I recently lost a friend who was suffering from severe depression. He was well known, well liked, and the shockwaves from his passing were far-reaching. Many people struggled to understand how someone so full of personality, so loved and admired, and with such a wide social network, could have been lost to us. Many people expressed feelings of guilt or regret that they’d not reached out more while he was still with us. I know from having had a near-fatal depressive breakdown that just because people desperately want to help, and would do anything in their power to help, it doesn’t mean it will make a difference.
For people who haven’t ever been seriously unwell with depression, it’s one of the hardest things to understand, and also one of the hardest to explain; when you’re actually in the midst of a depressive episode, it’s almost impossible to understand it yourself, let alone put it into words. While I am well enough to express it, I am going to try. I hope it helps, whether you’re struggling yourself or feel like you’re helplessly watching someone else suffer:
Depression has a very particular and insidious effect on our ability to accept help, care, support and love by making us believe that we are absolutely unworthy of that help, care, support or love.
I am lucky to have a large social network, lots of friends online and in real life. Despite being a little socially awkward, I make friends relatively easily (although the faceblindness can make it hard to maintain them, as I don’t always recognise them when I see them again!) When my breakdown became particularly noticeable, and I started to be more public on my LiveJournal about discussing it, I started to hear a common statement: “how can you be depressed? You’re always so bouncy!” or “you’re too fun to be depressed!” or “but you’re such a naturally happy person, you can’t have depression”. I heard these sorts of things so frequently that they became a dragging weight of expectation; an entire necklace of albatrosses. I felt a pressure to maintain this irrepressible care-free reputation; to be “fun on demand”. Looking back, it absolutely led to my increasingly heavy social drinking and ultimately led me to increasingly withdraw; if I couldn’t be this fun person, people would stop liking me. People wouldn’t want me around if I wasn’t that person. I am not that person, therefore I don’t deserve these friends. I believed that the love and support of my friends was dependant on my being Not Depressed, and therefore I would lose it by letting people in to the real world of my depression
Depression can make even people with a large social network feel incredibly alone, even while there are potentially
hundreds of people keen to support and help. Who can you really call, when you can’t stop crying? Who would you burden with that responsibility? Your empathy collides with your desperation; your need not to be “a bother” with a need to reach out. You become convinced that even the people who are there for you will get fed up of helping, will give up on you. You start to reject them, too. Not because you don’t want them around, but because you don’t want to reach the point of – in your eyes – inevitable rejection.
Some people with depression and low self-esteem can paradoxically come across as intensely arrogant; a weird juxtaposition of believing yourself to be so utterly worthless and awful that you are a huge drain on all those around you, that everyone else around you would be better off if you just weren’t around. In some of my slightly better moments (where “better” is entirely relative) I was able to grasp that people would be upset if I was gone, but I still believed that in the long run they’d realise they were better off. Those were the lowest and most dangerous moments – when my thinking was warped to the extent that I genuinely believed that ceasing to exist would just be the best thing for everyone.
That crippling self-loathing led me to begin pushing the very people away who most wanted to help, who (I now understand) understood that I wasn’t “bouncy” all the time, whose friendship wasn’t dependent on my being “fun all the time”, who probably understood my depression at the time better than I did. I couldn’t understand why they’d want to help me when I was – in my view – such a terrible, boring and destructive person. In my lowest moments, the more people reached out, the worse I felt. It was as if I was tricking all of these people into thinking I was worse helping, or that in some way I was using up their time that would be better spent on someone worth their time. I worried that they’d grow to hate me if they kept trying to help me.
When you hate yourself beyond all explanation, and someone says they love you, it’s just impossible to process. The people who loved me most, who stuck with me even as my behaviour became dangerously erratic and disconnected, where the people who bore the hardest brunt in this respect; because the more I hated myself the less I thought of the people who said they loved me. How could anyone love someone as dreadful as me? They’re either lying or foolish.
Even as I slowly started to get a little better I pushed people away; worried that if I accepted help to get well again, I would always need help. I worried that if I couldn’t do this on my own, I’d never be able to stay healthy independently. But this is part of our disconnection between mental health and physical health. No one can heal from any medical issue without any help at all – no one expects someone to heal a broken bone entirely on your own; you’ll need medical help, painkillers, maybe physiotherapy, people to help with personal care or household tasks. Just because a friend came around while I had a broken hand and a broken rib (roller derby…) to do the washing up and cook me some meals didn’t mean I couldn’t do that for myself once I was healed.
I’ve described depression in the past as one of those weird parasites that perpetuates the conditions it needs to survive at the risk of killing its host. We reject help, or at times even resent help, because the depression warps our thinking process to the extent we can’t understand or accept that help. This makes it incredibly hard to give advice to people watching their loved ones suffer. They might not be able to handle compliments, accept offers of help, they might not be able to answer the questions “what can I do to support you?” or “what do you need”. They might not be able to understand why you want to help, or know how to accept it, or how to feel about you offering it. You could check in with them occasionally, reassure them you’re a friend. Remind them that sometimes depression makes you think things that aren’t true. Love them, but don’t overwhelm them with love. The best you can do, when someone is this low, is simply to offer a willingness to understand, even when it seems beyond comprehension.