Patricia brought her husband, Dan, into therapy a couple of years ago, ”Can you try to help him understand what it feels like to have depression? He thinks I could stop the cycle if I was more positive, or exercised more.”
Patricia worked at a huge church, where she helped run their children’s Sunday School and daycare programs. She was an active, fun-loving mother and grandmother whose basement looked like an art studio, with her grandchildrens’ projects playfully displayed. She laughed a lot, and her giggle was so infectious you’d find yourself smiling and laughing along with her. Weight had always been an issue for her, but bariatric surgery had helped, and she headed out early every morning to work out. She and Dan had worked very hard on their marriage, and had found peace about other differences they had through therapy with me over the years.
But this argument had cropped up many times, and seemed as if they’d never reach an understanding.
Patricia suffered from Major Recurrent Depression. While she’d done a lot to manage it, there were times all her efforts didn’t work. Dan had a hard time understanding what his wife was going through; he knew she worked to keep her depression at bay, and when she was struggling, he thought perhaps she just needed to work a bit harder or more consistently.
It’s true that when you struggle with depression, it’s important to identify your unique triggers and do your best to manage them. During the years of the pandemic, for many this became increasingly difficult, and has been a factor in the alarming increase of depression in recent years.
Identifying your triggers and understanding chronic, recurrent depression
So, what were Patricia’s triggers?
- Winter was much harder for her, the cold, dreary months triggering sadness and loss of energy. She bought a special kind of light to use during that time.
- She’d loved being a hands-on mom, and had to rebuild a sense purpose after her last child left home.
- Her self-worth had suffered from her lifelong battle with weight. But that was highly entrenched with an embattled relationship with her father where he constantly had constantly criticized her a child. She was insecure around others, and a lot of our work focused on building a sense of competence.
- Depression ran in her family, especially on her mother’s side. She could remember her grandmother not getting out of bed for long stretches of time, her door shut, isolating herself from her family. She’d never wanted to be like her.
But at times, Patricia hit a wall, feeling like something invaded her being. She’d become weary of doing anything. She’d lose the desire to hear her grandkids’ voices. She’d have to make herself go to work. Then she’d come home and want to sleep, intrusive thoughts of hurting herself crowding her mind.
She hated losing control of her life and Dan didn’t understand. He couldn’t see that anything had changed and Patricia couldn’t always explain it herself. Sometimes years would go by without any major issues and they hoped her depression would never return, but then it would.
How can people — especially people who love you — understand this cycle, and the frustration that goes along with it? How can they empathize with something they don’t experience? How could Dan have compassion for the lack of control Patricia felt from time to time?
A story for understanding living with depression
So, I made up a story. I wanted Dan to imagine what it would be like — to be Patricia, ”Imagine you’re given a house to live in. The floors are covered with beautiful carpets from around the world. When you walk around, living your busy life, you enjoy it. You get to know its nooks and crannies.”
“But there’s a trick to this house. Every now and then, the powers that be dig a hole in the floor somewhere, a hole just big enough for you to fall through. Then the hole is carefully hidden by those same gorgeous carpets. You walk around like you did before, not knowing that the hole exists. But you eventually fall. When you do, you feel ashamed, as if you’ve done something wrong. You feel overwhelmed. You feel as if you’ve failed. And it’s very difficult to get out.”
“Now imagine how you would feel. It would take you a while to figure out what was going on this house. You can’t move — it’s the only house you have. You can’t get rid of the carpets. They came along with the house. How would you live without fear of falling? Your steps would be cautious, your ability to enjoy and feel free diminished. With enough time, you’d begin to feel safer. You could go for days without falling – maybe even weeks or months. So you go on living, distracted from the potential of falling in a hole. Until the day you do.”
“That’s how it feels for someone with recurrent depression. They have to live their life, knowing that they might not see the depression – the fall – that’s about to happen.”
“You learn you can get out. But you can’t always know what’s waiting for you. It’s your house. It’s what you’ve been given. There are beautiful things about it. But there are pitfalls and struggles that aren’t always under your control.”
Patricia’s eyes filled with tears.
Dan looked softly at her. “I’m sorry. Now I get it. I’d be paralyzed.”
People with recurrent depression can learn to live with it — to manage it. They can watch for signs or triggers. They can sit under light boxes, eat well, exercise, meditate, connect with others, take medication if needed, and get enough sleep — very good habits for all of us, but especially those with depression.
Yet absolute control doesn’t exist.
How can you help?
You can do your best to understand. You can listen. You can acknowledge that their depression isn’t a choice.
You can help by not judging and by giving them the respectful message that you know they’re trying.
You can help by supporting them to receive the treatment they need. With their agreement, you can help them watch for telltale signs or triggers. You can do this with kindness, not criticism.
You can help. But always remember that the holes can be hidden so well, no amount of effort can protect you.
You can hear more about mental health and many other topics by listening to my podcast, SelfWork with Dr. Margaret Rutherford. Subscribe to my website and receive one weekly newsletter including my weekly blog post and podcast! If you’d like to join my FaceBook closed group, then click here and answer the membership questions! Welcome!
My book entitled Perfectly Hidden Depression is available and you can order here! Its message is specifically for those with a struggle with strong perfectionism which acts to mask underlying emotional pain. But the many self-help techniques described can be used by everyone who chooses to begin to address emotions long hidden away that are clouding and sabotaging your current life.
Send me a voice message! You can record by clicking below and ask your question or make a comment. You’ll have 90 seconds to do so and that time goes quickly. By recording, you’re giving SelfWork (and me) permission to use your voice on the podcast. I’ll look forward to hearing from you!
This was originally published on December 3, 2016 and was updated on February 19, 2023.