A Practical Guide to a Post-Apocalyptic Life: More on Recovering From Depression

depression photo

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 — specifically, in a practical sense — do I live with the understanding that I have chronic recurrent mental illness?

I have chronic episodic depression, and probably will for the rest of my life. I’m getting better now, I’ve been better for a few months; but I accept that this is a chronic illness and I could get depressed again at any time. A few days ago, I wrote a piece about What All This Means: it was useful for me to write (a lot of my writing about depression is as much for myself as for anyone else), but it was a little philosophical, a little abstract and meta. So I’m writing this practical guide to how I plan to live as a currently healthy person who has a chronic recurring mental illness.

None of this is intended to tell anyone else with depression what’s right for them. This is entirely an account of what I think is right for me, written largely so that I can refer back to it later if I need to. If you find any of this useful, please take what you need and leave the rest. Continue reading “A Practical Guide to a Post-Apocalyptic Life: More on Recovering From Depression”

A Practical Guide to a Post-Apocalyptic Life: More on Recovering From Depression
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A Post-Apocalyptic Life: On Getting (Somewhat) Better From Depression

depression photo

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. Continue reading “A Post-Apocalyptic Life: On Getting (Somewhat) Better From Depression”

A Post-Apocalyptic Life: On Getting (Somewhat) Better From Depression

Revised, Updated, Somewhat More Optimistic Thoughts on Depression and Solitude

Being an introvert does not mean being a hermit.

woman alone in window seat
A couple of weeks ago, I wrote a piece about depression and solitude, in which I talked about a particularly troubling and annoying conundrum of being an introvert with depression. That condundrum: I like lots of alone time, and I like being a person who likes lots of alone time — but when I’m in a more depressed state, or a state that’s more vulnerable to depression, too alone time is bad for me, and I need to make sure I have a fair amount of social time every day. A lot of people responded strongly to this piece: I seem to not be the only one dealing with this. And among the many people who commented, saying some version of “OMLOG yes I totally get this,” my friend David Byars shared the piece on Facebook with this comment (quoted here with his permission):

I came to a similar conclusion at the end of June, which is why I reactivated all my social network accounts. I need to have the option of communicating with people, I need to know how friends and family are doing. And I need to know when to give myself a break from both society and solitude. And, as an introvert, the need to take breaks from solitude seems disconcerting.

Emphasis mine. “I need to know when to give myself a break from both society and solitude.” Reading this was like a lightbulb going on over my head.

Being an introvert does not mean being a hermit.

I’m finding this “depressed introvert who needs social time” thing a whole lot easier to deal with if I look at introversion, not as a clearly-defined either/or category, but as a spectrum. (This view also has the advantage of being accurate.) Being an introvert does not mean not wanting human company at all. Being an introvert means being closer to “introvert” on the introvert/extrovert spectrum. Liking lots of alone time doesn’t mean wanting to be alone every minute of every day forever. It means… well, it means liking lots of alone time. It means liking more alone time, and being comfortable with more alone time, than most people.

Therefore, needing the company of other people somewhat more than usual right now doesn’t mean I’m not an introvert anymore. It just means that the place on the introvert/extrovert spectrum where I’m currently comfortable is a little further from the “introvert” end than usual.

Or, to be more accurate: It means the range of “how much alone time is good and pleasurable for me” is a lot narrower than usual.

feet on balance beam
I’ve written before about a depression analogy I’ve found useful — the analogy of seeing mental health as a balance beam, suspended over a pit. When my mental health is more robust, the balance beam is wider — more like a catwalk, or a bridge, or a platform. When my mental health is more fragile, the balance beam is narrower — more like a tightrope, or a… well, a balance beam. When my mental health is more robust, I don’t have to be as careful with my self-care. I can watch more TV, eat more sweets, get less sleep, have more time to myself. I have more wiggle room. When my mental health is more fragile, on the other hand, my self-care routines need to be a lot more rigorous. I have to be more watchful about my mental and emotional condition, more self-conscious about exactly how I’m doing and what exactly I need right at that moment. The healthy range for a whole lot of things — too much food versus not enough, too much sleep versus not enough, too much work versus not enough — is narrower, and I have to calibrate it more carefully. I don’t have nearly as much of a cushion.

What does this mean for my introversion, and for time alone versus time with other people? Well, it doesn’t mean that the amount of alone time I’d like to have has decreased. It means that the amount of alone time that’s safe for me to have has decreased. Even more accurately: It means that the “alone time/ social time” balance that works for me and is safe for me is a lot narrower. When I’m feeling pretty healthy and pretty robust, I can handle fairly long stretches of being alone, and I can handle fairly long stretches of time around other people, without being propelled into a depressive state. When my mental health is more fragile, when the balance beam is narrower, I have to be more cautious, both about alone time and about social time. Too much isolation can depress me; too much social time can exhaust me, which can also depress me. To some extent that’s always true — but when my mental health is more fragile, that balance beam is narrower.

This sucks. It kind of sucks no matter what. But it was sucking more when I was feeling like my precious precious alone time was being robbed, like I’d finally come to some understanding and acceptance of my introversion only to have it snatched away. It is sucking less now that I’m realizing this isn’t really true. I still get to have alone time. I still get to be someone who likes alone time, and is comfortable with it. I just need to give myself breaks, not only from society, but from solitude. That’s always been true; that hasn’t changed. It’s just a little more true now than usual.

I can live with that.

Comforting Thoughts book cover oblong 100 JPG
Coming Out Atheist
Bending
why are you atheists so angry
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.

Revised, Updated, Somewhat More Optimistic Thoughts on Depression and Solitude

Some Thoughts on Depression and Solitude

So I’m having this conundrum.

woman alone in window seat
On the one hand: I love solitude. And I mean LOVE it. Long stretches of time to myself have always been a luxurious pleasure for me. Before I was with Ingrid, there were years where I spent Christmas Day alone every year — and it was one of the most delightful parts of the holiday season, an oasis of quiet solitude and self-indulgence in the middle of a social whirl. When Ingrid and I first got together and were contemplating whether to move in together, one of the issues we looked at was how I would get my much-needed time and space alone. (In fact, we didn’t move in together for seven years — not entirely for this reason, but partly.) And one of the biggest benefits of quitting my day job and becoming a full-time freelance writer was that it gave me long stretches of solitude.

In fact, I don’t just love time alone. I need it. I’m an introvert, and a big part of what that means is that I’m replenished and rejuvenated by time alone, and exhausted by time with others. It’s not that I don’t enjoy time with others — I do, very much. It’s just that I hit a wall with it. I enjoy it for a couple/few hours (more or fewer hours depending on the people and the situation), and then I get tired and need to go away and be alone for a while. (I believe the term for this is “social introvert.”) Solitude isn’t just a pleasure: it’s a necessity.

On the other hand:

Ever since this current stretch of depression, I’ve been paying attention to when I’m depressed and when I’m not. I’m paying attention to what gives me depressive symptoms, and what alleviates them, and what actually bolsters my mental health and makes me feel positively robust.

And I’m finding that when I have many days in a row where I spend many hours alone in the house without interacting with anyone but Ingrid and the cats, I tend to get depressed. When I get out of the house every day, and interact every day at least briefly with human beings who aren’t Ingrid, my mental health improves. This isn’t the entire picture, of course — my mental health also improves when I take my meds, go to therapy, get exercise, meditate — but it’s a big part of it.

I’m thinking about this because I’ve recently started a new mental health self-care routine. Instead of just generically promising myself that I’ll leave the house once a day to do some unspecified thing, I now have a specific routine. Every weekday, unless I have some particular other thing scheduled, I get to a cafe by 1:00 pm, and work on my laptop there. And I’ve found, just in the week that I’ve been doing this, with no other substantial change in my life, that my mental health has significantly improved. I’ve been having a rough patch with depression in the last few months — not terrible, but not great, and very stubborn — and just in this past week, I’ve become more alert, more energetic, more hopeful and optimistic, more engaged with the world. Heck, I’ve been positively bouncy at times — and I haven’t been bouncy in months.

Dammit to fucking hell. Continue reading “Some Thoughts on Depression and Solitude”

Some Thoughts on Depression and Solitude

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.”

hand holding ivy
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.

Comforting Thoughts book cover oblong 100 JPG
Coming Out Atheist
Bending
why are you atheists so angry
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.

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

Depression, and Revisionist Ret-con Time Distortion

(Content note: depression. Obviously.)

So I’ve been in this weird place in recent weeks, or maybe not so weird. I’ve been in this place with my depression where I have good days and bad days. I have days where I feel entirely fine — more than fine, actually, days where I feel good and happy and productive and joyful and engaged and connected and optimistic. And I have days where I can’t muster the motivation to work or shower or dress or leave the house. Because these days are coming in somewhat rapid succession (that’s unusual for me — I tend to slip in and out of my depressive states more gradually), it’s giving me a unique opportunity to observe some things about my depression. And here’s something I’ve noticed:

dali clock
When I’m depressed, my brain sometimes does this weird thing with time. When I’m having a thought or feeling that’s pessimistic or despairing or otherwise depressed, my brain goes back and rewrites my memories — so I think I’ve always felt like this. It writes a revisionist, retroactive-continuity version of my life, in which I have always felt like this. And it filters my perception of possible futures, so it seems obvious and self-evident that I’m always going to feel like this, forever.

The specific example that made me want to write about this: I was having this experience, where every time I had a moment of happiness or joy or connection, it would quickly be shot through with an intense consciousness of mortality. “Sure, you’re happy now — but remember, someday you’re going to die, and everyone you love is going to die, and everything you’re experiencing is going to disappear.” And these moments of consciousness of mortality weren’t just fleeting bits of awareness of the obvious. They were intense, they were powerful, they were painful, and they obliterated whatever pleasure I was experiencing. It was, unsurprisingly, extremely upsetting, and extremely hard to deal with.

And I wasn’t just having this crappy experience. It felt as if I had always had this experience. It felt as if every moment of joy I’d ever had in my life had been shot through with an intense consciousness of death. And it felt like this would be true for every future moment of joy, for the rest of my life. Continue reading “Depression, and Revisionist Ret-con Time Distortion”

Depression, and Revisionist Ret-con Time Distortion

How Humanism Helps With Depression — Except When It Doesn’t

This piece was originally published in The Humanist.

What is it like being a humanist with depression?

I’m going to preface this right off the bat by saying: I am not a doctor. I am not a therapist. I am not a mental health care professional, or indeed a health care professional of any kind. I’m just talking about myself here, and my own experiences. I freaking hate it when people give me unsolicited amateur medical advice about my mental health, so I’m very careful not to do that with other people. If you have depression — your mileage may vary from mine. Take what you need from this, and leave the rest. (And if you’re not already doing it, get professional help if you possibly can.)

So. Caveats are in order. What is it like for me to be a humanist with depression?

As regular readers may know, I’ve been diagnosed with clinical depression. My form of it is chronic and episodic: I’m not depressed all the time, I’m not even depressed most of the time, but I’ve had episodes of serious depression intermittently throughout my adult life. I had a very bad bout of it starting about a year and a half ago: I’m pulling out of it now, but my mental health is still somewhat fragile, I still have to be extra-careful with my self-care routines, and I still have relapses into fairly bad episodes now and then. And I’ve been thinking lately about what it means to be a humanist with depression, and how these experiences intertwine. Continue reading “How Humanism Helps With Depression — Except When It Doesn’t”

How Humanism Helps With Depression — Except When It Doesn’t

Depression, and the “Throw Everything Against the Wall” Method of Care

Please note: I am not a doctor. I am not a therapist. I am not a mental health care professional, or indeed a health care professional of any kind. I’m just talking about myself here, and my own experiences. Also, please note that while the self-care techniques I’m talking about here can be an effective part of a treatment plan for depression, none of them is treatment all by itself, and none of them is a substitute for therapy, medication, or other medical care.

I wish I had something to say about Robin Williams’ apparent suicide. I don’t — nothing other than “Fuck, that’s awful, that’s so sad,” nothing that hasn’t been said by many other people better than I could say it. But a lot of people have been talking about depression in the last couple of days, and I have some stuff I’ve been wanting to write about that, so that’s where I’ll go.

partly open window
I’ve written before about one of the smartest pieces of advice I ever got about depression, one that’s become a cornerstone of my depression self-care — both when I’m in a depressive episode, and when I’m not and am working to stabilize and improve my mental health. I was talking with a friend about the horrible self-perpetuating nature of depression, and how the depression itself saps my motivation to do the things I need to do to take care of my depression, and what a fucked-up vicious circle this was. The advice I got was this: If I ever have a window in which I feel any motivation at all to do any form of self-care, I should do it. When I’m in the middle of a bad episode, those windows don’t open very often, so I should walk through them when they do. And even when I’m not having a bad episode, I don’t always feel motivated to do mental health self-care — but doing it whenever I do have the motivation makes my mental health more robust, and makes a relapse less likely.

Now, if you asked me which form of mental health care was most important, and which I would do first if one of those windows opened up, I could probably give you a roughly prioritized list. But a more accurate and honest answer to “which form of mental health care is most important?” would probably be: All of them. What works best for me is to do every form of effective mental health care I know of, as much as I have time and energy and money for. What works best for me is to throw everything I have against the wall, and hope that some of it sticks.

There’s a couple of reasons this works for me. For one thing, when a motivation window opens up, it’s often very specific. I don’t always get a general jolt of motivation to do anything at all that will alleviate my depression. Instead, I get a specific glimmer of motivation to meditate; to masturbate; to get dressed and go to the cafe; to take a long walk outside. So even though exercise is one of the highest priorities on my mental health care checklist, if I have a sudden glimmer of motivation to meditate, then I meditate. (I was actually at the gym the other day, feeling irritable and unfocused and spending as much time staring out the window as I was working out — so I quit my workout, and found a quiet-ish corner, and meditated instead. Totally the right decision. My brain needed the self-care that day more than my muscles did.)

paint splatter 2
Throwing everything at the wall also gives me more options when I have more than one window of motivation. If I’m doing better, and I have a fair amount of motivation to do a fair amount of mental health care… well, I’m not going to meditate three times a day, or go to the gym three times a day. But I might meditate, and go to the gym, and go out to the cafe. And doing all three gets more care into my system.

And maybe most importantly: Throwing everything at the wall just makes my mental health recovery more robust, and more resilient. It gives it a broader, more solid foundation. I don’t always know what’s going to make me feel better, either immediately or in the longer term. But if I’m doing all of it, or as much of it as I can do, I’m playing the odds. I’m increasing my chances that one or more of the things will have an effect. If I throw everything I have at the wall, there’s a better chance that at least something will stick.

So here’s what I’m throwing against the wall.

Meds. I never blow this off. I take my meds every day.

Talk therapy. I never blow this off unless I’m sick. I sometimes have to schedule my therapy around my travel schedule, but if I have a therapy appointment in my calendar, I go unless I’m so sick I can’t think or talk.

(Note: According to what I’ve read, research shows that therapy plus meds is more effective on depression than either therapy alone or meds alone. Can anyone with more familiarity with the current research confirm or deny that?)

dumb-bell
Exercise. I try to take at least a 20 minute walk every day. I don’t always succeed, but I wind up doing this about 4-5 days a week. I also try to make my exercise more vigorous — going to the gym, dancing, taking a longer walk, something — 2-3 days a week. I don’t always succeed, but when I aim for this, I get more exercise than when I don’t.

Socializing. When I’m in the middle of a bad episode, or am teetering on the brink of one or pulling out of one, one thing I do if I can is make specific plans to see people. If I don’t have anything in my calendar, it’s all too easy to just stay home and stew in my own juices — but if I have a lunch date in my calendar, I almost never blow it off. And I know that seeing other people is one of the most important and powerful anti-depressants in my repertoire.

Leaving the house. When I’m in the middle of a bad episode, or am teetering on the brink of one or pulling out of one, I make it a priority to leave the house at least once every day. As a writer, it’s easy to just stay home in my bathrobe all day, and when I’m not having trouble with depression, that’s fine. But when I am having trouble, I make getting out of the house a priority. If for no other reason, it kills two birds with one stone: it gets me into the sunlight, and it gets me interacting with other people, even if it’s just a five-minute conversation with the barrista at the cafe. And working in a cafe, even if I’m just sitting alone at a table and not talking with anyone except to order more coffee, still feels less isolating than working at home alone.

Time outdoors, especially in the daytime. See above, re: leaving the house.

Meditating in urban environment
Meditating. My goal is to meditate every day. The reality is that I meditate about 5-6 days a week. It helps enormously.

Getting the right amount of sleep: not too much, not too little.

Sensual pleasures. Sex, masturbating, eating delicious healthy food, taking a long bath with bath scrubs, getting a manicure, getting a massage, taking the time to put together an outfit I enjoy… you get the drill. I try to do at least one of these every day. That’s a larger and somewhat complicated topic — there’s something weird about treating pleasure as medicine — but it helps, so I do it.

Writing. This is weirdly tricky: when my depression is bad, lots of extended time on the computer isn’t good for me. And when my depression is bad, it’s easy for writing time to turn into “dicking around for hours reading just one more thing on Facebook” time. But writing is activity, and writing gives my life purpose and meaning and forward direction, and writing gives my experience shape and cohesion, and writing makes me feel connected, and writing makes my brain feel better in ways and for reasons I can’t explain and don’t entirely understand.

That’s my mental health care toolkit. That’s what I’m throwing at the wall. What about you? If you experience depression, or have in the past — what’s in your mental health care toolkit? Do you have priorities among your tools, or do you prioritize whatever it is you have the motivation to do?

Coming Out Atheist
Bending
why are you atheists so angry
Greta Christina’s books, Coming Out Atheist: How to Do It, How to Help Each Other, and Why and Why Are You Atheists So Angry? 99 Things That Piss Off the Godless, are available in print, ebook, and audiobook. Bending: Dirty Kinky Stories About Pain, Power, Religion, Unicorns, & More is available in ebook and audiobook.

Depression, and the “Throw Everything Against the Wall” Method of Care

Depression, and Mental Health as a Balance Beam Over a Pit

Content note: Depression. Obviously. (Also note that this post has a somewhat different comment policy than usual: it’s at the end of the post.)

There’s this analogy I’ve been using lately to think about my depression and my mental health care. I’m finding it useful, so I thought I’d share it with the rest of the class.

I’m not the first person to describe depression as feeling like being in a pit. And as my depression has been getting better (in the classic “two steps forward, one step back” fits and starts), I’m not the first person to describe that process as feeling like clawing my way out of the pit. But there’s another stage of mental health recovery, the stage I’m in now, that feels somewhat different.

feet on balance beam
I feel like I’m out of the pit. But I feel like the ground I’m standing on is very narrow. I feel like I’m walking on a balance beam that’s suspended over the pit.

For some months now, I’ve felt more or less okay most of the time. But that okayness has felt somewhat shaky. Easily disturbed. Fairly small things make me feel bad out of all proportion to the badness; large things, or even medium-to-large things, can trigger a recurrence of the depression, or of some of the depressive symptoms.

And my mental health care has to be very carefully managed; my mental state rigorously monitored, my self-care precisely titrated. I need exactly the right amount of rest and sleep — not so much that I get torpid, not so little that I get exhausted. I need exactly the right amount of socializing — not so much that I get exhausted, not so little that I feel isolated. I need exactly the right amount of alone time — not so much that I feel isolated, not so little that I get overwhelmed. I need to spend exactly the right amount of time on work, exercise, meditation, pleasure, so I feel calm and engaged rather than overwhelmed, or aimless, or both. Small excesses in any direction have to be adjusted for immediately, or they can easily push me into the bad place.

This is not what I’m like most of the time. Of course I’m made happy or sad by external events; of course I try to keep work and pleasure and rest in a healthy balance. But when I’m not in the middle of (or recovering from) a serious depressive episode, I’m generally on a pretty even emotional keel. My basic outlook on life is not only steady, but is largely self-generated. And I can have stretches where my work and pleasure and rest, my time alone and my social time, are temporarily out of whack. I want them to balance out in the long run, but I can have longish stretches where I’m busting my ass to finish a project, or am running around being a social butterfly, or am lying around being lazy, without it risking my mental health.

It hasn’t felt like that lately. I feel like every step I take has to be small, and careful, and intensely conscious. And I feel like even if my steps are small and careful, I could easily be knocked off balance by a stiff breeze. I feel like I’m walking on a balance beam that’s suspended over the pit.

A few weeks ago, a couple of crises arose. (That’s generally what triggers a depressive episode: I can usually handle one bad thing in my life, but multiple serious stressors are what knock me into the pit.) So a few weeks ago, a couple of crises arose — and it felt like I’d been knocked off the balance beam. It didn’t feel like I’d fallen back into the pit, exactly. But it felt like I was clutching onto the balance beam with my fingertips, dangling over the pit, scrambling to pull myself back up. I got back on the beam again — but I felt wobbly, and my footing was shaky. And then another crisis came along, and I got knocked over again. I’m just now hoisting myself back up, and am trying to regain my footing.

catwalk FEMA_Mitigation_Team_Inspects_Raw_Water_Intake_Tower
So when it comes to mental health care, I feel like my job now… well, right now, today, my job is to hoist myself back onto the beam. But once I’m back on the beam, and my footing is steady and I’m not wobbling or flailing, I feel like my job is to widen the balance beam — so it’s more like a catwalk, or a bridge, or a platform. I’m doing carefully managed, rigorously monitored, precisely titrated self-care, partly because in the short run it keeps me on the balance beam, but also because in the long run it widens the balance beam, and makes it more stable.

I want to get to a place, not just where I don’t feel depressed, but where I can get bad news or have a bad day without it making me depressed. I want to get to a place where I’m not being knocked about by every gust of wind that comes along; where my mood isn’t totally shaped by whether the last thing I saw on Facebook was happy or sad. I want to get to a place where my mood is shaped by my fundamental optimism and empathy and high energy and general good nature, as much as (or more than) it is by the crisis of the week. I want to get to a place where I’m not constantly thinking, “What would be best for my depression now? Would it be better to finish that blog post? To go to the gym? To go to the cafe? To masturbate? To meditate?” I want to get to a place where I don’t have to drop everything and do self-care the moment I feel inspired to, because I don’t know when that window is going to open again.

The pit is always going to be there. That’s what it means to have chronic depression, even with infrequent episodes. I’ll never be able to ignore it entirely; I’ll always have to do some degree of mental health self-care to keep from falling into it. But I want to get back to a place where I don’t have to devote rigorous attention every waking minute to my mental health care, and can just get on with my life.

Comment policy for this post: It sucks that I should have to spell this out, but past experience has taught me that I do: Please do not give unsolicited amateur medical advice, to me or to anyone else with mental illness, in the comments. Or anywhere, for that matter. Talk about your own experiences until the cows come home; ask questions until you’re blue in the face (except for douchy passive-aggressive question like “Why don’t you understand that psych meds are poison?” or “Will you read this article explaining why psych meds are poison?”). If you need this spelled out in more detail, please read Why You Really, Seriously, No Fooling, Should Not Give Unsolicited Amateur Medical Advice to People with Mental Illness (Or to Anyone, Really), Episode 563,305. Thanks.

Related post:
On Being on Anti-Depressants Indefinitely, Very Likely for the Rest of My Life

Depression, and Mental Health as a Balance Beam Over a Pit

Secular Meditation: Both Restful and Active (Something I Forgot In My Post on Meditation and Depression)

There’s something I forgot to mention in my previous post about secular meditation and depression. It’s one of the qualities of meditation that seems to help me with my depression — and frankly, just with my life. I strongly think this would be a useful thing even if I didn’t have depression. So I wanted to share with the rest of the class.

It’s this: Meditation is both restful and active.

Meditation fills my need for activity, for something to do. And it also fills my need for rest, for quiet time and down time.

Meditation is weird. It both is and is not an activity. When I meditate, all I’m doing is sitting quietly and being aware of my breath (or my body, or the silence in the room, or one of a few other things). And yet it’s not like lying on the sofa spacing out and thinking about whatever. It is a focused activity, requiring attention and concentration and conscious work.

So when I’m meditating, I feel like I am simultaneously resting and being active. And when I’m done meditating, I feel like I’ve gotten the benefits of both rest and activity. I feel calm and refreshed, the way I do when I’ve had good rest; I feel alert and engaged, the way I do when I’ve been happily and productively active. And I get that sense of having done something valuable, something worth doing, that I get from both rest and activity.

So what does this have to do with depression?

feet on balance beam
When I’m having a depressive episode, or when I’m teetering on the brink of one, one of the hardest things to manage is the balance between rest and activity. If I’m not active enough, I get torpid and foggy, and I tend to fall into a vicious circle where I can’t muster the motivation or the energy to do the very things that would make me feel better. If I’m too active, I get overwhelmed and irritated and exhausted. In general, I’ve found that it’s best for me to err on the side of activity — but it’s a tricky balance even at the best of times, and when I’m having a depressive episode or am teetering on the brink of one, the range between “too much rest” and “too much activity” gets very narrow indeed. I have to be very careful to get it just right. It’s like walking on a balance beam, over an abyss.

And one of the hardest things about a depressive episode is that neither rest nor activity feels good. If I’m active, I feel tired and overwhelmed and groggy and like I want nothing more than to sink into my bed or my sofa. If I’m resting, I feel anxious and twitchy and like I should be doing something, anything at all, other than just sitting or lying there. Sometimes I even feel this as a physical twitching in my muscles, where every tiny ache or tension becomes intolerable and has to be relieved immediately. (I especially get that when I’m trying to fall asleep, which really and truly sucks.) It’s one of the defining characteristics of depression for me: literally no matter what I’m doing, it doesn’t feel right, and I want to be doing something else.

dreaming face
But meditation feels right. It feels like I’m doing something, and it feels like I’m doing nothing. There is something about consciously focusing my intense awareness on the activity of doing nothing at all: it gives the nothingness a richness, a vividness, that lets me savor the experience of rest and really absorb it. (In fact, sometimes when I meditate, that’s what I focus my awareness on — the experience of rest. I sit quietly, and I say to myself, “Feel yourself resting. Let the restfulness sink into your muscles. Let it sink into your brain. Let yourself take it in.”) And when I finish, it’s the exact opposite of the depressed feeling, where I feel both restless and torpid: when I’m done meditating, I feel both rested and engaged.

It is hard sometimes. It’s hard to just sit with my twitchiness, my torpor, my sense that nothing is right. Especially at the beginning of a session. It’s sometimes excruciatingly hard: when my brain is screeching at me, “Do something else! Do something else! Whatever you’re doing, do something else!,” it can be excruciatingly hard to simply sit, to notice the screeching and observe it without judgment and continue to sit, quietly, doing nothing about it.

But I don’t think I have ever meditated during a depressive episode — or any other time, for that matter — and come out of it regretting it. I don’t think I have ever meditated during a depressive episode and not come out of it feeling better. Not cured, not perfect, not “depression all gone now” — but better. And I almost always come out of it feeling both like I’ve been doing engaging and productive work — and feeling like I’ve had a good night’s sleep.

Secular Meditation: Both Restful and Active (Something I Forgot In My Post on Meditation and Depression)