Depression does not just limit how we feel and what we do. It steals who we are.
Millions of people suffer from “depression” and experience a range of associated debilitating symptoms. Unfortunately, many people use the term loosely and talk about feeling “depressed” the same way they talk about feeling “sad.” They think of depression as a transient mood state — something that makes us temporarily unhappy and then goes away.
This assumption is perhaps strengthened by depression being labeled “the common cold” of mental illness. And just like we respond to a temporary mood state, we assume that the impact of depression is similar to that of a cold – we suffer when we are depressed, but we emerge from our depression with our lives intact. I mean, no one ever says, “they had a cold and it destroyed their life.”
In fact, clinical depression, whether in the context of major depression, bipolar disorder or dysthymia, can be a devastating mental illness. Depression is not simply transient sadness – although most depressed individuals experience sadness. Depressed individuals suffer greatly and often cannot experience pleasure, have no energy, cannot concentrate, have trouble sleeping or eating. And this suffering can be both chronic and recurrent. An episode of depression can last for years and individuals who suffer from depression can experience multiple episodes throughout their lifetime. Thus, depressed individuals often can’t work or easily participate in social interactions for extended periods of time. As a result, the World Health Organization (WHO) considers depression to be the leading cause of disability worldwide. In the most severe cases, depression increases risk for suicide.
And yet still, many people assume that once depressed individuals recover from an episode of depression, their lives go back to normal. And in many cases, that is true. People who struggle with depression can lead long and fulfilled lives, especially if they seek out treatment to manage depression. However, depression can do more than impact our functioning. It can change how we fundamentally see ourselves as people. It can undermine our identity.
I have been thinking about this issue after talking with Dr. Michael Bishop of GWAR on the Hardcore Humanism Podcast about his research on the concept of identity. Bishop explained how music becomes part of a narrative of how we view ourselves and connect with our lives. In his case, he connected with punk rock and its confrontational nature such that it became a part of Bishop’s identity. And he described how organic that process was – just by hearing about Sex Pistols, seeing images of them and listening to their music, he was able to naturally feel a connection. And this connection became a dynamic, interactive process that not only provided Bishop a vehicle to express the ways that he wanted to challenge societal norms, but also an opportunity to become more open-minded and accepting of others.
What was so striking about Bishop’s experience was that it relied so heavily on the visceral connection one has to music, or anything else that is meaningful in our life. And this is often how we build our identity — through experiencing and discovering the things with which we connect in our lives. We may enjoy a particular band or kind of music. But when we invest time and energy engaging with that music to build a connection – those connections form the basis of who we are and how we understand ourselves.
And in listening to him talk, it made me recognize how difficult it is for depressed individuals to feel that connection when they are depressed. If we are anhedonic, not sleeping, have no energy and can’t concentrate, how connected can we be? And since depression can occur so often, this means that depressed people may have many points in their lives when they miss opportunities to feel those connections that may help develop their identity and self-concept.
Oftentimes, when suffering through a depressive episode, we experience the frustration of not being able to experience things the way we’d prefer. Or we feel the helplessness that we cannot carry out basic functional behaviors like work and self-care. This may result in a hopelessness that we will never be able to feel “like ourselves.” And in fact, research suggests that depressed individuals carry cognitive vulnerabilities to negative thinking that persist after recovery.
Unfortunately, our private fears are often echoed by others. Depression is often undiagnosed such that the people in our lives only see the symptoms. We seem less interested, irritable, withdrawn, unable to engage in enjoyable activities. We often can’t follow through on what previously would have been considered easy tasks such as basic self-care and organization. Thus, depression can create significant problems in our closest relationships, particularly in marriage where people are seeing us regularly and relying on us. Similarly, our work environment often crumbles as people are unable to comprehend why our functioning took such a nosedive. This matter is made worse by the stigma of mental illness whereby people often blame depressed people for their suffering.
How does this manifest over time in terms of our identity? Depression is not something that just disrupts our lives – it can change how we see ourselves as people. Let’s start with experiences and resulting connections that never happen because of our depression. Maybe we don’t have the energy to see a new band when they play a show in our town — so we don’t have what could have been a magical life-altering experience of discovering our favorite band. And our identity also becomes connected with helplessness. We don’t naturally assume we are someone who can “make things happen” and plan for the future, because we can’t be sure depression won’t severely undermine our life goals.
We start to lose faith in ourselves and our identity becomes connected with depression. We think of ourselves as a “depressed person” rather than someone who suffers from depression. Add to that the fact that our social relationships and work performance suffers and we assume that we are “not good at relationships” or “not a strong performer.” And as we see tangible evidence that supports these conclusions, our erroneously formed self-concept becomes further engrained as our identity and depression robs us of who we are.
So how do we build and hold on to our identity in the face of depression?
The first thing we absolutely must do is seek treatment. There are several empirically-supported forms of psychotherapy and anti-depression medication that have been shown to treat depression. Getting effective treatment reduces the time we spend suffering and feeling dysfunctional. Thus, we will be able to form the connections and engage with the work, activities and people we love and make tangible progress towards building our identity. By increasing our ability to manage depression, we will have more hope that we can “be ourselves” in the future.
Second, we need to remember that although we are depressed and limited because of our depression, there are still ways that we can retain our identity by staying connected to our lives in some way. We live with depression. We suffer from depression. But depression does not have to be part of our core identity. Even when we are in a depressive episode, we can remind ourselves that even though we have limited functioning now, we are still “us.” And we can let the people closest to us know that we are depressed so that there aren’t misunderstandings about our behavior and we retain those connections.
On a societal level, we need to work on reducing the stigma of depression. So much of what makes depression such an identity thief is that we suffer from depression in the shadows because of the fear or shame of being judged. And so, instead of getting the help we need, we avoid treatment because of the stigma. Further, because people often judge those who suffer from depression as “lazy” or “unmotivated,” it makes the social impact of depression more real at home and in the workplace. Educating people about mental illness, how to cope, and how to treat people who suffer, would go a long way towards breaking the vicious cycle by which depression destroys identity.
So, let’s see if we can work together to put an end to the identity theft of depression.
Photo Credit: Hamish Duncan
