Vocabulary of Depression

We lack the vocabulary to discuss depression. 

People have desperately tried to distinguish ordinary sadness from depression.  We rely on slew of insufficient metaphors as described in this link.  We tell the world, we can’t get out of bed, we describe it as excruciating emotional pain or joy-less malaise, we emphasize it’s physical manifestations reciting the list of symptoms, insomnia and loss of appetite.  Below are my amateur drawings to try to show the pain.  

Those who have no personal experience to draw from, nothing that seems comparable, lack an imagination to understand.  But as we age, certainly everyone has experienced some extreme stressor, hardship or trauma, and likens your illness to a feeling they have once known, that persisted for some time.  Because our vocabulary is so limited, we use the same words, rely on the same descriptors, that same un-useful list of symptoms we’ve seen published hundreds of time.  Unmotivated, unable to concentrate, lethargic.  But is there more that sets our experience apart?   

People have tried to explain situational depression versus endogenous depression. Situational depression has a root cause, may be a reaction to stress, trauma, loss, like losing one’s job, death of a loved one, being a victim of a crime, and endogenous depression occurs for no reason – it’s truly biological in nature.  But the distinctions are meaningless we are often told for the purposes of treatment.  Medication may be appropriate, talk therapy almost certainly beneficial, and let’s not forget our favorite new brand of wellness prescription, meditation and yoga.  And if want insurance to cover the cost, you’ll need a real medical diagnosis.      

Statistics on the rates of mental illness are totally unreliable.  It depends on how we identify our feelings, how we answer poorly written questions, whether we seek treatment, who is incentivized to participate in a study.  Our nationality, race, gender, class, age have an enormous impact on how we are socialized to think of our experiences, our struggles, our suffering and what to do about it.  As someone who has grown up trying to for the most-part to avoid the stigma, ashamed of my truth, I am wary of a new generation so quick to adopt labels I’ve desperately tried to eschew, to over relate.  Am I wrong though, are they just raised to be more self-aware? 

I worry that we’ve grown up with such overblown expectations of what we are entitled to this in this life, the Instagramable version of living our best life, that people are taking natural, inevitable disappointments and stress of living in a hyper-competitive capitalistic society and pathologizing it.  But at the very same time, I want us to hyper-critical of the norms of our society that are creating toxic cultures and damning ourselves to perpetual dissatisfaction.  I want us to recognize the harms of oppressions of all kinds, the toll it can take on our mental well-being.  But I also want us to be mindful of ways we should be combating oppression rather than using “mindfulness” as a way to counteract the suffering and ignore the oppression that caused it.     

But while we should all learn to take care of our mental health, as we would our physical health, I also want to recognize a difference between times a person’s mental health may be compromised, and people who are suffering from chronic mental illness.   Easily analogized to the broken leg versus the Type I diabetes (we love that diabetes comparison), but for me all the mental to physical analogies fall flat.  I’ve suffered numerous physical sicknesses, where as time wore on and the sickness persisted, the people around me get sympathy fatigue, and stop caring (I feel that same pressure to say I’m better before I’m actually better).  I don’t know that the physical analogue of mental illness gets me anywhere.      

I started this blog, with posts on self-harm and suicide, because it is often what easily sets apart my experiences.  Even though I was first hospitalized when I was 15, it was like that one was expunged, but once you’ve been hospitalized a few more times, whether in-patient or partial, that might put you into a category of severity that people might acknowledge.  But these are not personal details that are easy to offer up, they are shameful, traumatic and deeply uncomfortable.

In the psychiatric ward at the hospital, one day we all sat down together in an unfacilitated session of speaking with each other because of the skeletal staffing over Memorial Day weekend, and each talked about the life circumstances that contributed to our mental disorder.  Each one of us looked at the other person as having a more justified reason to be suffering.  So your parents were physically abusive, that makes more sense than me, you suffered incestual sexual abuse as a child, well your suffering is more real than mine.  While we shared outrage and validated each other for the harm we experienced by the outside world, we were more comfortable providing that validation to each other and questioned the legitimacy for us needing treatment here.  I interrupted us at one point, and reminded us that we all were suffering and there was some medical component and we were deserving of compassion. 

We all gravitate towards explaining reasons for our suffering, because we cannot describe the suffering itself.  We don’t have the vocabulary. 

When we acknowledge all the stressors, the contributing factors that worsen our suffering, it feels like an identifiable problem, with an identifiable solution, and open grounds for the opinions and advice of lay people. 

The English language fails me.  I perpetually feel at a loss of how to communicate with the people in my life as to foster understanding, to bridge a gap.  When I feel totally utterly unsupported by the world around me, I’m told to explain in clearer terms how they can be supportive.  But if they understood, had the capacity to grasp the depths of my suffering, wouldn’t they know what to do, how to help? (In the hospital we try to care for each other in the ways we want to be cared for, but we cannot, as sick as we are, be each other’s caretakers.)

But I am here, writing now, using my limited vocabulary, for those who will take the time to read, to see if I can offer a real window inside my madness.       

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