April 26, 2022
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Kristin Duvall/Stocksy United
Rather than viewing my depression as an on-off switch, I’m trying to adopt a nuanced and accepting mindset.
Losing the depression label feels, to me, like taking the P-plates, designated for new drivers in the UK, off my car.
Technically, I’ve passed my driving test, but am I ready for this? Do I still need to warn people of my potential weaknesses and erratic steering? Do I want to give up the sympathy of fellow drivers who pityingly wave me out of busy junctions?
In 2017, I was in my second year at university, undergoing intensive academic and practical training to become a veterinarian. The pressures of the course, the compassion fatigue, and the lack of rest (holidays were spent on exhausting placements in surgeries or out on farms) had left me in the grip of mental illness.
I was an irritable, emotionally unstable workaholic in perpetual fear of the next exam season. I lost interest in socializing, and I even stopped reading, which had been my most treasured pastime since childhood.
After many tearful heart-to-hearts with my increasingly concerned parents, I finally admitted I was struggling with depression, and I couldn’t keep living so miserably.
I made radical changes to my life: dropping out of university, seeing a therapist, and talking with my doctor, who offered a sympathetic ear and a prescription for antidepressants. I took up mindfulness and meditation, surprised to discover that they helped, despite my initial skepticism.
Since then, I completed a degree in English literature, and started reading novels again — lots of them. I got a part-time job working in my local public library, which I love. Things are looking up, and I feel relieved to have overcome a frightening depressive episode. So, why am I hesitant to describe myself as “OK”?
While the depression label stuck to me quickly, a term that was casually tossed around in doctor’s letters and therapy sessions, shedding this label appears to be a far more complex and ambiguous process.
The National Alliance on Mental Illness reports that, although it’s possible to experience only one depressive episode in a lifetime, for most people, the condition tends to recur.
A 2018 study found there are numerous factors that influence the likelihood of recurrence, and these read like a grim checklist for me. Comorbid anxiety? Yep. High levels of neuroticism, residual symptoms, and rumination? Check, check, and check.
It’s important not to attach too much significance to this list, however. The clinical psychology researchers who studied it concede that they can’t predict, with any degree of certainty, who will have further depressive episodes and who won’t.
It’s no wonder I have questions about what recovery really means when experts can’t seem to find an answer, either.
One of the arbitrary qualifiers in my mind for “OK” status is ending my use of antidepressant medications. I’ve been on two different types of medication, which certainly helped stabilize my mood during the worst months of my depression. Even with these benefits, I never viewed medication as a long-term solution, mainly because of the weird side effects I’ve experienced.
I suffered from uncomfortable and anxiety-inducing night sweats on my first prescription. Now that I’m taking a different drug, the night sweats have stopped, yet I’m still permanently fatigued and can easily sleep for 10 hours a night. Another effect of the medication has been a loss of appetite. Almost overnight, I grew nauseous at the thought of foods I used to enjoy. If I wasn’t currently single, I’d worry I was pregnant!
Despite these side effects, I remain hesitant about working with my doctor to wean off antidepressants. I keep waiting for the “perfect” moment. Maybe after starting this new job? Or should I give it a couple of months, so I’m properly settled into said job? Actually, maybe it would be better to hold off until spring, when the seasonal affective disorder-inducing British winter is behind me (despite my depression symptoms not following a seasonal pattern).
In periods of change, I still like to know that medication can keep my mood from spiraling out of control.
Perhaps my reluctance to end my medication use is due to the shadows of depression that linger threateningly at the edges of my awareness.
There are so many triggers that act as scary reminders of its darkest depths. Riding particular bus routes makes me think of my dreary commute into university, sometimes crying with overwhelming dread of the day ahead. I can’t listen to certain songs that used to cause me pain during the days when my sensitive mood could be instantly destabilized by a melancholy tune.
These triggers seem just as taboo as the depression itself, if not more so. It can be hard to talk about them with family and friends, who are simply relieved that I’m “better now.” Often, loved ones want to project a vision in which you had a little “blip” but have recovered and will stay recovered, as long as you keep up your daily walks and meditation app.
It’s easy to become complicit when you’re desperate to believe in this vision, too. I was broken, and now I’m fixed.
However, rather than viewing my depression as an on-off switch, I’m trying to adopt a nuanced and accepting mindset. My cautious attention to my mental health is not a cop-out from life; it’s an act of gentle self-love.
Some clinical psychologists are also re-framing their models of depression, considering it not as an episodic disorder but as a complex condition where low-level symptoms may remain between discrete depressive episodes.
Instead of assigning an arbitrary period after which someone is deemed “recovered,” some argue for a more individual approach to the concept of recovery that accounts for treatment, everyday functioning, and a person’s opinion of their own well-being.
In other words, being OK is something I decide, not a box-checking exercise that doctors or therapists complete for me.
There are future versions of me who have high-flying careers, make outspoken and dedicated contributions to social justice causes, and grab adventure and opportunity without hesitation.
Maybe these potential versions of me will come true, and I really will be OK. Or maybe I’ll always limit myself, carefully reigning in life plans to protect my fragile mental health.
The reality will probably be somewhere in the middle. When I drove without P-plates for the first time, nothing much changed. I still wasn’t a confident driver, but I didn’t crash or run any red lights either. To this day, although I can’t parallel park without needing a taxi to the curb, I get from A to B pretty competently.
The trick is to just keep moving forward.
Medically reviewed on April 26, 2022
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