This post is emphasizing the somatic or physical nature of depression. This is absolutely critical, so please read on. However, there is a second part to his blog which I wrote later on. For a post emphasizing the psychosomatic nature (more mental stuff and how that effects the body) check this one out.
https://noggybloggy.com/2017/07/25/a-devastating-team-sport-what-is-depression-part-2/

Using the term depression is very easy. I throw the term around lot not referring to its medical use. I would particularly use it when referring to the performance of my favourite football team who got relegated last year (not to mention England at Euro 2016). It becomes really easy for us to talk about being depressed emotionally when we are feeling down or disappointed. However, that is certainly not how I plan on using it here.

Depression is like a battle between soul and body where your brain takes sides with your body. It decides that it wants to wage war with your soul and starts to work with your body. It is never nice to be outnumbered. So naturally your soul wishes to call out for help and summon reinforcements. You want to reach out to friends or family, but you can’t. Your body has already thought of that and stopped you. Then your mind starts to be convinced that your body is right. This can lead to a paradox of a Darwinian variety. A person whose totality is working against itself. That is more what I mean when I say depression.

That isn’t an ideal situation. However, it is the reality for a lot of people. It is an issue that needs to be tackled with other people helping out. But there are two problems with this. The first is that no one with depression wants to talk about it, and we are right to feel this way. That isn’t to say that they shouldn’t tell people, but rather it feels impossible to. The second problem is that people without depression don’t know how to help. The primary reason for this ignorance is that no one with depression wants to talk about depression. This means that people without depression often do more harm than good when trying to help.

To recap, the people with depression don’t talk about depression which means that the people without depression don’t know how to help. They end up doing more harm than good and make the people with depression less likely to want to talk about depression. There is a great danger in this cycle, which hopefully we can break. This blog post is trying to address that problem using some examples of my life to highlight the problem a wee bit.

 

I was recently telling someone why I don’t like to travel. I used to love travelling. It took me roughly 20 hours of travelling to get from my house to my boarding school. Long journeys rarely bothered me, I had made several journeys across continents by myself or with family. However, with the advent of depression and anxiety travelling is really tough for me and often leaves me feeling extremely ill afterwards.

This person, although they are lovely and had no intention of upsetting me, proceeded to tell me all about how the power of positivity can make such a big difference in life. All I needed to do was have a better attitude and I would be better. This was a horrible thing to say to someone with depression (I am not opposed to having a positive attitude, but it wasn’t appropriate at the time. It is a great idea and is very effective in certain circumstances. This is kind of what Cognitive Behavioral Therapy is.). The response made me feel like my depression wasn’t a serious problem. It made me feel guilty for having such and ‘easily solvable’ problem. However, that isn’t what depression is.
First let’s talk about what depression is. Depression is primarily a physiological disability which has emotional, and spiritual consequences. This is very important to understand whether you have depression or not. It means that if you think of depression as an emotional issue, or someone struggling with a tough time emotionally, you need to restructure your ideas. Although things such as emotional or spiritual trauma can cause depression, it is the physical mechanisms which is the depression and causes the symptoms.

It is easy to see the importance of this when you draw a parallel with other physiological injuries with emotional and spiritual consequences. A couple of years ago I had quite a serious knee injury, dislocating my knee cap and tearing three ligaments. I had a clear physiological ailment which had plenty of physical symptoms, such as pain and swelling. However, it also made me angry that I couldn’t play football. This in turn meant that I couldn’t stimulate endorphins by exercising. This made me ripe for spiritual discontent as well. Thus, we have a situation where there is a physical injury, affecting the hormones in your brain, with emotional and spiritual ramifications. This is identical with depression. It is a physiological issue which affects the hormones in your brain, leading to emotional and spiritual ramifications.

When I hurt my leg the response from my friends was great. A group of friends brought round a batch of brownies for me to encourage me. They were constantly asking me how I was doing and inviting me to their houses. So many people were cooking for me and bringing me meals. My church organized a rota of drivers so I could make it to my lectures and social engagements. It was a great response.

In addition to this it was obvious that I was disabled. I was on crutches and had badly blistered hands from them. This meant that people opened doors for me. They constantly checked if I was ok. The clicking of crutches as I approached reminded them I was disabled.

This is where depression is vastly different. There are no crutches for depression. There is no reminder that I am disabled in this way. Essentially, no one brings you brownies when you are depressed (particularly fairtrade chocolate chip ones if any of my friends who like baking are reading this) because no one can see it.

This is why my friend’s response made no sense in regard to my depression. She couldn’t see the crutches in my life and so was not in the mindset that depression is a physiological issue. Imagine her response if I had a broken leg. She would not tell me to have a positive attitude. How could that solve a physical issue? She would ensure that I had crutches, she would ensure that I had pain killers, and ensure that she was opening doors for me.

These responses are one of the reasons why it is so tough to tell people about depression. They make it seem like it is your fault when it isn’t. This would be like telling someone with a broken leg, “If you have a better attitude your broken leg will heal.” Or perhaps “You need to man up, Even though you were hit by a car it is your fault you have a broken leg and you need to pull yourself out of it.” They may sounds outlandish and brute, but I have had these responses or similar things many times in response to my depression.

This response of theirs is crippling and isolating. It is driving you away and invalidating your suffering. It is dismissing a very tough situation. It makes it seem like they don’t care about you at all

Isolation

Depression is very isolating. It is isolating for the person in their dorm room at university with no friends. It is isolating for the person at the party surrounded by their friends. No one can escape it. This is one of the reasons why depression is so badly understood by those who have it and those who don’t. I believe it is one of the primary causes of the stigma around it. No one with depression wants to talk about it, and with good reason.

Before I had depression I would agree that I struggled to make deep friendships at university. I didn’t understand how you were supposed to make friends with British people. As a Third Culture Kid I wanted to have deep and personal relationships with my friends. I didn’t want to waste time with shallow pleasantries which I didn’t understand anyway.

In the UK people are initially more distant than I was used to which made me struggle to know when I was friends with someone. I didn’t feel like I knew anyone well in my first year. However, this is very common. I had faith that in my second year I would make friends. I earnestly hoped and prayed that the next semester my friendships would continue to grow slowly but surely. Despite the struggle to connect with people on a deep level I rarely felt lonely. I was still very close with my friends from school and had lots of promising relationships with people I had met at uni. But that all changed in my second year.

I grew into the superpower of feeling incredibly lonely and isolated when in groups of people I love. I developed the ability to be totally separate from my friends and family in the midst of precious time spent together. I remember so many times playing games with my friends, starting to think I could be enjoying myself, and then it would hit me. I would realise that the other people in the room don’t care about me and I don’t care about them. I knew it wasn’t true factually, but that was what my body were telling me. It was devastating and crippling. I was totally stranded despite being surrounded. Why would I want to be with people?

On top of that a ferocious cycle of anxiety kicked in. Any time spent alone would result in negative thoughts and a lack of desire to live. I would rather die than be on my own when I am at a low point. But the alternative isn’t much better. Anxiety made it seemingly impossible to spend time with anyone. Anytime spent with people terrified me. I start to feel light headed and panicky. I would start to feel dizzy and worried if I had to talk to friends or family about certain topics (the one person who this has never happened to me with is my nephew Owen).
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This anxiety also stopped me reaching out to people. “Why would they want to spend time with me? We are not that close anyway. If they really cared about me they would ask to hang out with me. If they really cared about me they would see how much I was suffering. People here are too busy working and prioritising work to look after me.” There is something disturbing about having friends who are too busy doing their university work to spend time with you when you are struggling. It is difficult not to think that they value their work more than you. This is compounded when you have depression.

A particularly bad memory of having depression was once when I was having a horrible day and tried to reach out to some friends. I knew I just needed to be with people so I mustered up all my courage and energy, ignored all the thoughts going through my head, and sent them a text asking if I could come and hang out at theirs. They replied that they were busy working so weren’t free. This was very tough for me to hear, but I decided to persist. In desperation I sent another text saying could I just lie on the sofa as they worked. But they said that they were staying home and working that day and that we could hang out another day.

They may have had good reasons for saying no to me, but I felt horrible. I had tried so hard to reach out to my friends. It takes an immense amount of energy to do this. Yet, I felt let down and inconsolable. They were indicating to me that their time working was more important than me or our relationship. Even though they wouldn’t agree with that, their behavior communicated it to me. It was one of those moments when I particularly hated life.

If you know someone who is suffering from depression, and they reach out to you for help, take it seriously. Never dismiss it. I didn’t care about life, but made a massive, energy wrenching, anxiety inducing effort to reach out none the less, and was spurned.
You should also feel honoured because they are probably using up a significant amount of their available energy and motivation to tell you. It is a remarkably strange thing for me to have so little energy. I am still trying to get used to it and figure out how it works and understand it. It is as if my body can’t be bothered to do anything. I went from being a fit teenager to one who sometimes hardly has enough energy to get out of bed. This there was one day this summer where I walked up the stairs and was knackered. Not like I didn’t have enough sleep tired, but like i had massive weights tied to me. I had to spend the rest of the day lying down on the couch because I didn’t have enough energy to do anything else. It is a very particular type of exhausted which I had never experienced prior to depression.

The lack of motivation also prevents you making any attempts to share your struggles. Everyone has tough days where they don’t feel like getting out of bed, but this is vastly different. The lack of motivation is far more serious. Some days I am not motivated enough to live, or exist. I cannot be bothered to and have no will to.

I just want to mention one more thing in relation to isolation. When you have depression one of the symptoms is shame, or guilt. These are very common and make it feel like the depression is your fault. It makes it feel like it is your burden. Society is pummeling us with images of people being happy, making friends, or enjoying life. Depression can take that opportunity away from you. It makes you feel less than human, like you are not living up to the proper standards of humanity. This isn’t just in advertising, but in facebook posts where people are always smiling, in church sermons when people foolishly equate joy with happiness, or on nights out when people encourage you to forget your troubles. People with depression can’t do these things and that makes us feel worse. We feel like we are doing something horribly wrong. This, paired with other symptoms, makes it terrifying to tell other people what is going on in our lives.
What are the facts?

Depression is the leading cause of disability in the world. Watch this video if you are interested in a visual presentation of it (presumably you are because you are reading this blog). In fact even if you aren’t a visual learner watch it. It is less than 5 minutes long and really good.

https://www.youtube.com/watch?v=z-IR48Mb3W0

Even though the statistics may not be relevant to where you live, they should give an indication of the seriousness of the issue. (Disclaimer: I do not know anything about electro-convulsive therapy or the transcranial magnetic stimulation. A friend of mine told me that they are used in more serious cases. The rest of the video was great so thought I put it in anyway.)

In case you didn’t watch the video it talks about ideas such as regions of your brain shrinking (the hypothalamus and frontal lobe). Depression severely affects your brain. I just googled brain scan of depressed brain to find this image. It is remarkable how much of your brain just seems to shut itself off. There is a significant physiological change occurring, and that is no one’s fault, but a symptom of a very physical affliction.

brain

Most anti-depressants work by trying to restore some balance to the hormones in your brain because its activity has changed dramatically. The chemicals in your brain are messing with your body. The balance of hormones is often dramatically thrown off.

Recent research has successfully linked certain genes to depression. This makes depression a genetic disability. This is possibly the case for me given my family history. There is a large body of physiological and biological work studying depression which lends more credence to the claim that to properly understand depression we need to understand it as a physiological condition.

Here is the NHS page on depression:

http://www.nhs.uk/Conditions/Depression/Pages/Introduction.aspx

The causes of depression are extremely varied. It can be triggered through the tough transition to your parents’ home culture, the death of a loved one, a concussion, or seemingly nothing at all. It comes about as a complex interaction between genetics and environmental factors. These factors are often some sort of emotional trauma.

The changes in physiology are what usually symptoms. It can be very counter-intuitive to think about it in such a way because the symptoms show up in non-physiological cases. Lots of people feel low on energy or motivation for all sorts of reasons. People feel anxious watching a scary film or a tense sports match. Even watching a stupid chick flick (which is pretty much all of them) can make some people feel sad.

I think it is because we associate these experiences with non-physiological causes that we enter into a discussion of depression with the wrong framework. I cannot stress enough how important it is for everyone to get on board with the idea that depression is as physical as breaking a leg. It is true that it has emotional and spiritual implications/causes, but it should be thought of as physical similar to a broken leg in some regards.

This does not mean we should not care about the emotional or spiritual aspects of it. Necessarily, they need to be engaged with for healing or closure. Because your brain has constant interaction with the spiritual realm it is important to keep this in mind. Not to mention the hormones in it dictate your emotions. Depression is still psycho

A final note here is that depression looks different for every person. To fully understand each person get interested and ask about their experience. Here are a couple of blogs which are very useful for communicating depression through a very different medium and experience. Particularly good if you like cartoons or visual stuff.

https://beyondthemeh.com/

http://hyperboleandahalf.blogspot.co.uk/2011/10/adventures-in-depression.html

http://hyperboleandahalf.blogspot.co.uk/2013/05/depression-part-two.html

This post is emphasizing the somatic or physical nature of depression. This is absolutely critical, so please read on. However, there is a second part to his blog which I wrote later on. For a post emphasizing the psychosomatic nature (more mental stuff and how that effects the body) check this one out.

https://noggybloggy.com/2017/07/25/a-devastating-team-sport-what-is-depression-part-2/