CW: Depression / suicidal ideation
I have schizophrenia. My psychiatrist told me that this basically trumps any other mental health nastiness I may have, at lest in clinical terms. So actually I have an anxiety disorder and a mood disorder as well but these don’t turn up on my list of diagnoses due to the fact that, well actually I don’t know. May psychosis is viewed as more interesting than anxiety? Not sure. Anyway what I am trying to say ifs that I have a mood disorder and it can be extremely unpleasant and at times life threatening.
I do not have unipolar depression. I get manic quite often too which is why I say a mood disorder rather than depression. Mania can be difficult and result in reckless spending and damage to my reputation but it is far preferable to its dismal little cousin, depression. I made a Yeme (Yenn meme) a while back saying that depression shouldn’t be called a black dog because dogs are nice. I suggested that depression is a black slug which seemed much more fitting. Slimy and gross as opposed to canine qualities like being loving and playful. My black slug comes to darken my door on reasonably frequent occasions.
I am autistic and one of the mental health conditions autistics often have – including me – is something called alexithymia. This is also known as emotion blindness. It definitely doesn’t mean I lack emotions but that it is hard or impossible for me to articulate or notice them. I remember being in hospital once talking to the psychologist. I was extremely depressed and was crying the whole way through the consultation. She said ‘you are really depressed’ but I had no concept of it and was surprised when she said that. I still struggle to notice when I am depressed. I have to observe what is happening in my life. Am I not tidying up? Am I struggling to find motivation? Am I having intrusive thoughts about self harm or suicide? Is everything an effort? If the answer to some or all of these is yes I know I am probably depressed.
Depression is often misunderstood. Some people think you can somehow will your way out of the dark place. Like you can ‘snap out of it’. It doesn’t work that way. And each person’s depression is different so what helps me may not help anyone else. Medications are often used to treat depression but these can be tricky and especially for autistic people who often respond to meds in an atypical way. A medication which works really well for one person may have no impact on another. Most people have to try a few different meds until they get some relief. I remember in the past trying about fifteen different antidepressants and none of them worked. This is probably because of the manic episodes I have as I am now on a mood stabiliser which is actually a lot more effective. Meds aren’t a magic bullet though and many people still get depression symptoms when on meds. The meds can help but they aren’t always 100% effective.
There are some lifestyle and psychological strategies which some people find helpful for depression. These include things like diet and exercise, mindfulness meditation and using strategies like ‘opposite action’ where you do the opposite of what your mood wants you to (e.g. getting up and having a shower when you feel like staying in bed all day). Distraction is also a strategy that lots of people find helpful. That is when you focus on something engaging – preferably something you enjoy doing – which can take your attention off feeling miserable. Different people find strategies which work for them and you can pick up new ones as you move through life. Depression is not a character flaw and it is not somehow your ‘fault’. It is a medical condition just like diabetes or heart disease and no amount of giving yourself a hard time about it will make it go away. In fact that will probably make matters worse. People with depression – and particularly autistic / Neurodiverse people with depression – need support and kindness.