Content note: Depression. Obviously. (Also note that this post has a somewhat different comment policy than usual: it’s at the end of the post.)
There’s this analogy I’ve been using lately to think about my depression and my mental health care. I’m finding it useful, so I thought I’d share it with the rest of the class.
I’m not the first person to describe depression as feeling like being in a pit. And as my depression has been getting better (in the classic “two steps forward, one step back” fits and starts), I’m not the first person to describe that process as feeling like clawing my way out of the pit. But there’s another stage of mental health recovery, the stage I’m in now, that feels somewhat different.
For some months now, I’ve felt more or less okay most of the time. But that okayness has felt somewhat shaky. Easily disturbed. Fairly small things make me feel bad out of all proportion to the badness; large things, or even medium-to-large things, can trigger a recurrence of the depression, or of some of the depressive symptoms.
And my mental health care has to be very carefully managed; my mental state rigorously monitored, my self-care precisely titrated. I need exactly the right amount of rest and sleep — not so much that I get torpid, not so little that I get exhausted. I need exactly the right amount of socializing — not so much that I get exhausted, not so little that I feel isolated. I need exactly the right amount of alone time — not so much that I feel isolated, not so little that I get overwhelmed. I need to spend exactly the right amount of time on work, exercise, meditation, pleasure, so I feel calm and engaged rather than overwhelmed, or aimless, or both. Small excesses in any direction have to be adjusted for immediately, or they can easily push me into the bad place.
This is not what I’m like most of the time. Of course I’m made happy or sad by external events; of course I try to keep work and pleasure and rest in a healthy balance. But when I’m not in the middle of (or recovering from) a serious depressive episode, I’m generally on a pretty even emotional keel. My basic outlook on life is not only steady, but is largely self-generated. And I can have stretches where my work and pleasure and rest, my time alone and my social time, are temporarily out of whack. I want them to balance out in the long run, but I can have longish stretches where I’m busting my ass to finish a project, or am running around being a social butterfly, or am lying around being lazy, without it risking my mental health.
It hasn’t felt like that lately. I feel like every step I take has to be small, and careful, and intensely conscious. And I feel like even if my steps are small and careful, I could easily be knocked off balance by a stiff breeze. I feel like I’m walking on a balance beam that’s suspended over the pit.
A few weeks ago, a couple of crises arose. (That’s generally what triggers a depressive episode: I can usually handle one bad thing in my life, but multiple serious stressors are what knock me into the pit.) So a few weeks ago, a couple of crises arose — and it felt like I’d been knocked off the balance beam. It didn’t feel like I’d fallen back into the pit, exactly. But it felt like I was clutching onto the balance beam with my fingertips, dangling over the pit, scrambling to pull myself back up. I got back on the beam again — but I felt wobbly, and my footing was shaky. And then another crisis came along, and I got knocked over again. I’m just now hoisting myself back up, and am trying to regain my footing.
So when it comes to mental health care, I feel like my job now… well, right now, today, my job is to hoist myself back onto the beam. But once I’m back on the beam, and my footing is steady and I’m not wobbling or flailing, I feel like my job is to widen the balance beam — so it’s more like a catwalk, or a bridge, or a platform. I’m doing carefully managed, rigorously monitored, precisely titrated self-care, partly because in the short run it keeps me on the balance beam, but also because in the long run it widens the balance beam, and makes it more stable.
I want to get to a place, not just where I don’t feel depressed, but where I can get bad news or have a bad day without it making me depressed. I want to get to a place where I’m not being knocked about by every gust of wind that comes along; where my mood isn’t totally shaped by whether the last thing I saw on Facebook was happy or sad. I want to get to a place where my mood is shaped by my fundamental optimism and empathy and high energy and general good nature, as much as (or more than) it is by the crisis of the week. I want to get to a place where I’m not constantly thinking, “What would be best for my depression now? Would it be better to finish that blog post? To go to the gym? To go to the cafe? To masturbate? To meditate?” I want to get to a place where I don’t have to drop everything and do self-care the moment I feel inspired to, because I don’t know when that window is going to open again.
The pit is always going to be there. That’s what it means to have chronic depression, even with infrequent episodes. I’ll never be able to ignore it entirely; I’ll always have to do some degree of mental health self-care to keep from falling into it. But I want to get back to a place where I don’t have to devote rigorous attention every waking minute to my mental health care, and can just get on with my life.
Comment policy for this post: It sucks that I should have to spell this out, but past experience has taught me that I do: Please do not give unsolicited amateur medical advice, to me or to anyone else with mental illness, in the comments. Or anywhere, for that matter. Talk about your own experiences until the cows come home; ask questions until you’re blue in the face (except for douchy passive-aggressive question like “Why don’t you understand that psych meds are poison?” or “Will you read this article explaining why psych meds are poison?”). If you need this spelled out in more detail, please read Why You Really, Seriously, No Fooling, Should Not Give Unsolicited Amateur Medical Advice to People with Mental Illness (Or to Anyone, Really), Episode 563,305. Thanks.