The Ache of Depression

There is an ache inside me that tells me I am a failure. The ache spotlights all the people I know who are more successful, who have secured higher profile jobs, who have found a spouse.

The ache is relentless. On this Sunday morning, before I’ve had a chance to brush my teeth or shower or meditate, the ache tells me: why bother.

The ache is familiar. The ache is a manifestation of my illness but also a manifestation of being alive. The ache swallows me up, tries to drown me. The ache persists, I challenge it and begin to look for the light.

What does this mean? Today, the light is getting out of bed; the light is taking my medication; the light is walking to the drugstore to buy more paper towels; the light is eating breakfast; the light is restructuring this Sunday so I don’t have time to ruminate in my own darkness.

This day, every day, is ours to create. We can choose to honor the ache or we can choose to let go of it. Actions—no matter how small—suffocate our pain.

If you are suffering, accept that the ache is not permanent. Accept the ache for what it is—your sorrow, your depression, your loneliness—and then choose to help yourself move on from it. This may mean challenging your negative thoughts. This may mean devising a plan for what you will do today, no matter how small: take out the trash, do the dishes, tackle the laundry, take a walk.

It may also mean finding a therapist, a psychiatrist, a new medication, a support group, or a loved one who can help you. There’s no shame in getting help.

Millions of people have shared in this suffering. If you truly accept what you are feeling, then you free yourself to move on from it.  As Thich Nacht Han writes in No Mud No Lotus, this acceptance may be what helps us find joy:

It is possible of course to get stuck in the “mud” of life. It’s easy enough to notice mud all over you at times. The hardest thing to practice is not allowing yourself to be overwhelmed by despair. When you’re overwhelmed by despair, all you can see is suffering everywhere you look. You feel as if the worst thing is happening to you.  But we must remember that suffering is a kind of mud that we need in order to generate joy and happiness. Without suffering, there’s not happiness. So we shouldn’t discriminate against the mud. We have to learn how to embrace and cradle our own suffering and the suffering of the world, with a lot of tenderness. 

[Image courtesy of Larry Smith via Flickr.]

Mental Health Heroes Do One Thing: They Listen

Last night, John Oliver did a nice job explaining our nation’s problem with talking about mental illness and caring for the mentally ill.

But for those of us living with mental illness right now, how can we talk to our friends, family, and colleagues with our (horribly misguided) national tendency to conflate gun violence with mental illness? How can we talk when the national stigma is that we’re “crazy people?”

I’ve been living with bipolar disorder for fifteen years. Three weeks ago, I was hospitalized for an acute manic episode. I came home from a yoga retreat having not slept and not taken my medication. I entered a state of psychosis, believing there was a Nazi conspiracy against me and that I was in fact a boy named Michael. My friend contacted my mother and my loving and supportive parents called 911. The ambulance brought me to the hospital.

In my first week in the hospital, I punched nurses. I threw furniture. I screamed. As sick as I was, I was also extremely fortunate to get treatment. After three rounds of electroconvulsive therapy, my brain returned. I returned. Because of the ECT and the Lithium, I returned. And here I am, getting better.

My Heroes

Most people don’t know how to talk about mental illness because they don’t understand it. Well-meaning individuals tell depressed friends things like: “You should really try to work things out for yourself. Are you sure you need medication?”

When I was in college, I suffered from a debilitating depression. I started antidepressants and a good friend at the time told me she thought I should work things out on my own. I had no support system. I wasn’t showering or eating.

I still managed to attend some classes. I was taking a film history course with a brilliant professor I didn’t really understand. She gave me a B-minus on a paper I wrote on a Hitchcock film. Rewrites were possible, so I went to her office and met with her. I will never forget that meeting. I asked her how I could do better on the essay. She looked at me, and she said, “Michele—you are not allowed to rewrite this paper right now. Please stop working on it. My assignment to you is this: go to the movies.” She said what she said with so much care. In between the lines, she was telling me: I can see how depressed you are. You are too sick to work. You need to help yourself.

I’ve never forgotten that conversation. Because of that professor, I went back to the health center and got the support I needed.

These people—the ones who listened—have offered moments of grace throughout my life.

Two years ago, after a break up, I became depressed. I was still going through the motions of my life until one day, right before a meeting with my boss, something snapped inside me. I started crying at my desk. I knew I wouldn’t be able to handle my next meeting, so I typed an agenda, printed it out, and then walked to my boss’s office. In his doorway, I told him I was not feeling well and needed to go home. I started to hand him the agenda I’d printed. He looked at me and tilted his head to the side. “Wait—are you OK? Please come sit down.”

He closed the door behind him. He knew something was wrong. He asked me to tell him. I started to cry and told him, “I need to meet with HR. Something is wrong with me. I need a break.” He listened. And then he told me this: “Many years ago, I had a doctor write me a prescription that said, stop working for the month.” And he said, “Mental health is no different from physical health.” He told me to not worry about HR. To take the time I needed to get better.

He’s my hero. His kindness saved me.

How to Find Your Heroes

Not everyone knows how to listen when it comes to mental illness. I don’t tell everyone in my life I have bipolar disorder. Not everyone in my life needs to know. Not everyone is ready to listen. You can be proactive about finding your heroes, however. Here are a few tips:

1. For starters, share with colleagues that you have a “chronic illness.” You don’t have to tell anyone you suffer from “depression” or “bipolar disorder” or whatever other specific ailment. You can share that you have a chronic illness and leave it at that.
2. Tell friends in a way that doesn’t solicit unnecessary feedback. “I have bipolar disorder and I’m being treated with Lithium and psychotherapy,” you might tell friends. If someone offers you advice, you might say something like, “I appreciate your wanting to share advice but I’m getting very good treatment and would appreciate it if you can just listen.”
3. People who are really there for you—your heroes—will show up. Just notice them when they do. This may be the friend who visits you in the hospital. This may be the colleague who just wants to support you. This may be the sister or brother who helps in whatever way you need.

Your heroes are out there. They’re the ones who listen. And you can be someone else’s hero too.

Show up. You may save someone’s life.

Why You Should Stop Focusing on What You Haven’t Done

After I was hospitalized for an acute manic episode my junior year of college, I returned to school with a new medication regimen—Depakote, Zyprexa, Risperdal, Wellbutrin—coursing through my veins. On the Risperdal, my eyes wouldn’t focus. I could hardly read. The Depakote made my hands shake, Parkinsons-like, so that I couldn’t bring a spoonful of soup to my lips without some of it spilling on the table.

In the months prior to my hospitalization, I had enrolled in a Hemingway, Faulkner, Fitzgerald course where, sitting next to me in the lecture hall, a guy with curly hair and wire-rim glasses used “maudlin” in a sentence made me swoon. A few weeks passed and, soon, I was manic and not attending any of my classes. The hospitalization lasted 28 days, and then I moved back home—all of my courses incomplete. I never stepped foot in that lecture hall again, and because this was the late 90s, before the sticky web of Facebook and email trapped everyone you knew in the same tangled, social sphere, I never saw the guy with the glasses again.

Back at school the following semester, the Risperdal made reading impossible. I fell behind in all of my courses.

Because of the kindness of a dean I’d met at some point while dealing with the details of coming back to school, my transcript had no ‘incompletes’ to indicate that I’d started courses like the Faulkner course and then dropped out. Instead, my transcript marked a medical leave for a semester.

Now, I had to finish long papers about To the Lighthouse or Lolita, but I was too medicated and beholden to sleep to stay up in the computer lab until dawn to finish essays in the only way I knew how—at the last minute with the adrenaline of sleeplessness coursing through my veins.

My doctor tweaked my medication every few weeks. I got enough done to finish out the semester, but in three of my four classes I had incompletes. Winter break, I tried to finish the essays, but I was too anxious. After another semester, summer arrived, and over a few months, I finally finished the essays to ensure my transcript was not marred by incompletes.

At that time, the unblemished transcript was an accomplishment. It was the document that proved I’d finished something important. But I spent so much time thinking about what life would have been like had I finished the Faulkner course, had I dated that guy, had I finished that semester.

When I am depressed, as I was feeling earlier in the week, this familiar feeling that I’ve not finished anything of substance, that my life is not complete, washes over me. I decide that what I am missing — a boyfriend, a bigger salary, a recently published essay—defines me.

What I try to remember is that it is my responsibility to focus on what I have instead of what I don’t. For me those marks are my meaningful friendships, a healthy lifestyle, a job I can tolerate, a commitment to yoga and spiritual growth, a medication regimen that leaves my hands still and eyes focused. Have I finished a novel? Nope. Will I finish this blog post? Almost there.

Remember that you don’t need to define yourself by what you have not finished.

Remember: you write the transcript of your adult life.

Remember: you are complete.

Notice the Mirror

All my life, I’ve struggled with the limitations of my mind. As a child, it was a painful shyness. As a teenager, depression and anxiety. As an adult, bipolar disorder, a ruthless master that arbitrarily seemed to decide how I was going to feel from one day to the next. My mind would shift from feeling fine for a few weeks or months to feeling like a failure for an extended period of time.

Buddhist teachings say we need to change our minds to change our experiences. If you have bipolar disorder, you may struggle with your mind more than others, but you also have the privilege of truly understanding this Buddhist view of the mind. Think about it: oftentimes people think to themselves, if only I had more money or fame or wealth or whatever, then I would be happy. If you live with bipolar disorder, you understand that these factors that exist outside of you have no true impact on your mood. You know that your happiness doesn’t reside in obtaining some misguided goal. Your happiness resides within you.

Take yesterday morning. I went to my nephew’s birthday party where twenty two-year-old children stuffed cake in their mouths and danced in circles to songs played by a jovial musician my sister hired for the occasion. Two of the mothers at the party, women I went to high school with, were either pregnant or holding babies. I made small talk with them. And I smiled to hide my sadness.

The self that I normally indulge and listen to throbbed with intense jealousy of these women who are younger than me and have husbands and babies. My feelings of inadequacy and depression were only exacerbated by news I’d inadvertently stumbled upon on Facebook earlier this week: my boyfriend, who told me he didn’t want children and who left me two years ago for a younger woman, is now having a baby.

During my nephew’s party, mantras I’ve listened to my whole adult life—no one will ever love you—you’ve failed at your life—pulsed through my mind.

Then I remembered the Buddhist lesson I learned last week. The teacher Kadam Morten talked in class about shifting from the perceived to the perceiver. In other words, we don’t helplessly succumb to our negative thoughts. Imagine you are looking in a mirror, he explained. Instead of getting lost in the reflected image of ourselves, we can notice the mirror—maybe a dot of toothpaste—and shift from being the reflected to the reflector. We step back and understanding that our truest self is the person who is able to examine our thoughts from a comfortable distance. The jealousy, the pain, the hurt: these are all parts of the mind we can accept and acknowledge rather than succumb completely.

I love this concept of accepting our suffering and living with it. We’re so pressured by society to believe that if we become happy there will be no suffering. But we can find beauty and connection in our suffering if we are able to accept it.

Thich Nhat Hanh explains in No Mud, No Lotus:

With mindful breathing, you can recognize the presence of a painful feeling, just like an older sibling greets a younger sibling. You can say, “Hello, my suffering. I know you are there.” In this way, the energy of mindfulness keeps us from being overwhelmed by painful feelings. We can even smile to our suffering and say, “Good morning, my pain, my sorrow, my fear. I see you. I am here. Don’t worry.”

Here’s how Pema Chödrön conveys a similar message it in Taking the Leap

The sad part is that all we’re all trying to do is to not feeling that underlying uneasiness. The sadder part is that we proceed in such a way that the uneasiness only gets worse. The message here is that the only way to ease our pain is to experience it fully. Learn to stay. Learn to stay with uneasiness, learn to stay with the tightening … so that the habitual chain reaction doesn’t continue to rule our lives, and the patterns that we consider unhelpful don’t keep getting stronger as the days and months and years go by.

Both of these books are worth reading in their entirety. Consider keeping them by your bedside, as I do, to remind yourself in dark times that you are not alone.

*Important note: None of this is to suggest we can “think our way out” of depression. I am a strong believer in medication paired with therapy to treat mental illness because it’s been so integral in my staying healthy. When I say that happiness resides within us, I mean that we can train ourselves to influence the workings of our minds.

How to Quiet Your Inner Critic

My inner critic tells me I am a failure no fewer than four hundred times a day. I’m not even sure that’s a hyperbolic statement. Between my judgments about how little I’m writing or how pathetic it is that I don’t have a husband—these undesirable mantras drum through my head and move me towards feeling miserable.

I’ve been writing about this voice in my head and its destructive power for the past few weeks because I’ve become acutely aware of how much louder it is than the part of me that’s able to feel proud of my achievements, however small they may be, instead of obsessive about all I have yet to do in the world or the mistakes I’ve made.

I want to be able to tell you that I’ve figured out a way to solve this problem, that I have 10 pieces of advice—all pared down in a neat list—to help you to not suffer in this way that I tend to suffer.

I don’t.

But here’s what I do have—I have a a suggestion about what to do with the inner critic. And it’s pretty simple.

Stop listening.

What this means is that instead of trying to silence the voice that beat me up today because I slept too late, because I ate a brownie instead of eating dinner, because I didn’t see my parents even though they were right across town—I accept her. I acknowledge the voice the same way you acknowledge that woman at work who always has a negative perspective on whatever the team is working on.  I say to myself: that’s your inner critic. She’s doing what she always does. She’s finding way to find fault with you; even if you cured cancer she’d have a problem with the way you went about doing it. You’ll never silence her.

To take away her power, you need to accept that she’s there and then diffuse the hold she has on you by ignoring her.

Pain vs. Suffering

[A reminder that this blog is not written as medical advice nor is it meant to paint a universal portrait of depression. This is my experience.]

Last week, the voice in my head got mean and all-too-familiar. You’re a failure. You’re not successful. You’re a terrible writer. Your job is stupid and pointless. You’re already 35 and look at all the things you haven’t accomplished.

The voice, when she arrives, is relentless in her negativity and brutal assault on every aspect of my life. She compares. She judges. She complains.

Nonetheless, because this certainly wasn’t clinical depression but rather a large dip in my mood, I was able to drag myself, just barely, to work last Tuesday. It felt like an accomplishment just being there. Later that evening, I made my way to yoga because I knew if I didn’t I’d go home and cry.

Before yoga class, as I was filling up my water bottle, the negativity still stirring around in my brain, I told myself: OK, you just need to think happier thoughts to drown out this all out. So I started to pump other sentences in my brain: You are smart. You are happy. You are doing well at your job.

This helped a little bit, but during yoga class I could still hear the criticism loud and clear. She wouldn’t shut up.

Towards the end of class, my yoga teacher (he’s my favorite because he offers words of wisdom, usually influenced by Buddhist tradition, in the class) started to talk about pain vs. suffering. He talked about how pain is inevitable. We all have pain. The goal is to release ourselves from suffering, to accept the pain.

And in that moment, I realized that I was going about this self-imposed cognitive therapy the wrong way: instead of trying to drown out that voice in my head, I needed to accept that she was there and then just shield myself from the darkness by creating an intellectual barrier to distance myself from my self-destructive thoughts.

I visualized a protective umbrella opened up over me and saw all the drops of negativity deflected from my body.

This may sound silly, but it really did help me last week. Somehow, by accepting that the depressive thoughts were pain, inevitable pain, I felt able to move further away from the suffering. I walked home, not feeling happy, but not feeling paralyzed either.

Do you have visualizations that have helped you through dark days? Please share in the comments so we can help one another!

Without Warning

I remember the first time I felt depressed. I was a junior in high school. One afternoon, I started crying and I couldn’t stop for days. There was no trigger for my tears other than a sudden, insufferable feeling that my life—that all of our lives—are void of any meaning.

That was twenty years ago. I know that since that happened to me, I’ve felt plenty of joy. I know I felt joy last week, last month, last year.

But yesterday, without warning, the same irrational darkness took hold of my brain.

I know that what I’m feeling is a symptom of depression. I know that it’s going to go away. But this logic isn’t making it any easier to get out of bed, to clean my apartment, to eat something other than the pint of Ben & Jerry’s ice cream I just swallowed down (and I don’t usually even like ice cream).

All I can do is make a small resolution to do something. For now, that thing will be the dishes. I will get up, I will walk to the sink, and I will wash them. Right now, that’s the small victory I need.

The Blue in the Rainbow

My two-year-old nephew tantrums, and my sister does everything she can to quiet him. I know I shouldn’t judge her because I’m not a mom, but I can’t help but think, let him cry and calm himself down.

On NPR last week, I heard someone talking about how we can’t experience true happiness—what he called the full rainbow —unless we have some blue in our life.

I’m paraphrasing because I can’t find the interview, but this simple comment stuck with me.

If we’re in the midst of depression or sadness, it’s impossible to appreciate the darkness. And I’m not suggesting we should. But, once we’ve moved on to brighter days, it’s helpful to look back and realize that before we felt joy, contentment, ease, we were ever-so-familiar with darkness.

Without the blue, there’s no fiery red or giddy yellow. The rainbow, arched across the sky, astonishes us because it bands all of those colors together into one, beautiful whole.

A Fun House Mirror Called Depression

When I am depressed, the voice in my head tells me I’m a failure. Completely worthless. That life is not worth living.

My vision of myself distorts completely, like an image in a fun house mirror. I am me, yes, but all I can see is the ugliest, most loathsome version of myself.

It’s hard to imagine how  a person like the great, the beloved, the outstanding Robin Williams could do anything but feel the utmost pride in himself, his work, his achievements, his greatness.

But depressive thoughts are not rational or real or true.

The next time I am in the midst of a depression, I will think of Robin Williams, of David Foster Wallace, Virginia Woolf and so many others. I will tell myself: right now, you are not capable of judging your own self-worth. You’re trapped in the darkness, looking at a mirror made of lies.

3 Things You Should Never Apologize For

Most of the time, I fit in just fine.

Nothing about my disorder—well managed, well medicated, well closeted—causes disturbance others would recognize. Even last week, when I dipped down into despair because of medication management issues, I somehow smiled my way through my pain in public before sobbing into my pillow once I got home.

At a bachelorette party in the Hamptons this past weekend, my mood had improved considerably and I was able to enjoy myself. But because just a few days prior I’d been suffering, I wanted to be vigilant about self-care. It can be hard to assert your needs when those needs are different than everyone else’s.

That said, here are some things none of us should have to apologize for or explain.

1. Not Drinking

I can’t drink more than a glass or two of wine. More than that interferes with my medication and I start to feel depressed. I haven’t been a teenager since the 90s, and yet I still experience peer pressure to drink from well-intentioned friends who want me to have fun. “I really can’t drink,” I tell them. No apology. Just fact.

2. Sleeping In

If I could have a superpower, I think it would be not to fly or to freeze time but to simply be a short sleeper. Unfortunately, I need 8-9 hours to feel rested. In relationships or on vacations with friends who are early risers, I’ve found myself apologizing for sleeping late in the past. But now I’ve come to accept that this is just part of who I am.

3. Feeling Sad

Over the weekend, I spent time with an acquaintance who is always upbeat, cheerful. I so admire her disposition. But I am not her. These days, smiling takes effort. Optimism is hard; crying is easy. I’m not particularly proud when I feel this way, but I understand that this too shall pass. And I’m not about to apologize for my feelings.