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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by mist on October 5, 2000, at 1:59:08
What can a depressed person say to friends (and others) who you know can’t deal with depression, loneliness, sadness? (Or simply aren’t interested in hearing about it.) I have to come up with things to talk about yet usually when I’m alone, I focus on feelings, thoughts, ideas not what I did or will be doing on the weekend or this year or with my life (like they do). I don’t care that I can’t get support from these people because I’m sure there will be others I can get support from (as I have before). And in one way I like not being able to “talk depressed” to some people so that the depression doesn’t take over my life—it’s not all that I’m about. But I can’t think of things to say that are upbeat yet not total lies. I think I’ve just gotten in the habit of having downer, negative conversations and don’t know how to break out of it. The fact is, there is nothing exciting going on in my life and I hardly ever make plans to do anything due to lack of motivation and energy. At the same time I enjoy simple things like a good cup of coffee and sometimes being amused by the absurdity of life, and I spend a lot of time looking for solutions to my problems (reading, information gathering, etc.). The particular people I’m talking about wouldn’t understand that and sometimes I feel more depressed when I talk to them (but maybe I’m depressing myself with what I’m saying to them?). I feel like not returning their calls but then my supply of friends would dwindle even further…
Posted by mist on October 5, 2000, at 2:53:14
In reply to How to talk to happy people?, posted by mist on October 5, 2000, at 1:59:08
Maybe i just don't know how to post messages correctly to this board but i thought i had posted a followup (a P.S.) to the post I started the thread with. As of this writing, it hasn't shown up on the board so maybe i didn't post it right. Anyway, the point of it was that the word happy in the subject title of my original post was in quotes but the quotation marks dissappeared when I confirmed the post. (My point being that the people I was discussing may or may not be happy--I don't know. They appear happy and seem to have a positive outlook but maybe they're just in denial about something.)
Posted by Nibor on October 5, 2000, at 12:16:38
In reply to Re: How to talk to happy people? (P.S.--again?), posted by mist on October 5, 2000, at 2:53:14
Hi, Mist
Good question. When I'm feeling low but still able to interact with "happy" people, I worry that talking about my mood will bring them down so they won't want to be around me. What I try to force myself to do is ask them questions about themselves, what they're doing and so on. People love to talk about themselves, especially when someone is really listening.
Sometimes I find out they're not as happy as I thought. Sometimes what they have to say is so appealing it brings me around. Other times it's neutral, but it gets me through the party or dinner or time together.
Take care,
Nibor
Posted by Mark H. on October 10, 2000, at 19:01:14
In reply to How to talk to happy people?, posted by mist on October 5, 2000, at 1:59:08
I share your problem and have lost most of my social skills (and friends) over the years to this peculiar symptom of depression. Even my closest long-term friends find it difficult to sustain a conversation with me when I'm at my most depressed, and no matter how intent I am on being positive, I invariably find only negative connotations and pessimistic connections to make. The few "positive" things I force myself to say are even worse, because they are so clearly false.
Like you, this then extends to not wanting to return telephone calls, even knowing that I will feel better if I get the matter off my plate. Invitations to lunch or dinner gatherings are cancelled at the last minute. A planned activity is replaced with staying at home and watching a video, or just sleeping extra hours. I then start going out of my way to avoid people I recognize in public, and finally don't want to leave the house or receive visitors at all. I become suspicious and fearful of other people's intentions, especially as they might involve me.
This cycles down to an organic "certainty" that I'll never get better and will wind up on the street living out of a cardboard box, alone, unloved, half-crazy and untreated, or at best an unbearable burden to my family.
I call depression the "selfish disease," because it creates an inability to take an interest in others, which as Nibor noted is the basis for social interaction (not to mention compassion and empathy). The world gets smaller and smaller, like a dark envelope closing in around me. It's not a choice; it's not laziness; it's not indifference or not knowing better; it's more like paralysis. Those who haven't experienced it have no way of relating to it at all.
In contrast, when I'm well, I exult in the magnificient illusion that EVERYONE is interested in what I have to say and, sure enough, my enthusiasm, even for the most seemingly trivial topics (e.g., growing bamboo), is sufficiently engaging not only to carry the conversation and lift moods but also to inspire cheerful and engaged responses from others. The relative reality is completely unchanged; the only variable seems to be the multi-level effect of having a few micrograms more or less of certain brain chemicals.
A friend of mine claims that all of what I describe can be summed up under the social organizing principle of "belonging." Those with high serotonin (and other neurotransmitter) levels are selected as natural leaders and have a strong innate sense of belonging. Years of depression have enabled me to pick them out of a crowd in a few seconds. I love high-serotonin people but, of course, EVERYONE loves high-serotonin people. They smell good, they're fun to be around, they make whatever activity or idea they're into seem like the most fun or most important in the world. Even if they are not particularly good-looking, we perceive them as being exceptionally attractive. We all want to do whatever they want to do, as long as they'll do it with us.
At the University of Oregon in the 1970s, the psychology department was doing long-term studies on depression from a behavioral standpoint. They thought if they put low-serotonin people together with high-serotonin people, the depressives would learn to mimic the behavior of the uppies and become un-depressed.
I think there is a certain *level* of depression at which behavioral and cognitive therapies are extremely useful -- those levels at which one still has (or with medication has regained) a choice, when one can still force him/herself to "snap out of it" for an hour or two with sufficient motivation, whether out of fear, love or necessity.
But for serious, longer-term endogenous depression, for people who cannot force themselves to go for a walk or invite a friend to share a pleasant activity, therapy of any sort falls short. At that point, having the information of how one "should" behave is just one more indication of how defective and damaged one has become. Even killing oneself becomes too much of a bother, an overwhelmingly complex act, the ramifications of which are beyond sorting out in this molasses-like state of impaired cognition.
"Sadness" and tears are, for many of us, so far "up" from depression that we forget even to mention it to our doctors. In the anhedonic haze of severe depression, the most troubling symptoms may be memory loss (where was I going? what did I do this morning? did I remember to eat today?); inappropriate guilt (feeling responsible for bad things done by other people, even historical figures); sleep disturbances, especially early waking with anxiety, fear and/or guilt; loss of appetite and interest in sex; loss of confidence in even our most basic skills; constipation; emotional numbness -- and inability to think of anything to talk about with others.
The seemingly continuous quality of severe depression is an illusion. If I pay attention, there are often periods, ranging from a few seconds to several hours, when I feel pretty good, even at my worst. If I let myself have those times when they happen without grasping (without trying to make them stay when they go) then I don't find the miserable parts quite so bad. And just being able to remember that depression will not last forever when I am in the worst of it helps.
Best wishes,
Mark H.
Posted by Phil on October 10, 2000, at 20:04:32
In reply to Long, Depressing Response, posted by Mark H. on October 10, 2000, at 19:01:14
I've never read a better description of depression in my life. Thanks.
Posted by mist on October 10, 2000, at 21:54:54
In reply to Long, Depressing Response, posted by Mark H. on October 10, 2000, at 19:01:14
I agree that was a very good description of depression.
Also I wanted to clarify something from the post I started this thread with. I said I can't think of any upbeat things to say that aren't lies. I want to be clear that I don't actually lie! It's just that sometimes I think, why not tell 'em what they want to hear? I can't, though, it would be too weird and anyway, why live if you have to pretend to be someone you're not?
However, recently I prepared for a call I had to return by thinking of nuetral rather than negative things to say (in other words not talking about my feelings--just the facts). The call went well and I was glad I had done that.
Posted by shar on October 10, 2000, at 23:10:39
In reply to Long, Depressing Response, posted by Mark H. on October 10, 2000, at 19:01:14
Mark H. -- One skill you certainly have not lost is the ability to put into words the pain of depression. I agree with Phil.
The Anhedonic Haze really speaks to me, and I think the flatline world out of the black pit is sometimes almost as bad as a trip to the pit.
Thanks for your excellent and authentic response.
Shar
Posted by mist on October 11, 2000, at 1:30:28
In reply to Long, Depressing Response, posted by Mark H. on October 10, 2000, at 19:01:14
P.S. to Mark-- Your observation about having periods where you feel good in the midst of depression is particularly interesting. I wonder what's responsible for that type of change? It sounds as if it's unpredictable.
In any case, I wish you more of the good periods. You're a talented writer--too bad things like being gifted and intelligent aren't enough to send depression on its way. Instead, it seems to be the opposite for many people.
Posted by medlib on October 11, 2000, at 1:57:25
In reply to Long, Depressing Response, posted by Mark H. on October 10, 2000, at 19:01:14
Mark--
I disagree--the *subject* of your post is depression, its effect is anything but. It is stunningly eloquent, and true eloquence is a thing of rare beauty--always uplifting, regardless of subject.
I believe that one's greatest gift (and most valuable possession) is not compassion, but understanding. Understanding unlocks the door through which compassion must enter to be experienced.
Thank you for the beautiful gift--and welcome back! You were missed.
Well wishes---medlib
Posted by chdurie2 on October 11, 2000, at 16:13:39
In reply to Re: Long, Depressing Response » Mark H., posted by medlib on October 11, 2000, at 1:57:25
> Mark--
>
> I disagree--the *subject* of your post is depression, its effect is anything but. It is stunningly eloquent, and true eloquence is a thing of rare beauty--always uplifting, regardless of subject.
>
> I believe that one's greatest gift (and most valuable possession) is not compassion, but understanding. Understanding unlocks the door through which compassion must enter to be experienced.
>
> Thank you for the beautiful gift--and welcome back! You were missed.
>
> Well wishes---medlibmark h. - your long, beautiful response was pretty depressing, i say, as tears come to my eyes. but i hope you know - and i think you do from your other postings - that depression needs no apology.
what i don't understand, and maybe it's rude to interject your poetry with rational stuff - as this is something i'm struggling with myself - is that as low as you go, you seem to be aware of times when you weren't so low, and you can tell yourself that your depression won't last forever.
for myself, my depression feels like an "always," although i must admit i'm sick and tired of being depressed. recently, i've started to have little "news flashes" within myself, that my depression doesn't have to be an "always." on sunday, when i fell into a horrible depression and called my p-doc for some "emergency" help, i found myself saying, "i know i'm not being rational." He told me to go on, and i found myself starting to say and feel like i could believe some positive stuff. i kind of ended the conversation by saying, "maybe i should go psych myself into this stuff." and he said "yes."
so my question is: if you can see the "up" side,
then why are you so depressed? (not meant critically) or is it that your "up" observations and your depression are divorced? perhaps this is meant rhetorically, or perhaps i sense that you have a wisdom about handling depression that maybe you do or don't have. Make sense?I don't know. As i sit here at 5 p.m., still in my pajamas, having started the day determined to face things i need to do, and having gotten waylaid by this website and other i-net things, i'm feeling pretty discouraged. i didn't mean to turn my compliment about your posting into my own pouring out, but i guess it turned out that way.
do you have any wisdom you'd care to share? and thanks for the compliment on my own writing.
guess it's time to get dressed and do something.
caroline
Posted by ksvt on October 15, 2000, at 16:06:13
In reply to Re: Long, Depressing Response...wisdom?, posted by chdurie2 on October 11, 2000, at 16:13:39
> > Mark--
> >
> > I disagree--the *subject* of your post is depression, its effect is anything but. It is stunningly eloquent, and true eloquence is a thing of rare beauty--always uplifting, regardless of subject.
> >
> > I believe that one's greatest gift (and most valuable possession) is not compassion, but understanding. Understanding unlocks the door through which compassion must enter to be experienced.
> >
> > Thank you for the beautiful gift--and welcome back! You were missed.
> >
> > Well wishes---medlib
>
> mark h. - your long, beautiful response was pretty depressing, i say, as tears come to my eyes. but i hope you know - and i think you do from your other postings - that depression needs no apology.
>
> what i don't understand, and maybe it's rude to interject your poetry with rational stuff - as this is something i'm struggling with myself - is that as low as you go, you seem to be aware of times when you weren't so low, and you can tell yourself that your depression won't last forever.
>
> for myself, my depression feels like an "always," although i must admit i'm sick and tired of being depressed. recently, i've started to have little "news flashes" within myself, that my depression doesn't have to be an "always." on sunday, when i fell into a horrible depression and called my p-doc for some "emergency" help, i found myself saying, "i know i'm not being rational." He told me to go on, and i found myself starting to say and feel like i could believe some positive stuff. i kind of ended the conversation by saying, "maybe i should go psych myself into this stuff." and he said "yes."
>
> so my question is: if you can see the "up" side,
> then why are you so depressed? (not meant critically) or is it that your "up" observations and your depression are divorced? perhaps this is meant rhetorically, or perhaps i sense that you have a wisdom about handling depression that maybe you do or don't have. Make sense?
>
> I don't know. As i sit here at 5 p.m., still in my pajamas, having started the day determined to face things i need to do, and having gotten waylaid by this website and other i-net things, i'm feeling pretty discouraged. i didn't mean to turn my compliment about your posting into my own pouring out, but i guess it turned out that way.
>
> do you have any wisdom you'd care to share? and thanks for the compliment on my own writing.
>
> guess it's time to get dressed and do something.
>
> carolineCaroline - excuse my digression and nosiness, but you wrote elsewhere about not wanting to take your law boards until you got a certain score on a certain test. What's that all about? It sounds like you're headed in some positive direction. ksvt
Posted by Mark H. on October 17, 2000, at 22:55:30
In reply to Re: Long, Depressing Response...wisdom?, posted by chdurie2 on October 11, 2000, at 16:13:39
Dear Caroline,
Thank you for your beautiful letter. I don't have any wisdom, but I have found a tiny crack in the monolith.
There is a mysterious and cruel seamlessness to the experience of depression. When I'm seriously depressed, it feels as though I have always been depressed, and I cannot remember what it was like to be otherwise. I lose the present, and I lose the past. If I think of something good I've done, I start questioning why I did it. Past periods of insight and productivity begin to seem like superficial hypomanic episodes rather than sustained and worthwhile accomplishments.
If I try to be logical, to use my intellect, then everywhere I look I see seemingly concrete evidence that the future will only be more difficult and dreadful than the present. Even positive thoughts -- I'm holding down a meaningful full-time job, I'm happily married, I have a nice home, my car is paid for -- can be turned around. After all, if I feel like I'm just barely keeping it together when things are this good, what would I do if faced with even minor adversity?
Just as strange, however, is that when I found a mix of meds three years ago that lifted me out of depression, within a few days I could no longer remember or relate to what it was like to be depressed. It wasn't subtle or gradual. Suddenly, it was as though I had left depression behind decades ago or that it had happened to someone else. Yuck, get me away from all these depressed people! But the depression eventually returned.
These experiences completely undercut my sense of reality. I've always felt I had a heightened capacity for love, for spirituality, for intuitive insight and being able to make connections across multiple disciplines. Now I read that these qualities I hold most dear are considered delusional artifacts of bipolar disorders and other brain diseases. My negative concerns about myself are equally grandiose and just as unlikely to have much validity.
Unable, then, to trust my feelings, my thoughts or my judgment, my accomplishments or my motives, the reality of my demons or my imagined abilities, what is left? What IS left if I take away everything I think of as being "me"?
What's left is awareness. Not concepts, not feelings, just awareness. (Note the inherent foolishness of my trying to use concepts to explain something that is beyond concepts; I'm a slow learner.) If I were able to sustain awareness, then perhaps over time I might also gain some wisdom. In the meantime, I'm still lost in the storm of my thoughts and feelings almost all of the time.
But to whatever microscopic extent I am able to experience simple awareness, I notice that my depression, even at its worst, tends to breathe, and that it is my thoughts about it that turn it into a seemingly uninterrupted living hell. If I can be aware of the thoughts and the depression and my feelings and the desire to get out of my own skin, then whatever it is that is aware also notices that the seamlessness of the experience is an illusion, a biochemical belief system doing mischief to my reality, just another temporary phenomenon that seems incredibly real and durable at the time I'm experiencing it.
If I can relax into awareness, without judgment, then the paralysis of depression doesn't last as long. I'm not as freaked out about bad periods or mindlessly relieved during good periods. I don't make the bad periods worse by striving to change or hide them, or by reifying them with self hatred and yet more concepts. I don't pretend that the good periods are permanent and plan the rest of my life around being reliably brilliant and affable.
I guess I should confess that I am a Buddhist, but a rather retarded one. I feel like life is beating Buddhism into my bones so it doesn't become just a social experience or a bunch of memorized rules and rituals. I'm not anywhere near ready to state that I'm grateful for my depression, but I have glimpsed why people who do have wisdom often are able to make such seemingly outrageous claims.
I hope some of these thoughts find a positive resonance with you.
Thank you,
Mark H.
Posted by Noa on October 18, 2000, at 16:30:13
In reply to Re: A Lengthy Addendum » chdurie2, posted by Mark H. on October 17, 2000, at 22:55:30
It has been great reading this thread.
It stimulated this thought: depression is like a bad researcher--who draws the conclusion first and then goes searching for evidence to back it up, selectively attending only to that which supports the conclusions and screening out that which doesn't.
There is a whole lot of ways that moods cause selective attention to different aspects of reality.
Posted by dj on November 8, 2000, at 20:11:20
In reply to Long, Depressing Response, posted by Mark H. on October 10, 2000, at 19:01:14
> In contrast, when I'm well, I exult in the magnificient illusion that EVERYONE is interested in what I have to say and, sure enough, my enthusiasm, even for the most seemingly trivial topics (e.g., growing bamboo), is sufficiently engaging not only to carry the conversation and lift moods but also to inspire cheerful and engaged responses from others. The relative reality is completely unchanged; the only variable seems to be the multi-level effect of having a few micrograms more or less of certain >brain chemicals.
Mark H.,I was just re-reading your eloquent description of depression as you and many of us experience it, at times. I'm particularly curious about the above paragraph. Do you consider yourself to have pure, unsullied depression or bipolar II or what? I've been puzzling over my mix myself and some elements of the descriptions of bp II stike a bell, lightly, as I can be like the above and revved up a bit at times to dominate discussion, but the mix varies at times, so puzzling and puzzled...as I am with ALL of these bizarre afflictions of the mind and soul.
sante!
dj
Posted by Mark H. on November 9, 2000, at 21:54:16
In reply to Q? - Re: Long, Depressing Response MarkH., posted by dj on November 8, 2000, at 20:11:20
Dear dj,
I know what you mean. I'm bipolar II, but for a long time I worried that I was probably "undiagnosed something else" as well. Neurotic, anxious, obsessive, schizophrenic, a mental time bomb waiting to explode?
Relief came unexpectedly easily. The "diagnosis" self-tests available at the Canadian site www.mentalhealth.com take about 45 minutes to complete, and while diagnosing me as Bipolar II and somewhat ADD, they also ruled out all the other things I was concerned about. (And I should note that the self-tests confirmed my psychiatrist's diagnosis of bipolar II, as well.)
I was writing about depression while in transition from down to up. In August and September, I can't write at all. By mid-December, I should be my most goofy hypomanic self. But even then, mixed states are common, and I can go from being the clown to despairing in the wink of an eye at times, especially if my "humor" unintentionally offends someone whose opinion is important to me. Everything seems to increase, including my sense of emotional vulnerability. Does any of this resonate with you?
Several people on this list helped me enormously last spring during a particularly intense hypomanic episode, the closest I've come to be manic I think. They reminded me not to stay up all night when I feel "too good," and not to trash my routine. When I felt I was going out the top, they directed me to my pdoc, who let me use Zyprexa to stabilize. As it turned out, I only needed to take it for about 10 days to 2 weeks, and my body gave me clear indications when it was time to stop taking it and resume my normal med regimen. But these guys really helped me through it.
How are you doing? Does your depression cycle on a regular basis? What meds are you taking, have you tried, and what works for you?
Thanks for your kind, kindred comments.
Mark H.
Posted by dj on November 9, 2000, at 22:18:29
In reply to Re: Q? - Re: » dj, posted by Mark H. on November 9, 2000, at 21:54:16
>and I can go from being the clown to despairing in the wink of an eye at times, especially if my "humor" unintentionally offends someone whose opinion is important to me. Everything seems to increase, including my sense of emotional >vulnerability. Does any of this resonate with >you?
Some resonance there, Mark! I'll have to check out he site you mentioned...
>
> How are you doing? Does your depression cycle on a regular basis? What meds are you taking, have you tried, and what works for you?
>Doing so-so... Prozax and Wellbutrin, Zoloft, Paxil and Impramine have helped in the past but didn't enjoy the side-effects. Expermenting with Manerix but been avoiding more than not. Occassional lorazapan for anxiety and checking out some chinese meds.... and some counselling options, still tinkering and pondering... : (
> Thanks for your kind, kindred comments.And you for yours!
Sante!
dj
This is the end of the thread.
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