The black dog...

naamah_darling posted an awesome, intelligent, insightful and remarkably calm post deconstructing some of the most shockingly dense comment-fail I have ever seen. Go here to read it's entire awesomeness, but I'm going to post some of my experiences here on the topic, as inspired by the above-linked post.

..why depressed people may not seek treatment.

Sometimes they do not know how to ask for help.

This applies to me. I had no idea how to even tell anyone how much I was suffering. When I finally went to my GP and said "I think I need to be on some anti-depressants" I'd already had vivid and intrusive thoughts of self-harm for months. It was only because I knew I wouldn't be able to resist the urges for much longer that gave me the impetus to seek help.

And that was only the most obvious, most immediately worrisome symptom.

Sometimes, as incredible as it is to say, people don't know they are depressed.

This also strongly applies to me. As one wise and dear friend puts it*, depression is a lot like being a frog in a saucepan. The temperature has been creeping up for so long you've never noticed it, and now you're just about at a rolling boil. of course, by this time it's a major issue, and has deeply embedded it's (barbed) hooks into your life and your psyche. Getting them out is not simple, quick, easy or painless. And it's an easy trap to fall back into without noticing, because being constantly vigilant of your own mental state is seriously draining, tiresome, and just plain bloody hard. And it's always so very, very, easy to let it slide, just this one time...

Sometimes they simply feel hopeless.

For me, at least, hope and volition are the first things that get drained away. just a tiny, tiny bit at a time, but that drain happens every moment that you aren't paying attention to stopping it. It settles itself over your shoulders while you sleep, when your attention is focussed on other things, and slowly it weighs you down, until it's all you can do to stand.

They may simply not be experienced at talking about their feelings, and such things may be difficult for them to articulate.

This has always been an issue for me. My subconscious is great at pondering things for a while and then pointing me in the direction it's decided I should go, but it's always been very unforthcoming about why. It's beyond taciturn and well into recalcitrant on the topic of actually sharing *why* it's made it's decisions. Most often, I have to throw questions surrounding the issue at it and then try to dowse the reasons from the varied tones of it's surly silences.

Some are afraid of placing a burden on their loved ones, or on a system that they believe is there to help other people, people with "real" illnesses, or people who might be more ill than they are.

And the irony of this attitude is that it quite possibly have saved my life. At my very lowest ebb, when I came closest to actually committing suicide, the tiny, fragile thread that stopped me was this sort of thing. I was a cobweb's thickness away from climbing a tall building and throwing myself off, but the thought of some poor bastard having to clean up the mess was what held me back. Hardly what you'd want to stake your life on, is it?

Those who seek treatment often find that it does not provide an immediate end to their suffering.

Here's something no depressed person wants to hear: even the best treatment in the world won't solve the problem quickly and easily. It's going to be a long, hard and painful slog regardless. It's going to feel like a Sisyphean task even under the best of conditions.

Because it is. Every day you have to push that stone up the slope. Some days it might feel like a the slope is almost vertical, some days it may feel horizontal, but it will always be there. And you have to somehow maintain the rest of your life as well.

The wrong drug can very easily make an unstable mental state worse;

The terrible truth of depression is that sometimes even the right treatment can kill you. Sometimes the sheer crushing weight of it is all that stops someone from having the agency to actually end it all. And sometimes the treatment only manages to improve things enough to supply that very agency. And that's a very bitter irony indeed.


(*) I've mangled their original metaphor to make it clearer to those that weren't in on the original context. Rest assured, it was a much more elegant thing to start with.