The comment policy for this post is different from my usual one. It’s at the end of the post. Content note: depression, obviously.
How do I live as a more-or-less healthy person, when I know I can get depression at any time?
My depression is chronic and episodic. When I total up the years of my life, most of them have been not-depressed, but I’ve had several extended bad episodes over the decades of my life. This last one, starting in fall 2012 when my father died and I was diagnosed with cancer, has been the worst and the longest by a long shot. I refer to it as Armageddon.
I’m starting to feel better. I haven’t had a significant depressive episode for a few months: I’ve had some depression-ish dips in my mood, motivation, and ability to focus, some stretches when my brain felt like it was wrapped in cotton. But for a few months now, those have been fairly short and easily handled. I think I’m getting better. And I’m starting to look at what that means, and how I’m going to live now.
See, I didn’t know I had chronic episodic depression until this most recent round of it. Before this, I’d seen myself as a mentally healthy person who’d had occasional episodes of situational depression. It took a fair amount of work, with both my therapist and my psychiatrist, for me to accept that my depression, while intermittent, is a lifelong thing. Yes, my episodes are situational in that they’re usually set off by external events — but once they get going, they’re self-perpetuating in exactly the way depression generally plays out. And not everyone responds to major traumatic life events with depression, several times throughout their life. The fact that I do means I have a chronic mental illness.
So now I know. And now I have to act on that knowledge. I have to be vigilant. I have to keep an eye on my self-care: I don’t have to be keeping at it constantly, throwing everything at the wall that I can muster in the desperate hope that something sticks, but I also can’t let it slide for very long. I have to keep an eye on my moods, make sure that tiredness and sadness don’t turn into depression, that laziness doesn’t turn into depression, that being exhausted and spending three days on the sofa after finishing a huge project doesn’t turn into depression. I probably have to stay on anti-depressants the rest of my life. And when major traumatic life events happen — especially when there’s more than one, my episodes are most often set off when there’s more than one trauma at a time — I have to get my ass back into therapy, and probably dial my meds back up. I have to be vigilant. But not too vigilant. Hyper-vigilance is itself not healthy. I have to be meta-vigilant about how vigilant I’m being.
And I’m not going to be the same person I was before Armageddon. Especially because this episode was so long, and so bad, I have to let go of any notion I had of “getting back to normal.” I am not getting back to anything. Being healthy, in this case, means letting go, and moving forward. A huge part of my recovery involves defining what my new normal is, and accepting it.
Some of that difference is okay with me. Actually, a lot of that difference is okay with me, and more than okay. My therapist and I have been talking about something called post-traumatic growth: for some people with PTSD or post-traumatic symptoms (I have the latter, I don’t know if I have the former), we can make meaning out of our trauma by making it a learning experience. I know that I’m a more compassionate person than I was before this last depression. I have more understanding of how life circumstances can fuck with people; more patience with people who don’t respond to trauma or illness with plucky, buoyant courage. I’m quieter, a better listener. I’m a different person than I was, and mostly I think I’m a better person.
But some of that difference is not okay with me. To make an analogy with non-mental illness or injury: Sometimes, we get sick or injured, and it takes a while to get better, but once we’re better we’re every bit as healthy as we were before. And sometimes, illness or injury takes a toll: we’re always weaker in that broken leg, our digestion is always somewhat delicate, our energy never quite returns to where it was before. I think mental illness may be the same. I don’t know if it will be for me. I don’t yet know if I’m always going to be a little more susceptible to low moods, brain fogs, lack of focus, loss of motivation, irritation, exhaustion. I think I probably am. I am for now.
I am also angry, and sad. Not at anyone in particular: intransitive anger can be just as much of a bugger as intransitive gratitude. These last three and a half years should have been some of the best years of my life. They were the years when my writing career finally took off and became what I’d worked towards for decades. During Armageddon, I published three books and started a fourth; I co-founded a local atheist organization; I co-launched a business. These should have been golden years, and I spent them in a fog at best and a black hole at worst.
I’m starting to cry right now, writing those words. That is really hard to accept. These should have been some of the best years of my life, they were unique and hugely important years in my life, and I am never going to get them back. I don’t know what to do with that, except grieve.
And I’m not sure what to do with my newly-found, newly-accepted identity as a person with disabling mental illness. I don’t know what to do with the mental illness community that has meant so much to me, that has helped me craft some goddamn meaning out of this shitstorm, that has given me so much support when I was crawling out of a black hole and trying to stabilize the balance beam I’d built over it. Do I still get to call myself depressed? Is that appropriative? And what does it mean to have chronic episodic depression and not be in the middle of an episode? In two years, what will it mean to be someone with chronic episodic depression who (hopefully) hasn’t had an episode in two years? I don’t know yet. I’m pretty much going to have to make it up.
I realize that it seems like I’m complaining about a good thing. I’m not. I’m getting better, and I’m happy about that. I know how lucky I am. I’m not complaining, except for the parts where I am. I’m just trying to figure this out.
Comment policy: If you yourself have depression or other mental illness, I welcome suggestions and perspectives on managing it as a chronic lifelong illness — but please frame them as what works for you, not as prescriptions for me or anyone else. If you don’t have mental illness, please don’t give advice of any kind. Thanks.