“That’s just the depression talking.”
If I had a dime for every time someone has said that to me this year, I might be able to pay my out-of-pocket hospital bills off by next week.
Blog readers know that the last several months have been a little rough. A back injury keeps putting my opioid-intolerant, claustrophobic ass in the MRI tube. I did a month of physical therapy and then ended up in the ER, and then a surgical center. I’ve been knocked out twice with propofol, and treated with steroids, fentanyl, liver-sizzling doses of ibuprofen, diazepam, ketamine, gabapentin, and who knows what else the nurses shot into my IV’s when I was groggy and/or out of my mind with pain. I also tried a chiropractor and massage, and politely declined offers of marijuana, acupuncture, Reiki, and homeopathy. Just as I was realizing that my back was still in serious trouble, all the hospital bills started to arrive.
“Just hang in there.”
I’ve been depressed as long as I can remember. So, especially since my intrepid pain specialist reduced my treatment to a bottle of Valium and the statement, “you just have to hang in there,” an agonizing, expensive, months-long medical ordeal doesn’t seem like a temporary annoyance. It seems like the latest good reason to die.
According to the website of the American Foundation for Suicide Prevention‘s (AFSP) Out of Darkness Overnight campaign, over 38,000 people die by suicide every year — the fourth leading cause of death for people ages 18 – 65 in the US. Over 100 people kill themselves every day, though the number of people attempting suicide is much higher. More men die by suicide, but more women attempt it. Over 60 percent of people who succeed in killing themselves have major depression, AFSP goes on. Depression is more common than cancer and coronary heart disease: about 15 percent of the population will suffer clinical depression at some point in their lives.
Though AFSP says depression is an extremely treatable psychiatric illness, with up to 90 percent of people who get treatment feeling better, the really scary thing is that, by AFSP’s count, 30 percent of depressed people attempt suicide, and half of those die.
That’s part of why I hate it when people say, “that’s just the depression talking.” To me, this common phrase, probably intended to help depressed people halt their pathological thought patterns, trivializes the seriousness of clinical depression.
Depression is an illness
Take meningococcal disease. It’s much less common than depression, with about 800-1200 Americans getting it every year, according to the National Meningococcal Association, but it can be dangerous, with a mortality rate of 10-15 percent. When a person with meningitis says his neck hurts, would you tell him, “That’s just the meningitis talking”? No? Well, the AFSP estimates that depression is fatal in 15 percent of cases, and if those patients are anything like me, they often hear, “that’s just the depression talking.”
A lot of people know what depression is really like, and a lot of people don’t. Clinical depression can make your eyeballs feel like the Hoover Dam, as you fight back tears all day. It’s a long, black, consuming, sour-molasses conviction that you’re worthless, no-one can help you with anything that matters, and that things will never change. It’s the certain knowledge that people love you because they’re deluded. The simplest choices swamp you with confusion or indifference. It’s dull headaches and a silent static roar that, if you forget to concentrate, can block out what other people are saying.
Depression is a different experience for different people. Some people lash out, some people seem sunny and social but sob every time they’re alone, some people have physical pain, and some people are immobilized by the misery. For me, depression manifests with an obsessive achievement drive, and that’s probably why no-one, not even me, had a clue anything was wrong until I was almost done high school. Who would be concerned about the straight-A student buried in extracurriculars? Today, my depression still doesn’t fit the stereotype of the person who can’t bathe or go to work. Rather, it drives me to keep working at all costs, and in that sense, it might fuel my career rather than hinder it.
Being depression’s dummy
Despite its treatability, depression is one of the most insidious conditions there is. If you have plantar fasciitis, you don’t mistake the pain in your feet for your personality. But depression affects how you feel, think, and speak. When you’re depressed, others can be annoyed or alarmed by the sad or hopeless things you say, or your apparent refusal to take their advice or turn your thinking around. They try to bust you out of your mental funk by saying, “That’s the depression talking,” as if the illness has turned you into its own ventriloquist dummy, and you can shake off that nasty puppeteer just by recognizing the problem.
But in my experience, telling someone, “that’s just the depression talking” doesn’t work any better than saying, “that’s just the appendicitis talking” when your friend has a really, really bad stomachache. This phrase implies that the sufferer can control her symptoms, or, in other words, that she’s choosing to be sick, or choosing to let her illness “speak” when she could and should be silencing and overcoming it.
“I think you are just used to the depression and want to hold on to it,” a friend concluded recently. “Do you really want to stay depressed? Why?”
It’s hard enough to cope with depression, but when others suggest that you brought it on yourself, or chose a bad mindset, it’s devastating, and can prevent people from seeking help, for fear of being judged.
And if you’re gearing up for the comments section to tell me that getting treatment IS my responsibility, just as it would be with any other illness, you’re right, it is. I am in treatment — the treatment that is best for me right now, after years of experience with many psychologists, psychiatrists, medications, and alternative strategies.
My therapist asked me a very perceptive question recently when I mentioned interacting with readers whose opinions are different than mine, or who insult me, or tell me I should keep quiet because they don’t like my arguments.
Deftly looking past an inherent morass of emotions, she simply asked, “How does it feel to have a voice?”
Later, it occurred to me that my writing career might not be the love affair with language that I always assumed it was. It might be something deeper that my early years often denied me: the opportunity to recognize and speak up honestly about the sad, unfair, painful, infuriating, bizarre, and hilarious things in our lives.
However I’m feeling, I have a voice.
So that may be the worst thing about opening up to someone else about how sad or hopeless or worthless I often feel, and having them answer, “That’s just the depression talking.”
Depressive feelings are still feelings
I understand the value of separating your sense of yourself from the symptoms of the illness. When you’ve been depressed for a long, long time, you wonder if being miserable on the inside is simply part of your personality. People who love you want you to realize that it isn’t.
But if all people can do is point out that “the depression is talking,” they’re simultaneously personifying the illness and downplaying the feelings it causes. Just because a feeling is a clear symptom of depression doesn’t mean it isn’t real to the person experiencing it.
So how do you cope with a depressed person? After writing all this about depression don’ts, you’d think I’d have a clear answer about what works, but I haven’t found it yet. It’s probably different for everyone. And I’m starting to suspect it’s almost as hard to live with a seriously depressed person as it is to be depressed yourself.
I would say that there is an immense courage in being able to really hear what other people say, even if their state of mind is frightening. Many of my family members are good at this. “Think about how I can help and then let me know. There is no feeling you have that scares me. I can hear it all,” one wrote on a very dark night. That kind of openness, without judging or personifying the illness, is a lifeline.
Others succeed simply by saying they care about me and that they’re concerned, and asking if I have a doctor or psychologist to talk to. They don’t judge. They don’t deflect or minimize. They just tell the truth: I could use help and there’s no shame in getting it.
Anytime I admit my fight with depression in public, I worry it will cost me in a competitive field, but I also think that many others are silently struggling and would benefit from an open conversation (and sometimes I feel like career writers who have never been depressed are few and far between). I appreciate this essay by a journalist who decided to make his journey with mental illness public. He says that if every newsroom had a “mental patient,” maybe the media as a whole could help reduce the stigma of mental illness.
For anyone who has ever been depressed or loved someone who was depressed, Allie Brosh’s “Adventures in Depression” and “Depression Part Two,” from her “Hyperbole and a Half” blog (now a book) are a raw, funny, and soul-soothing read. You can also listen to Brosh’s Fresh Air interview with Terry Gross, which helped me with the idea that it’s ok to talk about depression while you’re still in the mess of treating it.
Have you ever been depressed? What are the things that hurt or helped you?
This blog is for depressed and non-depressed readers alike. Hit the bottom of the page to subscribe.