What to say about depression?
Well, for starters, it sucks! I can’t think of a better place for shame to reside than in the depths of a depressive episode. Spend a few days, weeks, months, feeling sad and hopeless, struggling to get out of bed or sustain any kind of forward motion, isolated from your family and friends, ruminating about past injuries and mistakes, and see how you feel about yourself. Hopefully, you will have identified the previous sentence as sarcasm and know that I don’t wish for anyone to spend any time in depression if you can avoid it, it’s awful.
The last two years have brought with them an increase in depression and the damaging behaviors that sometimes accompany it, substance abuse, self-harm, suicide, etc. Recognizing that this time period corresponds to a global pandemic lends further credence to the idea that depression is mainly an environmental condition. I can’t imagine that it’s difficult for anyone to understand how widespread loss of loved ones, livelihoods, and meaningful connections with others, are linked to intense feelings of sadness and a fear that life will not get better.
Therapists and other health workers may have a special window into the broader impact of the pandemic and other environmental causes considering that many of us are meeting with upwards of seventy different people every two weeks, representing hundreds of their and their family’s experiences. For myself, I see this as a double-edged sword. I get to be a part of clients’ major life changes and get to see their strengths, resilience, and humanity first-hand. Sometimes this also means that I get to hear about all of the terrible things people are capable of and do to each other. Consequently, many of us who have remained in the profession have been struggling with feelings of sadness and helplessness right alongside our clients.
The second thing I will say about depression is related to my general statement about therapists and depression and it is that I am regrettably familiar with, and in what I am certain is an unhealthy way, somewhat comforted by occasional periods of despondency. I often feel a sense of safety in the isolation my melancholy brings me, wrapped in a cocoon of grievances about the world, how it works (or doesn’t), and how I’m treated. Although the truth is more complex, at times I think I lack the mechanism that would help me identify times when my brain and my body need a break and it is here that I think what may be the function of depression is revealed. What often happens for me is that a well-intentioned desire to help, coupled with an excessive seeking of validation from others, exert sufficient pressure to have me ignore the signs that would signal an impending breakdown, necessitating my brain and body to hit the emergency shut-off switch to prevent further damage from occurring.
In a previous post, I compared the onset of a depressive episode to the emergency shut-off mechanism one might find on a conveyor belt or other potentially dangerous piece of production equipment. The comparison I offer is not meant as a cure for depression but simply as a frame for viewing depression that may alleviate the shame associated with depressive episodes. I find that a functional lens helps refocus on the practical aspects a depressive episode may be providing clients, outcomes that may be achievable with less debilitating consequences. Success in identifying the conditions that necessitate the abrupt shut-down of our human equipment, our brains and our bodies, may provide us enough time to slow down whatever process we’re undertaking and prevent the intense stops and starts that rob us of our energy and hinder our progress.
When I conceptualize depression in this fashion, I am reminded of a time when I worked for a major shipping company, unloading packages from their planes at the airport. It was a relatively, straight-forward operation. The packages would come off the plane in large crates, shaped like a cross-section of the plane’s fuselage. The crates would then be transported from the plane behind a towing tractor and brought to the hangar where the package handlers were waiting to unload them onto a conveyor belt where they would be further sorted and distributed to the awaiting delivery trucks.
Although the unloading and distributing of the packages took the most time each day, some time was spent each morning on preparing and checking the equipment to ensure that there were no issues that would prevent their smooth operation once the planes arrived. There was a collective recognition that despite the unknowns regarding when and what would arrive with the planes, starting the process with worn-out or faulty equipment was inefficient at best and dangerous at worst. By comparison, any time spent evaluating our own coping strategies and our energy levels before facing our daily challenges, has tremendous value in preventing our human equipment from needing to be shut down before it has finished whatever task we have asked it to complete.
Once the packages hit the conveyor belt, there are many issues that can arise. Perhaps the most obvious would be an object or worse becoming lodged in the belt and causing it to stick. A conveyor belt that had become stuck would quickly burn out the equipment turning it. Much like in the production line, there are many situations in life that may cause us to feel stuck. Injuries and chronic illness can be exhausting. Relationships that continually overwhelm us and circumstances that we just can’t seem to change no matter how hard we try (think financial challenges, body image issues, dead end jobs, unemployment, complicated grief, etc) can quickly sap us of our energy and optimism, and burn us out.
Another issue would be the pace and consistency with which packages come down the conveyor belt. Packages at the airport came in waves. There would be short periods of inactivity while waiting for a towing tractor to dump its contents on the belt, and then a surge of packages piled on top of one another when it did. Similarly, a package might come down the belt that represents an acute challenge, it may be much heavier than the other packages or oddly shaped and difficult to move without assistance. At the airport, we had two methods of dealing with this condition, a speed setting on the belt that could slow the packages down, and an empty crate at the end of the belt to catch any packages that did not get sorted in the first pass. The lesson here for avoiding a shutdown is that when life is sending stressors your way faster than you can handle them, it can be helpful to slow your pace and to let some stressors pass you by. You can remind yourself that appealing as they may be, not all of the packages (stressors) that come down the belt are meant for you, and if they are, they are likely to come back around.
Although all of the previous metaphors point to strategies for preventing one, sometimes, despite our best efforts, shutdowns still occur. Similar to the pain and swelling that correspond to a physical injury, a depressive episode may be our brain and body’s way of requiring us to rest and recover after an injury to our psyche. And just like a physical injury, it will take time and effort to fully recover our mental and emotional capacities.
In the production line, two or three shut-downs in a row, or a lengthy period of time standing idle had a demoralizing effect on us package handlers and would make it difficult to maintain or recover momentum. Additionally, there could be the frustration of knowing that you had a part in why production was shut down or even worse, you could be aware of the frustration of others pointed in your direction. Many of us have a tendency to beat ourselves up over what we believe are avoidable mistakes. Therapists recognize this as shame and strive to help clients move beyond self-punishment. The lessons to be learned after a shutdown are only valuable in preventing future mistakes, insight does not turn back the clock. Fixating on the past beyond allowing it to inform us of what not to do in the future, is wasted energy, and being frustrated over the time it takes to get started again often prolongs it. Our best bet is to allow ourselves the time needed to fully recover from our emotional injuries, learn from past mistakes, make adjustments, and then start putting one foot in front of the other until we find that we’re moving forward again.
As with any mental health concern, if you or someone you care about is in the midst of a depressive episode, or struggling to prevent one, you may need to seek help from a trusted professional like your family doctor or a counselor to help address these issues and to help let others know how to be supportive.