Depression is a funny and inconsistent beast. It’s not like a skinned knee, which stings for a moment before flushing red, drops of blood appearing on the surface, following a predictable and neat pattern from beginning to end. You fall down, your knee hurts, you clean it, it scabs, eventually it heals over, first with pinkish, tender flesh and then with smooth skin like nothing ever went wrong. You can do it again and again without leaving a trace. Nor is it like asthma, a disease with clear and traceable symptoms, either you struggle to breathe and wheeze or you do not, either an inhaler helps you or it does not.
Instead, it manifests differently in everyone, one reason it is both challenging to diagnose and difficult to treat. Depression tends to act, for some, at least, like the edge of a whirlpool. To paraphrase John Green, you spin slowly into the gyre, and then, all at once, you’re sucked down. As you skid down the walls of the water, there’s no way to claw yourself back up, unless you’re able to defy gravity, and you settle to the bottom, forced to wait for the currents to slowly cycle back.
Sometimes the obstinate current leaves you there. Sometimes you find your own lift — maybe medication or therapy takes you there, perhaps the shifting waters become navigable as your circumstances change and your situational depression begins to ease. You still have the sharp memory of falling, slowly, then all at once, into the waters that threatened to never let you go. For some of us, the moment of sharp awareness that we almost drowned there in the depth of the water while waiting for something that never came, and also, the knowledge that some people do drown, that sometimes the whirlpool never lets people go and they are trapped there forever.
Maybe it starts with feeling a little tired. A little disinterested. Life feels a little out of focus and maybe frustrating around the edges. It’s harder to go out and be social. Bit by bit, things dull. Sometimes, people don’t even notice the slipping of your mood, how you start to shift from one person to another. Depression isn’t necessarily a switch that’s flipped — not even in the case of bipolar people. Sometimes, yes, you do snap from highs and lows with almost no intervening time, giddy one day and crashing the next. Sometimes, though, you slowly cascade through mania and into depression, wondering why just last week you were filled with energy and all the time in the world and now you’re slogging to get anything done and wondering if life is worth living.
Depression isn’t about being sad all the time, and it’s not about an abrupt leap into sadness. It’s a gradual shifting process that pulls your mind down, and you along with it. People like to say that depressed people should just ‘try harder’ and that if they snapped out of it, they wouldn’t be depressed anymore, but imagine climbing the walls of a whirlpool while the water is firmly forcing you down, pulling your body along. It’s a difficult, nearly impossible thing to imagine — the idea that you could defy a force of nature might seem ludicrous, almost laughable. Yet, that’s what people are asking of depression, that people just calmly step out of that whirlpool like they’re climbing a ladder and ‘move on.’
Observant people sometimes notice the slide into depression, the gradual markers of changes in behaviour, sometimes even before the depressed person does. They notice the fatigue or snappishness or disinclination to go out or whatever the symptoms of any individual’s depression are. They notice that someone is struggling. Offering help can be challenging, especially for people without a history of depression who don’t understand what’s happening to them and might be resistant to the idea that they need help. In other cases, it can be hard to know what to say, or do — in this case, the whirlpool metaphor falls apart because it’s not as simple as throwing a rope out when someone may resolutely refuse to grab it, more interested in continuing to fall, mesmerised by the waters to the point that she won’t take an opportunity to be hauled to rescue.
For those around people with a history of depression, it’s imperative to remember that mental illness can always return. Sometimes it’s exacerbated by a situation. Sometimes it randomly drops in for a visit. Sometimes it’s the result of medication failures or therapy modalities that aren’t working. Whatever the case, depression can come back, and it’s important to watch out for the signs. And to be aware that many depressed people hide their symptoms to fit in, to not make trouble, because they don’t want to deal with their mental illness — because even managing depression is exhausting when you’re in the thick of a depressive episode.
And it’s important to be aware that many people with depression don’t wake up one morning and decide not to get out of bed after being lively and active the day before. It starts small, with little signs and symptoms, little behaviours that are out of the ordinary, little markers that may be almost hidden without a larger picture, and it’s those that betray the slow creep of depression. Catch them early and you can stamp them out, tossing a rope out before it’s too late. Miss them, and someone may sink beyond reach, moving slowly, then all at once.
Photo: Whirlpool, David O’Hare, Flickr