Depression: My Uninvited Guest

In light of the suicides of Kate Spade and Anthony Bourdain:

Most people would rather discuss their heroin addiction than their depression. No one wants to say, “I have a mental illness.” Well, I have had skin cancer and cluster headaches, asthma, restless leg syndrome… and mental illness.

I’ve had depression all my life. I now realize both my parents probably also had depression. I was raised to believe that getting help for such things was weak and shameful; I only got treatment of therapy and antidepressants when I was 40.

I was fortunate. I had insurance that covered a therapist and medication. I had a good doctor and a good therapist, and a car so I could get to appointments (scheduled after working hours). Medication worked right away for me.

Most people are not as fortunate. They spend months trying to find the right drug(s) to work for them. Not every therapist is a good one, or a good fit. Getting to appointments takes reliable transportation; if you have a family and no childcare, that’s going to complicate the situation. If you don’t have insurance to pay for meds and the doctor, your choices are limited. If you don’t have a support system, or your family is actively negative about seeking treatment, you’ve got that to overcome. You’re afraid to admit you might harm yourself because you don’t know if that will land you in 72-hour observance in the county mental health facility. And many people are reluctant to take anti-depressants for a variety of reasons, which limits them even further.

Though the exact causes of depression (formerly known as melancholy) are unknown, there are numerous possible contributing factors including genetic predisposition, chemical imbalance in the brain, stressful life events, medical problems, a history of abuse or other societal dysfunction, and certain medications/drugs.

Depression is isolating. You learn to compensate publicly because people say stupid things like,

  • “Why are you depressed?”
  • “You’ve got everything going for you.”
  • “Look at  —- [some Godawful situation in the world]. They have it worse than you do.”
  • “I don’t know what you’ve got to be depressed about.”
  • “Cheer up! It can’t be that bad!”
  • “Have you prayed about it? God will heal you.”
  • “Do something nice for someone else.That always makes me feel better.”
  • “God never gives you more than you can handle.”

You get sick of hearing this and dealing with the ignorance, so you pretend you’re fine. You really just want to be alone so you won’t have to be nice. Are people with spina bifada  asked, “Why don’t you just go out in the sunshine and get your mind off it?”

These comics illustrate what some people with depression experience every day.

So many people have said, “They had it all. Why did they kill themselves?” Even with the best help available,  no matter how much money you have, when that dark night of the soul appears, you’re alone. You just wait for everyone to get away from you because you’re exhausted acting happy. You don’t want to have to deal with the sadness any more.

And “they had it all”? Maybe they had too much. The nice young man who used to live across the street had a girlfriend, a guaranteed successful career, a good family. After attending his memorial service, I came away thinking: “He had it all, but it wasn’t what he wanted. It was what everyone else wanted him to have. He was trapped. This was the only way out he could find.”

The standard advice now is, “You’re not alone. Call the Suicide Prevention Lifeline at 1-800-273-8255.”  And many people do; calls to the national hotline (and local numbers) jump 25% after suicides of famous people. But  the thought of having to make a call and talk about the indescribable crushing weight is more than some depressed people can do.

I was never suicidal, though a few times I felt that if a runaway truck jumped the curb heading for me, I wouldn’t bother to get out of the way. And more than once I stared at a pair of scissors, idly wondering what it would feel like to score my thigh just a little bit. (I never found out.)

I am not saying this for sympathy; I don’t want any.  I don’t think I am particularly brave for saying this. I know depression is out there, waiting for an opportune moment to invade my life, but I now have a better toolbox to help me through those episodes. I know where to get help if I need it, and I have had the life experiences to be able to have perspective on the depressive episodes so that they don’t swallow me alive. I am fortunate.

If you know someone who may be depressed:

  • Do not say, “I know how you feel. I was really sad when my dog died.” Temporary sadness is not the same thing. You don’t know how they feel.
  • Do not say, “Well, if you need anything, call me.”  The depressed person will not call you. YOU call THEM.
  • Do not say, “The Bible says suicide is an unforgivable sin.” Piling  guilt, shame, and fear on top is SO not helpful. And not every depressed person is thinking of suicide.
  • Call and arrange to show up with lunch. Sit down. Listen without judgement. Don’t offer advice unless asked. Then follow up. Call them again. Ask to meet for coffee, or come over with coffee.

Here is a guide on what to do if you think someone may be suicidal.

Throw out a hand they can reach for if they choose. Your efforts may or not pay off, but don’t not try because “I don’t know what to say.”  Just listen.

Barbara Rice
Barbara Rice is anewscafe.com's administrative assistant. She grew up in Igo listening to the devil's music, hearing tales of WWII, and reading James Thurber and Mad Magazine while dreaming of travel to exotic lands. She graduated from Shasta High School, Shasta College, and San Francisco State University. After too many blistering Sacramento Valley summers, she's traded it all for the ocean breezes of Humboldt County. She's been told she's a bad influence and that makes her very happy. She tweets, travels, and spoils cats. There's a dance in the old dame yet.
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39 Responses

  1. Avatar Beverly Stafford says:

    Oh Barbara, thank you for this column. Those of us who haven’t been touched by depression will never know what that crushing black wave is like, but you have described it beautifully. I regret that I hadn’t had this insight years ago so that I could possibly have helped my mother-in-law get the treatment she needed. Knowing what I know now, she probably suffered depression her whole life. You have no doubt helped many ANC readers today. I hope they are all as successful as you have been in seeking therapy and medication.

    And thank you for stepping in when ANC commenters become trolls.

    • Barbara Rice Barbara Rice says:

      Thank you, Beverly. I too wish that I could have had the insight to at least attempt to help my parents – but those were the days when we did not speak about these things.

  2. Avatar Matt Grigsby says:

    Depression is like walking through syrup; every step is heavy and a struggle and after a few steps you’re just so tired from trying to move forward. It’s sometimes just as hard to understand someone who suffers from depression as it is for the depressed person to understand someone who doesn’t.

    Your advice here is solid. Reaching out, listening, not offering advice unless asked, being a good listener. Thank you for sharing your struggle and for offering practical and clear advice for people who want to help someone they love. Connections with people save us all.

  3. Hal Johnson Hal Johnson says:

    Thank you for this important column, Barbara.

    I’m one of those who have no doubt hurt friends suffering from depression by trying to help them.

  4. AJ AJ says:

    I do not understand (does anybody, really) depression .. . any more than I understand diabetes or cancer or blindness or any one of a million things that I’ve never experienced. But then, we know that true empathy doesn’t require first hand experience, it requires first hand caring. These situations requires so much more than a simple “I understand” . . . which is usually a lie anyway. In my many years of living I’ve come to appreciate that is not that I am deserving of a life free of these things, (so far) it’s simply a genetic accident for which I am grateful every single day. And the converse is, of course, also true. Barbara, THANK YOU for a heartfelt and very, VERY important article. Thank you for standing strong and writing information that is so helpful to eery one of us.

    • Barbara Rice Barbara Rice says:

      Thanks, AJ. Sympathy is fine but it is not the same as empathy – which, if you don’t have it naturally, is much more difficult to cultivate.

  5. Avatar Eleanor says:

    Thank you for this, Barbara. Depression is a subject that should be way out front in the open; the more it is talked about, the more ‘normalized’ it will be (because it is). “Be kinder than you need, because others are carrying burdens heavier than you know.” None of us knows what another is enduring. Great guidance to listen, listen, listen. Unasked-for advice can do so very much harm. “Why don’t you…..” “You need to……” All bad openings. Just listen, and as you said, be there, be there.

    And yes, thanks for stepping up when people just step too far over that line on ANC, and doing so with humor.

    Your article today is surely a saving grace, and a relief, for many people.

    • Hal Johnson Hal Johnson says:

      “And yes, thanks for stepping up when people just step too far over that line on ANC, and doing so with humor.”

      Barbara, what Eleanor said. While your column should be the focus of the day, as an aside, I also want to thank you for all of your efforts in keeping ANC a civil place.

      Regarding name-calling, however, I still must maintain that there should be an exemption for “poo poo head.”

      • Barbara Rice Barbara Rice says:

        Oh sure. You let ONE person say “poo poo head” and the next person wants to up the ante to Mr. Poo Poo Face and then it becomes Your Mama’s a Poo Poo Face, and from there it all goes downhill. This is why we can’t have nice things.

    • Barbara Rice Barbara Rice says:

      Thanks, Eleanor. It would be great if we had an environment in which depression and other mental health issues were discussed with the same nonchalance as we discuss glaucoma or hyperthyroidism- that is, a disease without blame or stigma.

  6. Barbara, thank you for this honest, insightful piece of writing. I think depression needs its own #Me-too campaign, since I’m guessing that nearly everyone (well, except AJ 😉 has suffered from it. I have. And as you say, it should be looked a no differently than any other disorder. But for some reason, when it comes to mental health, there’s a stigma, as if it’s the person’s fault.

    You’ve gone a long way toward destigmatizing depression today, Barbara. Thank you!

    And I concur with those who praise you for maintaining civility in the comments section, with humor, which is always appreciated. I am so grateful you’re such a big part of aNewsCafe.com.

    xo doni

    • Barbara Rice Barbara Rice says:

      I heard from a number of people who had never discussed their depression issues out loud – it’s too difficult to admit publicly for various reasons (job, family). There is a lot of blaming the victim, which perpetuates the stigma and societal shame, and a closeting of the sufferer.

      Glad to be of service. As you said to me once, when the trolls take over, the nice people back away.

  7. Avatar Karen C says:

    Thanks for the insight…very well written. It is very hard to know just the right thing to say in any traumatic or uncomfortable situation. No matter what one says it always seems to be the wrong thing. I appreciate your last statement about bringing lunch and sitting down to listen to the other person. Sometimes, what one needs is a good long time to vent, and vent some more. It releases tension, makes that person feel better and less anxious.
    What would you think of someone saying, “I’d like to offer my assistance somehow for anything I can do to help out. May I call you in a week, and we can figure something out?”

  8. Deb Deb says:

    I love this column, and love you even more for writing it. If a person hasn’t gone through the dark night of the soul, they cannot fathom what it is to wonder if the dawn will ever come, or to feel like maybe it wouldn’t be so bad if it didn’t.

    Thank you for writing so eloquently about something that affects so many.

  9. Avatar SB says:

    These comments: “Suck it up”, “cowboy up”, “put on your big girl/boy panties”…soooo do not help either. I’ve had these comments directed to me a couple of times in my life, and remember thinking…oh wow thank you! That’s all I need to do to escape this black hole, and everything will be wonderful!! Not everyone was blessed with superior mental health.

    • Barbara Rice Barbara Rice says:

      I hear you: Don’t cry, that’s childish, what are you complaining about, on and on and on. You’re right: good mental health is a blessing, and just like physical health, it can deteriorate through no fault of one’s own.

  10. Avatar Candace says:

    Thank you for sharing. I believe the more we share the more we break the stigmas associated with depression. During a bout of post cancer, seratonin depleted depression I was lucky enough to have a mother who showed up every single day to ‘do nothing’ or ‘do something’, whatever I needed at that moment. She was my lifeline and instilled in me the belief “it’s ok to not be ok”.

    • Barbara Rice Barbara Rice says:

      Thank you for sharing that experience. That seems particularly cruel – to be recovering from a feared disease only to be hit with another.

      • Avatar Candace says:

        Thank you. Not sure I thought of it as cruel at the time. Scary, yes. Out of my control, yes. I learned later that chemo depletes seratonin and they (oncologist) typically tell you to watch for depression after you’ve completed your treatments. Unfortunately that appointment for me somehow slipped through the cracks and didn’t happen and instead I went on a roller coaster ride of emotions. If me talking about this out loud can help one person going through it right now, it’s worth it to me. They deemed it ‘situational depression’ which as odd as it sounds makes me one of the lucky ones.

  11. R.V. Scheide Jr. R.V. Scheide Jr. says:

    I’ve suffered from depression most of my adult life. I don’t like to talk too much about it. Kudos to you for doing so.

  12. Avatar Barbara Braun says:

    Babs Jr. – A well-written and insightful article about depression. I’m glad you sought help which seems to help you. I’m also glad you got to move into the cool coastal area! I’ll miss running into here in Town. Take care! Babs Sr.

    • Barbara Rice Barbara Rice says:

      Hi Babs Senior – thank you. Glad you liked this.
      I’ll still be coming into town now and then so there’s always a chance we’ll bump into one another.
      Babs Junior

  13. AJ AJ says:

    I was talking with a friend of mine who had dealt with some major depression for several years. I related Matt’s description of feeling like you were slogging through honey. My friend thought a moment, then nodded and declared that that was an absolutely correct description. Thank you Matt.

    Part of the problem in dealing with mental health issues and the understanding of them is that there is virtually nothing concrete to hang anything on. No X-ray or blood test that will help with diagnoses and lead to understanding. I think the view has been, for the medical field as well as the lay person and for way too many generations, is that if you can’t see it or measure it, then it’s just not real.

    Au contraire

    • Barbara Rice Barbara Rice says:

      That’s a very good point. Treating mental health issues compassionately and seriously is a relatively recent development in medical history. Tests can be run to rule out other diseases that cause depressive symptoms (i.e. Addison’s, hypothyroidism), but as far as I know, no tests are available yet to determine depression or other MH conditions.

  14. Avatar bruce vojtecky says:

    When I was younger I don’t know if you could call it depression or just bad times but I felt better through the use of alcohol and meth. Eventually I realized those options were worse than the problem. I think many that are addicted to Heroin and Opioids are in that same dark place. What worries me is I see all the ads on TV that promote drug use to heal depression and I believe that special cure is worse than the disease. In Denver a young man followed a mother and shot and killed her and two of her children. He told LE he had medical issues and just started a new medication that day.
    For those who cannot afford medical treatment the best options are support groups like AA is for alcoholics. These sobering centers, according to AZ news, are more a ripoff than a cure.
    But for anyone who has a depression problem the first step would be to look in the mirror and say, My name is —- and I have a problem.

    • Barbara Rice Barbara Rice says:

      This is why I wrote that people may have problems finding the right medications that work for them. Like any prescription drug, psychotropics don’t work on every person the same way. Antidepressants do not “heal” depression any more than insulin heals diabetes; they diminish the severity of the symptoms and allow the user to live a better quality life. Zoloft and Prozac kept me afloat until I could maintain and function without them.

      I do not agree “that special cure is worse than the disease.” This stigma associated with psychotropic drugs keeps some people from getting help – they think it’ll cause them to run naked through the mall or become an over-medicated zombie. Would you say to a person with lung cancer, “Hey, your best option is a support group – I know one that meets Thursday evenings at the pizza parlor”? That minimalizes and marginalizes the severity of that person’s condition.

      Depression is not the same thing as alcoholism or drug addiction in which one has to admit they have a problem (AA’s stance); some persons have been living with depression so long that they don’t realize they are depressed. If all you’ve ever known is sadness and despair, that is your normal. Making a self-proclamation (“My name is X and I have a problem”) is simply not possible when it’s all you can do to get out of bed.

      • Avatar Beverly Stafford says:

        Barbara, your responses to comments have been so helpful for those of use who haven’t suffered depression. “From the horse’s mouth” is very different from simply reading about symptoms and “cures” in a clinical article. Thank your for shining a light on this pervasive disease.

      • Avatar Tim says:

        Like shock-therapy, pharmaceuticals are a valid option, but probably shouldn’t be the first choice unless other family members have a history of depression that responded well to a particular mediction.

        Less than half of people respond to their first anti-depressant – and those that don’t are even less likely to respond to the 2nd drug they try (source: webMD). Of those that do respond, about half would have responded to a placebo (source: JAMA). Keep in mind antidepressants are serious drugs that often have side effects.

        On the other hand, talk therapy has proven to be as effective as medication (source: webMD). So has 20 minutes of daily exercise (source: Duke). Eating healthier helps as well, though not as much.

        The problem for doctors is that patients who are told to make lifestyle changes (diet, exercise, getting out more) rarely follow through. Depressed patients are probably even less motivated to take that first step toward change.

        So the default American answer is a pill, which takes 3 weeks to start working (if at all). If it doesn’t work by then, they’ll adjust the dose. If it still hasn’t worked after another 3 weeks, they’ll try a different pill…and another…and another. By the time you get through the more than two dozen FDA-approved anti-depressants, 3 years will have passed and maybe you’ll have gotten better anyway.

        This isn’t to minimize depression or say it isn’t real. Au contraire – it is a nasty disease that we know surprisingly little about. For example, the theory that brain chemistry is responsible for depression is widely accepted, but is still just a theory – it has never been proven. Doctors don’t monitor brain chemistry and adjust dosage like they do using bloodwork for other medications.

        • Barbara Rice Barbara Rice says:

          As I said, I was fortunate that I responded immediately to anti-depressants; many people do have to go through several or several combinations before they find something that works for them. When I began taking anti-depressants, I noticed results within a few days – not 3 weeks. The goal was to lift me enough that I could make life changes if necessary – which severely depressed people cannot do.

          It would be nice if mental health issues such as depression were resolved by eating fewer Sugar Pops and more broccoli plus a daily mile walk, but the nature of depression is such that the sufferer is unable to continue a program. It would also be nice if there was less stigma, fear, and guilt concerning the usage of psychotropic drugs, and more concern about simply doing what an individual needs to do to get well.

  15. Avatar Joanne Lobeski Snyder says:

    I had a lot of reservations about trying a drug to help me combat a disorder that had plagued me all of my life. I had all of the sorts of thoughts that Tim mentioned above running through my head. I knew from Sociology classes that depression was the result of overcrowding populations. I knew from Psychology that depression was the result of repressed or suppressed memories or unresolved issues in my life. I knew from religion that depression was a symptom of guilt for something. Or another. I knew from a counselor I saw when I was young that I was “doing this to myself.” I was completely blindsided by my first severe depression event. I had never heard about someone experiencing what I was experiencing. Decades later when I accepted that it didn’t matter what anyone else on earth thought….I took the course a young doctor and psychopharmacologist in Redding recommended. I couldn’t tell that I was taking a “drug” at all, but the periodic severe bouts of depression and panic attacks stopped cold. My life changed. Thank you Barbara for this article. I couldn’t have responded like I have if I were still working or in the military because the stigma of this disorder is still alive and well.

    • Barbara Rice Barbara Rice says:

      Thank you, Joanne, for sharing your experiences. Until someone has actually experienced the pits of depression personally, they cannot imagine how crippling it is. It’s all too easy for a bystander to say, “Hey, just do —– and you’ll be fine; you don’t need a drug.”

      Somewhere I have a piece of yellowed paper with a note written in pencil in my grandmother’s hand, detailing a cure for the deeply feared infantile paralysis (as polio was once known). It recommended dosing the patient with turpentine. One of my great-aunts also recommended turpentine for treating the bite of water moccasins.

      Would we turn to a home remedy like that today? Why do we continue to fear drugs available for mental illness – why are mental illnesses somehow different than physical? Or is it fear and misunderstanding of the illness itself, and the underlying suspicion that somehow the patient is to blame, and if they just pulled themselves together and let a smile be their umbrella they’d be fine?

  16. Joanne Snyder Joanne Snyder says:

    I may be older than you Barbara, but in my lifetime, schizophrenia was considered a psychological disorder as opposed to to biological disorder. The book and I think movie “I Never Promised You a Rose Garden” makes me cringe. The nurse knows that someday this young girl will gather the strength to deal with reality. An important book for me was the one Kurt Vonnegut’s son published in the 70s called “The Eden Express”. At the end of the book in the second edition he wrote that curing a mental illness by talking about it is like bringing down a fever by talking about it.