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There were never any "good old days" — they are today, they are tomorrow
"Things not to say to a person with depression" does not include "everything"! 
4th-Aug-2011 11:27 am
out of these shadows
[Brief and minimally-edited because I'm in a hurry.]

I am getting SO DAMN TIRED of reading discussions about depression in which people say "you shouldn't recommend exercise to a person with depression; I have depression and my inability to make myself exercise just makes me more depressed" or "you shouldn't recommend antidepressants" or "you shouldn't mention eating a healthier diet" or anything like that.

So just what the hell DO you recommend, then? "You shouldn't even bother"? "You should just lie down where you are and die"? Thanks, no, my depression tells me that enough already, I don't need to hear it from you.

I think part of what pisses me off about this is that this usually comes up in the course of a discussion in which the people making the recommendations have self-identified as having experience with severe unipolar depression. This isn't people pulling things out of thin air, or referring to something they read in Reader's Digest, or what Oprah said — this is people who have in-depth personal experience with being unable to leave one's residence for weeks on end, or being unable to feed oneself reliably, or going into the kitchen to find that the dirty dishes in the dishpan are invisible under an eighth-inch-thick layer of moldy scum floating on the water, or losing a job due to the depression, or any of the other myriad horrible experiences of life with depression.

Something specific that somebody recommends didn't work for you? Fine. Not terribly surprising. For all our commonalities and the few universals ("oxygen required", check; "nutrition and hydration required", check) we humans are highly variable; something that helps one person may not help another.


If somebody is struggling with depression, they will be better off if they can get themselves moving than if they can't. Yes, part of that is simply that being able to make yourself do something is likely an indicator that your depression is less overwhelming than the depression being experienced by somebody who can't make themself do something, but most of it is the fact that there are few exceptions to the rule that exercise and physical activity is just plain GOOD for animals.

Speaking from the perspective of somebody who has spent 35+ years struggling with this damn disease, the more time goes by the better I (think I) understand that compassionate like a brick wall aspect that Zen teachers get. It can feel like getting hit with a bucket of cold water to pour out your pain and sadness and suffering to this supposedly-enlightened, merciful teacher and in response get "Yes, and...?" *shrug* "That's just feeling. That's just emotion."

It can feel like having a door slammed in your face to be told that as far as getting better from depression, nothing's going to work until you make it work.

But it's the truth. Somebody who's stuck in a place of helplessness and believing that there's nothing they can do and that their only hope is from others (whether they're doctors or therapists or spiritual leaders) is unlikely to ever recover from the depression.

You have to make it work. You have to do something.

Maybe it takes all the energy and willpower you have right now just to pick up the phone and call your doctor. That's great — that's doing something. Maybe it's deciding to take your medications consistently. That's doing something. Maybe it's deciding that you will walk around the block once a day... and when you realize it's been three days and you haven't done it you go walk around the block instead of letting the depression tell you that flaking for three days proves you're hopeless. That is doing something.

But if all you're doing is saying "Don't recommend [x], don't recommend [y]" you're not doing anything to help yourself and you're not doing anything to help anybody else.
4th-Aug-2011 06:50 pm (UTC)
the people making the recommendations have self-identified as having experience with severe unipolar depression

Yes, but they could merely be claiming to have those problems. Self-identified is not much of a credential.

I do agree that you have to do something. Depression is way too easy to slide into. Just saying, if I claim I can fly an airplane, it doesn't mean much. (hmm.. well, actually I probably can fly a small plane, although landing might be a trick)
4th-Aug-2011 07:07 pm (UTC)
Well put. Baby steps are better than no steps for sure. Going from the depths of lethargy to happy doesn't happen with no effort any more often than magically losing 20 pounds does. No quick fix.
4th-Aug-2011 07:18 pm (UTC)
I think there may be something to be said for 'don't recommend', period. I do think there is a definite place for the basics - healthy eating, exercise, sunshine, medication - but people who are depressed generally already know there are a lot of things they 'should' do, and struggling against that weight of shoulds often only adds to the problem. My personal go-tos for things to say to people having problems with depression: "you're ok" "you're a good person" "focus on what you can do, not on what you can't - if you can only do a little bit, it is ok to do that and be satisfied" "think about things that make you feel good and healthy and do them" "take it one day at a time" "if these pills don't work, try different ones". Beyond that, it's pretty much "go and talk to a professional".
4th-Aug-2011 07:30 pm (UTC)
Yeah, I know I've seen posts in disability forums and by some disabled people I know that recommending things can be un-helpful. Sometimes they're talking about the "Well have you tried (snake oil)? My brother in law's cousin has (some disability) and they used it and now they're pain free!" style. Because if you have a disability and this is a valid solution, you probably already know about it and have tried it, etc. And if it's some crazy thing like mangosteen juice, you don't want to hear about it. And then there's the thing where the advisor goes "Well I told her about the mangosteen that helped my brother in law's cousin and she didn't even try it!"

Depression has a unique factor that I think sometimes makes giving advice okay, if people go about it in a tactful way. That is, you can be quite depressed and not realize that's what's going on. You just think the world is full of shit and why bother. If someone can say "You know, it sounds like you have some depression going on. Would you consider talking to someone about that?", that could be useful. Also, some people need permission to feel they can see someone or take drugs for it because our culture is so big on people pulling themselves up by their bootstraps. For some people it's helpful to hear that you were treated and are helped by drugs, etc.

And some people really have depression that doesn't respond to drugs, exercise, etc so all the advice is unhelpful.
5th-Aug-2011 05:03 am (UTC)
agreed. i think the only real help you can get (if you are capable of accepting it) has to be come in the form of a slap in the face. because i'm sure you know as well as i do that when you're depressed, even baby steps can feel like impossibly fucking bone-shatteringly enormous steps. although i also think it's a fine line between just-the-slap-in-the-face-i-needed and unhelpfulness because like kest said, there's a certain point where thinking about all the stuff you should be doing just overwhelms you with guilt and even more hopelessness.

man. depression sucks anus of a dysenteried goat, doesn't it? there's just nothin' like a disease that makes you too hopeless to function and then too hopeless to do anything about being too hopeless to function! FUCK YEAH DEPRESSION.
5th-Aug-2011 04:13 pm (UTC)
"compassionate like a brick wall" FTW
5th-Aug-2011 06:20 pm (UTC) - advice is tricky, no question
i've found that nobody ever takes in advice they didn't ask for (and rarely indeed the advice they did). and i doubt i've ever given any advice i didn't need my ownself.

when i was in deep grief (which is not the same as depression, though it's similar on the outside) a well-meaning acquaintance delivered herself of the opinion that if i'd just clean up my house, i'd feel better. i had not asked for her opinion, and resented the hell out of the implication that i was just being sad out of laziness.

fwiw. ymmv.
7th-Aug-2011 05:46 am (UTC)
i have a friend who calls every day and often seeks my advice, and he'd ask me questions clearly rooted in depressed thinking, and i'd ask if he's exercised / coax him to try the YMCA / do something. this is because i know that thinking as what i think when i don't exercise. and when i do, it's gone. well, so, he'd kvetch and say i didn't get it but then he just did it and it worked. he can work out and think in a more balanced way, or he can ride the crazy train down the drain, LIKE MOST PEOPLE ON THE PLANET. and now he seems to know this all as fact. it might take a few tries to break a funk but he works out hard and gets his sanity back. depression bends the thinking to think the problems are external, and maybe some are, but how we feel about them is internal, and that's what changes.
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