Wednesday, July 1, 2015

What Not to Say to a Person with Depression ... If You've Had Depression

How many times have you seen it? An article on what not to say to people with depression. Maybe five or ten or three things to say to your depressed [person]. With some stock photo of a thin white woman with her hands on her head in a shadow or a muted blue corner. You can have agency in a world of eggshells, it promises. If only you understood, if only you followed this list, people with depression wouldn’t have to live in corners made by your cruel words.

Depressed person being depressed
Why do all depression pictures look like this?
Yeah. When I was first diagnosed, I read those lists. I fistpumped to some of them. I forwarded them to people, figuring that once they had a list, they’d get it and suddenly talk to me the right way. I made my own lists. I posted them on Livejournal, back when it was a thing. I made a 1-10 scale for panic. I advised other people on making lists. And I figured I had a damn good handle on the things people weren’t supposed to say to someone with mental illness. Because I had it, I knew I couldn’t ever fuck it up.

Fast forward fifteen years.

It’s dark outside—raining—and I’m in bed with my spouse. I’m huddling a pillow, capillaries broken around my eyes. He stares blankly at the bookcase at the foot of the bed, the Elizabeth Moon novel he’d been reading half-opened on his chest.

“I just wish you’d stop telling me how to fix it,” he says.

I still said the wrong words.

There’s no article about how to talk to a depressed person if you’ve been depressed yourself. We assume that if we’ve had depression, we already know how to handle it in someone else. Which would make sense, except that depression and anxiety not only destroy your memory, but are also highly personal. Most of us will get depression or anxiety, and most of us will still manage to say the same stupid crap to people with similar mental health issues.

So here’s a list. Another list, yes—on what I learned when, having had depression myself, I became the caretaker of someone else with depression.

First off. Depressed people are…

1. Valid Without the Special Words

“You realize right now that what you’re saying is the depression talking,” I said to my spouse. “It isn’t true.” 
“It still feels true.”

Humanity privileges articulation. We laud our poets, our rhetoricians, our thespians. There’s a sense that if you say something well, it deserves to be considered on the sheer merit of your speech, rather than the merit of the idea. If you drop some powerful words, you’ll have people cheering along with you, even those who might not have initially agreed. But how often do we have the words? Do you remember the first time you fell in love? The day you came out? Did you begin with an enormous vocabulary and the practice of persuasion? Chances are you didn’t.

It’s the same with mental illness. Most of us start off assuming we’ll never be part of that club. Most of us are shocked when we realize it exists within us too. And most of us will struggle for years to find the right words, not only to express how we feel, but to get the help and compassion we need.

"Do you feel depressed?" she asked. "How did you know!" he said.
When you’re talking with someone who has depression, if you’ve had it already, you probably have a much larger vocabulary. If you are well and they are not, you have the energy to put into making yourself sound persuasive. You can afford to be cunning with your words. They, on the other hand, are essentially struggling to talk with a facehugger on, sucking their identity, smothering their voice. They are having a hard time believing they deserve to speak at all. Depression makes you feel unimportant, worthless. And I think that feeling was easy for me to forget over time, because treating depression is partially about separating yourself from the illness. It’s easy to see a facehugger for what it is when you’ve pried it off your face. When it’s on there, though, it seems to take up the whole world.

Respect the struggle, respect that facehugger point of view. When speaking people with depression, assure them of the validity of their feelings.

This means don’t obfuscate. Don’t list your symptoms alongside theirs as if it’s a contest. “You had panic attacks in the car? I had them in the bathtub!” “You don’t get suicidal thoughts? Ha! Man, you have it easy.” Don’t analyze the symptoms and pronounce that they’re either not bad enough to be depression, or that everyone has a mental illness according to the DMV. Don’t attack their support network as better than yours. In short,

2. Don’t Compare

Whether you’ve had or have depression, if they’re confiding in you and you have the spoons to respond, it is your duty to comfort them. It isn’t comfortable to have to compete, especially when you’re already pretty certain you’re a loser in all ways.

Now granted, you’re going to compare, because it is certain the other person’s mental illness struggle will have been different from yours. Mental illness visits different people differently. Every week, I Skype with two other women who have had panic disorder and agoraphobia. None of us have the same triggers, the same kind of panic. So why would we have the same treatments? 

3. Treatments Vary

Yet this is what so many who have walked the path of mental illness do: they assume that what worked for them will work for the world. And when I say “they,” I mean me too. I have dished out oodles of unasked-for, directed advice. If you’ve had mental illness, you know what I mean: Just exercise! Meditate! Pray! Take your vitamins! Use this mantra! Happiness is a choice! How about cognitive-behavioral therapy? You are taking drugs, right?

Like a dozen punches to the head
Drugs. That’s the main thing. Either people love them or hate them, but there’s always a conversation about drugs. Which SSRIs have you tried? Anti-psychotics? Anti-depressants? Marijuana? Klonopin, daaaaaamn. Silver Linings Playbook pretty much nailed this conversation. And talking about your experiences is fine: it’s great when you meet someone who has been a human guinea pig just like you.

When is it not fine? When you insist on behalf of someone else. I understand that sometimes, refusing to take meds looks like a person with a broken leg refusing a cast. But it isn't like that with depression and anxiety. Meds are not a Band-Aid, and there’s no one-size-fits all. We don't even really know why they work, in the case of SSRIs. We also know that many times, drugs fail. So...

4. Respect Agency

Having mental illness is hard enough: depression or anxiety is fraught with loss of control. Don’t be that person demanding mentally ill people surrender their agency by taking a drug when they don’t want to. You’ve been there—all you wanted was a say in your existence, even if you were too tired or afraid or worried to take the step. Agency is important to a person’s wellbeing, and it doesn't disappear when you get depressed. Taking drugs is very personal. No one drug works for everyone all the time. So when you find yourself stepping over the line with drugs, going from discussion to suggestion or insistence, step back. It’s not your call.

Also, do be aware that there is a percentage of people, despite all the therapy and drugs in the world, who will never get better. And even more people who will get better, only to relapse repeatedly throughout life. Saying that you got through it is wonderful: it’s great to know it can be done. But insisting they can get better too? It isn’t necessarily going to happen. Harping on your cure will only be rubbing your health in their faces. It’ll be like looking over a cliff at the climbers, telling them about how you made it to the top. It’s great to know people can get there, can get better, but not everyone can use your rope. 

5. Nix the Artist Halo

Another injurious attitude from fellow depressed/anxious folks is the artist halo. I’m sure you’ve heard the stereotype: all artists are dramatic, dynamic, depressed. They have drinking problems; they hear voices. The insinuation is that all artists have mental health issues, and it's the muse’s due for their superpowers. Appreciate your life clinging on the cliff: you’re meant to be closer to death! Some studies even support the idea that artists get sick. And artists will repeat this to one another, taking comfort in the halo. How many times did someone tell me that Emily Dickinson had agoraphobia

Did it make me feel special? Yes. Did it help me get better? No.

Despite all of the comfort it gives to people to say that they have superpowers, that they're exceptional, the fact of the matter is that the artist halo justifies treatment avoidance. Moreover, to many people with a mental health issue, mentioning the artist halo is the same thing as giving up, as silencing their pain. You’re not only saying that the wound is meant to be there, but that the sufferer will not be an artist if it is gone. Don't. Just don't.

6. And Don’t Compliment the Fakery

Another take on the artist halo is the adaptation obfuscation: “But you don’t seem ill.” In other words, Congratulations! I don’t care if you’re having suicidal ideation this very moment, because you’re arrived! You are the best faker in the universe! You’re underscoring the fact that the mentally ill person is indeed alone in the universe, because apparently she can walk around with her mind screaming death, and no one will know. You’re suggesting that as long as other people don’t notice, she shouldn’t talk about it. That she’s a hypochondriac, because she doesn’t look sick. 

And of course sick people should look sick, right?

Depression has many faces, and most of them will surprise you, even if you’ve been there before. When you had depression, it was present, it was inside of you, so you always knew it was there. But when you’re on the outside looking it, that presence is gone. And you might not realize how good you were at faking it, but we all do. All of us did. 
Telling someone they doesn’t look sick is playing the comparison game, too. You’re saying that if someone isn’t obviously sick, that sickness isn’t real. That it has to show in a way you’ll recognize before you’ll allow it to exist. Toxic, toxic thing to say.

Unsure of what to say, now? Well that’s fine, because it’s far more important to…

7. Listen. Need I repeat this? LISTEN.

Saying you’re hurt and asking for help are two different things.

When you have defeated depression and anxiety, you might feel like an expert. And, compared to the rest of the population, you are. But it is not your duty to give unsolicited advice. Remember (as I have forgotten) to separate the expression of hurt and the help request. Don’t presume that because someone confides they are depressed to you, that they’ve asked you to tell them what to do. What they’re asking for is validation, compassion, and you to notice their pain.

Go back to that hard place, the place before your wellness, the time when you were in a quagmire of fear and loathing, watching people walk by you as if your sinking didn’t matter.

Notice, my fellow former mental illnesses sufferers. Notice.

With love to Timothy Phin, Joely Black, Red, Foxicity, Catherine Mardula, and Joyce Chng.

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