On The Days Depression Makes You Feel Nothing At All

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Today is a blah day. It isn’t that there is anything terribly wrong today. There are issues looming, yes, but there are always issues of late. There is nothing pressing, though.

It is just a blah day, a day where I lay in bed, struggling to find a reason to get up. I’ve had to pee for a couple hours now. Yet, the dull ache in my bladder is not enough to pull me from under my covers. I should probably brush my teeth. Maybe get dressed and get a bite to eat. I have been awake for more than five hours now, even before the sun rose. Yet, here I still lay.

I feel blah. While the world around me continues with its hustle and bustle, I have no motivation, no desire to do anything. Nothing seems interesting or important. Nothing is pressing enough to pull me from this funk.

I would go back to sleep if I could, call in sick from life itself. I feel like nothing, not myself. I feel numb.

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Days like this are common with depression. Those who have never struggled often assume that depression is all bouts of random sadness and tears. Yes, I have those days, too, and it is draining when everything and anything feels heart-wrenching and makes me want to cry. Yet, even worse, perhaps, than the days when I feel everything too strongly are the days I feel nothing at all.

On these days, I have trouble pulling myself up or doing anything. I’m not being lazy. I just don’t see the point. I am pulled into a gray abyss, where there’s no purpose, no joy, no motivation, no will to live. It isn’t that I’m suicidal and actively want to die, either. I just have no will to live. The emptiness is all-consuming.

People suggest I should just “try” to be happy or to be positive. If only it were this simple. Again and again, the “should be” and “could be” options roll around in my mind but I’m numb to them all. Deep down, I know I should be getting up, doing something, living life.

Yet, my brain has me in a death lock. “What’s the sense?” and “Why bother?” it parrots to me again and again. Its voice is booming and deafening. I can hear nothing else. I would love to just smile, think a happy thought and have it vanish away like a puff of smoke but it’s solid and real to me. It takes the form of four solid walls, caging me in, holding me hostage, refusing to budge or listen to reason.

Those blah days are the worst because I feel trapped in this numbness. I cannot escape. I never know whether it will last one day or one week. There is never an end in sight, never a scheduled sweet release.

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Blah days drag on and on until at some point I begin to feel everything too strongly again. On blah days, I would welcome the tears, the anguish, the pain and the struggling just to feel anything at all.

It has been more than hours now, and I’ve barely managed to write a few paragraphs. Yet, those feel like a tremendous accomplishment. I call it a victory. I have done something, which is more than I am able to achieve on most blah days. I still have to pee, though the dull ache has grown into a steady cramp. Breakfast time has come and gone, and lunch time has arrived. Yet, I still don’t have any desire to eat anything, let alone get up.

There are calls I should make and things I should be doing. Yet, my depression still echoes in my head that I shouldn’t bother, that nothing is worth the effort. It tells me to stay in bed, just let this day drift on by, that it doesn’t matter.

Nothing matters. It is all I can hear. It is deafening. I am adrift in a sea of hopelessness and emptiness. I feel paralyzed.

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I swear I am not being lazy. I’m just trapped in a battle with my own mind. I feel lost and alone. I feel trapped in this emptiness. I feel nothing. I feel numb. I feel blah. This is what depression feels like.​

This Comic Sums Up Exactly What It’s Like Living With Depression

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This article was originally published at The Mighty. Reprinted with permission from the author.

The Many Conditions that Mimic Depression

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Finding the right diagnosis for any disorder requires a comprehensive evaluation. Indeed, many illnesses share many of the same symptoms.

Take symptoms such as headache, stomachache, dizziness, fatigue, lethargy, insomnia and appetite loss. There are countless conditions with these exact indications.

Similarly, many mental illnesses share the same symptoms, said Stephanie Smith, PsyD, a psychologist in practice in Erie, Colo., who specializes in working with individuals with depression. Which makes “the process of diagnosing mental illness tricky, to say the least.”

For instance, attention deficit hyperactivity disorder (ADHD) and bipolar disorder can look like depression. All three cause difficulty concentrating, trouble sleeping, and increased worry, Smith said.

Anxiety also mimics depression. According to psychotherapist Colleen Mullen, PsyD, LMFT, like individuals with depression, people who struggle with anxiety might not want to get out of bed. They might stop going to work. They might withdraw socially. However, depression isn’t driving the person’s behavior. Anxiety is.

“An anxious person may stop engaging in their outside world because of the level of anxiety they experience when they try to leave their home.” Because of this, they might, understandably, become depressed, as well. Still, it’s important to treat the anxiety symptoms first (which, in turn, will help to diminish the depression), said Mullen, founder of the Coaching Through Chaos private practice and podcast in San Diego.

Post-traumatic stress disorder (PTSD) is another condition that’s hard to distinguish from major depression. According to Mullen, “PTSD and depression share the following symptoms: memory problems, avoidant behaviors, reduced interest in activities, negative thoughts or beliefs about self or others, inability to concentrate, feeling disconnected from others, irritability and sleep disruptions, and of course, mood changes towards negative emotions.” The biggest tell-tale sign of PTSD is that a person experiences or is exposed to a traumatic or tremendously emotionally straining situation, she said.

Medical conditions mimic depression, too. Two examples are chronic fatigue syndrome and low blood pressure, Mullen said. In this piece Psych Central blogger and author Therese Borchard discusses six conditions that feel like clinical depression but aren’t: vitamin D deficiency; hypothyroidism; low blood sugar; dehydration; food intolerance; and even caffeine withdrawal.

Gary S. Ross, M.D., believes all patients diagnosed with depression should be screened for thyroid dysfunction. As he writes in his 2006 book, Depression & Your Thyroid: What You Need to Know:

There may be rare cases of depression that cannot benefit from thyroid treatment. Nevertheless, in every case of depression, it is optimal practice to test very thoroughly for thyroid dysfunction, much more thoroughly than is usually done in initial screening examinations. When the testing is thorough, then if anything is found in keeping with a low thyroid function, it is crucial to include some kind of thyroid treatment protocol in the overall treatment plan for maximum benefit to the patient.

(Learn more about testing and diagnosis in this piece.)

Having the correct diagnosis is vital. “[I]t leads to a more precise, effective treatment plan,” Smith said. “If we don’t know what we’re dealing with at the beginning of treatment, our interventions can be like shooting arrows in the dark: not very accurate and possibly dangerous.”

Indeed, an accurate diagnosis is life-saving. Literally. Mullen has heard horror stories of primary care physicians diagnosing women with depression when their sluggishness, depressed mood, and weight gain were actually symptoms of cancer. Similar symptoms also may be due to a heart condition, which if undiagnosed, puts a person at risk for severe medical consequences, she said.

This is why it’s so important to have a comprehensive evaluation. See your primary care physician for a series of tests to rule out medical conditions. Ask for a referral to a therapist who specializes in mood disorders, so you can receive a psychological evaluation.

What does a thorough psychological assessment look like?

“[A] good clinical interview includes lots and lots of questions,” Smith said. She asks everything from how long clients have been experiencing their low mood to whether they’ve recently had any changes in their life. Mullen takes into account the person’s current stressors and psychosocial history. The latter involves assessing social support—or lack thereof—and work, education, legal, medical and family history. “It helps us understand the person in the full context of their life thus far.”

Smith also might give objective screening measures such as the Beck Depression Inventory. “It can take one to four sessions to get all the information I need to make a fully informed diagnosis.”

You may or may not be struggling with depression. As Smith said, “depression is a condition almost everyone is familiar with, so it can easily become a catch-all phrase or diagnosis. But there are literally hundreds of other mental health disorders, one of which may better capture the symptoms you are experiencing.”

Either way, take your symptoms seriously and seek second opinions, Mullen said. Because you know yourself better than any professional who spends several hours assessing your symptoms. “Advocate for yourself and ask questions so that you understand what [the professional] recommends for a treatment plan and why.” This is your body. Your mind. Your health and well-being. Advocating for yourself in all areas of your life is one of the best things you can do.

10 Things People Get Wrong About Living With Depression

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There are many stereotypes surrounding depression, from being unable to get out of bed to crying at all hours of the day. But those living with the condition will tell you that the illness comes in many forms, and often looks far different than what we’ve learned over the years from movies and the media.

Because of these misconceptions, people who haven’t had a personal tryst with depression often don’t fully know the ins and outs of the disorder. For instance, depression is not something that you can “snap out of.” You can recover from it and manage it, yet it still can easily come back. And it’s entirely possible to be depressed but also experience joy in the company of friends.

Curious what other things people frequently get wrong about living with depression? Experts and people who live with the condition break them down below:

You can be depressed and not appear sad.

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“It’s a misconception that depression is all about constant sadness. Yes, persistent sadness is a symptom, but it’s just one of a range of emotions, or lack thereof, that someone living with depression can feel,” said Helena Plater-Zyberk, co-founder of Supportiv, an anonymous peer support network for people with struggles like depression. She added that many would be surprised to know that people with depression are also to experience an array of emotions, including joy.

Mike Veny, an author and keynote speaker who often speaks about his own depression, agreed. “People get confused when they learn that someone who is confident and smiling all the time struggles with depression,” he said. He added that just because a person appears positive and upbeat, doesn’t mean that they aren’t struggling to hold it together inside.

You can’t flip a switch to flip to feel better.

“The biggest misconception about being depressed is that you can just ‘snap out of it,’” said Samantha Waranch, a publicist in Los Angeles who lives with the condition, noting that it’s frustrating when people imply that being depressed is “all in your head” and can be warded off by “thinking happy thoughts, being around people or hitting the gym.”

“While things like exercising can help, I think people who have never experienced depression don’t understand that it is an illness, a chemical imbalance that is beyond your control,” she added.

Depression isn’t merely triggered by stressful situations.

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“People think depression is because of a trigger or that something bad had to have happened to be depressed,” said Katie Leikam, owner of True You Southeast, who has dealt with depression herself. “Yes, depression can come from things like grief, but sometimes you just wake up one morning depressed and you cannot point to a solid reason.”

Dr. Melissa Pereau, medical director and psychiatrist at the Loma Linda University Behavioral Medicine Center, said that depression can be a highly genetic disease involving chemical neurotransmitters in the brain. Depressive episodes that last weeks or months can also often occur without any cause.

“Asking a person who is living with depression, ‘Why are you depressed?’ is sometimes just as frustrating to them as saying, ‘You should try to be more positive,’” Pereau said.

Isolation isn’t always best.

Dr. Don Mordecai, the national leader for mental health and wellness at Kaiser Permanente, noted that checking in on a loved one who is suffering can go a long way in showing that you care.

“You can say things like, ‘I’m here for you. What can I do to support you?’ or ‘Depression is a real health issue that can be treated. Have you talked to your doctor about this?’” he said, adding that in having these conversations, you may be surprised to learn how much the people that you care about appreciate the opportunity to share how they are really feeling.

It looks different for everyone.

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“Depression looks different in people,” said Tameka Brewington, a psychotherapist and owner of Real Talk Counseling. “For instance, some people will want to sleep all the time, while others are not getting enough sleep. Some people will isolate and withdraw while others will engage in a hostile or aggressive manner.”

Since depression manifests itself in different ways, Brewington said it’s important to know that each and every person suffering from the mental illness will have different needs.

Medication takes time to work.

Medications can certainly help to ease the symptoms of depression, but they won’t instantly make everything better. It takes time. “Chronic diseases require chronic treatment,” said Dr. Michael Genovese, a clinical psychiatrist and chief medical officer of Acadia Healthcare.

Even when the medication does help, it’s important to continue on with your prescribed dosages until your doctor gives you the green light to back off. “I’ve seen many patients over the years that will start taking their prescribed antidepressants, and as a result of the medication, they will feel better. This can lead to patients abruptly stopping their medication, which is a mistake,” Genovese added.

He advised patients to work with their physicians on a long-term plan. “Evaluate your options after you have committed significant time to your treatment plan,” he said.

It’s easy to overlook.

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In addition to sadness, depression can also manifest itself in physical ways. For instance, people with depression may suffer from sleep and appetite disturbance, low energy, lethargy, difficulty concentrating, poor memory or low libido.

“Often these symptoms are misattributed to other illnesses and people suffer from undiagnosed and therefore untreated depression for years,” said Zainab Delawalla, a licensed clinical psychologist in Atlanta.

Not being properly diagnosed can be frustrating and people who live with the condition may end up bouncing from doctor to doctor before finally getting the proper help they need.

Having depression doesn’t make you weak.

The idea that only “strong” people don’t have a mental health condition is one of the biggest misconceptions about mental illness, said Kelan Kline, who runs the lifestyle blog The Savvy Couple with his wife and lives with depression.

“I consider myself a very strong person ― super happy-go-lucky all the time,” he said, noting that “depression can hit anyone at any time, no matter how strong you are.”

L’Tomay Douglas, a life coach and founder of Brand Me Beautiful Inc., added that people are misinformed when they think that people living with depression are lazy.

“As a person diagnosed with clinical depression since 2003, I often had people saying things to me like, ‘Your problem is you need to get up off the couch and do something,’” Douglas said. “What they didn’t know was I was living, I was still breathing despite the darkness that tried to suffocate me and tell me to end it all.”

Medication is not the only treatment option.

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Sydney Williams, who writes about her experiences of recovering from sexual assault on her website, Hiking My Feelings, said there’s more to managing depression than taking medication.

“Not everyone wants to take medications to manage their disease and some folks don’t have access to medications,” said Williams, who stressed the importance of exploring a variety of treatment options. This can include talk therapy, lifestyle changes (for Williams, that meant hiking) and more.

There is no time frame for depression.

“Depression is not a now/later or here/gone thing,” said Lynn R. Zakeri, a licensed clinical social worker based in Illinois. In fact, she added that “people often say that because they experienced it, they feel much more at risk of returning to that and even feel it is a faster route right back down to the bottom since it is now a familiar route.”

Leikam added that clinical depression lasts for at least two weeks at the time, but “you can go through periods where you are fine and then it can come back through circumstances or coming off of medication.”

When Family Members And Friends Don’t Understand Depression

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pexels-photo-341378We’ve come a little way in reducing the stigma that’s associated with mental illness, but not nearly far enough.

Consider these results pulled from a public attitude survey in Tarrant County, Texas, conducted by the county’s Mental Health Connection and the University of North Texas in Denton to determine the community’s view of mental illness:

  • More than 50 percent believe major depression might be caused by the way someone was raised, while more than one in five believe it is “God’s will.”
  • More than 50 percent believe major depression might result from people “expecting too much from life,” and more than 40 percent believe it is the result of a lack of willpower.
  • More than 60 percent said an effective treatment for major depression is to “pull yourself together.”

Unfortunately, these beliefs are often held by those closest to us, by the very people from whom we so desperately want support.

Resenting them for their lack of understanding isn’t going to make things better, though. It almost always makes things worse. Whenever I hit a severe depressive episode, I am reminded once more that I can’t make people understand depression any more than I can make a person who hasn’t gone through labor understand the intense experience that is unique to that situation. Some people are able to respond with compassion to something that they don’t understand. But that is very rare.

Don’t Mistake Their Lack of Understanding for a Lack of Love

Whenever I try to open the doors of communication and express to a family member or friend how I am feeling, when I try to articulate to them the pain of depression, and am shut down, I usually come away extremely hurt. I immediately assume that they don’t want to hear it because they don’t love me. They don’t care enough about me to want to know how I am doing.

But distinguishing between the two is critical in maintaining a loving relationship with them. My husband explained this to me very clearly the other day. Just because someone doesn’t understand depression or the complexity of mood disorders doesn’t mean they don’t love me. Not at all. They just have no capability of wrapping their brain around an experience they haven’t had, or to a reality that is invisible, confusing, and intricate.

“I wouldn’t understand depression if I didn’t live with you,” he explained. “I would change the subject, too, when it comes up, because it’s very uncomfortable to a person who isn’t immersed in the daily challenges of the illness.”

This is a common mistake that many of us who are in emotional pain make. We assume that if a person loves us, he or she would want to be there for us, would want to hear about our struggle, and would want to make it better. We want more than anything for the person to say, “I’m so sorry. I hope you feel better soon.”

The fact that they aren’t able to do that, however, does not mean they don’t love us. It just means there is a cognitive block, if you will, on their part — a disconnect — that prevents them from comprehending things beyond the scope of their experience, and from things they can see, touch, taste, smell, and feel.

Don’t Take It Personally

It is incredibly difficult not to take a person’s lack of response or less-than-compassionate remark personally, but when we fall into this trap, we give away our power and become prey to other people’s opinions of us. “Don’t Take Anything Personally” is the second agreement of Don Miguel Ruiz’s classic The Four Agreementsthe idea saves me from lots of suffering if I am strong enough to absorb the wisdom. He writes:

Whatever happens around you, don’t take it personally … Nothing other people do is because of you. It is because of themselves. All people live in their own dream, in their own mind; they are in a completely different world from the one we live in. When we take something personally, we make the assumption that they know what is in our world, and we try to impose our world on their world.

Even when a situation seems so personal, even if others insult you directly, it has nothing to do with you. What they say, what they do, and the opinions they give are according to the agreements they have in their own minds … Taking things personally makes you easy prey for these predators, the black magicians. They can hook you easily with one little opinion and feed you whatever poison they want, and because you take it personally, you eat it up ….

Protect Yourself

I have learned that when I fall into a dangerous place — when I am so low that mindfulness and other techniques that can be helpful for mild to moderate depression simply don’t work — I have to avoid, to the best of my ability, people who trigger feelings of self-loathing. For example, some people in my life adhere tightly to the law of attraction and the philosophies of the book The Secret by Rhonda Byrne that preach that we create our reality with our thoughts. They have been able to successfully navigate their emotions with lots of mind control and therefore have trouble grasping when mind control isn’t enough to pull someone out of a deep depression.

I struggle with this whenever I fall into a depressive episode, as I feel inherently weak and pathetic for not being able to pull myself out of my pain, even if it means simply not crying in front of my daughter, with the type of mind control they practice, or even mindfulness or attention to my thoughts. This, then, feeds the ruminations and the self-hatred, and I’m caught in a loop of self-flagellation.

Even if they aren’t thinking I’m a weak person, their philosophies trigger this self-denigration and angst in me, so it’s better to wait until I reach a place where I can embrace myself with self-compassion before I spend an afternoon or evening with them. If I do need to be with people who trigger toxic thoughts, I sometimes practice visualizations, like picturing them as children (they simply can’t understand the complexity of mood disorders), or visualizing myself as a stable water wall, untouched by their words that can rush over me.

Focus on the People Who Do Understand

In order to survive depression, we must concentrate on the people who DO get it and surround ourselves with that support, especially when we are fragile. I consider myself extremely lucky. I have six people who understand what I’m going through and are ready to dole out compassion whenever I dial up their numbers. I live with an extraordinary man who reminds me on a daily basis that I am a strong, persevering person and that I will get through this. Whenever my symptoms overtake me and I feel lost inside a haunted house of a brain, he reminds me that I have a five hundred pound gorilla on my back, and that my struggle doesn’t mean that I am a weak person not capable of mind control. At critical periods when I’m easily crushed by people’s perceptions of me, I must rely on the people in my life that truly get it. I must surround myself with folks who can pump me up and fill me with courage and self-compassion.

Depression support groups — both online and in person — are invaluable in this regard for offering peer support: perspectives from people in the trenches who can offer key insights on how to deal with the invisible beast. I created two online groups, Group Beyond Blue on Facebook and Project Beyond Blue, but there are many forums worth checking out, like the ones at Psych Central. Actual support groups hosted by such organizations as National Alliance on Mental Illness (NAMI) and Depression and Bipolar Support Alliance (DBSA), and support offered by a therapist, are also great resources to help give you the coping tools you need to get by in a world that doesn’t get it.