Depression and Self-Gaslighting

Gaslighting is a term you probably know, but if you don’t, it refers to the act of telling and convincing someone that their feelings or perceptions are not really true. In the context of interpersonal relationships, gaslighting is considered to be an abusive behavior, as it can render people incapable of trusting themselves and their own judgment, instead placing an undeserved trust in the gaslighter.

Cognitive distortion is also a term you probably know. It refers to a set of maladaptive mental habits that people with mental illnesses tend to have. (The Wikipedia list is useful, and I discussed some specific examples in this post.)

A cognitive-behavioral approach to mood disorders involves teaching the client the difference between thoughts and feelings. A lot of people will say things like, “I feel like a failure.” The therapist’s role is to remind them that “I feel like a failure” isn’t actually a feeling, but a thought. “I feel like a failure” is really “I think that I’m a failure.” The therapist may ask, “How do you feel when you have the thought that you are a failure?” The client may say, “I feel hopeless,” or “I feel miserable.” Hopefully, the therapist can help the client see that a lot of their thoughts are actually cognitive distortions, and that there are more helpful and realistic ways to think about the same things.

That’s the standard CBT frame that’s used in all the training videos I watch in school. But the reality, at least for me, is a little less tidy. Sometimes feelings come seemingly out of nowhere, and while I know there is a reason for them (and I usually know what the reason is), there was no proximal cause for the feeling. There was no maladaptive thought.

Sometimes I see a partner with someone else and I just feel awful. I don’t think, “I bet they’re going to leave me now,” or “That person is way cooler than me,” and then feel awful. I just feel awful. Is it because I trained myself to feel awful on cue, as a conditioned response? Maybe. Others would argue that feeling awful is a “natural” response to seeing a partner with someone else, though I disagree. Regardless, the feeling comes immediately and without any stimulus other than seeing the thing.

Sometimes I have to leave my family after a visit and I become extremely depressed. (I will have to do this in a few days. I’ve already had a few breakdowns about it.) I don’t think, “I WILL NEVER SEE MY FAMILY AGAIN” or, slightly more realistically, “It is Terrible and Bad that I have to leave my family.” I just think about the mere concept of leaving and instantly collapse in tears. (To wit: there is nothing less undignified than collapsing in tears while sitting on the toilet, but that just happened to be when I remembered about my flight home. It happens.)

Last year I wrote about some things I had learned from depression, including two slightly/seemingly contradictory maxims: “Not everything your brain tells you is accurate,” and “Your feelings are valid.” You can read that post to see what I meant by these things, but the jist of it is that depression can teach you to be more skeptical about some of the stuff going on in your brain, but also that you get to feel how you feel without passing judgment–or having others pass judgment–on it. Some would say that feelings can’t be “wrong.” They can be crappy, or not useful, or distracting, or whatever, but they cannot be empirically inaccurate or morally wrong.

However, this is where reality gets murkier than these convenient teachings. Feelings aren’t wrong, per se, but they can be premised on exaggerated or inaccurate fears or worries. I feel bad when my partners like people who I think are Better than me. But what is “better”? Can I really accurately say that someone is “better” than me, rather than maybe better at certain things and worse at others? And isn’t the whole point of polyamory that nobody has to leave anyone just because they’ve found someone “better”?

I feel depressed when I have to leave my family and go home to New York. But I know I will be just fine and quite happy when I get there. I know this because I’ve gone through it many, many times now. There is no reason to feel so depressed I can’t get out of bed for two days. Yes, it’s sad to say goodbye to your family. To me, personally, it is slightly tragic, even, that I can’t live close to them the way people usually do in our culture. But it is not that sad. It is not weeping-on-the-toilet-bowl sad. Few things in my life are objectively that sad.

These are far from the only situations like this that I experience; it happens all the time, every day. I get very frustrated. “No feelings about feelings,” a friend of mine says, not as a rule, but as an aspiration. I can’t make it work.

So I start gaslighting myself. “That’s not true.” “That perception is just wrong.” “That’s false and you know it.” “There is no reason to be upset right now.” “Your hypothesis that that person is somehow objectively better than you is premised on nothing but a pile of turds.” “THAT FEELING IS WRONG AND YOU SHOULD IGNORE IT FOREVER.”

Cutesy slang about jerkbrains and badfeels aside, what I’m now doing is very serious. Now I have abandoned a defensive stance and taken up an offensive one, with which I will battle the Wrong Feelings and vanquish them in a burst of light. Gaslight.

What happens when you teach yourself not to trust your own perception? How many toxic people become “just difficult for me to deal with because I’m so insecure and oversensitive”? How many untenable situations become marginally acceptable because “I’m only miserable about it because my brain lies to me”? How many injustices become annoyances to shrug at because “I’m just pessimistic about everything and don’t realize how good life is”?

People tell me that I’m so good at setting boundaries, but sometimes I wonder how much shit I have patiently accepted because I thought my brain was lying to me. In any case, I’m very glad I discovered feminism at the same time I discovered that I have depression.

Somewhere between “Your feelings are bad and you should feel bad” and “Your feelings are an accurate barometer of external reality” lies a vast unexplored land of feelings that are excessive but useful, of feelings that don’t make any sense but that alert you to an issue that needs to be explored, of feelings that can be discussed with a partner to build trust and intimacy, of feelings that have been spot-on many times before but have simply outlived their usefulness in this new and happier life you have built.

I wish I could really believe that feeling things is okay.

A Primer On Atypical Depression

At CONvergence two weeks ago, I and a few other people did a panel on myths about mental illness. It was really great, and I hope that there will be a video of it up eventually. At one point, I tangentially mentioned atypical depression, a type of depression that is sometimes contrasted with melancholic depression, or the “typical” kind.

Atypical depression is the type that I have, and that might be part of the reason it took me something like seven years to realize that I had depression at all. A few people have since told me that they didn’t even realize atypical depression was a thing. So I decided to write a brief overview of it in the hopes that more people who don’t have a name for what they’re going through might find a name for it.

There are some “classic” depression symptoms that most people think of when they think of depression: being numb or sad most of the time, being unable to take joy in things you used to like, insomnia, and loss of appetite and weight. You think of the person lying in bed unable to care about or take pleasure in anything.

Atypical depression has a rather different set of features. Instead of insomnia, you may have hypersomnia (oversleeping). People with atypical depression might regularly need to sleep 10 or 12 or even more hours. Instead of loss of appetite, you may overeat and/or gain weight. Instead of being numb or just uniformly sad, you have high mood reactivity, or mood swings. You may find that you’re able to enjoy things and feel happy when things are going very well, but as soon as things are neutral or even just a little bit bad, you feel horrible again. There are two other symptoms that are sometimes present: leaden paralysis, or the feeling that your limbs are very heavy and difficult to move, and high rejection sensitivity, which means being overly concerned about people not liking you or rejecting you, to the point that it impairs your social functioning.

Unsurprisingly, these different sets of symptoms mean that different types of antidepressants may work best for each type. I will quote Wikipedia here, since it’s sourced and there’s no good reason to rephrase it:

Medication response differs between chronic atypical depression and acute melancholic depression. Some studies[4] suggest that the older class of antidepressants, monoamine oxidase inhibitors (MAOIs), may be more effective at treating atypical depression. While the more modern SSRIs and SNRIs are usually quite effective in this illness, the tricyclic antidepressants typically are not.[1] The wakefulness-promoting agent Modafinil has shown considerable effect in combating atypical depression, maintaining this effect even after discontinuation of treatment. [5]

I don’t know how useful this information is to you if you think you may have atypical depression, but at least now you know that if your symptoms fit this pattern but your psychiatrist prescribes you a tricyclic antidepressant without further explanation, it might be worth bringing up this research. In addition, if SSRIs haven’t been working for you, you might ask your psychiatrist about trying MAOIs rather than a different SSRI or a higher dose of the same one.

In terms of therapy, I can’t seem to find any studies on the effectiveness of different types of therapy on the different types of depression (that may be because Google Scholar is actually a terrible search engine), but my educated guess would be that dialectical behavior therapy (DBT) would be extra helpful for atypical depression as opposed to melancholic depression. DBT is a type of therapy developed specifically to treat borderline personality disorder, which involves lots of mood swings, rejection sensitivity, and general troubles with managing emotions. DBT contains a lot of the same techniques as cognitive-behavioral therapy (CBT; the standard of evidence-based treatment), but it also emphasizes mindfulness and learning to cope with strong emotions. Atypical depression, with its mood swings and interpersonal issues, might be especially amenable to it.

To the extent that psychodynamic therapy is effective (actually, plenty of studies suggest that it might be), it might also be more effective on atypical depression than other approaches. Atypical depression tends to have an earlier onset, and people may experience it as an aspect of their personality that is rooted deeply in their life experiences. When practiced well, psychodynamic therapy may be useful for resolving these issues. But none of this is to say that standard CBT should not be tried.

During my senior year of college, I asked a professor who studies the neuropsychology of mood disorders whether or not he knew of any research on neurological differences between atypical and melancholic depression. After all, there’s been plenty of research on how depression affects the brain–in terms of active brain regions, neurogenesis (growth of new neurons) in various regions, and so on. Were all these studies really done using patients who might’ve had what looks like two nearly-completely different illnesses? Apparently. My professor wasn’t aware of any such studies, and I’ve only found one myself: some research that examined which hemisphere of the brain responds more to a particular face test, and in atypical depression patients, the right hemisphere was much more active than it was in melancholic depression patients and in non-depressed controls. The authors write, “This is further evidence that atypical depression is a biologically distinct subtype and underscores the importance of this diagnostic distinction for neurophysiologic studies.”

There also seems to be some evidence that atypical depression in particular is linked to thyroid dysfunction, which may explain some of the physical symptoms. However, the results seem to be rather complicated and confusing, and it’s definitely not a simple causative link.

Although the diagnostic criteria for depression contain both sets of symptom patterns and there’s even a special indicator for “atypical features,” the popular conception of depression is of the melancholic type, not the atypical type. This means that many people, believing that depression necessarily means “being completely miserable all of the time always,” may not realize that they might have depression and can benefit from treatment.

Atypical depression presents a classic boiling-frog problem. Because you are in fact capable of feeling happy for short or medium stretches of time, it can take a serious increase in symptom severity to realize that there’s anything wrong. Incidentally, as I mentioned, atypical depression also tends to have an earlier onset than melancholic depression, which means that you may spend your entire post-childhood life that way. For some people, certainly for me, it felt like it was “just my personality.” To make things even more confusing, the rejection sensitivity tends to be present even during periods of time when the rest of the symptoms are in remission. But when it comes to mental health, nothing is ever really “just your personality” if you don’t want it to be.

Hopefully, this overview will help people–at least the people who read this blog–broaden their awareness of what depression is. If there’s anything I missed in terms of research, by the way, please let me know. As I mentioned, my Google Scholar-fu is much worse than my Google-fu.

Of Ethics, Feelings, and Skyrim

I’m currently visiting my family in Ohio, which means catching up on all the gaming I’ve been too busy for during the last five years. My 12-year-old brother and I have a nice symbiosis going: he has a Windows machine, which meant I could install Skyrim on it, and I have a purchased copy of Skyrim. So we take turns watching each other play.

Kilkreath Ruins. Creepy, yeah? Well, maybe you just had to be there.

Kilkreath Ruins. Creepy, yeah? Well, maybe you just had to be there. Credit: Ekulylnam

Last night, while I was adventuring through the Kilkreath Ruins on a quest from the Daedric Prince Meridia, my brother remarked that he found the cave scary–the creepy noises, the unidentified black mist near the ground–and that started off a discussion about the emotional effects of games and how we feel about them.

My brother said that he’s actually glad that the game is making him feel things again. He has previously played it on Xbox (claiming, in fact, that he “beat the game”), but he said that after a while, he stopped feeling bad when people died or feeling scared by the parts that were meant to be scary. But he prefers to feel those things even though they don’t feel good, because otherwise he worries that he’s becoming unempathetic, somehow cruel. This, he said, is why people should be careful about letting little kids play games: you need to make sure they don’t get used to not feeling things.

I hadn’t actually thought of it that way before, though it seems obvious now. I had always been frustrated by how deeply I felt things that happened in games, and how much that actually restricted my gameplay. My ethics as a game character are not very different from my ethics as a real-life person: I don’t steal (unless, hypothetically, it’s vitally important), I don’t fight anyone who doesn’t fight me first, I try to avoid injuring innocent people with splash damage unless it’s totally unavoidable, I try to persuade people rather than bribing or threatening them, and I don’t hunt wild animals (except the ones that attack me).

But despite everything my brother said, we soon discovered that our styles of play are actually quite different (besides the fact that I play slowly and deliberately whereas he tries to get through quests as fast as possible, a difference that he had already remarked upon in frustration many times). After the Meridia quest, I ended up doing another quest in which I was falsely accused of multiple murders and ended up in a prison mine with people who had attempted (and failed) to recapture the city from people they thought were oppressing them. Together with them, we escaped from the mine, since they all turned out to be very capable mages.

Outside the mine, the escaped prisoners were confronted by prison guards. I had planned to fight alongside them, but here my brother started insisting that I kill the prisoners instead. Why? Because they have really good armor, I wouldn’t get a bounty, and I could kill them easily now that I had my own armor and weapons back. I said, “But they already gave me a set of that armor as a gift.” My brother said, “But it’s really expensive and you could make 10,000 gold just from selling all of theirs.” I said, “But I have other ways to get gold.” He said, “But it’s so easy! Just kill them!”

I knew one thing for certain: I had absolutely zero desire to make 10,000 gold by killing these men. At that moment, there was nothing I wanted to do less than to kill them. The idea just felt bad.

And so I told my brother, “Remember how you felt so scared of the cave you asked me to turn the sound down, even though you knew it was irrational? That’s how I feel about killing the men. It would make me feel bad. The point of playing a game is to have fun. That would make it very un-fun for me.”

He immediately stopped trying to convince me to kill the men and never brought it up again.

It’s true, refusing to kill the men was an irrational choice. Within the game, there were no disadvantages to killing them, and one huge advantage to killing them. But outside of the game, the advantage seemed so small–what’s 10,000 gold, really?–and there was also one glaring disadvantage–the fact that I would feel crappy and uncomfortable, partially defeating the entire purpose of playing the game to begin with.

Earlier I might’ve found this frustrating. I thought that I let myself get way too affected by virtual things. I’m the sort of person who would treat even a fairly rudimentary robot as I’d treat a human or a non-human animal.

Now, having had the first conversation with my brother and the subsequent moral dilemma with the prisoners and the guards, I started to think differently about it.

After all, we (I include myself in this) are more likely to think of it as a feature, not a bug, when we experience emotional reactions to things like films and shows and novels. (That, in fact, is what I reminded my little brother when he called me crying after finishing The Little Prince, and again when he called me crying several years later after finishing Flowers for Algernon.) Playful teasing outside, feeling terrified or very sad during movies is pretty standard. Why not in games?

Maybe it’s because we assume that the point of film and literature (as a fan, not a scholar) is to be absorbed into a story. The point of games, some might argue, is more tangible: to shoot stuff, to solve puzzles, to build cool things, to become the best. Stories may matter in games, but they don’t matter the way they matter in films and novels.

And there are definitely games I would play purely for those tangible aspects. I don’t get emotionally invested in the story of my SimCity creations (though maybe some do). I care slightly for the plight of Fez’s Gomez, who has literally had his entire world as he knew it torn to bits, but mostly I’m just there for the cool puzzles.

Persuade, intimidate, or bribe: Skyrim's eternal moral dilemma.

Persuade, intimidate, or bribe: Skyrim’s eternal moral dilemma.

But with games like Skyrim, I come for the fighting and stay for the interesting narrative, and that generally means starting to feel immersed enough in that world to feel bad when people die needlessly in it. The experience of considering (and strongly rejecting) the idea of killing the escaped prisoners for their valuable armor reminded me of something I think I already knew: that much of ethics, at least for me, is based on automatic emotional responses. Stealing feels bad. Threatening feels worse. Killing needlessly feels even worse.

There must be ethical systems out there that rely on something besides emotion and that still result in minimal harm to other people, but they feel alien to me. In any case, I doubt that those systems would transfer over to virtual worlds. Why bother?

Sometimes I wonder if other people feel that way, and if other people end up playing about the same way that they live (give or take a few magical abilities and badass warhammer techniques, of course). If there are gamers who feel bad when they kill NPCs, I wouldn’t expect them to ever say so, because nobody seems to talk very much about the emotional experience of gaming in general, and because of the hypermasculine culture of it.

But for me–someone who has no interest in participating in or belonging to any sort of “gaming community” and who wouldn’t even take up the label “gamer”–it doesn’t feel like a big deal to say that games make me feel things. Not just general things like excitement or fear, but specific things, like I feel sorry for that man who died even though he’s just a bunch of 1’s and 0’s. Or I wish I didn’t have to kill that dragon; it would feel much better if we could just be friends. (That one might be influenced by the fact that I recently saw both How To Train Your Dragon movies and really liked them.)

And now I’ve finally decided that I like it that way. It’s more rich and fun that way, even with the bad feelings too. Like my brother, I like myself better when I feel those things. Embracing that irrationality feels more human to me.

On Gender, Misattribution, and Kendall Jones

I’ve been a little preoccupied with travel and conferences lately, but now hopefully I’ll have more time to write. If you donated to my conference fundraiser, look out for a post thanking you and summing up the conferences, as well as any posts you may have requested.

For now, here’s a Daily Dot piece about Kendall Jones, the Texas cheerleader who’s become, by some accounts, “the most hated person on the Internet” for posting photos of herself with animals she killed in Africa. The rest of the piece cites some cool research, so you’ll want to click through to it.

Observing all of these responses that have been pouring in over the past few weeks, pro golfer John Peterson tweeted, “I support Kendall Jones. If it was a 60-year-old overweight dude posing with his African kills, no one would talk.” While Peterson doesn’t sound like he has a problem with hunting (indeed, his Twitter bio says, “If I could get paid to hunt, id be doin that”), he correctly notes that men who hunt don’t seem to garner such a reaction.

In fact, a Virginia Democrat—not on the ballot but seeking Eric Cantor’s House seat—named Mike Dickinson even publicly offered $100,000 to any “ex-boyfriends” who could provide naked photos or “sex stories” about Jones. (There, I hope, go his electoral dreams.)

First of all, using misogyny—or whatever noxious mixture of elements causes our cultural panic about women, sex, and nude photos—to abuse someone who’s done something wrong is not any sort of justice I believe in. Second, I’ve never heard of anyone bribing people for nude photos of a man, at least not as some sort of convoluted punishment. That threat is used against women and those perceived as women exclusively.

At the same time as the Democrat’s nudie pic requests went viral, a Facebook page popped up calling for Kendall Jones’ death.

I don’t want to say that the Internet hates Kendall Jones just because she’s a woman. To say that would be to conveniently ignore the cruel things that she does in order to make a point about sexism.

A more accurate way to interpret this might be that the Internet hates Kendall Jones because she’s done cruel things, but the only reason everyone even took notice of those cruel things is because Kendall Jones does not look or sound like the type of person we expect to hunt animals for sport.

Normally, the idea of trophy hunting isn’t one that most people, even those who generally care about animals, have much of an emotional reaction to. Some find it acceptable or even laudable; others mildly disapprove—but not enough to have strong feelings about the issue. It wouldn’t surprise me if seeing someone unexpected participating proudly in trophy hunting triggers a negative reaction that people then attribute to the person’s actions rather than their identity.

After all, it takes a lot of self-awareness to notice and think, “Huh, I seem to be having a very strong reaction of anger and disgust when I see a young attractive woman posing with animals she killed, but not when an older man does the same thing.” Most people will instead think, “Wow, I’m very angry about this. It’s disgusting to kill animals for fun like that.”

Most people who experience such a reaction would simply assume that it’s being caused by the most obvious thing: the pointlessly killed animals. They forget all the times they encountered the idea of men hunting animals for sport—because those encounters didn’t register on such a high emotional level.

Read the rest here.

Depression Is Not Sadness (Again)

[Content note: mental illness, depression, anxiety, suicide]

When I think about the frequent charge that therapists and psychiatrists and those who work with them are trying to “medicalize” “normal” emotions like sadness and fear, I think that people don’t really understand how emotions like sadness and fear can be distinguished from mental illnesses like depression and anxiety.

I’ve tried to explain this to many people multiple times, in person and through writing, and so have many other people with mental illnesses as well as professionals in the field. Yet people continue to conflate emotions and illnesses, or rather to assume that mental healthcare advocates are conflating them. It’s often difficult to continue engaging patiently with this claim.

Even those who are knowledgeable about illness and disability make this error. In an otherwise-fantastic blog post about the medical model of disabilityValéria M. Souza uncritically cites this very inaccurate view of antidepressants:

In The End of Normal: Identity in a Biocultural Era, Lennard Davis affirms: “A drug would be a prosthesis if it restored or imitated some primary state that appears to be natural and useful” (64). Davis makes this statement in the context of his argument that SSRIs are not “chemical prostheses” for depression, since happiness is not a “primary state” of being and since there is compelling evidence to suggest that SSRIs do not actually work (Davis 55-60).

I’ll address the SSRIs-not-working thing first since I have less to say about that and it’s not as relevant to this post. The reality seems to be more that SSRIs work well for some people but not at all for many other people and we haven’t really figured out why they work for some people but not others, or more specifically, which types of people they work for and which they don’t. And on a personal note, I’m a little tired of being told that SSRIs “don’t work” when they’re part of the reason I didn’t try to off myself four years ago. There is compelling evidence to suggest they do not actually work and there is compelling evidence to suggest that they do actually work, so I’m comfortable saying that the jury’s still out on this one.

More to the point: antidepressants are not meant to cause “happiness” because depression, the illness they are meant to treat, is not defined by a lack of “happiness.” Depression involves a constellation of physical, emotional, and behavioral symptoms that make happiness very difficult or even impossible. These symptoms have a number of other deleterious effects which vary for different people. There are many ways depression can ultimately “look,” such as being unable to get out of bed, being unable to hold down a job, bursting into tears several times a day over tiny inconveniences or in response to nothing at all, losing your sex drive, being unable to sleep, having to sleep over 12 hours a day, having severe memory loss, losing the ability to enjoy any previously enjoyable activity, experiencing complete emotional numbness, obsessing over death and suicide, physically hurting yourself, or attempting suicide.

Maybe being “happy,” whatever that even means, isn’t a “primary state,” but I would argue that being able to live a relatively normal life in which you can go to school or have a job, have relationships with people, and not want to kill yourself is a “primary state.”

Being treated for (and, hopefully, recovering from) depression does not give you extra things that other people don’t have, such as constant happiness and optimism. It gives you what everyone else has had all along, which is a reasonable and age-appropriate amount of control over your emotional state and the ability to create your own happiness if you want to and make the effort.

By the way, you can definitely be miserable and unhappy without having a diagnosable mental illness, but it’s rare to find a person whose unhappiness is truly caused entirely by their own voluntary actions. Depression can also develop as a result of voluntary actions; for instance, if you have a number of career options available to you but you choose an extremely stressful and mind-numbing (but perhaps lucrative?) option, you might end up becoming depressed because of it. At that point, your best bet might be to find a way to make a career change, but it’s likely that you’ll also need therapy to help undo the maladaptive mental habits that the situation has created. (Medication might help too, but in a case like this I’d personally recommend therapy first.)

I think a better way to explain the difference has been that, at least in my experience of mental illness versus mental health, there are things that mentally healthy people can do to significantly increase their level of happiness, whereas people who are going through a bout of mental illness can rarely make a huge difference just by stopping and smelling the roses or making more time to play with their kids or enrolling in a cooking class or whatever. They can maybe make a small difference, but it’s unlikely to reduce the mental illness symptoms themselves. I used to get so frustrated at things like The Happiness Project and other initiatives of that sort, until I finally realized that they weren’t aimed at me because happiness would literally not even be a possibility for me until I treated my damn mental illness.

(That said, things like that can be very useful for someone whose mental illness is in remission or otherwise low-grade. Right now, I’m not fully symptomatic for depression but I’m aware that it can probably come back at any time, so I do a lot of things to keep my mental health strong to try to avoid it coming back.)

It’s difficult to tease out all the complicated interactions between mental illness, mental health, and happiness, and of course it varies for different people. In my experience–which includes my personal experience, my interactions with friends and partners, and my studies and clinical experience, here it is in a nutshell: untreated/unmanaged mental illness makes happiness virtually impossible to achieve. Treating or managing your mental illness, whether through medication, talk therapy, or personal lifehacking, helps make happiness possible to achieve. But the work of achieving it is still yours to do. No drug or therapist can just give you happiness.

And most people with mental illnesses realize this. I haven’t met anyone who was just like “I wanna go to the psychiatrist and get a pill and just be happy always forever.” Most of us just want to stop crying all the time, or stop having panic attacks whenever we need to interact with new people, or stop having intrusive and scary thoughts of killing ourselves, or stop lying awake for hours each night because we can’t stop imagining all the bad things that could happen to us.

“Happiness” is the cherry on the sundae of mental health. You need to put the ice cream and the syrup and the whipped cream in the cup first.

(I’m not sure what it says about me that in reality I actually despise maraschino cherries and always ask for them to be left off my sundae. This is an analogy that was definitely intended for the presumably more normal people who will read this.)

If you still think that what we call “depression” is just an attempt to medicalize “sadness,” then you don’t know what one or either of those things are. So I’ll illustrate with an example of an internal monologue I have had when I was sad, and one I have had when I was depressed. The subject is the same, but the emotional response isn’t. See if you can figure out which is which!

I really wish I had a partner. It’s lonely not having anyone to come home to and it feels crappy seeing all my friends with their partners even though I know I should be happy for them. Sometimes I wonder if I’m just not that attractive or likable as a person. It seems like I’m the only person not dating anyone. I hope I meet someone soon, but I don’t know when or how that will happen and I’m not that optimistic about it right now. 

I really wish I had a partner. I feel like a complete worthless failure because literally everyone else I know is seeing someone and I’m not. I’ll probably never find anyone and I’ll just be lonely for the rest of my life and there won’t be anyone to call 911 if something happens to me and they’ll find my body in my apartment days later because nobody gave enough of a fuck to check on me. Not like I blame them. I’m so ugly and stupid that I don’t know why anyone would even want to hang out with me, let alone go out with me. Everyone’s probably pitying me because I don’t have anyone and everyone can tell that it’s because I’m completely pathetic. I feel like I might as well not even exist because what’s the point of going through life alone and unloved?

One of those is a sensical reaction to lacking something in your life that’s important to you (a romantic relationship); the other is over-the-top. The emotional response in the second example is disproportionate; it doesn’t make sense to leap all the way from “I’m sad because I wish I had a partner” to “I’m a worthless failure and will die alone.”

That second monologue contains a number of characteristic cognitive distortions associated with depression, such as all-or-nothing thinking (I have to have a partner or there’s no point in even living), disqualifying the positive (the good aspects of my life are irrelevant; it’s all bad because I’m single), mind-reading (everyone must be pitying me), fortune telling (because I don’t have a partner now, I will never have one), catastrophizing (something bad will happen to me and I’ll die alone in my home because nobody will help), personalization (it’s completely my fault that I don’t have a partner; none of it comes down to chance or being in the wrong environment or anything else), and emotional reasoning (I feel like a failure because I’m single; therefore I definitely am a failure).

While mentally healthy people do make cognitive distortions too, mental health is a spectrum: the more you’re able to refrain from thinking in these harmful ways, the more mentally healthy you’ll (generally) be. If you look at the first monologue, you’ll see some slight distortions, like the fear that you’re unlikeable or unattractive just because you happen to be single, or the perception that you’re the only person not dating when that’s obviously not true. But only in the second example do these irrational thoughts become all-encompassing. And, importantly, only the second example involves thoughts of death and suicidal ideation.

Note also that in the first example, being single is causing sad feelings, whereas in the second example, the emotional responses are not primarily caused by the singleness. Perhaps being single is the immediate trigger of the extreme sadness and negativity, but what’s really causing it is depression. A depressed person who is miserable about being single will not stop being miserable if they stop being single; they will usually be miserable about other things. That’s exactly what happened to me back when I was having that monologue. I’d inevitably get into a relationship and then be miserable because I didn’t think my partner liked me enough, or because I was worried about school, or because I felt like all my friends hated me, or because I hated myself, or just because.

Depression can trick you into thinking that you’re depressed “about” something. You’re probably not. You’re depressed because you have depression, and luckily, you can treat it.

Sadness, on the other hand, is about things. You can be sad because you’re single or because you got a bad grade or because you hate your job. Sadness is a normal, healthy reaction to experiencing things that you don’t like. It’s a useful and important emotion because it tips us off to situations that we should try to change if we can. Sadness can prompt us to take a step back and think about things and how we would like them to be better.

Medicalizing sadness and medicating it away would probably harm individuals and also our society as a whole. It would make things pretty boring. Isn’t it great that antidepressants and therapy are not actually trying to do that? Isn’t it great that we can help people avoid catastrophic, paralyzing, life-ruining sadness and fear like the ones associated with mental illnesses, while helping them get in touch with healthy and situationally appropriate sadness and fear? That we can help them understand their emotions and use them to change themselves, their lives, or the world, without having their lives completely governed by them?

Indeed. Depression is not sadness. Anxiety is not fear. Nobody is actually trying to eradicate sadness and fear.

~~~

At Skepchick, Olivia has a great take on this, concluding that:

I do think that it’s important to address our societal phobia of sadness, grief, and pain. But the way to do that is not to throw the mentally ill under the bus by implying they are running from their negative emotions when they seek out treatment. It also doesn’t mean casting shade on the few tools for treatment of mental illness that we actually have evidence are effective. A diagnosis of depression does not say “this person is too sad”. It says “this person can’t function the way they would like to because their emotions are consistently out of control”. There is a world of difference between those two statements.

The Perils of Facebook as a Hiring Tool

My new post at the Daily Dot is about Five Labs, an app that analyzes your personality based on your Facebook profile.

Some employers already try to use Big Five personality tests to assess prospective hires under the assumption that certain traits make good employees. At Jezebel, Hillary Crosley suggests that Five Labs could eventually become a hiring tool:

The tool is still in the beginning stages and isn’t a hardcore hiring weapon yet, but it’s clear how it could be. It could also poses problems because who you are online might not be who you are in an office setting. Maybe you’re awesome at work, but you like to go home and be crazy on the Internet? Technically, non-friends can’t see what you post on Facebook—but let’s be honest, the Internet is open to whomever is interested enough to crack your code.

That last sentence raises some concerning and frankly creepy implications. While it’s generally a good idea not to put things on the Internet (under any privacy setting) that would be particularly deleterious if they were to become widely known, we also shouldn’t consider it ethically acceptable for employers to hack into interviewee’s private online accounts in order to test their personalities.

I’d also question the hiring skills of any employer who’s that desperate to access a potential employee’s Facebook; their education, references, certifications, past work experience, and interview should really be sufficient.

As Crosley points out in her piece, most people do not behave the same way at work as they behave elsewhere. This is normal. In fact, this is preferable. I don’t think I would be effective at work if I acted the way I do at home or out with friends, and I also don’t think I would have any friends if I acted with them the way I act at work.

The expectation that many employers seem to be operating from when they stalk potential hires’ social media accounts is that people should not only leave their personal lives out of the office, but also take their work lives out of the office to everywhere else.

This is dismaying, but not surprising, given that the U.S. seems to have a uniquely work-obsessed culture. For instance, Americanswork more than residents of any other industrialized country, and they take the least vacation time. The U.S. also lags behind other comparable countries in terms of laws regulating sick leave and parental leave.

Being expected to take your office self home and into your online life isn’t nearly as bad as not being able to take paid leave to take care of your baby, obviously. But the two could be symptoms of a general cultural inability to recognize that it’s healthier to work to live rather than live to work.

Read the rest here.

Are Celebrities Responsible for Modeling Good Mental Health?

[Content note: depression, mental illness, suicide]

My newest piece at the Daily Dot is about Lana Del Rey, mental illness, and what we expect from artists and celebrities.

Singer Lana Del Rey has recently reignited an age-old discussion about the glamorization of depression and suicide among (and in) young musicians. In a Guardian interview she has since tried to distance herself from, Del Rey focused on death:

‘I wish I was dead already,’ Lana Del Rey says, catching me off guard. She has been talking about the heroes she and her boyfriend share—Amy Winehouse and Kurt Cobain among them—when I point out that what links them is death and ask if she sees an early death as glamorous. ‘I don’t know. Ummm, yeah.’

[...] It’s unlikely that statements like Del Rey’s actually make anyone go, “Huh, maybe I should try killing myself.” However, they can be harmful because they perpetuate norms that discourage seeking help and prioritizing mental health. Del Rey certainly isn’t single-handedly responsible for this, by the way—mental illness has long been associated with artistic brilliance, glamour, and even sometimes sexual desirability. Some believe that you can’t really be a great artist unless there’s something very wrong with your brain, but I think that’s largely confirmation bias. If you think that artists must be crazy, you’ll pay extra attention to the ones that are and little attention to the ones that aren’t.

We tend to expect that when artists go through difficult times, their way of coping is to make art about it. (Neil Gaiman gave a beautiful speech about this.) Making art can indeed help people deal with all sorts of adverse circumstances, including mental illness, but sometimes it’s not enough. Luckily, some artists, musicians included, have spoken out about seeing therapy and medication when they needed it—not an easy thing to do in a society where mental illness is still stigmatized and being a celebrity means having your private life constantly scrutinized and sold as entertainment.

On the other hand, I’m also leery when celebrities are expected to be “role models” and to demonstrate positive, healthy behavior to the children and teens who look up to them. It would certainly be nice if, when interviewed about her moods, Del Rey said something like, “I’ve been going through a hard time and dealing with lots of sadness, but I’m seeing a great therapist and taking good care of myself.”

But holding her responsible for the mental health of hundreds of thousands of young people is unfair and hypocritical. Del Rey’s young fans would benefit a lot more from seeing their own parents model good self-care, but we don’t encourage that in parents any more than we do in glamorous singers. Instead, we shame people who take poor care of themselves, and we shame people who are open about seeking therapy.

Read the rest here.

Trigger Warnings Are Not “Censorship”

In unrelated news, I have a post up at the Daily Dot today about trigger warnings. Excerpt:

Students at various universities have been trying to take trigger warnings offline by requesting them in certain educational materials. Predictably, even professional and reasonable writers and journalists have responded to this by unleashing a hysteria about “censorship,” “dumbing down,” “suppression of discourse,” “hand-holding,” and other terrible things that will happen if we choose to warn students about potentially triggering material before they read it.

First, a clarification: nobody, to my knowledge, has asked that students be exempted from reading material that they find emotionally difficult. If a professor assigns reading and a student chooses not to do it, that student’s grades will probably suffer. Even if they don’t, though, universities function on the presumption that students are adults who must be allowed to make their own decisions about things like time management, amount of effort put into schoolwork, and so on. Trigger warnings on syllabi do not change any of this.

Much of the panic about trigger warnings in classrooms also focuses on the fear that privileged students will avoid material that makes them uncomfortable. So if you put “TW: misogyny, sexual violence” on a syllabus next to an assignment, male students might think, “Ugh, I don’t want to read about that” and avoid it.

But privileged students already avoid material that makes them uncomfortable; that may be one reason you see way too few white students in courses on African-American literature. Trigger warnings might make this slightly easier, but it doesn’t fix the larger, systemic problem of people choosing not to engage with material that challenges their worldview.

Further, avoiding trigger warnings for the sake of tricking privileged students into reading material on racism, sexism, and other unpleasant topics means potentially triggering underprivileged students by refusing to warn them that the upcoming reading assignment concerns traumatic things they may have experienced. People who lack privilege relative to others are constantly being asked to sacrifice their mental health and safety for the sake of educating those others, and this is just a continuation of that unjust pattern.

Read the rest here.

~~~

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Masculinity, Violence, and Bandaid Solutions

[Content note: violence, guns, mass shootings, misogyny]

We’re all familiar with the pattern now: a solitary young white man goes on a shooting rampage. People die. The media describes him as “crazy,” “disturbed,” “troubled,” “insane.” Everyone collectively bemoans the failings of our mental healthcare system, presuming that its failure is relevant here. People with mental illnesses cringe at the reminder of what our society thinks of them. A few people advocate stricter restrictions on guns. The victims are buried and memorialized, the killer’s parents shunned or comforted, and the killer gradually forgotten.

And it happens over. And over. And over. Again.

Whatever depth there is in this analysis is limited to the parts of the internet where I live. You won’t see the anchors and talk show hosts on CNN or MSNBC or, obviously, Fox News, wondering what it is about white men that produces so relatively many mass shooters–relative to other gender/racial groups and relative to other countries. They will talk about one of two things, mostly depending on their party affiliation: gun control or mental healthcare.

And it’s so difficult to ask them to talk about something else because we should be talking about gun control and mental healthcare. More and better gun control and more and better mental healthcare would vastly improve quality of life in the United States, and maybe in the right combination, could even prevent many of these shootings.

But wouldn’t it be better to fight the ideas and beliefs that lead to violence?

There’s plenty of evidence that Elliot Rodger, the 22-year-old white man who murdered six people and injured seven more in Santa Barbara yesterday, felt entitled to sex with women and hated them for denying it to him. In a YouTube video uploaded just a day before the mass shooting, Rodger said:

You girls have never been attracted to me. I don’t know why you girls aren’t attracted to me but I will punish you all for it. It’s an injustice, a crime because I don’t know what you don’t see in me, I’m the perfect guy and yet you throw yourselves at all these obnoxious men instead of me, the supreme gentleman. I will punish all of you for it. [laughs]

On the day of retribution, I am going to enter the hottest sorority house at UCSB and I will slaughter every single spoiled, stuck-up, blond slut I see inside there. All those girls I’ve desired so much. They have all rejected me and looked down on me as an inferior man if I ever made a sexual advance toward them, while they throw themselves at these obnoxious brutes.

I take great pleasure in slaughtering all of you. You will finally see that I am, in truth, the superior one, the true alpha male. [laughs]

If this weren’t terrifying enough, OllieGarkey at Daily Kos points out that the YouTube channels to which Rodger has been subscribed included well-known men’s rights activists. According to David Futrelle, he was also a commenter at PUAHate, a misogynistic forum that has been down since the shooting. On one forum post, Rodger wrote:

Women have control over which men get sex and which men don’t, thus having control over which men breed and which men don’t. Feminism gave women the power over the future of the human species. Feminism is evil.

Rodger’s various online postings have all the language of sexual entitlement and misogyny: “get sex,” “breed,” “alpha male,” “slut,” “not fair.” I’ve heard this from many men who have assaulted or abused me or others. It is not uncommon.

I’m going to say something that should be obvious: a minority of men think about women in quite this violent and hateful a way. An even smaller minority act on that violence so brazenly. But many men violate women’s boundaries and autonomy constantly, and all men are socialized to think about themselves, about sex, and about women in similar ways.

In the coming days you will hear all about mental illness. (This is because most people only talk about mental illness when they get to blame an act of violence on it, and not when millions of people are merely suffering in silence.) You will hear about how the mental healthcare system failed Rodger, how mental healthcare is too expensive, how there aren’t enough mental healthcare professionals, how insurance coverage is fucked up, how medication doesn’t work or doesn’t work well enough or works too well, how irresponsible parents don’t get their children mental healthcare quickly enough.

You will not hear that, while 2 percent of violent acts can be attributed to people with mental illnesses, people with mental illnesses are four times more likely to be the victims of violent crime than people without mental illnesses. You will not hear about the ways in which people with mental illnesses are discriminated against for many reasons, one of which is that they’re believed to be inherently violent, partially because of how the media focuses on mental illness in the wake of every single mass shooting. You will not hear that Black people who commit violent acts are never presumed to be mentally ill; they’re just presumed to be Black. You will not hear about how it’s only “terrorism” if a brown person does it; the fact that it’s politically motivated and intended to terrorize a particular group of people is not, apparently, enough. You will hear a lot about “not all men,” but you will not hear that misandry irritates and misogyny kills.

You will not hear that boys and men are taught to believe that they are entitled to women’s bodies in uncountable ways, every day, in every setting, by their parents and by the media and by everyone else. You will not hear again about the boy who stabbed a girl to death for refusing to go to prom with him, or about this entire list of women being hurt or killed for ignoring or rebuffing men’s sexual interests, or the constant daily acts of violence to which women are subjected for exercising their right to autonomy.

And before you call Rodger “crazy”: it is not actually “crazy” to believe stuff that’s been shoved down your throat from birth.

I wish it were. It’d be nice if humans reasoned rationally by default, that if you grow up with people telling you things that don’t make sense, like religion or that sex is dirty or that women owe you anything at all, you’d just go, “Well, that makes no sense!” and refuse to ever believe it.

But we didn’t evolve that way, at least not yet. Unless we work very hard at it, we’ll inevitably believe what we’re taught so incessantly, as sexism is taught to all of us. Yet we are all capable of rational thought if we work at it, which is why I hold Rodger and all other men who believe in their conditioning and subject women to violence fully accountable for their actions.

A very good therapist could have helped Rodger with this process. Maybe. But when mass shootings happen and everyone bemoans the fact that the shooter didn’t go to (or wasn’t helped by) therapy, they never seem to ask themselves what this therapy would entail. You don’t go to therapy or go on medication and suddenly become happy. What you have to do is unlearn the maladaptive and harmful ways in which you’ve learned (or been taught to) think. For someone like me, this means learning not to be so afraid and not to treat every minor setback as the end of the world. In Rodger’s case, this might’ve meant learning how to be okay with not having sex with women for a while, learning the social skills to eventually find and keep a partner, and, most importantly, learning that women do not owe him a single damn thing. With that realization might’ve come freedom.

In other words, the way to help Rodger would have been to help him unlearn what he never should have learned in the first place. And there’s no guarantee that even the best of therapists could succeed at this; everyone in the field knows that sometimes clients are just beyond help (at least by a given therapist) and that it’s tragic and sad and don’t we wish we could’ve caught them earlier?

What if our culture had never taught Rodger these horrible beliefs?

What if our culture didn’t still treat women as possessions?

What if our culture didn’t emphasize hypermasculinity and getting laid at all costs?

What if, what if, what if.

So everyone’s going to blame our faulty mental healthcare system now. But let’s do a thought experiment.

A child is born in an area with terrible preventative healthcare. They don’t receive a single vaccine, and they are never taught about healthy eating, hygiene, and exercise. Nobody models good health for them, nobody teaches them in early childhood about the importance of washing your hands. Getting medical check-ups and physicals isn’t even an option. They have no idea what a healthy blood pressure or heart rate might look like. As far as this child knows, a doctor is where you go when you’re so sick you’re dying.

At 22 years of age, this person is now so sick that they’re dying. They have had a horrible diet for their entire life, and they have never treated their body well. They have suffered from increasingly worsening symptoms for weeks, but didn’t realize that they needed to see a doctor. The disease they have is one that they never received the vaccine for. Finally, at 22 years of age, this person goes to the hospital, and the doctors do their best but are unable to save them. The person dies.

Do you blame the doctors who tried but failed to keep this person alive? Or do you blame the entire system, the fact that there was never any preventative healthcare, the fact that they were not given a vaccine and they were not taught the skills to make contracting diseases less likely?

The type of masculinity that young boys are taught is not compatible with mental health and with ethical behavior. Full stop. We’re fortunate that so relatively few will take it to the lengths that Rodger did, but I don’t know a single man who doesn’t suffer as a direct consequence of it. I know few who have never made others suffer as a direct consequence of it. We need to inoculate boys against this harmful and maladaptive thinking rather than teach it to them.

Improving and reforming and revolutionizing mental healthcare is important, but it’s too important to discuss only in the few days after a mass shooting has happened. If this is something you care about, join me in discussing it all the damn time.

Remember this: by the time someone is in their early twenties and spewing hatred and bitterness, it may very well be too late. It’s never too late, however, to work harder at unlearning the lies we are taught about gender.

On Hating Yourself, And All Of Your Selves

[Content note: depression]

The self, as everyone learns in an introductory psychology class, is not a stable or definable entity. “Self” is not a biography or a fashion style or a set of identity labels–it is something more contextual, more situational, more fluid than that. Selves shift depending on who we’re with and what we’re doing and how our bodies feel at the moment and too many other variables to list, and anyone who decries the supposed “fakeness” of being a different person in different situations or with different people fails to realize that we’re all made up of multiple selves, and it’s not always obvious which (if any) are more “authentic.”

What, then, does it mean to hate yourself? If your self is multifaceted and constantly shifting, hating it is like trying to hold water in your hands.

Yet many people with depression or other mental illnesses will tell you authoritatively that they “hate themselves,” and, at least for me, that expression stems from a deep-seeded emotion that I can’t identify in any other way. It’s not a basic emotion like sadness or anger, but neither is it a concrete, System 2-type of thought, such as, “I am dissatisfied with my current approach to dating and relationships.”

All I know is that I feel the thing and I think that I hate myself, all of myself, the parts that come alive when I’m out in the city alone and the parts that only a few of my partners see and the parts that manage to think my way out of this and the parts that were brave enough to leave everything I knew to move here and the parts that make it possible for me to sit and listen to someone for an hour and the parts that are writing this now.

It doesn’t make sense to hate even the selves that I’m most proud of, but I do it anyway. At that moment I don’t want to pick and choose. At that moment I would happily surrender my entire self in order to receive a new one from some cosmic lottery. At that moment I’m convinced that if that lottery created a new me at random, reset all the sliders and let the chips fall where they may, that would still lead to a more optimal result than the one I’m stuck with now.

I’m convinced that it’s such a terrible hand that I hold that I’d rather discard it, reshuffle the deck, and draw anew, than keep playing with the cards I was dealt.

In reality, this is not a good model for personality or self or character or whatever it is that I hate so much. Selves can be improved; that’s the entire reason we have the whole genre known as “self-improvement,” as useless as many of these offerings are. And my selves were not the product of an unlucky draw, either. They are quite predictable results of my genetics, upbringing, environment(s), experiences, and so on. I’m sure that only a small portion of it is really random. While that doesn’t necessarily make me like the results any more, it does mean that they aren’t meaningless.

And on good days I have plenty of evidence that this self-hatred isn’t rational–that is, it doesn’t follow from the premises. One example is the way that I’ve managed to keep steadily hating myself even as I’ve changed dramatically over the last few years. Self-hatred, along with a few other things like love of writing, has remained a constant in my life when little else has. I remember bursting into tears on the band bus my sophomore year of high school and trying to explain to my first boyfriend that I couldn’t be happy when I hated myself so much. And now, eight years later, I have (for whatever reason) this blog and these readers and all these friends who are listening to me repeat the same tired fucking bullshit that I’ve been telling anyone who would listen since before any of these people even knew who I was. I am, more often than I care to admit, still the broken girl trying to communicate the uncommunicable to someone who had no idea what on earth I was on about.

I used to hate myself for being romantic and preoccupied with relationships. Now I hate myself for being cynical (on a good day I call it “realistic”) and apathetic about the whole thing while everyone around me starts serious relationships and moves in with partners and gets engaged.

I used to hate myself for depending on people just to get through the day without breakdowns. Now I hate myself for being unwilling to ask for the smallest bit of help from anyone outside my immediate family.

I used to hate myself for being weird and nerdy and obsessed with science and technology. Now I hate myself for being not weird enough and not nerdy enough and obsessed with the social sciences, except not in the right “scientific” way like all my friends are where you post articles about statistics and meta analyses and replication. (I’m interested in these things too, yes, but I hate myself for not being interested enough in them.)

I used to hate myself for being passive and never speaking up when people hurt me. Now I hate myself for the meticulous boundary-setting I do on an almost-daily basis.

I used to hate myself for caring so much about things like grades and achievement and being the best. Now I hate myself because I can’t be arsed to care.

I used to hate myself for being so pathetically and childishly insistent on telling my parents everything. Now I hate myself for the way I can’t bring myself to even tell them that I’m getting paid to write now, or that I spoke at a conference, or that I’m dating someone new.

Unless I’m just programmed to hate everything, this doesn’t make sense. Rather, it seems that I hate everything that I label as “myself,” no matter what values that self actually takes on.

And maybe everything I just wrote is wrong because I’ve never really hated myself “for” things; I just hated (and still hate) myself indiscriminately. I could accomplish all of my goals tomorrow and I would still hate myself. I could resolve all the unresolved conflicts in my life and I’d still hate myself. I could conquer all the demons and banish all the ghosts and open all the doors and insert more cliches here and I’d still hate myself, because it has nothing to do with who I actually am or what I actually do.

Maybe that sounds depressing and pessimistic, but to a depressed person–or this depressed person, at least–it’s actually incredibly freeing. There is no reason for the self-hatred, or whatever the proper term for that darkness is. I didn’t do anything to deserve it. It is, for whatever genetic or circumstantial reason, just my darkness to live in. For now.