The most common comment I get since moving to New York City a year ago is that I am too positive for this city and that it will change me. My response every time is that I have worked too hard for my joy, and it isn’t going anywhere.
But I realize that people probably don’t know what that really means. That, when people see me being positive, they assume it’s an inherent trait – one that exists just because it’s who I am.
They don’t realize that I actually have clinical depression – dysthymia, specifically. That the chemicals in my brain are not wired for me to feel okay and that when I say I’ve worked hard for my positivity, I mean it. Literally how I eat, my exercise, my daily habits, my alone time – not only are they built to support my physical health, but my mental health too.
My happiness, my positivity is a choice, but it’s one that I had to learn how to make over years upon years of work, not only personally but with the help of doctors, clinicians, counselors, nutritionists and, at times, medication. Because – just like how my body does not make insulin, it doesn’t create enough serotonin, the chemical that helps contribute to feelings of well-being and happiness. Everything can be going right but without serotonin, my brain does not have the ability to recognize it.
The ability to choose joy now comes after almost two decades of learning how to work with my body. In the moments when I was really in the depths of depression, happiness could not be a choice. There was no willing myself out of depression. If I ever could have, I would.
The only choice I had was to keep choosing to exist, knowing that I didn’t know how long the depression was going to last. Knowing that I didn’t know when this weight, like a heavy blanket I couldn’t kick off, would start to be pulled off.
I first started going to counselors when I was ten, shortly after I was diagnosed with type 1 diabetes (T1D). Depression and diabetes tend to go hand-in-hand, not only because T1D is a heavy disease to manage and the knowledge that I will never not be sick can be debilitating, but because my body already failed to create one vital hormone needed to survive – there’s a good chance it’s not doing so well in creating a whole host of other chemicals and hormones too.
Throughout my teenage years, primary care physicians, teachers, and endocrinologists all pointed out that they thought I needed to be getting help for my depression. I tended to respond with my more polite version of ‘screw you.’
I had a lot going on in my family life and I felt like it was a personal insult that they wanted me to get help. In my mind, I was being strong enough to handle the shit show that was my world so OF COURSE I felt like hell sometimes. It came with the territory of a broken home. It was my right and certainly didn’t mean that I personally was broken in any way.
It wasn’t until I was out of college that I started realizing that maybe the days of sinking wasn’t quite so normal. That, on a day that should have been like every other day, maybe being so overcome with darkness, sitting on the floor in my living room crying, unsure of how to help myself wasn’t something that I should be going through. I became scared that if I didn’t get help, maybe I wasn’t going to be okay. Because nothing – nothing that I loved to do, no one that I loved to spend time with – could have pulled me out of it, and I was deeply afraid that that darkness was going to be the rest of my life.
I started going to both a psychologist and a psychiatrist. My psychologist would help me talk through issues, examine coping skills and behaviors, and learn how my brain worked so I could better help it. My psychiatrist would talk through how I felt myself responding to situations, and from there – after a few truly awful experiences with other classes of medication that left me with extreme social anxiety, or panic attacks, or horrible night terrors (and sometimes a lovely mix of all three) – we figured out that I should try a class of psych medications called SSRIs, which help the brain hold on to more of the serotonin it produces, rather than it being reabsorbed.
No psych medication is ideal. There’s no way to figure out which one will work for you without trial and error. They all have side effects. It comes down to whether or not the side effects are worth it for you.
For me at the time, they were. I no longer experienced the extreme lows I used to. The issue became that I didn’t experience highs either, I was just always very level. Over time, that started to weigh on me, but at the start, it was just so nice to have a break from being desperately depressed. In the beginning, the weight gain, the lack of desire to actively engage with anything new – they were better than the inability to get out of bed, or eat, or interact with anyone.
Being on medication helped me avoid situations like when I was in the middle of a Macy’s and the fact that I couldn’t decide what pants I liked became the thing I couldn’t deal with, sending me into a fit of tears and feeling like I couldn’t support the weight of my own body. Those situations made me feel weak. They made me angry at myself. It pissed me off that I couldn’t just be normal. That, when I looked up at my mom and her husband, they were staring at me like I was being a brat, but I just couldn’t figure out how to be okay.
I felt like I was trapped in my own sadness without any ability to get out and, for a while, medication helped me out of that hole.
But over time, I realized that I wasn’t feeling the best I could. The SSRIs helped me survive, but I wasn’t thriving. For me personally, I didn’t feel like they were the best solution for my long term well-being.
So with the help of my doctors, I slowly weaned myself off of them and started leaning heavily on nutrition, exercise, meditation, yoga, acupuncture, nutritional supplements, journaling, and mountains upon mountains of personal development work. And even still, on some days, it’s not enough. Even after five years of this constant work, on some days I still sink, and I have to sit and assess where the sinking is coming from.
Did something happen? Am I stressed? Did an event bring on the sinking feeling?
Or is there something physiological going on? Did I forget to do something that would have helped my brain create the chemicals I need to keep going? Did the antibiotics I had to take for strep throat wipe out the good gut bacteria that help me hold on to serotonin? Are monthly hormonal cycles sapping out my energy? Did I consume gluten or dairy or any of the other myriad types of food that send my body out of balance (since the other place serotonin is created is in the gut)?
I’ll often go for months feeling absolutely fine. Calm. Collected. Unbothered. And then literally nothing will change in my actual life but all of a sudden I can’t cope. Everything feels immovable. Getting through the day feels impossible. Dragging myself out of my bed literally feels painful. It’s from a deep sinking feeling. Like nothing can go right. It feels like failure all over again – haven’t I been through this? Didn’t I fix this? Why again? Why now?
It all requires me to be tapped into my body and my mind on levels that I cannot explain. And often, that’s just not enough. Sometimes I end up curled up in a ball again, willing myself to remain calm until it passes, however many days or weeks it takes. All I can do is talk myself through it, being as kind as possible to myself until it goes away.
It’s incredibly difficult to do. Because not only are you dealing with an actual sickness, but with one that cannot be measured. There is no way for any doctor to measure whether or not my brain is creating adequate amounts of serotonin. I can check my blood sugar and give myself insulin if I need to – I cannot check my brain chemicals. So I must constantly be in tune.
And that’s what I mean when I say I’ve worked hard for my positivity. It’s not because I’ve not gone through anything. It’s not because I’m a happy-go-lucky, everything-is-sunshine-and-rainbows, type. It’s because my brain has been in total darkness before. I’ve been in states where I did not want to keep going and I had to fight, with every ounce of courage I possess, to convince myself to do so. And that is the hardest thing I will ever do.
For some, they couldn’t fight through it. And it didn’t meant that they weren’t strong. It just meant that the darkness was stronger. And I am acutely aware of what that means, and how thankful I am that, for some reason, I was let go.
So no. My positivity isn’t going anywhere. I worked hard for this. I will always work hard for this.
If you feel like you may be dealing with depression or any other mental illness – including reliance on drugs or alcohol – please know that it is just as much of a serious condition as my type 1 diabetes, or cancer, or anything else that people tend to see as more “real.” It is diagnosable. It is treatable. You can get help, and you owe it to yourself to take this seriously. Because if you don’t, you could die. And from me to you, please don’t let yourself do that. You are too valuable and I appreciate having you in my world.
Talk to your primary care physician or if you don’t have one, to the doctor at your local walk-in clinic – they can refer you to someone who can help. If you’re lucky enough to still be in college, most campuses have free, private, on-campus counseling. Do take advantage.
And if you need medicine, that is not a failure. Just like I give myself insulin because my body can’t produce it, your body may need help creating the chemicals to help you feel okay. Admitting that you need help, because you do, is courageous and I am proud of you. Be proud of you too.
THANK YOU to those who jumped in on our Facebook discussion about what depression felt like. I wanted to share a few of your answers in case it helps anyone else:
“It’s not the WANT to not do anything. But rather the INABILITY.”
“That you may KNOW you have 1 million reasons to be happy and thankful, but you are unable to come out of your darkness regardless.”
“…depression does not always look like “sadness.” Sometimes it’s rage – like flying off the handle suddenly when someone tells you “Just go for a walk!”
I’m all for using physical activity to lessen the effects, but DAMN that was insulting when someone who had never experienced that bleak place popped off with that.”
“That it’s super compounding because you feel like you should just be able to will yourself out of it, or be able to make yourself do simple things but you can’t, so you feel even more like crap because you’re getting down on yourself for not being “strong enough” in addition to already feeling terrible.”
“I call it “sleeping” over the course of years. It’s the cycle of staying in unhealthy situations, relationships, and places for longer than you need to because you’re “asleep”. You didn’t even know you gave up because of the depression, you just did. Then you “wake up” at some point, terrified you don’t recognize or really want the world you created. You may even find some health and desire an upswing. From there it varies on if I can find a way out, depending on the “dreams” that took place but invariably the cycle starts again. From the outside it looks like you’re flighty and irrational, even though you’ve been working internally for years. Kind of like sleeping.”
“That depression is really hard to describe. It’s not just sadness, or lack of motivation, or physical manifestations….the only way I could ever describe it was that everything was muted and I felt like I was living under a leaden blanket. And because it’s so hard to give it a “sensible” description, it can be really difficult to realize what’s happening and get the help you need.”
“That sometimes even getting out of bed is too much, and then you feel like a lazy piece of shit for staying in bed all day, and then you feel even worse and less able to get out of bed. See also: cleaning, laundry, bathing. That when you snap at your friends and family members it’s not because you’re mad at them, it’s because you’re mad at yourself. Deeply. All the time. That you desperately want companionship but are afraid to ask for it because you don’t want to seem clingy and drive your friends away (because obviously they have better things to do and closer friends to hang out with- you’re probably just like, the back-up friend). That you can’t sleep because your mind is racing with perceived slights, things you should have said, and every embarrassing or shameful thing you’ve ever said or done.”
“That it’s an illness and needs to be treated as such. There is so much stigma associated with mental health issues that only compounds the problem for sufferers. Also, that depression coupled with anxiety is an awful battle raging inside the mind.”
“Depression is physically painful. – Here’s a fact I have found surprising: Acetaminophen (Tylenol) works on the central nervous system. Therefore, it can be used to treat the physical pain of depression or loneliness. (Yet it can reduce feelings of happiness, as well). We tend not to realize how much our sensation of emotion relies on physical sensations in the body. Panic is butterflies in the stomach. Anger is a sensation of heat and tension. And so depression comes with physical sensations, too. Anti-depressants can blunt not just the “psychological” aspects of your emotions, but also the physical ones.”
“Depression is real even though it seems like it’s all in your head. And that even though I can smile, I have been practicing this fake smile and demeanor for a long time.”
“…depression looks different on everyone. And that it can be hidden behind the brightest of smiles. That it can be like a roller coaster.”