My relationship with depression is a complicated one. I have, clinically speaking, been grappling with it since I was a teenager; I was diagnosed for the first time at 15, and then again in my early twenties, and then again by my current therapist a little less than a year ago. The question of how long I've known I suffered from depression, however, is where things get a little hairy — I thought it was laughable at 15, and considered it a misdiagnosis at 20. It's only in the last year that I've really looked the thing in the face, accepted it as part of my life, and started to consciously do the work involved in keeping it under control.
A few months back, I wrote an article here on Vox about the 9 things I wish people understood about anxiety. I was comfortable writing that piece, because after a lifetime with generalized anxiety disorder and five years actively wrestling with how best to manage it, I feel like I really understand anxiety: its ins and outs, its ups and downs, the shape and size of the thing. I like to think that some day, I will be able to write that sort of article about depression. I like to think that some day, I will know this piece of myself that well.
Today, however, is not that day. Depression and I are in a much more tenuous place with one another. I am still learning its landscape, and it is still surprising me, tripping me up, and shaking the foundations of things that I once thought I knew. I can't tell you what I wish people understood about depression because I myself don't fully understand it yet, and I can't imagine delineating a list that I myself am still struggling to learn. So, instead, here are nine secrets I've uncovered about depression in experiencing it, which no one told me about, and which I never could have anticipated going in. They may not be secrets to everyone, and I hope they don't stay secrets to anyone for long, because knowing each one of them has helped me through this process.
1) Depression is a liar
If I had the power to put anything on television, it wouldn't be a channel that showed nothing but Boy Meets World reruns. It wouldn't be a ticker that ran along the bottom of the screen during sporting events with the text of the Harry Potter novels in it, so that those of us who hate football would have something to do in sports bars. No, it would be a 15-second spot, airing during every single commercial break on every single channel, that said: "If you have depression, it is lying to you." Because it is. Every moment of every day, in your waking and sleeping hours, depression is telling you lies.
Here is a small sampling of the lies depression has told me over the years: you're lazy. You're worthless. You're never going to amount to anything. If you ever do amount to anything, it will be a complete fluke, and not the result of any work, skill, or talent on your part. Your family hates you. Your friends hate you. Your family and friends don't hate you, but they would, if they knew what you were really like. You're rotten. You're stupid. The very core of who you are is garbage. The people in your life would be better off without you. The world at large would be better off without you. Nothing you do matters. Nothing you say matters. Nothing at all matters, except how terrible you are, which matters more than anything else could ever matter. You suck. You suck. You suck.
Today — to be strictly accurate, at the moment of writing this article — I know that these are lies. I know that they're lies because I've spent a lot of time in therapy learning that they are lies, and that depression is a liar, and that the things your brain spits at you when it's in a depressive period are lies the vast majority of the time. But when I'm depressed, I really, really believe these things are true. In fact, if during a future depression I were to come back to this article and stare at it, I can promise you I would think, "What was I talking about? Those aren't lies — in fact, that's the truth. The idea that those things might not be true — that's the lie."
2) Depression is a bully
It's a sneaky, manipulative bully. Not only that — it's a sneaky, manipulative bully that knows all your weaknesses and tender spots, and has at its disposal an arsenal of every uncomfortable moment, rejection, embarrassment, and emotional wound you've ever sustained in your life. It is, to put it simply, that kid who throws rocks at other kids on the playground.
I was lucky enough to grow up with two emotionally intelligent parents. They taught my brothers and me that bullying, more often than not, comes from a place of unhappiness. And of course depression is, in a number of ways, unhappiness given a name and a medical classification — it makes sense that it would have so much in common with that type of personality. But the thing about bullies is that the common wisdom about them often proves false. "Sticks and stones might break my bones, but words will never hurt me," for example, has been thrown around for generations, but most people I know (myself included) would happily trade a wallop with either object for the erasure of certain words from our personal histories. Likewise, the "just ignore it" theory, regularly presented as the solution to a bullying personality, is virtually useless advice when it comes to fighting depression. Depression does not want to be ignored; it wants to be in charge, and it will take advantage of any opportunity to gain ground. Left unchecked — indeed, ignored — depression can sneak and manipulate its way into the deepest recesses of your brain, becoming that much harder to eradicate.
Which is why:
3) If you think you might be depressed, you have to tell somebody
I know, I know — this isn't a secret. You've heard this one before. So have I: as part of anti-suicide campaigns, or scrawled at the bottom of pamphlets with things like "There Is Hope For You" written on the cover. I have to mention it anyway, though, because of the thought I've always had in response to the "tell somebody" advice: "It doesn't apply to me."
See, one of the complicated things about depression is that it comes in a variety of types and severities. The most visible types are the ones that can put people at high suicide risk: severe bipolar disorder — which can jerk people from manic highs to frightening lows — or an intense bout of clinical depression, which might drop someone so deep into what I think of as "the pit" that without seeking immediate help, they could be in very real danger of hurting or even killing themselves. And, of course, if you suspect that you or a loved one are at high risk for self-harm or suicide, you should absolutely tell someone at once. I don't for a second mean to suggest that that isn't the case. Tell your family! Tell a therapist! Don't tell me — I'm just a girl on the internet with some lived experience, and I make no claims of being a professional — but definitely, definitely tell someone.
Having said that, though, for a lot of us, depression isn't — or at least doesn't feel like — something that makes us high-risk for suicide. What I have, for example, is moderate clinical depression, linked in to my generalized anxiety disorder. It's the kind of thing that might slow me down or even stop me in my tracks, but it's never pushed me to a place where I was in danger of seriously harming myself. And that fact — the fact that I'm not thinking about killing myself any time soon — has, more than once, given depression an avenue to keep me from getting help. It has allowed thoughts like, "You're not depressed enough for it to really count," or "This is something you should be able to handle on your own," or, "Nobody wants to be bothered with your problems," or, "When they say you should tell someone if you think you're depressed, they're not talking to you."
I am here to say: if you think you might be depressed, then I am talking to you. Whether mild, moderate, or severe, depression is not something you should be trying to handle on your own. That's not, by the way, because you're not strong enough, or smart enough, or anything enough to deal with it by yourself — it's because depression distorts your thinking, and to sort through something that distorts your thinking, you need help that does not live inside your own brain. You need an ally that your depression does not have the power to affect. You need an objective party, and when you are depressed, thinking about yourself in an objective way becomes incredibly difficult.
4) Suicidal thoughts aren't always part of depression, and even when they are, they're not always active suicidal thoughts
An active suicidal thought might look something like this: "I wish I was dead, so today/tomorrow/next week/next month, I'm going to overdose on enough pills that I don't have to continue being alive." Active suicidal thoughts involve intent, even if it's intent to do something a long time from now. They involve a plan, even if it's a vague plan. They're what people think "suicidal thoughts" mean, and they're not wrong, exactly. It's just not the entire definition.
The other variety of suicidal thoughts looks more like this: "I'm going to go to sleep, and I hope that I don't wake up tomorrow," or, "Man, if I just jerked the steering wheel a little to the left, my car would flip over the highway partition and I could stop living — wouldn't that be nice?" These are what are called passive suicidal thoughts; there's no real intent behind them, and there's not necessarily a concrete plan involved. They are, in essence, fantasies about dying, which crop up because depression has made the idea of dying more appealing than the idea of continuing to be alive. I won't lie here, though I'd honestly prefer to: though I've never been in danger of truly harming myself, I've experienced passive suicidal thoughts alongside depression many times over the years. This type of thought is not as dangerous as the active type, of course, but that doesn't mean that it's not dangerous, because the one can lead to the other. Enough passive suicidal thoughts, built up over time, can become an active one.
Having said that, depression is often reduced — even in the minds of the depressed — to, essentially, the suicide disease, and that's neither accurate nor helpful. Some of us never experience suicidal thoughts at all; some of us have only ever experienced the passive ones I just mentioned; some of us have experienced active suicidal thoughts, but they've been few and far between.
Regardless of the volume of these thoughts, treating a friend or loved one who has told you they are depressed like they are automatically a suicide risk is often a mistake. For one thing, if a depressed person knows you are worried about that, they may be afraid to talk to you, or think that mentioning it would be burdening you, in the event that those thoughts do crop up. And, of course, there is the fact that the person underneath the depression — the person that depression is lying to, bullying, and bossing around — is probably very, very frightened of both the idea and the reality of suicidal thoughts. Having a part of your brain wishing you would die, whether actively or passively, is really scary, and it can be incredibly exhausting to have to comfort others on that subject when you're already struggling to comfort yourself.
5) Depression and sadness aren't (always) the same thing
Don't get me wrong — they can be. Certainly depression can bring with it bouts of sadness and despair. Certainly, when depressed, things that might not bring you down otherwise can sink you into a dark mood. Depression once made me burst into tears of anguish over a Simple Plan song, so trust me, it can find the melancholia in almost anything. But more than sadness, more than despair, the word that really characterizes depression is numbness. Depression takes your feelings and bottles them up, only to release them without warning in unpleasant, incongruous bursts. When you're depressed, you tend to bounce between feeling so much you think it might tear you to pieces, and feeling absolutely nothing at all.
The way that I always think of it can be sourced back to Terry Pratchett, the author of a number of my favorite novels. He brings up this paradox in a few of his books: "Open the box with the crowbar you will find inside." That's what the numbness portion — by which I mean, the vast majority — of depression is like. Your emotions, normal reactions, motivations, positive thoughts; these things are inside of a box, and also inside of that box is a crowbar with which the box can be opened. It's a frustrating situation, although, of course, it doesn't feel frustrating when it's happening, because your ability to feel frustrated is inside the box with everything else. Instead, you mostly feel like it doesn't matter, because you mostly feel like nothing matters.
6) You can be depressed without knowing it
Yes, it's counterintuitive. Yes, it sounds impossible. Still, the fact remains that it's true. The thing about the overwhelming numbness of depression, the constant certainty that nothing at all matters, is that it can blind you to changes in your mood and behavior. Even if you're tracking those things, if nothing matters, then they don't matter either. I've been depressed, more than once, without having any idea that that's what was going on. I've also realized that I was depressed in the middle of periods of depression, rather than at the beginning, and only realized the full extent of things in looking over the weeks and months prior.
The people in your life can be hugely helpful on this front, especially if they know what to look for, because:
7) Depression can be visible
It can also be invisible, of course, but the idea that it's always invisible is just not accurate. Depression often erodes one's abilities to complete basic tasks that wouldn't be a problem in a healthier, less depressed period, and personal care and hygiene are very much included in that list. When I get depressed, my clothing, hair, and physical appearance all tend to suffer, not to mention the cleanliness of my apartment (which I must admit is not what you'd call spotless at the best of times).
If you're someone who knows they are prone to depression, taking the time to sit down with the people in your life and ask them to keep an eye out for this kind of slippage can be really, really helpful in catching a depressive period before you're all the way at the bottom of the hole. Conversely, if there's someone in your life you know is prone to depression, it can be good idea to keep this point in mind. I'm not, of course, advocating screaming, "YOU'RE DEPRESSED!" in someone's face if you notice that they're not looking fantastic one day. But in the event that you see slippage for a few weeks at a time, it may be worthwhile to (gently, kindly) ask them if they are feeling all right, and if there is anything you can do to help. It can be really, really difficult for a depressed person to reach out and ask for help — remember, depression is a liar and a bully, and often insists that to ask for assistance is selfish and wrong. Your taking that first step can mean the world to someone who is struggling.
8) Depression responds to routine and structure
No, really. It does. When you're depressed, it doesn't feel like it's going to. When you're depressed, the idea of maintaining any routine, following any structure or, indeed, getting out of bed often feels borderline insane. But the fact remains that this is true. Conversely, long periods without routine and structure can be depression's breeding ground; this is why unemployment and depression are common bedfellows.
I'm not, by nature, someone who is much for either structure or routine; in fact, if I'd been born neurotypical, my life might well be a nomadic one where I followed my whims, or the remaining members of the Grateful Dead, or both. As it is, I've figured out a variety of little routines and structures that I can apply to my days, weeks, and months, and which help immensely in keeping my head above the depression waters. I'm not going to detail those routines here, because depression management is a very personal thing, and works a little differently for each person. But it is manageable.
9) Depression is not the end of the world
It'll do its best to trick you into believing it is, but that's just another one of its lies. The truth is, depression is a pain, both figuratively and literally; it can be dangerous and frightening; it can slow down or even stall out your life for a while; it can be hard to deal with, overwhelming, and upsetting. But it's not the end of the world. It's just something that requires some careful thought, awareness, and management — in other words, it's something that requires some work. The trick, at least in my experience, is knowing that it's doable work, work that you are more than capable of handling, no matter what your depression tries to tell you. And, like all work, it gets easier the longer you do it. The incomparable Allie Brosh wrote a two-part post on depression a few years ago, which was then and remains to this day the best explanation I've ever seen on this topic; it's sharply funny as well as being searingly honest, and I highly recommend reading it. It truly illustrates the whole of the thing — the way there is struggle to this, but hope too, and levity even where you're not expecting to find it.
As for me: today, right now, depression is still hard work, but it's not the backbreaking effort it was a few years ago, or even the uphill climb it was a few months back. Some day, I truly believe that managing it will be no more difficult than, say, feeding myself, or keeping my unruly hair in check — daily tasks that, though not effortless, I mastered years ago, and even take some pleasure in doing these days. Until then, I will continue to strive and struggle, succeeding in some moments and failing in others, and taking heart in the fact that I am far from alone. That's no secret, but it bears repeating: no matter where you are in the process of figuring out depression, you are not alone.