You’ve taken the most important step. You’ve sat down with someone you trust. Looking them in the eyes, you think carefully about what to say, and…..nothing.
Worse, maybe you’ve even mustered some sort of an explanation (though you know it doesn’t even come close), and they’ve just looked back at you puzzled.
And so comes the tough question that I’m attempt to answer today.
How can you explain depression to someone who doesn’t understand!?
Depression isn’t even something that makes sense to you. How the hell are you going to make it make sense to someone else?
This post is a little different from what I usually write about at Project Monkey Mind. It’s a little bit dark. But that’s because depression is a dark place, so it’s necessary to bring some light to it (terrible pun intended).
There is often a perceived stigma which makes people who suffer from depression not want to share it. Though openness is what can lead to social connection and recovery. This stigma is not helping the problem. In fact, it’s antiquated and serves no one.
Imagine for a second that you had a cold but you feared going to the pharmacy? It would be incredibly frustrating to say the least.
How to explain depression: why is it so hard?
When we try to tell someone what depression is, it’s common that you can feel like something’s getting lost in translation. To you it may seem like they’ll just never understand, and to them it may seem like it just doesn’t make sense.
The reason it’s tough to share your experience of depression with someone is because it feels like you’re sharing a deep part of yourself. And not the part of yourself you’re proud of. It’s the part that you don’t like, the part that you don’t want the world to see.
It’s your weakness, your dirty little secret, the silent critic that can make you question every compliment you get, every positive experience you have, self-worth and self-belief. It’s confusing, exhausting, ugly and, justifiably, not really anyone’s favourite topic of conversation. Sometimes you may not even know why you’re feeling so sad for what may seem like no reason at all.
One mistake that depression sufferers make when trying to explain their illness is that they focus on the feelings. Unfortunately, there are no words that can communicate the feeling of depression without the person having had a reference experience that would allow them to understand it.
Because it’s so foreign to most people that haven’t experienced it, the best way to explain it is with metaphors and analogies that allow them to relate depression to their own life experiences – like the Pharmacy example above.
Why is it important to explain depression?
Despite how difficult it can be to try and talk through depression with someone you care about, it’s incredibly important in the management of the illness.
When you’re going through a depressive episode, a lot of the time you can’t rely on your own opinion to point you in the direction of health. It’s therefore crucial that you have someone you trust who can non-judgementally help you see things from outside the bubble of depression. However, to get to that place of trust, you must first open up and allow them to at least begin to understand what’s going on in your mind.
“There is no point treating a depressed person as though she were just feeling sad, saying, ‘There now, hang on, you’ll get over it.’ Sadness is more or less like a head cold – with patience, it passes. Depression is like cancer.” – Barbara Kingsolver, The Bean Trees
Typically we think of depression as something for the depressive and the therapist to deal with. But it affects not just the sufferer, but their friends, their loved ones and their wider community. So really, it’s an issue that needs to be managed, and understood, by everyone. What I’m trying to do with this article is explain depression so that the non-depressive, be it a close friend or family member, can best understand what is happening, and how they can effectively deal with it.
How to set the ground for the conversation
Because talking about depression is hard, you need to make sure that it’s a conversation that you don’t need to repeat over and over again.
Here are some ground rules to start the conversation off on the right foot.
- Make sure that the person you’re talking to knows that this is important to you
- Let them know how much they mean to you and why you trust them
- Let them know that the conversation is important, and that it would be best if you can have it at a time when they won’t be distracted by their phone or other obligations
- Make sure that you schedule a time to talk about it
- Let them know that they don’t need to be worried
- Be ok with silence and long pauses
What they need to know
#1: Our brains are working in very different ways
My brain is different from yours both structurally and functionally. In fact, chronic depression actually causes brain damage, which means if I’ve been through this before, there is a chance my brain has been permanently altered by it.
To be specific, during and following a depressive episode, the brain’s hippocampus and frontal lobes shrink, meaning it’s very difficult to regulate emotions and focus attention. The amygdala, which is activated when recalling emotionally charged stimuli, such as fear, becomes overactive – this continues even after recovery from depression. Also, susceptibility to stress is increased, and it’s possible that there can be some issues with memory.
There are several neurotransmitters which are responsible for mood, sleep, appetite, as well as stress and pain relief. During depression these aren’t functioning as they are supposed to.
Imagine a car honks behind you. You jump, your body tenses up, and once you realise it’s a car, you take a deep breath and try to relax. Then you keep walking, and another car honks, startling you again. Then another, and another, you try to stay calm, but eventually you snap.
That’s what it’s like with negative thoughts when you’re experiencing depression. Every time you have a negative thought it plants itself in your body. You can try and relax and let it go, but another one pops up. You can try to stay calm, but at some point you’ll spiral.
Your mind might seem like a calm country road, but at times mine is going to feel (and sound) like rush hour in Shanghai.
#2: There is a difference between what I know and what I feel
Don’t you know that you should think positive?
Don’t you know that stress kills?
Don’t you know that it’s not the end of the world?
I do. I definitely do. In fact, I understand all these things a lot better than most people. I’ve been forced to think about them because of the circumstances.
But while I understand intellectually that what I feel isn’t logical, the experience I have is very different. So, before you give any advice, simply pause for a moment and consider if what you’re saying might be perceived as condescending. Remember, no one likes a backseat driver.
Don’t ask ‘why are you depressed?’ and get frustrated if there is no clear answer. There is almost never a clear answer, sometimes there is no answer, it is incredibly complicated and every case of depression is different.
I know that there are 350 million people that experience depression worldwide according to the World Health Organization – but I’m likely to feel like I’m the only one.
Try to understand that I’m not experiencing the same emotional palette as you. During a depressive episode;
- Joy is transformed into lifelessness.
- Challenge feels like overwhelm.
- Fears and anxieties become paralysing.
- Sadness is experienced as mourning.
#3: A lot of the time I’m making decisions from a place of tiredness and exhaustion
You know how when you’re tired you make bad decisions or get snappy? Imagine an extreme version of that.
Depression, for the most part, is incredibly exhausting, I’m spending a lot of mental energy simply trying not to succumb to negative thoughts. Even very basic tasks like getting out of bed or preparing a meal can sometimes feel incredibly taxing. Consider what it feels like to be stuck in quicksand, this is how moving through a depressive episode can often feel.
This also means I’m trying to be ‘normal’ in the midst of feeling tired, so if I slip up every now and then, try your best to give me a break.
#4: I probably feel guilty and scared
Guilt is one of the most common emotions that I’m going to experience. Guilt about not being happy when I have so much more than many other people, guilt about being annoying or a burden to my family and friends, and sometimes maybe even guilt for those moments where happiness is experienced.
It’s also quite a frightening experience. You’re literally seeing yourself transform into something that you didn’t think you were. The fallibility of emotions and moods and feelings and your own sense of self are revealed to you first hand. Most people live with the comfort that they can rely on their self-image and narrative – “I’m George, I do X in Y situations, I like Z” – because it’s comfortable. But when your brain chemistry starts playing games, you’re shown that this really isn’t the case.
You start to see behind the veil, that a lot of what you’ve worked for and a lot of what you believe in stand on shaky ground. What you enjoy one day could be taken away the next, and that’s something no one who hasn’t had that kind of experience could understand – nor would you really want them to.
#5: There are many lies that my mind will tell me when I’m in a depressive state
Probably the most practical thing you have to know is that because my brain is in such a state, my mind is going to tell me a bunch of lies.
These lies have little or no basis in reality, but they are dangerous, and when they come up they are going to feel as real as the fingers on my hand.
So, if you hear me saying any of these, please, non-judgmentally acknowledge that while they definitely feel real, they are just tricks of the mind.
I am a burden to others. This is one of the most dangerous lies that comes along with depression and has a high correlation with suicidal ideation. Chop it down whenever you see it.
I need to be isolated. The desire to be away from others is related to feeling like a burden. It probably stems from the urge to separate ourselves from the tribe when ill. But we’re not living in 150 people groups, and isolation only serves to deepen the depression and confuse those around us. Depression is self-perpetuating. Imagine someone who had a nut allergy was craving nuts. Isolation causes depression, but depression causes a craving for isolation.
The world doesn’t love or care about me. If I have moments where I only seem to perceive the worst in other people, don’t take it personally. My brain has ramped up its’ negativity bias so it’s very difficult for me to appreciate (and feel) care and love when I receive it. Ironically, it is care and love that can break through and challenge my depressive state, which is why persistence on your part is important.
These feelings will never pass. Memory is state dependent (see mood congruent memory bias), which means when I feel down, all I can remember is other times when I felt down and all I can imagine is other times that I will feel down. In this state, I won’t be able to picture a positive future – but I need to begin to construct one in order to get enough momentum pull myself out of the rut.
I am my past. This is an extension of the point above, but essentially, I’ll be feeling that because I have had depression I will always have it.
I am these negative feelings. Instead of being able to understand that I am feeling depressed, angry or hopeless, I will start to feel that I am depressed, I am angry, or I am hopeless. Again, this is another example of me being frozen in psychological time, everything will feel stagnant.
I don’t have the strength to overcome this. The combination of exhaustion and hopelessness will try to convince me that no matter how many times I have found the strength in the past, this time I won’t be able to find it. It’ll be gone. Simple reminders can be surprisingly effective at dismantling this lie. Journaling is also incredibly effective.
Depression is my friend. This is one of the sneakiest lies that depression will tell me. Particularly if I’ve lived with it for a long time. Depression becomes familiar. If I’ve overcome this on multiple occasions, I’ve probably begun to see my struggle with the illness as a core part of my personality. This means that the prospect of losing depression altogether is almost like losing a part of myself, or a friend. Both you and I need to be acutely aware of this trick sneaking in, as it can result in subtle self-sabotage, such as not committing to the right medical treatment out of a fear that it will ‘change me.’
#6: I can still have good days
“Every day may not be good, but there’s something good in every day.” – Alice Morse Earle
Because I have depression it doesn’t mean that every day is going to be terrible. And when I have a good day it doesn’t mean that everything is cured. I want you to celebrate the good days with me but don’t let either of us get too attached to them.
How you can help!
Ask me what you can do to help. This is the most effective but often most overlooked strategy. Just ask me! I might not know straight away, but an idea may come up in the next day or two or three. It also lays the foundation for me being comfortable enough to ask you when something does come up.
Watch out for and counteract the lies that depression tells me. Those sneaky lies above will come back again and again and again. I will ruminate over and over, and it will be hard to stop. It’s your job to outsource your healthy mind to me so I can know when I’m being tricked, but understand that this requires a lot of trust.
Acknowledge my experience. If I express my train of thought, you can respect how and why I might be thinking that way, but also explain how someone who isn’t currently depressed may think about it.
Don’t be scared to apologize. Don’t be afraid to say sorry if you feel you’ve said the wrong thing. Let me know that you’re not a clinical psychologist and that you’re trying your best to try and understand the situation, you’re only human and you make mistakes too.
Be patient. Patience is important because as much as I want to permanently overcome depression, my brain may have structural and biochemical differences which means even if I overcome it this time, I’ll probably experience it again. 50% of those who experience one episode will have another, whilst 80% of those who have two episodes will have a third.
If you’re going through a depressive episode, please don’t hesitate to reach out and ask for help.
It’s tough, it’s uncomfortable, it’s really kind of shitty, but it can allow both you and those around to get a better grasp and control of the situation. And when all is said and done, you can emerge from the experience with stronger relationships, and a deeper and richer appreciation of life!