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“Little Alice fell
bumped her head
and bruised her soul.”
–Alice’s Adventures in Wonderland
I am not sure how to answer these two questions. Frankly I don’t understand how any human being can possibly not experience depression at some point in his/her life, but that’s just me. Anyway, I’m going to try to take a stab at exploring ideas and see where it can lead us, by exposing some of my favorite myths about this state of being.
Depression is the result of a sad situation.
Everyone feels sad and hurts from unhappy thoughts sometimes. And events like the loss of a loved one, the end of a relationship, trauma or abuse can all serve as triggers of depression—but depression is not always the result of a loss or negative occurrence.
Depressive episodes can last for lengthy periods of time, and cause feelings of extreme tiredness, hopelessness, sadness, and/or suicidal tendencies. These can occur suddenly—even when life seems OK.
A diagnosis of Clinical Depression (made by a physician, usually a psychiatrist) is not simply a matter of being sad, down in the dumps, or unhappy. It is a serious illness, which when diagnosed, accounts for numerous symptoms affecting daily functioning, physical well-being, behavior, thoughts and feelings over the course of at least two weeks. The National Institute of Mental Health lists these at the website, https://www.nimh.nih.gov/health/topics/depression, and they follow below:
Hardly a matter of just simple moodiness.
Depression can be dealt with, by “pulling yourself up by your own bootstraps.”
I love this one; talk about crazy making!
I’ve gone through two major clinical depressions during the past twenty years. These were not short-term by any stretch of imagination—one lasted a jobless year, and the second lasted a couple years. My husband totally didn’t get this last one, which landed me in the hospital twice in one year. When he started with the bootstraps lingo, I wanted to scream: “This is an illness! I’m not making this up in my head, and it’s not a matter of choice!” (Even I was able to finally accept this and stop blaming myself.) However, soon after I asked him to come with me to my therapist’s office, he began to get it. My therapist laid out a description of what I was going through, as I was having a tough time doing so in a coherent fashion.
For anyone who’s gone through this with family, I can’t stress the possible benefits of inviting someone to come with you to a therapy session. My therapist and I had already discussed how the session would be structured, and it was amazing: my husband began to really understand. He not only got it but stopped asking “what’s wrong?”and was only very caring of me—taking over around the house, insisting we go out for dinner and so on.
My lesson: it’s not necessary to accept anyone’s message to “go watch a funny movie,” “find a job,” or my all-time favorite—“snap out of it.” All of these might help, if you’re choosing to do them, but during a crisis or falling down the dark hole of a depression, they can seem judgy and leave one feeling totally misunderstood.
Everyone will think I’m crazy.
You may be surprised at just how many people have either suffered from mental illness or know someone who has. According to NAMI (National Alliance on Mental Illness), approximately 1 in 5 adults in the U.S. experiences mental illness in a given year. That’s 43.8 million, or 18.5%. Approximately 1 in 25 adults—9.8 million, or 4%—experiences a serious mental illness that significantly interferes with one’s functioning. And Major (or Clinical) Depression affects about 6.7% of adults; overall, between 20% and 25% may suffer from this debilitating disorder during their lifetime.
While the stigma surrounding mental illness still exists to some degree, organizations like NAMI, local agencies and the increased availability of mental health professionals have sought to normalize emotional disorders through treatment methods and provide information to families to help their suffering loved ones.
All that being said, when you are seriously depressed it can be very difficult to not feel alone and totally unique in your thoughts, feelings and/or actions. Often these are accompanied by a sense of shame, guilt or feeling like a failure. (Maybe I should just hide.)
If you have been suffering some of the previously listed symptoms for more than two weeks, please consider checking with a therapist and/or psychiatrist to see what treatment options are best for you. If you don’t know a mental health professional to call, reach out to a friend, family member or doctor to help you find someone.
Reaching out for help has probably been the best decision I have ever made.
Instead, you may be saying to yourself, “I think I’m hurting too much, and really do need some help,” but are not sure how to find it. Rather than go off on a million, unsuccessful tangents, you could do a search for “therapist near me” or “psychotherapist near me” (in this post the terms “therapist” and “psychotherapist” are used interchangeably). But I’d like to first share some experiences and information which I hope might prove helpful.
What is considered an emergency? An emergency is when you are in such emotional pain that you don’t feel like you can continue hurting so badly, or you want to physically hurt yourself or someone else to make the pain just STOP. (Yes, I have been in this place before.) What can you do?
WHAT KIND OF THERAPIST?
The type of training the therapist has had, will shape their therapeutic approach. Counselors, social workers, psychologists, psychiatrists, and spiritual healers…there is a wide array of professionals who offer “therapy.” And there are also music and art therapists, who utilize the creative arts in the healing process.
It can be very daunting to find the right person to work with—and I choose the word “work”, because you ultimately want to pay for a professional’s work, to help you find your way to emotional wellness, right? And the old adage holds true for your own effort: you will get what you put into it.
So, in the United States, psychiatrists are now primarily medication “managers.” That’s not meant in a pejorative manner, it’s just that there aren’t enough of them to fill the needs, and they don’t have enough time to do everything for their patients. The best ones remain in contact with one’s therapist to keep up. They usually see you for a brief 15 to 20-minute session, check on hoped-for benefits of prescribed medications, and insure that you are not suffering from bad drug interactions or side effects. Some offer therapy sessions, but this is the exception rather than the norm. They tend to be expensive, and don’t always take insurance; it can also be difficult to find one who is taking on new patients.
Many individuals seeking therapy see psychologists, social workers or mental health counselors. If you wish to do a little research prior to seeking out a therapist, online articles can provide you with brief overviews of different kinds of psychotherapy. At https://psychcentral.com/psychotherapy/, for example, an article written by John M. Grohol, PsyD, offers a concise description of half a dozen different types of treatment—including Cognitive (CBT) and Dialectical (DBT) Behavior Therapy, as well as a thorough guide to finding the best therapist for yourself.
So, when you make your call, keep these things in mind:
Please remember above all: It’s very difficult when you are hurting and feeling vulnerable, to take the steps to ask for help. And therapists know that.
Psychotherapy has come a long way; most therapists no longer offer long-term treatment. More and more, therapists are utilizing short-term models such as CBT, which encourage clients to engage in an interactive dialogue with the therapist, exploring the ways in which one’s thoughts, feelings and behaviors interact with one another. The primary goal in short-term treatment, is to help you develop a “toolbox” of better and stronger coping skills.
I recently went online and read reviews about a specific CBT practice in my area. I told the receptionist on the phone what types of issues I was working on and asked who might be available to see me soon. I lucked out and am now working with a CBT trained social worker, who is gifted, knowledgeable, and good at her craft. Because when you get right down to it, therapy truly is an art. It is often a difficult process, but an incredibly enriching and helpful one which can guide you on your way to owning your life.
If you have further questions or ideas, please share your comments so we can have a dialogue!
One of the most difficult things in life is grounding ourselves in the present moment, and not dwelling on past and future events. How often do we worry about things we’ve said or not said…hurts we’ve inflicted, or imagined hurts for which we’re responsible…actions we’ve taken, paths not traveled?
* What will happen in my meeting tomorrow?
* How is my friend going to respond to me?
* What will my partner do now?
I used to work with an amazing therapist and mentor, who described this mental overload as a form of “hallucination.” “There you go again, Sharon; you’re hallucinating by placing your thoughts into someone else’s mind.” This is also called “projection”—and I think most of us do it to some extent or other. But I grew to prefer the term, “hallucination,” because it’s as if my mind’s churning and cycling around someone else’s imagined conflict, is actually real. When we engage in this type of obsessing, we emotionally beat ourselves up for the pain and conflict we think we may have created.
And how does this affect my present moment? And consequently, the future one? First, I fall into a funk, and then expect something horrible to happen–and if it does happen, I think, well, I’m not surprised. And if it doesn’t, I end up confused and awash in such a mix-up of feelings that I cannot be present and feel pretty stuck. Argh!
Holding on to a jewel-like mantra may help us focus:
I resonate most with the words of Thich Nhat Hanh—Zen Master, global spiritual leader, poet and peace activist, revered around the world for his powerful teachings and writings on mindfulness and peace. Described by Dr. Martin Luther King as an “apostle of peace and nonviolence,” his key teaching is that it’s only through living mindfully–living in the present moment–that one can truly develop peace, both in one’s self and in the world. (Check out this link for his writings: www.amazon.com/Thich-Nhat-Hanh/e/B000AP5YRY )
These quotes may all sound beautiful, but if you are in a present moment of feeling stuck, lovely teachings can sound impossible to reach, touch or understand. They may even sound trite and superficial. However, they do offer us a bit of hope which we can try to remember, and perhaps hold on to in a lighter moment.
“I knew who I was this morning, but I have changed a few times since then.”
—Alice in Wonderland
There seem to be warning signs: sometimes if you know your own signs, or “symptoms”, then you can learn when you are nearing a place—or you may be actually in the place—that causes you distress. Once we recognize that these signs are active, it is time to reach out for help! We can begin to seek out a trusted close friend, a loved one, a doctor, or a therapist, but this is often times not so easy.
Examples of signs: Some people start needing to sleep more than usual. Eating habits can change, one direction or the other. Some individuals find they are less able to focus, while others just feel an overwhelming sense of the blahs. I think that figuring out your own signs is critically important; without being armed with this knowledge, I have ended up facing much more difficulty than might have been necessary, and without the support which could have made life so much/somewhat easier.
I think my first warning sign of incoming danger is increased irritability. Towards other drivers for being stupid, the weather for being too cold to too hot, my dog for taking too long outside. My other “firsts” include:
And all the while that these are progressing, causing me physical and emotional pain, I am facing the world with a smile, acting like everything is fine. I have even gone into a therapy session, prattled on for at least half an hour before breaking into tears and stating (with some surprise!) “I’m really down.”
Yes, I am an expert at hiding. During these super down times I seem to think that no one else has ever experienced depression before, and I become a consummate artist at faking happiness. The last time this happened, I felt irritated with my spouse for several months until I finally decided that it might be time to give him a break. At that point I was just unable to hide anymore and realized I was in trouble. I’m not talking about being blue, having a rough day, or feeling sad. I’m referring to heading toward down-the-hole, wrestling-with-the-demon, depression. In this pre-state, I can occasionally wash my face, put in my contacts, makeup, pull an outfit together—if I care about the people I’m going out to be with; otherwise, I really just don’t give a shit. And that’s my signal: not caring enough about others or thinking I don’t care—and I don’t mean worrying about how others might judge me, but just that I stop caring enough about those I love cuz I’m so stuck in my own head. Not sure I can really clarify that more…perhaps another time.
A while back I met with a (potential) new psychiatrist for medication management. I liked him: he was totally professional, really knew his meds, knew how to lead a short interview, and spent a good amount of time checking on my current mood. He ended by saying he’d like to see me in a month, to establish a baseline of how I’m doing.
I didn’t even tell him that I might be growing more depressed, managing somehow to pull off this great acting job.
But I don’t think I did. Most likely, hiding is another one of my signals. I’ll have to remember to let him know…if he didn’t figure that out already.
All the best,
Photo by Miguel Angel Ruiz Sanchez
Depression is no stranger to me; Yeah, I’ve known the demon’s seductive power throughout most of my life. There have been too many times when I’ve been unable to avoid tumbling downward, and it seems to have taken way too long to learn my warning signs, indicating something is just not quite right.
My first major depression occurred after the early death of my father at age 44. I was 14 years old, entering high school within the month. I have never done a search about grief to find out what is a “normal” (I try hard to avoid that word, since I’ve never met anyone or thing which I would consider normal) length of time for grieving the death of one’s parent. That first year I went about life at school in a rather numb state, crying silently every night in my bed, lest anyone should hear. I did ask to see a psychiatrist, as I was afraid that I was going “crazy,” but was reassured by my mom that I wasn’t—and that was that. No one talked about my father; no one referred to his long illness, the toll it took on all of us. No one talked.
That’s how I grew up—no one talked about feelings. So, I poured them out into journal notebooks; and when I did finally meet with a therapist in my early 20’s, I recognized that I’d been grieving all those years, unable to come to terms with the loss.
I’ve suffered several depressions since then: during a difficult marriage…the year before my divorce (my first time taking anti-depressant meds) …the year when I couldn’t find a job…the year spent working in a terribly toxic atmosphere—ultimately landing me in a psych unit for almost a week…and returning there for another week, eight months later. The hospitalizations occurred in 2016, so it’s not that long ago, and I can see that this depression has been the most difficult, still lingering around. It’s been very helpful for me to trace back and figure out how and what I was feeling about life going on around me, as well as within myself. I can see that each time it’s been tougher to wade through…
I have to mention in all this, that I have been in some form of psychotherapy since my 20’s (!), and taking meds pretty consistently since I turned 40. For me, this combo is good, strong and productive. Particularly when I do a lot of work outside of therapy sessions—i.e., journal writing, staying active, focus on self-care, avoid the pity parties as much as possible—then, I feel ok. But this has meant trying many different medications—for anxiety and depression. Some work for a while, then they are increased—which works for a while. Then they don’t, and I end up with a whole new regime. Psychiatrists are no longer gods to me, and I have become pretty strong at standing up for myself, letting the doctor know that some med is no longer working. I figure no one knows the workings of my brain better than I do. So, I have become my strongest advocate. But it took a long while to get here…
Some studies indicate that if you have suffered more than one major depression, that additional periods of depression may be more likely. That information scares me. But I continue to explore the ways in which my quirky mind and feelings work, and how my soul attempts to send me signals that I am really hurting—and when I do encounter the demon again, well, my aim is to try to manage the journey a day, an hour, or even a minute at a time.
This blog, “Through a Rabbit Hole”, takes its name from Alice’s Adventures in Wonderland, written by Lewis Carroll. This is a favorite book of mine since childhood; I realized as an adult that Alice’s falling down the rabbit hole is a perfect representation of what it’s like to suffer from mental illness—in my case, chronic depression and anxiety.
In Alice’s attempts to follow a unique looking white rabbit running by, she ends up slowly falling down a seemingly bottomless rabbit hole. Her journey to get through Wonderland and return home, causes her to face many obstacles—some terrifying, while others merely seem “curiouser and curiouser.” Her struggles in dealing with each one of them eventually land her back home and her “normal” self.
This blog is meant to be viewed as an opportunity to anyone who experiences the struggles, the ups and downs of mental illness, and to share stories–hopefully finding some support for yourself. While I am a trained clinical social worker, I am not putting myself into the position of a therapist. Please do not take any of my postings as professional advice. I am solely offering a platform; feel free to respond to any posting—but only with kindness, gentleness and a lack of judgment. All offensive postings will be deleted.
Take good care,