Priorities, When Depressed and When Not: Grief/ Cancer/ Depression Diary, 2/21/13


So there’s this thing that’s making it harder to manage my grief over my dad, and my recovery from cancer surgery, and menopause landing on me all at once like a sixteen-ton-weight, and what can only be described as mild PTSD from having all of these things happening within less than a month of each other, and the depressive episode I’ve been having as a result.

When I’m in a depressive stretch of my life, I have to make managing my depression pretty close to my top priority. And among other things, this means that if I have any impulse at all to do something that alleviates the depression, I do it if I possibly can. If I have any impulse at all to go to the gym, to get outside, to socialize, to write, to masturbate, to get a manicure, to read for pleasure… I do it if I can.

This is actually one of the best pieces of advice I ever got about depression management. If I’m having a hard time getting motivated to leave the house and take a walk, and a window opens up where this amotivation lifts… in that moment, my friend told me, I should get the hell up and get out of the house. The self-perpetuating, vicious-circle nature of depression is one of the shittiest things about it: there are all these things you could to do to make the depression better, but the depression is sapping your ability to do them. (And the depression then makes you feel guilty and worthless and lazy for not having the minimal will power it takes to get off the sofa, put some clothes on, and take a walk.. which then makes you feel worse, which then makes it harder to get up.) So if your brain is giving you a reprieve and offering you a window in which you actually do feel motivated to do things that alleviate your depression, you take that window, and you fling yourself through it.

All of which means that my priorities aren’t what they normally would be when I’m not depressed.

For instance: I’m prioritizing going to the gym a lot more than I normally do. I’m prioritizing getting outside more, which means activities that give me an excuse to get outside are getting prioritized as well. (Take a forty-minute walk to go to the bakery and get a loaf of bread? Sure!) I’m prioritizing things that reliably give me pleasure a lot more than I normally do. And if I have the impulse to write anything at all, I write it… whether it’s on a topic that my normal, non-depressed self would consider a priority or not. (Translation: Yes, I’m writing about fashion even more than I normally do. Writing about fashion is fun, and it gets me writing.)

But I feel like this sometimes creates a problem with the people in my life. I worry that people in my life are thinking, “You have time to go to the gym, but you don’t have time to make a lunch date? You have time to get a manicure, but you don’t have time to give me feedback on my book/ video/ blog post? You have time to blog about fashion, but you don’t have time to blog about this important issue I’m letting you know about?”

I feel like I want to scream to the world, “No. I don’t think getting a manicure or blogging about fashion or going to the gym is more important than whatever it is you want me to do. I think that managing my depression is more important than whatever it is you want me to do. I think that keeping myself away from the rim of the event horizon, keeping the black cloud from descending over my head, is more important than whatever it is you want me to do. I’m genuinely sorry that I can’t do as much as I normally can… but managing my depression is what’s going to get me back into a condition where I do have all that energy I used to have. Please bear with me.”

But complicating this is… well, a few things.

Complicating this is the fact that I don’t have a clear sense of whether anyone in my life is really thinking any of this, or whether this is just the usual critical voices in my head, telling me that whatever I’m doing, I’m doing it wrong. Voices which, inevitably, get amped up when I’m going through a depression. Even at the best of times, it’s hard for me to tell when the people in my life are actually disappointed in me, or whether I’m disappointing my own high expectations of myself and then projecting that disappointment onto other people. I suspect that sometimes it’s one and sometimes it’s the other… but I have a hard time telling which is which. And I have a harder time making that distinction when I’m depressed.

Also complicating this is the fact that I think the whole question of personal responsibility and mental illness is incredibly complicated. This is a very large question that I plan to write about in another piece… but the tl;dr is that I don’t think my depression absolves me of all responsibility to other people. It absolves me of some of it, but not all of it. I think I get to cut myself some slack while I’m working on getting better — but I don’t think I get to cut myself infinite slack.

And complicating this is the fact that these are my own priorities we’re talking about here. It’s not just about what other people expect from me. It’s not even just about what I expect from myself. It’s about what I want from myself, and for myself. I don’t actually think that getting a manicure or taking a long walk is more important than blogging about atheism or having lunch with a friend. And while intellectually, and even emotionally, I get that managing my depression has to take pretty much top priority… on a day-to-day level, doing this often feels like I’m making the wrong choices, like I’m dicking around with trivialities, like I’m wasting the one life I have.

Then again: Part of being depressed is that, with a few exceptions, I’m uncomfortable with almost everything I do. When I’m feeling depressed, with a few exceptions, I pretty much always feel restless and twitchy and like I want to move on to the next thing these days. Even when I am doing things that resonate with me deeply and that I think are important. So that feeling that I’m doing the wrong thing and really should be doing something else… right now, it’s not a reliable barometer.

I don’t know. I think I’m going around in circles here. Thoughts?

Comments

  1. great1american1satan says

    My dude is having the most depressed years of his life right now, which feels a bit like my fault ( :-P ), but yes, this brand of spontaneity is something we’ve endeavored to practice as well. Complicating factors for us: Some kind of sugar crash / hormonal thing makes it so any effective exercise for him feels like being tormented by demons. Going from “I feel OK” to crying in seconds. Plus, we have no car, so our spontaneity options are hella limited.

    Ideas…. Uh, no, but sympathies, big time. Depression is almost impossible for a neurotypical privilege monkey like me to understand. It turns an otherwise loving person into a fucking Dr. Phil clone, of they ain’t careful. Good luck!

  2. great1american1satan says

    Clarifications: that emoticon looks happy. I can be sad while sticking my tongue out, frankly. Also, the person turned Dr. Phil is not the depressive, but the joker that is close to them… How close have I come to saying “Stop doin’ that!” … I’m already bald. I just need moustache dye and a Texan bellow.

  3. Armored Scrum Object says

    there are all these things you could to do to make the depression better, but the depression is sapping your ability to do them

    The fact that you can make the depression better by doing various activities is enormously promising. This is actually one of the most maddening narratives for me to encounter when I’m in a depressive episode (and I do encounter it, because therapists love the hell out of it). When I do the supposedly anti-depressing things, it usually makes me feel worse because I’m then fatigued on top of being depressed.

  4. otrame says

    When I was most depressed, when getting the dishes done after supper was an act of physical courage, I took care of my babies. My kids were clean, fed, and played with.

    I am very proud of that. It took literally every single thing I had at the time, but I did it.

    I’ve been on SSRIs since that time. Went to college, got a Master’s Degree and a profession I loved. Managed being forced to retire from said beloved profession due to medical issues and have been enjoying my free time. I still have occasional bouts that go over the top of my meds, but I always know those times will pass.

    So, yeah, I know depression.

    My advice? If the depression is still debilitating you need to talk to your doc. You might need a course of antidepressants to kick you out of your situational depression. It is not uncommon. You probably won’t need them long. Sure, you’ll work your way out of it without them, but why shouldnt you get out of it faster with a little help?

    The other advice, and this is especially important if you don’t want the meds (which would, frankly, be silly, but some people have an issue) is GYM. Long walks. A couple of hours of exercise a day. It makes a huge difference.

    As a little more annectdotal support, I’ve been watching my son fight his way out of depression and alcoholism without benefit of meds by getting a gym membership and going every day. It is working.

  5. Corey Henderson says

    This is a very accurate portrayal of depression. Most of my episodes went past this point, to where I couldn’t do anything at all. There were no windows.

    Reading this post has helped me realize how much my medication is working. It has been a couple months since I’ve been this bad. I am sorry you’re experiencing this, but if it offers any encouragement at all, whether as a general emotional lift, or to continuing writing, it is this: You are helping others who do not have the ability, energy, or bravery to write.

    Keep it up as best you can, and thank you.

  6. says

    I was diagnosed with dysthemia a few years ago, basically a chronic, low-level of depression deriving from brain chemistry rather than grief or stress. Believe me, I am familiar with the landscaping of the place you are standing.

    What has helped me is mindfulness, basically a Theravada Buddhist approach stripped of mysticism and mumbo-jumbo. It involves being aware of what I am doing and what I am feeling, and being honest with why I am doing or feeling it. It involves learning the difference between self-medicating and lifting my spirits, and reinforcing habits that lead to more lasting pleasure: if I am going to get dressed anyway and go out, I will be happier for longer if I leave my wallet at home and take a book to read in the park than I would be if went to the grocery store for a box of Mallowmars.

    Oh, and it involves telling the critical voices in my head that they are pissy queens who can just fuck off and die, that is an important one. And remembering that when the choice comes down to either laughing or crying, I’m usually better off laughing.

    You don’t mention medication, but that is also an option. Not a short term one, though: it can take weeks for the drugs to build up to theraputic levels, and then you need weeks more once you decide to get off of them. I’ve been on a low dose of bupropion for just over two years now, and it has made a difference for me. It’s not a cure — dysthemia apparently runs in my family and, in my case, is likely genetically based — but it has helped.

    In any case, thank you for writing this. I wish you well.

  7. Greta Christina says

    Reply to a couple of people: I am on meds, and am in therapy. It’s a good suggestion: they’re helping. I’m doing a lot better than I was. It’s just not back to normal yet. I suspect that’s going to take time. Another thing that helps for me (although this probably isn’t universal, and varies depending on how bad one’s depression is) is framing the more depressive episodes as bad drug trips. It’s helpful to remember that the way I’m seeing things at that moment isn’t how things really are — it’s a temporary bout of bad brain chemistry, and I just have to ride it out.

  8. Uncle Ebeneezer says

    Complicating this is the fact that I don’t have a clear sense of whether anyone in my life is really thinking any of this, or whether this is just the usual critical voices in my head, telling me that whatever I’m doing, I’m doing it wrong.

    Is there some historical precedent for thinking that you disappoint people and are unaware of it? Have you had people tell you this sort of thing in the past? In other words, what does the evidence/data suggest? Based on your writing, you don’t really seem like the type that would be oblivious to disappointing those you love. You seem far too conscientious for that, so I’m guessing that you are just naturally hard on yourself (like alot of us.)

    On having lunch with friends, I know just what you mean. I worry about stuff like that too. The best thing I do is remind myself “he/she is probably just trying to be nice and doesn’t really care whether we meet or not.” I figure even if it’s a lie to myself, it’s a fairly harmless lie (with a non-trivial likelihood of actually being true) and allows me not to beat myself up. Frankly, good friends should understand that when you’re depressed socializing often isn’t as attractive an option as staying in or going for a walk alone or writing about fashion etc. And being depressed is all about choosing whichever options are best suited for YOU in that particular state. When you feel better, you’ll wanna socialize more. But until then, you just gotta be a bit selfish, and most importantly, forgive yourself for said selfishness (or just don’t penalize yourself in the first place…easier said than done, I know.)

  9. cthandhs says

    I have a close family member who went through depression after her cancer. She was concerned with something similar, so she told all of her close friends something along the lines of “I’m depressed, so I may be flaky, the most important thing right now id for me to focus on getting better. I would love to hang out and make plans with you, but understand that I can’t RSVP and I may have to cancel at the last minute. If I do cancel, I still love you, I just have to deal with the depression first.”

    It has worked very well for her. Friends who can’t deal with flakiness don’t invite her to things as much, but then she isn’t anxious about pleasing them. When she does get invited to hang out, she knows there’s no pressure, she can go if she feels like it, or not.

    To use a business term, she’s “set expectations” so she doesn’t have to worry about letting anyone down. Whether or not they are let down, or would be, it’s immaterial. She isn’t worried about it.

  10. says

    While I can’t say I understand what’s put you here in this time in your life, I can say that I completely understand what your depression is like. I’ve been dealing with mine for two years now due to my life dealing me a rather shitty hand all at once (more directly personal tragedy than yours, where things are gone that can never come back). I think your first impulse, with treating your depression as immediately as possible as much as possible, is the best first step I think there is a way to get everything closer to “normal’.

    For me my calling has always been storytelling. Whether it’s through prose or a game or critiquing other works, I love to tell stories. When I hang out with people, I tell stories. When I get up in the morning I frame my day as a story I’m in the process of telling. It makes it easier to plan things out to understand them. When I’m depressed, though, the stories just stop. My days become listless and boring with no direction. They become unplanned and messy and I feel abandoned by my own faculties. When I need to get out of this, when I need a story again, what I do is reach out to other people and tell them stories. I ask them to tell me stories about themselves. I build new stories with other people. And that’s really the ringer of it for me – involving other people. It’s easy to get down and depressed when you’re working alone on something that fascinates you or drives you, but if you involve someone else (even if you’re retreading old ground, perhaps especially if you’re retreading old ground) the involvement of literally anyone else can put you back in that place where you can work again. Where you can focus on what you love and want to achieve.

    I think depression comes with a secret and discreet element of self sacrifice. We want to make ourselves humble and avoid others, to be as minimally impacting as possible. So we don’t upset other people, so we don’t stand in other people’s ways. This goes to the point where even things we know we’re good at we stop doing because, at some point, other people will have to be involved and there’s no need to trouble them. The easiest things to do while depressed are those that involve the fewest interactions with other people as possible. The best way to get out of this, I think, is to have someone else who’ll reach into that dark place and encourage you to do things. Anything. The communal work will move around your depression since to inconvenience someone is unthinkable when you’re depressed – you just want to get out of their way. They, however, can be patient and just encourage you to do what you want to do or need to do. Whether it’s for your benefit or theirs.

    That’s why when I’m depressed the best thing I can possibly hope for is for someone to ask me to tell them a story. To describe something. To ask me to do something for them. Then I’m serving again, and it’s not about me -it’s about them. I can get back to me when my impulse isn’t to shed myself as fast as possible out of depression and pain.

  11. says

    I just want to say thanks for this post. My problems and concerns aren’t the same as yours, but the feelings that arise from them, and the urges of what to do about them, are very similar. It’s nice– and helpful– to see it spelled out like this.

  12. hillaryrettig says

    Greta – Sorry you’ve been through such a hard time. It’s amazing that you continue to give – through this blog, speeches, etc. – throughout all that.

    The critical voices in your head may be triggered by the depression / PTSD, but they sound very much like the voice of perfectionism. Anne Lamott, in Bird by Bird, calls perfectionism “the voice of the oppressor,” and it’s basically the voice that tells you nothing you do is good enough, you’re not good enough, etc.

    If you can eliminate perfectionist thinking you still might be left with the depression and PTSD but in a more manageable form. Constantly or frequently having to fight a self-critical voice is in itself demoralizing and depressing (not to mention, fatiguing).

    I wrote an article about what perfectionism looks like and how to fight it here:

    http://www.hillaryrettig.com/what-to-do-if/what-to-do-if-you-are-perfectionist/

  13. johnthedrunkard says

    Hello again;

    Thanks for stirring this pot some more. I had been on SSRI’s (Zoloft, then Cymbalta) for years when last year’s catastrophes piled up on me. I HAVE been able to keep working out, making meetings, writing and talking all along, which must be good.j

    Now I am facing a switch-over in health coverage and might be in a position to get off these meds. I am definitely coming out the the situational depression (going blind, going broke, going on disability, my first lover dying before I could find her etc.) which raises the question of whether my old ‘mild depression’ diagnosis is still valid.

    I worry about having to fight my current GP to get cooperation in trying life on the natch again.

    Thank you again for the update. You have my support (for what its worth) for putting self care above other things. As in the airplane instructions: if you don’t take care of your oxygen supply FIRST, you won’t be able to help anyone else.

  14. kestrel says

    It’s funny how your feelings can influence your perception of things. Like waking up convinced you’ve gained 25 pounds overnight (which is physically impossible) or your hair being glorious one day and a pile of crap you want to shave off the next. Again, pretty unlikely to have happened overnight. It’s a lot more likely your feelings are interfering with your view of the world.

    I just try and tell myself this too shall pass… life is peaks and valleys. And even if I’m in a valley, even if I have a migraine and can barely see (I get the type with the colored sparkles clouding my vision) and I feel really grief stricken (my Dad died too) I still have to go out and do my chores. I live on a farm and have animals. Well, you have cats – I am sure you know how that is. You HAVE to take care of them. You don’t have a choice. That’s actually good for me because it motivates me to go out and do things I otherwise would not, and funny thing is, it often helps me feel better to get back in the house and know all the animals are fed. At least I know I did that right.

    Going by the people in my life, my guess is the people in your life are really great people and are backing you 100%. I think I often don’t give people in my life enough credit; they are cool people and can tell clearly enough when someone is struggling.

    This is a long-winded way of saying, my take on it? Keep taking care of yourself. Hug the people in your life and hug your kitties. You are on the right track.

  15. meursalt says

    I normally lurk here, but you asked for responses, and this is a topic I’ve put some thought into. Stay the course. It sounds like you have an excellent set of priorities. You may feel a bit guilty because society expects certain behaviours and priorities from you. But you of all people know that society’s expectations are not exactly the gold standard of morality.

    This is going to sound simultaneously callous and melodramatic, but I firmly believe that there are times in life where “looking out for number one” should be a top priority. If you don’t take care of your own health first, what good are you to the people you care about? How can you provide support to your friends, family, and community, without supporting yourself first?

    For many people, this affliction is quite literally a matter of life or death. Being miserable all the time is bad for your health, and over time it will shorten your life. You seem to have a good understanding of the self-reinforcing nature of this condition. You can’t turn your back on it. You can’t say “Oh, the depression is minor today, so I’ll just accept it for what it is, and deal with it later.” You should take any opportunity to improve your mood, because if you wait, that opportunity or motivation may be gone when you truly need it. If enjoying some simple momentary pleasure alleviates your symptoms, by all means, do it. A physical workout is probably one of the best non-pharmaceutical treatments for this condition, so don’t skip your gym visits in order to appear more sociable. Your friends are probably more understanding than you realize.

    In summary, I think you’re taking an excellent approach. Humans are social animals, and are prone to guilt when we don’t meet social expectations, so your doubts are natural. But in the end, do what you have to do to be healthy.

  16. bowdsquared says

    Greta,

    As something of a fellow sufferer of depression, all I can say is to do those things that help make you happier (along with the usual caveats of don’t hurt friends/partners). Sometimes they may not understand, and that can hurt. But, you do the best you can. I have some challenges (using business speak) in my life around some of those same issues. Your partner is your lifeline if they understand your challenges. Outside of your partner it is your friends.

    I do wish you luck in dealing with everything, I know my situation isn’t yours, nor is yours mine. I can understand the feeling of being the miserable gerbil on the wheel and hoping to do something slightly different to be able to change the wheels trajectory.

    Hang in there, and I hope things level out.

  17. notreallyalice says

    This sounds like what I went through a few years back. I called it a nervous breakdown, jokingly, and then I looked it up and went, “Oh. It IS a nervous breakdown.”

    One of my roommates said, basically, do whatever it takes. Be selfish. Get through it. We know you’re going through a hard time and you’ve got a pass. Don’t worry about our feelings or what we want, just do what you have to do.

    Turns out that’s hard for everybody. Still, good advice.

  18. postwaste says

    I too, have had severe bouts of depression. I find it interesting and infuriating that while recovering from surgery or illness, one (generally) has ample time to recover, but when it is a mental disorder or disease that same level of basic human decency is lacking. Clearly, more education is needed.

    Take all the time you need. Ultimately, you owe none of us anything. I read your blog, have read your book and find valuable information and insight. You have provided all this essentially for free, because you care. Ignore the naysayers, believe all the gushing praise, and cling tightly to those who love you.

  19. Tethys says

    I’m so sorry to hear that you are going through a rough patch. I agree with Hillary’s diagnosis of perfectionism, which makes the depression/ PTSD/grief/recovering from cancer all at once even more difficult.

    I actually popped in to see if you had posted on the latest episode of Project Runway. I enjoy the way you combine the critique with social issues, and it is nice to have a subject that is completely non-controversial.

    Put on your awesome shoes and go for a walk guilt free, we will be here when you get back.

  20. says

    So the best time to deal with depression is when you’re not depressed. Mental illness is ubiquitous to such an extent that most people have never knowingly encountered anyone who is actually sane. And yet sanity is realizable. Start with a daily meditation practice. Here’s one that will help even when you are depressed –
    Stage 1: Laugh for 10 minutes, for no particular reason, just keep laughing, even if if feels bogus at first, and move your body to help it flow.
    Stage 2: Cry for 10m minutes, wail and sob and beat a pillow to keep it going, but don’t sink into passivity.
    Stage 3: Sit for 10m minutes with your back upright and your eyes closed in any comfortable position, in a chair if you prefer. Watch your breathing, and the other stuff that’s happening in the body. If the mind is still busy, just let it be. Don’t interfere and don’t encourage, just watch.

  21. nautilus says

    For me, “thinking in circles” is one way my depression ( the OCD part), keeps me immobilized, an excuse of sorts. While i respect “thought” by all means, sometimes you just need to GO OUTSIDE…, or DO SOMETHING PHYSICAL to change the brain chemistry. Once the depression subsides, ” thinking” returns to a more productive mode.

  22. Sastra says

    Part of being depressed is that, with a few exceptions, I’m uncomfortable with almost everything I do… Thoughts?

    Ok, this thought certainly won’t rank up there in quality, eloquence, or usefulness compared to what others have written above, but my main thought right now is that part of being a regular Greta Christina reader is that, with a few exceptions, we’re comfortable with almost everything you do. Really. We like you.

    Consider that part of a reality check.

  23. Emptyell says

    Greta,

    I think you are being way too hard on yourself. I’m sure you know this but if you don’t take care of yourself you’re not much good to anyone else anyway. I know it’s hard to keep the right balance especially when thinking in circles. Though I’m probably not one to offer advice. I cope with depression with large helpings of Yankee stoicism seasoned with liberal splashes of California happy sauce.

    Even now you are doing lots of good just posting about your depression. FWIW you inspired me to get off my butt and finally go to the gym (a small thing that is really not so small) and other things that I need to get on with. From what I’ve read it seems others are getting even more out of this post. Besides, you have built up enough credit for your good works that as far as I’m concerned you could retire now to just indulge your heart’s desires and still rank as one of the (much) better persons to have graced this planet.

    I hope you can excuse the sycophancy but your writing has meant a great deal to me. You have been a significant influence in my increased involvement in social justice issues and particularly in my feminism I which I am beginning to move from sympathizer and supporter to activist. I feel I owe you a great deal but understand that the only way to repay that debt is to go out and find my own ways to help others.

    Anyway, thanks for being. Also cheers and best wishes.

  24. maneatinglemur says

    I’ve struggled with depression for decades and I stumbled across this entry at one of the lowest points I can ever remember. Greta, thank you so, so much for this, for articulating feelings I couldn’t put into words and for the insight about looking for those windows. I hope you’re beginning to see some daylight shining through into the abyss, and I hope it helps to know that you gave me a lifeline when I needed it the most. Thank you.

  25. ftbeth says

    I hope you feel better. I registered here for the first time in order to tell you that you have helped me and I agree with Sastra.

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