October '23 - Depression Awareness

[Polegnyn Nemeara]

TarValon.Net talks...
Depression Awareness​

This month, the Servant of All Team will be talking about Depression: what it is, how it physically affects the body, how it's portrayed in popular culture, and most importantly, resources one can use to support someone they may know who struggles with Depression. We understand this is a sensitive topic for many. Regardless, we encourage anyone to share their experience as much as one feels comfortable in doing so. We are here for you, too.

​

What is depression?​

Depression. We’ve all heard about it. But what is it really?

According to National Library of Medicine, Depression has been documented as early as 460 BC. Known then as Melancholia, it was a very broad generalization of several conditions. Melancholia eventually became associated with a more modern description for “despair”. It wasn’t until the mid-19th century did a division of “Melancholy” into more descriptive diagnosese of “bipolar” or “manic depressive” emerge.

This is important because it shows Depression has affected humanity for centuries. It is not a modern day occurrence and people experiencing it are not alone or looking for excuses to be lazy. It is a legitimate and incredibly serious issue.

How does it differ from mood swings?​

(Thank you, Nebka!)

1. Depression causes functional interference in daily life. Functional interference means normal tasks become impossible. Mood swings may make life difficult, but the person will still have an interest in keeping up with work or spending time with friends.
2. Depression shifts priorities. A person who struggles with depression will appear to have a general sense of apathy towards the world and rarely get excited. Someone who is only facing mood swings will still react with joy if you buy them concert tickets or take them to see a movie, for example.
3. Depression is persistent. A person with depression will feel that the sadness is uncontrollable. While people can easily feel overwhelmed by emotions, a person who struggles to regulate emotions will still have periods of reprieve and happiness.
4. Depression doesn’t always have a clear trigger. Depression may not present with a clear reason or source for the extreme sadness. Because depression is a result of an imbalance of chemicals in the brain, clinical depression often appears to have no source. Mood swings, however, can typically be traced back to a trigger (whether it’s a thought, a bully, a disagreement, etc). A person may not confide in anyone what the origin of a mood swing is, making it harder to determine.

Source: https://thelightprogram.pyramidhealthcarepa.com/

 

[Ashara Koh'inor]

Thank you for this

 

[Ephrem Elpidius]

I like that you added the ancient history part in to it, you don't see that very often.

 

[Polegnyn Nemeara]

Thank you for this

I should have included it in the original post, but thanks goes to @Lilli O' Neeus for suggesting this topic during Depression Awareness Month

I like that you added the ancient history part in to it, you don't see that very often.

Of course. It's unfathomable to believe people believe this is a relatively new thing or naturally lazy.

 

[Lilli O' Neeus]

 

[Seryse ni Cousland]

Thank you for this. <3

 

[Polegnyn Nemeara]

What would everyone like to add to these particular points? There are a lot of academic facts posted, but what practical knowledge or insight should be shared as well?

 

[Lilli O' Neeus]

It is very frustrating and very hard to explain how depression makes me feel. It's not always sadness or numbness. Sometimes it's obsession or avoidance.

Not knowing what to say or how to say it is sometimes the worst part. And please don't tell me to go outside. I know I will feel better while I am out there. It's after that keeps me from going. Relief from the symptoms doesn't mean they won't come back as soon as the activity is over, and knowing that makes the thought of going outside just to have it taken away abhorrent sometimes.

These are the feelings that can't be quantified. And they're the ones that sometimes make it seem like we don't want to get better. We do. But we also know that most of it is only temporary, so why bother?

 

[Catt Heckathorne]

I have depression as both a primary diagnosis and a side effect of a PTSD-class diagnosis. There are absolutely days it feels like I have chronic fatigue. Meds make living with it better and so I can usually function, but on some of the bad days it's hard to do anything but call it a blanket fort day and treat things like a sick day.

I do use a self care app (thread is in the Health & Fitness forum for it as this isn't really the place to discuss that) and it's been helping a ton with the little daily hygiene stuff that depression makes me feel like it's impossible to do.

I'm going to echo the "please don't suggest xyz" sentiment from Lillian. Especially don't suggest marijuana. I feel like there's a time and a place for trying to suggest stuff and someone dealing with depression (or frankly any illness) and being treated for it by licensed professionals is going to have other options at their disposal that will be far better for their situation. Telling someone to try a federally illegal substance because it has helped you is obnoxious at best, but you would be surprised at the number of people who try to suggest just that. If someone is venting about feeling like crap, the best thing to do is to support them by saying "What can I do to help out?" instead of "Have you tried [fill in the blank]?"

 

[Satara al'Caelahn]

There was a really great comic that I ran across one time and I wish I could remember the name of it. It had a person struggling with depression who was curled up in a blanket burrito under a blanket fort with some snacks.

The first panel showed what not to do, which was a person standing there telling them it was all in their head, just go for a nice walk, spend some time in nature, just do things to make yourself happier.

The second panel was what to do, which showed someone asking permission, and then crawling into the blanket fort with them just to be there and spend time with them.

Sometimes when someone vents about depression, they're not looking for an answer or a solution. They're just looking for understanding, especially because opening up about those kinds of struggles is sometimes really hard.

Now for the more personal stuff...

Spoiler: Just my depression story

It's taken me a long time to even admit to myself that I have depression. I've been in therapy for two years now and I always swear up and down that I'm fine, perfectly a-okay. Until my therapist had me fill out a very pointed questionnaire and she said I was one point away from severe clinical depression.

For me, it presents as this generalized apathy toward everything. I don't want to do anything, and I was in denial about depression being the cause because I thought it was a symptom of other diagnoses that I have like Hashimoto's, or the suspected diagnosis of PCOS (I see the doc for that in January.)

What really hit the nail on the head for me and made me realize that not all was well upstairs was my therapist pointing out this intrinsic self-loathing that I just kept turning a blind eye toward. It's not wanting to speak up because I don't want to bother people with my issues. It's the fear of taking up any emotional real estate so I just... go on with my life, keep my problems to myself, and try to deal with it the best I can, but that's not really living life to the fullest, so I'm trying to pay more attention to it. I deserve that much, at least.

 

[Seryse ni Cousland]

I have bipolar depression and often experience depression after C-PTSD is triggered. I'm not sure that it's 100% applicable to this thread and my experience is not going to be everybody's experience. Nonetheless.

My "downs" are soul-crushing. It starts with a general agitation and a "fog" where I can't think things through, start tasks, finish tasks, and constantly just feel stuck in neutral. I've been more fortunate lately and had a very competent physician, but in the past, it devolves into a deep, nameless grief. When I started really experiencing the depression side and not just the fever pitch of mania, I described it like being homesick for something that doesn't exist.

It looks like fatigue, chronic pain, overstimulation, and burnout - but the kind of burnout that is on a hair trigger rather than a straw breaking the camel's back. Everything feels too big to tackle. I'd say the most defining feaure of my depression is shame. I really struggle to be kind and gentle to myself when I'm depressed, so what might be a blameless incident becomes undeniable proof that I'm a "bad" person.

While what I feel is valid, it is hardly ever realistic and almost always disproprtionate when I'm depressed. This makes it really hard to claw your way back out.

 

[Lilli O' Neeus]

Yes, that's a big one. My psychiatrist says I need cognitive behavioral therapy. I think I just need reality checks. I have a hard time separating what gets in my head from reality. Therapy often helps me examine the big things to see if they're actually big things or if they're only big in my head.

 

[Catt Heckathorne]

I want to add to mine:

Most people with an invisible disorder such as a mental health disorder really, really dislike it being mentioned as part of who they are. If they are venting about symptoms the best thing to do is sit with them and be there without offering any sort of suggestions. And for the love of the Light please. Stop. Suggesting. yoga or meditation if you're not a substance user. Please just stop. If it helps you, great! But please remember that nobody is a cookie cutter with mental health involved.

 

[Polegnyn Nemeara]

Thank you, Lilli, Catt&, Satara, and Seryse, for sharing your insight The Servant of All team has noted your comments and improving a future post because of your willingness to share your experience.

--

Various Classifications of Depression​

As mentioned in last week's post, depression has been around a long time and originally lumped into a single category called "Melancholia". Now we know there are more specific types of depression and therefore it can be managed with more precise, individualized care. Instead of a single category for everything or only a couple 170 year old classifications, there are now at least five major categories to help understand what is going on.

Spoiler tags have been used to shorten this post for those following along on mobile devices and in case content is triggering.

Spoiler

If anyone is unfamiliar with them, these are the current five main classifications for depression including a link to a more detailed description to help understand each better:

• Clinical depression (major depressive disorder): A diagnosis of major depressive disorder means you’ve felt sad, low or worthless most days for at least two weeks while also having other symptoms such as sleep problems, loss of interest in activities or change in appetite. This is the most severe form of depression and one of the most common forms.
• Persistent Depressive Disorder (PDD): Persistent depressive disorder is mild or moderate depression that lasts for at least two years. The symptoms are less severe than major depressive disorder. Healthcare providers used to call PDD dysthymia.
• Disruptive Mood Dysregulation Disorder (DMDD): DMDD causes chronic, intense irritability and frequent anger outbursts in children. Symptoms usually begin by the age of 10.
• Premenstrual Dysphoric Disorder (PMDD): With PMDD, you have premenstrual syndrome(PMS) symptoms along with mood symptoms, such as extreme irritability, anxiety or depression. These symptoms improve within a few days after your period starts, but they can be severe enough to interfere with your life.
• Depressive disorder due to another medical condition: Many medical conditions can create changes in your body that cause depression. Examples include hypothyroidism, heart disease, Parkinson’s disease and cancer. If you’re able to treat the underlying condition, the depression usually improves as well.

Someone might be saying, "Wait, there are more!" Correct. Underneath the clinical depression umbrella, there are at least three more distinct classifications of depressive disorders:

• Seasonal Affective Disorder (seasonal depression aka "SAD"): This is a form of major depressive disorder that typically arises during the fall and winter and goes away during the spring and summer.
• Prenatal depression and postpartum depression: Prenatal depression is depression that happens during pregnancy. Postpartum depression is depression that develops within four weeks of delivering a baby. The DSM refers to these as “major depressive disorder (MDD) with peripartum onset.”
• Atypical depression: Symptoms of this condition, also known as major depressive disorder with atypical features, vary slightly from “typical” depression. The main difference is a temporary mood improvement in response to positive events (mood reactivity). Other key symptoms include increased appetite and rejection sensitivity.

As Seryse mentioned, those with bipolar disorder also experience episodes of depression in addition to manic or hypomanic episodes.

Source: ClevelandClinic.org, https://my.clevelandclinic.org/health/diseases/9290-depression

Depression Triggers​

To make things even more complicated, different things can trigger various types of depression.

Spoiler

• Stressful events — Most people take time to come to terms with stressful events, such as bereavement or a relationship breakdown. When these stressful events occur, your risk of becoming depressed is increased if you stop seeing your friends and family and try to deal with your problems on your own.
• Personality — You may be more vulnerable to depression if you have certain personality traits, such as low self-esteem or being overly self-critical. This may be because of the genes you've inherited from your parents, your early life experiences, or both.
• Family history — If someone in your family has had depression in the past, such as a parent, sister or brother, it's more likely that you'll also develop it. It's thought that severe depression in particular may be partly caused by the genes you inherit from your parents. But depression is usually caused by a combination of triggers such as life events, so having a family history of depression does not always mean that you'll develop it.
• Pregnancy and giving birth — Some women are particularly vulnerable to depression after pregnancy. The hormonal and physical changes, as well as the added responsibility of a new life, can lead to postnatal depression. Sometimes depression starts before you give birth. Depression in pregnancy is known as antenatal depression.
• Menopause — Menopause is when your periods stop due to lower hormone levels. Sometimes menopause can trigger depression, particularly in the first few years. Menopause can also cause symptoms such as sadness and mood swings. Mental health symptoms caused by menopause are different from depression.
• Loneliness — Feeling lonely, caused by things such as becoming cut off from your family and friends, can increase your risk of depression.
• Alcohol and drugs — When life is getting them down, some people try to cope by drinking too much alcohol or taking drugs. This can result in a spiral of depression. Cannabis can help you relax, but there's evidence that it can also bring on depression, particularly in teenagers. "Drowning your sorrows" with a drink is also not recommended. Alcohol affects the chemistry of the brain, which increases the risk of depression.
• Illness — You may have a higher risk of depression if you have a longstanding or life-threatening illness, such as coronary heart disease, cancer or a condition that causes long-term pain. Head injuries [or even naturally occurring neurological trauma from conditions such as Hydrocephalus] are also an often under-recognised cause of depression. A severe head injury can trigger mood swings and emotional problems.
• In some people an underactive thyroid (hypothyroidism) can cause depression.

Source: National Health Service, https://www.nhs.uk/mental-health/conditions/depression-in-adults/causes/

How is Depression depicted in popular culture?​

From television to YouTube, depiction of depression is depicted in a myriad of negative ways. While there are some positives, namely celebrities speaking out about their own struggles with mental health and deeper awareness and understanding by society as a whole, these conditions are not as stigmatized as they once were. Source: Centres For Health and Learning, https://cfhh.ca/blog/how-pop-culture-has-helped-reduce-the-stigma-of-mental-illness/

One may have also heard Eeyore mentioned during their educational journey or conversations about depression. Why? All the core Winnie the Pooh characters are used to represent facets of mental health. Eeyore, in particular, is representative of having a major depressive disorder. Despite this, he is still supported and included in his friends' adventures when he feels the desire to participate. Read more: https://www.abmhealthservices.com/winnie-the-pooh-mental-health/

 

[Delara Morellin]

Thank you for mentioning PMDD, I've had it since I was ~11 years old but didn't receive a diagnosis until my late twenties and that was only by accident (I was having to track every little thing to try and find out what was triggering my hemiplegic migraines and my neurologist spotted the pattern).

I'm lucky that I've found treatment that takes the edge off without the side effects being too awful but yeah, if you ever hear me praying for the Menopause, this is why 😅

Also: all my favourite cups have Eeyore on them 💙

 

[Catt Heckathorne]

PMDDer over here as well. It's a bit rough when you get three or four types of depression all going at once.

 

[Seryse ni Cousland]

I was misdiagnosed with PMDD, once upon a time. It turns out that with specific kinds of trauma can impact your relationship with your body; after I did years and years of bodywork, my periods became much more managable. But I am so sorry to hear that y'all struggle with it so much!!

 

[Tobyas Cuendrelle]

We tend to be drinking enough coffee to make sure we stay more anxious and high-strung than depressed.. like our thing is to always always need some stimulus and to be constantly on the edge & doing things & achieving things &&&

But certain of our alters - or one in particular - have more traits of depression and just this apathy
And I think the frantic activity in some way masks that.. like, being constantly, pervasively dissociated from oneself and one's body and one's environment & other people, means that everything is kind of fogged over and grey and impossible to touch. Which is.. well, idk it's pretty depressing. It can seem that no matter where we are or what or how much we do, nothing is real and nothing matters. like having a life vest on and trying to immerse yourself in the water.. and you end up just floating there vaguely, flailing your limbs...

I don't think we as a whole would ever be diagnosed with clinical depression - we seem to find motivation to do things regardless, at least on the outside, and our dark spells tend to be brief and intense - but.. there is that.

 

[Catt Heckathorne]

It's both really useful and superbly annoying that some alters take on the depression holder role. As a system with alters who also do that, I'm not sure if I'd rather have the straight disorder or keep it so compartmentalized with a sort of shared burden, but I guess there are pros and cons to both of those! Currently I'm very glad that sort of arrangement exists, for us it means more days of being appropriately functional and less days of deep depression symptoms.

 

[Tobyas Cuendrelle]

It's both really useful and superbly annoying that some alters take on the depression holder role. As a system with alters who also do that, I'm not sure if I'd rather have the straight disorder or keep it so compartmentalized with a sort of shared burden, but I guess there are pros and cons to both of those! Currently I'm very glad that sort of arrangement exists, for us it means more days of being appropriately functional and less days of deep depression symptoms.

For real.... ig that's why we split in the first place, is to compartmentalise things that are just too heavy to hold. i mean if hamlet had to front like. ever.... we would never do anything. same with our other trauma holders

In considering how I'm ever gonna communicate about my trauma [as in like past history mostly] to a future partner, im thinking they'd often be like o.o this is Too Much. and id be like yeah. it literally. is too much even for me 😂😭 soo.. it would have to be very slow and gradual