Essay on depression

Making Sense of Depression

One Person's Inside Thoughts

An essay written in Spring 2008 and made available as a contribution to Making Sense of Depression  and Mental Health From The Inside with the permission of the author.

It’s hard for me to articulate what it’s like “on the inside” of depression, largely because I have a hard time recognizing myself as depressed, but also because my damnable career in psychology has imbued me with the sense that it is inherently wrong for me to define the experience of another. But the scientist in me cries out for corroboration and consistency across a population in defining a disorder or even something with less valence, like an event or why humans even make tears, and I’m just stuck vacillating between trying to figure out what the hell is wrong with me and telling myself nothing is wrong at all. It’s just all so subjective and lacks any control, though perhaps it would be best to start at the beginning, because that’s where I go when I talk to myself about being depressed.

I had a wonderful childhood. I am blessed with two parents who love me, a sister who adored me when we were younger, I grew up in a small, tight knit community, I kept plenty of animals around me, I had friends, I played outside for hours everyday, I adored school and participated in extracurricular activities and I even had a little “boyfriend” whose mother joked with mine about being future in-laws. We weren’t, and aren’t, rich, but I still got a new dress every Easter and handmade gifts from my grandmother every Christmas. I believed in God, and could pray to someone whenever I felt anxious or upset. On the whole, I have absolutely nothing to complain about. My mother was raised by an abusive alcoholic and a man who sired her out of wedlock, married my grandmother after cuckolding her first husband and refused to admit he was my mom’s father until my sophomore year of high school. Grandma Jane would forget Christmas, pass out drunk leaving my mother to care for her six younger sisters, and once broke a beer bottle over my mother’s head. Mom wasn’t taken to the E.R., instead Grandma Jane stitched her head up at home and told her to tell no one. My mother survived years of mental and physical abuse, but the scars showed. Mom has always been an emotional powder keg and sadly several of my earliest memories of my mother are of her crying, inconsolate on the couch over some perceived slight from my father. Or yelling at us for making too much noise -- she worked nights. As I got older, I noticed my mom didn’t behave like other peoples’ moms did, my father would later explain it as “emotional unavailability,” but I hasten to clarify that she wasn’t like that all the time. She was utterly compassionate when my first rabbit died, and the next, and the next, and she also single-handedly saved my beloved buck Bugs from death by administering extensive home care when he got a hairball. Still, mom didn’t stay at home with us. Slowly my dad began assuming more of the child-rearing responsibilities, and he was great at it. Dad didn’t handle crying too well though, and consequently my sister and I to this day hate it when we cry. I cannot help but think of crying, especially women crying, as an attempt to get other people to do things for them, and that’s shameful and rude. I lived for making my adults’ approval, so I tried to rein in the tears, do well at school and in 4-H. My little life was doing great, until we moved.

Adolescence bites, and it bites more when you’ve moved. Several moves exponentially increase the degree of bite and negotiating all this when you’re mother is jealous of your comparably better life bites the big one. At fourteen, I decided I might be depressed. I’d attempted to hang myself a few times when I felt I’d failed someone, and there seemed to be a running dialogue in the back of my head alternately about how worthless I was as a person and about how I wish I had the guts to just die. Despite the fantastic fights and the hysterical crying, I still loved my mother. Grandmother Jane committed suicide before I was born by walking out in front of a bus. Mom named me after her mom, and it became perfectly clear over time that the death of either me or my sister would be catastrophic to her, moreso if it were a suicide. I asked to see a therapist, who asked me how often I thought about death. My father was in the room with us, and when I answered seventy to eighty percent of the time, he told me that was impossible. I couldn’t function if that were true. The therapist, upon hearing my family’s history, decided my case was genetic and the only resolution would be drugs. That was the last time I admitted that I might be depressed to anybody. On the whole, the remainder of my adolescence was uneventful. I had eating issues like every Western white girl, and the fights and unceasing feeling of impending or realized failure didn’t stop, but I had fun and depressed people don’t have fun. I was also functioning; I kept a job at a local veterinary clinic and used the money I made to send myself to Germany, I was in honors classes at school and doing well, and though I’d fallen in with the goth and punk crowd, I still managed to find good, intelligent friends. Again, nothing to complain about.

The cutting began sometime in my junior year of high school. I’m reticent to call it cutting, because I’m actually too afraid of causing irreparable damage to myself with the prototypical razor blades. It started with scratching. When I went to meetings about college or preparing for the future, I would get afraid. Everything would go blank except for this terrible, awful, horrible feeling in which I drowned and couldn’t get out. I couldn’t even hear myself tell me it was all in my head, there was nothing but fear and heartbeats and an overwhelming desire to feel anything else. I didn’t cut, I picked and scratched at my hands, worrying a spot between my thumb an index finger until it bled or until it hurt so much it broke through the suffocating aversiveness and let me think about something else . Later I would scratch at my wrists and cover the evidence with sweatbands; ashamed that I was harming myself, ashamed that it wasn’t actual cutting, and punishing myself because the sweatbands irritated the scratches. Many of my friends who cut had it much worse than I; by now I was an NHS student, a student leader in the gifted and talented club, and a star pupil. The addition of a boyfriend just before my senior year pretty much stopped the scratching. I left for college as my mother and my sister entered therapy for depression and ADHD respectively.

I had a scare when my grandmother threw a clot my sophomore year at college. I stayed with a HA and threw out both my scissors to keep from hurting myself. It was also about this time that I got tested for and began an informal regimen of Adderall; when I get stressed or panicked I cannot think, intrusive thoughts about other things, song lyrics, and old prayers drown out anything I try to put together. I only took Adderall when I was seriously stressed, like the last two days of final week. Other than that I was doing great; I was very sad when I didn’t get the DAAD, which would have allowed me to study in Germany a whole year, but I never thought of hurting myself. My mother and sister were changing too: my mom got better every time I talked to her as my younger sister seemed to be backsliding. It didn’t seem too odd, she was just being a teenager. Germany was fine, and the domestic half of my junior year was doable too even when my sister ran away and my boyfriend dumped me by not calling. I spent the summer volunteering in lab, working in the library and serving as a HA for a group of high school girls studying science on campus. The very last day I worked with the girls, I got a call from my best friend Elizabeth.

Elizabeth’s dad had had cancer ever since I got to know her in eighth grade; it was the primary reason her family had moved away. When she called me in tears, I sort of just knew what was happening. That didn’t mean I could understand it. I flew down to see her as soon as I could, ready to help in any capacity. I knew I was going to be hurt by watching my friend hurt and not be able to do anything about it. I wasn’t prepared for how deeply it frightened me, nor had I realized how much I cared for Elizabeth’s father. He didn’t just die, he wasted. The worst shock was how quickly thereafter life went on without him. Nothing stopped, nothing seemed to change, but Elizabeth’s dad was gone and everything felt just every so slightly turned or wrong. Nothing changed, and more importantly, I had no reason to be upset. He wasn’t my father. I began losing hair at this point, but assumed it was stress that would go away once the year began and I had things underway. It did, until Erica, my best friend at college, moved away to be with her fiancé's family across the country. Then my hair began falling out again. I thought I might be depressed, or stressed, but it was an intellectual quandary with no visceral backing. I spoke to therapists, but left the room showered in mutual laughter. I couldn’t be depressed, I was too happy. Halloween I felt ill and elected not to go out; parties make me nervous anyway. I called home to talk to my Dad, knowing full well I wouldn’t get through. It is a long standing tradition in the Smith household to call Grandma Smith, the only grandparent I’d ever known, and tell her what the little trick-or-treaters were wearing this year. When I didn’t get the busy signal, I casually thought to myself in my most typical, worst-case-scenario kind of way, Gee, I hope Grandma isn’t dead.
I would give my college degree to take back that thought.

I know my thought didn’t kill my grandmother. Her heart did that. But I can’t shake this combination of guilt and insane disbelief. The counselors here gave me three months for proper mourning, but it wasn’t until the Neuroscience seminar on depression and OCD when I really knew something was terribly, terribly wrong. As my peers casually listed symptoms, in terms of happening to someone else, as we discussed what depression might be, but always as something outside of that room, as our professor waxed philosophical, I realized I’d been dealing with this big ugly thing sitting in my head telling me terrible things and choking any other emotional experience out of existence for three months, and it didn’t look like it was going away.

Therapy doesn’t seem to be working. It helps to know I’m not crazy given the circumstances I grew up in, but that doesn’t make moving from my bed in the morning any easier. I have been gradually increasing my Adderall dosage, trying to coax a coherent thought from the quagmire of self-loathing a doubt. It seems, given my grades, that all this has done is increase my startle and drop my weight to levels which disturb my friends. One night I had been drinking with some people I didn’t know, and one person informed me that I only speak to hear myself be right. When I got back to my room, there was something else sinister in my head. I cannot describe it because it wasn’t me, and it was telling me to do things to end myself. I cut as hard as I could with my scissors before I realized that I couldn’t not do what this entity was telling me. If I still believed in God, I’d swear it was Satan or some other demon in my head. I spent the night in the Health Center because I was too afraid to go to the ER: my mother would find out, and I already have enough difficulty trying to get health insurance due to a series of abnormal pap smears (so add impending fear of developing cervical cancer to all of this). So, I recognize that I have a problem, or I may. It would seem that if I am depressed that self-doubt would be one of the primary symptoms thereof.

So when I ask myself if what I’m feeling is depression, this is what I think about. Then I think about the prototypical “depressive” symptoms. Anhedonia: It could be that I’ve lost interest in the things I used to, or it could be that they just aren’t as fun period. School seems to get harder and harder with very little payoff that I’m interested in. I do have a hard time starting anything for fear of failing, and while I used to love writing (especially for cathartic or expressive purposes) I now loathe my assignments. Every. Single. One. Increased or decreased need for sleep: I sleep all the time. If I have nothing pressing to do, I sleep, and sometimes when I do have something pressing. When I need to get work done, I pump myself full of caffeine, Adderall and nicotine so I can’t sleep. This just makes my later extended sleeps seem reasonable, despite the fact that earlier rebounding from an all-nighter just required an extra two to three hours. Concentration problems; this intrigues me, do I have concentration problems because I’m depressed, or because of the ADHD categorization which runs through my family? It would seem like this depression has been building over time which would make it the causal factor, but if it’s acute, onset with the spate of deaths I’ve experienced recently, maybe depression only exacerbating my attentional issues. The other two common symptoms, self-loathing and feelings of hopelessness or despair, have been my constant companions since adolescence, and it’s almost more frightening to assume that I’ve been depressed that whole time. Again, I cannot think of myself that way, because I have good times. I have fun with friends and party without being invaded by demons. I can smile. I have no reason to be depressed. It’s impossible to do what I do and be depressed.

It would seem my case seems to match our professor’s characterization of depression as a mismatch between visceral signals and what my I-function seems to think of them, if I am in fact depressed. What worries me is that despite seeking psychoanalytic therapy, and supportive friends and family, and a serious reduction in stress, I feel worse. I’ve been crying more than I have my entire life. I miss my grandmother so much it actually physically hurts. Food looks repulsive, my boyfriend’s affections annoy me and I’m so desperately afraid of failure I put off my senior work until a point in time at which failure was all but guaranteed. I just want it all to stop. I’m too afraid to do anything about it, and I don’t know what to do about it.