Struggling With Major Depressive Disorder
By: Carol Burt
Tags: Mental Illness, Malingering, Mental Health, Life Expectancy, Depression

Struggling With Major Depressive Disorder

I wish more people understood how it feels to have chronic depression.

Do normal people know depression feels like dying? Because it does. When it’s a bad episode I’m sure I am slowly dying, but in that state I don’t much care.

Mostly I just lie in bed and wait to see. For the sake of those who love and depend upon me I hope to get better, to somehow get up, get going, shower, clean my house, engage in my hobbies, and enjoy my full and blessed life. But I can’t do those things during a major depressive episode.

Dying, it seems, would solve my biggest problem which is that sometimes — more often since I’m older — I cannot muster the effort it takes to get out of bed. The sheer weight of depression lays on me like a lead blanket. It’s sometimes so heavy it seems I cannot lift my arms — and certainly not my whole body.

Do people understand that depression causes those of us who are afflicted to feel guilty and ashamed that we cannot function properly? We are often thought to be lazy and shiftless for not getting up and doing the things adults must do in order to have good lives. Worse than what others say is depression causes us to readily pass the same judgement on ourselves. It doesn’t matter we have a diagnosed brain disease and its symptoms and manifestations have nothing to do with the quality of our character. We still feel the crushing weight of guilt on top of it all.

Depression Hurts

If one has the flu it’s expected they will stay at home in bed. No one expects someone with the flu to be up and going about their regular business. It’s not understood by most when depressed people can’t get out of bed, shower, dress, go to work, shop, prepare meals, etc. We’re often just seen as lazy.

Too many in this supposedly enlightened time do not know that in addition to the psychological effects, depression has terrible physical effects. A major depressive episode hurts. Pain is magnified. The entire body often aches and joints feel stiff and painful. The worst, though, is the overwhelming exhaustion. We are too tired to live when we’re suffering through an episode.

It’s never that I actually want to die. Most depressives don’t. Instead, I’m just too exhausted to live.

Somewhere in my sick chemically unbalanced brain I still want to get up and do the things I love. I want to keep working on the restoration of my old house — it’s one of my favorite activities — and I want to go junking. I want to cook. I enjoy cooking for my husband and grandson. I want to go spend time with my mother. I want to take her places she can no longer get to by herself. I want to go to the library. I want to play with my paint and markers. I want to rearrange rooms and reorganize all the stuff stored upstairs.

But sometimes I can’t get up and get dressed. And even when I eventually can, I first lie in bed for hours trying to will myself to ignore the heaviness, the aching, and the feelings of hopelessness. When I finally drag myself out of bed, shower and dress, I’m exhausted. After that monumental effort, I’ve used up what energy I could muster. So I’m up and dressed but usually I accomplish little or nothing.

Depressed People Aren’t Lazy; They Are Incapacitated

If everyone understood depression can leave one as incapacitated as a physical disability, the lives of those who have it would be easier. How awful it is to be so ill and miserable and have others label us as “just lazy.” It is not ok to say things like that.

It’s also not ok to say things like, “snap out of it,” or “rise and shine” or any of those well-meaning but irritating things that can trigger sadness, shame or, in some cases, extreme irritability.

I had a marriage fall apart because,according to him, I was “laying around crying all the time.” I was. I was depressed and not on medication. He said I was feeling sorry for myself. I was guilty of that, too. I felt sorry for myself, but also hated myself for being unable to function.

He found someone who was happy, he said, “like you used to be,” and left me. Money was tight during that marriage and I didn’t want to make it worse by running up bills seeing a psychiatrist or getting therapy.

I’m over it, and found more happiness with the good man I’m married to now. But that divorce was largely due to untreated depression.

Depression Tricks Us Into Believing Nothing Will Help

It is depression — the very ailment we have — that tricks us into thinking it’s hopeless to seek treatment. When one is in a bad patch, it’s hard to imagine anything that could help.

Major Depressive Disorder (MDD) can and does wreck lives. It cannot be minimized as “a feeling of sadness.” It is so much worse than that.

Depression comes and goes and no one knows why except that the chemicals in the brain become unbalanced. There are no real answers as to why it happens. Moreover, it only happens to some of us, and happens temporarily for most people, while it can be a chronic and lifelong condition for others.

I first experienced depression as a teenager but had no idea what it was. Adults saw me as overly dramatic when I cried over the smallest things. I was kind of a melancholy kid from all the photos I see. I remember feeling as if no one loved me — although that was not true at all. I knew I was loved. But that’s one of the disastrous effects of depression. It can cause us to adopt low self-esteem. It makes us feel as if no one could ever love us even if the facts prove otherwise. We often feel worthless. In the most acute phases of major depression, we have no hope for ourselves or the future.

Extraordinary Losses Often Caused By MMD

I’ve only been suicidal once, in my twenties, and I was able to get myself to a hospital and ask for help. After a few months of hospitalization I was well again. But I then had to cope with the ruins of what had been my life. The losses were extraordinary and changed the course of my life — though not in a good way. Whatever I had built was gone, my job, the trust people placed in me, and the lifestyle I had lived. My child, who was only 6 years old, was hurt by what she experienced as abandonment. My parents were scared half to death and worried whether I’d ever be alright.

Fortunately, I got help instead of dying. It was excellent help, and I’ve never since been truly suicidal. But there were still heavy consequences. When I was released from the hospital I had to deal with them whether I felt strong enough or not. Regular therapy and medicine kept me stable and I maintained mostly good mental health for years, although there was sometimes an underlying low level depression.

When I was younger it was easier to manage my depression. Like most people with clinical depression, my meds would make me feel fine. So well, in fact, that I would decide I no longer needed psych meds. Then shortly after I stopped taking them I would fall back into the black hole. It seemed to be worse each time and harder to get under control. A combination of meds and therapy would bring me back to health, but it took some time.

Now that I’m old I know better than to stop my medications. I’ve finally learned, through many bad experiences, that I cannot do that. Not now, or ever. The costs are too high, and relief is hard and slow to attain.

It Becomes Harder To Stay Well As We Age

I don’t often feel fully free of depression anymore. Meds “wear out” and don’t work like they once did. Then it takes weeks to change over and start a new medicine, and more weeks to wait and see if it works. Meanwhile, I’m depressed until the new med kicks in. And sometimes I’m left with full-blown major clinical depression if it doesn’t. Then a new one is tried. Hopefully in a few weeks it will take hold and lift the black fog in which I must exist while I wait for my brain chemicals to get adjusted.

Maintenance becomes more difficult as one gets older. But, as if to compensate — sarcasm here — major depression shortens one’s life expectancy even more than smoking.* That’s hardly cheerful news and knowledge that adds to the hopelessness of depression.

There’s depression, and then there’s MDD. Anyone can become depressed over a terrible event or tragic loss. Almost everyone will at some time experience sadness that becomes depression to some degree. Most of these episodes are very treatable. The type depression related to events or circumstances has a definite cause, unlike chronic clinical MDD. Situational depression can sometimes be alleviated with therapy alone.

Medication and therapy don’t always completely alleviate MDD. Aging is tough for most people. But it’s when our old stand-by medicines stop being effective and therapy seems pointless after one has already been counseled, analyzed, and had an alphabet soup of therapy methods.

Being unable to completely control my depression caused me to retire early from a job I loved. I had planned to work several more years but it became impossible.

To make things worse, many of the newer, more effective antidepressants aren’t recommended for people over 65 because of possible serious or fatal side effects. Isn’t that just peachy?

What Does 40 Years Of Antidepressants Do To A Brain?

No one yet knows what effect a lifetime of taking antidepressants has on a person. There’s not a lot of research on it. Maybe because we die relatively young? Before they can study the long term effects of depression. One effect seems to be death and I guess any others become moot issues once the research subjects kick the proverbial bucket?

With antidepressant medication we basically force our brains, through artificial (medicine) means, to produce more of this chemical and less of that, etc. It can’t be good for it. Early dementia is fast becoming a concern, too. Maybe the stuff we have to take wears out our brains, especially since they were atypical in the productions of brain juice anyway.

No wonder those of us with MDD are so often bummed. First they tell us we have considerably shorter life expectancies than others. Then they tell us we’re at increased risk for dementia. Basically we’re going to go crazy and die early. Ok. So, don’t worry and just be happy.

In the last few years I’m more apt to feel the anger and increased irritability that can accompany some phases of MMD. It might have something to do with a prognosis that this disease is not only killing me before my time, but probably driving me crazy beforehand, too.

Psychiatrists, Too, Can Be Uninformed

When I see a new psychiatrist (which happens often at the teaching and research hospital where I get mental health services) I often feel like I’m more of an expert than they are. One bright and cheerful very young psychiatrist told me recently that major depression and bipolar disorder are “usually outgrown” by the time one is elderly. I argued, of course, and she informed me that the “newest theory suggests people will outgrow most brain disorders as they become senior citizens.” What? And she said that with a straight face after seeing the list of medications I take and discounting everything I had just told her. I’ve never been violent in my life — but I really wanted to slap her smug little face even though I wish she was right.

The next time I went in for medicine check there was a different psychiatrist, also new, possibly an intern, since she seemed to be under the supervision of an older doctor. I was just too tired to go into detail — again — about my lifelong battle with depression.

I told her I just needed my refills. The only thing worse than possibly needing a new medication is being put on one an inexperienced shrink thinks “might” work. That’s ok, but no thanks. I’ve been there and done that. I’ll stick with my current medicines and manage until I can see someone more experienced. As an old lady with chronic MDD, I don’t feel like experimenting.

Depression is a disability that causes one to sometimes be unable to function. It can put me to bed as easily as the flu or any other acute illness. When it hits me I can’t function normally. It is impossible for me to get up and dress to meet the day. I’m not saying that seeking pity. I’m saying it because it’s true. It’s a fact of my life and I wish, for the sake of others as well as myself, that people would educate themselves and learn the symptoms and disabling characteristics of depression. It is not just feeling sad and wallowing in it.

However, I try to forgive people for not understanding and for thinking I’m just malingering. After all, I thought that of myself before I adjusted to and learned the effects of my mental illness. I’m easier on myself now. I’m not ashamed on the days I don’t get dressed. I don’t bother to hide my frequent inability to get out of my house and I don’t care who knows I have MDD.

I Suffer Along With 16 Million Other Americans

It could always be worse. Besides, I’m far from alone or unusual. An estimated 16 million people in the United States alone are afflicted with MMD and suffer a serious episode at least once a year. The World Health Organization estimates as many as 300 million people worldwide suffer from depression and it’s the world’s leading cause of disability.

A large number of depressed people commit suicide. It’s estimated every 40 seconds someone with depression kills themselves.*

More women (8.7%) than men (5.3%) suffer with depression and people of both sexes most often experience their first episode between 18 and 25 years of age.

So, while it’s a serious and prevalent disorder, it’s one that has sparked much research and new medicines are constantly being developed. Someday not too far in the future it is hoped we will be able to conquer depression just as so many other maladies have been cured or prevented.

Until then I’ll just struggle along as a not-quite-crazy-yet old woman, take my medicine and write my articles. Amazingly, I can often write when I cannot do anything else. Granted, I often write in bed under the covers, but mostly, I can write. With the one exception of when I had to be hospitalized so many years ago, depression has never rendered me completely unable to write. For that I am very thankful.

*Sources:

www.research.va.news/features/depression.cfm

https://psych central.com/news2018/07/13life-expectancy-in-mental-illness

National Institute of Mental health

Https:www.bbc.com/News/Health-13414965

World Health Organization