By Richard E. Bleil, Ph.D.
The reality is that depression is a real disorder. It cannot be controlled by those of us who suffer from it, and it’s difficult to understand for those who do not. It’s not being “sad”, because it impacts so much more of our lives. Every day can be a struggle to get out of bed, to take care of ourselves, even for basic functions such as eating. I cannot tell you how many days I’ve fasted for the lack of motivation.
My depression is not terrible. Others have it so much worse than I do, but I have it. For me, service is the best motivation. I’ve never missed work for it, because I don’t want to let people down. My friends know me well enough to ask me to bring something if they want me to show up, say at a dinner or party. If they need something, they know I’ll be there, damnit.
The holidays are particularly brutal on the depressed. Those of you who do not suffer the condition can probably not understand just how lonely one can be surrounded by people, even those who love us. This is made worse by the thought that we “should”. We will often beat ourselves up, because we “should” be happy, we “should” be able to control it, we “should” not be sad.
The first step to understanding depression is that it is truly a medical condition. Advances in medicine and MRI imaging demonstrate the difference in brain function for the depressed (as well as other conditions such as schizophrenia). The depressed can control their brain functions no more than anybody else, so to suggest that depression is a choice is to ignore these medical advances. My own depression has been diagnosed as related to my serotonin. When I have been on anti-depression medication, it has focused on reducing serotonin uptake (in other words, I don’t have enough serotonin in my brain because it gets cleaned up out of my intracellular fluids too quickly, before they can make connection with the active sites to prevent depression).
I remember, as a teenager, separating myself from the family and friends. As they were in the living room enjoying themselves, I went to the empty, and dark living room (save the lights on the Christmas tree), to be alone. I needed this alone time. I reflected, but also, I knew everybody else was enjoying their time, and I really didn’t want my mood to affect their fun (like I said, service to others).
There are some “do’s” and “don’t’s” to spending time, and especially the holidays, with the depressed. And it is important to note that not everybody who suffers this condition is open to discussing it. Chances are pretty good that you know people who are depressed, and you are not aware of it.
DO invite them to events. Everybody needs to feel wanted, needed, and welcome. DON’T take it personally if they don’t come. It’s not you, it’s us.
DO be open to listening, and providing advice if it is insightful and wanted. DON’T give advice that is unwanted, or worse, trite. “Just be happy” and “It’s a choice” is not only unhelpful, but it’s very hurtful because it places blame for the condition (again, a medical condition) on the victim of depression. This “Peter Pan” advice is as useless as telling your single friend that “there’s someone for everybody”. We appreciate that you are concerned, and that you are only trying to help, but it actually hurts.
DO be understanding if your friend “disappears” for the holidays. DON’T make them feel bad about it. As I’ve mentioned earlier, I will often remove myself from holiday festivities, not because I’m somehow “anti-holiday”, but because I know I will be depressed, I know events will likely make me feel worse, and I know that I don’t want to bring everybody else down. I’m actually trying to be nice by not showing up.
We know that you love us, and we love you. All we ask is understanding.