[Content Note: Depression, Surgery]
One of the really frustrating things about depression is how well it succeeds in camouflaging itself as a "nothing" disease, the mental equivalent of having a touch of sinus drainage in the morning, or of needing your joints to warm up for a few minutes before you can really hit the ground running.
Part of this is social, I think. As a society, we really don't take mental diseases seriously at all. When I left the hospital after my surgery this year, I was given an entire notebook of instructions on how to take care of myself, what activities I can and cannot do (as well as an honest-to-god timeline on when those activities magically become available to me!), what dangers are posed to the hardware in my back and to the bone grafting process in general, and who I can call for help if I experience any serious issues during recovery. But no one, at any point in this process, said to me, And oh-by-the-way, the meds you're on might make you severely depressed, in which case you should call this number.
I'm ridiculously fortunate in my fate. I have a loving and supportive family with the privilege and finances and kindness to carry me through this. I have a mother who researches medications on a regular basis and who was able to warn me at the first sign of serious trouble that my emotions were no longer under my control. I have a number of social networks that have kept me afloat. And I have a definitive cause for my depression (medications) and a multi-step plan for getting off that cause and hopefully away from the depression. Having a concrete "reason" for depression and a set exit strategy from it is helpful beyond belief. In all these ways, I'm one of the lucky ones -- but it doesn't mean I was taken seriously by society at large or by my own dedicated health professionals.
Beyond the social notion that depression is really nothing to get all het up about, there's a lot of personal minimizing that comes along with depression. Depression can by its very nature be utterly self-loathing and terribly minimizing. There's an internal voice that has come along with my depression that has consistently minimized the effect of depression ("It's just a bit of sadness. Perk up and deal with it.") while constantly criticizing myself for not accomplishing more, and for not accomplishing the "correct" things.
I was raised with a Puritan work ethic. I was raised to believe that work came first, and then you played. If you didn't have enough time to do all your work, then you didn't get to play. You played "catch up" until the work was done, whether that took a day or a year. Bootstraps!
Depression has, for me, magnified that work ethic into a terrible impetus that has several times driven me into a dark spiral of helplessness and self-loathing. The depression would keep me in bed a little later, watching TV just a little longer. That "play time" then cut into my self-assigned "work time", and I would end up blogging a little less, answering fewer emails, addressing my medical bills a little slower than I felt that I should. When the depression buckled down on the loathing because why are you not getting you work done, Ana, then the cycle just got worse: more bed, less work, more self-hatred. Lather, rinse, repeat.
And depression is able to get away with this vicious cycle because it pretends that you're not really sick.
So you don't get a break from your "work time" because you're not really sick. You're a little sad, yeah, but who isn't and doesn't practically everyone grapple with depression from time to time and aren't they all doing pretty well, so you don't get an excuse. No slackers around here! And this is completely bullshit for a number of reasons, but because you genuinely do care about getting your work done and being a useful person, you either buckle down and work yourself into the ground, or you fail to do your work because your body simply can't or won't cooperate and you end up loathing yourself even more. What successes you do have get chalked up as nothing more than the bare minimum anyone could do; your inevitable failures are magnified into full-blown character flaws.
(And I say "inevitable" there quite consciously, because you will fail at times. For years now, I have kept a daily To-Do list. I almost never finish every item on that list because I always underestimate how long it will take to complete tasks. It was only after my depression, however, that my daily failure to complete all my tasks became a serious source of anxiety for me. Suddenly I was a terrible person -- not because I estimate tasking time badly, but because a good person would be able to complete all her tasks in time, regardless.)
Also, you don't get more "play time" when you're suffering from depression because you're not really sick. So anything that could reasonably be chalked up to a healing process or a coping mechanism -- sleeping more, playing video games, looking at bright colors, re-organizing discrete items -- is really just you playing around when you should be doing real work. And every moment you spend on this "play time" is a moment wasted, which just goes to show that you really are a terrible person for wasting all this time and potential productivity.
These are all things that the depression has led me to think in the past few weeks. They're also garbage.
If you are suffering from depression, then you are really sick. Yes, you really are. Depression is a real illness, it's not 'just' something that you can banish on demand. Whether you suffer from it daily or weekly or a couple of times a year, when it's on you, you are really sick, just as my mother is really sick with allergies even if they only flare up at certain times of the year (spring) or in certain places (theaters) or in conjunction with certain stressors (other illnesses).
When you are really sick, there's still unavoidable work to be done. But you have an official pass from me to prioritize. To decide what really, really needs to be done and what would simply be nice to be done. You have the right to let low priority things slip as needed. You have the right to ask for help to complete your work. You have every right to be proud of the things you manage to accomplish while sick, rather than feeling upset with yourself that you didn't do more. You are really sick; everything you manage to do while sick is something to pat yourself on the back for.
When you are really sick, there's all the more need for rest and play and self-medication. You have every right and reason to rest when your body requires it, to play games that will perk you up, to look at soothing things or spend time completing small, concrete tasks that bring you pleasure. Seeking pleasure and distraction and calm isn't a character flaw -- it's a sign that you are unconsciously aware of your illness and you are taking steps to treat it. You are really sick; any change in your routine that helps you to feel better is a change that acknowledges that. Intuitively treating your disease is something that you should be proud of, not something that you should criticize yourself for as one more piece of evidence that you are lazy or procrastinating or slothful.
It's not always easy to remember all this. Society doesn't take depression seriously as an illness, and depression itself isn't conducive to that kind of self-diagnosis. It's hard to think of ourselves as being ill, because it would be so much easier if the depression were just a spot of sadness that a few more tugs on the bootstraps could clear up. But if you believe that you struggle with depression, then it's alright to believe that you are really sick. It's alright to play a little more and work a little less, just as it would be if your arm were in a sling or if you'd just been through major back surgery. It's alright to ask for help.
If you are really sick, please don't beat yourself up for being sick. Sicknesses can't be healed by willpower alone, or even necessarily by time or medicine. My surgical incision heals on its own time, scoffing at medications and topical ointments. My back will never be fully straight. The fact that I can't change these things -- the fact that they affect what I can and can't do, and what kind of work/play balance is healthy for me -- does not make me a bad person. It makes me a person struggling with a serious illness.
The same is true for depression.