that I've been diagnosed, my mom still asks me why I don't just exercise or do yoga, despite the fact that some of my worst depression came when I was working out two hours a day.

After about three years of college, I found myself on a forty-five minute, twice-a-day commute, upon which I, every single day, ended the ride home in tears because I had logically convinced myself that I should die. I now no longer even remember why, but at the time it was all terribly convincing and may or may not have involved some kind of global economic analysis. I think it was around a couple months after then that I started therapy and meds.

On the whole, I've found meds not really all that great, for me. It takes so long to find something that both works and is affordable with my insurance that it's hardly worth it because the effects start to diminish immediately. They're a finicky method of dealing with a still poorly-understood problem, and even with the newer ones, the side effects range from annoying to nigh-unbearable.

But that doesn't change the fact that I am incredibly sick of the narrative that unconditionally condemns anti-depressants. It's the worst kind of glib nonsense, based on the idea that depression is a kind of vanity illness, that taking medication is the equivalent of wanting to get liposuction instead of exercising to work off five pounds. I've had plenty of problems with medication, but the fact is, I take it because I'm desperate and nothing else works. When I'm on medication, it's because I don't want to have to to think constantly about suicide, or take every comment and article I read as a personal attack on my humanity.

You want to warn me about side effects? Try it on someone who hasn't been researching this stuff since about age fourteen. At some point, one of the things a lot of this article boils down to is that people should try to accept that unless they're actually a doctor or therapist, maybe I know more about my problems than they do.
posted by Tubalcain at 2:50 PM on August 3, 2011 [16 favorites]

"Just cheer up" was the one I used to get from my ex-.

Most of us can recognize if a comment is made with kindness or not. Sometimes, in the depths of depression, one small kindness can reduce me to overwhelming tears. I have, on my computer desktop, a .txt file with this: The koan that I use is "everyone's hardest struggle is their hardest struggle." The competitive suffering thing is rarely a useful way to talk about or to people who are in pain.
posted by theora55 at 2:51 PM on August 3, 2011 [4 favorites]

o, and I meant to add that it's a quotation from jessamyn.
posted by theora55 at 2:51 PM on August 3, 2011

Reading things like this makes me feel like I'm not so out there. I'm 27, I've been wrangling depression for over 10 years, and I've heard every one of those (except about my period, because I'm a guy).

I'm a confident, bubbly person. I go out, kick ass, and seem to have my shit together. The minute I got home, though, I'd completely fall apart. I have a wife, a career path, and everything I could want. And that almost made it worse.

It was interesting - I started writing a blog about various things, including my ADHD, anxiety, and depression. I was hiding it at first, but I started pushing my updated to Facebook. A lot of my college friends, who always saw me as popular, outgoing, and maybe just a little flaky, saw a whole new side of me.

I got so many compliments from people who I thought were popular and outgoing. They were dealing with the same things I was. Still am. I have a whole new group of the same college friends I'd always had, but now we chat about how we're feeling and the little things that are making our lives better. It's been an amazing experience. I've never felt closer to a lot of these people.

I'm glad people are talking about it more - it definitely helped my situation. I'm not alone, and people out there understand me; it just turns out that those people were closer than I ever could have imagined.
posted by SNWidget at 2:52 PM on August 3, 2011 [5 favorites]

Or perhaps there have been as many people depressed as right now, but medical science has improved to the fact that we now know what to do about it

I'm not sure that that's so, actually. There was an interesting two part article in the New York Review of books discussing the increase in diagnosis rates and some work that's been done reviewing and critiquing the clinical reasearch that supports anti-depressants. There are a lot of things we don't know about what causes depression (we can say that chemical x us elevated in the cerebro spinal fluid of people who are depressed, but a bruise isn't the cause of an arm injury) and a lot of the evidence backing these drugs is from tests on severely depressed patients without complications --- it's not at all clear that something that may work well for a severely depressed patient will work as well or in the same way for a moderately depressed one, nor to do we have a clear read on how these drugs interact --- and an awful lot of depressed people are on more than one medication.

To be clear: depression is real, it has been around a long time, and there are many people for whom these drugs have been benificial.

But for me personally, I'm inclined to be a little skeptical that this is a nut we've cracked. It is interesting how confident every era is in its own good sense, even while it scoffs at the benighted fools who came before it....
posted by Diablevert at 2:55 PM on August 3, 2011

"I wish I'd called your bluff the last time you said you were suicidal." Thanks, husband.
posted by The otter lady at 3:01 PM on August 3, 2011

I can't help but think that if you had a crushed hand, you wouldn't be unhappy with your friends for not being surgeons and helping you, but somehow it's okay to be unhappy at them for not being psychiatrists and helping you.

Well, to be clear, at least with regards to myself, I don't blame my friends for not getting it. It's really difficult to get, as you point out. I also don't think things would be all that much better if they did get it, but that's a different conversation.

Let's not confuse frustration with the clueless comments of well-meaning friends for blame or fault-taking. We can talk about the frustration and the negative feelings that those comments engender without saying that those other people are assholes. They're not, not really. They're trying to help and doing so badly. I can appreciate their good intentions and still be affected and isolated by their comments.

Let's also separate that kind of thing from the actual blame that is attaching to idiot health professionals or volunteers, who are producing chaos and anguish in the space where they should be producing aid. Those people do deserve blame, because they are specifically employed in this service capacity and they ought to know better.
posted by Errant at 3:02 PM on August 3, 2011 [3 favorites]

Or, on non-preview, people like The otter lady's husband. It doesn't take medical training to know that that's a stupid thing to say.
posted by Errant at 3:04 PM on August 3, 2011

Yeah, universalizing lists like this don't really cover every situation, but basically, you should *think* about what you are about to say, *empathize* and *be alert* to the person's response in case you get it wrong and then follow their lead so you can repair if needed. Getting regular massage, for example, can lift depression as well as therapy for some people—so that's not a crazy suggestion.

Sometimes people *want* concrete suggestions and fixes, sometimes they want "there, there, I understand." being sensitive is recognizing this and changing to the appropriate style as needed.

What is bad is condemning people's chosen approach, particularly if that happens to be meds. We stigmatize antidepressants like we stigmatize addiction because we see dependence as addiction (which it's not: addiction is compulsive use despite negative consequences; dependence is needing something to function and we all are dependent on many things so having different or additional needs is not something to look down on).

I am really irked by the people who claim antidepressants are all placebo: posted an article today showing why new research adds to the multitude of evidence that this is false.
posted by Maias at 3:08 PM on August 3, 2011 [3 favorites]

True exchange:

One person: I don't know whether to kill myself or get a good night's sleep.
Other person: ::::understanding laugh of recognition:::::::

Moral: sometimes it helps when insiders recognize each other.

And regarding the one size fits all (yes or no) perception: let's go with the label I see on any number of wearables nowadays: "one size fits most."

Relief is a movable target.
posted by datawrangler at 3:09 PM on August 3, 2011 [2 favorites]

Most of my friends are fellow musicians and music lovers. When one is going through depression, and Lord knows they often are, I'm usually able to convince them through various methods of coercion to sit down and play with me, even if they have never played an instrument before. That part is easy to fix.

As someone who has dealt with tremendous quantities of both physical and mental pain, I believe that confronting the pain head-on is the key to surviving it. Can't count on medicine to "cure" anything, and there are no magic words to make it all better, so the best way to cope is to stare your demons straight in their beady red eyes and tell them you're not afraid, you're not gonna let them destroy you.

Obviously, this is the hardest thing in the world to do when you're clinically depressed. But you know what helps A WHOLE LOT? Avoiding words entirely. I've found that holding a guitar or a set of bongos gives people some kind of superhuman courage to open up and express their emotions, even (especially) those who are the most withdrawn and self-conscious, although it takes a little while to work up some steam. Playing with a friend demonstrates, beyond a shadow of a doubt and with platitudes utterly out of the picture, that you trust them, accept them, and want them on your team.

Just that little encouraging nod and eye contact, to say "Your turn to solo. Go for it! Let 'er rip!" is an unmistakable affirmation of your value and worth, and that your mistakes and flaws are of no matter; we can keep the song going no matter what, I've got your back, you're not alone.

Think I'm a drug-addled hippie? Well, you're right.
posted by jake at 3:26 PM on August 3, 2011 [6 favorites]

What a great bunch of posts--thoughtful, caring, funny, touching, helpful and in some cases appropriately serious. And I do not think there are more than a handful of snarky/glib/flip responses. All in All, made my day just a bit better. Thanks Again
posted by rmhsinc at 3:32 PM on August 3, 2011 [1 favorite]

Someone once posted a comic here that showed a guy with a crushed hand

That would be this.
posted by Gator at 3:33 PM on August 3, 2011 [16 favorites]

jwhite1979:

has the symptoms of Parkinson's, which I'm told often afflicts people who have been on antidepressants for a long time.

Cite, please?

While SSRI's are not indicated and are problematic in treating Parkinson's depression, the only thing I could find with regard to your statement is this, which refutes what you claim.
posted by BlueHorse at 3:37 PM on August 3, 2011

has the symptoms of Parkinson's, which I'm told often afflicts people who have been on antidepressants for a long time.

Cite, please?

While SSRI's are not indicated and are problematic in treating Parkinson's depression, the only thing I could find with regard to your statement is this, which refutes what you claim.

I think they're probably thinking of anti-psychotics, which have been shown in some to have side effects that mimic Parkinson's.
posted by Lutoslawski at 3:50 PM on August 3, 2011

When you are suffering - it doesn't matter from what - and people around you say things that are boneheaded or not helpful, for the most part they mean well. They may not understand, may have absolutely no relevant experience to call on, they may just have a horrible case of foot-in-mouth disease like I often do under stress, but most of the time what they're *trying* to say is: I want you to be well and whole and have the things that you want for yourself.

And the ones who don't want those things have their own problems. It's not about you.

I remember the magical thinking of my darkest depression. These lists make me uncomfortable, in part because what's helpful to me isn't helpful to someone else and vice versa, but also because there was a time when I believed I got to decide what other people got to say, and blamed my emotions and behavior on them when they didn't do things the way I wanted. I don't think this kind of talk is helping anybody.
posted by Lyn Never at 3:54 PM on August 3, 2011 [4 favorites]

I kinda needed a post like this today. I don't feel so alone anymore.

I sent the links to my husband, who (like me) has a genetic family history of depression. We've both been struggling with it lately, as he has a degenerative spine disease and the doctors are useless (that's a rant in itself), and I'm pretty much the only family he has, so the caretaker role is all mine. (Thankfully I have a good support network of wonderful friends & family.)
posted by luckynerd at 3:56 PM on August 3, 2011 [2 favorites]

This struck me as a bit odd:

Several of the comments in my last list negated my view of my own illness. I can understand that it may make people very uncomfortable, but denying the existence of my problems is very disempowering.

Personally, I have drawn a lot of strength from people who negated my view of my anxiety. If I thought life was not worth living, I'd want them to negate that too. It seems weird to assert the absolute right of an individual to believe what they want to believe in the context of mental illness.
posted by AlsoMike at 3:58 PM on August 3, 2011 [2 favorites]

I'm not reading all of the comments, but I did want to address the pile-on I witnessed in the first couple dozen on Malice.

I am clinically depressed. I have been for as long as I remember. I've been on a bunch of different meds looking for something that worked, and I still regularly end up sleeping for 12 hours at a stretch or unable to get out of bed at all. I have self-medicated through alcohol, cut myself, made suicide plans, all that shit. I know whereof I speak.

And yeah, I *do* kinda think that the malaise of the modern world has something to do with all that. I think the point about not being special, not being irreplaceable, and knowing god damned good and well that there is not a single thing you can do that makes you very useful at all is a pretty big contributor. Knowing that no one cares about you, you serve no significant function in the world, and that probably about six people would care at all if you completely disappeared is, in fact, a bit of a downer.

It's quite probable that I would find something else to fixate on and excoriate myself over if I had none of this. It took me a while, but I have finally accepted that, yes, there is something chemically wrong with me and there has been for pretty much my whole life. But I do know that I feel immensely better about myself and my life on those few occasions when I feel like my existence makes some god damned difference in the world. And I know that those times are few and far between. (Yes, I volunteer. Yes, I'm in therapy. Et cetera.)

I think it's quite true that the fact that we're all utterly replaceable makes depression worse. At least for me. I don't think Malice was trying to indicate that It's All In Our Heads (In A Non-Chemical Way). I think it's a good question, and I think that the answer is yes, this does make a difference. If I felt I served a valuable function in my community, if I even had a community, a lot of my insidious feelings of worthlessness and self-hatred would be diminished.

Speaking from the front, it really is a good point. Yes, depression and other mental illnesses exist no matter what. But, much as we can sometimes diminish their effects through therapy and exercise and all that other stuff we officially believe in, they can also be moderated by differences in society. Why is that so offensive?
posted by Because at 4:02 PM on August 3, 2011 [10 favorites]

Seriously though: "You should get some exercise!" is probably the worst cuz it's also like hey thanks I'm fat too. No I don't want to hear about Kettle Balls.

Hm? My shrink has been pushing me to exercise for the last few sessions. I'm lazy, so I chose meds, but apparently it really helps.

The best thing I got told was that I even had depression, that normal people were happy, and that there was help. Just having people around and caring does wonders too.
posted by Lovecraft In Brooklyn at 4:04 PM on August 3, 2011

Personally, I have drawn a lot of strength from people who negated my view of my anxiety.

I understand what you mean, but there's a fine line here. When I'm having a panic attack, I don't want to be told that my anxiety isn't real, because my shaking hands and pounding heart are very real. The people who have been able to hold my hand and say "there's nothing to be scared of, I'm here for you no matter what," are like gold.
posted by desjardins at 4:38 PM on August 3, 2011 [2 favorites]

It seems weird to assert the absolute right of an individual to believe what they want to believe in the context of mental illness.

Yup.

Good thing nobody is doing that.
posted by LogicalDash at 4:38 PM on August 3, 2011

I think it's quite true that the fact that we're all utterly replaceable makes depression worse.

Well yes but wouldn't that be ten times worse for someone who, say, works 18 hours a day every day of the week in a diamond mine in West Africa? How useful do you think they feel?

It is not a "modern malaise". Books, essay, dissertations, articles have been written on the history of depression and it dates back to the first eras we have literary accounts from. Yes literature, before photography and film, before the internet, before academic journals, is the one source of approximate documentation we have on how people lived before us. Now, what's the word that was used before the term depression? Melancholia. Where does the word melancholia come from? Ancient Greek. Yes, ancient Greece knew what depression was and coined a definition for it and an explanation for it that involved their own idea of physical causes. In ancient mythology it could easily blamed on the gods. In monotheistic religions, any mental illness could be easily blamed on sin or lack of faith in god or demonic possession.

Medicine and science took a while to catch up in the mental health department, so you have all this wonderfully vast area of literature, mythology and religion to draw from if you want to find out how human behaviour and human states of mind were described before we had the medical terms for them.

One such great source is also the Bible. Even just the Gospels. You know how that guy goes around healing everyone from all sorts of illnesses and casting demons away? that guy may not have existed, or existed but not actually done all the things in those stories, or not done them quite as we're told, but the people who wrote those stories surely did exist (And it wasn't a first world society they were living in, was it?) and the people and societies they were describing also surely existed, and all those stories of Jesus healing people from mysterious illnesses and possessions are a goldmine for the history of psychiatry. There's psychotics in there, manics and even anorexics, you name it. Right in one of most famous oldest book of stories that mankind is familiar with.

So please, let's not keep repeating this tiresome cliché that it's a "modern malaise". That's the kind of self-important illusion artists used to cherish while sipping their absinthe and smoking their opium a couple of centuries ago, imagining a romanticised past arcadia where everyone was happy and carefree, poor and beautiful. Which may have been great for art, this romanticising of the past, not so much for purposes of historical accuracy and understanding of the evolution of medicine towards current standards and definitions that, without counter-romanticising the present, at least do offer some practical advantage over theories of possession and divine punishment, I'd say.
posted by bitteschoen at 4:48 PM on August 3, 2011 [3 favorites]

has the symptoms of Parkinson's, which I'm told often afflicts people who have been on antidepressants for a long time.

Cite, please?

While SSRI's are not indicated and are problematic in treating Parkinson's depression, the only thing I could find with regard to your statement is this, which refutes what you claim.

I think they're probably thinking of anti-psychotics, which have been shown in some to have side effects that mimic Parkinson's.

That probably was what I was thinking. I have a hard time keeping straight which meds are which. But I also seem to remember a video I saw in an undergrad psych class where a person having been treated for severe depression over a period of years started to exhibit some Parkinson's-like symptoms like trembling, and it was explained as having something to do with re-uptake. I can't cite anything. I'm not making a scientific claim. I'm only telling ya that my mom trembles and twitches awfully. It's really sad to watch.


I really, really don't want to be judgmental but this is actually something I would really like included on a list of things not to say to people who are depressed. It took me a long time to become comfortable with being on medicine and then even longer to accept that I'd never be able to stop taking it.

Clearly you're right. If I talk with someone who is struggling with depression I'm not going to discuss my family's history unless I'm asked. I know how difficult the decision can be to use or not use a prescription drug. But I also think it's important in a forum like this to share my experiences. From talking with others I know what has happened in my family is not unique. So for every person talking abstractly about the benefits of prescription drugs, I feel compelled to offer a different perspective.

Another reason I hate the whole industry is the ease with which pills can be prescribed. In the case of my mother, it was nurse practitioners and MDs who handed out the scripts, not trained psychiatrists. Every couple of years when I was growing up my mom would have to be institutionalized because some pill prescribed by one doctor was interacting terribly with another one. Apparently it was up to my mother to keep the drugs straight, but she was an addict.

So if the drugs are working for you, awesome. Use them. I certainly won't be knocking on your door to tell you you're doing something morally wrong. But they are dangerous, and people need to know that before they start taking them.
posted by jwhite1979 at 4:51 PM on August 3, 2011

The best thing I got told was that I even had depression, that normal people were happy, and that there was help.

Seriously. As a non-depressed person, sometimes I feel like my best bet would just be to remind people that feeling depressed all the time is not how most of the population goes through life, and that if they do feel that way maybe they should think about getting some sort of help. My uncle realized he was suffering from depression(in addition to a lengthy cocaine addiction) a few years ago, and he at some point said "I didn't realize life wasn't supposed to be a bad thing." That's the insight that people with serious depression are missing; they don't need to be reminded of all the reasons they should be happy.

As a person without mental illness, it's really hard to understand what it's like to have mental health issues. My wife is bipolar(Mrs. Pterodactyl upthread), and if it weren't for eight years of being in love with her, I wouldn't understand what's going through her mind AT ALL. I think a lot of the problems relating to people with mental illness dealing with people without mental illness could be lessened if only those of us who aren't mentally ill remembered that we just have no clue what's going on with the rest of the population.
posted by Bulgaroktonos at 4:52 PM on August 3, 2011 [4 favorites]

Hairy Lobster may be right, but I used to say "are you okay" to someone who struggled with horrible depression, and at least from my small experience, it seemed to really hurt the person. It may be that "are you okay" is just too ambiguous for someone suffering that much. I think maybe a severe episode feels like they're dying, and to ask if they're okay is almost adding insult to injury. That said, I may have just been saying something to say something - oftentimes i just didn't know what to say and was trying to get the person to explain to me, but didn't know how to do it very well at the time.
posted by scunning at 4:58 PM on August 3, 2011

It may not be a modern malaise but I can't help but wonder if some modern things contribute to it.

The light pollution in my life is insane, for instance, and I more or less disregard my natural rhythms and the rhythms of the season (as best I can, since I have SAD).

There is endless noise in my life.

8+ hours a day I sit still.

I can go days without seeing more than one friend, and before I was dating someone, I had to schedule a friend-a-day in order not to get too weird in my own head. I sure as hell don't have a village, or even a neighborhood to speak of.

And who knows about modern diets? Homogenization? Drugs in the meat? Monocultures? I don't have the first idea.

I don't think depression is modern thing, but if it turns out modern life exacerbates it, I won't be surprised.
posted by small_ruminant at 5:08 PM on August 3, 2011 [8 favorites]

I think this has been a great thread, but I also think this is the reason it's so frustrating when people are all, "why do people always recommend therapy" in AskMes. Because your friends and family, even if they mean well, are usually only sorta helpful or really, really unhelpful, as the lists of "what not to say" show. Some of my closer friends definitely supported my belief that I had mental health issues, but their advice was unhelpful -- they armchair diagnosed me with personality disorders or ADD based on nothing except the fact that I was frustrating them, when the real problems were regular ole anxiety and depression. Since I wasn't quiet and pessimistic, but rather high strung, not sleeping, erratic, super talky, and other fun stuff, it didn't fit with what they thought depression was. That's okay and understandable, but the armchair amateur diagnoses were not. Also, when I was depressed I was looking for *help* ALL the time, from everyone. If the guy at the grocery store said something weird to me or looked at me in a certain way, I'd want to glom on to everything that happened in that moment to "teach" me something. It was totally weird. I was so vulnerable. I'm so glad I had my no nonsense awesome therapist. I'd say, "My friends say blah blah and I think it's really important because..." and he'd be like, "What? That makes no sense. Ok, now our plan for the week is..."

I know its hard to find someone who's a good fit (I talked to eight therapists before settling on one) but anything involving medical care is hard. You just have to do it, and keep at it.
posted by sweetkid at 5:12 PM on August 3, 2011 [2 favorites]

"There's no depression that a good piece of chocolate can't cure!"

Sigh.
posted by Lucinda at 5:21 PM on August 3, 2011

One of the few nice things about my time in LA (which was mainly marked by alternating fits of anxiety, boredom, depression and insomnia) was the group of people I met in my housing complex. Among other activities, we started RPing on Sunday nights. Now, I was unemployed, went to community college two days a week and spent 90% of the rest of the time on the couch in my apartment or in the midst of a 14-hour sleep session: a depression poster-boy, basically. Anyhow, my sleep cycle was completely broken, and it was around 3 PM on Sunday that I was into hour, I don't know, ten of being asleep, having gone to bed around 5 AM that very same morning. My girlfriend at the time comes into the bedroom to wake me up because "your friends are here."

Griphus, I say this without trivializing or mocking, but this reminded me of a very affecting episode of Community . There's an article somewhere that talks about how it deals with depression, but I can't find it.
posted by Lovecraft In Brooklyn at 5:27 PM on August 3, 2011 [1 favorite]

. . . he at some point said "I didn't realize life wasn't supposed to be a bad thing."

This is what truly effective treatments made possible for me, just this past year. I understood, and had always understood, that most people were happier than I was. What I didn't understand is that not everybody walks around in life with a lead jacket of fear, apprehension and dread -- that the default state of an intelligent, perceptive person is not endless horror and anomie. I thought it was just that most everybody else was a stronger person than I was, and could bear it.
posted by Countess Elena at 5:40 PM on August 3, 2011 [13 favorites]

This is what truly effective treatments made possible for me, just this past year. I understood, and had always understood, that most people were happier than I was. What I didn't understand is that not everybody walks around in life with a lead jacket of fear, apprehension and dread -- that the default state of an intelligent, perceptive person is not endless horror and anomie. I thought it was just that most everybody else was a stronger person than I was, and could bear it.

THIS
The idea that people are generally happy, or at least content, was mystifying to me.
posted by Lovecraft In Brooklyn at 5:42 PM on August 3, 2011 [1 favorite]

Depression certainly isn't a modern ailment (you can find analogues in rats)—but there are many features of the modern world that make it more likely. The most important of these is lack of social support. We used to live in small groups that knew everyone and we stayed together with them most of our lives. Now, this presented its own issues, but they were generally not related to lack of social contact (quite the opposite, often).

Now, people live alone, they have fewer close friends than they did even 30 years ago (even with social media, something like a quarter of people say they have *no* one they could confide in in middle of night if needed and another large group only confides in spouse). We move a lot and have much less time to hang out and support each other and to hang out with babies when they are most in need of intense attention from minimally-stressed people. Hell, we don't even require paid family at all leave when you have a child in the U.S. Not even 2 weeks after a birth or adoption!!!

There's also the fact of greater awareness and better treatment which adds to the feeling that suddenly everyone is depressed. not to mention that unemployment also contributes to depression.
posted by Maias at 5:44 PM on August 3, 2011 [1 favorite]

I'm not reading all of the comments, but

And this is where I stopped reading your comment. Why should anybody read your words if you can't be bothered to read theirs?
posted by Gator at 5:52 PM on August 3, 2011 [5 favorites]

The next time someone equates being depressed with feeling sorry for yourself I think I'll give them roughly the same consideration that I give someone who's complaining about x, y, or z public service because it's a "waste of the taxpayer's money" (the official complaint about everything these days).

Or even better, my favorite one in the South -- "God never gives you more than you can handle." Fuck off.
posted by blucevalo at 5:59 PM on August 3, 2011 [4 favorites]

The deadly sin of sloth (acedia) can be mapped with some accuracy to depression. Suggesting it's not a modern invention (which is, like, duh, but I found it interesting).

Acedia describes a state of listlessness or torpor, of not caring or not being concerned with one’s position or condition in the world. It can lead to a state of being unable to perform one’s duties in life. Its spiritual overtones make it related to but distinct from depression. Acedia was originally noted as a problem among monks and other ascetics who maintained a solitary life.
posted by Sebmojo at 6:03 PM on August 3, 2011 [2 favorites]

In medieval literature, taxonomies of sin often link sloth to "wanhope," or despair. So yeah, I'd say there's a connection there.
posted by duvatney at 6:15 PM on August 3, 2011

"Happiness is a choice."
*seethes*
posted by carsonb at 6:16 PM on August 3, 2011 [5 favorites]

The idea that people are generally happy, or at least content, was mystifying to me.

The idea that people's experience is generally characterized by any particular quality remains mystifying to me.
posted by LogicalDash at 6:27 PM on August 3, 2011 [1 favorite]

Because of the way my brain works, in little swirly microclimates of joy and sadness and overall high-tension electrical storm responses to the things I encounter from day to day, and our culture of armchair psychiatrists armed with just enough talk show wisdom to feel like they can out-diagnose actual professionals, I've been "diagnosed" with a lot of maladies.

"Oh, Joe, you've been in this funk for so long, you really should be checked out for clinical depression," they say, and I love their concern and compassion, but they're wrong.

I have long, desolate blue stretches sometimes, but there's something important in my indigo days—I can always backtrack to the root causes, and if I rally and beat those frustrations back, silencing the bill collectors, changing careers to leave a bad job, tuning out of the Grand Guignol news cycle, and aborting toxic relationships, my blues go away. It breeds an ugly kind of arrogance, that pattern of defeat, effort, and success, because we're all programmed on some level to believe everyone thinks like we do.

"You just have to be happy," I used to say, with the kind of smug brilliance that comes from feeling like you know something so simple and important that the world would change for the better if people knew what you know. "You just have to imagine the joy and wonder of the world like a little spark and fan the flames until they consume you."

I'm so ashamed, sometimes, but I am a product of my culture and my environment, so I have to forgive myself almost everything, because my arrogance came from ignorance.

I could only imagine a brain that works like my own, and as someone who's already the odd man out from the rest of the world, based on my fizzy, shiny-seeking, hyperfocused mind, I should have known better, but we need help—all of us, from the people we hurt the most. It's a lot to ask, but when I want people to understand that the way I see the world isn't the way you see the world, a distinction that might have made my school years so much more than they were, I have to become a poet. I have to be patient and understanding, even to those who do me harm without knowing what they do, and turn words into that shifting, simmering, undersea world that exists in constant flux that I know and treasure.

I've been doubly lucky to have two difficult experiences in this century.

First, I've had the good fortune to make the acquaintance of an artist who's just one of the most stunningly talented, visionary, wry, and multidimensional creative minds I'll ever come to know, and she's someone who's dealt with severe unipolar depression that digs a hole so blue and so deep that she just can't escape it, and feels at times like she'd rather just leave the world than endure. When I met her, I loved her work, loved her words, and loved the way she transformed the world through her art into something so rich and peculiar and perfect.

When the blue holes swallowed her up, when I talked to her, there was that arrogance in me, the sense that maybe, just maybe, I could talk her out of that place, or give her support by working to get her artwork out in public, where it could be seen, and I'd have that ridiculous thought—well, she's a lovely, amazing woman, with a handsome, talented husband and a kid who's just a superstar, just seriously, a bonafide superstar, and she has a wonderful house and wonderful things and…well, how could anyone be sad with this life?

It's just hard, the complexity of all of it, when you really want to just think that every problem has some solution that's so simple and obvious that everything can be fixed, and I've had ten years getting to know my friend, getting to see how she works, and how it is when she starts to fall, and how it is, or as much as I can see from my vantage point, when she feels like the best thing in the world for her would be to just not be there anymore. I've come to an understanding that I don't want to know, because I don't want to know that some people face problems that can only be managed, and balanced, and dealt with like walking barefoot over Niagara Falls on a tightrope made of razor blades, but still, I'm glad to know.

There's a disease that afflicts us all in this country, the putrid mythos of the just-world hypothesis, where we blame the sick for indulging their illness, the poor for their lack of initiative, the lost for their uncertainty, and it's just wretched, how much a part it is of our national character, feeding the movements that push for Ayn Rand's shrugging Atlases and a society for the selfish, ruled by the selfish, to the glory of me me me. It's a manageable illness, and I've been doubly blessed on my way to not saying the things you hear on talk shows, where rich people tell poor people to just suck it up and be an übermensch.

My friend gets by, day by day, sometimes, and her engagement with her demons shows in her art, and though I feel like we're swimming in TV prescription psychodrugs, self-diagnosed vanity illnesses, and self-pitying people who maybe could just get themselves together, I am blissfully thankful for the sea of chemicals that let me enjoy having someone so special in my life.

The other thing, for me, was the love of an impossible man.

Part of the defense strategy you build up when you're just a different child, at least in my case, is to master the art of detachment and substitution as a way of making it okay that you don't get what you need when you need it most.

Popularity? Pssht. Popular kids are fools. They'll never enjoy what I, alone, enjoy in my odd little world. Hell, I don't need them at all.

Success? Phbllbpt. I am a shining success at being me! No one knows how cool and unique I am, or what I can do, but I know, and I am very successful at being that guy. I don't need money or a reliable car or nice things or security. That's for capitalists and TV-chasing morons.

Love? [eyeroll] Yeah, sure, good luck with that. Hell is other people. Man, have you seen my apartment? It's perfect. It's like the inside of my own head. Why would I want anyone around to mess that up?

As it happens, it was love that finally knocked me off my high horse. Didn't want it, didn't expect it—hell, didn't even see it coming from someone who wasn't remotely my "type," whatever that means, and someone who was just a year out from losing the love of his life in the most horrendous way, who told me, often and forcefully, "nothing will ever happen with us."

Except, well, love did happen, and it was a shining star when it was good, something I'd never experienced in that way in my previous two relationships, in the way where anything is fair game, and everything's okay, even when it hurts like hell. The impossible man loved me back, even though he said he wouldn't, not now, not ever, and even though loving someone so deeply hurt hurts in ways I'd never imagined, I was irretrievably in the thick of it.

We'd be on again, and I'd just have the constant internal dialogue of intrusive thoughts about him, about our problems, about how fucking desolate and impossible it was, and we'd be off again, and I'd have the constant internal dialogue of intrusive thoughts about him, about how much it hurt, and about how I couldn't just disengage, because it wasn't the one-sided thing he'd tell me it was when he hurt too much inside to give me a sliver of room. Sometimes I felt like I was dying, caught in a limerence so deep and profound that when I tried to imagine how it would be at the end of his assignment, when he'd move away forever, I feared I'd die from Takotsubo cardiomyopathy, an actual physical collapse they call "broken heart syndrome."

Where my friend taught me to listen, love taught me that there are things in life you can't escape, no matter how much you want to, or need to, and that's where the blush of compassion starts to spread, deep in the gut and in the soul, a feeling of understanding that comes over you like a flower in your head with roots unfurling through your blood vessels in delicate, teasing, invasive tendrils until you just know. You just know.

I am a vastly better writer because of this. I can take those fragments of dialogue I hear, and those faces, those circumstance, the way people move and the things they dream about, the way that suffering and loss turns bones to charcoal and hearts to rags, and it's a gift I never had when I was still the master of the easy dismissal, when my writing was clever and self-conscious and gimmicky. I am better for having been through what I went through.

Hey, though, it's over, right? It's over and it was sad as hell and he's three thousand miles away and five years out from the moment he drove off for home, with me standing there, crying, watching his car dwindle into the golden sunset like something from a movie. It's over and I'm okay, and I've dated a little and moved on and had my third career move since he left and it's just fine.

"Joe, you're my best friend, and you know how much I love you, right?" he said, on a recent business trip that brought him back into my orbit, and then he explained that he'd met someone, and that he was ready to explore that, and that maybe he loved the guy, but he just had to see.

"Oh, that's great. I'm so happy for you. I knew you'd be ready one day, and all I want for you is to be loved by someone who knows why you're so amazing," I said, and I meant it, though my head was sort of buzzing. I left his hotel room, put the top down on my car, and headed for home with my head hurting from that old familiar interior dialogue—a monologue, really, where I go over and over and over what I should have said, and I cried almost continuously for three solid days.

How can I not be over this? Jesus, I've been his friend for five goddamn years, and I've had a life, and things are good, and I know it probably never would have worked, and besides, he's kind of a dick, anyway, and wasn't nearly good enough to me and...and the monologue rambles on, and the shame comes, and I am such a fucking loser, just such an idiot, like a little girl in love with teacher.

Five years on, there's no denial, no Stalinist rewriting of my own history, no distraction that's enough, and I am humbled by that realization, that there are things in life you can't fix easily, and sometimes, you just have to accept that they're there, deep in your meat and marrow, and that you'll only ever be able to make the best of what you have, and find the ways to deal with those blue, blue, impossible places inside you.

In another flush of that rare, bottomless understanding, I find I can't be arrogant like I was, because I can't claim to be the master of all my problems in the way I've used that to defend myself. The world will destroy me one day, just like it destroys all of us, but in the meantime, I have problems, solutions, and things that can only be managed, so they don't constantly return to slam the brakes on as we travel along our path through the world.

I've had a blue month, since talking with my friend, my love, or whatever the hell he is, and I've made it through with distractions and diversions, knowing full well that I'm sidestepping something that needs to be addressed, and I keep telling myself "but, hey, think of how much better your writing is now! This is progress! Can't make an omelet without breaking eggs!" as a palliative, to make things okay, as much as I can.

It's as much as I can manage, but in all honesty, I'd rather be a bad writer, and who I was before, as small and frustrated as I was then. They say what ever doesn't kill you makes you stronger, but lately, I'd rather be be weak, but this is the tenor of this funk, and I will get through it. When I want to wallow in self-pity, I have to remember that I will clear the blue when I deal with what's making me blue, but that's not always how it works, and never is, for some people.

It's just such a gift, those people who are patient enough to deal with our judgmental, intrusive, arrogant impulses and who can breathe that bad air in and exhale it as simple language that makes sense from the inexplicable and is kind when we are thoughtless.

For everyone who ever felt the familiar sting of cheap psychiatry delivered by fools and roused something more articulate and meaningful than anger, legitimate though it may be, I can only say that I am so glad that you are in this world, and I am lucky to have encountered you along the way.

This, too, is often not enough, but it's true, nonetheless.
posted by sonascope at 6:27 PM on August 3, 2011 [22 favorites]

The pastor said that at the service for my brother after he committed suicide. God never gives you more than you can handle. I still seethe at that. I saw it as a giant fuck you to my brother for being too weak to continue living in the church's eyes.

When I went to the community mental health center and asked to speak to someone when I was afraid I was going to kill myself they told me that they don't take walk-ins and when someone eventually sat down to talk to me their total advice was to go home and take a bath.

I'm amazed that I kept pushing for help. Kept demanding that I have a right to access treatment.

It has always been the blithering idiots in mental health care that have made me feel worse. I lucked out getting my current therapist and he basically does the type of therapy that fits me and tells them to screw their mandate for CBT therapy only.

Sorry for the anger but its a touchy subject for me. Someone shouldn't have to fight ignorant attitudes from the very people who are supposed to help them when they are at their lowest point.
posted by kanata at 6:29 PM on August 3, 2011 [14 favorites]

This thread is too depressing for me to really engage with today.

That's not a blithely tone deaf attempt at humor. Reading this thread has really drained what emotional energy I had today. If I must pick at something here (and I can't help it), it's the assumption that there is a science of mental wellness that bothers me pretty deeply. There's not; a traditional route of therapy or psychiatric medication may help you, or may damage you. That's pretty much a game of chance, and assumes you live in a first world country where such services are even offered and are something you can afford. Lots of people don't and can't. Regular exercise alone is not going to completely cure serious depression, but it doesn't hurt; endorphins feel good and exercise is healthy.

Bleh. I'm just annoyed by all the knee jerk accusations and assumptions that there's this One True Way to Battle (not Live With; that never even seems to be acknowledged as a reality in conversations about mental health) Mental Illness and that you know what that One True Way is and everyone else is Doing It Wrong. It's depressing. So is the rush to shut down anyone whose outlook on depression isn't atomic and individualistic. Social and cultural factors absolutely influence mental and emotional well being (genetic factors, too; I don't like absolutes) and seeing your depression as a personal disease is a great way of writing a self fulfilling prophecy, in my experience.

(sigh)

I can't finish this post. I get angry thinking about this stuff, so I just took a walk to get some perspective. I like all of you. You're doing the best you can. Be safe and responsible and considerate of others' situations. There are no clear maps for these territories and most will have to draw their own. There is really no final resolution beyond learning to live with whatever flavor of crazy you have, however you can.

My own attitude toward mental illness is: whatever gets you through the night. If reading that sentence doesn't make you a little bit nervous, you probably don't share the sentiment.
posted by byanyothername at 7:37 PM on August 3, 2011 [4 favorites]

I don't understand that. I feel like this was a respectful thread.
posted by sweetkid at 7:46 PM on August 3, 2011 [1 favorite]

I've always wondered why optimistic people are so optimistic. The reality is that they're just normal, or non-depressed, to use a less judgmental-sounding term. Resiliency is something I have plenty of, under the right circumstances. What I don't have, even after all these years, is a stable mechanism for seeing the world that doesn't feel like it's a house of cards sitting on the sand waiting for a gust of wind to blow it over. I have had many necessary treatments that have saved my life. I feel lucky, and fortunate, and blessed. That doesn't change the fundamental nature of who I m at the core.

There's a bio of Churchill by Gretchen Craft Rubin that explores the idea that he was never depressed -- that the depression was laregly a creation of Churchill's egotistical and fame-seekng personal physician, Lord Moran. Sure, Churchill sat in front of the fire and buried his head in his hands while he was being painted by Sir William Orpen, but that was just because he was depressed about the Dardanelles, and, well, who wouldn't have been, amirite? Rubin theorizes that because Churchill enjoyed and took vigorous pursuit of daily activities that he relished, like painting, writing, and bricklaying, that he couldn't have really been depressed. But this multitude of hobbies was a way of escaping the "black dog," of not "standing beside the side of a ship and looking into the water" because "a second's action would end everything." There's this persistent idea that heroes and leaders shouldn't show any evidence of frailty or human misery and pain -- and that's evidenced by the notion that because Churchill wrote and delivered so many stirring speeches about the futility of despair and conquering helplessness that he couldn't have possibly been speaking from a place of deep despair himself.

Social and cultural factors absolutely influence mental and emotional well being (genetic factors, too; I don't like absolutes) and seeing your depression as a personal disease is a great way of writing a self fulfilling prophecy, in my experience.

I appreciate your sentiments, and I don't disagree that social and cultural factors come into play, but seeing my depression as a "personal disease" is what saved me from death. The idea that you "learn" to "live with" depression (as opposed to treating it), or the corollary, that you "get over yourself," or "stop throwing a pity party," or whatever the current phobic platitude is, didn't work for me. I don't think I'm alone.
posted by blucevalo at 7:53 PM on August 3, 2011 [2 favorites]

Let me amend that statement: "When I'm depressed, what I don't have, even after all these years, is a stable mechanism for seeing the world." When I'm not depressed, I am able to picture a pretty good facsimile of that stable mechanism, and I find ways of constructing it that resemble the normal non-depressed person's. But that doesn't mean that I will ever have the non-depressed person's life experiences that accrued over time from childhood and gave them the mechanism that's a solid stone wall.
posted by blucevalo at 8:02 PM on August 3, 2011 [3 favorites]

Reading this thread has really drained what emotional energy I had today.

It's odd, to me it's the exact opposite. In reading the statements by so many members that I, well to be honest, look up to, seeing them talk about the same things that I feel, going through the same trials, it's incredibly uplifting.

On the early discussion of exercise:
This summer I've been working out quite a bit more than normal. 50km bike rides 3 days a week, an hour of weights another 3 days. Cooking almost all my own food, healthy food.
And two weeks ago I fell heavily back into my depression. I've barely worked out [probably 100km biking and 2 hours of weights]. I want to go for rides. I want to lift weights. I want to cook, for hell's sake. I feel good when I do. But it's like I'm paralyzed, I don't know what I'm doing when the day dissolves around me.

Usually exercise helps me. It doesn't help everyone, I know, but it does me. Not this time. Right now it's anxiety [probably triggered because I didn't get an interview for some articling positions I wanted for next year], and it's killed my work, I'm gonna have to do a month-long death march to get my research done this summer. The one light is that I'm not feeling suicidal this time. If I was, then as in the past, I'd be planning on that as a way out from my problems instead of trying to solve them, which makes them worse and makes suicide an even more attractive solution.

So I know I'll pull through this one. It's going to take a while. A friend was driving through town last 10 days ago, I made plans to have dinner but had to bail on him - I was unable to shower, go out, make small talk. This weekend a friend's coming to town for work and staying with me. A close friend, he would be there for me if I needed, I know, but I still want to tell him to get a hotel and avoid him. I won't. I'll see my friend, remember what it is to be human and be social.

It's funny, a few years ago, at the end of undergrad, I had been suicidal and hiding it. Didn't want to burden my friends, because I like being the rock for people. I like helping people with their problems, not the other way around. But after I pulled through (I don't know how), I posted on my facebook about what I'd been feeling. The number of close friends who privately talked to me and admitted to the same feeling was shocking. Nobody expected of me, and I didn't expect it of them.

And yet right now, I don't want to talk about it with my friends. I don't want to admit to being depressed, I want to be strong for them. I don't want them to think of me as broken. Which is a pile of crap, but it doesn't matter. I'm depressed, it will wax and wane, and all I can do is survive it. But at least I can do that.

[/ramble]
posted by Lemurrhea at 8:18 PM on August 3, 2011 [5 favorites]

I think this is the first time I've realized and acknowledged being depressed while in the midst of it. I think mainly from reading everyone's posts, above. Thank you, Metafilter. Seriously.
posted by Lemurrhea at 8:19 PM on August 3, 2011 [8 favorites]

I understand what you mean, but there's a fine line here.

Part of me is annoyed because I feel that behind what she says, there's an undercurrent of resentment about more than just people being insensitive. It's almost as if their lack of awareness of mental illness reminds her that she has been deprived of being normal, which is something they have that she will never have. I don't relate to that at all, I feel like anxiety saves me from being normal. I feel like it's something I have that they will never have. Maybe it's a cliche, but I have a soft spot for that Apple ad: "Here's to the crazy ones. The misfits. The rebels... They push the human race forward."

Some people go too far with this and claim that mental illness doesn't exist, its just a different way of thinking and it shouldn't be treated, and so on. I don't agree with that either, and people definitely should get treatment. But at the same time, I just can't bring myself to think of it so simply as uniformly negative, it's a complex mix of good and bad for me. But I have never felt like a failure as a parent because of it, so it's great that she's writing about that. It's one possible and perfectly valid way of relating to mental illness. And there are others.
posted by AlsoMike at 8:59 PM on August 3, 2011 [2 favorites]

At the beginning, I thought that only "bad" psychiatrists prescribed it before lots of other therapies. So when my first visit to a psychiatrist resulted in a prescription, I was convinced that she was callous and didn't care, and just threw meds at all patients. I even switched psychiatrists immediately. But then a funny thing happened-- I began to fell better. And on the second visit, my replacement psychiatrist prescribed a second medication to deal with all the guilt I had been feeling. I actually cried when I read the symptom description on the drug pamphlet... it was a list of things I had been feeling... and I didn't dare hope that the drug would work as described. I know drugs don't work for everyone, but they did for me.

Fast forward a couple years of frequent therapy later, and here I am. I, a lifelong member of the Social Phobia and Perfectionism clubs, can actually talk about this stuff in the open.

A couple of weeks ago, I had a few "down" days, and then I found a $100 citation on my car (with tow notice). I grumbled and felt irritated, but took a deep breath and told myself I'd deal with it later. The next morning I found another $100 citation on my car. And BAM, I was so livid, so internally twisted with rage, that as I drove home I experienced an impulse to jerk the wheel into oncoming traffic, just to make it all stop. I just wanted all the bad stuff to stop. And so my brain said, "hey, just die! voila! problems solved!" Fortunately or unfortunately, I have lots of practice at ignoring such thoughts. And then, some 15 minutes after I'd found the ticket, I managed to let it go and regain equilibrium.

I felt pretty good about the whole thing, actually. I hadn't experienced a suicidal thought for over a year, even after going off meds. Just 15 minutes of that out-of-control feeling before I was fairly ok. I was even able to talk about it later the same day when my friend called.

My friend didn't feel as good about it as me. She's a med student, and we'd been talking about psychiatry and how many people need therapy, so I mentioned my little episode as an example of how much better I am after lots of therapy. But hearing people describe suicidal thoughts is scary, even to people like my best friend, who's worked in psych wards. She has a difficult time understanding, though she tries. I think what scares her most is because the mind is so complex, there's nothing she can do to help sometimes.

It makes life even more difficult that people don't understand depression, brush it off, act like it's your fault. Even the most well-meaning people can be frustrating. Including my friend, who just wants the world to make sense. But if what it took for my friend to understand was to go through it herself, I wouldn't want her to understand. Enough people already do, I think.
posted by zennie at 9:40 PM on August 3, 2011 [1 favorite]

This thread has elicited some very beautiful and heartbreaking comments.

Thank you
posted by Unicorn on the cob at 10:18 PM on August 3, 2011 [4 favorites]

It makes Depression into a First World Problem, and puts me in the weird position of wishing I lived in one of those agrarian villages and at the same time feeling like I should be more grateful that I don't.

It's obvious to me that mental illness has been in my family for several generations, but I do think that modern, urban life makes it much worse. Having a set of very concrete problems that must be addressed NOW - getting hay into the barn before an impending rainstorm causes it to mildew and rot, planting & harvesting food at the right time of the year, making sure that your livestock are healthy and fed, making sure that equipment and buildings are regularly maintained - gives you a regular sense of genuine satisfaction when task are completed. If you're feeling low, you don't have to maintain a cheerful demeanor - you do what needs to be done, and you go home.

Office work, OTOH, is a never ending merry-go-round of shifting papers from one side of your desk to another, hurry-up-and-wait project deadlines, often leading to a sense that you have accomplished nothing of any real importance. You might be feeling desperately suicidal, but you have to maintain a chipper professional demeanor - if you can't, you're not a good employee. The stress of always having to maintain a cheerfully bland facade can be overwhelming.

Isolation is definitely a problem for some people with mental illnesses in farming communities, but it's more about not having enough day-to-day contact with enough people. Urban isolation is a whole different kind of beast - you're surrounded by so many people that it becomes stressful, and you find yourself retreating into yourself as a form of self-protection.

Families in traditional farming communities often consist of multi-generational and extended relations who live within 5 - 10 miles of one another and rely heavily on one another for socializing and nurturing. That's very rare in most modern urban settings.

TL;DR, I don't think that there is less mental illnesses in rural communities; it's just that the stresses of modern urban living can make mental illnesses manifest in a more severe form.
posted by echolalia67 at 10:35 PM on August 3, 2011 [6 favorites]

4) “But you can’t be depressed! You’re so confident/bubbly/jolly/self-assured (delete as applicable)!”

People with depression are the best actors you'll ever meet.
posted by deborah at 11:07 PM on August 3, 2011 [15 favorites]

I, too, am a functioning depressive/great actor - coming as I do from a family who regards admitting to any 'weakness' or, god forbid, actually talking to a mental health professional about your feelings, as a massive betrayal of all that is right and good with this world/our family.

Despite this, I've been fortunate enough to find a therapist who treats me as an intelligent adult and doesn't trivialise my condition. I have a deep-seated aversion to routine, and so, we have an understanding: I will agree to ask for help/book a session when I need it, and she won't insist on regular attendance. Somehow, just knowing that there is someone I can talk to - without fear of judgement - as and when I feel I need it, is almost as beneficial as actually turning up.

It was in one of these sessions that I blurted out: 'sometimes I really think that I'm fucking crazy' and, without hesitating, she said: 'no, I think you're perfectly sane'. I can't adequately describe how it felt to hear that - possibly for the first time in my life - and from one of the very few people I've ever been completely honest and forthright with. I think in that moment I realised just how long I'd been lugging that particular menhir around. I won't say that thirty-odd years of doubt, anger, fear, numbness and grief lifted exactly, but something inside creaked and shifted a little. Definitely.

On a lighter note, I keep this pinned above my desk. It never fails to make me smile.
posted by tuckshopdilettante at 1:00 AM on August 4, 2011 [1 favorite]

TL;DR, I don't think that there is less mental illnesses in rural communities; it's just that the stresses of modern urban living can make mental illnesses manifest in a more severe form.

Or even in a way that gets you to see a doctor/counsellor/psychiatrist/psychologist/freudian analyst/CBT therapist etc. and get a diagnosis in the first place.

I agree generally, and I think you make a lot of good points, but when generalising about depression (or other mental health issues and specific disorders etc.) I do believe it's very, very important to keep in mind that the definition, the identification of depression and its prevalence in one or the other society, environment or period of time in history depends on it being reported, signalled, diagnosed or in any way expressed.

And you do need awareness of it for it being diagnosed in the first place. And you need access to some form of treatment, and social acceptance of that form of treatment.

Talk therapy especially could be a ridiculously fancy and modern concept for people who didn't live in a place/time where it's become a normal thing. It could be a luxury in more ways than one, cost, accessibility, and social perception. If you lived in an envinroment where that was a thing only for the rich and educated people who lived in the city, then indeed depression was a luxury you couldn't afford. So you wouldn't even have the tools to acknowledge it.

I'm saying this as applied especially to the past, because I think if we're talking modern rural communities in a modern western nation, then well the availability of media and information and social changes and advances of medical knowledge has made these differences a lot less marked. But just go back a few generations and whoa, another world. I'm not going to get into personal family anecdotes to illlustrate this point, but that's in a nutshell what makes the difference between older rural traditional large-family communities and modern approach to depression - ignorance, denial, repression, shaming and lack of access and means.

So, as far as I'm concerned, I say let's hear it for modern/urban life, for all the new issues it can bring, let's be thankful for the tremendous social and medical advances it has given us. Whenever you hear "we didn't have the luxury of being depressed back then", what that really means is "we didn't have the luxury of getting diagnosis and treatment for it". Again, I believe romanticising the past, or more traditional societies, may be all fine and dandy for artists and poets, not so much when it comes to social and health issues.

Let's be careful also of the risk of romanticising rural work or hard physical work itself, when it's done for livelihood, and not as therapy or antidote to the stress of office life... Especially when it was done for livelihood in the past... Ask the women in those older traditional multi-generational farming communities how satisfied they felt at the end of the day after working all day in the barn or the fields and then having to feed a number of multi-generational mouths and handwash all linen and scrub the floors clean and and and. I've heard all this before and whenever I've heard it straight from the source, suddenly that whole contradictory line of denial about any mental issues ("back in our days we had it so hard, there was nooo such thing as depression that's a fancy word for being spoilt and lazy") was set aside, and there was no rose-tinted nostalgia for the actual physical hard work and deprivation and struggling to make ends meet that supposedly functioned as an antidote for troubles of the mind.

One thing is to say you need a purpose in life, and you need something to keep you busy, and a structure that gives you meaning and sense (and it needs to be a structure and sense that fits you). But looking at more traditional societies and seeing only the appeal of close-knit communities and hard work while glossing over the rest is a bit of a dangerous delusion really.

(Not arguing against anyone here specifically, just saying in general - because oh I've heard that argument before, so many times)
posted by bitteschoen at 1:03 AM on August 4, 2011 [5 favorites]

I'd like to add "but you're so sociable!" to that list of things not to say. Yeah, I'm sociable because I'm sometimes afraid that if I'm left alone with just my mind and my demons, I won't make it through the night. I've had days where certain things are actually dangerous to me because I so actively want to die: knives in my kitchen, my balcony, the train or bus to school/work.

I'd also like to point out that some depressed people aren't pessimistic. I've had so many people exclaim that I'm very optimistic and they don't understand how I do it. I am depressed to the point of getting a cat to feel I had someone who gave a fuck about my existence (and then got a second cat because I felt I wasn't good enough company for him), to the point where I have to hide in my house because I'm afraid I will come up with a way to die if I leave my bed and I so desperately want to live. Is that what qualifies as optimistic now?

Lastly, thank you for this thread. I've been in a horrid downswing lately and haven't really let myself see it but this thread made me think about my behaviour and realize that I am struggling and it may be time to find help again.
posted by buteo at 1:18 AM on August 4, 2011 [5 favorites]

I have had a therapist tell me that I wasn't serious about getting well, just because I refused his suggestion of medication in the first 20 minutes of conversation.

Never mind that he had made me wait outside his office for fourty minutes, on a day where I had cycled to his practice in the pouring rain, and I was literally dripping on his carpet, sitting on a towel he had given me so I wouldn't sully his couch.

Never mind that I had told him at first blush that one of the reasons I was seeing him is that my friendly GP had been giving me serotonin regulators but I was unhappy with the result.

I don't think "you are not serious about getting well" is something you say to someone who's cycled in the rain to try and get treatment.
posted by kandinski at 1:35 AM on August 4, 2011 [4 favorites]

I have had a therapist tell me that I wasn't serious about getting well, just because I refused his suggestion of medication in the first 20 minutes of conversation.

Oh god.

I'm familiar with another variation of that, consisting of a ridiculously outdated personality test that shall go unnamed and proceeding right there to declare "your answers indicate you are stubborn and resistant to treatment". At the first 'getting to meet' session. And it wasn't even free. And a lot of other obvious signals that it was a bad match. Blind date gone wrong.

But, there's a great silver lining in blind dates gone wrong: when it's so obviously bad from the start, you don't even bother with a second appointment, you proceed straight away on your shopping-for-therapist quest, and sometimes luck repays your stubborn search so much more than you could have imagined.

(Or at least you get to practice your therapist-radar until you get a good enough signal.)
posted by bitteschoen at 6:13 AM on August 4, 2011 [1 favorite]

that the default state of an intelligent, perceptive person is not endless horror and anomie

Hope this isn't a derail, but this idea that there is a 'default' mood or way of being that can then break down or be overcome by something else is the wrong way to look at it IMO. Being 'normal' is as much a construct of our brain chemicals/patterns/whatever as being depressed.

Life is pointless and we're going to die, day-to-day life is boring drudgery for most people, we're not special snowflakes and most of us are unlikely to achieve much. And yet us 'normal' people overlook all that and go on with varying levels of energy and modest hope for the most part - and that's as much to do with the constant efforts of the brain as any other way of being. That most people (maybe not as many as we think) manage to stay in this 'natural' or 'normal' way of being is the real miracle, and it's hardly a surprise it twists to become something else in so many people.
posted by Summer at 6:47 AM on August 4, 2011 [3 favorites]

I am depressed to the point of getting a cat to feel I had someone who gave a fuck about my existence (and then got a second cat because I felt I wasn't good enough company for him)

buteo, this. I am pasting this on my fridge - this is me. Maybe you didn't mean the humor, but I hope you don't mind if I grin. I so need to laugh at myself more.

Thank you. And thank you all for this thread.
posted by Surfurrus at 7:12 AM on August 4, 2011 [2 favorites]

Totally anecdotal, so totally for what it's worth: I went around with untreated bi-polar for most of my life. I was not suicidal. I did feel pretty down a lot of the time though.
There was a point when I realized how much of my life simply had been destroyed by feeling that way.
Medication was the last thing I wanted to do, but it has actually been pretty liberating. I find that it helps me with the down times, and this one is IMPORTANT if you are bi-polar, the times when I am dangerously happy and might as a result do stupid things.
posted by Katjusa Roquette at 7:19 AM on August 4, 2011 [1 favorite]

Thank you, all of you for sharing.

I've mentioned in the past that Mrs Arcticseal has depression, it runs in her family, and she's lost family members due to it. I had no experience of it until we'd met so I wasn't set up to deal with it when it first manifested. My parents had no skills for coping and weren't helpful - "Just smile!". But together we coped and she's doing well. I've learnt some and I'm still learning, and I'm there to help her and spot the signs when it deteriorates.

What galls me is the stigma mental illness still labours under and the failure of society to recognise depression as a serious medical condition.

Jessamyn's mantra of us all fighting our own battles has struck a chord with me and it keeps me mindful of others. Hugs to you all.
posted by arcticseal at 7:51 AM on August 4, 2011

"How about, "So go ahead then. Do it."

Please expand, what does this mean?

I think it means, "go ahead and kill yourself." Implying that otherwise, it's not really depression.

Right. That's meant as an example of what would be an insensitive response to someone with depression.

I am depressed to the point of getting a cat to feel I had someone who gave a fuck about my existence (and then got a second cat because I felt I wasn't good enough company for him), to the point where I have to hide in my house because I'm afraid I will come up with a way to die if I leave my bed and I so desperately want to live.

I think dogs work better than cats for this. Hope you feel better.
posted by knoyers at 8:26 AM on August 4, 2011

I was diagnosed with bipolar disorder at 25, but for years before had thought to be suffering from depression - I've been on meds of one kind or another since I was 18 years old, and become good at hiding it.

In my third year of my degree, I moved back into halls of residence (dorms) thinking it would make life easier, but being with younger people whom I didn't know or had anythign in common with didn't help, and I became quite withdrawn. One day I plucked up the courage to offer some kind of explanation, feeling that one was needed. 'I've been feeling very depressed recently.' She shrugged and said 'Oh well, probably just the weather.' She was studying medicine; I wonder if she;s a GP now, and whether she can tell the difference between everybody's ups and downs and someone minimising clinical depression in an effort to seem normal.
posted by mippy at 9:51 AM on August 4, 2011

whether she can tell the difference between everybody's ups and downs and someone minimising clinical depression in an effort to seem normal.

How would she be able to tell?
posted by small_ruminant at 9:54 AM on August 4, 2011

How would she be able to tell?

One great way for a clinician to understand more about their patients is to talk to them. Ask them questions, don't just let them talk and then go, "Oh, it's probably just the weather, you need to buck up."

My grandmother's doctor did a lot of the "it's just the weather, you just need to get out more" kind of stuff. Then Grandma switched doctors and her new doc listened, asked Grandma how long she'd felt down, asked about family history, went over her chart and asked clarifying questions about previous issues, walked her through the Burns Depression Index questions, and then offered to talk about treatment options for depression ranging from medication only to medication combined with therapy sessions to no medication and a more managed diet/exercise/therapy plan.

I know, not every medical professional has the time to do all of that with each patient. But isn't that a big part of the problem itself?
posted by palomar at 10:06 AM on August 4, 2011 [4 favorites]

Being 'normal' is as much a construct of our brain chemicals/patterns/whatever as being depressed.

Maybe I'm misunderstanding what you're getting at, but I would disagree that normalcy (i.e., non-depression) is "as much a construct" as (the implication seems to be) depression. The term "normal" in and of itself implies freedom from impairment, healthiness, and a usual, default state -- a state that most people enjoy, whereas the ones who don't enjoy it are the exceptions. If well-being is only a construct, then nobody is normal, and nobody is depressed, either.

Change places with me for a month or a year and see if you continue to believe that normalcy and depression are simply constructs.
posted by blucevalo at 10:37 AM on August 4, 2011

One great way for a clinician to understand more about their patients is to talk to them. Ask them questions, don't just let them talk and then go, "Oh, it's probably just the weather, you need to buck up."

Oh, certainly. Somehow I thought you were just fellow students or something.
posted by small_ruminant at 11:02 AM on August 4, 2011

Somehow I thought you were just fellow students or something.

Oh, I'm not the person who made the original comment, I was simply responding to the question.
posted by palomar at 11:03 AM on August 4, 2011

"Put on some lipstick. You'll feel better if you look better."

No really.

I spent what Mr. Sophie1 and I refer to as "My Year in Bed". Neither of us "believed" in therapy or medication (it was great for other people, but not for us) and we were very adamant about it until my husband finally told me that if I didn't see someone, he would take me himself.

I probably had undiagnosed depression for 20 years. I've been in treatment for that and an eating disorder for the last 8 years. I have easily had some of the best times of my life in these last 8 years. I wouldn't be so bold to call myself cured by any stretch, but it has been years since I thought about the wall that I had chosen to drive into (which wouldn't hurt anyone but myself).

I don't know what to say to anyone else who suffers from major depression except, "Me too."
posted by Sophie1 at 11:31 AM on August 4, 2011 [1 favorite]

Speaking to the "everyone has it better" idea; I know there have been a number of articles written lately about how facebook has enabled a new era of "keeping up with the Joneses," and the impact of generally rosy (if not embellished) status updates. To that end, as I've said before, I take ample opportunities to talk about some of the negative things in life, as well as depression itself (including posting these two links). Sometimes, I get a helpful reply, and sometimes, just sometimes, I reach out to someone who didn't know anyone else felt the way they do.

I do really appreciate this thread. I wish I could sit down and talk with each and every person who shared their experiences here, to just listen to your stories, your thoughts, and your feelings for a bit. Hugs available on demand. Somewhere remote, somewhere quiet, where it's just the two of us and the sound of the rain. No, I don't think it would fix anything, but as said above, whatever gets you through. Sometimes, you just wanna put the world on pause. Sometimes, you just want to get out of yourself, because it's not a pleasant place to be.

(And yes, I'm an actor.)
posted by Eideteker at 11:57 AM on August 4, 2011 [5 favorites]

Great thread, folks!
Just like to comment on number one of list one.
TV and internet make the concept of little pick-me-ups for depression easily testable.

Normal person (I assume): take the night off for some lolcats, sitcoms, flash-games, and porn to ease your nerves.

Me when depressed: 4-5 days of doing the absolute bare minimum to not lose my job and apartment (sometimes failing) while spending every other fiber of my being restlessly scouring the internet for something to distract me from crushing feelings of guilt and impotence.
posted by es_de_bah at 1:38 PM on August 4, 2011 [10 favorites]

Maybe the thing you say to a depressed person is to just be honest about the reality of your life. I've spent this whole thread going, "You mean it's not just me?" It doesn't help to know other people are suffering, but it does help to know all this shit I'm going through isn't just because I'm a uniquely awful mess.
posted by Space Kitty at 1:43 PM on August 4, 2011

buteo, this. I am pasting this on my fridge - this is me. Maybe you didn't mean the humor, but I hope you don't mind if I grin. I so need to laugh at myself more.

Go for it. I realize it sounds absolutely ridiculous when I type it out but it was such a real concern for me at the time! Shows how depression can really mess with your perception.

I think dogs work better than cats for this. Hope you feel better.

No room for dogs in my apartment and no time in my life for one. I have looked into getting a psychiatric service dog just so I can take them everywhere with me (thus having time for them and room for them) but keep convincing myself I'm not sick enough for one.
posted by buteo at 1:43 PM on August 4, 2011

If well-being is only a construct, then nobody is normal, and nobody is depressed, either.

Well, normal only means what is most usual. A stable, mostly hopeful, non-suicidal frame of mind is more usual or common when all things are equal than one that isn't, which is why it is considered 'normal'. If it wasn't like that the human race would struggle to continue.

But that state of mind happens as a result of brain chemistry, same as depression. So it's not so much a question of asking people 'snap out of it' as to 'snap into it'.

The point I'm trying to make is that every brain state is just a state, and therefore on a spectrum. The idea that there is a default 'normal' that can be reverted to if only people could just get over themselves isn't the right way of looking at it.

Change places with me for a month or a year and see if you continue to believe that normalcy and depression are simply constructs.

I'm not quite sure what you're trying to say. I'm not trying to downplay the horribleness of depression. I'm trying the say that the 'snap out of it' people wouldn't say that if they gave more consideration to how easily their own 'normality' could dissolve and how powerless they would be to change anything if that happened.
posted by Summer at 1:47 PM on August 4, 2011

I'm trying the say that the 'snap out of it' people wouldn't say that if they gave more consideration to how easily their own 'normality' could dissolve and how powerless they would be to change anything if that happened.

That's how I read your original comment as well, Summer. It makes depressive people less of an "other" if more people understand their tenous grasp on "normal."
posted by sweetkid at 2:06 PM on August 4, 2011

"How's your day been?"

Boyfriend, ten minutes ago, over the phone, from tens of thousands of miles away.

me: "Ah... um" (I've described my horrible, monotonous, isolated, futile, soul-sucking days to you how many times already?) "well, I went swimming" (baseline sanity-maintaining activity, the days I don't do that are basically a lost cause.)

Yes, every so often I have a good day. No, the pressure to come up with a story of a day I might imagine a semi-human being to have had does not help. But hey, I feel much better now. Certainly better than if we'd talked about something interesting, or something stupid the dog did, or...
posted by tigrrrlily at 4:47 PM on August 4, 2011 [1 favorite]

I'm trying the say that the 'snap out of it' people wouldn't say that if they gave more consideration to how easily their own 'normality' could dissolve and how powerless they would be to change anything if that happened.

I misread what you were saying -- I apologize for my misunderstanding.
posted by blucevalo at 6:57 AM on August 5, 2011

but its the depression that makes the problems depressing, not the other way around.

it's our eyes that make light, not the other way around.
posted by cupcake1337 at 11:07 PM on August 5, 2011

Thank you for posting this thread and thank you to everyone who shared their stories and made it possible for me to try to bring about positive change for myself and anyone who wants or needs to understand Depression.

Basically, the sentiments expressed here, the obviousness that my experiences aren't solitary and isolated inspired me to "come out" as mentally ill to my community of gaming friends. It took a lot out of me to say these things where anyone with an internet connection could see and judge me, but less than a day later I've had people show new understanding of what exactly Depression is and the reality of living in that state constantly, so I consider it a win.

I really value the community at Metafilter. You all have helped me through several crises simply by virtue of your existence and my ability to read what you say, so I wanted to share my coming out letter here, in the hopes that it might help someone else. Whether its someone like me who suffers the illness themselves and might need to draw strength and inspiration from others to cope, or simply someone looking for a clearer perspective on what their loved one is going through, I want to try to contribute and help achieve understanding.

Here is the letter, posted on my gaming community's forum. Maybe it will help someone, maybe it won't, but the only way it has a chance to do so is if it's passed on. So please, by all means, if you find what I wrote helpful in any way, spread the word. As daunting as the idea of coming out like this was, now that its done I want this small effort to benefit someone else too, if it can.

Thank you for your consideration, and Be Well.
posted by Rstriker69 at 1:47 AM on August 6, 2011 [6 favorites]

France, U.S. Have Highest Depression Rates in World, Study Suggests
posted by Obscure Reference at 5:38 AM on August 6, 2011

To the ladies who get bad depression with PMS, there's now a name to this - Premenstrual dysphoric disorder. You are not alone!

I've found that anti-depressants + birth control pill continuously (no sugar pills) has helped a great deal. (Plus no period!)
posted by evening at 4:40 PM on August 6, 2011 [1 favorite]

I love how the most unhelpful statements are mostly from the medical community. I've experienced it too.

When I was on Wellbutrin long ago and did a tilt table test for my dizziness, the two techs looked at me and said "depressed? What the hell do you have to be depressed about?"

And most recently, every trip to the ER (3 of them), if it wasn't the nurse saying it's probably in my head it was the ER docs. Sorry doc. I DID overhear you say I'm "histrionic" because you know, "she's on Prozac".

Nice.
posted by stormpooper at 7:57 AM on August 8, 2011