Monday, 9 September 2019

(MIS)DIAGNOSING DEPRESSION

Photo by Ian Espinosa on Unsplash

I was at a literary event recently when the conversation swung to depression. It started when a man presented a poem about this state of mental health and suggested that ‘a smile, a hug, and some love’ could get people out of their depressed state. For the most part, the poem resonated with people because it was relatively well written and delivered, and being a sensitive topic, people could relate; or so I assumed.

While I was processing the words of poem, someone mention that it was important to note that depression was not ‘having a couple of bad days or being sad. It is a clinically diagnosed illness and must be treated that way.’

In the past, I would have nodded my head in agreement. I understood the sentiment and the need to be sure that people weren’t misdiagnosing depression when in the real sense, they were briefly unhappy or in a funk. But, my idea about depression changed a while back. Before I get into what caused the switch, let me share a train of thought that I followed through as I listened to the debate.

Have you ever had a blinding headache? Those things can be the worst! You can’t think, you can’t sleep, you can’t eat, you think you head is about ready to split, and if it is really bad, you are almost crippled from the pain. When you go to the hospital, the doctor may diagnose a headache, migraine or something worse. In essence, the doctor is affirming what you already feel. You know the intricacies of the pain you are feeling. What the doctor does is to give you a ‘fancy’ name for what you are dealing with, and hopefully, a medical solution.

So, let us say that you don’t go to the doctor. Do you still have the symptoms? Yes. Can you tell that you are in great pain? Yes. Do you know that something is wrong with you? Yes. What you may not know is the technical term for what you are going through, but you know that something is wrong. In some cases, you know that if you can just sleep, you may be better for a bit. In other instances, you know that seeing a medical personnel and taking some drugs can help you get better. And while you may want to take that option, you know that sometimes, there are a number of factors that may prevent you from seeking that help. So, you sleep. Or eat. Or rest. Or just lie down because you know that it would get better…until the next bout comes up.

In this case, does the absence of a medical diagnosis negate the existence of your headache? I think the answer is no.

The same is true for depression.

People who are suffering from depression know that there is something wrong with them. They know that the gnawing emptiness they are feeling is a symptom of something bad. They understand that those panic attacks are not normal. They realize that their appetite – whether they are eating very little of way too much – is a sign of something troubling. They wish they didn’t have to sleep so little…or so much. They get that their complete lack of desire for anything, and sometimes, their only desire which seeks to end it all, is a product of a situation that is…bad.

They know this.

They also know about the days when pretending to be fine is the wall they need when their entire essence is crumbling apart. They understand the need to reach out, and the countering need not to be a burden. They can taste the fear of not knowing whether they would be understood or dismissed, or the hope that someone would see through their façade and help them. They also remember all the times when the voices in their head tells them, ‘didn’t I tell you? Nobody cares about you.’

They know this.

What they may not know is the fancy name for what they are feeling.

A little over six years ago, I began to feel sad and unhappy about my life. I didn’t seem to be making much progress for the timelines I set for myself and I started having this feeling that I was failing at this thing called life. It was a gnawing feeling that seemed to be here today and gone the next. However, I noticed that, with each session, the sadness seemed to take deeper roots. It felt like I was in quick sand and while I was only ankle deep, I couldn’t get out. As the years wore on, I continued to descend into the abyss until it got to a head a little over two years ago.

I lost my mind.

I started having repeated panic attacks, and once, when I could feel my heart closing up and my lungs refusing to draw in enough air, I thought I had come to the end of the road. When it passed, I felt empty. For one week afterwards, I didn’t have a shower. My bedroom was a dumpster; filled with plates from days before, wraps from junk food, bottles and clothes strewn everywhere. I was listless and couldn’t feel anything beyond the overwhelming emptiness of what was my life.

I was depressed.

And guess what? It started with a couple of days of sadness. It started with some unhappiness. It started with days when I was in a funk.  Which is why when people say, 'depression is not having a couple of sad days and being unhappy', I shake my head. Only a person having those feelings can tell you what they are feeling. Only a person having those feelings can tell you how deeply lost they think they are.

Image from Twitter
It is important to note that people who are depressed do not share the extent of their listlessness with other; one, because explaining it is hard, and two because, there is such a pervasive culture of dismissal in our communities. As soon as you share your sad moments, there will always be someone who wants to get into a pain competition with you. ‘Oh! You think you are going through hell? You haven’t seen my own hell.’ Women (especially) have learned to minimize their pain because, ‘you are not the first to go through this’. And men don’t even share their pain because…toxic masculinity. So…to the average outsider, it may look like just ‘a couple of days of unhappiness’.

Let’s go back to the conversation at the event.

One major statement that rubbed me off the wrong way was: ‘you cannot get a person out of depression by smiling at them or giving them a hug. People have to be treated for this…medically’.

There is some truth to this statement. Some forms of depression have to be treated medically. But…that is not the only way to treat depression; as many doctors would tell you. And the obvious reason is that there isn’t one form of depression. In fact, on this article on WebMD, you will learn of at least nine types of depression. And with many of them, the recommended treatment could include talk therapy, psychotherapy, light therapy or more. These may or may not include medication like antidepressants.

And it is because of this that I feel the aforementioned statement about positive energy is flawed. Some people have become better because they have had people show them love, listen to them, walk through the worst of their pain with them, understood them or just see them. I think I stayed sane for as long as I did before I lost it because I had people who loved and cared for me helping me through the funk.

I remember one time when I went off social media because I was in a one of the worst throes of the depression I was going through. Anyone who knows me can tell you (for free) that I am an internet junkie. People think I either tweet too much or talk too much. So, when I went off, I hoped someone would notice I was gone. Only my sisters and my best friend noticed. Remember that thing about the voices and self-worth? Yeah! It got worse for me.

Maybe because of my journey with this illness, and pretending to be fine so that people wouldn’t worry, I can tell the symptoms of depression in people.

I know a woman who has what can be concluded to be psychotic depression. She has had a really bad life. Her spirit has been broken by the circumstances that shaped her life – rape, emotional abuse, domestic violence, being a victim of fraud and more – and she is in a state of perpetual unhappiness. The sadness around her is palpable…almost like a cloak. Nothing seems to give her any kind of joy. It was said that she couldn’t sleep, barely ate anything and if she didn’t feel that people who committed suicide 'would go to hell', she would have killed herself.

Would it be a misdiagnosis to say she is depressed? No. All the signs are there…even for people who are not medical personnel. Of course, it would be great to have her diagnosed by a doctor so that we can be correct with the term, clinical depression. But the absence of a diagnosis doesn’t negate what her symptoms are.

It is therefore important not to negate people’s experiences because they tell you they have a couple of sad days or they are in a funk. Being unhappy may just be the part of the iceberg that you see…or they are willing to let you see. Or…it could be the best way to explain what they are feeling, because they themselves do not understand the emptiness that is burying them to oblivion.

In essence, be willing and open to learn. Having head knowledge of depression is good. Knowing that it is an illness is great. Understanding that it needs to be treated is fantastic. But living that depression? Understanding it? It requires empathy that goes over and beyond head knowledge. Again, be open. Be willing to learn. And most importantly, don’t be too quick to negate people’s experiences by telling them their depression is anything but.


Photo by Mobola Odukoya on Pexels

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