Earlier this year, I was diagnosed with mild depression. This, as it turns out, is not particularly unusual. Lots of people get depressed. The WHO estimates that around 350 million people worldwide have it. That's slightly more than the population of the United States.
I have a slight genetic predisposition towards depression. But I fortunately have never had what's called "major depressive disorder," which is much harder to deal with and which I wouldn't wish on my worst enemy (Well, maybe I wish it on Donald Trump), and instead have only had "minor depressive disorder."
Culture tends to portray depression as a form of extreme sadness, but that hasn't been my experience of it. For me, it's largely been a sort of emotional flat-lining coupled with a particularly mean, very convincing voice in my head. This voice had always been there, but it got a lot louder all of the sudden in the midst of a few major life changes.
It started for real when I quit my job to become a writer. This was a major career landmark for me -- it was a giant risk, it was a pay cut, but it pushed me more in the direction of the career I really wanted. "Work from home" is usually presented as some sort of liberating gold standard (work with no pants!) but it's actually insanely trying -- seeing and interacting with other people is no longer built into the structure of your day, and it's really easy to neglect your physical health when there's no actual reason to leave the house on a regular basis. Throw on top of that a move to a small town where you don't know anyone and don't have a car, and things can turn kinda dark pretty fast.
The Low Point
I hit a low point about a year ago, in the build-up to our wedding. Mental illness is an awful thing to have during what are supposed to be the best days of your life: depression in particular likes to find reasons to tell you you're a complete piece of shit, and if you give it an excuse to whisper, "Why aren't you happier? Man, you don't deserve this or her," then depression is going to seize on that shit.
Fortunately, weddings are a natural counterbalance to mental illness. All of the things that exacerbate depression -- like isolation, lack of social interaction, lack of meaning, feelings of worthlessness -- just aren't in the cards during a wedding build-up. People take the opportunity, during weddings, to tell you all of the nice things they think about you that they maybe haven't told you before. Friends jump through hoops to do nice things for you. And people are insanely generous with their time and money and love.
The night itself was -- literally, not in a "oh, I have to say this," way -- the best of my life. And the next day and the honeymoon were also great. But after the festivities ended, and as we started the slog through the holidays, I started to realize that the depression hadn't gone away. I did not have the stamina or the funds to keep throwing weddings to get my spirits up, so some other action needed to be taken.
Mercifully, I'd been given a bit of a nudge during one of our pre-wedding events. I was talking with a couple of friends, and somehow, the subject turned to struggles with mental illnesses. I am lucky enough to have friends who are super open about this kind of thing. One friend talked about how much getting help... well, helped, so when the post-wedding high wore off, thanks to the testimonies of my friends and the gentle urging of my wife, I started to look for therapists.
It's really, really hard to find a therapist.
On the Jersey Shore, at least, there is something of a mental health professional shortage. It took me about a month to find an office that was accepting new patients -- many of them say on their websites that they're accepting new patients, but then tell you it's not the case when you call them. Considering how hard it is to ask for help, this is really not fun.
When I finally found a nearby spot accepting new patients, I spent about 45 minutes on the phone, alternating between being put on hold and reading off my name and birthday and Social Security Number to a woman who was not motivated to do things quickly. I think there's a decent chance she filled out the forms in triplicate, and, instead of simply checking what I had previously told her my name spelling was, decided to get her information from me all three times.
I am fairly certain, after this experience, that medical bureaucracy has resulted in deaths. If I were in worse shape, this would not have been promising. If I wasn't sitting next to my wife in the car, I may well have hung up the phone and called off the search as hopeless.
Once I'd slogged through the bureaucracy, the woman said, "Okay, the first appointment I have available is February 2nd."
It was December 29th.
"I'd really rather not wait that long," I said. "It's... you know. It's depression."
"Sorry sir, that's all I have."
Over a month later, I started going to therapy. My therapist is the opposite of the people at his front desk, which is to say he's pretty cool. He, like my older sister, is not a psychologist, but is a social worker. I have had the very pleasant experience of seeing, from the other side, what my sister does. I am now certain that she has one of the most important and thankless jobs a human being can have.
Depression doesn't just "go away."
Therapy has been helpful, but depression is unfortunately not as simple to get rid of as, say, a broken arm. It takes a lot of work, and some days are better than others. One of the strange side-effects of depression is that I'm at my best when I'm around other people -- I'm pretty isolated in my day-to-day life, so being around family and friends is like a breath of fresh air. So the people closest to me -- with the exception of my wife -- don't actually get to see what's going on, and actually see me in peak form. The idea, then, that something is wrong, probably would never cross their minds if I didn't tell them. Which makes it even more isolating.
I've tried writing about this for over a year. I have a really ambitious webcomic I want to do on the relationship between my depression and some of the more nihilistic feelings I've had (nihilism which I've been actively fighting for a few months now), but at some point, the project was too huge to confront when simply picking up a pencil felt like a gigantic challenge. So I'm writing this blog instead, with the idea, "Don't worry about saying something new, worry about saying something."
I want to say something because, for me, what made the difference was someone else saying something. The friends who talked to me about what they went through -- well, I don't think I told them how much it meant to know that people I love have felt what I feel, and had been along the same dark roads that I felt I was currently walking. So this is a circular way of telling them, "thanks," and is also hopefully, in some sense, paying it forward to someone else. It means a lot to know that you're not alone in a disease which is, by its nature, isolating.