I was diagnosed with depression associated with chronic pain and then later with Major Depressive Disorder a bit back. I am currently on Abilify, due to my lack of an ability to take antidepressants, as they worsen depression. I respond quite well to it actually and I am very pleased with the difference. Found that out the hard way as that is a preventative treatment for migraines and fibromyalgia. The depression had been going on for years and I hid it decently I’d say so that no one knew the extent of it. Until my rather exceptionally poor reaction to Cymbalta. (You can check out Why I hid my depression for years). I rather like hidden depression. In the sense, I didn’t have to experience others reaction to it. Having chronic pain I can hide it well and people do not to see how much I suffer, including the fact it had emotional consequences that developed over time. I don’t like the fact that people I loved would see my suffering. And know they could do nothing about it. And depression, compounds suffering on top of the pain. Pain is an exhausting battle without the depression making you ruminate on how Horrific it is.
There is some things I learned about open depression though. Once it is in the Known.
People have no idea how to talk about it: It is like the massive elephant in the room people dance around or actively avoid. Not everyone, but some people. My spouse, for example, had no idea how to talk about it. I could see it hovering there. These questions and concerns and no concept of how to discuss them. But actively avoid them if I broached it, yes.
People Fear for you: Unlike pain, where your loved ones are concerned about your pain levels and capacity to function with pain… depression makes them fear. Actively fear. They don’t understand suicidal thoughts or intent, or the difference, and it terrifies them. Hell, it terrifies everyone. It is great to have a psychologist because one who knows about chronic pain know suicidal ideation, well, happens. But suicidal ideation is not the same thing as suicidal intent, which is scary. And there is a line between therapy and medication as well. When therapy is enough and when medication is needed. One where I needed the medication. The therapy obviously is very, very important too. But the fear in others is not something you can forget. You can’t alleviate it. You can’t explain your brain. You can, for example, explain the hell of chronic pain but not the depression. The depression is a war within your head. That seems ultra-logical but is overthinking and quite a bit of faulty reasoning. You can’t explain the downward spiral of thoughts that leads to a pit of despair so thick you can’t swim out of. You can’t explain that thoughts of death feel like an escape. From the pain mostly, for me. Just the suffering. The profound suffering. You can’t explain how your brain is the enemy here. My mind could be a very dark place. You can’t explain it… because it would seriously freak them out to know what you were thinking. The fear would not abate it would spark into an inferno. So you pretend it is getting better, even though you still struggle. Until it is getting better or the medication helps so much that it is like night and day.
I saw the fear my spouse had. It made me realize I had scared him a great deal. And I tried to resolve that by doing the work in therapy. And trying to improve as best I could. So the fear wouldn’t be there.
Stigma: You experience stigma in unusual and unexpected places. I don’t talk about the depression at work. But I remember one co-worker who had depression, went on leave for it, came back with restricted hours due to it. They gossiped about her. Mocked her. Called her crazy. I remember that well. I was pissed at the time (depressed back then too), but I hate malicious gossip. They had no clue what it was like to have depression, live with it, cope with it or recover from it. In her case, it was MDD as well and her treatment wasn’t as effective as mine, so limited capacity to work.
I personally had medical stigma. A doc in the ER knew I was depressed and assumed the chest pains I was having were ‘anxiety’ even without one test done. He gave me Ativan, which I tossed. Because I don’t have anxiety. I had inflammation around my heart, which I already knew and was going back because it seemed to be getting worse. So that is stigma and discrimination there for you.
A friend of mine was told to ‘get over it’. And there are many more such things you can hear. My friends and family were very supportive so I never had this issue.
You feel exposed: I’m a private person and that is one reason I likely hid the depression. Suffer in silence and deal with it myself. It is what I do. Having people know made me feel exposed. Like people knew something deeply personal about me. And it made me feel weak because we are told people with depression are weak. And you think others opinions of you will change like they will think you are weak.
Other than stigma, none of this lasts. It is normal for loved once to be concerned and fearful and perhaps not know how to address it. It is normal if you have hidden depression that when it is in the open, you’ll feel exposed by it and uncomfortable. But when it is open, for me, that is when I got treatment and progress was made so I cannot regret that. I am not open about it to others, mind you. And with good reason, stigma is a very big deal that I don’t want to deal with in other situations. In the end, I got effective treatment and for me, that is what matters. I likely wouldn’t have if it remained hidden.