Bit of Depression
Begin with a confession: I wrote myself into a trap with my last entry by glorifying the idea “nothing really matters”… and then didn’t write anything for nearly a year. It wasn’t until I shared this blog/website with a new friend that I was horrified to look at my previous posting date. While I don’t entirely disagree with my prior entires, upon reflection, I can see that I used a broad brush in my logic and need to revise those statements/thoughts. This revision will occur in a future update, but for this entry I want to address the the culprit for my inactivity – a deeply debilitating unhappiness.
The short of it is that in my previous location/job I was hit by this sort of unhappiness — not, “Oh, I’m grumpy now,” or “My job sucks,” but an overwhelming blasé of inactivity. I hesitate to call it depression because I don’t want to minimize a medical condition and I don’t think I was in a major depressive state recognized as “clinical depression”, but as stated on the MayoClinic website, “Depression ranges in seriousness from mild, temporary episodes of sadness to severe, persistent depression…” and I was somewhere inbetween. Therefore, for the rest of this article I will use the term “depression” with an understanding that my personal situation may have involved a milder form of the condition. Regardless, I was hit by an introspectively subtle, depressing toxin that sucked away personal ambition, and one of the results of this toxin was an avoidance of writing. The specifics in my recent bout don’t service this article, but you can know that my conditions have changed and I feel inspired to write again. Furthermore, reflection on my inactivity has inspired me to discuss the subtle depression that creeps after TBI.
Whatever your situation, after brain injury depression is almost assuredly present. If not gobbling the entirety of your existence, depression is at least peaking around the corner and leering with its invasive gaze. There may be times, days, or even weeks when you think this despicable intruder has moved on until, suddenly, it is uncomfortably near again — perhaps as a barbarian of emotion that brutalizes each step, or maybe just a perverse whisper that slithers in your ear, “Why? Why do you even try? It’s all going to be wrong anyway.” And you may be ready for this, as it’s healthy to have developed a mantra of “focus on the good, positive, affirming impulses of living” – but the depressive poison can mute these words, dampen motivation, strangle inspiration, encourage endless inactivity because, to repeat a summary of my prior depressed blog entries, “nothing really matters”.
I’m reminded of depression during my early recovery after TBI. Specifically, I recall it appearing around strain of normal activities each day – activities that are not difficult for most people becoming grueling tasks that, while not unsurmountable, required a clear focused effort. Something previously effortless was now a Whole Thing. Examples — picking clothes in the morning that try to make a “statement” in some way, and these choices result in walking around university campus dressed in a poorly fit, secondhand suit and jacket — imagining suave debonair but better resembling a clown until I was intercepted by friends who abashedly corrected these fashion-less failures. Attempting to remedy the fear of talking with people by having a script of short lines, monologues, and “off-the-cuff” remarks memorized and rehearsed, but sounding like a broken record when sharing such remarks in repeated company. The anxiety of being entertained — the sheer terror of laughter — because if I enjoyed myself “too much” this laughter might escape self-control and devolve into a rasping gasp that grates the air at a socially uncomfortable volume. These situations are specific in my memory and can be accompanied by many more, but the emotion that dominates all these experiences is fear of being ashamed, and this fear led to depression.
Survivors who read this may have similar experiences of this fear, or there may be another set of circumstances that come from your injury hampering your daily life, but if you find yourself stalled and inactive, I encourage you to question, “Am I depressed?”
Depression in not uncommon after TBI – according to brainline.org, approximately 3 in 10 people experience depression after TBI (as compared to 1 in 10 people in the general population). What’s more, I suggest that this number might be underreported, especially if we include a milder, but still debilitating, depression as I recall above. It makes sense that it goes unreported, because in early recovery we are schooled to recognize the fortune in survival and may feel foolish trying to acknowledge depression, as if feeling depressed is a sign we are ungrateful. I recall constant reminders from doctors, friends, family, and my own personal insistence that I was alive, I had survived, I am grateful – whether I felt fortunate seemed secondary to the known fact that I should feel fortunate. I don’t think I was ever diagnosed as having depression and I was never given medication, but upon reflection I can see symptoms from that time — feelings of hopelessness, increased use of drugs, reoccurring thoughts of suicide — yet I put on a show that insisted I wasn’t depressed – I was grateful, damnit!
When brain injury occurs, likely effects include being stripped of some physical and mental ability, loss of cognitive flexibility, loosing social outlets, and other aspects of life that help to define personal identity either falling away or drastically altered – it is understandable that depression might come from this. If you feel like your life is stalling and there is less drive to get things done, recognize that this can be depression. Acknowledge what is real and do not criticize yourself for this feeling. No shame – recovery is hard and depression happens. Ignoring your feelings will only make them more persistent. It’s like an itch, an itch at time when you can’t scratch – if you put your mental focus on this itch and tell it to just go away, the tickle bothers you more, calling other irritations as support and reinforcements for the discomfort, and soon it’s an army of itches irritating spots you didn’t know exist. Denying or ignoring depression works in the same way, only becoming worse until you are able to let it go.
But the question remains, “So what do I do? How do I get rid of this depressing itch.”
To begin, on helpguide.org I found a good list of 7 simple tips that can help with depression. CLICK HERE to read this list. I don’t want to parrot the ideas here, but please read the article – it is filled with simple activities that can help you to let the depression go.
Notice my wording – “..let the depression go.” My thoughts jump back in by stating I don’t believe depression is “cured” or “fixed”. You don’t “get over” depression but let it pass by, and finding new activity outlets can encourage this passage. You need to know that it is okay to let depression go, but attempting force, insistence, or denying your feelings will lead to further frustration that exaggerates the situation. Returning to the itch analogy, focusing on the itch only makes it worse, until your distracted by other activities and the itch disappears as less than a memory.
That’s not to say ignore the depression, but instead of dwelling on it, ask yourself “Where does this come from?” and “What of these circumstances can I realistically change?” Then set goals for how to make these changes. It may be that you can’t change the root cause, perhaps there’s a job requirement or living situation, but I suggest you find healthy ways to release the angst. Try exercise, or a weekly card game with friends, or start a blog. Find distractions that don’t focus on depression or what you can’t do – focus on what you can do. Let the itch pass. This is recognizing, acknowledging and feeling, but then allowing both the depression and yourself to move on.
Speaking to survivors of TBI, your life has infinitely changed, and it is depressing to focus on all that you can’t do now. Don’t ignore this, you need to be realistic as you navigate the rebuilding of life, but take more time to focus on what you can do and what you want to do. Set goals that are realistic challenges and take pride in completing each goal – maybe running 10 kilometers, completing a painting, finishing a class online. This doesn’t necessarily “cure” depression, but by engaging in alternative activities, depression can be that itch you no longer need to scratch.
To accompany that article, now that I’ve recognized my depression and filled it with changed circumstances, I’m back. My current plan is to post biweekly and I’m happy to say I’ve arranged my schedule to help that occur. If this article, or any of the prior entries, snag your attention, please read, comment, and share with anyone who might appreciate the ideas. Take care and chat soon.
