Tuesday, February 25, 2014

Trying to Hear a Plea

My friend Leah wrote this, which I can say if you are strapped for time, what you should read instead of what I shall write here. I guess also that I am writing this post because Leah responded to my question 'what can I do' with 'thoughts?' so really this article, is the context of what I will write here.

I also tread with trepidation of saying the wrong thing, when sharing my thoughts, and I guess much of depression itself must be discussed in the more accurate but less understood dimension of feelings as well.

Here is my clearest thought as to the Plea itself: 'speaking out about depression is an important battle against the debilitating stigma surrounding depression and mental health issues. It is not the cure to depression and mental health issues, speaking out sadly can make this issues worse for the speaker, those hearing the speakers need to not just hear, but listen.'

And so I find it odd, to be invited by Leah to share my thoughts. What I felt immediately on reading Leah's plea and this other piece she wrote 'from inside the illness' was shock. I had no idea until yesterday that Leah suffered from major depression. I also felt scared, perhaps terrified.

But to be clear, and fearing that I am in danger of saying the wrong thing. It's because depression is a terrifying concept to me that I cannot relate to in any of my conscious experiences. I am NOT scared OF Leah, I am NOT scared or terrified FOR myself.

I am scared by the idea that depression can afflict people, debilitate to the point of paralysis, cause them pain to the point were no experience at all can seem preferable to the experience of their day to day life, seemingly unconnected to environmental factors. But I am on the outside, the fear I feel is akin to the fear I feel watching a slasher film, were Leah is not even the actress, but the role of the person who has to creep through the psycho's house. I am a mere spectator trying to identify with Leah.

And that's where it is hard, I have never, ever, experienced depression. The closest I have come akin to depression is grief. I have had the moment of introspection to marvel at how hard it was when grieving to find the energy to shave my face. Yet Leah writes about a paralyzing state where she can't actually get out of bed to go to the bathroom.

Grief is clearly driven by one's environment. Environmental factors, and with the exception of the effects of denial, it's really easy to identify what is causing one grief. When I think about how bad I have felt while grieving, how difficult things become - the magnitude of actual depression is quickly beyond my ability to imagine. I cannot imagine a state of mind that saps more energy than grief, not one I feel I could survive. I already need shock, anger, denial just to survive the pain of grief.

Depression itself then, is thus far beyond any understanding for me that is not cognitive. On the same day that I read Leah's account of having to lower herself out of bed on her knees and then crawl across her living room only to fail and have to crawl back to bed, I had already been up and run an 800m and later that day ran 14km with a friend. I thus returned to my bed exhausted, but in my life exhaustion marks a good day, it is the end of a good day.

To wake exhausted, unable to leave bed is the opposite of my existence. The self defeat felt when one stops on a run must again be nothing compared to the self defeat when one fails to make it to their kitchen or bathroom.

Which means, deprived of personal experience to relate myself to Leah, I have literally no insight to offer, no advice or counsel (as opposed to when a friend is grieving). What I needs must do, is learn what to do. One of the most painful parts to read for me was:

At my weakest and in intense distress I need to find energy in order to downplay and act to make sure friends are comfortable. (This is why people with depression may decline invitations from well-meaning friends to catch up or chat. We don’t have the energy to moderate symptoms.)
I am so glad Leah wrote these pieces, and linked to so many other accounts. I had no idea. But I do feel strongly that nobody has ever really been served by not understanding. I think I/we non-sufferers, our dumb-lucky minority of people free from mental health issues, are always inclined to look for an environmental factor, something to be addressed, fixed - so we can move on. Why beyond blue does such good work and why I think this excerpt from one of the documents on Stigma Leah linked is really important to keep in mind:

There are different types of stigma associated with depression and anxiety, which include: 
 personal stigma – a person’s stigmatising attitudes and beliefs about other people 
(“People with depression should snap out of it.”) 
 perceived stigma – a person’s beliefs about the negative and stigmatising views 
that other people hold (“Most people believe that a person with depression should 
snap out of it.”) 
 self-stigma – the stigmatising views that individuals hold about themselves (“I 
should be able to snap out of my depression.”) 
 structural stigma – the policies of private and governmental institutions that restrict 
the opportunities of people with depression and anxiety (“Mental health services 
and research don’t deserve as much funding as other health problems.”). Structural 
stigma may be either intentional or unintentional. 
When one's mood, emotions and energy levels become detached from the environment, it is unsettling, it is unnatural in the Darwinian sense - every individuals survival actually depends on getting pleasure from eating high calorie foods, feeling secure in one's own home/shelter, satisfied by the attachment one gives/recieves from their partner. Without this reinforcement depression is in very alien territory to me, probably everyone including the sufferers.

So it must feel very very wrong and be very very painful. I shall endeavor to watch Malencholia, but I imagine to the limits of my imagination that this is why Kirsten Dunst bursts in to tears when the meatloaf tastes like ashes. A world in which we can't feel simple pleasures is a world now trying to kill us.

That last statement is a speculative armchair-evolutionary biologist speaking, not somebody who has experienced anhedonia or anything.

I believe Dr Gordon Livingston said 'Mental Health Requires Freedom of Choice' a key and vital distinction I feel in this conversation. For one, the very word 'depression' is bastardized, people say 'I'm so depressed' in a callous and trivial matter, eg. 'I have four assignments due next week I'm so depressed' when in fact you are not experiencing depression at all. But the other side hardest for me to comprehend, is that people just get depressed, and they can't 'perk up' as Ruby Wax was most annoyed by, and they can't just go for a run and clear their head and feel better, and unlike grief there's no reasonable guarantee that the episode will pass with time. People in other words can't choose to be depressed or not, they perhaps (because environments are complex and I feel nobody knows the answers) can't even make the indirect choices eg. eating healthy and exercising to actually bring about some relief from the symptoms. And for somebody struggling to get out of bed, suggesting a 10km jog seems stupid to me.

I do think though, that it's important to understand this shit. I feel very strongly about destigmatising mental health. As a non sufferer, I am not immune to the effects of depression. Clinical depression has cost me a relationship - My first sexual partner dumped me because I ceased to be able to make her happy, I was a misidentified environmental factor prior to her diagnosis. She is now married, and self medicates through long distance running, but it was sobering for me to find out that despite every visible evidence of a happy life - meaningful work, loving partner, passionate hobby... she still suffers from severe depression.

I've also in my life, while been a victim of sexual repression driven by homophobic stigma, despite myself being hetero normative.

My point being, that I am not the real victim, but I am a victim. Don't simply think because an issue isn't your personal one, doesn't mean it's not personal. You are being naive if you think that depression will never effect you, because you don't have depression, or how LGBTQ's are treated won't effect you because you are straight, or that racial discrimination won't effect you, because you are white. You owe it even to your potential friends and partners and family, that these issues get dealt with. That the changes occur.

My sister told me the stats run up to 60% of women suffer from anxiety or depression by adolescence. These issues are virtually guaranteed to affect you.

What I think about now though, is the next time I see Leah, or her boyfriend through whom I met her (on their first date I believe), and what I'm supposed to say or talk about, or whether to not say anything at all. Again Dr Gordon Livingstone cautioned that the longer an illness persists the more it becomes a part of a person's identity, and I'm sure Leah no more wants every conversation to be about depression even while she champions it's understanding and destigmatisation. I'm really glad and proud and relieved and inspired that Leah did share her experience with me and everyone who wishes to know about it, but I'm sure she wishes she didn't have this illness, and wants her identity to consist of what she chooses to do.

Leah is a talented and professional artist, a hero assuming the downside risk for others unable or unwilling to speak, stunning, a friend, an excellent party host and I for one am not shocked or scared enough by depression to forget these things that draw me to her.

Nor is Leah my only friend afflicted by major depression, but she is one of the few to extend to myself/us the credit that 'I don't understand' is not the same thing as 'I can't understand' so I'm going to keep reading and watching and try and make the most of this opportunity.

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