21 votes

This is what it's like to live with high-functioning depression

14 comments

  1. [10]
    zoec
    Link
    Thank you. This is a very important topic. I've been living through it, and one of the worst thing that hurts is the denial, first of all by myself, and by those close to me. With denial comes...

    Thank you. This is a very important topic.

    I've been living through it, and one of the worst thing that hurts is the denial, first of all by myself, and by those close to me. With denial comes stigmatization. I can't, I won't really blame them, since I had been in denial about my mental health too. It's an easy mistake to make, and the cost is high.

    Perhaps we as a society put too much emphasis on "functioning" and not enough on how one experiences inside. If mental health symptoms are signals to the self, the epidemic is a societal signal indicating that we may need to inspect the structure of our social norms and the way we conduct human relations in it.

    And antidepressant ads... this is a thing in the US? It's quite inconceivable what good it can do. I feel that ads for Rx-only medicines are a poor idea in general.

    BTW completely off-topic. If the @OP could remove the query part from the URL? I.e. the ?utm_campaign=broad&utm_source=broadlyfbusads string. Just to make the URL more canonical :)

    13 votes
    1. [4]
      patience_limited
      (edited )
      Link Parent
      I'm sorry to hear you're suffering, and welcome to the club. :-/ I've posted this previously with regard to "functioning depression". There's no question that this type of depression has a...

      I'm sorry to hear you're suffering, and welcome to the club. :-/ I've posted this previously with regard to "functioning depression". There's no question that this type of depression has a biological component, but that's like saying that the pain of a broken bone is "psychological" and needs cognitive behavioral treatment. The biological component of functional depression is a neurochemical change arising from learned helplessness, in the face of a devastating cultural environment.

      It's highly suspect that the OP article complains that half of sufferers don't get help, then goes straight to "help" consisting of antidepressant medication and the serotonin hypothesis, while also mentioning that medication fails to help as many as 2/3 of sufferers.

      My latest episode came about after a long stretch of unrelieved 70 and 80 hour work weeks, with cross-time zone travel and a bad case of the 'flu that turned into pneumonia. It felt like I never recovered my energy afterward, was constantly anxious (of course there's perfectionism involved), and stopped sleeping normally. Even the most trivial tasks felt like crushing burdens, but I kept going. After a round of normal physical test results, the doc pulled out a prescription pad and the cycle of medication, psychologist, psychiatrist started... and kept running in circles with less and less helpful drugs and more and more side effects. Finally, things got to the point where the light bulb came on and I realized I wasn't so much depressed as burned out at work - speaking of denial!

      I'm holding on - cut work back to an average under 50 hours/week, raised hell with management (somewhat assisted by a wave of people quitting with the same complaints), created rigid boundaries for sleep and exercise, started meditating again, and I'm sending out resumes. I've gone from barely holding on most days, to enjoying time with family and friends again.

      And there is a tremendous amount of medication advertising in the U.S., designed to send newly anxious people to the doctor seeking drugs for problems that suddenly and magically seem fixable. No, it's not a good idea.

      9 votes
      1. [3]
        zoec
        Link Parent
        Thank you for sharing your story, @patience_limited. I see incredible resilience in you! I wish you best of luck finding your next job, and I hope they'll value you there. Keep holding on!

        Thank you for sharing your story, @patience_limited. I see incredible resilience in you! I wish you best of luck finding your next job, and I hope they'll value you there.

        Keep holding on!

        2 votes
        1. [2]
          patience_limited
          (edited )
          Link Parent
          It's not exactly resilience, and it's still an effort not to keep ruminating over the damage done to relationships and opportunities for love and friendship. You spoke of denial, both on your own...

          It's not exactly resilience, and it's still an effort not to keep ruminating over the damage done to relationships and opportunities for love and friendship.

          You spoke of denial, both on your own part and others. There's an underlying assumption of unfettered agency, that you're somehow choosing to behave and think in harmful ways. The very language we speak creates cognitive framing about depression like "counterproductive", "lazy", "dysfunctional", "negative", as if externally measured productivity is the normallly functioning and positive state.

          The point of the story is that no one should have to ride a tiger to work and smile all the way, or otherwise endanger themselves and their family relationships to make a living, even if they love (or are addicted to) the job. And a living is all it is, whether you're building skyscrapers or subsistence farming - everything else is internal and social narratives about merit.

          Before it was medicalized, the "functional depression" in the article would have been a good description for workaholism.

          If you're unable to derive self-esteem, find meaning, structure your time, let go of control, learn to set boundaries, sustain mutually beneficial relationships, or ask for help, without the narrative centering around work, it's a recipe for inner misery. The worst of it is, the mechanisms of corporate capitalism nurture and thrive on exploiting those tendencies.

          In the U.S., we're building immiseration back into the political and economic system, by setting everyone up to starve if they can't sustain whatever soul-crushing hours and conditions their employers demand. The social media landscape punishes any hint that you're not materially successful and "happy".

          These days, I'm recognizing that rage is the energized version of despair, and trying to channel the feeling positively.

          Tildes doesn't have a private message or chat system as yet, but we could certainly stand a subgroup for life.depression.overthrowing.the.dominant.paradigm.

          3 votes
          1. zoec
            (edited )
            Link Parent
            I do feel that perhaps we've got a lot to say with each other. Maybe we need to get a room... (There's private messaging on Tildes, but not multiparty PM). Can't agree more. I used to tell an...

            I do feel that perhaps we've got a lot to say with each other. Maybe we need to get a room... (There's private messaging on Tildes, but not multiparty PM).

            And a living is all it is

            Can't agree more. I used to tell an acquaintance once, that after being thoroughly roasted by my work (science) and its hostile environment (real or perceived (but perceptions were at least partially planted by the reality)), and all the refusal to listen, I got solace not from any of the scientists who had so much to write about doing science, but Simone frigging de Beauvoir. In her Ethics of Ambiguity you could derive many messages and I think that message you expresssed is one.

            I don't know what's "exactly" resilience. I use "resilience" to refer to something vaguely perceived inside oneself that hold the self together. I think it is embodied in you, despite/because of/standing side by side with your efforts and struggles.

            I feel that the capitalistic machinery of the world is like a monotonous voice telling you "I'll make you not yourself. I'll make you Other." It's no wonder surveillance, compulsion, and capitalism are in cahoots so "naturally". The subsistence farmer used to be minimally affected by the architect. The former could afford not to give a damn about the latter. Well, we've invented a world order in which we, they, can compel one to, via instant access to individuals by the Inflicting Artefact, the nameless Big Other in the Internet media (remember the days in which we felt as if it were the inverse, our instant access to the Wonderful Artefact). We have the technical means to drown one in symbols, and it generates a lot of money in a positive feedback loop.

            In the middle ages, St. Caterina da Siena heard Jesus say to her "I Am He Who Is, and you are she who is not." At least that was a voice who experienced the suffering of being "who is not", and Caterina could put her faith in that voice because she believed that voice was love (those who are in love knows it from what isn't love). Even from an atheist, humans-made-gods angle, we could say in good faith that some of us once attempted, at least, to construct an image of an Artefact (God, or gods) that was capable of love. In this age we've banished such fantasies, and there's this Artefact saying "I am the thing that is not, and I judge you that you're invalid."

            Edited for dyslexic sentences.

            2 votes
    2. [4]
      Warkweh
      Link Parent
      You're welcome. I have high-functioning depression, and multiple people close to me also have diagnosed mental illnesses, so advocating for this sort of stuff is important to me. And sorry about...

      You're welcome. I have high-functioning depression, and multiple people close to me also have diagnosed mental illnesses, so advocating for this sort of stuff is important to me.

      And sorry about the link! (brand new to Tildes). I posted this on mobile. Is it possible to edit it even though I've already submitted it?

      3 votes
      1. [3]
        zoec
        Link Parent
        Ah, there's nothing to apologize for. Yes, I think the OP can edit their own post.

        Ah, there's nothing to apologize for. Yes, I think the OP can edit their own post.

        1. [2]
          Warkweh
          Link Parent
          But how? Is it under "delete" or something? Because I see a "tag" button and a "delete" button, but no "edit".

          But how? Is it under "delete" or something?
          Because I see a "tag" button and a "delete" button, but no "edit".

          1. zoec
            Link Parent
            Sorry, I must have made a mistake. And sorry about the derail.

            Sorry, I must have made a mistake. And sorry about the derail.

    3. Neverland
      (edited )
      Link Parent
      @Deimos - this page had a canonical link in the source <link rel="canonical" href="https://tonic.vice.com/en_us/article/9k3eb7/high-functioning-depression-is-the-easiest-to-miss" /> And an amphtml...

      @Deimos - this page had a canonical link in the source

      <link rel="canonical" href="https://tonic.vice.com/en_us/article/9k3eb7/high-functioning-depression-is-the-easiest-to-miss" />

      And an amphtml link as well

      <link rel="amphtml" href="https://tonic.vice.com/amp/en_us/article/9k3eb7/high-functioning-depression-is-the-easiest-to-miss">

      Assuming this is relatively widespread, maybe on posting, you could look for these and always defer to canonical url when available in the topic link. This would allay the issue brought up by @zoec. At the same time, add a link named “AMP” below the url to provide that feature if you are interested in implementing that feature.

      2 votes
  2. [3]
    Tenlock
    Link
    Thanks for sharing this article. Hits close to home. Over the past year, as I've been exposed to more and more discussions about depression, I'm starting to come around to the idea that I may be...

    Thanks for sharing this article. Hits close to home.

    Over the past year, as I've been exposed to more and more discussions about depression, I'm starting to come around to the idea that I may be depressed. I've always denied it because, just like the article says, my symptoms have never looked like "traditional" depression.

    I'm driven, hard-working, and I don't sleep much. But the world has definitely turned a lot grayer for me, I've stopped enjoying things altogether, and I feel tired all the time. It feels similar to burnout (I'm in a high-pressure occupation) but I've gone through burnout several times before, this change feels deeper somehow. Thankfully I've never had suicidal thoughts.

    But I don't know how to get tested/diagnosed, and I only have catastrophic insurance so I don't know if I'll be able to afford it. What's someone to do at this point?

    4 votes
    1. [2]
      patience_limited
      Link Parent
      "Driven and hard-working" - who or what is driving? That's a question I got confronted with in therapy... I felt exactly the same as you described, that it was wholly unlike previous episodes of...

      "Driven and hard-working" - who or what is driving? That's a question I got confronted with in therapy...

      I felt exactly the same as you described, that it was wholly unlike previous episodes of both burnout and depression, a much more insidious fog of physical and mental exhaustion which didn't go away and drained the joy out of everything, accompanied by a torrent of dread for every new task. It took gradual appearance of the suicidal thoughts and a threatened divorce before I finally sought help.

      Please don't wait that long! If you do have any thoughts of suicide, you're having significant changes in your relationships or ability to work, damn the expense and get to a doctor.

      1. Start with a general physical and labs, even if not covered. The symptom of fatigue is so general that it could be something easily treatable. "Depression" is at least partly a diagnosis of exclusion - if there isn't a clear physical cause and you match a certain number of checklist criteria, a GP can arrive at the initial diagnosis with fair accuracy. [I did make a mistake in that I allowed my GP to prescribe a currently fashionable SSRI the minute he didn't find a physical cause, and didn't seek further expert mental health care immediately.]
      2. There are many low-cost mental health resources available, but finding good quality care when even the professionals can't agree on diagnosis and treatment is challenging. Your GP may have a trusted resource, but the specialization you're looking for is cognitive behavioral therapy. To the extent that there's evidence for any strategy, CBT seems to have the greatest effect and most persistent results without drugs. If you don't see progress with CBT, that's the time for psychiatric intervention.
      3. Zero or very low cost lifestyle changes - enforce regular food, exercise, sleep and socializing periods in your life, take up mindfulness meditation (at the cost of a phone app) to manage daily stress, and minimize caffeine/alcohol consumption. Each of these is an effort, but cumulatively, these steps alone may lift the fog.
      4. I don't know your profession, but start looking for ways to redefine your job role so that you're not under constant pressure. CBT can help you recognize and manage perfectionistic or self-abnegating tendencies that make you take on more than you should, or controlling traits that make you unwilling to share your load with others.
      5. Talk with your coworkers. If there's a competitive culture of braggadocio about who's working hardest, start asking questions - are you happy, do you ever see your kids, when did you last take a professional development course, etc. Sometimes it just takes talking one another down from the precipice of karoshi. If enough protest to management or start muttering about quitting, you might get more people hired.

      Shutting up now, but I hope you get some benefit from this advice.

      3 votes
      1. Tenlock
        Link Parent
        That's very helpful! You've given me a lot to consider. I'll set up an appointment to rule out physical issues and figure out if CBT is the right path for me, and in the meantime I'll try to...

        That's very helpful! You've given me a lot to consider.

        I'll set up an appointment to rule out physical issues and figure out if CBT is the right path for me, and in the meantime I'll try to incorporate some of those lifestyle changes (definitely need more sleep and exercise). Points 4 and 5 will be tougher but worth trying.

        I hope things have been better for you and I appreciate the advice. Thanks.

        1 vote
  3. LordManley
    Link
    Damn that hits home. I can never get the help I need, because I am lucid, affable and a good communicator, so I always come across as okay. I am not okay.

    Damn that hits home. I can never get the help I need, because I am lucid, affable and a good communicator, so I always come across as okay.

    I am not okay.

    3 votes