The Elephant In My Head

I don't know when the flame went out. It was something that happened gradually. So gradually I didn't notice until it was too late. So gradually, I didn't notice the increase in nothingness that had become my life until I realized I was staring blankly at my computer screen, feeling none of the passion, the happiness, the creativity that used to envelope my mind with bursts of color and sound. Reading became a gray scale movie stuck on mute, a ghost of the effervescent dreams that would swim 'round and 'round my brain, bursting at the edges and flooding beyond the pages. The notes on my music sheets no longer danced around with glee, no longer enticed me to translate the black and white to vibrant sound that pierced the soul. Instead I watched from my mind's cage as the world around me withered into a fuzzy shadow of what used to be. It taunted me with small bursts of color, but they were always too fleeting to grasp. After a while I stopped acknowledging even those small bits of color, succumbing instead to the darkness.

Depression is not romantic, as poetic as my descent into madness may sound. It is not fun. It is not something a 13 year old expects or even wants to face when dealing with the scary place that is life. Yet that was what I found myself facing, not knowing at the time what it was or even how to deal with it. I knew something wasn't right, but my own confusion and anger prevented me from reaching out. Instead I shoved it down, bottling it up and letting the pressure build until I cracked.

There is no happy ending to my story. No magic pill made everything better, though it sure took the bite off those exceptionally hard days. No single moment catapulted me out of depression. Instead I was stuck with years of gritting my teeth together, bearing the pain and hoping for each day to be better than the previous. Some days I succeeded in my goal. Others left me feeling hopeless and tired, a worthless being, paralyzed by the degrading thoughts in my head. Eventually I looked back and realized that my tiny steps had finally gotten me out of the worst part of my own darkness, and my world was slowly returning to color.

Those few years it took for me to figure out coping mechanisms are years I do not go back to. I am so far removed from that time, I've forgotten the finer details about hitting and staying on rock bottom. My memories are permanently skewed towards the positive things I latched on to and continue to cherish to this day. The Liz that people describe from those years is a complete stranger to me.

With all the progress I've made, I still cannot say I have beaten my depression. Unfortunately, it's not something I get to beat. It's a daily struggle, where some days I'm allowed to win and other days I have to concede a loss to the hardest opponent of them all: myself. Where I did win is in my ability to say I have never returned to those dark times where (dare I say the word?) suicide seemed like my only out. 

In the ten years since those fateful days, I have seen and experienced the stigma that surrounds depression. It is one of those invisible illnesses that leaves the afflicted on an island, where the ocean that surrounds you is others' misunderstandings about what you're going through. I have been accused of faking it, told to just get over it, and been scoffed at by the very people I thought I could open up to. One of my friends just recently told me all I have to do is "not think about it" and "stop being so pessimistic." 

What is the best way to combat these misunderstandings? Education.

What is depression?

The National Institute of Mental Health defines depression as:

Depression (major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks.

 Some forms of depression are slightly different, or they may develop under unique circumstances.

• Persistent depressive disorder (also called dysthymia) is a depressed mood that lasts for at least two years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for two years to be considered persistent depressive disorder.
• Perinatal depression is much more serious than the “baby blues” (relatively mild depressive and anxiety symptoms that typically clear within two weeks after delivery) that many women experience after giving birth. Women with perinatal depression experience full-blown major depression during pregnancy or after delivery (postpartum depression). The feelings of extreme sadness, anxiety, and exhaustion that accompany perinatal depression may make it difficult for these new mothers to complete daily care activities for themselves and/or for their babies. 
• Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations). The psychotic symptoms typically have a depressive “theme,” such as delusions of guilt, poverty, or illness.
• Seasonal affective disorder is characterized by the onset of depression during the winter months, when there is less natural sunlight. This depression generally lifts during spring and summer. Winter depression, typically accompanied by social withdrawal, increased sleep, and weight gain, predictably returns every year in seasonal affective disorder.   
• Bipolar disorder is different from depression, but it is included in this list is because someone with bipolar disorder experiences episodes of extremely low moods that meet the criteria for major depression (called “bipolar depression”). But a person with bipolar disorder also experiences extreme high – euphoric or irritable – moods called “mania” or a less severe form called “hypomania.” 

Examples of other types of depressive disorders newly added to the diagnostic classification of DSM-5 include disruptive mood dysregulation disorder (diagnosed in children and adolescents) and premenstrual dysphoric disorder (PMDD).

What are the signs and symptoms?

• Persistent sad, anxious, or "empty" mood 
• Feelings of hopelessness, or pessimism
• Irritability
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in hobbies or activities
• Decreased energy or fatigue
• Moving or talking more slowly
• Feeling restless or having trouble sitting still
• Difficulty concentrating, remembering, or making decisions
• Appetite and/or weight changes
• Thoughts of death or suicide, or suicide attempts
• Aches or pains, headaches, cramps, digestive problems without a clear physical cause and/or that do not ease even with treatment

Depression manifests itself differently in every person. Some experience only a few symptoms, while others experience many.

What causes depression? What are the risk factors?

Depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors.

Risk factors include: 

• Personal or family history of depression
• Major life changes, trauma, or stress
• Certain physical illnesses and medications

 How is depression treated?

Depression, even the most severe cases, can be treated. The earlier that treatment can begin, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two. If these treatments do not reduce symptoms, electroconvulsive therapy (ECT) and other brain stimulation therapies may be options to explore.

For more information about depression I recommend Beyond Blue (this website is Australia based, but still provides excellent information), and the National Institute of Mental Health.

If you are experiencing thoughts of suicide, please visit this website which provides phone numbers for a number of locations across the world.

October is depression awareness month. Green is the color for depression awareness, so expect some green themed posts from me.

For those of you reading this who suffer or have suffered from depression, know that you aren't alone. You don't have to stay silent. You are loved. Do not be afraid to reach out.