Depression From the Inside

Ishmael 8 Feb 08

Waking up in the morning feeling ok and then getting progressively more uncomfortable as the day wears on, to the point where all one wants is for the day to be over so one can go back to bed.

Feeling everything to be heavy, things, even simple ones, are just too hard to do. Starting things, not being able to finish them, developing into a feeling that therefore nothing is worth starting.

Having great difficulty finding anything enjoyable, or even imagining anything that might be.

Feeling that nothing will ever change, that one's discomfort is what has always been, will always be.

A profound inability to "will" change in either behaviors or mood

A very real "pain" that is hard to describe, poorly localized (though I eventually learned to associate it with some gut discomfort)

Some contributions to broader picture based on these...

Depression is not simply a "mood" disorder. It has quite real cognitive features, as well as aspects related to interpretation of sensory input, to motivation, and to temporality. And it has features indicative of a "dissociation disorder", including awareness of altered behavioral capability and of discomfort.

Emily 10 Feb 08

You open your eyes and hope that you are still asleep, just waking into another horrible dream. It takes you an hour just to convince yourself to get out of bed and not feign illness for the rest of the week. It then takes you another twenty minutes to actually get out of bed. When you finally do, you realize that you had told yourself the previous night that you would wake up early and finish the work that you never actually started. Unfortunately, this never works out for you. Seeing as you have
not done your work, you do not really see a point in going to class, because you'll just be tired and confused, and so you might as well just go back to sleep and hope that you wake up feeling well-rested. This also never works out for you. You try not to think about the busy world around you as you fall back asleep. Your roommate wakes you up, telling you it's time for dinner, and do you want to eat? No, you would much rather stay in bed and sleep; besides, you haven't felt hungry in a few days anyway. When you do eat, you choose the food that will be the most filling in the smallest serving size so that you can eat quickly and feel somewhat full. You fall back asleep and dream of better things. You wake up the next dayand do it again.

Ishmael 11 Feb 08

Yep, recognize it well. Is interesting in that some "depression" involves almost the opposite, difficulty in going to sleep. One of my tricks for dealing with this particular feature of depression is to tell myself its ok to get up "a little bit at at time", with rewards between, ie go brush teeth, go back to bed, put clothes on, go back to bed, etc, etc. That makes the getting up task seem less daunting to me, and seems to ease me one step at a time into being awake.

Virginia 12 Feb 08

Whatever I write feels incomplete. It feels hard to distinguish what is depression and what is "normal" or "me" because even during times I've felt my best some kind of sadness or unease or feeling of being slightly "off" has always been in the background, I think. Depression for me...

going from one unpleasant feeling to another-- a mix of emotions, all painfully intense-- sadness, hopelessness, frustration, loneliness, despair, anxiousness, guilt. Feeling numb like some people describe would be welcomed...

it's like feeling pulled underwater, drowning and just when you think you're going to reach the end you're let up for a breath of air only to be dragged down again. Mostly bad days punctuated by a few short-lived days of relief, which are like teases and seem to make things worse.

it feels like depression is the reality, and once I find myself depressed it feels acutely familiar, I feel like I'm right back where I started, better times quickly become distant or surreal like. Feeling stuck or trapped, time feels slowed down. Periods of depression feel expanded and periods of no depression feel compressed.

feeling very lonely and removed from everything. Being with people usually only intensifies the loneliness, making me more aware of how disconnected I feel.

spending lots of time convincing myself no one should care so I end up keeping everything inside me, which probably only adds to feeling more detached.

sometimes after feeling okay for awhile, a confusing, perverted feeling of nostalgia for feeling sad again maybe only because that is what is most familiar, feeling good eventually starts to feel foreign. Not being able to stand one feeling for too long whether or not it's good or bad.

feels like my "storyteller"/unconscious/whatever is making too many stories so that I end up with an overwhelming number of conflicting or always changing "stories", can never really say quite how I feel. I think storytelling=bad, wish it would stop and give me a rest.

when I'm depressed I feel like I think way too much, about everything, back and forth between lot of things, over analyze, like my mind never turns off.

can't stay focused on anything for very long, hard to find things to get interested in, distractible. A lot of thoughts jumping around. There's always a voice that pops in and reminds me that anything I do become mildly interested is pointless because it will soon become unsatisfying, so no point in trying.

Feeling least worst in the morning and feeling progressively worse as the day goes on. Wanting to sleep all the time because it's the only way to turn off my mind. Getting out of bed in the morning is usually not hard, it's waking up and having my thoughts turn back on and pick up right where they left off. I don't so much dread having to face people or "the world" as I dread having to face myself and the daily dialog in my head.

Decisions are usually rationalized not by what will make me feel good but make me feel the least worst.

Ishmael 12 Feb 08

Nope, not "really out there". Recognize this one too. And hence makes the important point that there is real diversity in depressions.

Virginia 14 Feb 08

I feel like I am on a roller coaster ride with each depression feeling worse and worse. If I expend the energy to feel good for awhile, when I inevitably feel bad again it is usually worse than the last time so that the differences between feeling good and bad become more and more extreme. So, just feeling "bad", not good but not "horrible" winds up being the best bet to defend myself from hitting rock bottom... I think I described it as having a motor tic, you can try really hard to suppress it for awhile, but eventually it comes out usually worse.

Ishmael connected this to the idea of getting it less wrong... sometimes in order to get it less-less wrong you have to get it even more wrong than before, 2 steps forward, 1 step backward. Glad to know my existential anguish is useful/interesting to something, I guess...

Ishmael 21 Feb 08

The sense of not being able to turn off thoughts but of the thoughts not being productive/satisfying is an instance of the Damasio phenomenon?, of a working story teller that is having trouble generating a useful/meaningful story? one that is accepted by the unconscious? Hence giving the story teller a good story from the outside is a way to calm it down?

Emily 24 Feb 08

I am going to try to write something because I have been feeling...for lack of a more encompassing word, depressed. More so than usual. Last week I only made it to one class. Heavy is an appropriate term. I haven't felt hunger in a while, and so I haven't been eating. I know I'm losing weight but I've never felt heavier. I want to make the distinction between an eating disorder and depression here -- it isn't that I think I'm heavy, I just feel heavy. This is one of the reasons it is so hard to get out of bed. Yesterday I didn't get out of my bed until 6:00 in the evening. Everytime I think about doing something productive, namely my homework, I begin to think about how pointless it is. Nothing ever gets done.

I don't know when I fell asleep, but I haven't been awake for days, possibly weeks.

I don't feel connected to anyone anymore. I feel as though novels could be written to fill the silence that lingers after my failed attempts at conversation.

I was recently told that I am a brick wall. I appear to be emotionless, I have no opinions, I do not care about anything. I thought about it. That isn't how I perceive myself. But sometimes now it is.

Ishmael 25 Feb 08

Some additional thoughts .... that don't follow directly from either of yours, are in fact from different place (not being currently depresssed) but may be relevant nonetheless. Was noticing some feelings in myself recently that I tend to identify as possible warning signs of future depression

1. A "voice" that occasionally breaks out and says aloud "I'm not happy".
2. A restless wish to have new toys (in particular this time, the promised but not yet delivered opening up of the I-phone to new applications).
3. A feeling that there is some really important problem that I'm right on the edge of solving.

Relevant to all of this, but most obviously 3, is the NBS seminar tuesday night that I mentioned to both of you, and the depression as motion sickness idea that came out of that. Also relevant is the "bipartite brain" evidence deriving from comparison of brain images following drug treatment and CBT, and the cognitive behavioral therapy distinction between feeling anxiety and being anxious (and similar distinctions in other realms).

Ishmael 24 Feb 08

Have been mulling our thoughts so far. And finished reading Styron's Darkness Visible. Some of what all that makes me think ....

The Ishmael (8 Feb) and Emily (10 Feb) compared to Virginia (12 Feb) contrast is important. What I was recognizing/connecting with in both of you out of my own experiences was "heaviness", and I do think that is an important feature of the experience. What Virginia talked more about though is equally part of my experience: "feeling stuck or trapped ... a mix of emotions, all painfully intense ... wish it would stop and give me a rest ... mind never turns off". And Emily told me in a conversation that she recognized it as well. Its interesting that I responded more to/more readily retrieved memories of heaviness than the agitation of thought.

Both the heaviness and the internal agitation are pretty evident in Styron too. He writes of "slowed down responses, near paralysis, psychic energy throttled back to zero" but also of his brain "as an instrument registering, minute by minute, degrees of it own suffering" and about "the diabolical discomfort of being imprisoned in a fiercely overheated room".

My guess is that both the heaviness/paralysis and the sense of internal agitation are present to varying degrees and perhaps at varying times in most people experiencing depression. Its actually an odd combination, when one thinks about it. And may help to account for the so difficult to describe associated pain (which Styron too acknowledges is almost impossible to put into words). Does agitation trigger paralysis or the other way around? Or are they both consequent on something else? And how do they relate to sleep? Most people (Styron included) seem to get some relief when they sleep. But some people seem to have more trouble falling asleep (Styron also included) whereas others don't.

Virginia's "roller coaster ride" also appears to be a general characteristic (Styron included), and worth thinking more about. Why is it better for some people in the morning, others in the evening? Why does it vary at all? And there is, of course, the common feature of a sense of personal worthlessness. Where does that come from? How does it relate to heaviness/agitation?

Styron also writes about an additional characteristic that I suspect is common in one form or another to most people with depression ... "a sense of being accompanied by a second self". One is aware of one's own behavior/feelings, but can't do anything about them. Perhaps that relates to another feature that appears common ... a sense of indifference to either past or future? of being trapped in a painful and permanent present?

Its too soon to try and make too much of a story about all this, given the risk that a story could obscure aspects of the experience we haven't yet touched on. So let's be sure to try and continue drifting for a bit and see what else surfaces? At the same time, stories can sometimes help bring additional things to the surface, so let me see if one that comes party from my past and partly from our exchange helps in any way along those lines.

I've made sense of my own episodes of depression in ways that relate to Styron's "being accompanied by a second self" or, more accurately, by imagining that the "normal" me consists of two parts, an unconscious and a conscious or "story teller" that normally work so smoothly together that the presence of two entities is for the most part not experienced. The unconscious does much of the work, conveying to the story teller what it is experiencing and doing in the form of a host of feelings, intuitions, and emotions related to a wide variety of different activities. It is from these that the story teller creates a coherent sense of oneself that it in turn sends to the various components of the unconscious to see if it is useful. This exchange and negotiation normally happens very much behind the scenes and yields a continuing but invisible revision of both the unconscious and our conscious existence.

Sometimes though this dialogue gets interrupted. When it does, the conscious is suddenly without the host of feelings/intuitions/emotions that is normally relies on to make sense of itself and its relation to the world. And what it experiences is great difficulty in doing things together with a flatness about life and its experiences. To varying degrees, it also feels frightened and at loose ends and so tries to create stories on its own, none of which seem in fact to work very well. From that a combination of heaviness and agitation? And a sense of worthlessness? And relief if/when one falls asleep (since the story teller is then inactive)? The story raises as many questions as it answers, but maybe that's a good thing rather than a bad one, perhaps providing some new directions in thinking about depression? And maybe, at least, it can serve to bring some more of the experiences of depression itself to the surface? What additional things does a story along these lines help to make sense of? What things don't seem to fit it at all?

Virginia 25 Feb 08

Haven't completely sorted through [the above] but re the heaviness and agitation. What I was feeling a couple weeks ago was definitely a lot of agitation, followed by a relatively good week, now I am back to feeling bad again, but more blah and not the same as before. I guess more of the "heaviness", not anxious like before, don't really care about some of the
things that had me overly worried about before. Feel kind of blank so not really sure how to describe it. Really just want to sleep now to pass the time and for lack of anything else to do, not that I need to turn my mind off like before I guess. No "mix of emotions, all painfully intense" right now, just nothing, though if I'm gonna feel bad I'd rather feel this way because I don't even care that I feel bad, maybe.

Emily 4 Mar 08

Also, I had a thought today in philosophy class: We were informed that the philosophers of ancient Greece (if I recall correctly) reasoned that they would only have to live three times, as opposed to everyone else having to live ten times. I guess this means that philosophers did not enjoy life? Or it was much better to not have to live? Are most philosophers
depressed?

Virginia 9 Mar 08

Here are some of the things that came up yesterday...

Self-comforting cf. child development-- When I'm feeling particularly anxious/agitated I can't find anything that is comforting. Not sure if it's not knowing how to comfort oneself, but rather just the inability to be comforted.

Urgency-- When I feel anxious the most uncomfortable feeling is the sense of urgency to both find something immediately comforting, and more generally to not be depressed in the long run...

Ups and downs-- inevitable, but can maybe be made less intolerable if one expects to go back and forth between feeling good and bad.

And something else I've been meaning to add... I'll just quote Andrew Solomon from The Noonday Demon because I think the way he describes it is pretty accurate for me:

"It is too often the quality of happiness that you feel at every moment its fragility, while depression seems when you are in it to be a state that will never pass. Even if you accept that moods change, that whatever you feel today will be different from tomorrow, you cannot relax into happiness as you can into sadness. For me, sadness always has been and still is a more powerful feeling... When I am happy, I feel slightly distracted by happiness, as though it fails to use some part of my mind
and brain that wants the exercise."

Sometimes I think I was just not made to be a happy person and that I should stop trying to be one... not to settle for depressed/sad/etc. but just something in between.


And Emily, Hume has an answer I think for your question... "I believe it is a certain fact, that most of the philosophers who have gone before us, have been overthrown by the greatness of their genius... I have noticed in the writings of the French mystics, and in those of our fanatics here, that when they give a history of the situation of their souls, they mention a coldness and desertion of the spirit, which frequently returns and some of them, at the beginning, have been tormented with it many years."

Emily 8 Mar 08

"Sometimes I think I was just not made to be a happy person and that I should stop trying to be one... not to settle for depressed/sad/etc. but just something in between." - Virginia (9 Mar)

I feel exactly the same way. It isn't that I don't deserve happiness, I just will never have it, and so it often seems best to give up and settle for something that isn't as wonderful as happiness but also isn't as terrible as depression.

I sleep and sleep and think about all the times I have spent sleeping. I think about all the times I spend not sleeping, just in bed doing nothing for hours, days - the times when even sleeping isn't interesting. And neither is being awake. So then I sleep some more.

Ishmael 9 Mar 08

Is very much worth thinking more about. Yes, something different from "depressed". But is being "happy" something to be aspired to? What is being "happy"? Reminds me of something someone said about using ecstacy. She felt "happy" but it didn't seem "natural". So if not being depressed doesn't mean "happy" what does it mean?

Re sleep, there was an interesting posting from a depressed mathematician. See also the discussion here of "other views of depression".

Virginia 27 Aug 08

I have been FRUSTRATED and ANGRY at everything, small things, big things, and at nothing, and at myself. I am pretty sure I'm feeling better than before, but then sometimes I don't know. I feel good. Then I feel bad. Then I feel good. Then I feel bad again. It makes me feel overwhelmed. I feel, for lack of a better word, CRAZY. Maybe fragmented is a good word. And I don't like how my mood/mind can do a complete 180 and downward spiral all of a sudden and very quickly. Within a few days. Within the day. Within the hour. It makes me feel like I am overall not doing better after all.

I'd characterize myself as more anxious rather than depressed in the last few months. I started taking Klonopin regularly and today have been thinking about how it makes me feel. I do feel less anxious. But I feel like it just strips away the anxiety to reveal a depression that is still there. I can cry and cry and cry, I might drown in my own tears one day. I feel DARK. And kind of eerie. It makes me feel mental pain more acutely. Physical pain doesn't register. I WANT to feel physical pain, but it feels like there's too much mental pain whirling around up in my brain that physical pain can't compete. If I sawed my entire arm off I really don't think that it would hurt.

Emily 29 Aug 08

I started to feel better a few weeks ago. I'm guessing it is due to the Wellbutrin I began taking three weeks prior to that. It crept up on me. I noticed I wasn't in such a terrible mood all the time. I began to enjoy things again. Not everything, but more so than before. I smile. I bought tickets to see two concerts. A few months ago, I bought tickets for shows but either slept through them or went unwillingly. I was pleasant to my doctor yesterday. I used to speak in a monotone, which matched the bored and indifferent way I felt. It is still difficult to get out of bed, however.

As Virginia (12 Feb) said a few months ago, "sometimes after feeling okay for awhile, a confusing, perverted feeling of nostalgia for feeling sad again maybe only because that is what is most familiar, feeling good eventually starts to feel foreign." I feel as though there is a part of me missing, an important piece of who I am. It upsets me that I almost yearn for an absolutely horrible day where I just feel so incredibly vacant. It is familiar, and it was so easy not to care about anything. Feeling good doesn't feel too strange to me. I'm trying to enjoy it while I can, because I can't shake the ominous feeling that the depression will come back in full force to knock me down, maybe for the last time. It feels as though there will always be this void in me, hungry to be filled and enlarged with sadness. I worry about it everyday. I feel very vulnerable and unstable, as though I could go any day. I just hope the diminishing sunlight doesn't trigger it.

Without the mask of depression, my anxiety has returned. I didn’t care about anything enough to have panic attacks when I was severely depressed. I generally feel anxious in social situations, but a few months ago nothing mattered and everything seemed so disgustingly pointless. Now that I care again I’m finding that I can care too much about other people in my surroundings. When I was depressed I told my therapist that I would much rather be depressed than anxious. I’m not so sure about that statement now, but if my anxiety escalates to the intensity I experienced in middle and high school, then I might have to agree with it.

Emily 15 Sept 08

I was reading over Models of Mental Health and realized that I think of myself as a "passive resultant of forces", that I have little to no control over my mental health. Depression happens to me. Anxiety happens to me. In therapy I shy away from Cognitive Behavioral Therapy (CBT), but I never really thought about why. I think I am afraid of being responsible for my own mental health. If something doesn't work out, I feel like it will be my fault. I can't place all the blame on my environment growing up. Genes can't always be my scapegoat.

I carry a lot of guilt, and lately I've been on the fence as to whether it is my fault or my mother's. I usually blame myself for everything that is wrong with our relationship and make up excuses for her. I feel as though in this situation the depression was an uncontrollable force. Mental illnesses are in my genes, I wasn't "nurtured" in a good way, and I contributed negatively to my environment (the latter has been confusing me for months, so I'm still not really sure what's going on there). Even if I saw it coming, I don't think I could have completely prevented it.

So I think that when it comes to improving myself, I'm afraid of holding that responsibility. I don't have confidence in myself to not mess it up.

On a slightly different note, sometimes I feel like I need there to be something wrong with me when nothing is. My story of myself, my identity, very much includes medications, depression, and anxiety. Without them, I don't know who I would be. They are my crutches. This is who I am. And sometimes I am unwilling for that to change.

Ishmael and Virginia 25 April 09

Trying to finish something when one is feeling badly about oneself is likely to make one feel worse. The better thing to do is to start something new... besides, creative people start new things before finishing others all the time.

Rose 10 May 09

When I am depressed my thoughts are like the water gurgling up from the well that isn’t working so well on the farm where I live... they are dirty, gritty manure brown things. The words are worn, tired, boring directly they are written. It hurts to write... tightness in the chest that can not be relieved. Nothing is clean, new or pure. There is nothing abstract and therefore, no creativity. Such apathy. I can’t stand it. So restless. So many senses, associations, inputs without a story, meaning, or connection. I am wandering through an obscure landscape, lacking distinction between anything, not gray but brown. Brown is the mixture of every color, paint pigment together. In purity, there is beauty? In careful combination there is beauty? Where is beauty? How do I create it? How do I find her?

Rose 11 May 09

Virginia 12 May 09

After a pretty good, maybe even great, week I’m crashing and burning. The better I feel and the longer that feeling lasts, the harder I fall. The pattern I’m noticing is 1st I’m happy/content/serene/optimistic, then 2nd I’m doubtful/anxious/agitated with lots of (mostly negative) energy, yet enthusiasm to do stuff; but there’s always a block stopping me from going forward. 3rd comes depression with lots of crying, loneliness, sadness, anger, and frustration; very emotional. And 4th comes a feeling of total apathy, wanting to withdraw, give up, and just sleep, or do anything to turn off my mind; emotionally flat. 5th... ???

It’s physically tiring and both emotionally and mentally draining to imagine myself repeating this pattern over and over. I like control, but I’m trying to learn to live with less control. However, if I have the control/power/ability/responsibilty to change myself then I should be doing so. But I just can’t. And I feel so. damn. emotional. I want to continually apologize for myself.

Self-injury, alcoholism, pills to sleep the time away, anorexia, drugs, bulimia, suicide... they sometimes seem so repulsive but other times so appealing, tempting, and inviting.

Virginia 24 May 09

I usually set my alarm even if there is no place I have to be in the morning. And usually I get frustrated when I ignore my alarm and don't get up early as planned the night before. But this morning I didn't have my alarm set and I just let myself wake up when my body wanted to, which felt really good.