Skepticism

AI: Admitting mental illness

Something I’ve been happy to see around the internet is the number of people coming out and talking about their mental illnesses. It almost seems sometimes like the stigma is over… but it’s not. And sometimes I feel like there’s an even weirder image of mental illness portrayed that at some point, everyone gets depression, they blog about it and take some pills and everything gets better eventually. No big deal.

Yet mental illness is still killing people. And it seems like there are acceptable and less acceptable kinds of illnesses to have. Like you can have OCD… and everyone you know will be like “OH I’M SO OCD TOO! I totally have a thing about flushing toilets and when people don’t it’s SO GROSS, right?” But that’s cool. It’s JUST OCD. Or anxiety or depression. But while you need to admit your problems, you can’t talk about them too much. You can’t bring people down with them. You SHOULD come out about it but you shouldn’t make it seem like things are sad or scary or overwhelming. Just be brave and show everyone how it gets better.

I suppose that’s our preferred narrative for all things bad. We want to hear the stories of triumph. Or we want to hear the stories of utter tragedy and loss, followed by triumphant and defiant rebirth. We dislike stories of prolonged pain and suffering with no end, with no punctuated turmoil. We don’t want to hear about depression simmering in your brain, kind of ruining everything slowly and quietly, but not destroying everything. Discussing it like that is just a downer. It’s so depressing. SOOO EMO.

So while we are doing this really great thing where we stand up and say HEY! I AM MENTALLY ILL AND I AM NOT ASHAMED! We really still aren’t addressing what that means, at least I don’t think we are. Or at least I’m not.

I think it’s important to come out and discuss mental illness, but I’ve kept my own experiences relatively private. Which I am not proud of. Because I don’t keep anything private. I mean, I’ll mention casually that I have some anxiety issues or that I’ve been depressed or suffered postpartum depression (which is like the most acceptable mental illness on earth… I was surprised it was so horrible because it sounds so glamorous. I mean FFS Brooke Shields had it.) And when I’m having an especially bad day, I might tweet something alluding to it. But I’m not shameless about it like I am about tweeting a selfie from the toilet.

But today that ends, because women who write blog posts with images of themselves dry heaving Cholula are not women who have business being all “But I can’t talk about that… what if people judge me?”

I’ve suffered a lot. And I’m suffering now. And I’ve spent months trying to hold my life together because of crippling anxiety. I fear my email. I fear the phone. I fear talking to people. I have unmanaged ADHD which leaves me unable to get most things done or think clearly. And it’s depressing as hell. And I’m sad and I’m angry and I spend most of my waking moments fearing cancer. But right now, at this point in my life, it’s not even that bad comparatively.

Through my early 20s I was hospitalized repeatedly for suicide attempts. I self-mutilated for years. I try to pretend no one can see my scars on my arms… because I’m a grown up and cutting is such a drama-queen-teen thing… super embarrassing and not something respectable grown-ass women ever did in the past (and especially not as adults.) I was also hospitalized several times for eating disorders. As a grown up. Another thing I don’t mention because it’s hard for people to take you seriously as a former anorexic/bulimic when you’re morbidly obese. I did a lot of drugs. Tried rehab once.

And there was the PPD, but again, that’s a cool-kid mental illness. And everyone gets how you can be depressed when you’re tired and there’s a stranger in the next room who won’t stop crying if you stop showing her your boobs.

I talk about these things like they’re past and over, on occasion that I might mention them at all. But they’re still there. Even when they’re not actively destroying me, which they’re not. They’re still a part of my brain. The thought-scars are there. They still affect the way I’ve learned to view the world. It’s not drama and sadness then overcoming and healing and being stronger. Now it’s “what can I do with this today?” So to manage my anxiety, I run. It helps mostly to keep panic attacks in check, but general irrational fears are still overwhelming. To manage the other stuff, I do nothing and that’s hard and I know I should do something, but sometimes doing something is harder than just putting up with it.

I feel like my story isn’t the right story. Because it’s not hopeful and the bad parts are embarrassing and dramatic and put me out of “acceptable mental illness”… they’re still stigmatized. And yes, things are better, but they’ll never be great. I won’t even be one of those who OVERCAME!!!! So I don’t say much.

And I have a generally happy demeanor. Despite having horrible social anxiety, I’m still an extrovert. Once I can get over the part of being physically ill out of fear of being around people, it’s actually really fun for me to do it. And I feel good having done it. So it always seems a little unbelievable that I’m actually struggling or that it was ever so bad.

So there it is. It’s not exciting. It’s not inspiring. It’s not even interesting. But it’s real. And if I believe it is important for people with mental illnesses to talk openly about them, I can’t hide my own out of embarrassment.

Life is fucking hard. Brains aren’t good at this shit. That’s the way it is. It’s nothing to be ashamed of.

Do you struggle with mental illness? What do you think about the coming out stories? Are they helpful? Hurtful? Unrealistic? Do you discuss your own experiences? Do you discuss them in full or do you hide the more “embarrassing” ones? Do you think mental illness is easier for the skeptically inclined to cope with?

 

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Elyse

Elyse MoFo Anders is the bad ass behind forming the Women Thinking, inc and the superhero who launched the Hug Me! I'm Vaccinated campaign as well as podcaster emeritus, writer, slacktivist extraordinaire, cancer survivor and sometimes runs marathons for charity. You probably think she's awesome so you follow her on twitter.

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49 Comments

  1. A thousand thank yous for sharing. Depression/anxiety runs rampant in my family, and I’m about the only one so far not yet diagnosed/medicated for it, I think only because running keeps me functional. Though I’ve often been wondering lately whether it’s time to look into treatment, and then I’ll have a few shiny days and forget about it and assume my fitness regimen is working. I ADORE the coming out stories and feel much more at ease with myself when I read them, thinking/hoping this sense of fraternity may help me work up the nerve to treat it when it becomes necessary.

    I don’t discuss it because I feel like a poser since I’m not missing work and destroying relationships or physically harming myself and whatever other extreme behavioral themes show up in the prominent narratives of capital-D diagnosed Depression. As long as I’m still stumbling through and keeping my head above water, these circling fins aren’t presently a danger, right? It’s like there has to be some episode of being dragged under before it’s worth addressing head-on, a turning-point event that I’m waiting on, but I don’t know what it will be.

    Like I said, I’m functional, so I don’t feel like I have a claim to the D-word. Not yet, anyway, since I always bounce back without intervention. . . . For now.

  2. You’ve seen me on Twitter…

    I’ve got a pretty serious depression problem with a side-order of anxiety. So wonderful that I can’t do anything and I also can’t sleep through the depression… I so very much envy the people who get depressed and sleep 16 hours a day. I’m depressed and I never sleep more than 2-3 hours without waking up, and sometimes I can’t get back to sleep at all. I haven’t had insurance in a few years, so no meds. I sometimes drink pretty heavily, which makes the depression worse but kicks the anxiety to the curb. I’ll have a horrible couple of hours and then sleep for 6-7 straight hours which is a real gift for me. And because I’m already on the edge, anything goes wrong and I’m knocked off a cliff.

    I talk about it online, on Twitter or whatever, because no one knows me and no one really cares, and they can engage or not as they can stand it. At least it keeps me from dumping it all on my wife who has her own problems and doesn’t need to be burdened with any more than she already has. Of course, that leaves me open for the sort of “concern” that seems like 25% concern and 75% “you’re freaking everybody out and ruining the fun, why don’t you go get help so you can STFU already? Fucking loser…” So that part is pretty awesome too.

  3. I’ve been in and out of treatment since I can remember (pre-school). Most of the people I know struggle with it, so I guess I don’t ‘get’ coming out stories.

    There’s a reason therapeutic environments are four-walled, I think. There’s a need to put a face on it with people who aren’t afflicted. I don’t want people who don’t know me intimately to see me at my worst. That’s just surviving in a social environment.

    I remember an author who had published a memoir about her struggles with depression being interviewed about her book. One of the critics had said that the book didn’t make her look brave, it just looked pathetic. She replied “Yes, that’s the point. That’s what this disease does to you.” I thought it was a very salient point.
    I don’t like being vulnerable. It’s very uncomfortable, to say the least. It’s the truth, but I don’t have to like it.

    Skepticism is really useful for anyone navigating health care of any kind. Skeptics, as people, enjoy arguing too much to be really helpful. More likely to do harm than good, in my experience. The last thing I need is an interrogation or lecture.

  4. I suffer from chronic severe depression and have all my life. One of the biggest things I experience from others is that they don’t believe that I can’t just get over it. I have to explain to them that as in other diseases, some people get over it and some don’t, like measles or cancer. It’s not a choice like some people think it is. This is one of the most frustrating problems I come across with this. I’m honest about it, but unfortunately it tends to drive people away. Finding a girlfriend is next to impossible because I haven’t found any women who want to deal with the depression and frankly, I don’t blame them one bit.

  5. I’ve recently been diagnosed with anxiety, depression, and PTSD. I never talked to anyone about what I was going through, which included suicide attempts and self-injury, led to more self-injury and problems in school, and were starting to lead to problems with my marriage. It’s hard to go from never letting anyone see anything but happy me to trying to reach out.

    I’ve told a couple of friends now so they’ll have some idea of why I’ve been acting particularly weird lately, and luckily they’re internet types who interact with other internet people who have mental issues and thus mostly stick to the internet and are way more open about this sort of thing. I haven’t told my family. I come from a very close-knit but devoutly religious family who seem to have a history of mental and emotional issues, but since the solution is always “Offer it up to God and pray more” and that never worked for me when I was younger, I’m reluctant to let them in on this now.

    I’m kind of glad to see other peoples’ stories because before I got the courage/desperation to seek professional help, seeing what worked and didn’t work for other people was how I navigated my own issues until I couldn’t any more. Since the common thread seemed to be “actually see someone whose job it is to help you,” that’s what I ended up doing. But it’s hard after a lifetime of trying to suck it up and avoid notice.

  6. Hi. Nice to hear it when someone opens up. Education is the best way to get rid of the stigma. You asked them,so I’m just going to answer them:
    Do you struggle with mental illness? Yes, daily. Sometimes hourly. It’s difficult to get beyond the problems, but that is the goal. I work for a Not-for-Profit Peer Agency. Have for almost 6 years. This was after sitting around the house for 3 years in a funk that is likely both the same as, and different from, yours. Before that, I was the bread-winner while my wife took care of our 3 kids. I had 21 years in a utility company when, one day, I just couldn’t do it anymore. Your page, however, is not the place for my details.

    What do you think about the coming out stories? Are they helpful? Hurtful? Unrealistic? As I began, Coming out stories are excellent. They are one of the best ways to help others. For some, it is the realization that they are not alone, For others, it is learning that there is nothing to fear because someone they know has a diagnosis. I also take joy in hearing them. It may sound odd, but to me, it shows how much someone trusts me to hear their story and is willing to bare their soul with no guarantee of sympathy. I respect that.

    Do you discuss your own experiences? Do you discuss them in full or do you hide the more “embarrassing” ones? As I mentioned earlier, I work for a peer agency that assists people with mental-health diagnoses in getting their needs met. From “what bus do I take to go shopping?” to assistance with applying for benefits or housing. We are currently about 90% peer-operated. Most of us have been there at one point and know the challenges it can present. We also are there to show our clients that there can be an other side to their current issues. I have discussed my experiences to individuals and groups. I don’t reveal all of the embarrassing experiences, but I have passed some on.

    Do you think mental illness is easier for the skeptically inclined to cope with? No. It is the entire person’s make-up that allows them to cope. Or not. I do find that, as an atheist, no “promise of heaven” makes it damn hard to even contemplate suicide.

    Once again, thank you for sharing. Keep it up. And come back here some day. Reread your story, compare it with what you are telling people now, and see how much you’ve changed by braving the storm.

    1. I do find that, as an atheist, no “promise of heaven” makes it damn hard to even contemplate suicide.

      I have the opposite experience. No hell means suicide would really just end the pain. And conversely, there’s no “reward” for sticking with it. It won’t get better in this life, because now I will start to have to deal with “normal” age-related health problems more and more, on top of depression and anxiety. And there’s no life afterwards to look forward to as a reward for sticking it out until it’s natural end.

      1. I gear what you are saying and understand. It was my acknowledgement of my lack of belief that was the catalyst for my statement above.

        For me, however, this brief experience is it, so I try to make the most of it. Even then, it’s no bowl of sunshine. I have my bad days, too. It’s my personal experiences that I use to try to help others.

        I hope that you, as well as some of the others here, can find your way to the other side of these issues. The reality is that some may never get there, but I can hope.

  7. It is difficult (impossible?) for some people to understand depression. Unfortunately there are some who will use a person’s depression to try and hurt them still more. These people must be avoided. Good therapy with a good senior clinician with good psychopharm can be a life-saving intervention. Of course bullies don’t want people to get healthier and stronger, they become harder to bully then.

  8. Been there, done that, still have the prescriptions bottles in my cupboard. I’m on a twice daily antidepressant, and I’m in the same boat. While I’m better while on the medication, I’ll never be perfect. I’ll never be 100%. I go to great lengths to avoid emotionally charged situations, and I’ve made significant life choices to limit stress in my life. I even avoid trying to feel too happy (sympathetic) because I know the flip side will always be soul-crushing depression (parasympathetic). I can count on one hand (one finger, actually) the number of times I’ve felt genuine joy and contentment in the last decade. And I just had to get a bump in my meds — the third time since being diagnosed — because my body keeps developing tolerances to the drugs. I know in a couple of years, I’ll have to make a change again because that’s just part of the cycle. It sucks and it’s frustrating, but it’s just the way of things. For all that I have a good life, and I’ve learned to enjoy the good parts as much as possible around the mood disorder screwing things up. I have a supportive spouse, which is great, and a (mostly) supportive family, and it’s always nice to see people writing about their own illnesses and working toward reducing the stigma. I keep meaning to write more about mine, but most days it just doesn’t seem worth the energy expenditure. Maybe I’ll still get around to it eventually.

  9. …and everything gets better eventually. No big deal […] while you need to admit your problems, you can’t talk about them too much. You can’t bring people down with them […] We want to hear the stories of triumph. Or we want to hear the stories of utter tragedy and loss, followed by triumphant and defiant rebirth […] I won’t even be one of those who OVERCAME!!!!

    Nothing is more depressing than forced optimism, or positive thinking as a moral duty.

    1. True, and if you fail to be optimistic you feel inadequate. Also, forced optimism is just avoiding the problem, so it’s useless anyway.

      I had a breakthrough when I stopped blaming myself for my illness, and realized that it’s just something that happened to me. That made me stop beating myself up over it.

      1. I’d like to rephrase this: “Also, forced optimism is just avoiding the problem.”

        What I meant to say is that forced optimism is forcing yourself to feel something other than what you actually feel, and that’s impossible, and will always fail. I suppose you can change how you feel in the future by focusing on what is positive, and that this could lead to optimism, but faking optimism itself is not going to work.

  10. Thank you for sharing your story. Of course it is difficult to talk about mental disorders. I have found that people either don’t want to hear about your sordid tale or don’t know how to respond or don’t understand it (or all of the above). The reality is that mental disorders are hard to understand even by the people who study them. Untrained friends and family often times have no clue how to respond or help. We understand relatively little about how the brain works. Even people with the same diagnosis can manifest completely different symptoms.

    One time, I had to go to a doctor, who was not my regular doctor, for an unrelated health problem. The scars on my body came into question. “Are you getting help?” he asked. “Yes, I am receiving treatment from a Psychologist and a Psychiatrist,” I replied. That is about all anyone can do in some cases…make sure you are getting appropriate treatment.

    People didn’t want to hear about the dreadful, consuming thoughts that brought me to the brink of self-destruction. They didn’t want to hear the agonizing suffering that seemed to have no end, no solution, no remedy. Despair without hope killed the conversation. It was a story of death without glory or meaning.

    This year, a friend died of cancer. She fought it for years, staying positive even when things seemed hopelessly bleak (near the end). She had two young children and decided, at the very beginning of the battle, that she was going to fight her illness and live life to its fullest. Her story, when fully told, is one of embracing life. It is inspiring. Depression, in some ways, is the opposite. I was dying. I was choosing death. There was no fight. There was no hope. I wanted to give up. How do you console or help someone who not only doesn’t want to be helped, but is choosing death? I know this is not how every mental illness manifests itself…or even depression for that matter. But, in my case, I wanted to die. I truly did. There was nothing to talk about and no one could help me. All anyone could do was help ensure that I was safe and receiving appropriate treatment.

    I now choose life over death. In fact I embrace it. I live with a routine of medications, appropriate sleep, light therapy, exercise, appropriate food, and psychotherapy, but it is now just part of my life. I am happy to share my story with anyone who cares to hear it. But, at an individual level, I wonder what purpose it would serve. Nothing gave me hope or meaning when I was in, what I called, ” the pits of despair”. And for those that haven’t experienced it, it provides little meaning.

    The relevant concern, in my opinion, is having a policy discussion about 1) the rights of the mentally ill and how they should be treated, 2) research and funding for mental illnesses 3) access to appropriate care for people and 4) training and general awareness for people to help identify and help the mentally ill.

  11. Thank you for sharing your story, Elyse!

    Here’s mine.

    Disclaimer: All of my closest friends, my current and former boss and some of my co-workers know all about my mental illness, so I feel relatively comfortable sharing some words about it from the relative safety of this pseudonym.

    Since my teens, I’ve struggled with deep depressions, anxiety and low self esteem. Much of the time it’s been hell. A few years ago I was also diagnosed with bipolar disorder, which I’ve experienced in much the same way as Steven Fry, except for two manic episodes where I went completely insane and had to be hospitalized.

    All this time I tried to figure out why this was happening to me, and I came to understand the mechanisms of it deeply, but was unable to improve the situation. Rather, the opposite happened. I was clearly missing some crucial insights.

    It finally came to the point where I realized I needed help from a professional with an outsider’s perspective. I fortunately found the right therapist, and over the last year and a half we have discovered the cause and the cure for my problems, and I’m on my way to a full recovery. I’m already a different man. Although parts of this will stay with me for the rest of my live, I hope of a day when the illness and agony is just a distant memory.

    That’s not to say that this has in any way been easy. The last few years have been really hard, but making steady progress is encouraging!

  12. Do you struggle with mental illness? Yes. The “official” diagnoses are Dysthymia, Narcissistic Personality Disorder, Avoidant Personality Disorder, Social Anxiety Disorder, and a very low self-esteem. As bad as all that sounds, I’m pretty sure that’s still only the tip of the iceberg.
    What do you think about the coming out stories? Are they helpful? Hurtful? Unrealistic? Sometimes helpful, sometimes hurtful, sometimes unrealistic. Sometimes all three at once. Most of the time I’ll just read them and cry, because “cry” seems to be the only emotion I’m capable of feeling.
    Do you discuss your own experiences? Do you discuss them in full or do you hide the more “embarrassing” ones? I don’t think anyone should be subjected to what goes on in the cesspool of random thoughts that I call my mind. Unfortunately, that applies to therapy as well. I’ve been in and out of therapy for much of my life (I’m in my 40s) and I tend to convince myself that I’m “OK” and stop. I can’t seem to figure out that it’s an ongoing process. Obviously I am able figure that out from a logical standpoint, but I guess I don’t care enough to go the distance. It is far easier to be miserable. At least misery is something that comes naturally, happiness is something that I would have to put serious effort into.
    Do you think mental illness is easier for the skeptically inclined to cope with? Honestly, I don’t know. I don’t really have any direct evidence that putting in the effort to make myself “un-miserable” is worth it. After suffering for as long as I have, not being miserable is pretty much the best I can hope for. I’m pretty sure that there have been times in my life that I have been at least partially happy, and certainly there have been isolated moments, but I can’t remember any of them, try as I may.

  13. OK, here my answers to the questions:

    Q: Do you struggle with mental illness?

    A: Yes. See my other post.

    Q: What do you think about the coming out stories?

    A: Most importantly, it’s good to see that I’m not alone. Also, listening to other peoples experiences put mine in a new light.

    Q: Are they helpful? Hurtful? Unrealistic?

    A: For me, they are generally helpful. For others, I don’t know. Some can be overly optimistic or pessimistic, and in that way be unrealistic, but if you write what you feel then that’s how you feel about it.

    Q: Do you discuss your own experiences? Do you discuss them in full or do you hide the more “embarrassing” ones?

    A: I only discuss my experiences with those very close to me. (It took me a long time to open up to my therapist.) I definitely hide all the embarrassing stuff, unless I’m totally comfortable in sharing it (and sharing it is actually useful). Most people have no idea I’m struggling. My co-workers only know that something is up because I’m only working half time. It don’t discuss this with them.

    Q: Do you think mental illness is easier for the skeptically inclined to cope with?

    A: I don’t know generally. For me, skepticism has been useful in analyzing my thinking, and avoiding quack cures. Even the times when I went totally off the raise, I was able to reflect on my madness in a rational way, which helped me recover really fast.

  14. I have depression and some anxiety, which I generally talk about pretty openly. Not always in great detail, but I don’t tell people I’ve been doing great if things have actually been pretty shitty.

    A lot of my tweets are about my depression. One could probably look at the past few months and track my good and bad days/weeks/months. I also blog candidly and in detail at my personal blog.

    Overall, people coming out is great. Having it portrayed as something you ‘conquer’, ‘beat’, ‘get over’ is really defeating. Neurotypical people get distorted ideas about mental illness, neuroatypical people feel invalidated because they’re not magically getting better.

    Not sure if this applies to other people, but skepticism is the main reason I’m working to treat my depression, and the main tool in figuring out how to successfully get by, day by day. It sucks a lot. It’s hard. I’m not good at managing it yet, so I just feel bleh all the time.

    Bleh.

  15. I struggle with depression and social anxiety. Sometimes it’s so bad I can’t make myself interact with anyone, even my family. I’ve accepted that it’s not something that is every going to be “fixed”, but there are better times and worse times and medication does help. Having time alone does help and it makes me more grateful for the times I’m with people and more willing to relax and enjoy their company.
    I think coming out stories did help me feel less alone in the beginning. I think people who write about living with mental illness every day like Jenny Lawson help me more. I really like how she always says, “Depression lies.” It’s true. When I’m feeling really bad I’m convinced it’ll never get better even though I know from experience it will.
    My more embarrassing encounters I’ve only shared with a few people – my counselor and my husband in a shared counseling session. I’m afraid that I’ll be labeled as “crazy” and lose credibility with my job and my family. I’ll be told that I should find religion again because obviously being away from it isn’t making me happy. *sigh*
    I’m not rational when I’m really depressed or anxious or panicked. It does help to remind myself that it won’t be like that forever and that time will make it better. So maybe being secular does help. If I can get myself into a more logical mindset it helps relieve the panic and anxiety, if not the depression.

  16. Me too.
    In the past I’ve worked at ‘charities’ for affective disorders (depression & manic-dep., aka bipolar) and even schizophrenia. IMO, lack of info is as big or bigger than stigma. So here is some basic info, point form:

    Over lifetime, depression occurs in double-digit percentages in both genders. Just ONE GIANT reason to remove the stigma!

    Mental illnesses have physiological roots, and even the term “mental illness” is a slight misnomer. In reality, depression is an “illness” rooted in imbalances of neurotransmitters (chemical messengers in the brain). Hopefully, knowing this fact helps takes some more of the stigma out.

    The following illnesses often occur in two’s or three’s rather than by themselves
    * Depression, aka unipolar affective disorder, OR manic depression, aka bipolar aff. disorder
    * Anxiety, panic attacks, agorophobia (which is really fear of having a panic attack in public)
    *OCD (obsessive-compulsive disorder)
    * anorexia & bulimia

    “Sadness” is not “depression”. The differences are quantitative & qualitative. Depression is a long term thing without much in the way of temporary relief – it’s “chronic”. Chief qualitative diffs. are: sadness that runs quite deep, feelings of despair (things will never get better), inability to enjoy ANYTHING, sleep and/or appetite interference, feeling very isolated, physical lethargy (sometimes quite severe).

    In the old days, and still today, severe depressive episodes were often called “nervous breakdowns”. Ask earlier generations about family history using THAT term, it’s more likely to get an accurate response. Affective disorders have a significant genetic component so family history is usually relevant.

    IMPORTANT: good people just don’t know this! IF YOU ARE WORRIED about a friend possibly feeling suicidal, there is a simple way to find out: just ask them, point blank, in a normal, and of course concerned, tone of voice. “I’m worried about you. Are you thinking about maybe killing yourself?” is as good a way to phrase it as any other. No big need to feel apprehensive about asking. Worry more about the answer! If you think someone is in imminent danger of self-harm, call the police on the *emergency* number.

    Depression and ‘talk-therapy’ go together in a lot of cases, though certainly not all. However, talk-therapy has little impact on severe cases, so anti-depressants can be used bridge that gap.

    Anti-depressants are safe. They are not addictive. They do NOT “mask” the feelings that you need to deal with, nor prevent you from “dealing” with them. The problems that have been reported in the past have been largely mitigated by better practices (eg. suicide risks in Prozac-takers). It is not really possible to O.D. on antidepressants. Do not maintain a prejudice against meds!

    All that said about antidepressants, it’s still not QUITE that easy. Unfortunately. Different types of antidepressant have differing levels of effectiveness in different people. So it often happens that it doesn’t work out the first time, and you have to try out another one. PERSEVERE!!! It’s a pain-in-the-ass, just try to deal. ALSO, the same kind of uncertainty applies to side-effects: you may have to try more than one type of pill to get to a treatment that works well enough. The good news about side-effects is that they are generally not severe, just inconvenient, and they often (but not always) just go away after a few weeks.

    MOST IMPORTANT THING ABOUT ANTIDEPRESSANTS:
    They hardly ever take effect **right away**. It usually takes a couple of weeks. Yeah, WEEKS! Sometimes up to 6 or 8 weeks. Again, try to deal with it. It’s a real bummer to try a pill for 6 weeks, decide it doesn’t work very well, then wait 6 MORE weeks to see if pill #2 will work better. The reason I call extra attention to this fact is simply that even good doctors too often fail to mention that “little” detail – and a lot of otherwise-treatable patients give up before they’ve given the pills a chance to work properly.

    ECT, Electro-Convulsive Therapy, aka Shock-therapy, actually works. Unlike in the past, ECT is no longer an unpleasant experience (you’ll know what I mean if you’ve ever watched “One Flew Over the Cuckoo’s Nest”). Both anesthetics and muscle-relaxants are used, the electrical currents used are much lower, and the currents or more localized, than in the past. The only common side-effect is slight retrograde memory loss (you forget a few things from your past, but your present/future memory still works fine). ECT tends to be used as a therapy of last resort, when other treatments have failed, and the case is severe enough to warrant it.

    Sometimes depression is a response to real-life events, such as death of a loved one, or having been abused during childhood. But sometimes it seems to occur for no discernible external reason. Then it called “endogenous” depression. It can sometimes be a bit harder to treat, but not that much. Depression can also be caused by other physical illnesses, and so this is a HUGE reason to ALWAYS see a fully-qualified medical doctor if you’re depressed. If nothing else, s/he can rule out other illnesses – or diagnose and treat them, which would also fix the depression.

    1. In reality, depression is an “illness” rooted in imbalances of neurotransmitters (chemical messengers in the brain).

      not really. and the popularity of that story also frustrates me, because I don’t know what to do when the nurse/doctor/therapist who is supposed to help me is telling me a false (or at least simplified to the point of wrongness) story. It makes me lose confidence in whatever they’re suggesting, and it’s hard to be honest about what’s going on with someone you know is telling you less-than-correct information.

      http://www.npr.org/blogs/health/2012/01/23/145525853/when-it-comes-to-depression-serotonin-isnt-the-whole-story
      http://www.badscience.net/2008/01/washing-the-numbers-selling-the-model/

      1. I’ve long suspected it to be the other way around, that it’s the depression that causes the imbalance.

        In my case this turned out to be true. In therapy, I finally found the cause of the depression: coping strategies that had worked fine through my childhood, but failed once I was forced to come out of my safe bubble and deal with the the real world and the expectations of other people. I have now had help developing new coping strategies, and this has given me a way out. Medication helped me through this process, but I will eventually be able to get off it.

        I now know that my depression was a natural reaction to the immense pressure I was under, just in order to feel good about myself, and that the bouts of mania was a necessary, though unfortunate, part of the healing process.

        I won’t generalize this to anyone else. Everyone’s story is different. Whichever way it is, the imbalance is real, which is why finding the right kind of medication can help restore it, and at least make life more bearable.

  17. I’d like to add:
    Not to make anyone envious, but I am the Poster-Boy for how well talk-therapy can work. I had somewhat aloof and neglectful (and odd-ball) parents, esp. my father, and was depressed to one degree or another for more than half of my childhood, and an even bigger portion after I turned 20.

    But at 29 I went to see a psychiatrist, he told me point-blank my parents had been the real problem, and since that time I have experienced ZERO depression. Over 25 years of freedom, and my point is this: if you are suffering, then go see a doctor. NOW! No guarantees of course, but when were there ever guarantees anyway?

      1. Even here, though, there are not enough therapists to go around, so the waiting lists are long. Often I’ve felt guilt that I’m taking up resources that could be better used to help others who need it more.

  18. sometimes I feel like there’s an even weirder image of mental illness portrayed that at some point, everyone gets depression, they blog about it and take some pills and everything gets better eventually.

    yeah, the dominance of that narrative has been bothering me a lot, too. Not specifically because of suicide risk (I’m drowning in “suicide awareness” stuff), but because sometimes depression is that thing that makes you live a very long, very miserable life, but all advice is always “well, I’m sure there’s a pill and/or therapy out there that you haven’t tried that’ll fix it” as if that hasn’t been tried, and as if pills and therapists are free.

  19. Do you struggle with mental illness? YES. Depression and anxiety, which make it near impossible to Do Things. Like right now, when I should be doing homework but instead I’m flooding my brain with the internet, because that and being asleep are the only ways of not being in constant, extreme pain.

    What do you think about the coming out stories? Are they helpful? Hurtful? Unrealistic? I think they’re an important step. But at the moment, they make me just feel worse, because of all those people who got to get better when I’m not, no matter what I try (which is only a little, whenever I have access to healthcare; still, nothing I tried over the last 19 year has worked properly)

    Do you discuss your own experiences? Do you discuss them in full or do you hide the more “embarrassing” ones? I have started discussing them more openly. I mean, I’ve bren saying “I’m depressed” for about a decade now, but it was just a label. I’ve only recently started to actually talk about what this means in my case. And whenever I do, it feels like I’m raining on someone’s “depression can have a happy ending” parade.

    Do you think mental illness is easier for the skeptically inclined to cope with? No.

    1. I hope I didn’t come across as a happy ending guy. I still have bad days and sometimes even a week or more. For me, what it boils down to is awareness and support.

      I won’t argue that medications and talk therapy, among other treatments, can be helpful for some people, but I didn’t find them so. I took meds for years. Paxil, Prozac, Abilify, Effexor, and others. The only one that seemed to do anything (for me, at least), was Wellbutrin. I was on that one for several years until it stopped working (“working” is a relative term. It only felt like things were a little “less worse”.) My next step was Cymbalta. I took it for about a year, working my way up the dosage ladder. I was experiencing side-effects without feeling any benefit to warrant putting up with it. It caused me to decide, horror of horrors, to just quit taking it. It is not recommended and I don’t recommend that others try it. I had no issues, but have seen and heard of the negatives that could happen.
      When I next saw my therapist and told her what I had done, she told me my psychiatrist would write that I was being “non-compliant”. I was already well involved in Advocacy at the time, so I asked her what, exactly, it was that I wasn’t “complying” with. I had entered treatment and was taking medications voluntarily, based on the psychiatrist’s recommendation. I had already been off the medication for a month, so it was pretty much clear of my system, and there had been no ill effects. I was also clear that I had no intention of trying further pharmacological treatments. Four years later (May of this year), I ended my talk therapy. It was agreed on between myself and my therapist, with the understanding that I can always come back, if necessary. That was something else that I felt no significant benefit from. I would go in every other week to once a month and felt that all I was doing was venting my current problems, which relieved the pressure, then walked out of the office to face the same problems. I, too was just taking a spot away from someone who might benefit, so off I went.

      Now I work on watching how I feel and I am lucky to have a good support system of friends and family to back me up. (Just to note: not all of my friends and/or family are supportive.) It helps that I have always been a wiseass by nature and take pleasure in making people laugh, smile, or even groan at how bad my jokes can be. I find that working, especially in the Mental Health field, is a good way to get past some of my depression. To sit with someone who is struggling; who has just managed to spill their guts to me, and SEE the spark in their eyes as they listen to me explain WHY I understand what they are talking about, as they realize that I’m not just saying that I understand, that is one of the greatest feelings I have ever experienced. That spark is hope, being reborn.

      I will part with a personal opinion. ECT should never be an option. I’ve known people who have had it done, both years ago and recently. They don’t have anything good to say about it. I almost had it done before I knew of this and am glad it didn’t happen. If anyone is considering it, read! Check the sources of the information, too. Negative reports can be as biased as positive ones. Just be an educated patient/consumer.

  20. @Jadehawk…
    I was not thinking. I live in Canada. I was born in England. I have no real idea of what it could be like to worry about your LIFE maybe depending on your JOB. Sorry about that. All the advice I ever gave to anyone regarding depression etc. was to another Canadian citizen.

  21. This is the first time I’ve shared my story with more than one person at a time. This is a bit risky, since you never know what effect your words have on people, especially on such sensitive topics.

    I have, thought, seen the power of sharing my story with one individual. I know a girl (I won’t be more specific than this to protect her identity), who I’ve known for a long time, and as we’ve hung out, gradually she has come to know about my problems as I’ve opened up to her. A while back, I could see that she was sliding into depression (due to problems in her family), and this time, instead of distancing myself from her problems like I would usually do because it brought up my my own pain, I decided to spend more time with her. I didn’t bring up the topic of depression at all. I knew she would talk about it when she was ready to, because she had come to trust me.

    Instead we just hung out, played games together, went for walks with the dog, played music together and generally had a good time. I took interest in her interests and she in mine. We had a lot of fun. I also hung out with her family a lot. During this time, she sometimes dared to share a little bit of what made life hard for her, but we didn’t dwell on it. I just shared a bit of what had helped me in a similar situation, and I could see her relief, and we shared a hug and moved to some other topic.

    Today, on a walk in the forest, she finally opened up to me and told be about her depression, and how hopeless it had been, but that it had gradually lifted over the last year or so, and that she was now really enjoying life again. Even her family was’t fighting and yelling at her as much anymore. I can’t ever know to what extend I have helped her out of it, but it has certainly brought us closer, and I know for sure that I’ve brought some light and hope into her life. I can now say that I truly love her, and she loves me, unconditionally. We will certainly spend more time together in the future, though only as friends. (For reasons I’ll leave out here, again to protect her identity, there are very good reasons why a romantic relationship out of the question.)

    Using all that I’ve learnt through my 25 years of battling depression, I may have helped my friend avoid years of agony. This makes me very happy.

    1. OK, that just got weird when I wrote it like that, so I’ll explain who she is: she’s my niece. Yeah, I’m getting back in touch with my family, and it’s great! They are good people, but a little troubled, just like me. I hope it will get better.

  22. Hi there. I’m Giliell and I’ve been in therapy for almost two years now.
    And I’m not going to tell a happy ending story because I ain’t dead yet, so I have no clue about how this is going to end. Just for the moment I feel better.
    I value the coming out stories of other people a lot, because personally they allowed me to seek help early enough. Reading about kick-ass people I really, really admire who are struggleing with mental illness allowed me to shed some of the stigma attached. It made me understand that I’m not a weak abysmal failure for needing help. I’m trying to pay forward by fighting stigma at least in safe online spaces. I’m not really able to share most of it in meatspace, although there are people who know, people who help me.
    The thing about mental illness most people don’t understand is that it’s first and foremost illness. And illness doesn’t always have a happy ending. There are illnesses that can be fully cured, there are those that leave you scared for the rest of your life, there are those that are chronic, there are those that kill.
    I know I’m better now, I’ve changed, i worked a lot, I developed routines and ways to deal with it, I’m much better now than I was last year. But I’m not “healed”. There are still times when all I want to do is to hide in bed. There are times when all I do IS to hide in bed. There are days I’m binge-eating and then puking it all out (and I haven’t told that to anybody in meatspace).
    But it’s alos important for me to know and understand that I don’t need to be happy Miss Sunshine and tell the wonderful story of how I beat mental illness. If I had broken my leg in a complicated way then nobody would expect me to ever have a leg again like it was before the accident. Why should anybody expect my brain to be like it was before mental illness?

  23. I’ve suffered from chronic depression since my early teens. I don’t volunteer that information to everyone, but I will talk about it if the topic of mental illness comes up in conversation. My husband and my close friends know about it, but I seldom talk about the depth, and there are a few details I have never told anybody but my immediate family or a therapist. Depression runs in my family. My younger brother has suffered for even more of his life; he never finished high school (but got his GED), worked for a while but is now on disability. He still lives with my parents and probably always will. I definitely recognize signs of depression in my father, but he has never been in treatment for it.

    I am very fortunate in that I have good health insurance, and medication does a very good job of controlling my depression. I see a psychiatrist just to manage my medication, but I am not currently in therapy. I have had periods in my life that were more challenging than others. A few years ago, I became very unhappy with my job situation but felt that I couldn’t just walk out because I would lose my insurance. I recognized that I was starting to slide and let my psychiatrist know, and he specifically recommended cognitive behavioral therapy (he is very evidence-based in his practice, which is great for a skeptic like me). I wound up seeing a therapist for about a year; that and an eventual change of jobs got me back to the point where I didn’t feel at risk.

    As for coming out stories, I do find them helpful in general. On the “Stigma of Mental Illness” panel at CONvergence, one of the panelists mentioned that as an atheist and a feminist she feels even more pressure to present as “happy”, else she confirm stereotypes of atheists as miserable people and feminists as angry man-haters. I definitely connected with that line of thinking, even though I had never put it into words. Knowing that others who share my values also share some of my more challenging issues in life is comforting somehow. Even so, hearing people’s stories often makes me sad, especially if they are not in the position (due to lack of health care or otherwise) to get the kind of help that I have benefitted from.

    1. I do want to specify that the first antidepressant I tried wasn’t a miracle cure, and I stayed on it longer than I probably should have when I knew it wasn’t really helping. Fortunately, the second one I tried worked remarkably well, and I’ve been taking it for about 16 years. I’ve also seen several different therapists over the years; some were a better fit than others, but none of them were totally unhelpful.

      My brother has never found a medication that worked for him. Part of the problem is that he’s a hypochondriac and will develop any documented side effect. But I think there must also be a difference in our brain chemistry if the drug that is so effective for me does nothing for him.

      1. It may be that your brother needs an alternative treatment. As I mentioned above, most meds did nothing to help my symptoms. It was working in the mental health field, as a peer, that has improved my situation. I receive SSDI (Social Security Disability Insurance) and have heard people, including clients I have helped, tell me that they were told, sometimes by SS staff, that you can’t work when on Social Security benefits. This is not true. There are guidelines and limitations that need to be understood when looking for work, but they are not insurmountable hurdles. Even the worst-case scenario would be finding volunteer work. Benefits would definitely not be affected, but sometimes having a purpose or a place to go can be great therapy.

        It might also be beneficial to look for Peer Services in the area.

  24. I suppose I’m coming across as a happy endings guy. I didn’t know there was such a thing, and I don’t want to give the impression that all my problems are now over and everything is going to be great. In fact, talking about this on here is bringing out all my self doubts (Oh no, why did I write that? What are people going to think about me? I should clarify it. Nobody is replying to what I’m writing, why are they not responding? Do they think I’m weird? etc.)

    So, yeah, I will probably never get over this, but at least now I know what’s wrong and I have ways of dealing with it. This helps.

    1. Just to add to this, I’m in real danger of going into a manic phase now, and I depend on sleeping pills to even get a little bit of sleep. I got up now, thinking it was morning, but it turns out I misread my clock and it’s still hours till I should be getting up.

      I have days when I just have to take a day off and spend time in bed (like Tuesday). Other days I need chocolate. I no longer feel as guilty about this as I used to. If that’s what I need to stay alive, the I’ll do it.

      I am extremely fortunate to be surrounded by supportive people. Even so, some of the advice I get is bad. I’ve been annoyed at phrases like “oh, you’re setting to high standards for yourself”. As if I’m the one who decided that I need to be perfect in order to feel god enough about myself.

      I spend so many years blaming myself for being somehow broken, and taking it upon myself to fix myself. All alone, with no help. I finally realized that I’m not responsible for what happened to me, and I was ready to seek help. I am further fortunate that my therapist is very evidence based indeed, is is skeptical about the effects of medication. Together we have constructed a very simple model that explained why I got ill. This helps me understand my illness and gives me tools for dealing with it.

      The whole problem seems to go back to a time where I was too young to remember anything. I must have felt scared of the world, and my coping strategy was to hide away in a room and build a safer world there out of LEGO and later music. In my teens, though, I was forced to come out of my bubble, and had to face the real world, the scary place from which I had hidden all these years, and that’s when things started to go wrong. When, as I saw it, the whole world crumbled around me I no longer had a safe place to retreat. I didn’t know what happened, and I saw no way out.

      I’ve been struggling ever since. There have been good times, but most of the time I’ve been depressed. When I come out of the depression, and I never know why this happens, I often have the feeling that now, finally, everything is going to be all right! So I’m ecstatic and full of energy for a week or two until I run out of steam and am back in the depression.

      Stories by famous people that I look up to has helped me. Steven Fry’s documentary made me realize how much this seemed like what I was going through. Reading the auto biography of Craig Ferguson, who was a hopeless drunk who finally sought help, and now has his alcoholism under control, although it will always be with him. My situation is much like alcoholism, except no alcohol is involved. I need to get away from the patterns of behavior that lead my into depressions.

      Lately, I’ve been having day where I don’t feel either happy or sad, but just relaxed and at ease with myself. This is a new feeling, and a good sign that something is going the right way. I have also now cried for the first time since I was 12, and I’m starting to cry just writing this. I will have to take another sleeping pill and get some more sleep. I need to do what I need to do to survive.

      So no, this is not a happy ending, but at last I’m hopeful about the future. That’s something.

    2. The statement “depression lies” is true. But so does mania. It tells me that now, finally, everything is going to be all right! I will have no problems any more! That’s no less of a delusion than thinking nothing is ever going to be OK anymore.

      Life is a bumpy road. That’s OK. It’s much better than swinging wildly from delusion to delusion, up and down, like I’ve been doing, not knowing when I was dealing with the real world and when I was deluding myself.

  25. Thank you for posting this. I’m another depression/anxiety person who hides it because I don’t have a happy ending. I hate the “I got sick, had a few bad years, now I’m all better!” stories because if other people had it worse and got better, why can’t I? I must not be trying hard enough, must just be lazy not sick, etc, etc (Which is the depression talking, but it still hurts). The stories that help are the ones like yours and Jenny Lawson’s and Stephen Fry’s – the Crazy is always there, there are good times and bad, and that’s ok.

    Skepticism definitely influences my choices of treatment. I prefer treatments that have had double-blind studies (for the drugs) or lots of evidence proving their effectiveness (for the therapy). I’m also more likely to stick to lifestyle changes if I read “doing X caused Y to improve in rats”-type studies rather than people telling me vague platitudes about exercise and mood.

    It can also make me frustrated at the mental health community as a whole – I wish more people would admit that we don’t know much about the brain and we are nowhere near having treatments for brain problems the way we have treatments for other organs. I think it’s important to be aware of “fashionable” treatments, whether that’s drugs or flooding or CBT. They may work for some people, but we don’t know why the same treatment can save someone’s life or cause them even more trauma. Assuming that the latest popular treatment is the cure for everybody can be hugely damaging.

    Even though we know so much more about the brain than we did 50 or even 10 years ago, we still know bugger all. It’s trial and error, with quite a lot of error. Being able to survive with mental illness while the mental health field is still in its infancy? That’s totally strong and awesome!

  26. As someone who is lucky enough to be able to manage my depression without meds and more than the occasional visit to the therapist, I get really frustrated when depression is dismissed as so much whining.

    I really appreciate Hyperbole and a Half’s humorous and accurate depiction of depression, at least as I and many of my friends have experienced it.

    http://hyperboleandahalf.blogspot.com/2011/10/adventures-in-depression.html
    http://hyperboleandahalf.blogspot.com/2013/05/depression-part-two.html

    I’ve found them helpful for explaining depression to people (especially family members) who don’t understand it.

    1. Those really are great. Adventures in Depression capture depression in a very good way.

      Many people seem to be under the impression that depression is a kind of sadness. Rather, it is the lack of emotion. Depression is a natural reaction. When emotions get too hard to handle, it’s easier to feel nothing than to have to face them. This is not a choice, and many who are depression find it hard to understand why they can’t feel anything.

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