Depression is an asshole. There, I said it. Thank you for your time.
Okay, so maybe this isn’t a profound statement. Anybody who has ever been afflicted by or close to somebody with depression knows that it’s shitty and ruins your life. And not just because it makes you sad sometimes or forces you to cry in the bathroom at work for no reason or fastens you into the same set of pajamas for three days straight. Depression is an asshole because it is inherently contradictory. This is the foundation for my theory of The Depression Paradoxes.
Paradox 1: You’re Numb Despite “Having It All”
Clinical depression has no rhyme or reason to it. Unlike grief or situational depression, which can be linked to a single problem or event, clinical depression often pops right out the blue clear sky. As a result, things can often be going pretty well for you but, out of nowhere, you start to feel absolutely miserable. For someone with depression, this can be even worse than your entire life falling apart ,because then at least you would have an explanation for your sadness. Not having a “reason” to be upset about something makes the voices in your head that much more cutting. “You just got a promotion, you ungrateful fuck! Why are you blubbering in the shower?” or “You’re on a yacht in the middle of Caribbean, sipping champagne with Joseph Gordon-Levitt, and you can’t smile for one. friggin. second?!” (Anybody else have that fantasy? Just me?)
So hopefully this explanation makes it easy to understand why a common piece of advice spewed by everyone ranging from Instagram yogis to Dr. Phil doesn’t often work for people living with depression. You can hear a choir of soothing New Age-y voices crooning it now: Practice Gratitude. Now don’t get me wrong, I am all for not being a greedy prick and being thankful for what you have. And gratitude is an amazing and powerful tool for those not in the middle of a depressive episode. But for someone agonizing in their own personal hell for no reason other than shitty neurotransmission, counting blessings can be a rough reminder of the fact that they are still suffering despite all they have been given. Even more, for someone with the messed-up thought patterns characteristic of mental health disorders, this can quickly feed into the cycle of negative self-talk and depression.
Paradox 2: Exercise Is Supposed To Make You Happy, But You Can’t Even Get Out Of Bed
I, like many of my fellow mental health warriors, have googled the phrase “how to fight depression” or some variation of that more times than Kanye West has googled “Kanye West.” (Mom, if you’re reading this, that’s a lot of times.) What pops up are several different blog posts listing the same strategies tested by time and scientific evidence: exercising, eating well, socializing, and looking on the sunny side of life! And, of course, all of those things are wonderful suggestions for people with or without a mental health disorder. However, to quote Carrie Underwood, “There’s just one little problem…” Depression makes those things pretty much impossible, especially when you’re knee-deep in self-doubt, fatigue, and crying spells.
Before you yell at me, I am a lifelong student of the sciences, with degrees in Nutritional Sciences and Physical Therapy. I am a big proponent of healthy living, both mentally and physically. Professionally, I have seen the positive impact of appropriate exercise, solid nutrition, and social interaction on people with mental and physical disorders. Personally, however, I have seen just how difficult it is to follow this advice when you can barely get out of bed in the morning. I, a physical therapist and normally an avid exerciser, had an entire three (okay, six) month span where I did not exercise a single minute. I used all of my social, physical, and mental energy just getting myself to, through, and from work. By the time I got home, I could barely keep it together enough to binge on Triscuits and The Office before crying myself to sleep at the thought of waking up and having to do it all over again. And what made it even worse was knowing that I should be exercising, I should be meeting up with friends, I should eat a goddamn vegetable once in a while. (Translation in my brain: I am definitely a waste of a human and probably do not deserve be living on this planet anymore.)
Don’t get it twisted—it is not my intention to for these paradoxes to function as excuses or reasons not to engage in methods proven for battling depression. It’s just that these practices require two things that are often lacking in the depressed mind: energy and motivation. The point of this is to 1) explain why depression is a total dick and 2) provide compassion and understanding of how depression operates for those coping with the disease as well as those living on the outside trying to empathize. It is only by identifying and demystifying these paradoxes that we can begin to address and modify our treatment strategies to make room for hope and healing in the depressed mind.