Trying to understand someone's depression

In My Humble Opinion
21

I’m trying to under his situation with his depression, I’m not making some kind of judgement about him or being clueless like he just needs to shake this thing off. The only people I know of that have depression are employed. Based on the people who have known him even longer than I have, he is a great guy and has many friends. He comes across to me personally as being kind. I find the situation sad and would like to see him improve and be well.

My impression until I started this thread of people who had major depression was that they couldn’t function with any every day things. So there appears to be many more levels of major depression.

22

You say you’re not judging him, but in the next breath state you ‘just want him to be well’. When clearly your interpretation of ‘being well’, means working a job.

The point is, he may be as ‘well’ as he’s going to get. His going to conferences, meeting friends etc, may be his best ‘well’ time.

I think perhaps you are being a little judgemental. You keep returning to how everyone you know, who has depression, holds down a job. Like that means something, in regards to his depression. Persons too depressed to hold jobs are often living such lives as you would not cross paths with them, is the explanation, I think, of why you don’t know any.

Why are you so invested in whether or not he works anyway? You’re not supporting him, others are. Why do you care if they are, in fact, enabling him? How is it your concern?

23

There are days when I’m fine. I do some accounting - I’m currenting working on taxes for a friend’s business. But eight hours a day of focus is not coming out of me right now. And about once a week I either sit in a closet or sob uncontrollably - with very little control over that.

There is lots of medication, but not everyone will respond…the hope that is held out is that you’ll respond to something, but its no guarantee.

Its also tough to diagnose (although they are starting to be able to do tests to see what you respond to). My diagnosis is anxiety and major depression. But I may be bipolar with my highs being other people’s normals and my lows being cra-cray.

In between episodes used to go for years. This last couple have been months. My cycles of “decompensation” are getting shorter. So there is a very real chance that I’ll get to the “no meaningful work” stage.

I was a six figure a year IT project manager. If I go back, it won’t be to that. (Turns out that like teaching, information security isn’t good for anxiety).

24

Oh, despite my current state, I’m planning a Disney World trip. The initial plans were made before my breakdown - and the trip isn’t until the end of the Summer. Airplanes don’t set me off, so I’ll get there fine, but crowds do - so if I’m still in this state, Facebook will show the two hours I spent in the parks before heading back to the room and the two hours I spend back in the park in the evening - it will look like I’m having a normal time. (I’ll may ask my doctor for a week worth of Antivan if I still have the anxiety - the stuff is addictive so I don’t like to use it - and if I get to control my environment, and don’t need to have a public face much, I don’t need it).

25

I work in IT. Information Security is a stressful and frustrating job. Doing that kind of job you have to have a combination of many talents besides technical but being a detective and a “fireman” too. With you doing a job like that, I’m sure you have many other talents as well.

26

I wish you a good trip. Thanks again for sharing such a personal situation here. It gives others a better understanding of the situations with depression and the different types. Now that I know more than when I started this thread I have gained a better understanding which was my intention.

27

Try not to judge him on his ‘ups’, which are normal things he can be capable of, and which you can cherry pick to say, “See, all is ok.”

Don’t do that.

28

In this particular context, it was an assessment for disability benefits.

29

A huge difficulty is distinguishing between actual pathology, as opposed to personality and situational factors. Even if there is a pathology, you need to assess severity and distinguish depression from from transient moods, dysthymia, bereavement… Moreover, form many mental health conditions, subjective allegations are a major - if not the primary - source of diagnostic information. I readily acknowledge that there are some folk who are unable to perform any work due to mental impairments such as depression and PTSD. My personal, non-medical opinion, tho, is that a far greater number of people could work, but for various reasons do not.

Life is hard for just about everyone. I’d suggest it is a rare individual who does not occasionally wake up and feel like they don’t want to get out of bed, or dread going in to work on Monday. Lots of jobs are stressful and unrewarding. Yet, the majority of folk find a way to drag themselves out of bed and do what they need to do.

Others find someone to enable them - or a source of funding other than employment. Or, relatively few decide to take themselves out.

It is also difficult to factor out numerous factors. Hell, the job market is tough enough for someone with an education, work history, lack of criminal record… Subtract any of those, and you make the job search tougher. Add in relationship stresses, poor financial choices, and life gets tougher and tougher. Also, factor in the environment. Millions of Americans are raised in shitty households, with substance abusing, neglectful, uneducated, and abusive, or absent parents. If your life sucks, it would be surprising if you WEREN’T depressed to some degree or another. Then there is the mistaken belief that everyone’s life ought to be as portrayed on TV and in advertising, where everyone in young, beautiful, wealthy, and happy, and no one ever cleans a toilet.

In my opinion, the most persuasive instances of mental health disability are ones in which someone previously was functioning at a reasonably high level - making decent money, then stopped, and not due to a lay off, firing, etc. Also, not everyone who gets fired later gets to say, “Ooh - it was because of my mental impairment!” Some folk are just shitty employees, or fuck up, and deserve to be fired. Again, bad choices.

And some folk lack realistic expectations. Take the ex-teacher in the OP. OK, maybe he can’t handle the challenge of being a teacher Doesn’t mean he couldn’t push a broom, or flip burgers. And what do we do when our economy has so many jobs that are so undemanding and unrewarding?

Allegations/diagnoses of bipolar or episodic impairment can be especially troublesome. Hard to accept that your neighbor is unable to work, when their family just got back from a vacation. Some people do cycle. IMO, many others simply have mood swings which are within the range of normal, and the prefer not to do things they do not find attractive.

There is SOME appeal for folk in lousy situations to present themselves as victims. Far more attractive to persuade others that one can’t help their situations, as opposed to acknowledging that they are fuck-ups. In my experience, I find most refreshing some of the ex-cons and ex- substance abusers I encounter, as they at least take responsibility for their situation.

Don’t minimize the fact that MANY folk and industries benefit from the identification and treatment of mental health issues. The psychologist who writes that someone is “unemployable” is getting paid for his/her services, as does the lawyer representing disability claimants. Health care institutions and bureaucracies have incentives to inflate the size of their clientele, and the need for their services. There are tons of groups on-line and in-person where folk who wish to present themselves as impaired can find support and affirmation. Some improve as a result - many others simply fine-tune their “resume” presenting themselves as disabled both to themselves and the world.

Hugely difficult issues. Ones I’m not at all convinced American society is dealing with well.

30

I have no doubt that you’re just trying to figure him out. But you are also coming across as “judgy”. It is 100% okay to have doubts about someone’s alleged helpless, but own those negative feelings. Even though I’ve had my own bouts with depression, I know I’d be tempted to be judgy if I knew someone like this. It’s pretty hard not to judge when someone isn’t conforming to our ideas of what makes someone respectable.

Yes, there are different levels of major depression. There’s the “I’m catatonic and can’t wipe my own ass” kind. There’s the agitated “I can’t sit still and I’ll bite your head off if you try to make me” kind. And there’s everything in between. Some people have circumstances that allow them to cope better than others (like great psychotherapy, loving family). And some people are simply stronger than others. This guy could be dealing with more than just depression. So it doesn’t make sense to compare him to your friends unless you control for all the variables.

Showing up to work is not a reliable sign of mental wellness. Most of us have heard of someone who showed up to work on a daily basis and put on a good front, only to one day kill themselves without warning. And then there are the miserable wretches who show up to work and drive everyone else nuts. We don’t know what kind of state this guy is in to know that he’d be better off working.

31

I have depression, though not severe, and I manage it through means other than medication, and I also know others with depression. It seems to me like both he and his support are taking the wrong approach and enabling him. When I was out of work, it was particularly bad having so much spare time and so little motivation to do anything, and the longer I was out of work, the worse it got. It wasn’t uncommon to spend 10-12 hours a day sleeping, when I can get by on 6 or less just fine when I’m working, working out, and otherwise engaged. The problem is, it’s just a downward spiral and it’s difficult to escape if it isn’t early.

This is why I think the support you’re talking about is probably counterproductive. If someone is far enough gone that they’re on medication, getting support from friends, family, and the community, and still unable to even get some sort of part time job, then it’s probably severe enough that he needs more serious professional help and/or he’s getting enough help to just keep his head above water but not enough to really make a difference. This is why he didn’t take up the offer on starting the website, it’s the kind of help that could probably really help him long term, especially since that sort of work would let him do it in spurts based on his motivation, but the amount of effort seems utterly impossible when one is far enough down a hole.

Even now, I’m dealing with someone that is bipolar and depressed and only just a few days ago had I realized that I was enabling his self-destructive behavior and that he was far worse than I realized. Unfortunately, like this person in the OP, trying to provide the push that I think he needed, things got way worse and others saw me trying to push him to take action as cruel and stepped in to continue enabling him. When I confronted them, they are in straight up denial that anything is even particularly wrong other than that he just needs a little bit of help… never mind that it’s been months and children are involved.

So, I guess my point is, really, unless you have depression to some degree, it’s really hard to really know what it’s like. What really helped me when I’ve been there wasn’t just people giving me a little money, but actually putting in the extra effort to make me feel loved and connected to the world again. That is, yeah, I needed help paying some bills, but if they hadn’t done that, maybe just stuff like taking me to lunch, hanging out, getting me out of the house, I’d have been stuck still needing their help paying bills much longer.

32

If someone consistently makes bad choices, at what point can we conclude that they are indeed mentally impaired? It doesn’t benefit anyone to pretend that a “fuck up” is just a normal person who likes to fail. Maybe instead of using standardized tests to determine mental impairment, we also need to look at outcomes.

The guy in the OP could probably push a broom. But does it make financial sense to give up disability and Medicaid so he push a broom 8 hours a day for minimum wage? And I know if I had my choice between hiring a 40-something year old former professional who has never done anything menial in his life, with long gaps in employment (and probably visibly out of shape), and a young guy right out of high school, I’d pick the latter. There are no “easy” jobs out there anymore. The rat race is everywhere.

And yet a lot of people spend their whole lives beating themselves up for being a “fuck up”. They can’t keep a job or maintain relationships, and they conclude it must because they have some moral or character failing. But then they go to the doctor and discover they have been dealing with a disability all this time. I suspect that almost all “fuck ups” are dealing with a bonafide medical or psychological condition. Perhaps in another time, they wouldn’t even be a “fuck up”. But we are in a day and age where employers love to remind their employees how disposable they are. Every day, the precarious ledge that the employed person walks along gets narrower and narrower, while the safety net shrinks more and more. In a system like this, why wouldn’t our society be filled with people who refuse to accept responsibility? If my mental and psychological abilities only allow for me to qualify for minimum wage, but I’m competing against college grads for jobs, why shouldn’t I feel like I’m disadvantaged due to factors behind my control?

33

Today’s job market is certainly tough on most folk - especially folk with some impairment, or who have misstepped in the past. But the fact that the job market is tough impresses me as a somewhat different topic than whether an un/underemployed person has a mental impairment of a certain severity.

The 40-something guy you mention might not want to push a broom, no employer would hire him, but so long as he is able to do what is physically and mentally involved in pushing that broom, he ought not be collecting SS disability and Medicare. Each state has its own standards for Medicaid. And the VA is absolutely insane (IMO) in what they will determine renders someone “unemployable.”

Heck, I’m a huge supporter of all manner of social services - educational, medical, vocational training/job placement, government jobs programs, etc. Could even envision systems of “universal minimum support” that I would support. But I am NOT a huge fan of increasing the number of folk whom we designate as “disabled.” Unfortunately, since the “end of welfare” back in the 90s, Social Security disability is largely the only lifering available to those who find themselves struggling. And a huge number of those claims are from folk alleging impairments that do not lend themselves to objective indicia - migraines, fibromyalgia, and - yes - many mental and emotional impairments.

Americans - and people worldwide - are going to have to decide what people are expected to do, and for what income, in an increasingly automated world where we simply DO NOT NEED the services of all employable folk.

34

And the project management part of it is a piece of cake as well. Here, do this project, realistically it will take you eighteen months and six million dollars with a team of seven dedicated to it. You have two million dollars, six months and no dedicated people, they all have different jobs.

To Din’s point, I’m lucky. My husband can support me through this. We have college paid for for two kids who are in high school and 401ks pretty well funded. Our mortgage is $300 a month. I have lots of highly paid quarters worth of social security in. I’m ten years from being able to get to my 401k. If I end up working 20 hours a week at Starbucks, that will be sufficient - I don’t need my big stressful job back to make ends meet. I don’t - at this point - need to convince a disability judge of my disability to keep a roof over my head.

35

So you’re saying that someone who cannot actually get a job because of his mental or physical condition, but who could theoretically handle the duties of a job if his condition didn’t mean someone else would always be hired first should not be considered disabled?

36

If no employer would hire him, and he ought not to be collecting disability and Medicare, what should he do for income?

You have a medical or mental condition that precludes you being able to find a job, but we’re not going to consider you disabled. In our present system, people who fall through the cracks like that are the ones who end up in the homeless camp down by the river, or locked up in jail or psych ward, or simply dead. Medical care and the like are good and useful services, but they don’t put food on the table, and paying for educational or vocational services for somebody whom no employer will hire is simply throwing money away.

37

Simply stating what the law currently is with respect to SS Disab. 20 C.F.R. 404.1566(c), 416.966(c) to be specific. That is not anywhere near one of the many aspects of SS disab that I personally find most problematic.

The term “disabled” itself is - IMO - extremely problematic, as it has no universally agreed upon definition. Personally, I would prefer that the government put a broom in the guy’s hands and pay him to sweep the sidewalks, instead of designating him as “disabled.” Far too many (by no means all) people welcome the designation of disability, because it absolves them of personal responsibility. “It’s not my fault, I’m DISABLED!”

But I apologize if I have started/encouraged a hijack.

38

I wish the best for you.

After the first of two psychotic breaks my folks took me to Toronto on vacation. This was about four months into recovery time. ISTR it helped, at least in the short term. I definitely recall being well enough to volunteer at a certain audience-participation feature in an educational/entertainment center there as a “Johnny Carson”-type talk show host, with “guests” such as “Farrah Fawcett” and “Evel Knievel”. (Other parts of the general exhibit, with presenter/audience format, showed how certain special effects were set up.) I think the opportunity to ham it up was as substantial part of the benefit.

I certainly hope you will be well enough to enjoy the trip this summer.

I had no idea Adivan could be addictive. Perhaps by that time an alternative will be there for you.

39

If I can’t get a job because I’m not smart enough or emotionally/socially put together enough and I don’t have the means to improve myself, why wouldn’t I think of myself as disabled? What does disabled mean if it doesn’t mean “disadvantaged through no fault of one’s own”?

You seem to think that people who are having difficulty supporting themselves but who do not have a diagnosis should automatically point the finger at themselves. But that does not solve the problem of having no money. Acquiring a diagnosis and pursuing benefits does, however. It makes total sense for people to eschew “personal responsibility” once they have determined they aren’t getting anywhere with the “self blaming” game.

If we made it so that everyone was automatically eligible for the social safety net, there would be no need to put “disabled” on a lofty pedestal.

40

It does absolve people of responsibility. I see it all the time with parents of kids who are not neurotypical - a friend had a severely disturbed foster kid who didn’t treat my daughter well, and when my daughter refused to have anything to do with him, my friend insisted his behavior was to be tolerated because “he’s disabled.”

There is a line to walk between making accommodations - including providing SSDI - and enabling behavior.

I think you and Dins both agree - it would be far better to provide economic support to the unemployable without relationship to their disability - unfortunately that isn’t the system we currently have set up.