Depression Marathon Blog

My photo
Diagnosed with depression 16 years ago, I lost the life I once knew, but in the process re-created a better me. I am alive and functional today because of my dog, my treatment team, my sobriety, and my willingness to re-create myself within the confines of this illness. I hate the illness, but I'm grateful for the person I've become and the opportunities I've seized because of it. I hope writing a depression blog will reduce stigma and improve the understanding and treatment of people with mental illness. All original content copyright to me: etta. Enjoy your visit!

Tuesday, July 29, 2008

A Program of Action

AA is often referred to as a "program of action." In fact, I just finished a post about this topic over at The Second Road. Recovery from alcoholism definitely requires action. Putting down the drink wasn't enough for me, I needed to recover physically, emotionally and spiritually. I needed to learn a new way to live. In this way, I think recovery from alcoholism and recovery from mental illness are very similar. My recovery from mental illness also requires ongoing action.

Without taking action to heal, I cannot hope to recover physically, emotionally or spiritually from devastating depression. Sitting around waiting for health to happen is unrealistic, yet don't some of us expect that? I did. After all, my illness came on without warning or explanation, why shouldn't I expect it to go away similarly? I'm sure that's what I thought during the early years of my illness. I didn't take action.

I was so wrapped up in the unfairness of my lot, I couldn't move forward. I felt like shit. I had no energy. I lost my spouse, my job, my house--all because of this illness. I wanted to die, and all I could do was focus on wanting to die. The more I focused on my pain, the more painful my life got.

This constant misery focus is a trap which I think may be unique to mental illness. We, of the non-Hallmark illnesses, must face constant stigma, shame and discrimination not encountered by those with hotdish-friendly diseases. (Huh, you say? When your depression symptoms were most debilitating, did the church ladies bring you a casserole and jello? I didn't think so.) Our experience, our suffering is not only misunderstood by friends and relatives, it is downright invalidated. Hence, we repeat and reiterate how badly we feel, how much life hurts, in hopes that someone will get it. Worse yet, I internalized the invalidation--sometimes still do. I think my misery focus may, at times, have been an attempt to convince myself that, yes, I really was sick.

At some point, perhaps as a result of DBT training, I realized focusing on my pain wasn't going to help me heal. Perhaps it happened when I stopped caring who believed and who didn't, although that's still only the case on my best days. Or maybe it was because I had finally surrounded myself with a stable, supportive, and caring treatment team who validated my experience. Validation (and hotdish) is something people with cancer, MS, or heart disease get almost immediately, whereas it took me 4 years to get a nonjudgmental, professional team in place. Their validation and support freed me to focus on recovery and healing. (I still haven't received a hotdish, though.)

By removing the need to convince them of my pain, my treatment team allowed me to focus on therapeutic action instead. Perhaps if we know the people around us believe we are "really sick," getting well is not so daunting. I mean, if we are stuck in the trap of proving our misery, aren't we less likely to take actions which may lessen our misery? Are we scared that if we improve before anyone believes we were sick, we might hear, "I told you so," from the non-supportive, non-believers? I don't know. It's just a spontaneous thought I had, and I realize it may be a prickly thought for some readers.

I assure you, though, I am NOT saying that we don't get well on purpose! NOT AT ALL! For ME, just ME, it makes sense that I began taking more positive action once I had the support and validation of the people around me. And recovery requires action.

Without action I cannot maintain my health today. My depression is not gone, but it is certainly more stable than in years past. However, if I stop taking the actions--if I stop taking my meds, getting exercise and sleep, eating well, and finding meaning in every day--if I stop doing those therapeutic things, I am sure my tenuous grasp on stability will fall quickly away. Recovery, for me, requires action.


deepblue said...

This post rings so true. I think that the way that some Drs. over-prescribe antidepressants without really understanding my symptoms is another way I feel "invalidated." It feels like they don't really want to deal with it, so they just hand out the meds.
And I'm not opposed to meds. I just wish someone could validate my experience and not minimize it with brushing me off with a prescription.
Anyway - great post.

la said...

I write a lot about my experience of depression but I'm not in any way sure that focusing on it helps. And, yes, maybe it is me saying, "Take me seriously!" to the world. There are times when my friends and family say, "Oh, you seem fine now!" when I want to shout, "I AM NOT FINE! This is me trying my hardest to be well! I still need your help and support." Maybe I need to seem ill for them to acknowledge I have an illness.

And there definitely isn't enough action, or structure, in my day.

Thank you for posting this. It's given me a lot to think about.

etta said...

Thank you la and deepblue for your comments. la, you said, "maybe I need to seem ill for them to acknowledge I have an illness." You hit it right on the head! As I said in my post, I think this is unique to mental illness. If someone has cancer or MS they are free to laugh, joke, have a great day without fear of someone questioning their illness. Quite the opposite, actually, we think, "Oh, isn't that great! She's so brave to be living well despite her cancer." Whereas, I think in the past, I may have unconsciously suppressed or muted any positive emotional displays around people who either weren't supportive, or who couldn't wait for any sign that I was all better. It stems from lack of understanding of mental illness, and it is one of the reasons I focus on depression, the illness, rather than "feeling depressed," when I talk about my health with friends or speak publicly. We need to educate people that depression is more than feeling sad. Like people with other diagnoses, we can have good days filled with laughter, and that does not mean we've been cured. We still have the underlying illness, and the illness affects more than our feelings--like other illnesses, it often encompasses every aspect of our bodies and lives.
Glad you liked the post, guys. It's made me think a lot, too, even though I was the author!

Denise said...

Everything you say is so true and has also been my experience. I have thought alot about the focusing on wellness and I have realized, I can do it if I am at a certain level of wellness already. When I am in the throws of dark despair, it seems the only way out is to endure it, until it is at a manageable level that I can take steps to help myself. That in itself is a major break through for me... to be able to put suffering behind me without having to have the whole world be in empathy with me. Somewhere along the line... I, like you, quit caring if anybody understood my illness... that helps.

You are so spot on. (I like to compare the depression to cancer as well.... and isn't that also a fine commentary? It isn't an illness (in the eyes of the world) that can stand on its own... it has to be compared to something awful to get the point across)

etta said...

You are so correct about the ability to focus on wellness only when you are "up to" a certain level of wellness already. Exactly my experience as well! Like you, once I hit the total darkness, there is nothing I can do. And maybe I am being a bit revisionist (and too hard on myself) when I say that I used to sit around and wait--not take any action. Much of the first few years of my illness were spent suffocating and confused at the bottom of a deep black hole.
However, I do think learning to endure is a skill. Today I am much better at hanging on during the lowest times, because I have learned those times are temporary. So, in a way, by NOT panicking, self-medicating, running away, etc...during those dark times, I am still taking an action--the action of inaction. Hmmm...
Thanks for your comment.