Apparently, I Have High-Functioning Depression

I saw an article recently on upworthy called “The danger of high-functioning depression as told by a college student.” It’s about how having high-functioning depression may be more dangerous than non-functioning depression because the people around you don’t know you have it. Since you’re good at pushing on and putting on a cheerful face, you can be on the verge of suicide without giving off any of the signs most people go by to tell if someone is at risk. And my brain went, “ah, there’s a name for it,” and “I have high-functioning depression.”

Before I go further, let me say: Don’t worry. I am not at risk of suicide. Honestly, it’s not a path I can take.

But I am very good at hiding my depression. I imagine that if I told any of my coworkers or over half of my relatives that I regularly struggle with depression, they would laugh and say, “Yeah, right.” I joke a lot, I smile a lot, and I am always running somewhere and doing something. Depressed people don’t act like that.

Wrong. Some depressed people don’t act like that. Some depressed people act even more like that the more depressed they are. They crack jokes because it’s a habit. Because if they don’t laugh, they’ll cry. Because it’s easier to hide the pain behind a distracting joke than when talking about something serious. They keep busy because when they stop, they crumble. Because if they keep busy, they don’t have to think about everything that scares them or depresses them.

I read the article and the lack of symptoms, and I understood why the psychiatrist would be afraid because the 16 year old was horribly depressed but had a 4.0 and was very active (AKA she had high-functioning depression). It’s because those are the suicides that no one sees coming.

It made me start thinking about everyone I’ve lost to suicide. What they were like before and whether we had any warning. The result was frightening. Of the 6 friends and acquaintances I’ve lost to suicide in the last few years, over half of them were always smiling and joking. And when I got the news, I was surprised. They always seemed so happy. For some, their lives were improving or headed in a good direction at the time.

That’s why I know how people around me would react to finding out I’m depressed. I’ve been on the other side. I’ve seen the happy exteriors. I can’t blame them for sneering at the idea of someone who’s always moving and smiling being depressed or suicidal.

I don’t know if there’s a point to this article except to warn you to look deeper. Even if someone’s always joking or busy, don’t automatically assume they’re happy. They might have high-functioning depression and feel worse than you could ever have realized. Ask them if they’re ok. Ask them how they’re feeling. Ask how things are going really.

It’s not about hounding them. It’s about being kind and showing them that you care. Showing them that they matter to you. You’d be amazed at the difference that can make. It’s also about letting them know that they can talk to you and trust you. You see, all depression tends to be secretive. High-functioning depression is even worse about hiding itself. You can’t force anyone to tell you, but letting them know that you’re there to listen and that they can trust you goes a long way to encouraging people to talk to you and share their troubles.

Even though I have high functioning depression, that’s all I can think of. Can anyone else think of a way to know that someone has high-functioning depression? Or some way to help them?


Life Is Watching Everyone You Love Die

I struggle with this idea a lot. That life is watching everyone you love die. I can’t keep it out of my head. Ever since it occurred to me, it’s like a constant panic and depression lurking inside. A feeling of absolute helplessness or insecurity. Like ignorance and naivety were my shield, my security blanket, and now they’ve been ruthlessly stripped away so that safety and happiness feel like illusions. Like self-deception.

I didn’t use to think that way. Then, over the past few years, I lost more and more of the people I care about. Relatives, friends, and acquaintances. As a kid, I’d only lost one or two, and they were spaced out by years. Now, it was like Death had a monthly quota to fill, and only people I knew would do. People died of cancer and heart failure. They died of old age. They died in stupid, senseless accidents. And far too many of them died by choice.

I couldn’t deal with it. Can’t. Even now, sitting here writing this, my throat is closing up, and my eyes are filling. When deaths hit you one after the other, you don’t have time to adjust, to deal with the grief and anger. And after a while it hits you that this is your future: watching everyone you love die one after the other unless you’re lucky enough to go first.

That’s when the fear wraps around your heart. Any illusion of control disappears. There’s nothing to shield you from the helplessness any more, nothing to hold it at bay or defeat it because you know, without a doubt, that every single person you love is going to die and that no matter what you do, there’s no way to change that. Not one. Our future deaths are the only truly certain things in life.

As if that weren’t dark and depressing enough, the onslaught of deaths emphasized the fact that not only is everyone you love going to die, but you also have no idea when it’s going to happen. That epiphany has a great effect on the nerves. It maintains a constant level of anxiety, like an abused person flinching from a raised hand, expecting a blow.

Sometimes, you can hide it for a while. Push it down where it’s not as obvious or cover it with cushions to muffle the screaming. But it always comes back. You hear a song about loss. You watch a character die in a movie. Your grandparents talk about all the people they knew who are gone.

That’s when I really choke up. When I talk to the elderly, people have already lost their grandparents, parents, siblings, and most of their friends. Even thinking about losing my grandparents and parents is emotionally crippling to me. If I was an actress, I’d never have to worry about crying onstage. All I would have to do was picture my life after losing my family, and the tear faucet would be on.

It’s a problem. It’s a serious problem because I can’t fix the cause. It’s not something that’s going to go away or change. In fact, it’s only going to get worse the older I get. So what do I do? How do you deal with knowing that life is watching everyone you love die without getting so depressed and anxious that you ruin your own life?

Afraid of Trying: Do Emotional Issues Ever Die?

Imagine that those feet belong to someone who’s never used a skateboard. That’s the feeling.

You might’ve gotten a hint that I have some issues (Why else would someone be afraid of trying?). It’s been a few years since the worst ones started, and I thought I’d gotten a lot better about dealing with them. Fate must’ve laughed pretty hard when I thought that.  Now, I’m wondering if emotional issues ever die or if they just go into hiding until you run into another situation that brings them up.

My main issues are depression and anxiety, and both are firmly tied to a lack of self-confidence and self-worth (see “They Call Them the Depths of Despair for a Reason” for more details). That’s what caused the fear of trying – a few years ago, I believed, no, I knew, that I would fail. That there was no other option. That no matter how hard I worked or what I tried, there was no possible way to succeed. Add that to a need for people’s approval, and you have a recipe for a hideous mix of depression and anxiety.

Over the past few years, I’ve worked on rebuilding my confidence and trying to develop some self-worth. I thought I was doing pretty well. I thought I was getting stronger and confident enough to deal with, well, life. Notice the past tense. After this week, I have to face the fact that either I was wrong, or I still have a long way to go. Or both.

This week, I found myself facing change. New challenges. New responsibility. New possibilities. And are they bad things? No. They’re probably very, very good things. Things that I’ve wanted for a long time. Things that I still want. Things that would be wonderful and amazing if I could make them real. And even the idea of trying to make them happen gives me enough panic that I can’t sleep at night.

Because I’m still afraid of trying. Like all the things I’ve tried over the past few years didn’t count. I can try new things in very specific areas – new angles on things I’ve already tried. But new stuff? Trying things in other areas? Oh, no. No. That’s no good. Run away, my insides say. Get out now.

That’s when I realized that I’ve carefully formed a bubble around myself. I have layered myself in a comfort zone that gave me a sense of security and false confidence. Within those parameters, I can be confident. I can have worth. But outside of that? Outside of that, I’m not sure if anything has changed. Even thinking about trying something outside of those bounds makes my stomach knot and my chest feel shaky.

Somewhere, somehow, my subconscious has labeled the inside of that bubble safe, and the outside as dangerous. As risky. And risks are scary, especially if they’re risks that rely on me. And all these changes I’m facing rely on me. I have to make them succeed. No one else can. And because I don’t believe that I can, because it is easier to believe that I can’t, I find excuses not to try. I put it off and put it off because then I can tell myself that I’ll do it someday, that the timing’s wrong.

Hurrah for new insights to my problem, but how does this help? Knowing that I’m afraid to try these things doesn’t help me overcome the anxiety. I can throw logic and deep breathing at the anxiety all night – it still doesn’t lower enough for me to sleep. Running numbers, showing evidence that, yes, I can do these new things, that I can make them successful doesn’t lower the conviction that, no, no, I can’t.

All I can do is hope that if I force myself to do it, force myself to try, and I succeed – despite the panic and the anxiety and the doubts – then, maybe, maybe, the anxiety will fade. Maybe, the panic will stop. Maybe, the bubble will grow. And just maybe, the next time I find myself facing a change, I will be less afraid of trying.

Wish me luck.

A Nursing Professor Tells A Student That Her Self-Harm Scars Are Inappropriate

There is a very interesting blog, The Mighty, that focuses on serious issues like mental illness, rare illnesses, autism, etc. One article, “When My Nursing Professor Told Me My Self-Harm Scars Were ‘Inappropriate‘” by Kathleen O’Brien, describes an incident that happened to her in nursing school. To summarize, a nursing professor noticed the 19-year-old student’s self-harm scars in class one day, called a meeting with the student later, and told the student that the scars are inappropriate and should be covered in front of patients.

You know, I think if I were teaching and saw that a student was cutting, my first concern would be to check on the student’s mental well-being. This so-called teacher didn’t even ask the student about her well-being. Not once. Instead, she told the student to hide the scars as if they were somehow shameful.

It doesn’t take a rocket scientist to figure out how that would make the student feel. But just in case you’re wondering, this is what she said about it.

“I was shocked, hurt, sad and confused. I left her office in tears.”

To add insult to injury, when the student asked a friend what she thought, the friend supported the professor.

“I wouldn’t trust you to be my nurse. I would walk out of the office if I saw your scars. You are not mentally competent enough to be a nurse.”

What a thing to say to a friend who struggles with depression and several anxiety disorders. Even if that’s what you believe, saying something like that so bluntly and ruthlessly is pretty cold.

I’m still struggling to process this story. I know I don’t think like a lot of people. But how would self-harm in any way make her unqualified to be a nurse? It’s not like she’s going to hurt her patient (unless the patient is herself). Cutting is an unhealthy way that people deal with interior pain or stress. Overcoming that shows that someone has learned to deal with their problems in healthier ways. I would think that both the strength and the healthier habits could be useful as a nurse.

And sometimes patients feel safer or more comfortable if they feel their caretakers really understand what they’re going through. Saying it would make patients doubt her competency is like saying that people’s skin color or sex would make patients doubt the nurses’ abilities. It’s true because people have prejudices against both, but it’s not a concern that should be catered to.

And it’s not like they aren’t going to have nurses who suffer from depression or anxiety. Or do you now have to pass a psych eval to get hired as a nurse?

On the other hand, I automatically question stories told from only 1 perspective. Is the professor reacting from experience? Has she seen patients become disturbed after seeing a nurse’s scars? And what about the friend? Is she thinking of more than the scars? Is there something in the student’s behavior that makes her seem like an unreliable caretaker? I don’t know. The student probably doesn’t know.

And having those perspectives be true doesn’t make hers false.

Because even if those other perspectives are true, they didn’t show any empathy, forethought, or even simple kindness. As far as the friend is concerned, I know that many people who don’t have anxiety or depression have trouble understanding it or knowing how to support people who have it. That isn’t helping me stifle the gut reaction that she’s not much of a friend. There’s honesty, and then there’s cruelty. At the very least, she owes her friend an apology for her delivery.

And teachers who have that little concern for their students’ health make me angry. For her to completely ignore the topic of whether the student is coping and getting treatment is extremely cold and irresponsible, especially when the teacher’s actions are likely to make any problems worse. And especially for a nurse who knows what the scars are and should be aware that that would probably be the result.

IMHO, that teacher is probably very lucky that the student didn’t complain to someone. It’s pretty hard for a university to publicly endorse professors insulting students’ self-harm scars. And if the school would have supported the professor’s actions, if that’s a common attitude in the medical field, that student has a long road ahead of her.

I think that’s what I’m circling around the most. She talked to 2 people and got the same response. So is it a common attitude, or was that an anomally? Would the school support the professor and say the scars are inappropriate? And would patients really be afraid to have a nurse with self-harm scars?

How 1 Thing Going Wrong Ruins Everything

mistake fuck-up 1 thing going wrong ruins everything

It’s stupid. I know it’s stupid. That doesn’t stop it from happening. That doesn’t explain why it happens (Other than the whole depression/anxiety bullshit). That’s how. I know how it happens. How one thing going wrong ruins everything.

It starts with that 1 problem. It can be a small, insignificant thing. Something that most people wouldn’t even consider a big deal. Like putting your foot in your mouth or screwing up your nail polish. Or it can be a big thing. Something that even non-neurotics would worry about. Like having a bill sent to collections. It doesn’t really matter which one – at least not if you’re as messed up as I am. The point is something goes wrong.

Usually right before going to a social gathering or a party. Something I have to force myself to do anyway. And going to that social whatever immediately becomes harder because now all I can think about is what I fucked up.

Now, I’m on the verge of tears, I’m cursing myself, I’m obsessing about every little detail of how I screwed it up, and I have to go be around people. Something that usually leads to more fuck-ups (hello, introvert with social anxiety and self-confidence issues). And given the recent one, I’m sure it will. It’s kind of like saying to yourself, “Well, time to go humiliate myself in public and pretend it’s fun.”

Exactly how are you supposed to have fun with all that going around in your head?

No answer? That’s because you don’t. Fun? Yeah, right. You just keep freaking out. Dwelling on the fuck-ups leads to tension and second-guessing, which lead to, guess what? More fuck-ups. A whole evening, a whole day, hell, a whole week can be totally ruined by one stupid, ridiculous thing going wrong.

Or if I really want to be honest, the fact that I can’t let go of that one stupid, ridiculous thing ruins everything else. I know people who can let their mistakes go and move on like it never happened. Go to a dinner right after one? No problem. Think about now, right?

Yeah right. There’s no way. Because I don’t know how to be any other way. How do you stop dwelling over stuff that’s gone wrong? Especially if it’s not over yet! Like the collection agency or facing someone after putting your foot in your mouth. When it’s not over, I keep going around in circles of what I did wrong, what I should’ve done, how could I be so stupid?, and what am I going to do to fix it? Can I fix it? Or is doing anything just going to make it worse?

And even if I did fix it, does it matter if I can’t fix me? If I can’t make myself stop circling? Can I hide the tears and pretend to be happy and having fun when I really want to go home and cry? Then, at least no one I know will realize how fucked up and stupid I am. Oh, wait. That’s the end of the cycle. It’s time to go back and start from the beginning.

And that’s how 1 thing going wrong ruins everything. Over and over and over again.

Does 1 thing going wrong ruin everything for you, too? Or have you figured out how to stop the cycle – how to fix it. If you have, I’ll take whatever notes you’ve got. Because I’m sick of this.

Sabrina Benaim’s “Explaining My Depression to My Mother”

Sabrina Benaim’s poem, “Explaining My Depression to My Mother” is sweeping the internet. I can’t help but think that proves just how powerful the poem is. And how common depression is. For those of you who haven’t watched it yet, here it is.

I can’t say that’s exactly what my depression and anxiety are like. Her metaphors and expressions are different. I am not confined to my bed. I am chained to my emotions. I am dragged down by sudden onsets of fear, rage, weeping, and more. I force myself to go out for that same keeping busy that she mentions, and I do have fun until the instant when the outing is over. Then, I rage at myself and beg people who aren’t even there to forgive me for my stupidity and worthlessness.

No, her story isn’t exactly like mine. A detail here. An idea there. But it isn’t the details and the ideas that make her poem so strong or give it the voice to speak to my heart and make it crumble. It isn’t her metaphors. It isn’t her mother’s questions although God knows anyone who has tried to explain depression to someone who doesn’t have it has heard a series of problem-solving questions so similar that they might as well be identical.

These questions and suggestions echo with variations on the theme that you are weak. That what is happening to you is your choice. Your fault. Until you feel like you need a tattoo on your forehead: I am not a problem to be solved, and there is no off switch for my depression.

And that is the key to her poem’s power. Not the details, not each moment, but the feelings behind them. It is her emotions that we remember, and it is those emotions that are the same. The despair of being understood. The frustration as each explanation is twisted and misinterpreted so far from your meaning that you have to wonder why you bothered to speak at all. The sly, lying voice that delights in destruction that tries to convince you that they’re right so that you can have one more thing to feel guilty about.

As if feeling guilty for existing is not enough

Whether you hide under the blankets, run from one party to the next, distance yourself with drugs, or any other escape – the pull downwards, the darkness and the bear, the nagging voice of self-doubt and self-despair – the emotions that trap us or send us running are the same. Like links in a chain. People with depression bear similar burdens like jumpsuits in a prison.

If you cannot understand the why of depression, if you cannot understand the reasons or reactions that come from it, please, try to understand at least this: the emotions are real. Whether you understand them or not, they are real, they are strong, and they can easily become overwhelming. Fighting against them is a struggle, and there is never a finish line where you can check off a victory and forget about them forever.

Even if you cannot understand, you can respect that they are. Do not dismiss them. Do not wave them aside as fantasies or delusions. Do not act like there is an easy fix. There isn’t. There are behaviors that can help. There are treatments. But there is no simple or permanent solution.

Instead of seeing a depressed person’s reaction and thinking, “Why is he so upset over nothing?” Think “He’s really upset. What would it be like to feel that upset over something you ‘logically’ know isn’t important?” If you can do that, if you can put yourself into that other person’s shoes and feel that frustration, pain, and despair for that lack of control over your own emotions, then you will have an inkling of what depression is like.

And if you can do that, I challenge you to watch Sabrina Benaim say her poem about explaining depression to her mother again without feeling some of that same pain and despair. Can you? I can’t.