Firstly, I would like to preface this post by saying that although I have experience of depression myself, I could not possibly pretend to understand someone else’s experience of depression – particularly if they are in the thick of it. I don’t think anyone can understand depression. To understand it, you have to be rational which you simply aren’t when you’re depressed. You can only try and understand it from afar.
This article is intended to be emotional and anecdotal, NOT clinical.
Most of this advice is a combination of personal experience (my own is detailed in the next post in a spoiler), the concerns I’ve seen cropping up on TSR, an informed medical knowledge and reading around the subject. I don’t claim to be an oracle. I just want to help in what small way I can. If you’re reading this you’ve probably looked at other information about clinical depression. I don’t want to just splurge the same information you can find anywhere else on the internet. Though I do want to make special mention of a book called “Malignant Sadness” by Lewis Wolpert. A link to much of the book can be found here.
What is depression?
Someone once told me that it’s human nature to be perpetually in a mild state of depression. Of course, people talk about feeling “depressed” and having a low mood – but that’s not the clinically diagnosed depression I mean.
The one definition that I found fitted my experience was: when what you have to cope with significantly out-weighs your coping mechanisms. You simply can’t shake off how you feel (“pull yourself together”, “mind over matter”, “get a grip”)
The problem with depression is that it’s often perceived as a weakness, excuse or even a complete fabrication. There is a severe modern social stigma. This also means that people do not admit readily admit that they have had depression. Because so few people speak out openly about it (remember the hoo-ha when Stephen Fry admitted to being manic depressive?) it can be criticised and taboo. I suppose in some ways the desire to be a “depression-denier” makes sense – depression at its worst is terrifying for those suffering, and also for those watching others suffer. No wonder people would rather it didn’t exist.
Of course there are those people who, as some would say, ‘flaunt’ their depression. Like I said, I’m in no position to judge someone’s experience of depression. What I will say is that if you’re clinically depressed you will generally be 1) trying to do something about it because you realise you’re no longer YOU 2) entirely in denial without realising anything is wrong. Depression’s hallmark, to me, is the lack of rational thought. Instead your rational thinking is overtaken by self-defeating and distorted logic.
What are the symptoms of depression?
There are three clinically recognized types of depression: Melancholic, Atypical and Manic. Melancholic is where people typically present with insomnia (particularly early morning wakening), and anorexia and experience severe mental anguish - in the worst cases they fail to respond to any pleasurable stimuli whatsoever. Atypical is essentially the opposite. These people oversleep, overeat and put on weight and their depression is worse in the evening. The can be temporarily cheered up by some pleasurable stimuli unlike in melancholic depression. So what symptoms you have will depend on what sort of depression you have. It is important to distinguish depression from normal mourning and grievance - everyone experiences these but they can be a trigger which leads to full on depression in some (possibly genetically pre-disposed) people.
Many of these you no doubt will have seen before
- overwhelming sadness
- thinking about negative things far more frequently
- feeling no emotion
- feeling no happiness/taking no pleasure in previously pleasurable things
- thinking about death/suicide
- crying for no reason
- disturbed appetite (eating more or less than usual)
- disturbed sleep patterns (sleeping more or less than usual)
- fatigue, loss of energy
- loss of ability to concentrate
- avoiding social interaction (don’t want to talk, can’t talk, talking is worthless)
- inability to even smile or chit chat with people
- intense feelings of guilt, nervousness, helplessness, hopelessness, worthlessness, isolation/loneliness and/or anxiety
- worsening memory
- indecisiveness/ apathy
- feeling abandoned/lonely/irrelevant
- aching muscles, tinging skin and other unusual physical symptoms
A characteristic feature of depression is the loss of interest or pleasure in almost all activities. Even when something good happens the depressed mood does not improve. Illogical and irrational thinking is also symptom and is central to the way depression works.
What causes depression?
It’s generally thought there are two types of depression:
Situational/reactive depression – external causes Post-natal depression is an obvious example but there are many other triggers: death of loved ones, extreme stress, financial troubles, unemployment, relationship problems, sexual abuse, crime victim etc. There are also some illnesses and medications that have depression as a symptom/side effect. These external causes can place a significant burden on you and your ability to cope with life. Please see the section about being a depressed student because external causes are not always these easy-to-pinpoint enormous life-changing things.
Internal causes Depression is certainly a very internal thing. There are theories that there is a genetic disposition in some people or/and that chemicals aren’t working properly in the brain. Believe of disbelieve it as you will. For some people it may be a comfort to think “it’s an illness caused by something biological, it’s not my fault.” However, depression isn’t your fault even if it’s caused by purely external factors.
What does depression feel like?
Obviously the symptoms suggest a total unhappiness. However, if you haven’t experience depression it’s difficult to imagine what that feels like. Of course it also affects different people in different ways. I can say though that it’s nothing like feeling a bit glum or miserable.
“Until one has experienced a debilitating severe depression it is hard to understand the feelings of those who have it. Severe depression borders on being beyond description: it is not just feeling much lower than usual. It is a quite different state, a state that bears only a tangential resemblance to normal emotion. It deserves some new and special word of its own, a word that would somehow encapsulate both the pain and the conviction that no remedy will ever come. We certainly could do with a better word for this illness than one with the mere common connotation of being 'down'.” – Lewis Wolpert, “Malignant Sadness”
There is a lot of romantic, metaphoric and descriptive writing about what clinical depression feels like. In my own experience: I didn’t feel like me, instead I felt out of control, terrified of the emotions I was experiencing, totally anti-social, lacking any glimmer of hopefulness or happiness. I felt disconnected from the world and other people, completely full of despair and grief yet at the same time entirely empty.
Who gets depression?
Latest stats suggest that at least 1 in 10 people will have depression at some point during their lifetime. It doesn’t discriminate, any one can have it.
Being a depressed student
As educated people, we probably expect more from ourselves in general and don’t really want to have perceived ‘weaknesses’. Being a depressed student presents unique problems. You expect yourself to be intellectual and may think you should be able to do “mind over matter” and shrug depression off. You may be thinking you’re in your prime, you’re in a relatively good position, and you should be enjoying yourself. Being able to think intelligently and see the disparity between what you think you should be and what you currently perceive yourself as being can compact feelings of worthlessness. At this point it may be helpful to point out that depression can force to you to give yourself a false logic that you convince yourself is perfectly reasonable.
There’s also the horrible and unavoidable fact that sometimes our ‘friends’ at school/college/uni won’t understand,
Financial worries, stress, workload, feeling intellectually feeble (especially in comparison to previous stages of your education), comparing yourself to the ‘success’ of others, inactivity, poor diet, ‘shallow’ happiness, peer pressure, feeling like you don’t have any security - they are all very real outside pressures. Combine this with the potential for a lot of thinking time and no wonder our mental state can become less than healthy.
What is the treatment for depression?
Various anti-depressants and talking therapy are the most common ‘treatments’ prescribed by GPs.
Often the lifting of the external cause will make a big impact on your ability to cope and you can claw yourself back from the brink. If the external cause is so severe as to contribute to depression it’s usually not something easily resolved, particularly if you’re on your own. Sharing the problem allows someone else the chance to have a think about what they can do to help. Sometimes talking is all you can do, but sometimes you can do more practical things like phone the bank or speak to your dissertation supervisor.
Medication and counselling are useful, and if you can try to take on anything external that’s great. However, depression doesn’t magically disappear. Getting rid of depression involves making some changes even if they are difficult and unappealing.
Here are some things that might help you tackle depression:
- a better diet
- more activity (running, walking, swimming, anything!)
- telling people you trust
- not drinking alcohol (you don’t need any more logic impairment when you’re depressed)
- doing something regularly every day (force yourself to have a reason to get up)
- not isolating yourself (this doesn’t mean making yourself be sociable if you don’t feel like it, but just sitting and hearing other people’s mundane conversations can sometimes help
What can you do for someone who is depressed?
Be alert. Some people may not realise they are depressed. Some people know they are and are hiding it. When I had depression I hadn’t realised how abnormal my mood had become and the strange comments I was sometimes making and how I was avoiding people. If a housemate is hardly around any more, is uncharacteristically gloomy or antisocial don’t just put it down to them being ‘weird’.
For me, telling my friends was a huge thing. As soon as I did it helped. Not quite a problem shared is a problem halved, but something like that. Knowing I could knock on their door at any time and that they would come and knock on me if they hadn’t seen me for a while helped in its own small way.
Depressed people may feel useless and unworthy of taking up your time. They may feel guilty for sharing their burden. These feelings are likely to be symptoms of the depression. If someone confides in you, this may be a big deal for them. It may have taken a lot of courage.
At the same time people with depression may be snappy – nasty even. They may say you don’t understand what they’re feeling. At this point I’d like to repeat what I said at the beginning: I don’t think anyone can understand depression. To understand it, you have to rational which you simply aren’t when you’re depressed. You can only try and understand it from afar.
For someone outside it is often extremely difficult to understand why the depressed person should be in this condition, particularly when there are no obvious reasons for it. It can seem that the depressed person is just not trying hard enough. But trying to push someone out of depression or to persuade them to snap out of it does not work.
Thinking about “doing something stupid”
Yes, that. Doing something stupid plays on the minds of depressed people a lot. Whether it’s a real plan or just thinking how much better everything would be if you weren’t there. Again, thinking illogically is a hallmark of depression. You can sometimes wind yourself up into a state and suddenly suicide becomes a super idea. My one piece of advice is: postpone. Stop, wait, go to sleep. Then re-think. Often, your irrational thought process goes away, you feel less wound up and suicide is no longer your perfect solution.
You can’t really have any perspective when you’re depressed. You wind yourself up, become overwrought and you work yourself into a bit of a frenzy of false logic and irrationality. Suicide seems like a good idea. Postpone. Wait till your emotions have subsided and it’s the cold light of day. 99.9/100 there will be the relief that you didn’t do anything.
The Samaritans are useful to talk to in suicidal moments. They are there to listen and having someone impartial to talk to helps. Don’t be afraid to hang up and re-dial if, for instance, you’d prefer to talk to a man rather than a woman (or vice versa).
Telling the doctor you think you’re depressed
Is as easy as that. “I think I’m depressed” is your answer to them asking you why you’re there. They’ll usually take the lead from there, asking you questions and ascertaining your mood on an arbitrary scale (1 point for sleeping too late, 2 points for lack of joy…). Although they’re not there to judge you, they will of course have to assess you in their mind. Don’t underplay your emotions – depressed people have a habit of feeling guilty for troubling other people. Don’t leave feeling dissatisfied. By that I mean, don’t leave without them asking you to do something, to make another appointment to come back. At first I let the doctor tell me to jolly along and ‘see how it goes’. Then I realised how serious it was, went back in floods of tears and a different GP made me keep a mood diary and visit again in two weeks. He made me make the appointment that day.
Be on your guard for it creeping up on you again because you’re more likely to have depression for a second time if you’ve had it once. And you’re even more likely (in the region of 90%+ I believe) to have it again if you’ve had it twice.
I found reading around the subject really helped me. I personally found “Malignant Sadness: The Anatomy of Depression” by Lewis Wolpert really insightful. Again, it’s clear-thinking that can help overcome illogical depression.
A TSR member's experience of depression
I’ve got a strong family history of mental illness on both sides of my family (bi-polar, depression, suicide). The true extent of it was never explained to me until I told my parents I had depression and then all the skeletons came tumbling out of the closet. I always knew my gran had been a ‘manic-depressive’ and that she stuck her head in the oven on occasion, but that had always seemed like such a distant and unrelatable thing until I experienced it myself.
I became depressed in my final year at university. I think I was depressed before Christmas, but I hadn’t realised it by then. That Christmas I felt like I was always putting on a fake smile and something inside me kept thinking, “I should be enjoying this more.” I carried on completely oblivious until March when uni work cranked up a notch and I couldn’t cope properly any more. I was sleeping nearly all day, I desperately avoided socialising with housemates by cooking in the kitchen at strange times, and nothing seemed to make me happy any more. I felt dead to everything. Someone close to me told me they recognised what could be symptoms and that I needed to make an appointment with a doctor because I wasn’t functioning normally. So I did, the next day.
I went to the doctor. I remember sitting down and saying, “I don’t feel very happy.” The doctor asked me to explain, and I told them about my lethargy, not wanting to socialise, thinking about ending it all, how cold I was all the time, how even my favourite song couldn’t cheer me up, how I felt I was losing close connections with my family and how I was beginning to think even people who I ‘knew’ loved me really hated me. It all came out as a torrent. The GP asked me to think about the last time I was happy. I was unable to say. The GP asked me to keep a diary for a week of my mood in the morning, afternoon and evening and any times I thought “bad thoughts”. I did. I was shocked. I hadn’t realised how abnormal my mood and my thoughts had become. When I returned I told the GP about my diary (which described a total lack of positivity, perspective and rationality – but I didn’t realise at the time of course). I was put straight on anti-depressants.
My care was pretty shoddy, really. I was whacked on the pills and told to go the university for counselling. I went to the university nurse and she made an emergency appointment for me. It was poxy and useless. I’d had unsuccessful counselling before which may have had an impact on my attitude to it. What I needed was support. Things got progressively worse – the pills I were on didn’t help and I had to change 2-3 times to others. And of course each takes 2 weeks to kick in. Then suddenly I just couldn’t do it any more. After trying I buckled under everything and just stopped. I was told that evening to go home for 2 weeks and have a break – to forget about work (not easy in your final year) and get sorted after. The 2 week break went quickly and I can’t say anything much changed.
After my break, though the university deliberately made appointments for me to see people every single day to check in with them. The nurse gave me her home phone number and told me to ring any time of day or night should I need to. The offer was comforting, but I knew I’d never take it up. They helped re-structure my work so I could cope with it better. Unfortunately I was bottling up more and privately I was staying up late, crying my eyes out, ringing my boyfriend at all hours in the morning saying I was going to kill myself, calmly rationing that really there was no point to my life. Thinking back to those times scares me and makes me very sad. I wasn’t me, I was scared of my own personality. I was scared of what I was going to do to myself. It was the blackest, deadest, most horrific feeling inside. I think it was like anything good or sustaining inside me had been killed by this terrible, overwhelming, possessive and evil emotion. I can’t even begin to explain it in any way that resembles how it was.
As a big deadline approached, I tried to kill myself. It was probably a pretty lousy and impulsive attempt, but it scared me. I really felt like no one gave a **** about me in the hospital and I didn’t want to go out like that. Seeing my notes with words like “severe depression” and “high on suicide ideation scale” and the like really hit home that I was in trouble and needed more help. But then I didn’t tell anyone at university about the attempt, just that I’d “been to hospital” when I didn’t go to a lecture and they all worked it out I suppose. At this time my medication started to work as I felt less numb to positive things. I called the Samaritans twice during my whole depressed period and they did help, just as a listening ear. They helped unravel my ridiculous logic that my life wasn’t worth living. Their job is not to talk people out of depression or suicide, but a detached person can make a difference, I found. I was so glad my attempt failed. My biggest piece of advice to a depressed person considering doing something “stupid” would be to stop, go to sleep. You can’t really have any perspective when you’re depressed. You wind yourself up, become overwrought and you work yourself into a bit of a frenzy of false logic and irrationality. Suicide seems like a good idea. I no longer think it is. Postpone. Wait till your emotions have subsided and it’s the cold light of day. 99.9/100 there will be the relief that you didn’t do anything.
What was my turning point? I don’t know. It just sort of lifted. I think with my projects in, that burden raised and the need to focus on my finals my situation changed and my extreme stress shifted. I could finally see the end, see past the here-and-now and see a bit of future if I let myself. I dug my heels in, did my finals (I was told I could defer for a year if I wanted), graduated and carried on taking my tablets for 4 months. Too short, really. But I’m stubborn.
I’m of the opinion that my depression stemmed strongly from the stressful situation I was in. That was over a year ago now. I’ve had a few times where I’ve started to feel hollow, started to rant about not living and promptly gone to the doctor. As a result, I’m back on the tablets again and I intend to take them properly. At some times I’ve just sat and tears have filled my eyes up and I’ve just thought, “I’m feeling sad again”. Maybe I can keep it away by simply not letting it in. Luckily those “feeling sads” and even my suicidal rants haven’t slipped beyond my control. I’m scared for if they do, I don’t want to be the out of control person who was terrified of themselves.
I do feel hopeful for the future, but I know I have a strong chance of having depression again, having suffered it before and having a strong family background. I’m apprehensive about one day having a child and the chance of post-natal depression. However, worrying about being depressed again doesn’t rule my life, but it’ll always be in the back of my mind. Depression has proved to me that I am a strong and determined person and that I want to keep that up and not be the weak and hopeless person I was in the worst times.
A second TSR member's experience
I was always bullied at school, I think from about a month in. I remember every word that was said to me and every beating a took. But I never let them get to me, I never had a day off school. I started college, failed my first tear miserably, and I knew I was. I told lies, just so that I could get attention, I didn't know why i needed attention, I just did. I cut my arms open. I didnt feel right and I didn't know why. I didn't know what I wanted to be, and I couldn't cope with the 'freedom' of college. I wasn't bullied anymore but I wasnt happy either.
After I failed my first year, I started again. Then I met my boyfriend and I started bunking off college to see him. Again, I dropped out.
In the following september, I restarted at a different college - Doing Business and Accounts. I loved it! I was happy at last and I was distinction standared. 3 weeks into college though I had a car crash. I was ok for a bit but then I started getting frightened to drive in, and I was put on Citalopram - an anti depressant. It got to the point where I was so frightened I wouldnt leave the house. I would have panic attacks at the thought of my family leaving the house and I wouldnt be left alone. I started to write suicide notes because I felt that I had no life anymore, i was trapped in dispare and I didnt know why.
I was refered to the home crisis team, where a team of nurses and doctors visit me every day at home, to give me small targets like washing me hair and getting dressed. To help with the panic attacks I was given Perasyazine which calmed me down alot, but I cant take it any more.
I appeared on BBC Radio 1's the Surgary when they where talking about panic attacks.
When I had my appendix out I was better for a bit but then I found out my boyfriend had been cheating on me, because I was so depressed I wouldnt have sex with him. I was diagnosed with a mental breakdown and I left him. Funnily enough though my depression 'lifted'. I wasn't trapped anymore in a dead end relationship. My family has a history of depression and suicide.
I am in a new relationship now, and i noticed that my depression lifted towards the summer months. I have been diagnosed with Bi-polar so when its winter I am pretty bad but I am coping with it. I am at college again but studying an evening class and I can't deal with lots of people and having councelling. I am also on citalopram still but much happier.