How do I come to terms with my depression?
December 28, 2012 6:15 AM   Subscribe

How did you learn to accept that you are depressed?

I have been seeing a psychologist for about a year now for depression and anxiety. About a week ago I began seeing a psychologist and was prescribed antidepressants. Both the psychologist and the psychiatrist, based upon my symptoms, diagnose me a depressed. But part of me has difficulty accepting this diagnosis. It's a feeling of doubt--that I'm exaggerating my symptoms or that I am overly sensitive.

I've mentioned this to my therapist and she feels that I have a tendency to be too hard on myself. This probably true. I also know that these feelings are probably an inherent part of being depressed, and part of what makes it so insidious. Both are fine points, but I still don't feel satisfied. How do I come to terms with this nagging doubt?
posted by anonymous to Health & Fitness (18 answers total) 24 users marked this as a favorite
My psychiatrist has me take the Beck Depression Inventory when I feel down. It gives us guidance as to what's bothering me, what to work on. You might find your results of interest.
posted by Carol Anne at 6:24 AM on December 28, 2012 [12 favorites]

This will be an overly simplified way of describing things, so please forgive me.

You have a part of your brain that I call "depression brain". Depression brain is the part of your brain that makes you depressed. It, like all living things, has a survival mechanism. It cannot thrive when you exercise, take care of yourself, are up and about and with people who care about you and take your medicine. It will lie to you in order to avoid it dying. It wants you to be depressed.

So it tells you, "You're not that bad. You're just being too sensitive. Suck it up and don't have to take antidepressants. You can just make a decision to be okay."

But you can't. There's a reason you feel bad. It's not just a switch you can turn on and off. If you could, you wouldn't have been spending a year depressed and anxious.

So, do your best to acknowledge where this voice comes from and why it tells you the things it tells you. Then take your medicine anyway and work with your doctors to feel better.
posted by inturnaround at 6:28 AM on December 28, 2012 [19 favorites]

During bouts with depression I always refused to label it for what it was, because there was a part of me that felt like accepting the 'depressed' label meant also accepting a bunch of baggage that I had attached to it: that it meant I was weak, that I was making too big of a deal of circumstances that weren't really 'that bad' compared to other people who had less privileged lives, etc. Similar to the doubts that you express.

It was really only this year, after twenty someodd years of dealing with it, that I was willing to label it for what it was. Part of what allowed me to do so was focusing on thinking of it as a medical condition without any value judgment attached to it, in the same way that we wouldn't judge ourselves or others for having broken arms or cystic fibrosis or influenza or any number of other maladies that we judge as purely 'physical' in nature.

For me, a focus on mindfulness meditation helped, because it trained me to pull myself out of my own feelings and view them as an observer, without judgment, and then let them go. The most insidious thing about mood disorders is the way that they wrap themselves around you and present themselves as the only truth, so you end up living inside a house they build for you without even realizing that you can open the door and go outside. Mindfulness in Plain English is often recommended on AskMe as an introduction to the topic. I got a lot of help from Pema Chodron's When Things Fall Apart, too. It doesn't make the depressive moments go away, but it makes them a lot more bearable. Stephen Fry's perspective in this letter was also helpful to me.

Sometimes opening that door is really hard: it can take a long time, often requires help from others, and may require medication as well. (But again: view it as what it is, a medical condition, one that needs treatment the same as any other.)
posted by Kosh at 6:35 AM on December 28, 2012 [2 favorites]

I had a very hard time acknowledging that I was depressed, even to myself. I was always the happy, fun one, and I didn't want to "let people down." The depression kept whispering that my family and friends would be disappointed, and that if I just tried harder I'd get through it, and it's not like things were even that bad, and that I was just making a big deal about nothing. When I suddenly realized that there were more days in the past week where I'd cried then where I hadn't, I made an appointment with my doctor and said, "I've been crying a lot."

For me, the therapy and antidepressants helped me realize that that doubt is the depression. It didn't want me to get better. (Honestly, I pictured it like the pollution monster from the terrible movie Ferngully, which fed on the pollution and grew and grew. My depression fed on my doubts and miserable feelings.) Dealing with the depression gave me a frame to give myself permission to just feel shitty when I was feeling shitty, instead of feeling shitty PLUS feeling like I was also being a jerk for feeling so bad about nothing.
posted by SeedStitch at 6:46 AM on December 28, 2012

It's a feeling of doubt--that I'm exaggerating my symptoms or that I am overly sensitive.

Feeling depressed can put you into survival mode, in a way -- and then you start thinking that as long as you're physically healthy/getting by at work/etc., you shouldn't complain about not feeling "good". So being normally conscious of your state can look to you like "overly sensitive", and being objective about your symptoms can feel to you like "exaggerating".

And that's okay. Realizing that it's happening can be empowering and can help you establish an understanding of how you're working right now. It can give you a framework to rationally assess yourself and come to your own conclusion about your condition/state/diagnosis.

One suggestion which may or may not be relevant: Instead of assessing whether your symptoms are "good enough", perhaps it would help to compare yourself as you are now to yourself at a time when you were not depressed (if such a time exists). Are there differences in how you behave? How you spend your time? What you eat, how much you sleep, and/or other self-care metrics? If so, being aware of those differences might help you to accept your diagnosis.

Ultimately, what's most important when you're depressed is to make sure you're taking care of yourself -- and it sounds like you're getting treatment. So even if you can't totally accept the diagnosis now, when you feel better you might accept it in retrospect.
posted by cranberry_nut at 7:00 AM on December 28, 2012 [2 favorites]

For me, the key to getting over years of very deep depression was the doubt -- I refused to identify myself as depressed and I refused to completely accept the diagnosis even though I knew that's what was keeping me down. It was when I started to frame the situation as the assertion, "This may be me now, but it will not be in the future" that I came to terms with reality, accepted the diagnosis AND began to push my heart and mind out of the suicidal ideation and the long sleeping spells and the anorexia and everything that was coming to a head because I was really depressed. I am a perfectionist and woefully stubborn about doing things myself, and so while I didn't take meds to smooth the process, I did have a committed therapist who provided the constant support and guidance I needed to make the second half of that assertion up there true. The key was that I wasn't doing it for anybody except myself and it was the first step towards taking care of myself properly, something I hadn't been doing for years. That's when I started to really see why I was depressed and it gave me the tiniest little inkling of "maybe I don't have to stay this way if I don't want to".

I am still depressed sometimes. I am better now at identifying when I am just normal-sad, and when I am depressed-sad, and I take a minute to acknowledge the seriousness of the situation when the latter occurs and say, "This is the depression talking" and now I fight with all my might to not succumb to the seductive state of being that depression used to be for me.

Be good to yourself here -- accept the diagnosis so that you are able to get the assistance you need but maybe resist it just a little too because it can plant seeds in your mind about overcoming what's happening. You need to want to overcome it.

But accept the diagnosis so you're not resisting treatment. Good luck.
posted by These Birds of a Feather at 7:04 AM on December 28, 2012

Being depressed sucks. It sucks to BE depressed, and it sucks to know that you've got something going on that your body can't take care of on its own. And it also sucks that the very motivation to fix things is often one of the biggest things that depression itself messes with.

But there's a flip side to knowing you're depressed, too. You've got a diagnosis, which means you have POSSIBILITIES. You've got smart people (including yourself) and a piece of paper, if you so choose, that says that this long slog of a funk is really not your fault. This can be such a freeing thought.

To bring up the often-used analogy: if you had a broken leg you wouldn't walk around on it for a month, right? You'd go in and get it set and figure out how you'll help it heal. Same with depression: you go in and get it diagnosed and figure out how you'll help it heal.

And to take it a step past that: if you had a broken leg, you wouldn't expect to be able to run a race, would you? And if it gave you pain, you should be able to grimace and blame that pain on the fact that a major part of your body has something wrong.

Depression is the same in that sense, too. The only difference (and it's an unfortunate one) is that it simply isn't as visible as if you were limping around with crutches and a bright orange cast. But just because others can't see it as easily doesn't mean that you should give yourself any less care, or disallow yourself to flop back on the couch once in a while and say, "Yeah, going out would be too much of a hassle tonight."

One of my top rules for life is that you absolutely never know what's going on with other people. The people you consider the most successful can (and typically do) have tremendous issues in their own lives that you'll never see. Being compassionate towards others, I've found, makes it easier to be compassionate towards myself. I say, "Things might suck today, but it's not my fault, and I'll just try to do better tomorrow." Whatever value of "better" I think I can do.

You can do this, too. Depression exists, but it's only part of who you are and how you live your life.
posted by Madamina at 7:27 AM on December 28, 2012 [1 favorite]

After a few months of telling myself I just needed to suck it up and get over it, there was a specific moment when my depression became too tangible to ignore. I was at my internship and they asked me to get something from downstairs in the basement. I trudged downstairs, sat down, and started crying hysterically because all I wanted to do was die. I stared at the floor for a good 20 minutes wondering how cold a gun barrel would feel against my head.

When you're depressed, your reasoning abilities are probably not accurate. For me, such a large part of my depression was feeling like I was a failure and that my depressive thoughts were stemming from the fact that I was too weak and stupid to will them away. My internal monologue went something like, "You big baby. You're not depressed, grow up! Get over it, you stupid pig. You don't even have real problems. You just don't deserve to be happy."

Antidepressants made a world of difference to me. Medicine alone won't fix it, but it did give me the boost I needed to finally address my irrational thinking.
posted by thank you silence at 7:37 AM on December 28, 2012 [1 favorite]

There is lots of good advice here already but something in the wording of your question made me want to contribute.

diagnose me a depressed

I don't know if that was a typo, but it might be easier if you realize you aren't a depressed. You suffer from depression. And that is two different things entirely.
posted by chrillsicka at 7:40 AM on December 28, 2012 [2 favorites]

What exactly would change if the diagnosis were wrong? What concretely are you worrying is the real-world effect of having been potentially misdiagnosed?

Maybe you wouldn't need medication? In that case, the best way of figuring out whether the medication will help is to keep trying the medication for a while and see if it helps, right? So whether or not the diagnosis is accurate, right now it makes the most logical sense to continue doing what you're doing.

Maybe your therapist wouldn't see you, because you wouldn't "deserve" her help? It sounds like you floated this idea past her and she told you you were being hard on yourself, which would indicate that she thinks you're worth helping now, as you are, even if she's misdiagnosed you. Therapists generally work with people who are seeking help even if they don't have a diagnosed mental disorder, and it sounds like even if you are misdiagnosed there are still things you'd like to seek help with (otherwise you wouldn't have started therapy at all), so right now it makes the most logical sense to continue doing what you're doing.

A diagnosis doesn't really change anything here, basically. You're still the same person with the same issues. A diagnosis (which can almost always change) just gives the people who are helping you a framework and a game plan for continuing to help you, and a way for your insurance company (if you're using your insurance) a way to justify paying for your treatment.

That's it. You don't even really have to accept the diagnosis, just the idea that you want to feel better, somehow, from how you feel right now. Work toward feeling better -- and even better, it sounds like you've got supportive knowledgeable people that you trust, at least mostly, in your corner, and that you're doing that work already. That's all you have to do right now.
posted by jaguar at 7:49 AM on December 28, 2012 [1 favorite]

The fact that your doubt is part of your depression isn't a "fine point". It's a great big paradigm-inverting or paradigm-invalidating transformation that pulls your alleged other points inside-out. Sheesh. Depressed people can be crap at logic sometimes. (Please imagine this said in tones of kindly exasperation, with plenty of irony due to my own history and that of pretty much all my close friends.)

One reason 'doubt' can trip us up is because we use the same word for two different things: critical inquiry, and denial. Critical inquiry is healthy: it's why we consult not only experts but also evidence, why we ask the experts to show us their work, etc. Denial on the other hand is what prevents us from fully accepting a situation and committing to a path of appropriate action. Judging by what you've written, your doubt is the latter, not the former. How do I come to terms with this nagging doubt? By understanding it as merely one aspect of the larger situation which you and your team are working to transform.

"If there is a pot of water which is turbid, stirred up and muddy, and this pot is put into a dark place, then a man with a normal faculty of sight could not properly recognize and see the image of his own face. In the same way, when one's mind is possessed by doubt, overpowered by doubt, then one cannot properly see the escape from doubt which has arisen; then one does not properly understand one's own welfare, nor that of another, nor that of both; and also texts memorized a long time ago do not come into one's mind, not to speak of those not memorized." -- the Samyutta Nikaya.
posted by feral_goldfish at 7:50 AM on December 28, 2012

The first 50 pages of "Feeling Good," the often recommended book on Cognitive Behavioral Therapy and Depression, were a revelation for me.

There have been times when I was younger when I was probably majorly depressed, but I think that kicked off bad cognitive habits that led to a constant state of low level depression. While not a week went by where I would not fantasize about suicide, I lacked any real intent, and like you, felt that I wasn't really *depressed*, per se. Or if I was, that it was due to real issues and I should figure them out on my own.

Reading the beginning of the book alone pretty much kicked me out of that stupor. Hearing that other depressed people always say the same kind of things, e.g. "But *I* really am a loser," or whatever, made me realize there was no point in minimizing my own depression. I still had that nagging feeling that in my case those things were true! But if it talks like a duck, and the duck fills out Beck Depression Inventory and comes out depressed...

In other words, I identified enough with the descriptions of depression to say, fuck it, whether or not I'm technically depressed, I shouldn't ever be thinking this much about suicide, and until I stop, I may as well treat this as depression.
posted by User7 at 8:24 AM on December 28, 2012

Here's what helped me:

My thyroid is out of whack. I probably inherited the problem. Maybe the crap I ate as a child made it worse. Now I need medication to make my thyroid work correctly. If I don't take the medication, I have symptoms like swelling and fatigue and heart arrhythmias.

Replace "thyroid" with "brain":

My brain is out of whack. I probably inherited the problem. Maybe the crap I experienced as a child made it worse. Now I need medication to make my brain work correctly. If I don't take the medication, I have symptoms like self-hate and gloominess and shame.

Why would I respect and treat my thyroid symptoms, but not respect and treat my brain symptoms?

As others have pointed out, your doubt is the depression talking. If professional, third-party observers and objective measurements like the Beck Inventory say you've got depression, then you've got depression. It might be better to use the "I've got depression" terminology than "I'm depressed," to emphasize that the depression is a medical condition that's affecting you and it's not a feature of your personality.
posted by ceiba at 8:55 AM on December 28, 2012 [7 favorites]

I remember feeling like that when I was first diagnosed with depression. I was so very tired and sad, but i kept getting up in the morning and putting on my clothes and somehow pushing through the day. I figured because I wasn't lying in a mud pit with no money and no hope that somehow I was just lazy and I just needed to pull myself up and what was I complaining about anyway, etc. etc.

That's the depression talking. It's okay to get help before you end up in the pit.
posted by tuesdayschild at 10:11 AM on December 28, 2012 [1 favorite]

I've been depressed all my conscious life. After awhile, it simply became internalized as just the way I much a part of "me" as the color of my eyes.
posted by Thorzdad at 11:30 AM on December 28, 2012 [1 favorite]

It sounds like you believe that something good will happen if you accept your depression. What is that thing?

Only guessing, but do you believe that you'll start to treat yourself with more gentleness and compassion? That if you accept that you're depressed, you'll stop beating yourself up?

Good news! You can start treating yourself more compassionately anyway! You can start now!

When you're feeling low and an internal voice in your mind starts to call you names and beats you up for being a weakling or whatever, take a look at your poor, beaten up self. Can you find a little bit of love or compassion within your heart and extend it toward that poor person who has been called lazy and worthless and ...? Can you make yourself a nice cup of tea or coffee or hot chocolate, or whatever. Can you cover yourself with a warm blanket and feel some small spark of compassion - toward yourself?

I'd suggest you question it whenever you think there's something that you have to do first before you can treat yourself with some degree of compassion. Compassion and gentleness is not a reward reserved for you only if you do the right thing. Compassion is your due, for carrying the burden of being human.
posted by jasper411 at 4:34 PM on December 28, 2012 [3 favorites]

The best thing I ever read: "A person that is never depressed must be a real psychopath"
I tend to agree.
posted by yoyo_nyc at 5:35 PM on December 28, 2012

I'm in a fairly similar situation, judging by your description. I've struggled with depression for years and often chalked it up to my own "weakness", that I was overstating the severity of it and should be able to just buck up and deal. I, too, recently started seeing a psychologist and a psychiatrist and have often had those doubtful wonderings about the diagnosis.

Basically, I accept that the depression monster is chemical. It's not my choice, it's not in my control, and I try to think of my reactions/moods through this lens.

I say to myself (even if I think it's total bullshit at the time), "This is that depression thing talking, and this terribleness will eventually pass."

When things do lighten up a bit, I try to take notice of that, pause a moment to reflect and think, "Hey, I guess I was right. I feel a little better now, that bad thing must have been the chemicals switching over."

It gives me a cause and effect process to reflect on - proof that the doctors' diagnoses are quite real. Lather, rinse, repeat with every mood cycle.
posted by woolly at 6:42 PM on January 2, 2013

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