Sheffield, Anne - How You Can Survive When They're Depressed

[oyceter]

(subtitle: Living and Coping with Depression Fallout)

I picked this book up for pretty obvious reasons, and because I thought it would be interesting looking at depression from the other side. It's basically the first bit of literature on depression that I've read, so I don't have much to compare it to.

Anne Sheffield suffered from what she calls depression fallout -- the fallout and often subsequent depression and emotional damage caused by living with someone who is depressed. In her case, it was her mother. She later went through a depressive episode or two of her own, and also joined a group of family members and loved ones of "depressives." I was a little weirded out by the term "depressives" and how casually Sheffield uses it ("your depressive" or "the depressive may do blah"). I personally don't like thinking of myself as a depressive. She is also extremely pro-medication, which I have yet to make my mind up about. She generally says that while talk therapy can be useful, medication is the most efficient way to get well.

Of course, I focus more on the depressed person's perspective. But Sheffield's accounts of several relationships with depressed people and the subsequent fallout really is incredibly... er... depressing. I felt like quite a monster by the time I was done with the book. I feel it probably has good advice for people who have to live with other depressed people, and it is good that there is something focusing on them. Sheffield comments more than once that the focus of books and doctors all tends to be on the depressed person instead of on those around them, which is probably true. So all in all, it probably has good advice, but it was still pretty painful reading it and thinking about all the nasty stuff I inflict on other people.

Comments

[livinglaurel.livejournal.com]

I read an interesting bit in an article re nomenclature and mental illness -- a doctor wouldn't say, "He is pancreatic cancer," or "She is pneumonia." But you get "He is schizophrenic" or "She is bipolar" as if that disease is the essence of the person.

[mrissa.livejournal.com]

"She's diabetic." I think it depends on both the disease and the doctor. I'd bet money that many doctors talking amongst themselves on a busy day will refer to "the stab wound in bed 6" instead of "Rob" or "the knee replacement in room 319" instead of "Jenny."

[oyceter]

Huh, that is interesting. And yeah, I think calling people "depressives" really does tend to make the depression the central fact of the person.

[livinglaurel.livejournal.com]

I think part of it is medical shorthand, but it does also point to a problem with the medical system that uses that shorthand -- the Western mechanized POV of looking at someone and seeing, say, a tumor, or a diabetic condition, or a mood disorder, and focusing on that. It's a v good system in some respects (surgery and so on) and falls down badly in others (I think it's particularly easy for people with mood disorders to slip through the cracks, be mis- or under-diagnosed, to minimize their illness or simply not have the words for it, and the typical "My doctor doesn't listen to me" complaint can become disastrous when treating depressed people).

[oyceter]

Yeah! I often wonder how the psychiatrist and therapist do it, with just some general descriptions to go on, when how everyone describes things must be so different. I am quite impressed with what they have to do.

[livinglaurel.livejournal.com]

I think the standard checklist in the DSM-IV is pretty good, esp for depression -- it's when you start edging off into things like neurosis and borderline personality disorder and hypomania that I start getting wary of the medical establishment. But they definitely have clinical tools, like the MMPI or other briefer depression-measuring scales (and self-administered questionnaires), as well as observation (the shrink who prescribed my first ever medz left his notes on the table while he went to get samples, and I read "vegetative" -- and the word was underlined and had an exclamation point after it!). At first I thought he meant I was A VEGETABLE, but he explained the difference between agitated depression (someone who can't stop pacing, wringing their hands, talking continuously, super-restless -- a bit like how you were describing your bad reaction to Paxil) and vegetative depression, someone who's withdrawn, doesn't talk, doesn't sleep, doesn't eat, and so on. I think generally when by the time a shrink sees someone who's depressed it's pretty evident (clinical skills require docs do it anyway, but asking a severely depressed person how they feel is an exercise in futility).

[rachelmanija.livejournal.com]

My favorite book on depression is Tracy Thompson's The Beast. She's a Pulitzer Prize-winning journalist so it's very well-written, and also has one of the most thoughtful and non-hysterical analyses of the interaction between the mind, the illness, medication, and the outside world that I've ever read. I highly recommend it.

She does talk a bit about how depression screwed up her relationships with other people, but also analyzes how it contributed to keeping her stuck in unhealthy relationships with people who weren't good for her. I'd classify the whole book as realistic but very hopeful and inspiring. In fact, reading it was a major factor in my decision to get medical help for my own depression.

[thinkum]

Thanks for the rec -- I'm going to go hunting for that one...

[oyceter]

Thanks for the rec! I will dig it up.

[livinglaurel.livejournal.com]

That's a great book -- it is v well-written, and she also shows you the etiology of her depression from childhood and adolescence on, so it's really presented in context. I think she was also one of the first professional people to sort of "come out" publicly and write about her depression, in her own paper no less.

[mrissa.livejournal.com]

When timprov was first clearly depressed, I went to the library and got a book about "when your close friend or family member is depressed." And oof, it just pointed out to me what a heck of a considerate Timprov he is even when depressed. The monster perspective is incomplete at the very least.

[oyceter]

I hope so, although I do feel in my case it was pretty applicable.

[arethusa2.livejournal.com]

Yes, people with depression can be difficult and selfish, but so can people with any illness. Don't feel guilty, just concentrate on feeling better. You're not a monster, any more than someone with pneumonia or a heart condition is a monster for needing extra care.

I can't make my mind up about medication either. I don't want an efficent cure, I want a cure that keeps my mind clear and which I can control. I also realize that I tend to get more depressed when I am unhappy with an aspect of my life that I've been to frightened or lazy to change, and I don't want to medicate that feeling away. It forces me to be strong enough to change. But all this depends on the severity of the depression, I think. People who are very severely depressed might be unable to do anything to lift themselves out of it by themselves, and might need medication.

[thinkum]

I can't make my mind up about medication either.

It really should not fuzz out a patient's brain or create a loss of control, nor remove the ability to feel "down" or unhappy -- antidepressants aren't tranquilizers. Correctly tailored prescriptions will eliminate inappropriately-wide swings in mood, so that a patient is not faced with a completely unmanageable emotional load. On the medication and dosage that's right for them, they can deal with everyday problems from a more objective viewpoint; their energy can go into implementing change more efficiently, rather than struggling to recognize it and form a gameplan.

Having said that, medication is not for everyone. It does, indeed, depend on the severity of symptoms, and on the root cause of the patient's depression. (It can also take a while to fine-tune, by trial and error, the right set of prescriptions.) All I'm saying is to not rule it out, or get stressed at the idea. There's no reason to let life be any harder than necessary, when there are treatments that can help "normalize" how the brain functions. Think of it as leveling the playing field. ;-)

[oyceter]

I sort of reached the point in which I really just wanted it all to stop. Ergo, meds now. Thought I was doing pretty well on them, though it seems like there are some not-so-good side effects. It is interesting though, because I have the same depressive thoughts and the like. It's not a reboot to the brain for me... it just prevents the depressive thoughts from spiralling into suicidal ones. A bit of a safety net, if you will.

medication

[uuesti-ajutine.livejournal.com]

I do wonder, myself, that my disastrous experience with medication (4 different drugs and my situation deteriorated much faster when medicated and after a year on different medication I had lost ability to work or, indeed, function in the society nearly entirely) may not be entirely blamed on the drugs - it is entirely possible that the drugs DID have the potential to help, but being on drugs was such an additional stress on me, that the additional stress may have been the reason for the decline, not the drugs (even if my mind wants to lay the blame on the drugs, of course).

Of course, as the distress was too big to talk about (in fact there were times I was nearly mute) the talking therapy did not help either.

Even if one therapist agreed to talk to me instead of expecting me to talk and THAT made me understand that being talked to DOES fish me out of being mute.

[mamculuna.livejournal.com]

Somehow you don't seem depressed most of the time. Going through a tough time makes you normally depressed, but everyone around you knows it won't last forever. In my experience, what made being with a depressed person difficult was the realization that things wouldn't ever change--whereas if your main depression is caused by what's happening in your life, it will change, even if slowly.

I think getting help from friends in a tough time actually can build friendships.

[thinkum]

Somehow you don't seem depressed most of the time.

Appearing cheerful on the outside, when you're dying on the inside, is so common with depression that there's a standard term for it: smiling depression. Even my doctor calls it that, and it perfectly describes my own experience with the disease. It can make for extremely complicated interactions with friends, family, and co-workers, who see the smile and discount (consciously or subconsciously) the knowledge that you're suffering.

[mamculuna.livejournal.com]

Yes, I know that one--and it's very hard on the person who suffers, especially because they don't get support since noone knows what they're feeling.. But I was thinking that O. has recently had something bad happen, and that depression in response to a recent event is a little different from long-term depression with internal causes.

[thinkum]

True, although it's not unusual for the two types overlap, with a triggering event compounding a preexisting lesser depression. Been there, done that! ;-)

[mamculuna.livejournal.com]

Oh, ugh. That does sound bad. Hope it doesn't happen here.

[oyceter]

I think I hide it pretty well, and I just sort of started posting about it. Before I would post all these things and then immediately private-lock them because I was so ashamed of it. I thought for a long time that it was just caused by stuff going on in my life -- job search, relationship troubles, etc. But whenever one thing gets solved, another problem comes up, and I think depression is just there underlying everything and making it worse.

[mamculuna.livejournal.com]

So it's not just recent badness--sorry I jumped to conclusions. I know hiding it is what seems like the best thing to do, but maybe keeps you from getting some of the support you need. I hope you're finding a solution.

But I guess what I wanted to say was that at least for us who know you from LJ, your presence is a real joy, a positive thing. If you're the same way with your RL friends, you're surely not giving them any problems.

Hugs.

[oyceter]

No worries -- it is hard to tell because I kept it off LJ for the most part. It's only lately started coming out. And it really has been a relief and I have been finding a lot of support here, which is something I am so incredibly grateful for.

And thank you so much for the kind words ^_^.

[thinkum]

Yeah, I hate the term "depressives", too. I never say "I'm depressed", but rather "I have depression." As redredshoes notes above, the disease is not the essence of who I am.

Don't let yourself feel guilt about the disease. All the "nasty stuff" is a product of the disease, not you; you are a patient, not a culprit.

What I'd really like is a book that concentrates on depression and the workplace. There is so much misinformation and misunderstanding about the disease, that just adds to the stressload when you go to work and people make inaccurate assumptions about your situation. I don't want special considerations or to be treated with kid gloves, but there are things a supervisor could do to maximize my performance without sending me off the deep end -- if they know what those things are.

[oyceter]

I never really thought about saying "I have depression" but I think that makes sense. Plus, it helps with the more mundane problem of people thinking that "I am depressed" just indicates your mood.

I do not like disliking a book before I even see the cover...

[cychi.livejournal.com]

I must agree with the people who hate the term, "depressives"... it's such a destructive word. It encourages the reader to look at the person in depression as the disease itself, and puts them down, totally ignoring their personhood. It's not unlike the difference between calling someone a 'retard' instead of recognizing them as people with retardation. It's a terrible thing to do.

I've read two books also for those supporting those with depression, and they seemed much less biased than your descrpition of this book. I can send them to you if you like! They have very similar titles, and one was mentioned by someone else in your LJ comments.

Finally, I can definitely relate to smiling depression, I was like that in HS... It was kinda funny how many people I talked to very day that did not seem to notice.

Re: I do not like disliking a book before I even see the cover...

[oyceter]

Ugh, yes to the term "depressives."

And hey, more books is always good! I am finally trying to read up on the subject.

not related

[(Anonymous)]

this is not related to your post, but i just wanted to say that i know i said i was going to call to you last weekend but i didn't. i haven't forgotten but just have been busy these past few weeks. weekdays are bad times for me, and during the weekends, it just varies. anyhow, i haven't forgotten but i will try to call some time. if not, i'll leave you a msg on IM or something.

(anlee)

Re: not related

[oyceter]

Hey, no worries... I'm pretty busy with all sorts of stuff too. But it would be great to talk with you sometime and I hope you're doing ok.

[mad-aristocrat.livejournal.com]

Hi, I bookmarked you some time ago, and your post about Sarah Dessen caught my eye... I just recently read "This Lullaby", which I loved to bits, and plan to buy in the future. So I browsed back to this post, which I found interesting as well. Have you ever read "The Noonday Demon"? I just bought the book at a very low price, and am busy rereading it, because it's that inspiring, and that informative--I recommend it whenever I can. It's by Andrew Solomon- I seriously suggest checking it out ^___^

[mad-aristocrat.livejournal.com]

Oh right.. btw, that seemed kind of random. The book focuses on depression-- Amazon.com says it better: "Off the charts in its enlightening, comprehensive analysis of this pervasive yet misunderstood condition, The Noonday Demon forges a long, brambly path through the subject of depression--exposing all the discordant views and "answers" offered by science, philosophy, law, psychology, literature, art, and history. The result is a sprawling and thoroughly engrossing study, brilliantly synthesized by author Andrew Solomon."

[oyceter]

Ooh, yes, I'm definitely getting myself more Sarah Dessen books in the future.

I haven't actually read The Noonday Demon... well, I've borrowed it once, read a few paragraphs, and then it sort of got buried under my gigantic piles of books -_-;;. I do plan to pick it up again some time though, so thanks for reminding me!