When I think back to my younger self, I wince at my ignorance about depression. Back then, I thought I didn't know anybody affected by it. Only later did I realize that there were indeed victims of depression close to me — it was just that they hadn't admitted to it and had passed off their symptoms as something more acceptable.
Now, nearly 20 years after being diagnosed myself, after a long battle and my eventual recovery, here’s what I wish I had known about depression:
1. Depression is indeed an illness.
When I was younger, I used to imagine that being depressed meant just feeling sad and gloomy, as in “I’m sooooo depressed I haven’t been asked to the party!”
And nowadays, the word depression is used so loosely it's almost meaningless.
But it’s important to distinguish between "feeling depressed" and clinical depression: a serious illness. Clinical depression is when something goes wrong with your brain — and it has clearly identifiable and very unpleasant symptoms.
2. Depression can descend very quickly.
I describe it as the feeling of a trapdoor being opened suddenly beneath you. I went from being a functioning working mother and journalist at the London Times, with no history of depression and no prior symptoms, to being admitted to a psychiatric hospital within three short days.
I had previously assumed that depression was something that slowly unfolded. This may be true in many cases — but not in all.
3. Depression can be accompanied by physical symptoms.
During my own depressive episodes, each second of each minute of each hour was lived in a pitch of intensity and pain that I had never experienced before.
I suffered from nausea, a racing heart, insomnia, and an acute sense of dread, as though I were on a plane that was about to crash. My head felt as though it were bursting with a swarm of insects, devouring the insides of my skull.
While the more common symptoms of depression are lassitude and fatigue, it was the opposite for me. I later learned that depression that is born of heightened anxiety can present in this way.
4. The causes of depression can be complex.
Britain’s Royal College of Psychiatrists lists seven possible causes of depression, including genes, gender, and physical illness.
For many people, the illness accompanies a traumatic life event, be it divorce, bereavement, or childbirth: often an event associated with loss.
I initially didn’t understand how childbirth could be linked with loss. But after years of therapy, I realized that as much as I rejoiced in having children, I also experienced a sense of sadness over the demise of my younger, carefree self.
5. A privileged life doesn’t mean privileged health.
Mental illness doesn’t care about your background. A privileged life, like the one I was fortunate enough to enjoy — with a successful career and a marriage to a junior banker at Goldman Sachs — did not ward off depression.
In fact, the guilt I experienced at being unable to fulfill my roles as a journalist, wife, and mother was exacerbated by the feeling that I had “nothing to complain about.”
6. Antidepressants are not to be taken lightly.
I used to think antidepressants were rather fun pills you could take if you felt vaguely miserable. But they are strong drugs to be administered in extreme situations.
And they can come with debilitating side effects. For me, these included weight gain, a dry mouth, drowsiness, constipation, and blurred vision. I actually felt worse before I felt better.
This is one of the most alarming aspects of the treatment of depression and one of the reasons many patients give up on the drugs before they have actually started to take effect.
7. Medication can take six weeks or more to work.
When you are waiting for the drugs to kick in, and potentially feeling suicidal, this time period can feel like a lifetime. Every morning I would wake up and scream, “When are the drugs going to start working? I need them to work NOW.”
Fortunately, they often eventually will do the job they’re supposed to do, and in my case, were an important part of my recovery.
8. Depression is survivable.
Although I’ve thankfully overcome it, I don’t regret suffering from depression — it has made me who I am today. In a paraphrase of the words of Corinthians, my strength became more perfect in weakness.
9. Depression is no one’s fault.
When I wrote about my personal experience of the illness in my memoir, published last year, people kept telling me how “brave” I was to share my story. The subtext in many of these conversations seemed to be that I was exposing something shameful to the world.
But the truth is that no one should be ashamed of being ill. Of all the things that I’ve learned, I feel that is the most important of all.
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