Some Thoughts On Depression, and Why Self-Care is So Hard

(Content note: depression. Obviously.)

I’m currently pulling out of a depressive episode — not a horrible one, but not a trivial one either. I’ve been looking at one of the shittiest aspects of depression — the self-perpetuating nature of it, the fact that the depression itself kills my motivation to do the things I need to do to help pull out of the depression. And I think I have a new insight as to why that is. (For me, anyway — not sure if this is true for anyone else.)

Depression is generally a motivation-killer. But for me at least, it’s not an equal-opportunity motivation-killer. It does reduce my motivation to do much of anything — but it’s especially murderous when it comes to my motivation to do self-care, to do the very things that would make me feel better. Exercise, eating well, meditating, masturbating, going outside, seeing people — these are the things that are hardest to do when I’m depressed.

And I think the clue is in the phrase “make me feel better.”

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Exercise, eating well, meditating, masturbating, going outside, seeing people — these are all things that make me feel better. But they are also things that make me feel, period. That’s not some sort of goofy coincidence. Feeling better means feeling, you know, something. To some extent, self-care makes me feel better because it makes me feel something.

And feeling is exactly what I don’t want to do when I’m depressed.

Depression, among other things, cuts me off from feeling pretty much anything. It disconnects me from my emotions. Hell, it disconnects me from pretty much everything. At its worst, being depressed feels like being wrapped in thick layers of cotton wadding, which little or nothing can penetrate. Emotion, physical sensation, other people, even my own basic experience of my own consciousness — all of it feels distant, unreachable. This disconnection is a core defining feature of the illness — and it also serves a function, if it can be put that way. I get depressed when there are things happening in my life that I can’t cope with. For me, depression gets triggered when I have two or more horribly stressful things happening in my life, and my brain goes, “Nope. Too much. To hell with that. Not gonna experience that. Time to shut down.”

So when I’m depressed, things that make me feel better are things that I resist — because I don’t want to feel anything at all.

It’s often said that the most dangerous time for a dangerously depressed person is the time when they’re just starting to feel a little bit better. When depressed people start to feel a little bit better, two things happen. We’re feeling something at all — which means we’re actually deeply experiencing the shitty depressed feelings instead of being cut off from them. And we’re starting to feel motivated again — which, if someone is dangerously depressed, can mean they now have the motivation to hurt themselves, something they might not have had when they were in the deepest part of the pit. (This is one of the reasons suicide risk goes up in the first few weeks that people are on anti-depressants — and thus, it’s one of the reasons people need to be monitored very carefully during this period.) I’m not dangerously depressed in that sense — I’m not suicidal, and I’m not self-harming except in the sense that when I’m depressed, I don’t always take care of business and my self-care sucks — but I do experience this “Holy shit, do I really feel this bad?” thing when my depression starts to ease and I’m starting to feel a little bit better.

When I’m feeling okay — when I’m not in a depressive episode — these self-care things aren’t a struggle. In fact, I actively enjoy them. Exercise, eating well, meditating, masturbating, going outside, seeing people — these are some of my greatest pleasures, some of what make me feel most alive and most connected to the world. But in one of the shittier paradoxes of depression, the very fact that they are deep pleasures, pleasures that make me feel alive and connected — that’s part of what makes me push them away.

***

I’m not sure yet how to apply this insight. But I’ve found in the past that having some intellectual insight into how my depression works — and what works to pull me out of it — does help. It’s not a magical cure-all, but it does do some harm reduction. As I’ve written before: The habit of skepticism, the habit of knowing about cognitive biases and the ways our brains deceive us, makes it easier for me to trust my knowledge of what’s really real rather than my lying depressed brain. It doesn’t make me feel any better in the moment — but it gives me a lifeline, something to hang onto, a sense of trust that I won’t always feel this way. Sometimes, when I’m depressed, it’s like riding out a bad drug trip — it’s like, “I can’t see it at the moment, but I know this isn’t going to last forever, so I just have to hang in there and feel like shit until it lets up.” So I’m trying to document these insights, in the hopes that the next time I have a bad episode, I’ll have yet another lifeline. The more I can remember, “Depression lies, and in my case one of the biggest lies it tells me is that I’ve always felt this way and always will,” the easier it is to ride it out.

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Greta Christina is author of four books: Comforting Thoughts About Death That Have Nothing to Do with God, Coming Out Atheist: How to Do It, How to Help Each Other, and Why, Why Are You Atheists So Angry? 99 Things That Piss Off the Godless, and Bending: Dirty Kinky Stories About Pain, Power, Religion, Unicorns, & More.

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Some Thoughts On Depression, and Why Self-Care is So Hard
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9 thoughts on “Some Thoughts On Depression, and Why Self-Care is So Hard

  1. 1

    You just captured a lot of what I feel but really couldn’t explain it until now. I suffer from some pretty (non-suicidal) severe bouts of depression now and then and don’t want to do ANYTHING!! And you’re right in the fact that what I love doing the most are the things I really don’t feel like doing.

    What you described may not (and probably doesn’t) describe everyone, but you described me. I’m glad to know I’m not alone. 🙂

  2. 3

    Yeah, I mostly pulled out of a long depression streak two years or so ago, but apparently, it’s very easy to forget the knowledge of depression’s mechanics/effects and easy to fall back into habits of self-hate.

    It took a few recent weeks of feeling super anxious, stressed, and down before I even recalled “Hey, I’ve suffered this junk before, I knew it might come back, it’s depression and not your life falling apart as you spiral toward unhappiness/death”.

    Thank you for the reminder, Greta!

  3. 4

    kellyw. posting here

    I never was cut off from my emotions–I always felt, but it was feeling horrible things. Being numb to the pain would have been a relief. Never a break from it until my meds got properly adjusted. But I did have apathy badly. Although I’m doing much better now (been about two years since my fall into the abyss…not counting a bad backslide this past December when I was switched to a horrible-for-my-brain med), the apathy still lingers. It’s a reminder of my illness. Wish I could figure out how to work through it so I can do the things I want to do. I still feel a little lost.

  4. 5

    Strongly supported by my experience. Two parallels spring to mind:

    1. In Oliver Sacks’ ‘Awakenings’ there is a quote from one of the patients, to the effect that the near catatonic state was not hard to bear, because even the IDEA of activity was simply of no interest. The disease of mobility was, simultaneously a disease of the will to act.

    2. Just about anyone who’s been an active addict or drunk will have a personal demonstration that NOT using/drinking just feels better than using/drinking. But the transition either doesn’t feel good, or is so distressingly unfamiliar that they reject the possibility.

    The most difficult thing about feeling ‘better’ is the unpopular fact that it means feeling DIFFERENT.

  5. 6

    In my case I know I’m depressed when I stop brushing my teeth. :/ I have been depressed for many years and in the last 10 years was in treatment with an antidepressant. I’ve always been puzzled about how even when I know regular self care makes me feel better I just don’t do it, but now you have put it in a new perspective. Btw I’m a long time reader that just recently came back to reading your blog and I’m glad to find you again, Greta!

  6. 7

    This rings true for me too. It’s like, when I’m depressed, I don’t think I’m suicidal but I don’t really want to think about my own existence, so I just ignore all sensory input as well as my own emotions. I don’t really taste my food, have very low libido, I hide from my friends. Being part of the world and leaving any mark on it is too painful. My shame is too painful to bear so I try to vanish into silence and stillness.

  7. 8

    I’m currently trying to crawl out of a months-long slide into shittiness, and it’s awful. The last 2 weeks were rock bottom, and I finally had to bring my husband into the loop and ask him to hide the meds in the house so I couldn’t do something harmful if I got a sudden burst of motivation. He puts my daily antidepressants out for me each night. The hardest thing for me right now is the idea that I can get “better” enough to keep me alive, but never better enough to be happy. My husband asked what happy would look like, and I honestly can’t even picture it. I have absolutely no idea anymore.

    I’m still barely eating, I can’t bear the thought of having to interact with people, and I’m awful with my kids right now. I am finally functional enough to do basic chores like folding clothes and feeding people on a regular basis, which isn’t much of a motivation to become functional, honestly.

    I’ve lived with depression long enough that I know the things my brain thinks aren’t true, that I’m seeing things through a distorted lens, but it doesn’t change the fact that I’m still miserable. It’s like meta-depression. I’m depressed because I feel defeated by my depression.

  8. 9

    I’m currently going through a longer than usual depressive period and have just recently felt the return of some executive function, feelings of pleasant anticipation, and a general feeling of the future as something I can work with. This depression started last October, and felt like it had the potential to get very bad, but it didn’t. And a big part of why it didn’t, is that I was able to just let all my self-care routines fall by the wayside when they got to feeling like too much of a burden.

    My insight this time around is that when we are depressed, feeling anything strongly may be detrimental to the system. The reason we’re depressed is that our bodies aren’t currently able to handle a lot of “current”. Self-care then becomes a matter of keeping the emotional stress on the system to a minimum. This time around I really encouraged my body to tell me what it needed and I listened without judgment.

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