Exploring Testimonies and Technicalities: What Does Depression Feel Like?

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What Does Depression Feel Like?

Exploring Testimonies and Technicalities

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“There was a constant chattering in my brain. It was my own voice talking about depression, agony, hopelessness,” said Deirdre Lehman, a woman in her 60s who had tenuously contended with bipolar disorder for over a decade. After receiving groundbreaking depression treatment, Deirdre went on to describe the relief as follows: “By lunch, I could look my husband in the eye…That was the most peace there’s been in my brain since I was 16.”

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Deidre’s words describing her depression and its relief revealed to me significant holes in my understanding of what depression feels like. While those of us who have not experienced depression will never accurately know the sensations and feelings, a better understanding helps us draw closer to several indispensable goals.

On the clinical end, this understanding grants researchers access to “disimpassioned passionate approach”, wherein treatment contains more personalized care. On the personal end, a greater understanding grants us non-clinicians to become more empathetic day-to-day supports for anyone close to us who is wrestling with their mental health.

For such understanding and empathy, we must not only uplift but also integrate the various voices who are best equipped to speak to the experience of depression. Voices of technical experts, voices of thought leaders, and, most importantly, voices of those who have first-hand knowledge.

Through conversations with clinical psychologists, neuroscientists, and individuals who resiliently share their personal testimonies, this article seeks to present an empirically informed, personally validated, and authentically expressed picture of what depression feels like.

What psychology tells us depression feels like...

Depression is a mood disorder that negatively affects how you think, feel, and act, and can lead to a variety of emotional and physical burdens. Clinical psychology offers a uniquely multifaceted lens into the experience of depression. Drawing from both research and a clinical education as well as a bulk of first-hand interactions with depressed persons, the clinical psychological perspective bridges the technical and the personal.

Depression feels like meaninglessness

“A large portion of the people who are depressed don’t feel anything,” Daniel Mansson described. He is a clinical psychologist and currently the co-founder and CEO of Flow Neuroscience.  “You’re just flat. So, you go through life and you look at things that before have made you happy and nothing. And that’s super frightening…things just pass through. You don’t value or evaluate things. They just pass.”

 

After years of speaking and interacting with depressed individuals, Daniel conveyed that flatness is most salient to understanding what depression feels like. For Hanna Silva, one of the principal sensations of depression is hopelessness or “meaninglessness” – feelings which, different from flatness, are quite painful. Hanna is a practicing psychologist herself and a content author for Flow Neuroscience. 

 

“You feel hopeless. Most things are meaningless or hopeless.” She said, “You feel that way even when really positive things happen. For example, when your baby smiles at you, you can’t feel joy.”

 

Hanna explained this feeling as a compound of sadness, hopelessness, and even shame, the product of a self-perpetuating cognitive cycle: depression induces a low mood, this low mood decreases motivation and interest, the motivation deficit prevents you from seeking potentially positive experiences, the lack of positive experiences further decreases your mood, and so on. This cycle can continue seemingly without end.

Depression feels like forever

When asked what is missing from the common understanding of depressive feelings, Hanna immediately homed in on what she believes to be at the core of depression misconceptions: how long the sensations last.

“The feelings do not fade away as you would expect them too as if you were, for example, sad or uninterested in something,” Hanna began. “You would expect them to go away. The negative feelings are so persistent – you can’t snap out of it…depressed feelings can take hold of a person. The emotions do not change from moment to moment.”

In any one particular moment of a depressive experience, the negative sensations might be comparable to the deep sadness and grief that many of us are accustomed to feeling on occasion. However, it is the devastating perpetuity of these feelings which separate depression from even the lowest lows of a depression-less life. Daniel similarly cautioned against assimilating depression with commonly understood sadness.

“The popular picture, that I kind of bought into, was: depression is a sad person…they’re sad about something, and sometimes they know what they’re sad about, sometimes they don’t know what they’re sad about. But depression is a lot more complex.”

The term “sadness” sometimes implies that happiness is right around the corner. As both Hanna and Daniel noted, the security of knowing better things are to come is something which depression strips away.

Depression feels like clarity

Daniel elaborated on what exactly the complexity of depression entails. He described how many individuals experience their depressed state not as an impairment but a level of newfound clarity. 

 

“In general, I have kind of found that people perceive depression as a veil being lifted,” he said. So when you actually get depressed, the veil is lifted, you see the world for how it really is…now they are aware of their surroundings in a ‘proper way.’” 

 

A “lifted veil” hardly seems to jibe with how depression is commonly understood, but this seemingly paradoxical concept of clarity has some support in the literature. Depressive realism, as it is technically referred to, is an often overlooked phenomenon in many cases of depression. Depressive realism suggests that an individual experiencing depression might interpret the meaninglessness not as the adoption of a pessimistic bias, but the removal of an optimistic bias – the veil. 

 

Hanna, in her own practices, has come across a similar phenomenon. 

 

“Depression will make you think that all of these negative pessimistic thoughts and feelings that you have, it is also reality. Everyone else living happy lives are the ones fooling themselves. It is very common to think that depression is the truth.”

What neuroscience and its sister fields tell us depression feels like…

Neuroscience and its adjacent fields (neurology, neurobiology, neuroendocrinology) are often the sources of the most advancement but also uncertainty when it comes to understanding depression. Nevertheless, they can offer a helpful view into depression’s most gripping and misunderstood symptoms and sensations.

Depression feels like captivity

Perhaps most salient to depression experiences is the feeling of being trapped in negative affect. 

 

“The negative state starts to invade every part of everyday life – every action, every thought,” explained Dr. Helen Mayberg at a TEDx talk at Emory. “To do anything that one wants to do gets hung up on that loop of hesitation, and it ends up feeling like you can’t move at all.” 

 

Dr. Helen Mayberg is a renowned neurologist whose neurological approach to the depressive experience has rendered her pioneer in depression treatment development. Some of her most impactful research has been in identifying what parts of the brain might provide insight into the pervasive and paralyzing anguish which often marks depression. She explained that feeling trapped in distressed emotional states can be partially explained by a faulty flip-flopping of neural activity which many of us take for granted.

 

“Even if a healthy person experiences an intense recollection of a personal loss, Limbic areas, core drive-state areas dominated by a region called the Subcallosal Cingulate or Area 25, led the charge. When [Area 25] activated, it shut down the cortex – areas that drive thinking, planning, moving are offline when these emotional centers are activated. If one mapped how [healthy people] responded clinically as they got well, there was a flip of the pattern. There is a natural toggle between our emotion and our action.” 

 

In individuals with depression, however, this flip does not always occur: “What happens if that natural toggling no longer happens?” 

 

Dr. Mayberg, in fact, knows the answer. When the limbic areas take over in instances of depression, they often remain in command indefinitely – leaving other important functions, and the individual, captive to crippling emotional monopolies. 

 

To a neurologist like Dr. Mayberg this emotional captivity, broadly speaking, occurs “when the brain fails to be able to adapt to circumstance, to the situation, when it breaks.”

Depression feels like battle

Neuroscience might also reveal hidden truths about the experience of depression which skin-level considerations fail to capture.

 

“You look at someone with a major depression who’s just mired in this psychomotor retardation stuff and there’s this temptation to start thinking about them as just so wiped out,” began Stanford’s Robert Sapolsky in a lecture nearly a decade ago. Sapolsky was a professor of both biology and neurology & neurological sciences during his stint at the Californian university.  

 

While this all-consuming fatigue (to which he refers using the technical term: “psychomotor retardation”) is a common and severe symptom of depression, Sapolsky went on to explain why halting our understanding at fatigue ignores a tiresome internal chaos which often transpires behind the scenes. 

 

“[There is] this enormous battle – all of it going on internally. This is someone whose body is having a massive stress response 24/7.”

 

According to Sapolsky, this stress response is due to, among other things, stress hormones – specifically, a hormone called glucocorticoids, commonly understood as “cortisol”. The stress response can lead to emotionally disturbed and distressed states.

 

While the list of neuroscientific inklings continues far beyond the comments of Dr. Mayberg and Professor Sapolsky,with this specific insight, Sapolsky importantly reminds us that the feelings of depression can extend past the mind: “The bodies of people with major depression work differently.”

What our neighbors, coworkers, and friends tell us depression feels like...

Most essential to understanding the sensations of depression are the accounts of those who have spent years grappling nose to nose with the phenomena described by the experts above. For these individuals, depression consists of more than neurological anomalies and cognitive spirals. Depression is a daily confrontation which arises in both seemingly banal tasks and the most emotionally charged moments, deftly molding itself to the unique forms of an individual’s life experiences.

 

The stories of Mark and Annie offer powerful and unique insights into depression and, if nothing else, are a testament to the relentless courage which life with depression necessitates.

For Mark, depression feels like an abyss

Mark P. is a middle-aged man living in England. He’s Scottish and spent many of his early years in Wales. He spoke to me after a peaceful day walking along the beaches of his hometown. 

When Mark described his experience with depression, he described a place.

“You can go into a very dark place. And no matter what you do, it’s really hard to come out.”

Mark most frequently referred to this place as an “abyss” – synonymously referred to throughout our conversation as a “dark place” or a “low place”. The abyss, while always dark and always low, is not static. It moves along a path plotted by Mark’s current sources of stress and past points of pain. 

For instance, sometimes, the abyss is his childhood house in Wales – in many regards the origin point of Mark’s experience with depression. He currently lives 252 miles away from this house, has not been back in over a decade, and, in no uncertain terms, does not plan on returning anytime soon. 

“[I] just would rather not go back there. To me, I feel anger when I think of that place because I know I’m going to slip into the abyss. And that abyss makes me angry.”

Other times, the abyss takes on a more quotidien shape: a crowd of people, for example. 

“I’m the type of person who doesn’t really like crowds,” Mark explained, “And I find that it can really set off [my depression], I get very anxious. That’s when I know I’m going to go into a depression.”

How Mark arrives in the abyss is similarly variable. He “slips” into the abyss, he “falls”, he “crashes” – the movement is always downwards, out of control, and with lucid awareness of the impending darkness. 

Mark’s experience with depression, however, extends beyond simply a place or a movement. Part and parcel of Mark’s depression is the hatred he feels for the abyss, for the fall, and for himself. 

“I hate it. I hate it with a passion…When I’m going through a depressive period, I hate who I am. Depression is something that, you know, you’re reacting in a way that you shouldn’t be reacting. However, it’s out of your control.”

The hatred which characterizes Mark’s experience is borne of the tension between how clearly Mark understands when and to where he’s slipping and the arresting reality that he cannot avoid the destination nor its consequences for himself and his loved ones. 

“I’ll take my depression, I will lash out at anybody who gets in my way. And it’s wrong. I know it’s wrong. But trying to stop yourself, that just doesn’t happen, and it’s really, really quite horrible.”

Mark will be the first to say that, for him, there is really no “getting over depression”. However, there are gaps in the clouds. “I’m the proverbial tigger,” Mark chuckled, referring to the occasional afternoon when one might find him dancing and singing in the kitchen. 

The abyss is never too far away but neither are his loving wife and son, nor his quiet workshop, nor the English beaches.

For Annie, depression feels like a fog

Annie L. is an English, Creative Writing & History student going into her third year at university. She recently finished a big move, but was still able to chat over email in between bouts of packing and unpacking. 

“My first visit from depression was when I was quite young.” Annie explained. A “visit” from depression was a turn of phrase she used often. Annie’s depression, which she has nicknamed “The Big Sad”, has taken on various shapes and forms over the course of “a decade of practice.”

When she was younger, her depression was no more than a feeling of being different – a sensation not too unfamiliar for many adolescents.

“I felt estranged from everyone else who seemed to enjoy their hobbies and friendships, whereas mine always felt a little fake.”

Since then, she has come to detach her depression from her sense of self, sometimes describing it as a different self. She avoids using language that connotes permanence or intrinsicness. This separation reminds Annie the depression is not her true identity, not her authentic self: “it’s a thing separate from me that comes to visit rather than an integral part of me.”

Nowadays, she typically settles on depression as a fog. Annie took me through what a day in the fog feels like:

“I can usually see it in the distance… I brace myself and wait. Then one day I wake up and…things that used to be colourful and familiar are just dark silhouettes…It’s lonely.”

The fog is a viscous fatigue that permeates all nooks and crannies of her daily schedule. The fog makes getting out of bed feel like heaving herself out of thick mud, chewing feels like “a mammoth effort,” and “even the idea of standing up for so long is tiring.”

As the day continues, the fog becomes an even more formidable foe. 

The fog interferes with Annie’s appetite, hardly touching the food she orders for herself. She might tell a friend she is too busy to make plans, but what she really means is: “I don’t know if I’ll be able to get out of bed that day.” And by some twisted irony, once in bed, the fog continues to mettle: “By the time I get to bed, it’s like I’m too exhausted to sleep. I toss and turn for hours.” 

This arduous routine continues for weeks. 

Annie warned that the fog is not simply a state of inactivity, beneath the shroud is an ongoing and laborious fight. “It might look like I’m lazy or unmotivated, but the opposite is true. I’m fighting harder than I ever normally have to just to leave the house.”

Beneath the shroud is a stream of self-directed anger as well, a constant and often acrimonious inner dialogue. “I think angry thoughts to myself like ‘You could have run away from the fog if you’d run fast enough’ or ‘You walked right into it – you deserve to be lost in the fog’ or ‘Other people have thunder and lightning instead of fog, what have you got to complain about?’” 

Quite incredibly, through the haze of these dizzying and discouraging thoughts, despite the daily trudges amidst deafening fatigue, Annie thinks often and dearly about others:“My biggest worry is always that people I love will think I don’t love them. I do.”

Annie strives to uphold this attention towards others rain or shine. In fact, she always simply aims to do her best – enjoying the sun when it’s out and otherwise trekking resiliently through the fog.

What now?

In many ways, understanding what depression feels like is an impossible task, as the voices featured here would agree. However, by seeking out these voices and the teachings they offer, we can draw closer not necessarily to a singular truth but to a more empathetic, thorough, and caring echelon of understanding.

 

These voices urge us not to respond to the complexities of depression with evasion or distance,  rather with genuine attention and presence. Few can explain this concept of subtle, quiet care as powerfully as Mark.

 

“A lot of people think that because one may have depression, they don’t go near that person,” he told me as our conversation wound down, “You don’t need to get involved with that person. Sometimes. Sometimes, all it takes is a simple somebody coming up and giving you a hug. And that can actually make your day. Somebody just coming up and saying, ‘It’s okay. I’m not here to give you answers. I’m just here.’ Sometimes they just need somebody to be with them at their side. Not to tell them what’s right and what’s wrong – but just to sit there for you, to know you’ve got somebody.”

 

This brand of support is within an arm’s reach for all of us. It requires little more than the attention and patience which you have provided this article. Perhaps to understand what depression feels like, to synthesize the insights of psychologists and neuroscientists alike, is to know when to say simply: “I’m just here.”

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