Archive for August, 2012

On Living with Chronic Clinical Depression

August 3, 2012 2 comments

I am suddenly struck, once again, by the intense desire to try to explain the experience of clinical depression to those who have never endured it.

The word “depression,” to so many people, conjures up mere sadness, and makes them shake their heads in bafflement at how such a thing can entirely derail a person’s life. Those who have lived through intense sorrow or intimate grief understand better how all-consuming such emotions can be. But depression, at least for me, has very little to do with being sad, or even being anhedonic (devoid of feelings).

To me, depression means a bone-deep fatigue, an exhaustion that is physical, mental, and emotional all at once, as though I have just spent a week pushing myself through such stress and hard work that I’ve reached the very limits of what my body and mind can stand. Maybe those of you who have gone through military training or getting a PhD or working backstage during a Broadway production any other form of intensive hazing may have a sense of what this is like…. except that depression, at least as I experience it, has no discrete and perceptable cause, is not limited to a short span of time, and does not include any sense of accomplishment to mitigate the pain.

For the rest of you, I ask you to remember a time when you were ill with a particularly unpleasant bout of flu or cold. There was probably at least a day, at the beginning or end of this sickness, or when you were recovering from a major injury, where you felt neither distinctly sick — in the sense that you had no fever, were not vomiting, were not in actual pain, etc. — nor explicitly well. You were stuck, at least temporarily, in an unsettling in-between state whose existence you had probably never even considered before.

Everything seemed to require more effort than usual — walking, talking, even thinking, as though you were half asleep and wearing weighted clothing. Your mind and body were clumsy, and easily pushed off balance. You were capable of doing most things, and maybe even capable of doing them well if you concentrated very hard, but there was no such thing, that day, as an easy task.

You could lie on the couch and watch TV or perhaps read, but any other activity, no matter how fun, or chore, no matter how light, seemed overwhelming and, frankly, not worth the effort. Going to the grocery store, fixing yourself a meal, studying, balancing a checkbook, making a phone call, having lunch with a friend, seemed to require not only more physical energy than you possessed, but more ability to concentrate, and more emotional fortitude as well. Ultimately, you wanted more than anything else to rest, to recharge, to be free for the moment of the obligation to do anything more complicated than breathe.

I hope you can recall an experience like this one. Now imagine, if you can begin to do so, spending at least 50% of your time feeling more or less this way. Having to struggle every morning to drag yourself out of bed as though you haven’t slept in days. Clinging by your fingernails to moments of clarity, energy, momentum, or motivation, because you don’t know how long they will last or when they will come again. Slogging through the basics of what has to be done — cleaning and feeding yourself, keeping up with the bills, walking the dog, going to work or school — always struggling to do more than the bare minimum required but oh so rarely able to do as much as you want.

I live like this. With a near-constant weight inside my chest dragging me down, a ball and chain around my mind and will. Every day I push through it, fighting just to keep moving. Like a wind blowing against me, it is a constant force, but the force of it is not constant. It lightens for a few hours or days at a time to the point where I barely notice it. Sometimes it vanishes altogether, briefly, and I realize with shock how much affected me even on the “light” days.

Then it sneaks up on me again so subtly I nearly grind to halt before I notice it has returned. Or else it hits me out of nowhere with the full force of a line-backer’s tackle. Sometimes I freeze, mid-moment, suddenly unable to lift my fork to take another bite, or write the next line of text, even holding my breath as the wave crashes into me and I suddenly have to re-evaluate my plans for the rest of the day, even the next hour…. and wonder, each time, if I must re-evaluate the rest of my life as well. If I can even bear to continue.

Every time, I say yes. I have no desire to die — none at all. Perhaps this is because I am on medication for my depression, and as bad as everything I’ve described sounds, I know it really isn’t that bad at all in the grander scheme of depressive disorders. I also know that my life is a relatively easy and greatly privileged one, and I sure as hell don’t want to give it up.

All the same, I live almost every day on an internal battlefield, and some days it takes everything in my power to hold the line, let alone feel victorious. The word “depression”? It doesn’t even scratch the surface.

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