TW: Suicide, Depression

Quick Disclaimer: I am not a mental health professional by any stretch of the term. I am just trying to add to an existing conversation from a place of experience as a “patient.”

Mental illnesses are a tricky thing. They create overpowering, controlling mental frameworks for those who live with them; but those same frameworks are utterly foreign and inaccessible for those who do not. There is a lot of online conversation about depression and its natural end if left unchecked (i.e. suicide). Honestly, as someone with the brain chemistry imbalance known as “Clinical Depression,” I think it’s awesome that this conversation is happening. Depressed folks (whether clinically or situationally), often feel completely alone with this crushingly painful thing that is drowning us every waking second. The more that people talk openly about depression, with compassion, and not judgment, the less alien and alone depressed people will feel; and the more likely those who are still suffering will be and ask for help getting out from under this thing that’s been quietly killing them. The mere act of having the conversation is the first step to hope for a lot of people.

…as long as that conversation is one of humility and compassion, not judgement. I’ve noticed a pattern in conversations about depression and suicide on the internet that seems to make the discussion less productive than it should be. That pattern, as far as I see it, has two parts:

  1. People who have never experienced depression sitting in judgement on those who have, rather than recognizing that this is something outside of their experience that they could listen to and learn from.
  2. The tendency for people who have survived situational depression to preach to those with clinical depression, believing that they are the same thing, and thus, can be dealt with in the same way.

This first part of the pattern is a case of people who don’t speak a language trying to correct its grammar; people with no history of depression who tell the depressed person, (both clinical and situational) that we are “so selfish,” and “just looking for attention,” and “just self -centered.” Here’s the thing that, I think, many depressed folks wish that this panel of judges could keep in mind:

You can’t really understand what our world is like unless you have been in a depressed mindset. Depression is a sonofabitch for a lot of reasons, but one big reason is the fact that it lies to you–about who you are; about how others see you; about your impact on them. The chemically skewed brain of a clinically depressed person spends every waking second telling them: “you’re worthless; you’re a failure; you are a burden and a problem to the people that you love; everyone would be better off if you weren’t here. Just take yourself out of the equation, so your loved ones can find someone better to replace you.”

Keep in mind that it’s our own brains telling us all this. Those with untreated depression cannot  see beyond the lies that depression is telling them, because the chemical imbalance colors EVERYTHING about how they see the world. Depressed people loathe themselves passionately, because their brains tell them that they are less than trash, and NO ONE would even blink an eye if they were gone.

Before I was treating my depression, I once asked my mother if she would bother to hold a funeral if “something happened to me.” In my chemically -skewed thought process, I could see my loved ones disposing of my remains in a dumpster and then immediately forgetting that I was ever there…and that course of action was completely logical to said chemically-skewed brain. Now that I have been taking medication for a while, and my wonky brain chemistry is balanced out, I see how illogical and horrifying that idea is; but when I was in the depression, I didn’t see it, and I wouldn’t have, no matter how many other people told me that it wasn’t true.

When a clinically depressed person kills themselves, they think they are doing their loved ones a FAVOR, because depression is a lying soneofabitch who lies, and when you’re in it, the lies sound like logical truth.


Now, to that tricky topic of selfishness: “How could anyone kill themselves? That’s so selfish.” When I was in the grip of my chemical imbalance, and living my life in constant, intense, psychological pain, the people who asked this question sounded like the selfish ones, to me. From my depression-framed perspective, these folks were telling those who were suffering: “you really should continue to live with this crushing, unrelenting, excruciating psychological pain…you know, for my sake.”  To the person who’s in the grip of depression, here’s what it sounds like you’re saying: “I don’t give a damn about your pain. I want you to stay in that pain for an undisclosed amount of time, because I want you to be here with me. As long as you’re with me, I can’t be bothered to care whether you are miserable or not; that doesn’t matter to me. –and oh, by the way, you’re really selfish for wanting your unrelenting, tyrannical pain to end.”

Please do not say these things to, or about, a depressed person—because, I’m sorry, but you don’t get where we are coming from–and now you’ve helped shore up depression’s lies about said depressed persons’ worth by telling them what a horrible, selfish human being they are for having pain that they did not ask for, and wanting that pain to stop.

Instead of accusing the depressed for the crime of having a condition they didn’t create, it’s essential to have compassion on them, and help them get what they need to make the pain stop–the same way you would for someone who was in a large amount of physical pain.

People with depression didn’t “choose it” or “bring it on themselves.” I hear this every now and then in discussions about suicide; “People who commit suicide are so selfish. how could they make that choice?”

It’s important to note that people who commit suicide because they have a physical, chemical imbalance in their brain putting them through psychological agony aren’t that different from people who pass away from cancer.

The clinically depressed person doesn’t “choose” to have skewed, unhealthy brain chemistry any more than the person with cancer “chooses” for their cells to mutate and become diseased.

Both conditions are rooted in the body (remember, the brain is an organ, just like the heart or the liver is); both conditions can have a hereditary component, meaning there was a genetic predisposition there that the individual had no control over. Both conditions are the result of something going wrong in the body that the sufferer cannot control; and both conditions can easily be fatal if left untreated.

As I understand it, “Situational Depression” is precisely what it sounds like: a set period of time in which one is depressed and/or suicidal in response to some kind of traumatic situation (such as the loss of a loved one, a serious illness, etc., etc.) This is something that comes on you, you fight through it (and it’s terrible), but, eventually, it will go away, and you will be back to your normal self. Situational Depression is rooted in your circumstances.

“Clinical Depression”, on the other hand, is rooted in your body, and occurs completely independently of outside circumstances. A clinically depressed person has a severely skewed outlook—on themselves, and the world—because the chemicals in his or her brain aren’t balanced out the way they are meant to be. Generally speaking, when a system or area of the body isn’t functioning the way that it is meant to, it causes severe pain that does not “go away” until the improper function is corrected. This is just as true for wonky brain chemistry as it is for anything else.

The only difference is that the pain that a clinically depressed person experiences manifests itself in their thought processes, instead of their bones or their muscles or their blood. Depression that is rooted in a malfunction of the body, rather than a situation, will not “go away” if you just “wait it out.” It requires active steps to correct it, just like any other illness would.

The other important thing to point out regarding the difference between clinical and situational depression: they are both serious, and can both end in suicide if not addressed, but they are not necessarily treated in the same way. That’s why you talk to a professional about how to handle this kind of thing—because you are dealing with two different, serious conditions. Talking to your friend who was situationally depressed that one time about how to deal with your clinical depression will probably not help you, because you are talking about two related, but still different, conditions.

Let me explain why I’m bringing this up. When I first started taking medication to treat my Clinical Depression, I had well-meaning loved ones tell me not to take the medicine that would control my condition and make my life live-able because, “I knew someone who took those once, and the pills made them suicidal.” Here’s the thing, about that: if someone is situationally depressed, and they take medication that’s meant to treat a clinical depression, they will probably have a very bad experience with that. Know why? Because that person’s brain chemistry is probably working correctly, before they take the medicine. So, if that medication is trying to “correct” brain chemistry that doesn’t need corrected, that means that, for them, those meds are probably going to throw their healthy brain chemistry out of whack, which may well make them suicidal.

But, here’s the thing: when you take medication for a condition you don’t have, you don’t blame the medication for making you feel sick. You blame the ill-informed doctor who told you to take medication for the thing you don’t have.

Let’s move this away from the brain, for a minute, just to illustrate the point:

Let’s say Person A has a heart condition. If person A says:

“Hey, person B, my Dr. just gave me medicine for my heart condition. It’s called XYZ.”

And person B replies:

“Oh, you shouldn’t take XYZ. Someone I know that for their bone condition, and they wanted to die the whole time they were on it.”

The logical response from Person A should probably be:

“Ummm…they took heart medicine for a bone condition, and it’s the medicine’s fault that things went badly?”

So, please, situationally depressed folks, and people who knew situationally depressed folks, once: stop telling clinically depressed people not to take our medication. Because The Thing We Have is not The Thing You Have. No, it is not the medicine’s fault that you took it when you actually didn’t need it. That’s the fault of whatever doctor told you to take the wrong thing. And the clinically depressed can’t, “just wait out,” or “just power through” clinical depression, like you can with situational depression. Clinical Depression is all day, every day, for the rest of our lives, without a break for air, unless we treat it.  So stop it, and let people who need the medicine take the medicine without telling us we’re bad for taking it. Ok? Ok.

Sorry; I didn’t mean to get a bit unprofessional in tone, there. I get emotional about this one, because there might be clinically depressed people out there who are needlessly suffering because well-meaning but incorrect people are telling them not to take medication. And, as someone who lived with untreated clinical depression for almost twenty years, the mere thought of that breaks my heart and fills me with indignant rage.

People who’ve never lived with depression would do well to listen and try to understand, rather than try to dominate the conversation by sitting in judgement. Let’s keep the healthy conversation going, by all means—but let’s not forget that it won’t work if both sides are not willing to be a little humble, and listen a little closer.



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