Thursday, May 9, 2013

The Grate Depression

After a very long hiatus, the wonderful Allie from the webcomic "Hyperbole and a Half" has returned with "Depression, Part Two," a follow up to "Adventures in Depression." Before I go further, I cannot stress enough: I really like these posts. Anything that helps to normalize and destigmatize depression is wonderful, and Allie does it with authenticity, vulnerability and humor in fantastic ways.

The part that elicited the strongest reaction from me, though, was the pervasive sense of powerlessness throughout. Specifically, the sense that depression is just something that "happens" to a person, like one's own personal black rain cloud that follows you around for no reason.
Eyeore and a black rain cloud.
"The Hundred Acre Wood's drought was finally over. BUT AT WHAT COST?!"
I realize that this is the way it feels. That no matter how hard you try, you cannot care. That all of your actions are shrouded in this persistent feeling of incompetency and meaninglessness. That you are alone and your attempts to reach out to other people are met by misunderstanding and incessant problem solving. Everyone encourages you to be "happy" or to "fix it" in some way or another and each time you think "Fuck you! If this was just about choosing to be happy I probably would have done that by now don't you think?" Allie's metaphor of the "dead fish" is beautiful because it so aptly illustrates how people really do want to help, but they're trying to help with the problem they think is there not the one you're actually grappling with.

Indeed, often times you try so hard and hate yourself so much (as wonderfully illustrated [haaah] in Allie's first depression comic), and you find yourself simply incapable of feeling better and hating yourself for your failure to do what "should" be so very easy. Someone at the Counseling Center yesterday said she's been trying to live by a quote to the effect of "Don't let your best days always be in the future," meaning that one should try to find a way to make now be the best. And I love that idea and hate it because I so desperately want now to feel good. However, as you have probably noticed if you've been reading any of me for the past ever, despite trying so very hard I have yet to find a way how to make it so.

Captain Jean Luc Picard of the USS Enterprise!
I'm trying, goddamn it!

And this is where my reservations come in. It feels like it's happening for no reason and no matter how hard I try I can't shake it. But I also firmly believe that, at their core, depression and anxiety are adaptive. Biology/brain chemistry may predispose us to them or exacerbate them when they arise, but these conditions are not solely the creation of brain chemistry. Brain chemistry may open a gate wider than those found in other brains and brain chemistry may make what we find on the other side more difficult to endure, but we still on some level decide to walk through.

It's important here to be clear: I don't think people choose to be depressed or to be overly anxious. Those things suck, unambiguously. But I do think people choose to stay in situations where they are unfulfilled. I do think people choose to not express their anger towards others. I do think people choose to direct disproportionate anger towards themselves. I do think people choose to remain constantly vigilant for threats to themselves and their loved ones. I do think people choose to be incredibly afraid of the judgment of others. Etc. And I do think those choices have negative consequences which often manifest as depression and anxiety.

The important distinction here, again, is that it's not necessarily that a person wants these bad consequences. But they choose to engage in behaviors that elicit them because the alternative, in their minds (and usually heavily informed by their experiences), is worse. Living in fear gives them some sense of control that they can prevent something terrible from happening. Not expressing anger allows for less conflict with others (avoiding the punishment expressing anger brings). Fearing judgment of others helps keep you from doing things that incur that judgment and its consequences. Etc.

All of these choices are valid. They are not arbitrary or stupid: they make sense and we get something from them. For instance, it was "better" for me to direct my anger at myself than express it to my father because doing so would only end up with me hurt more. I felt miserable, self-loathing, and guilty, but I also gained some control and safety. At the time, those were more important.

So too, it's not someone's "fault" they are depressed. This is not about blame. I made that choice (although it felt less like a "choice" and more like a "necessary adaptation") when I was younger, and even though it did immense damage to me, at the time I really think that was better than the alternative. No one else can judge what is an acceptable risk or the "best" course of action for you to take regarding decisions that affect only you. Hypervigilance to protect against risks may be what you need to feel like you can exist in the world and even as it's incredibly stressful and scary, it might be what you need to feel like you can stop horrible things from happening (usually again). It's not anyone else's place to say whether the stress is worse than giving up that sense of control.

However, I also know that as I have gotten older and my circumstances have changed, the consequences have increasingly been outweighing the benefits. I'm still really afraid of the consequences because I know so painfully what they can be, so change is coming really hard. Yet I've increasingly learned that change is the only way for me to get what I want from life (to wit: close, meaningful relationships and to be a good therapist). That's more important to me than the benefits of this pattern, so I'm trying to do the very hard work of changing.

Sometimes change happens when we explicitly decide to give something up in order to get something different. For instance by giving up the pursuit of perfectionism, we risk and likely endure some disappointment in exchange for less anxiety and guilt.

Sometimes circumstances change and we don't have to make the choice, such as when your partner in a toxic relationship breaks up with you and after initially mourning you feel better without them.

Or sometimes something happens to make the choice easier, such as "My therapist listened to me and supported me; I feel safer because someone is on my side, making the potential consequences of taking this new action less hurtful so I can choose to take it now."

But, at the core, I think we are still making choices, even if the results hurt a whole fucking lot. And deciding that some actions, consequences and risks are better than what we currently have is often how change happens.

I don't know Allie, and I don't know what's happened to her or why she's depressed. I know that not feeling things sucks. That it's frustrating and confusing and feels so damned hopeless. That it feels like it has no reason. But I also know that not feeling often feels better than being hurt (like you were when you did feel, whether you did that damage to yourself or someone else did it to you). I know that it often inoculates from fear, from disappointment, from rejection, from anger. I know that it's a way to protect one's self from fully engaging difficult questions about the purpose and meaning of one's life. Etc.

I don't know if any of those things are happening for Allie. It would be presumptive to guess. And I fully believe that it feels beyond her control. But as a therapist and as someone who's had decades of depression for herself and her family, the brain chemistry black cloud model is just intolerable for me to accept. I have to believe there's a reason. I have to believe there's hope, that change is possible. That Allie can change.

It may not matter that we find the reason; there are options for change that happen when we get certain things we've been lacking that make change seem almost inexplicable. Maybe medication may help. Maybe she'll make an epic pilgrimmage to the corn palace and she'll experience a moment of existential transcendence that will prove to her that though she is but one kernel in the great cob of life, it is the kernels that make corn possible.

I don't know. And maybe this is more about what I want to be true than what actually is. But I really do believe there is a place for hope in depression. And this is how I've found mine.
Kernels of wisdom, cobbled together throughout the ages
as humanity stumbles through this maze we call life.

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