On Depression

advice-iconIn surfing the transgender blogosphere, it’s not unusual to come across people suffering from depression. Clinical depression certainly isn’t unique to those of us with gender identity issues, but perhaps our alienation from the larger society makes it more likely to occur, or it may increase the severity when it does. So I’d like to take this opportunity to offer a bit of advice based on my own struggles with depression.

Here’s one thing I’ve learned: depression is not part of who I am. It’s a separate thing that I have to live with, but it’s not me. It’s something that invaded my mind, or grew within me, like a tumor or a virus.

This is how I figured it out. When I was depressed, I’d worry my problems like a dog with a bone, because I thought they were the reason I felt so lousy. One day, I realized that those same issues didn’t seem quite as bad when I wasn’t  depressed. It was puzzling: one day I’m able to deal with my problems (or at least co-exist with them), but the next day they seem insurmountable. What changed? It certainly wasn’t my problems; they’re pretty much a constant. The only difference was the depression itself.

It’s human nature: you get depressed and then try to figure out why. Big mistake. We’ve all got problems, so if you go looking for a reason you’ll always find something. But clinical depression doesn’t need a reason; most often it just happens, like the flu. Looking for a reason is pointless.

I’m not trying to downplay anyone’s pain. We all have problems, and some are certainly larger and harder to handle than others. But it’s also important to distinguish between depression, as an emotional response to a difficult situation, and clinical depression as a type of mental illness. The terminology is confusing, with the same word used to label two very different things. They only appear similar on the surface, to other people.

This isn’t just splitting hairs. It is absolutely necessary to separate your life problems from your illness. They are certainly entwined, with one making the other harder to deal with, but they are not causally related. Clinical depression is caused by either (or both of) a chemical imbalance in the brain or life-long unhealthy mental habits (low self-esteem being my choice); it is not  a direct response to the issues you’re struggling with at the moment.

All well and good, you might say. But what can we do about it?

Here’s what I do. I like to think of depression as a mean little toad crouched in the back of my mind saying bad things about me. All those negative thoughts that bubble up when I’m feeling down—they come from the toad. But his mind is not my  mind, his thoughts are not my  thoughts. (This is the opposite of a Vulcan mind-meld.)

I’m not just being flippant. Humor is one of the best weapons we have for dealing with depression. If it helps me or anyone else to conceptualize this illness as an odd-looking amphibian, then so be it. If a tool works, use it; if it doesn’t, use something else.

You can also do this: blame the toad. Not for the depression itself (which would be circular reasoning), but for the negativity that comes with it.

Like I said, the toad’s thoughts are not your thoughts. He has his own agenda, which is to make himself more powerful by making you feel worse. And he’s not fussy how he goes about it. He’ll twist the truth, overlook your good points, obsess over your failings. He’s a liar, a cheat and probably the meanest bastard you’ll ever meet; after all, he’s a toad. But he’s not you.

Weaken the toad by disowning all that negativity. It’s not you, it’s all him. The toad wants you to lie in bed thinking about how worthless you are, because that makes him bigger and stronger. So do something else.

Get up and wash your face. Feed yourself (something healthy, not leftover cheese doodles). Read, draw, sweep the floor, do situps, go for a walk. Exercise is often mentioned as a treatment for depression, but the main reason it works is that it gets you doing  something. Anything that gives you a sense of accomplishment, however small it might be, will shrink that toad (bearing in mind that unhealthy things like junk food, pessimists and daytime TV can have the opposite effect).

This is important: don’t worry about what you should be doing, just do what you can. (The toad loves the word “should” because it makes people feel guilty.) Worrying about things you can’t do only strengthens the toad. Try to live in the moment; the toad hates that.

This should also apply to your work life. A lot of people will tell you what you “should” be doing—to keep your job or to get ahead—but that’s just feeding the toad. Do what you can and most often you’ll find it’s enough. And if it turns out not to be, in some situation, then the best thing might be to accept that this particular environment is too stressful for you and it’s time to move on. That’s a worst-case scenario, but it’s better than being depressed. Starving the toad has to be job number one.

That mean old toad may never fully disappear, but leave him muttering to himself in the basement where he belongs and I think you’ll find that life in the rest of the house can get back to what passes for normal.

I hope this helps.

Amanda

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PS. I recently told someone on a message board that their feelings of worthlessness were “not real”. On the face of it, that may seem an absurd thing to say. Of course my feelings are real!

Let me take a moment to explain. A feeling like this is real in the same way that a sore throat is real, as a symptom of an illness. But no one would describe a sore throat as an integral part of who they are. Even if it’s there long-term, it’s not a normal part of being human and it’s still a symptom of an illness. It’s the same with the sort of feelings caused by depression.

Consider the parallel with a physical disability, like being unable to walk. To an outsider, this might seem to be an integral part of the affected person. But it’s striking how strongly that attitude is rejected by people who have to live with such challenges, and who often state that they do not  want to be defined by their disability. In my opinion, depression should be regarded the same way, as a kind of disability. And the feelings it creates are not part of the affected person; they belong to the disability (i.e., blame the toad).

10 thoughts on “On Depression

  1. Thank you very much for this post, it is very helpful advice for me right now and largely fits my own situation, in how my depression seems to manifest randomly and leads to me dwelling on things that don’t particularly bother me when my mood is better.

    Keeping in mind that your self and your depression are separate from each other is immensely helpful to me, and a different take on things than I’d encountered elsewhere for dealing with depression.

    Thank you very much, – B-Rex

    • I’m glad it helped. It’s sort of an on-the-ground “view from the inside” take on depression, so it’s different from the “view from the outside” that we get from medical people. And it’s something we have to keep in mind, even when we’re feeling better, because (as we all know) negative feelings can sneak up on a gal. Take care of yourself, B-Rex. You’re not alone in dealing with this.

      By the way, many thanks for your kind words about my work on your own blog. Color me slightly amazed that you only recently discovered my work (I’ve only been doing this for ten years), but better late than never!

  2. Good advice Amanda- The key is to identify the cause. In my case of was being forced to live as a man in 2012 and 13. Back to being a woman 24/7 I couldn’t be happier. I can be my natural self again. Living taxa man I felt in a [un]ease, unnatural and threatened. I had to bind my breasts to even half look like a boy. And a petite older boy with wide hips and narrow waist, no trace of facial or body hair.

    I should add that if others tease and make light of my situation I actually find it helpful if not mean spirited— I laugh all the time myself so they laugh with me not at me.
    But I need all the friends possible, especially girlfriends like myself.

    • Re: Depression. If there IS a specific cause, then it’s great to be able to identify that cause and do something about it—so congratulations on that. Oftentimes, though, there isn’t one specific cause and then it can be damaging to try to pin one’s depression on the current crop of problems. That’s been my experience, at least. It can be tricky, trying to decide whether a given issue is a fundamental cause (of feeling bad all the time) or just a convenient scapegoat (there’s another animal metaphor).

      Amanda

  3. I’ve written about the struggle with depression myself from time to time; I usually describe it as a damaged vessel made worse when the damage-control computer refuses to operate properly. But I like your “evil toad in the back of my head” image, too. This separation definitely helps let go of the draining feelings, and sometimes enough to actually do something about them.
    Here’s hoping that depression in particular and mental illness in general loses its social stigma, and eventually becomes seen as “something that happens” as opposed to “part of the person”, which will make treatment and recovery that much easier and effective.
    Thanks very much for writing this marvelous piece of non-fiction, with all the skill you show in your delightful fiction.

  4. Thank you for writing about this. I think there needs to be a lot more discussion about this. You made several excellent points. However, I think it is important to evaluate and determine the source of depression. There is a huge difference between having “the blues”, feeling down, and clinical depression. You are correct stating that the same word is often used for all of these. But treating these might be vastly different.

    Some of the reasons for clinical depression include heredity (do any of your family members suffer from depression?), other mental illnesses that might be present (such as anxiety), and medication side effects. For example, one of the side effects of birth control pills is depression and doctors are urged to prescribe an anti-depressant with them. Now what about the hormones prescribed (or taken illegally) during MtF transition which are much stronger? I don’t think anyone has done any research to see if these hormones are causing double digit depression for those who are transitioning. (And if they are causing depression, would someone stop their feminization to stop their depression?)

    Finally, I think there is a huge stigma attached to depression. No one wants to admit being depressed. Those that do are often reluctant to seek treatment or use anti-depressants. It is too bad depression cannot be cured. If evaluated properly, it can be treated successfully temporarily to alleviate symptoms in order to live life a little more normally.

    • Terrific comment. You’re right, of course. If the source of one’s depression can be identified, so much the better for treating and dealing with it.

      My main point is that people need to distinguish between the symptoms of depression (e.g., feeling worthless) and whatever problems they may be having in their lives. The point being that one doesn’t necessarily cause the other, so they have to be dealt with separately.

      I know we’re not debating this; I just wanted to emphasize my point for anyone else who might be reading this.

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