I’ll take a catastrophic thought with a self-flagellation chaser (or why depression is like an addiction)

So here I go with another post about depression.  The other night I had another crying spell.  It happens once in a while but not so much that I’m worried about a relapse.  While sitting on the couch at 1:30 in the morning, contemplating all of the reasons I’ve been clenching my fists lately I had a bit of an insight.

Now this might be hard to understand for those of you that have never suffered from depression but here we go.

Depression is kind of like an addiction.  Except that instead of being addicted to some substance you become perversely addicted to abject misery.  I know, you’re thinking, “What the hell are you talking about? Nobody wants to be sad.” Well, ask any addict and they’ll tell you just because they need the next fix doesn’t mean they want it. 

Depression is not just about a chemical imbalance.  Drugs may be effective but they are not the most effective treatment.  No, the most effective long-term treatments for depression are cognitive behavioural therapy (CBT) and mindfulness based cognitive therapy (MBCT).  Next in line we have exercise and time spent in nature.  The first two are about learning how to recognize when you’re thinking like a depressed person so that you can short the circuit and the last two are about getting out of your head all together and being more connected with your physical reality.

So, you ask, how does a depressed person think? Well, let me tell you.  It all starts with the question “Why do I feel so crappy?”  In my case I was reading a self-help book about emotional eating and it got me thinking, why have I been so tense lately? What’s the underlying anxiety? It didn’t take long to come up with a few answers but of course a depressive is never satisfied with “Well, I’m anxious because we’re short on money and I can’t afford the childcare to get any work done during summer vac”, no.  The depressive is then compelled to contemplate how this reflects on her worth, her character flaws, the hopelessness of her life.  She enters an altered state of self-flagellation. 

The best thing you can do at this point, before you get too deep in of course, is to call someone that you trust to be supportive.  Just talking with another human being, about anything, can bring you back to earth at least for a little while.

So, tip #1 for recovering depressives: Never start thinking about why you feel crappy when it’s too late to call anyone for support.

Of course, I never have a breakdown when Howard’s home and awake and if he’s asleep I either avoid bed altogether or I crawl into bed and weep silently into my pillow.  Not because I’m a martyr but because this amazing man has been with me for sixteen years and has witnessed one of my worst depressions ever.  He has heard every single one of my most persistent insecurities ad nauseum and I have reached the point where I can’t bring myself to make him listen to them one more time. Same goes for my mother, my sister and my closest friends.  So even if it’s the middle of the day, I still don’t want to make the call but I do it.  Because I know that they would want me to.  I know that no one wants me to be miserable and they will listen to me as long as I need them to.

But to call them in the middle of the night? No, I won’t do that.  Maybe what I need is a sponsor. 

So this is where I get to test-drive my self-reliance.  Can I pull myself out of this on my own?

First order of business: music.  Not the music that reflects your despondent state, something that reflects your feelings but has a sense of hope or something that tells you what you need to hear.*

Second, take a step back.  Make some hot milk – or something else that breaks the rumination while also soothing you – and think about all the reasons your doom and gloom thoughts are wrong.  Because trust me, they are. I find that thinking of the depression as something apart from yourself helps. So when those thoughts start to push their way in you can remind yourself that that's the depression talking.

Finally, if possible, find something to make you laugh or at least smile.  It might be a memory, a photograph or a Youtube clip (I highly recommend Tim Conway’s elephant sketch). 

Now, to quote a popular book, go the f*** to sleep.

“But wait,” you ask, “I still don’t get why depression is like addiction.” Well let me tell you in a nice bullet point list:

• No matter how long it’s been since your last depressive episode, you know that you’re never totally free.  There might still be another drop-kick around the corner.  It’s a state of constant vigilance. Every time you feel down you wonder, “Is this it? Is this going to be the time it gets me?”
• When you’ve been living in the fog of depression for a good chunk of your life, happiness can be terrifying.  Just like sobriety.  It’s so unfamiliar, how do I live like that? And if I do “get better” I’m going to have to make something of myself. What if I can’t? What if I really am as useless as I always thought I was?
• Conversely, that black abyss is perversely seductive.  You know it’s the road to Hell but in it’s own twisted way there’s a dark comfort in just curling up in a ball and hiding from life.  When you are fighting so hard all the time to stay well, that 2 am call to give up doesn’t always sound so bad.
• You get depressed because you’re afraid of being depressed.  Just like you take a drink and then feel full of shame and take another drink.  When you start to think you might be headed for another depression it feeds the sense of panic and impending doom and you get that much closer to falling over the edge.
• The only way to stay well – especially if, like me, you’re trying to wean off of the meds (God help me) – is to take it one day at a time and to know your own limits.
• You know that you will always be “in recovery” and never “recovered”.

*"Go to" songs:

• Don’t Give Up by Peter Gabriel and Kate Bush
• I Don’t Wanna Be by Gavin DeGraw
• Long Way to Happy by Pink
• Nobody Knows by Pink (okay that one is a pity party but it’s the only one)
• Whether You Fall by Tracy Bonham
• 18 Wheeler by Pink
• Conversations with my 13-year-old Self by Pink (what can I say, her lyrics speak to me)

Book recommendations:

Learned Optimism - Martin Seligman
Authentic Happiness - Martin Seligman
The Mindful Way Through Depression - Mark Williams, John Teasdale, Zindel Segal, and Jon Kabat-Zinn
I'm the One That I Want - Margaret Cho
Inside Out - Evelyn Lau


So, what do you think? Does anyone else have some “go to” songs? Can you think of other similarities between depression and addiction? Is this true for other mental illnesses?