How Are You Today?

                                 

How are you today?

It's a question that we ask people every day. We don't want a real answer to this question. We want answers like "great," "good," "fantastic," "wonderful," or even answers like "I've been better," "tired," "stressed," "Oh, ya know... living the dream" (said sarcastically). Even blatantly negative answers are okay, as long as they are just a word or two. Anything beyond the socially acceptable trite answers, we don't really want to know because the question isn't an honest one. It's a placeholder. It's something we say so we don't have to experience the "awkward silence."

Yet, this phrase isn't just used in casual conversation. Most of the depression self-help books and programs recommend some form of this question as a daily "check-in." Even many of my therapists have used a version of this question: "On a scale of 1 to 5, how bad is your depression today?"

I find it almost impossible to answer these questions.

People who have never suffered from Major Depressive Disorder (also referred to as "Clinical" Depression) often don't understand the incredibly complex and multi-faceted nature of the disorder. There is a tendency for people to believe that MDD is simply feeling "sad" or "down-in-the-dumps." And there is a corresponding tendency to think that people who do suffer from this disorder should be able to just pull themselves out of it by keeping gratitude journals or repeating positive affirmations or choosing positivity.

Major Depressive Disorder is so much more complicated than that, though. I have spent my entire life battling this disorder. It has ebbed and waned over the years since I was about 10 years old. I might go through a depressive episode that might last from 6 months to a couple of years. Then I might go 3 or 4 years before it hit again. Generally, until this last episode, I had more "good" years than "bad." But this latest bout, the one I am still suffering through to this day, has last over 15 years. No, that is not a typo. I have actually been suffering from unabated symptoms of MDD for the last fifteen years. Let me be clear. I have had moments of joy, of peace, of accomplishment. But even those small victories I have won have been smothered under the weight of my overarching depression. To employ an oft-used cliche, I may have won an occasional battle, but I am losing the war in a spectacularly bloody fashion.

But back to the original question: Tanya, how are you doing today?

As I said before, I find it nearly impossible to answer this question. I tend to think of my depression as manifesting in three different mood types: melancholy, anger, and numbness. And within those broader categories are a range of emotions and behaviors that make any simple answer to the above question a near impossibility.

MELANCHOLY

This first mood category--melancholia, or sadness--is the one that is most often associated with depression. It is also the mood that is most dangerous for me. I include in this category emotions such as grief, loneliness, hopelessness, despair, helplessness, failure, low self-esteem, uselessness, desperation, etc. The emotions I grapple with the most frequently in this mood category are grief, hopelessness, low self-esteem, and uselessness. The grief relates to everything I (and my kids) have lost over the last 11 years. In just that relatively short amount of time, I have lost my mother, my brother, my stepfather of 30 years, my grandmother, my grandfather, my uncle, three very close friends, and four beloved pets (I lost my father, my other grandmother, and my other grandfather years ago). In addition, there have been a number of more distant friends and acquaintances who have passed away or otherwise disappeared from my life. 

It's not all about losing other people, though. I have lost my physical health and my mobility. I have lost my financial stability, either due to job layoffs or due to not being able to find a job. I have lost my independence because I have to rely on my kids to financially support me and because my physical limitations mean I have to rely on others to do things for me that I used to be able to do for myself. 

What I grieve the most, though, is my loss of self. I have no idea who I am anymore. I was once lively, energetic, funny, ambitious and determined. I hungered to improve my life and the lives of my children. All of that is gone now. Now, I consider it a productive day if I can get myself to take a shower (I wish I was kidding about that). At one time, I was a full-time high school English teacher and play director and single-mom of two kids. I worked a part-time job on the weekends and was working on a Master's Degree. Now I can't even find a job. While I have never been the kind of person who enjoyed going to the gym, I used to enjoy taking long walks, or playing in the snow with my kids, or doing other physical activities. Now, because of my spine issues, I have trouble getting out of my chair... and I have gained about 140 pounds. I used to love reading and writing, but my migraines and vision problems have made those difficult. I used to love to sing, but I can't tell you the last time I did. I used to hunger to learn and keep myself educated, but now I often think "what's the point?"

Everything I was has vanished. I am no longer the same person... and not in a good way. I am now a lesser person than I once was -- in society's eyes and my own. 

It is all this loss -- family, friends, social standing, financial security, physical ability, and sense of self -- that leads to my feelings of uselessness and hopelessness. Things are really shitty for me right now, and I don't see any way for them to improve. I often wonder, "Why bother?" Why should I keep going if things are never going to get any better? I certainly don't want to live like this for the next 25-30 years. This is why melancholia is the most dangerous mood for me. It's the one that makes me wonder if it wouldn't just be better to die.

Behaviorally, this mood manifests most frequently for me in the following ways:

Weepiness: I cry... A LOT. Often, this crying will come out of nowhere, with no apparent trigger. I might be watching a TV show and suddenly start crying over some silly comment someone made. And I don't mean that I get a little misty-eyed. I mean full-out waterfall. It doesn't even have to be a particularly emotional comment. It could be a joke that somehow sets me off. Or, there may be NO trigger what-so-ever. I could be doing the dishes, or showering, or sitting on the damn toilet, and all of the sudden ---- hysterical sobbing. It's ridiculous.

Sleep Irregularities: This is a big one for me. I vacillate between not sleeping at all or sleeping ALL THE TIME. It's not unusual at all for me to be awake for 36 hours and then sleep for the next 36-48. Yesterday, I sleep for 24 hours straight, despite having slept pretty regularly for the last week. There really is no rhyme or reason to my sleep schedule. 

Lack of Motivation: Anytime I feel myself slipping into the blackness of melancholia, I can also count on experiencing a significant lack of motivation. It's as if nothing matters but the pain I feel, and that pain is all-encompassing.

Suicidal Ideation: Let me start by saying that, no matter how much I might think about it, I am not actually at risk of committing suicide. I would never, ever do that to my kids. They have lost too much already. For me, the ideation is more passive: I wish I were never born, I wish I didn't exist, I wish I could go to sleep and never wake up. These thoughts run through my head constantly. And, although I would not classify them as suicidal thoughts, my therapist says they are. Occasionally, I will have a more direct suicidal thought, but even if it weren't for my kids, I doubt I could ever go through with it. See, I don't believe in an afterlife. I think when you die, you just cease to exist, and that thought terrifies me. I do think about death a lot when I'm in this mood, though. Too much, if I'm being truthful.

ANGER

The second kind of depressive mood I encounter is anger. I think most people who know me would be surprised to see this on my list of moods because I am not a person who generally seems angry. But to me, anger is more than just feeling the need to shout at someone. The emotions I personally equate with the mood of anger include frustration, self-loathing, extreme disappointment, discouragement, fear, anxiety, stress, and deep-seated rage. 

While I feel that most of these emotions are self-explanatory, I do want to address what I mean by "rage." To me, rage is something that boils below the surface. It's something that is long-term and grows over time. People can get terribly angry without ever feeling rage. I most often feel rage in response to the severe injustices in our country -- the injustices of racism, sexism, homophobia, transphobia, xenophobia, classism, etc. I equate rage with the term "outrageous." If I look at something and think, "That's outrageous. How could someone do/think/say that?" it's a good bet I am feeling rage about it. It also doesn't have to be in response to a social injustice. It could be one of a hundred things that simmers in my gut. Complaining about teacher shortages, yet refusing to fund education -- rage! People who interrupt me or talk over me as if I'm not there -- RAGE! Having our city listed number 12 on the New York Times fastest growing Coronavirus spread among all cities in the US with populations over 50K and having no one in power doing anything to address the problem -- RAGE!!! 

It seems like every day I come across something else that fuels my frustration, disappointment, discouragement, and rage against the world. 

Some people might wonder why I include fear, anxiety and stress under the mood of anger. The answer to that is pretty simple. The more I feel those emotions, the more angry I become at the world. That's it. Full stop.

As for the self-loathing? Well, I take full responsibility for that one. There are actually times when I find myself repeating "I hate myself, I hate myself, I hate myself, I hate myself..." sometimes, for hours on end. I suppose it's because I feel so disappointed in what I have become. I literally cannot think of a single thing I like about myself. And, of course, the more I hate myself, the more depressed I become, the less likely I am to do something to improve myself, the more I hate myself. It's a vicious, vicious cycle.

The behaviors that manifest as a result of the anger mood are:

Misanthropy and Social Isolation: Generally speaking, I've come to hate people. Don't get me wrong, on a one-to-one basis, most people are fine. In fact, there are even a few people in this world that I like quite a lot. But as a group, people are awful. Every day, we find more and worse ways to hurt each other, hurt our communities, hurt our environment... hurt ourselves. Every day, we become more fractured, more hateful. It is all so despicable. It fuels my frustration, my anxiety, my fearfulness. It fuels my rage. I started self-isolating long before the pandemic was ever a thing. It's been years since I have had any sort of social life, aside from an online one. I worry that I might be becoming agoraphobic, since there are times when I can't even stand the idea of leaving the house. 

Irritability: There are times when I feel like I am losing my ability to empathize with people. I have moments when I become easily irritated by even small things that people do. This irritability also increases my stress and anxiety, and vice-versa. It's another of those vicious cycles. I get irritable, which makes me feel stressed and anxious, which makes me more irritable, ad infinitum. My blood pressure goes up. My migraines get worse. The pain in my muscles, joints, and nerves increase. It's a mess.

Panic Attacks/Anxiety Attacks: Fear, anxiety, stress, and self-loathing all contribute to an increase in panic attacks or anxiety attacks. This is why I haven't finished my dissertation yet. Whenever I try to sit down to write (when my physical/health issues will allow me), I almost immediately start having a panic attack. I suffer from a pretty severe case of Imposter Syndrome. I have no confidence in myself. I don't think I'm smart enough to have a PhD. But these panic attacks are not exclusive to my dissertation. I have them about our financial instability, which contributes to my self-loathing because I'm such a useless piece of shit that I can even get a job to help my family survive. I have them about the pandemic, the environment, social issues, the election, our car, cooking supper. Sometimes I become so stressed and anxious about everything that I simply cannot function.

NUMBNESS:

The last of my mood categories is numbness, which honestly, is just like what you would think. It's that "I just don't give a shit anymore" mood. I can't list emotions related to this mood... because there aren't any. I think this mood is a kind of mental defense mechanism. While I still don't feel any positive emotions like joy, happiness, or excitement, I also don't feel all those negative emotions that I feel with the other two moods. There is just emptiness, nothingness. Nietzsche said that when you stare into the abyss long enough, the abyss stares back into you. That's what this mood feels like... staring into the abyss and seeing that nothingness stare back. 

Yet, for all its nothingness, this mood is the one that actually tends to cause me the most trouble. 

This mood manifests in the following behaviors:

General Listlessness: When I am feeling numb, I truly don't care about anything (except my kids... they are the only thing that can break through to me). When I feel numb, I sleep a lot. Or, I stare vacantly at the television for hours on end. Or I play games on my phone for hours. Anything to pass the time without making me FEEL  anything or DO anything. 

Poor Housekeeping: I don't cook, I don't clean, I don't do the laundry. I forget to feed my cats. And this goes on so long sometimes that when I do finally shift out of this mood, I realize we are living in squalor. That's not me. That's not who I am and how I was raised. I like order and cleanliness. So, when I finally emerge from this numbness, I am left to deal with this chaos and filth, and it's so bad that I don't even know where to start to get it all back to normal. 

Poor Hygiene: I don't brush my teeth. I don't shower. I don't comb my hair. I don't get dressed. I don't change into clean pajamas. I don't do my skin care routine. I don't cut my toenails. I don't shave. Because I don't care. Who's going to see me anyhow? 'Nuff said. 

Neglecting Responsibilities: Even though I have been off work for almost a year, and I don't earn the money for the household, it is my job to deal with the finances. But when I get numb like this, handling money can be a real issue. I don't pay the bills. Maybe I forgot, or maybe I just didn't give a fuck. Sometimes, I might even spend the money that should have been earmarked for bills on frivolous things I don't really need. I also don't complete other work that needs to be done. I might forget to fill out applications for a job until it is past the closing date. Or, maybe I forget to file my appeal when I am turned down for SSI (true story). Or forget to sign the new annual lease for the apartment. Or I forget to turn something in at work. Or I procrastinate on the job (like taking too long to return a student email or getting grades returned). This, as you can imagine, gets me in trouble a lot. I frequently forget what I am doing or what I need to do. I often end up paying fines and late fees. In the end, the guilt and self-loathing scream at me for what I have done. 

Complete Lack of Interest: It's not just the responsibilities and keeping the house (and my person) clean. It's a lack of interest even in the things I have always loved in the past. Even though I have trouble with my eyesight and migraines that make it very difficult for me to read, I still enjoy listening to audiobooks. It's not quite the same, but it's a fair substitute. But when I am in this numb mood, I can seem to find concentrate long enough to listen, nor do I gain any enjoyment out of it. Another example is meditation. I have been meditating off and on for the last 5 years. Sometimes, I'm really good at meditating every day, even if only for 10-15 minutes. But when I am feeling numb, I can't find the energy to meditate. Think about that for a second. Meditation is literally sitting and doing nothing but breathing for 10 minutes. But I don't have the energy to do that? The only thing I might do is watch TV, but even that is done half-heartedly. I don't really pay attention; I lose track of the plot. I can't even bring myself to care about something I love doing as much as I love watching TV and movies.

Then, when I finally come out of this numbness, I pay the consequences. My house is filthy. I AM FILTHY. Dishes are piled up. Bills are piled up. And the guilt and anxiety and stress and despair and uselessness and self-loathing and RAGE broil inside of me. 

WHAT IT ALL BOILS DOWN TO:

The worse part of all of this is that, despite the fact that I can lay this all out in writing in a neat and organized manner, in real life, none of this is neat or organized. I bounce between these moods and emotions like a ping-pong ball, often feeling several moods/emotions at once. 

So, "How you doing today?" is an impossible question for me. I am numb, angry, confused, sad, grieving, stressed, panicky, fearful, self-loathing, weepy, misanthropic, guilt-ridden, useless, hopeless, desperate, and a little bit dead inside, thanks. How are you?