According to Jin Liu, Hong Ma, et al., (World Psychiatry 2011: 10:210-216) throughout the entire world and among all illnesses, the treatment gap for mental disorders is huge. This number in China is unacceptably high, with 91.8% of all individuals with any diagnosis of mental disorders never seeking help. For psychotic disorders, 27.6% never sought help and 12% saw non-mental health professionals only.
Depression falls in this sector. When suffering from depression and unable to function normally it is exceedingly difficult to help yourself. Continuing with the theme of this chapter: I have major depression, what do I do? let’s explore some of the approaches you can take to cope with major depression disorder (MDD). Again, there’s no one single route to recovery. Each individual might have his or her own way of dealing with it.
This lesson is about what worked for Xiaojie
In lesson 5.1, we talk about the DON’TS
In lessons 5.2 and 5.3 we will talk about the DOS
Lesson 5.2: I have major depression - The DOS (Part 1)
Major depression disorder is a serious illness and dealing with it is challenging. The social stigma and ignorance attached to it makes it even more difficult to treat. It takes time to heal and it is helpful to remember that as time passes and your life situation changes your depression will start to lift. Lesson 3.1- Part 1 speaks about the environmental causes of depression and this may help you to adjust your situation in life.
Studies have shown that if you have had multiple episodes of depression, you can start to have a depressive episode out of the blue.
To understand more, take the standard University open online class on depression by Professor Sapolski .
It is similar to a physical injury. If you sprain your ankle multiple times then it may be more susceptible to future injury – you could sprain it just by walking down the street. MDD is the same. It is a chemical imbalance in your brain and if your body is prone to this sort of imbalance it may be sparked by very normal life activity.
I spent the majority of the time during my MDD feeling confused, fearful, and anxious. Even during moments when I was feeling well, I had a feeling of impending doom and was expectant of my depression’s return. During other moments I felt completely hopeless. My depression took all of my physical energy and it is very frustrating to feel that your body is not working properly. I also felt guilty for burdening those around me with my troubles and as though I had let everybody down.
After 9 years of depressive episodes I had to find a way out. I had to try something different regardless of the result. I had to become active so that I could stop feeling helpless. It was during the time when I was suicidal, every day brought the same question: “Should I live another day?” It is common for suicidal people to feel that life is nothing but hell. Life felt like endless torture and never-ending despair.
One day brought another mental breakdown, and I texted my boss, who offered care and support. Please refer to Lesson 4.1 for guidelines about telling people about your depression. She invited me to her house and asked me to draw a picture of a tree and to write some positive affirmations. At the time I didn’t believe what I wrote. I knew that logically I should believe it and so I wrote it anyway.
The picture I drew in 2014 at my boss’s home.
Hours later, I walked out of her house and into the late afternoon of Beijing hutong on a blue sky day. There were cotton candy fluffy white clouds against a pure blue backdrop. I still felt disconnected from the world, but I heard this voice inside me:
How about trying to live How about trying to live with this madness It’d probably take 2, 3 years if you are lucky If not, it’d take longer…(I know, sweetheart) Even when you get better, I know, you might get back here again, I know But how about trying to live Not just for a day, but for a while
This voice was so weak and trembling. I tried to silence other voices and stay with this positive yes-voice, until it was strong enough and became an answer.
I didn’t really believe that my depression would heal, but I tried to be hopeful and to pretend to myself.
From that moment on, I started to focus on dealing with it, not running away from it.
Depression Strategy #1：Acceptance
Accept the fact that depression takes a long time to heal. That’s where patience comes in. Patience brings space to allow curiosity to emerge, curiosity may inspire you to learn about depression and this will empower you.
It turned out that it didn’t take years. 2 months later, I was no longer depressed. In fact, not only did I return to my norm, I was so energetic, motivated and happy. I remember going dancing one weekend, and dancing for 14 hours! I had a full day workshop, and a night filled with social dance. I danced so much that I ended up losing 3 toenails, and injuring my hips due to overuse. I had to go to physical therapy for 5 weeks. I became a different person.
Something was not right. Entering a depression without much environmental stimulus, and then coming out of depression without a single thing changing in life is atypical. I remembered something a psychiatrist, who I saw back in 2012 because of my rapid mood changes, had said: “It seems like you may have bi-polar disorder.”
“What? That’s a fashionable word!” I thought to myself. “Psychologists are good at coming up with theories and names for things that they haven’t fully understood. I don’t even know if you are qualified to diagnose me with your insufficient 2 sessions of counselling.” That was my reaction; I had a lot of resistance to the proposed diagnosis. I ignored what she had said and never went back.
The flashback got me to rethink what she had said. I though that perhaps it was time to do some research on this. I began searching online, and there it was: the pattern of my emotions and symptoms seemed to match the description of bi-polar II.
“Oh my gosh. So I am not a crazy person. I just have bi-polar disorder. Yeah, that’s a real thing!”
Knowing that it is a recognized medical disorder calmed me down. I sought to learn more about it. In the following months, I started to read about psychology, especially neurology. I got hooked on online courses, TED talks, university open courses, and documentaries.
I took a deep dive into an ocean full of words that I never thought I’d care to know.
One day, while I was watching a TED talk, the neurologist speaking explained how she felt while she had a stroke. I burst into tears as she described her sensations during the stroke. I felt it!
For the first time, I realized that I wasn’t crazy. I just had a medical condition. My brain was sick and that was the problem.
Jill Bolte Taylor's Stroke of Insight
Throughout the years of my depression I had heard the same abusive voice telling me that I was a weak person and couldn’t get it together. Now I had a response to that voice.
No, I am not a weak person, I just get sick sometimes, like everyone else. For some people it might be a heart attack, but for me, it’s depression. One never tells a person with a heart conditions that they are weak, and one should never tell a person with depression that they are.
In that moment of acceptance, self-blame and self-shaming disappeared. For the first time, I made peace with having depression.
Depression Strategy #2: Knowledge
Empower yourself with knowledge about depression. It helps you to further accept who you are, and to diminish the confusion. Knowledge gives you the tools to cope, a crutch to lean on.