Talk to me about depression

I have a good friend named Sharon who suffers from depression. I will gladly admit that I don’t understand it, because I’ve never suffered from anything worse than the occasional blues.

The thing I’m having a hard time dealing with, though, is that I believe that Sharon’s attitude and behavior directly affect the severity of her depression. I know you can’t chose to be not depressed, but I do believe that the choices you make – focusing on the negative, obsessing over your circumstance, etc. – can affect how depressed you are. Sharon has a great life. She has a terrific S.O. of six years who adores her, a beautiful house, and the world’s best dog. She had a fantastic job where they loved her lots, but she just quit that because she couldn’t deal with it or something.

Her life is one that people envy, and yet it’s not good enough for her. Her aunt passed away a few months ago, and I know that was tough for her, but it wasn’t like they were incredibly close. Other people I know have gone through so much worse than she has, and I confess that I don’t understand why she’s having such a tough time. To be truthful, sometimes it seems like her depression is a convenient excuse that she uses for being completely self-absorbed, to the point where it’s affecting everyone else around her, and I’m really sick of it and I don’t know if I can continue to be friends with her.

But the minute I think that, I also feel guilty for not being a supportive friend. I feel so out of my depths here because I don’t have any first-hand experience with depression. Is there a line between being genuinely depressed and clinging to your depression like a safety blanket, being a victim in every situation? How much is the non-depressed friend supposed to put up with? When do you call the depressed person on their B.S.? Do you call them on it at all? If you’ve dealt with a situaion like this, have you ever just cut your ties and called it a day, or did you stick it out? Do you regret your decision?

Since I don’t know your friend, I can’t say whether she’s full of it or if she’s actually depressed. I’m inclined to believe anyone who says they suffer from depression. You may think her life looks lovely, but that doesn’t mean it feels that way to her. Please don’t be insensitive towards her in the case that she really is suffering. Hopefully she will seek medical help and try to get the problem under control.

I’ve suffered from bouts of depression my whole life, and I know it’s hard for some people to relate to if they’ve never had it. They can’t understand why we can’t just “cheer up,” but it’s not that simple at all. Depression is often a chemical imbalance in the brain, and that’s not something we can control on our own. My doc likened it to telling a diabetic to just go ahead and “make some insulin.” It would be ludicrous to suggest that, and no one would think of blaming a diabetic for their problem. Same goes with depression.

That said, I understand how frustrating it can be when you see a person who just doesn’t seem to want to get better. You can only lend a shoulder for so long before it begins to wear you out. There is no easy answer to the question. You feel you’re insensitive for leaving them to their own devices, but their moods bring you down. Tough call.

If someone’s depressed yet their life looks pretty decent otherwise, most depressed people will feel things like how they’re just complete losers and how everyone in their life will soon realize that. How they don’t deserve any of that good stuff at all.

Assuming she’s not just full of it, her attitude and behavior are her depression. That’s what depression is. It totally warps how you see the world, how you react to things, how you feel about yourself and everything that happens.

One of my problems when I’m dealing with depression is that reminders about it shame me and lead me to try to avoid dealing with the depression. (“I’m horrible, I’m worthless, I’m so stupid that I can’t even do anything right. I don’t want to think about this.”) If you want to try to help her, try phrasing things such that it avoids blame - “You’re a great person, and I hate to see you feeling so down, and you need to do something to start working your way out of that depression.” Try to present it as something temporary and not innately part of your friend; too many depressed people feel that they’ll always feel that way and that they’re to blame.

That being said, I also think that some people who are depressed are like alcoholics in that they might have to “hit bottom” in order to get treatment they’ll stick with.

Please try to understand that the “focusing on the negative, obsessing over your circumstance” are part of the disease, not contributing factors. Trust me-- if she could stop she would.

<i>Her life is one that people envy, and yet it’s not good enough for her. </i>

NO, she is just too ill to see that it is good. There is a difference. DEpression doesn’t have to be linked to a sad event, or a bad life. It can be an illness, appearing from nowhere, that destroys one’s ability to enjoy life to any degree.

Please don’t treat it as BS. It can be as real as any other life-threatening illness. Help her get the treatment she needs.

Also, I can assure you that she probably feels quite enough guilt and self-blame without you adding to it. That, too, is part of this illness.

It seems that way when you’re on the outside, but in reality, it’s not like that. Focusing on the negative and obsessing are symptoms, not causes. Get Sharon to a doctor and pray it’s a better one than the one I got.

Quitting her job is a sign that this is a real, serious illness. She’s overwhelmed by the depression and can’t deal with the everyday portion of her life.

You (and she) would be surprised how quickly you start to feel better. It takes about six weeks on medication before you realize the benefits, but just taking steps to get there can make you feel better. If she hasn’t already seen a doctor, she should. There are many drugs to choose from, and her doctor will help her find one that works for her. Good luck to you and her. Many people get their “old self” back. I hope she’s one of them.

Look, I know depression is a real disease. I’m sorry if I ever gave the impression that I think it’s something that someone can just “snap out of,” because I know that’s not at all the case. I know that depression is as real as any other disease, and it needs to be treated as such.

HOWEVER, because we are talking about an affliction of the emotions, I don’t think that being depressed mitigates the person from any personal responsibility. If you are depressed then I think that attitude plays a huge role in how quickly you can recover – just like any other disease. If you choose to focus on the things that suck in life, whether it’s the ways people have let you down or how much the current administration sucks or whatever, then I firmly believe that you’re being self-indulgent, to some extent, and you’re going to have a tougher time than someone who faces what is wreaking havoc in their life and comits to dealing with it in the best way they can, whether that’s through counseling or pharmaceuticals or acupuncture or church or whatever will help them get through it.

See, the thing that’s upsetting to me is that there’s this pervasive attitude that the depressed person is completely above reproach, that he or she cannot be questioned because then you come off as the asshole. Why is that the case?

I don’t think that’s completely the case. I really do understand your frustration. I have a friend who has a manic-depressive disorder, and I’ve been watching his downward spiral for years. It’s hard to watch him self-destruct and blame it entirely on his depression. He acts as if he has no free will in the situation, so when he acts badly he just blames it on the disease. I find it irritating and hard to deal with, but yet, I still feel guilty for getting angry with him because I know he has these problems.

If it’s affecting you so negatively, maybe you should back away from this person for awhile.

That’s the one thing that makes depression so difficult to understand from the outside. The sufferer appears to be ‘choosing’ to focus on negative things, or to not be optimistic, or whatever. The reality is that the depression is preventing them from choosing any alternative to this. Trust me, if it was a matter of choice, depression would vanish overnight. Nobody wants to feel that way.

Yes, it’s unreasonable to make unlimited allowances for people with depression. But at the same time, you cannot impose ‘normal’ expectations on them. Rough-and-ready parallel: an otherwise-healthy person who is struck down with flu isn’t going to go for a five mile walk with you. This isn’t because their body is physically incapable of it, nor that it will massively damage them further. But it’s not going to do them any good, either. A person with depression is capable of appearing to function normally on a day-to-day basis, but you can be sure they’re not deriving pleasure or satisfaction from it, and it’s not helping them get over their problem.

In the movie “Dead Poets Society” one kids suicide would come as a complete surprise to people who do not understand depression. Though to me it was clear that he committed suicide because he was sick and everyone was treating him as if he was not. It’s like a doctor telling you that your back is fine when you can’t even sit down without pain. The doctor won’t convince you. If you tell Sharon she is using depression as a scapegoat she will not believe you because she knows that the depression is controlling her. Support her or just stay away.

I found that antidepressants helped me get to a place where I could actively choose to focus on something positive. But without them, there simply was no way of doing it. It’s hard to explain because it sounds like a logical thing, but it’s not. When I was depressed, EVERYthing was awful.

if she’s really suffering from depression, pointing out how great her life is is like pointing out a beautiful sunset to a blind person…they just can’t see it. Depression is really about the loss of ability to feel pleasure even about the things should, even most fundemental. Food doesn’t taste good. Sex? Hah.

Actually one of the worst things about depression is being able to see…dimmly…somehow…all those things that you know should make you happy and feeling, still, cut off.

No, please, don’t think it’s choice.

And maybe feeling guilty because you couldn’t possibly deserve those good things when you can’t appreciate them properly and they should be happening to someone who would enjoy them instead. I’ve heard that memories are emotionally coded, so that when you are happy, it’s easier to remember happy memories and when you’re depressed it’s harder to remember happy memories. I’m prepared to be debunked on that, but it would make bouncing back harder.

I know that back in the time when I was depressed, I felt different physically. I had no energy. It felt like gravity had been turned up. Which is not to say that I never got anything done, just that I rarely gave myself credit for what I did. I knew how much I wasn’t doing and judged myself by that.

Ok, again: I KNOW THAT DEPRESSION IS NOT A CHOICE. I never said that someone can choose to be depressed. I’ve never thought that, and I never will.

What I am questioning is how a person chooses to deal with his or her depression, which is totally different than someone saying, “Just cheer up already!”

Let’s just say, hypothetically, that Person A and Person B are both clinically depressed, and, for the purposes of this example, suffer the same level of depression. Person A recognizes the depression, faces it as best as he can, gets treatment, gets medication etc. Person A makes a conscientious effort to keep away from things and topics that aggravate his depression, and refuses to let himself be beaten by this disease.

Person B focuses on how much his life sucks. Person B refuses treatment, refuses help, and uses his depression as an excuse for absolutely everything. You can’t convince me that Person B isn’t going to get well – or at least bring his depression to a manageable level – at a slower rate (if at all) than Person A.

And actually, take away all the extra stuff from above, and let me ask this question: How is a depressed person any different from an alcoholic, in that in order for change to come about that person must want to change their situation and/or do something, anything to make a change? Isn’t it possible that for some depressed people their depression is weirdly comforting, because it is so familiar, and because change is such a scary thing for anyone? Or are the people who are the friends and family of the person just supposed to grant a carte blanche for that person to act and do whatever the hell she wants because she’s depressed?

Marco, please imagine for a moment, that your life has a plug - like a spigot at the bottom of a water barrel. Depression rips that spigot out, and all the contents drain away. Imagine, if you will, watching a sunrise, and as you watch, all the color fades out, and all the sounds of breeze, birds singing are silenced, all texture is lost. You know it’s still there, but you can’t experience it. Now imagine that someone has placed a 1000 ton boulder on your back, squarely between your shoulder blades. It flattens you, it presses all the vital juices of your being out, it grinds your soul down to a thin powder. It hides the world behind a foot-thick wall of glass. You can see out, but nothing touches you.

That’s depression.

I’ve only ever experienced mild bouts. I’ve never had a suicidal urge. I’ve never self-medicated with anything scarier than chocolate. I’ve never lost my ability to function. Even then, what I went through is something I wouldn’t wish on my worst enemy. I could look at all the good things I had in my life - friends, family, job - and it was all ashes in my mouth.

Your friend is ill. The pessimism you describe is a symptom of the disease, of neurochemistry that is out of balance. It is as physical as a broken leg, and in the end, a lot more dangerous. Please, plead with your friend, her family, her friends, to get in and see a doctor. There are medicines which can help.

I would also recommend that you read the following by Peter McWilliams, a man who struggled with depression for nearly his entire life: How to Heal Depression. The entire book is posted for free, and reading it got me through some very dark times. It may help you understand better what your friend is going through.

I found that the Cognitive therapy model of depression helped me a great deal with my depression. YMMV. In this model, depression is not seen as an emotional disorder at al, but rather a cognitive one. The bad feelings that are associated with depression, then are actaully symptoms of the cognitive disorder. In otherwords, being clinically depressed doesn’t mean that you feel bad, so you think life sucks, but rather that you have a percpetual/cognitive disorder that causes you to frame reality in such a way that you think things are awefull, and so experience reality in that way.
In many ways this in analogous to Aneroxia, wherein ones actual perceptions of reality are distorted. The good thing about this model is that it has shown remarkable success when applied to treatment. According to some information, Cognitive therapy is as effective alone as most modern drug therapy alone (something traditional talk-therapy cannot boast). Of coarse, a combination approach has shown even more success.
That said, however, you are entitiled to your view that she may be “leaning in” to her illness. Having depression is horrible, but it does require action on the part of the depressed to recover. Acting in spite of depression is incredibly difficult is it is a severe case, but an outsider cannot know how much someone else is cabable of. Sometimes actually talking to someone who is depressed about what you see can help them see another perspective for long enought to get help, or sometimes it won’t. I strongly suggest tact.

I suffer from a mild but chronic form of depression. Because it was mild, my doctors tried behavioral therapy – exactly what you’re suggesting. The thought was that if I didn’t act depressed, if I forced myself to focus on the positive, learned to interact with people in a different way and quit obsessing about things I had no control over, then I wouldn’t be depressed.

It didn’t work.

Another doctor put me on medication. The difference was striking and immediate. Even so, my body changes from time to time, and my family, friends and co-workers know exactly when it’s happening because my mood and behavior change, even before I realize it. I have to go back to the doctor and have my medication adjusted.

It’s unlikely your friend has any idea of how she’s behaving, just as a color-blind person can’t see an entire rainbow. Can you call her on it? Yes, gently. You can tell her the effect she’s having on her family and friends (and you.) But it may not work, and then you have to decide what your next step is.

Depression can be “weirdly comforting”. Giving up responsibility because you can’t act can be a bit of a release for some people. Granting carte blanche can actually be one of the worse things you can do, because it can enable the person to further isolate and separate from reality further. However, it is important to keep a sense of perspective and to realize that capacity may be legitimately diminished. I personally have been at time literally unable to get out of bed due to depression, and absolutely unable to fathom that things getting better was even possible. At that point someone telling me that I was leaning in to my illness would have been pretty pointless, as all I wanted to do was die. Once I’d made a commitment to get better, and had gone down that path a ways, and I was engaging in behaviors that put me at risk for a relapse (For example, stopping my medication, or being financially irresponsible) then I was at a point to be able to take in the concept of leaning in to my illness.
I hope this helps

I have a suggestion besides the medication route, which is always a good idea.

Tell her to stop eating carbs for a couple of weeks.

No, not necessarily Atkins. Just have her cut out all the sugar and junk. My husband, who has had depression for years, did this and it worked WONDERS. The change I saw within maybe 4 days is/was astonishing.

Couldn’t hurt to try.

Perhaps your friend really can’t see that there can be a light at the end of the tunnel.

It is possible for someone to take comfort in feeling like crap. In my experience, the people in my life who have exhibited completely negative attitudes don’t consider themselves to suffer from depression. But I have never known anyone with true clinical depression to enjoy it whatsoever. Or maybe it’s that the scary thing isn’t the outcome of proper treatment, ie feeling better, but the process of treatment itself. It’s a long, scary road. And if you’ve never been treated, you may not realize that therapy can work for you. It takes a whole lot of effort on the part of the person undergoing therapy, and when you’re in that consuming black hole called depression, you can sometimes feel that it’s too much bother.

You know, you don’t have to. If the situation is bothering you this much, it may be in your best interests to tell her that her problem is becoming your problem and you need to step back.
Look, I am in much the same situation that your friend is in, and have been fighting and losing this battle since I was a child. I’m taking steps to get back on my feet, but I know that right now, I am not well. Some days are better than others, but overall: It. Fucking. Sucks. I’ve heard the same things you’ve said on here from my family. I’ll tell you one thing- no amount of “tough love” has ever worked. I’ve distanced myself from people who refuse to even pretend to understand what I’m going through.

However, I do see your point of view. You want her to get help, she’s not doing anything about her problem. My advice to you, my friend: Walk away. You’re not doing any favors for her or yourself by getting frustrated with the situation.