Depression Management: Public Perception vs. Internal Wars

With the onset of Mental Illness Awareness Week, I’d like to take a moment to discuss depression: some hard truths, some public misconceptions.

When you suffer from depression, wrangling your mental health is unpredictable at best. Yet time and again, that’s what you’re told: manage it. You’re better than this. You’re stronger than this. You’ve got this.

The thing is, more often than not, it has you, and you can throw down the gauntlet as many times as you want, but you’re not going to win. After all, the disease is there long before you ever notice its methodical creep.

I know, because it has been stealing my breath away since before I even reached high school.

Outsiders don’t tend to realize that depression isn’t just when my voice goes flat and my eyes go dead. Depression is always there. Perhaps 90 percent of my waking life I spend dealing with my depression, one way or another—thoughts of self-hate, mutilation or outright suicide. This doesn’t mean I don’t pick up a sword and drag its ass to the dueling field, but it does wear me down relentlessly, waiting for just the right moment to lunge.

Depression always has more energy than I do. It is more patient and more studious as well.

So when you see what many would consider “normal” me, with his easy smile, his incessant need for laughter, his outgoing adventurism, know that at the very same time, a second life can be living itself out beneath my skin. “Out” is a good term for it, too—since that second me is methodically going over all the reasons I do not deserve to exist any longer.

This is, bear in mind, even with pills in place to suppress it. People that hear you are on pills for this sort of thing tend to think one of two ways. Either: A. You’re crazy or B. Well you’re medicated, so why aren’t you happy yet? Pills are not end-all be-alls. They make you more susceptible to healing and to change, but they don’t themselves make the change. They make it possible to heal—they don’t heal on their own.

That’s the polite way of saying that, even on my pills—and by the way, I’m not even remotely going to go into the expansive discussion of finding pills that actually work for you—I can still feel like I’m losing my damn mind, and act like it too. This runs contrary to what we are taught and accustomed to with western medicine, I know. Take a pill, feel better. It confuses many when I say I am medicated and I am still struggling.

“Just give it time,” is a phrase that gets dropped more often than not. With mental health, time can be an ally every bit as much as a foe.

Frustrating the search for a cure is the fact that the same methodology of uplifting me from such dire straits may not be the same every time. Hell, what sets the depression off in the first place may not even be the same.

There are times it can be as simple as sleeping away the pain. Other times, I could lie in bed all day and still feel it welling inside, eating away at me. Those are the days I recognize I need to get up and move like everyone else, but convincing myself to do it takes on titanic levels of travail. In fact, this adds to the stress: this sense that I’m trapped in my own body.

There is rarely a point I don’t realize I’m acting irrationally, that this doesn’t make sense, that I shouldn’t be acting this way. Yet my mind won’t let me actively pursue any other direction.  The most perceptive truth bearer in the world can recognize all these things, lay out a concrete argument for why it should not be, and yet…

And yet. There’s a lot of “and yet.” The most rational, intelligent person in the world can still, in the face of depression, be dragged kicking and screaming into the dark—and I don’t claim to be the most intelligent person in the world.

Sometimes, depression doesn’t even have a source. I can just wake up to find it lying next to me with a big old grin on its sallow face, saying, “Hello, chicken shit,” and then the terror begins anew.

If you haven’t gathered by now, I am saying depression is not fun. Neither I nor any other sufferer chooses to be this way. When you see us withdraw and tell us to suck it up, or turn this into something about you, I want you to realize how cruel and undeserved that is. I can’t speak for everyone, but when I go quiet, it is an attempt to dissociate and protect.

I am not doing it to protect myself. I am doing it to protect you, be you my friend or common passerby. I lock it all down deep, put on a false face, and go numb. In fact, I will guilt myself without end if I feel like I am being unproductive or lazy. What you call relaxing, I begin to hound, ravaging myself with the cruelest internal monologue because “I should be useful.” Some call this high-functioning depression. By all outward appearances, I am still going through the motions of the day because the day demands it—but I am certainly not living. In fact, this is one of the most dangerous states.

This is precisely the point when someone should step in, no matter how much I seem unreceptive, because once I have hit disassociation, the world has ceased to be important to me. What is more, I have ceased to seem important to it—from my point of view. This is when self-harm tends to come into the picture. At this point, the numbness is worse than outright pain—I want to feel something. Anything. Of course I can hurt myself, because at least then I feel something, and if I do not belong anyways, what does it honestly hurt?

After every suicide, there is someone standing off to the side with a shake of their head saying, “It was the ultimate selfish act.” I had a teacher in high school, a brilliant, caring man in so many other aspects of life, who told us that phrase openly once. Then he carried on with discussion, as though by this act, the person who had ceased to exist had erased their relevance from the world. He thought it was about something he refused to give them.

Depression is not about attention. Most people do not understand this, and that is fine.

That is why I am writing this. To help people understand. They understand even less, however, the notion of hurting and not being the one to reach out.

In most situations, this is what we are taught to do. Get in a car accident? Reach out to the cops, the paramedics, everyone you can. Get fired from work? Go get some drinks with friends and shit talk all the crap that led to this. Family member passes? Gather everyone together and celebrate their memory.

Depression doesn’t work like that. Depression is not an immediate problem and it does not have an immediate cure. It is the slow motion creep of decay that makes you feel constantly old before your time. It made me feel decrepit in Middle School, when I first made its acquaintance; it still makes me feel aged at 28. And this steady creep is what makes it so different.

When you do not believe you deserve to exist, or see any point in continuing to exist, you also do not see much point in reaching out to others.

Again: this is not for attention. I could not care less about attention. When I am hurting I do not want to bring that pain to others and I retreat a little more each day.

So, why doesn’t someone cognizant enough to write an essay like this call the crisis line? Why hasn’t your friend, with seemingly everything to live for, called their therapist?

I hurt


Call doctor

I don’t deserve to exist


Go silent

Numbers like the crisis line are important. They do save lives. I am not saying they don’t. What I am saying is, expecting the depressed person to recognize this and take the initiative is setting up a lot of room for failure. Numb people do not tend to reach out. Distraught people do. They need encouragement from others to do so, not abstract messages from nameless sources. People—real people—actively breaking through the barrier, telling them they need help because PEOPLE care if they are gone, PEOPLE care if they hurt, PEOPLE still have a place set out for them, is what helps. Will it make them distraught? Sad? Angry? Yes, all of the above. No one wants to be the person that made another weep.

But I’m here to say that a person weeping is worlds better than a person with no feeling at all, pondering what lies on the other side of a knife’s edge. Depression ravages. It destroys those it lurks within and ripples outward, hurting the lives of all those with which it comes into contact.

Do not make the mistake of treating it like any physical illness. It can feel impossible to weather, seeing a friend cave to it time and again, and seemingly never being able to get through to them. Think how they feel, actually living with that demon inside. If you want to help, and understand, just be there. Do not go into the battle with preconceived notions. Learn the signs. Reach out.

It has saved my life more than once.


One thought on “Depression Management: Public Perception vs. Internal Wars

  1. I have watched, as I loved, supported, and hoped for a better tomorrow for you. Frustration runs high when you want to drive the depression from one you love, but you come to realize you cannot perform the miracle. I can only continue to offer my love and support at all times.

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