A random thing I've been meaning to write down for a while, brought to you by the letter D:
I hate who I am when I'm depressed. And I mean, who doesn't; depression doesn't bring out the best in anybody; that's kind of definitional — and it's a vicious cycle, too, because being in a state of hating yourself and/or your life makes it awfully hard to find positive thoughts and supportive actions to take when every second of every day, you're fighting off wanting to die.
Having ridden this train for the majority of the last quarter-century, I've learned a few things; and one of them is definitely "an ounce of prevention is worth a shit-tonne of cure" — you can crawl back up from the bottom, sure; months or years of concerted effort, forcing yourself to therapy over and over, carefully meting out whatever drugs or supplements you've found that work, and more than anything that daily slog of thinking about it, trying, failing, crying, writing and coming back to square one over and over again — it can work; I think I've proven that. It can't work "for good" or forever, at least not that I've figured out yet; not if your condition is chronic, like mine is. But Recovery can work, and it can get you back to a place where you can move back to Prevention: and my point is, Prevention is much much easier.
What is Prevention for Depression, though? If you're a chronic diabetic, you know that you have to guard your dietary equilibrium, always keeping in mind that a night of drinking or a day of skipping food or bingeing on twinkies is going to cost you a long hard climb back to Healthy again. But what if your body's tendency isn't to short out the glucose-metabolism system, but rather to short out the emotional-will-to-live system? What can you do, once you've done the hard slog (or gotten ridiculously lucky) and found equilibrium again, to keep it?
It was about ten years ago, I guess, that I first got serious about figuring out how to do Prevention. I had an infant then, and man, having a kid really slams home how vitally important it is that you be, not just functional in the basic sense, but also reasonably well-off emotionally; because even as tiny babies, kids are wildly affected by their parents' moods, their mumbled thoughts about life, their outlook on the day, the expressions their faces take on when they're not thinking about it. I do sometimes wonder if the fact that I was raised by a woman who was depressed much of the time had anything to do with the fact that I grew up with this giant monkey-wrench in my emotional regulatory system; and of course the very last thing I want for my own kid is to deal with the same thing living in her own head. (She's eleven now, which is when things got really bad for me; and so far, no signs. Fingers crossed.) So faced with a still-in-formation kid who saw me every day, 24/7, in my worst as well as my best moments, it became suddenly critical that I figure out, not just how to save myself when I was mired in that hole, but how to live my life for the best possible chance of not winding up in it to begin with.
Here's what I came up with, in case it can help anybody else:
1) Be brutally picky about who you're around, especially when you're feeling tired, vulnerable, sad or suggestible. One of the many sick ironies about depression* is that it can be worsened by isolation, and yet it makes getting and keeping company much harder. Not only aren't you great company, but you often don't want to be around people, sometimes just because you feel bad for them and don't want to alienate them with your moods, and sometimes just because you feel like you can't handle the emotional effort of another person in your space. That means that both staying alone all the time, and allowing "whoever will put up with you" to be the people in your space, are easy to fall into. But you mustn't, and not just when you're feeling depressed, but always. Almost nothing has the power to drag you down like bad relationships; abusers, manipulators and the like all feed off of that precious resource of self-esteem and emotional balance that you desperately need — having them around is like inviting in tapeworms when you're diabetic. It can be hard as hell to enforce this, I know, especially when you have to cut people off and haven't replaced them with anyone better yet; but you absolutely must control and limit your exposure to negative influences. We all have to deal with them sometimes, yes. But if you have capital-D Depression, you can't afford to deal with them more than you absolutely have to; and when you have to, you need to take extra measures to counteract that influence (i.e. get more good people and/or alone time, and other things that support and strengthen you). And people who cause or make worse your Depression must go, MUST be excised from your daily life, even if they're spouses or parents or BFFs. It's hard on the heart, especially since when you're young and unable to control your Depression, you probably built relationships that make it worse; you will almost certainly have to let some go that you really value, and/or have had for years. But eventually you can't ignore anymore that these people could literally kill you; that they're not just parasites, but parasites draining you of a rare and precious resource, and if you want to survive this ride, and to succeed at things like raising kids and being functional and succeeding at some goals in life, you can't stay with them.
2) Be brutally picky about your job(s). Yes, we all do what we gotta do to eat; and work isn't required to be fun, by any means — most humans come home from work tired, eagerly await their days off, and gripe about their bosses and coworkers; such is life. (And any Depressed person will tell you, just dealing with Life and how it is a blessing. Someone in the D-hole would kill to be able to just get up and go to work and have a crappy day like everybody else. A simple crappy day with no unexpected crying-fits, nightmares, anxiety attacks or whatever other lovely symptoms you get — and without worrying that such things are right around the corner – would be awesome.) But we've also, most of us, had those jobs that really suck, that really do burn some life out of you every single day, either because they involve a bad relationship (see point 1) or they're morally repugnant or what have you; and if you have Depression (or even just if you're going through a really bad patch and depression-the-feeling is particularly bad and hard to avoid / escape right now), you can't allow those to continue. Obviously the sooner you realize this and the luckier you get about changing to a new gig, the better; but "meh I'll just tough this out, other people do it" is stupid thinking. This is your weak spot and you need to guard it. A little emotional draining from your money-making gig is to be expected, but you don't have the same stores, the same stability, to count on as other people, and you need to accept that (not easy, I know) and do the responsible thing. And let's define "responsible" here: Money and things are necessary in life, but they're not as necessary as mental health and staying basically functional (i.e. getting out of bed, eating, speaking, staying out of the hospital, and not offing yourself). If your choice is "court a huge and dangerous Depression, or make an existing one worse" or "have to move into a friend's basement or live in a car for a little while," guess which one is better?
I guess one of the biggest lessons of Prevention is that YOU HAVE TO TAKE YOUR CONDITION SERIOUSLY. This is extra challenging in a world that can still barely get its head out of its ass long enough to refrain from telling you you're not really sick because it's "all in your head", but you absolutely must do it. Like any chronically-ill person, nobody can make you take care of yourself in the long run: You have to accept responsibility for it, and do your damndest to make good choices no matter what.
3) Also, apropos of living in friends' basements, another key part of Prevention is that you must accept help where you can get it. Nobody wants to be a freeloader, and I'm not suggesting you should — we all have help to give, too, and we should give it wherever possible. But the isolating and shaming parts of Depression make it easy to hide your problems and/or refuse or refuse to seek help from the people in your life who are good and/or lucky enough to be able to offer it right now. Because you won't feel like asking for help when you should, get in the habit of asking yourself, whenever you're unhappy about a situation, is this something a friend or family-member could help me with? Maybe a little money, a night off from the kids, or a place to crash would really make a difference right now: buckle down and ask for it; don't just drop hints or act hopeful and pray that someone will notice. A) that's obnoxious; B) you'll feel like shit when it doesn't work, and wrongly tell yourself that there's no help available; and C) studies have shown and wise people know that asking your network for help is a big thing you can do to strengthen your relationships. It does not, in fact, "burn" goodwill or harm your status in someone's eyes when you need help; often, giving them the opportunity to help a friend (etc) in a meaningful way is a great gift to people, and makes them feel closer to you. And of course, know thyself: If you tend to never ever ask or lean on people (like I do), then make yourself do it twice as often as you think is actually necessary. You'll benefit coming and going, from assistance where you need it to stronger relationships.
Also, don't overlook that when your pancreas is out of whack, often it makes you crave sugar when sugar would be the worst possible thing: And when your emotions are out of whack, they're going to tell you that getting help (or in fact doing anything directly useful to fix the problem) is a bad idea. When I'm depressed, even if I desperately want a night off, I don't feel like I want a night off, and my inclination is to refuse one. A night off doesn't feel like a fix anymore; I want to burn the world down and jump in front of a train; that's the only thing that feels like a fix. That's not so much of an issue when you're accepting help as part of Prevention, but I think anybody who's read this far knows how ridiculously easy Prevention can become Emergency Mitigation in these circumstances. So watch for that.
4) The last major component of Prevention is broad and tricky, but that's because every mind-body is unique in some ways, and the details of what helps and hinders you are going to be, at base, something that only you can figure out. You need to learn what affects you most strongly emotionally, and control your exposure to those things as much as humanly possible. And this is going to feel like it looks silly at first: We don't laugh at diabetics who pore over the ingredients of things, or can't eat at a restaurant with us; but sure as hell many people won't understand that it's a medical necessity for you to avoid romantic comedies, wear loose clothes, never watch a movie in a theatre, and move out of Detroit. You'll probably get a good deal of labeling as "eccentric", "picky", and variations on that theme. I can't say I have the best solution for that part, because it is very isolating sometimes; but I can say that after a decade of ever-more-firmly implementing my Exposure Control Protocol (haha no, I don't really call it that, though you're forgiven if you thought I might) I've learned that people actually care a lot less about such things than you'd expect. They're also extremely easy to lie to about them, and after some moral flailing about it years ago, I decided that lying to worm my way out of judgment for something I need to do in order to be healthy is perfectly acceptable. Why don't I ever go to the movies? Why, I'm an MPAA-boycotter. Or have bladder control issues. Or I always fall asleep so it's not worth the money. Why did I have to leave D-town even though my family is there? Job market. (Not untrue, but not nearly all of the truth.) Why don't I watch the news, or even own a TV, or now that we think of it even consent to sit near a TV in a restaurant or tolerate one in a waiting-room? Oh, it's a political thing. Viva las Adbusters. Whatever. The point is, people have neither a right to nor an interest in most of these details — but you do, because you are living on a subsistence budget of happiness, and you are doing it in the fucking deserts of Dune, where what might be a minor slip-up in other places, for other people, can kill you like *wham*. TAKE IT SERIOUSLY. Every little bit helps, both in the positive (doing a thing) and the negative (avoiding a thing) senses. Absolutely have a list of things that bolster you emotionally, and things that drain or unbalance you; update it frequently and use it every day to add as much from Column A to, and excise as much of Column B from, your life as possible. …And even though it should probably be a point of its own, I'll list here that your diet, getting regular exercise (probably more than you think you need! Exercise is a huge help with both recovering from and preventing depression) and keeping your physical environment positive (i.e. clean and comfortable) are all things that should be heavily represented on that list.
Prevention is hard.
But it's not as hard as Recovery.
Take it seriously. Help the people you love take it seriously (for you or them or both). Depression kills — and if you're lucky, you have to remind yourself of that. If you're not so lucky, you've lost someone, or nearly lost yourself, and you know it firsthand. But either way, don't let anything make you forget it.
*I capitalize Depression when I'm referring to the clinical variety, the monkeywrench disease that causes, prolongs, and strengthens emotional lows independently of events in your life. When I'm talking about the lows themselves, the emotional state of "feeling depressed" that we all experience sometimes no matter how emotionally healthy we are, I drop the capital letter.