Diving deep into depression

Speaker 1: 0:03

Welcome back to You're Always Fine a space to show up for yourself and embrace the mess that lives underneath. Because, let's be real, it's exhausting always being fine. So grab your headphones and allow yourself to listen, laugh and even cry, because you are not alone. And we aren't always fine, and that's okay. And we aren't always fine.

Speaker 2: 0:25

And that's okay. Major depressive disorder affects approximately 17.3 million American adults in a given year, so why is it still so misunderstood and stigmatized? Well, today we are diving into this complex condition in hopes of creating a small dent in starting the conversation.

Speaker 3: 0:44

I'm your host, christine, and I'm Teresa, so let's freaking get into it.

Speaker 2: 0:53

Okay, Titi, can you tell me what you found when you looked up?

Speaker 3: 0:54

the definition of depression, just so we can ground us. Yes, so according to the NIMH, depression, also known as major depressive disorder, is a mental health condition characterized by persistent feelings of sadness, hopelessness and a loss of interest in activities you once enjoyed. It's more than just feeling down for a day or two. It can last for weeks, months or even years if left untreated. The causes of depression are complex and can involve a combination of genetic, biological, environmental and psychological factors. Things like traumatic life events, chronic stress, certain medications and underlying medical conditions can all contribute to the development of depression.

Speaker 2: 1:37

Okay, so when you think of depression, Titi, what is like the first few things that like come to your mind?

Speaker 3: 1:43

I would say someone that has a really hard time getting out of bed, someone that is overall not very happy and, honestly, someone that has their life kind of consumed by their own thoughts. That's what I would think.

Speaker 2: 2:00

So that's kind of exactly. What kind of sparked me to want to have this episode was because a few nights ago ago I was in my hot tub and I was just sitting there and I realized like, oh my gosh, like I'm in a pretty dark place right now, and for me depression doesn't look like not being able to get out of bed or consumed by thoughts I feel like is not fair to even say, because I'm always consumed by my thoughts. So I'm going to leave that one out. But a lot of the stereotypical things that are listed in depression aren't for me Like. I can still put on a pretty happy face, I can pretty much make it through my day. I find that maybe my perfectionism turns up a little bit. What I really notice is this vast amount of like emptiness, and not like unemotional, but not emotional, but just like it seems like there's an ocean of empty inside me. And that's when I'm usually like, oh no, I'm not in a really good place. But that took me a really long time to realize what depression looked like for me, because when you start thinking about, oh, am I happy or I'm not happy, or is it hopelessness or sadness, those can feel kind of like easy to either mitigate or make an excuse for them like off.

Speaker 2: 3:15

And I find that it's so important to understand that there's different types of depression, there's different onsets, and then everyone experiences depression slightly different, and I think that society has kind of made it seem like we have control over this sadness or the way that we've framed it, right, like oh, can't get out of bed, right. I think both of us know, through different avenues, about not being able to get out of bed or being so sick not being able to get out of bed. And I know for me I could not accept that it was depression as opposed, because it felt like it was directly invalidating that. I was like what my body was feeling like. But then I started to realize like it's not the chicken or the egg kind of thing. It all combined At some point it does become like I'm just depressed because I'm so sick and I can't get out of bed, not so much that my flare up is still bad. Does that make sense?

Speaker 3: 4:06

Yeah, I think for me it's also very hard to have an idea of what depression is when you don't struggle with it yourself. So I never have. I've been in like I would say ruts and stuff like that, but that's like typical things. I think that you would go in ups and downs. I've never actually struggled with depression. So I think it's also really hard for people like me to understand all the nuances in depression, because I've seen very bad depression in, you know, family members and things like that. And then I've also seen the other side of it, where I feel like depression can get manipulated. So that's also difficult for someone that never really deals with depression, because it's hard to recognize it and recognize which one is actually a reality for someone that they're dealing with or if it's being cherry picked for someone to use, if that makes sense.

Speaker 2: 5:09

No for sure. Two things. One, when you were talking about that it made me think of when we first met. You really struggled to understand like my flare ups and you're like just text me back. I'm like it's just not that easy and I will never forget the like time you went live and you like basically gave me like three years later, this like apology because like you were just going through like some of your own stuff and you realize, like you realized it from a different perspective. But I feel like that's kind of what you're talking about with depression Like it's really hard to like put yourself in something that you just seems infallible, like you know, or like seems truly, like you can't imagine.

Speaker 3: 5:45

Well, yeah, because there is varying degrees, like you said, there's degrees like I can't get up, I can't get out of bed, pretty severe. But then there's also, like you said, you can function, you can move, but you have that feeling of emptiness and that's not necessarily as obvious. It makes me think of Robin Williams, right, who's so happy comedian and then all of a sudden, everyone's like what the heck happened? I don't know.

Speaker 2: 6:10

Exactly. I feel like this can be a very, very silent battle.

Speaker 2: 6:14

And also because some of the stigmatization that we have right around. You know, essentially like, oh, it's something that you can help just get out of bed, just like see some sunlight, and it's not that easy and I not realizing it if that makes sense, Like I don't know. For me it's one thing. When I start to realize it, then I feel like I can start to do something about it. But you know the process of getting there.

Speaker 2: 6:41

I don't always know if I like notice, or you know you never think it's like that bad, or until it is, yeah, this isn't depression, you know, this is just. I'm upset because of X, Y and Z, and that for me, I think, is the scariest part, is not realizing that you're getting to that place. Like you said, there's a mild all the way to severe, like depression, and I think there's also and we do this with a lot of things I think our generation and I think just with so much consumption and stuff, does this thing, where it's like a depressive thought, can get misconstrued or minimized as like, oh, this is just. I think I've seen it go both ways. Where it's like people will underestimate or exaggerate. You know, like, oh, that's my OCD and it's like. Well, your OCD is more than just like organizing your fridge, you know. Well, that's the other thing.

Speaker 3: 7:28

I was going to say I also do feel with social media and TikTok and all that. I do feel like mental health issues and this is going to sound so bad and I don't want to make anyone mad, but sometimes they're getting to be a trend where people will, just off the cuff, be like oh yeah, like you said, I have OCD and it's like that's actually a real thing. So, and like you, very well might have it, but you can't just classify it.

Speaker 3: 7:55

You know what I mean. It just seems like it's a bandwagon right now.

Speaker 2: 7:59

Yes, exactly One behavior isn't encompassing of it, and, while I think that the awareness and the exposure is obviously overall good for the most part, but there is a lot of serious dangers One, I mean knowing your root cause is so important when you're trying to get treatment and stuff, and so it's really important that you're not just diagnosing yourself and you're also not, you know, to your point. It's a complicated issue, right? I think we're seeing that with ADHD a lot, where so many adults right now going for ADHD that there's a lot of serious consequences. People aren't able to get their medicine. Doctors are now really hesitant on prescribing medicine, right, Because of, I think, this new exposure that social media has brought, Like I said.

Speaker 2: 8:37

So I think it is a good thing, I think it does bring awareness, but I think we have to be careful when we're consuming these things that are already, in my opinion as a clinician for 15 years, super hard to diagnose. Like diagnosing is one of my least favorite parts of my job because you know there are just so many factors that can attribute to it and you're seeing a snippet of something and you're trying to get it right and you're trying to find the most the root cause to get a treatment to give this person some relief.

Speaker 2: 9:05

But I mean just in depression, right, there's major depression, there's persistent depressive disorder, there's seasonal affect disorder, there's postpartum depression, like right, and all of them have like their own set of you know symptoms. One of the major things about you know depression is, you know, lasting more than two weeks but less than six months Right, Because otherwise it's considered chronic. And I think you know, oddly enough, my disease has opened me up to the like being open about depression if that makes sense, or being able to talk about it in a way that doesn't feel, I guess, threatening to who I am. But if you look at some of the other symptoms lack of energy, fatigue, difficulty concentrating I feel like that's everything that comes up, I have all of those things Right on a normal day for me everything that I have, all of those things you know, the normal day for me, and I'm not.

Speaker 3: 9:55

That's not something I struggle with, so it is. It's, it's hard. It's hard. It depends on your circumstances, it depends on prior traumas, your experiences. There's a lot that goes into it and you do want to get diagnosed correctly because you know, for example, like you just listed off, fatigue, lack of concentration and what was the other one difficulty concentrating okay, so all three of those things right there, right lack of energy, that's lack of energy

Speaker 3: 10:21

I have all three of those and I know that I have all three of those because of vitamin and mineral deficiencies and stuff like that right, but if you and this is what I mean about like social media and consuming so much, if, if you know, you see all that and then you have a bad day one day or whatever, and you don't want to get diagnosed with something you don't actually have, if you don't want to get diagnosed with depression, get put on something and then, in reality, you just have like a mineral deficiency or whatever. So I do think knowing the nuances and stuff like that is super important for not only the people that are trying to seek help and figure out what is going on with them, but also the people that are diagnosing them.

Speaker 2: 11:02

Yeah, and you know, I think too, like we saw in COVID right, this like increased, like loneliness and this, you know, realization, that I think so much of our, like, our worlds were like externally validated and outward that we never had a chance to sit with ourselves and I think that we saw a heightened depression because when that was all taken away, all we were left with was ourselves. And you know, for someone like me that opened up my world, but for most people it closed their world. I think too, when we think of depression, sometimes I think there's an easy jump to suicide. And while, yes, you know, reoccurring thoughts of death or suicide is a severe, on a severe end of DSM diagnosing, there is to me also a very real every day. It's almost like the chronic aspect of chronic, you know, just like that repeat, and then you know there's change in appetites and there's loss of sleep and those are all things right that could also help you get out of it.

Speaker 2: 12:00

So you know, I know for me one of the reasons that depression and my flare-ups are so intermingled is because I lose my routine. And the second I lose my routines that's when I go down this like very slippery spiral and you know, you keep pushing, you keep pushing, and but I did, I literally in my house. I was like I am so empty right now, like why is this happening? Nothing works, nothing is happening. I think that's the hard part, too right. It's like doesn't always have to be something bad happens or something bad happens.

Speaker 3: 12:28

Yeah, there doesn't have to always be a reason.

Speaker 2: 12:31

Yes, and you know that chemical imbalance, I think sometimes is really misunderstood, you know, I think we understand, I think more depressive episodes, right, your kid gets like chronically diagnosed with something or a tragedy, a trauma, right, we understand that yeah they make more sense.

Speaker 2: 12:49

Yes, out of the blue just again, and for me it doesn't feel sadness. Sometimes I wish it did feel like sadness and I could, I think, easier pinpoint that Right right. But for me that emptiness doesn't feel like an emotion and it's harder for me to identify. And I'm on so many medications I can't always look for like the loss of appetite or the loss of like interest in activity. Because, let me tell you, the last thing I wanted to do is come on here and record this podcast today. It was down there with you know, I don't know the worst of the worst of the things, you know.

Speaker 2: 13:25

Feelings of worthlessness, too, I think is an interesting one, especially being a woman. I think I struggle with my worth all the time. It's a constant telling myself I'm enough. So sometimes I think the indicators that we have aren't always the easiest ones to help us navigate that. And then I think, too, medication.

Speaker 2: 13:43

I think one of the most fascinating things about being a therapist is having so many people come to me and seeing how they want to try to work things out, because sometimes you try and you try and you try, and I never bring up medication unless one I can diagnose and I can refer so that someone can get medication bring up because it doesn't feel like a solution I can actually help with.

Speaker 2: 14:07

But you know, when you're sitting there and you're doing CBT or you know you're doing these modalities week after week and you're trying to get out of the hole and it just feels like you're not able to do it, you know, sometimes I tell them you've been putting the work in. It should be a little easier. I think you should explore this, you know, and that always gets an interesting response, depending on where people are in their journey. Because, again, you know, one of the big things is like do I have to be on this for life? Do I have to like? What does this mean? And it's so true, you know. I think it opens up this scary realm of is this forever?

Speaker 3: 14:36

Right and it's hard because I mean, I'm on the other side of it in terms of like medicating and stuff like that. You know, obviously that's up to people and what they want to do. I am more on the holistic ends of things and there are holistic means to try and help mental health and stuff like that, but I think it's not really mainstream right now and I think that's difficult for people to look into that side of things because a lot of times, right, you do, like you said, want to get to the root cause of why you are depressed, and when you're looking at root causes not even just like trauma and stuff like that there is other parts of your body that could be affected. So it's interesting because sometimes you can give someone a prescription medication for depression and it could make them worse or it could not be enough, or you know you got to not have it with something else, or so it is a lot and it's, I think, it's difficult to try and figure out the best way to go for your unique individual situation.

Speaker 2: 15:40

Well, and you know. It's interesting that you say that, because the number one thing of all these antidepressants usually is a increased risk of suicide within the first two weeks of taking it which is great right which, when you think about, when you think about just the basics of giving someone who's already in that state, that seems like a huge risk, you know. But you know to your point. I also think sometimes we want a quick fix, you know and.

Speaker 2: 16:02

I think a lot of you know medication. I think the craziest thing is medication, at least in my experience professionally and taking it it isn't going to. The opposite of depression is not happiness, right, it's just not. It's baseline, right. It's like we're talking 10% better. So just as little as it took how you started to feel that way is as little as all of a sudden you're just one day will just be a little easier, you know and it's not.

Speaker 2: 16:33

Again, the weight of the world can feel on you and you would think that you would feel that weight lift Right. It feels so subtle that sometimes it's even hard to know is this medication working? Until I stop taking it and because I think that, oh, like it's not, you know, I'm fine, Everything's fine, I'm regulated, whatever have you, and then I stopped taking it and about two weeks later I'm like okay, it's not the worst of the worst, but it's not. I can feel that 10%, no longer like there.

Speaker 2: 17:02

And you know that's where, like the therapy, they're, like the thought, repatterning. I'm constantly telling people that it's an everyday battle, me versus my internal world.

Speaker 3: 17:12

Like period.

Speaker 2: 17:12

And who's going to win that day? I'm never sure. Trying to do the right thing when you're tired, walk when you don't feel like walking, you know, like all the things like that walking pad was. The best thing I think I've done for my depression was, you know, to keep my body moving, because I didn't know how much is stored in your body. So I think it's just. I guess it still amazes me that, like in 2024, we still really do struggle though having these open conversations. You know you're someone who doesn't experience it. I'm someone that I don't know if I would have ever identified it as, but you know kind of narrowed all the things.

Speaker 3: 17:54

It's really all I could be. I think the conversations can be had like we're doing right now, if you don't have expectations, and what I mean by that is I remember speaking to someone about depression. They were experiencing it, or felt like they were experiencing it. I, however, was seeing a completely different side of this person. Right, I was seeing a person that was depressed in only certain situations, and these situations were situations that limited this person's ability to do things.

Speaker 3: 18:26

This person could spend hours on hours on hours getting ready to go out on the town and have fun and do all this stuff, but then, when it would come to doing things for their family or having things to be done, it was that's when they would say they're struggling. And then they wanted my opinion on it, and I'm like I'm not the expert. From my view of someone that has never experienced it, it's clearly something's going on, but I don't necessarily think that it's that, and that person got frustrated with me, but again, I'm not someone that deals with it. So I think that you can have conversations like this, as long as you both know we can experience the same things, or you might not be able to fully understand and then just have an open. Just don't have an expectation that I'm going to agree with you or that I'm going to be like, yes, that's definitely what you have, because that's just not my area of expertise. You know what?

Speaker 2: 19:25

I mean, I think people want to feel validated and that's like the struggle, you know, is like you want to feel validated by people around you and feel seen, and I think that's part of the problem. You know, is like if someone doesn't know all the factors or whatever, it can be frustrating and it can feel invalidating, but that's not what you're trying to do. It's just that's the way that you see it. You know, and I think we've always done a really good job of being on sometimes opposite sides of the issue and being like okay, I'm going to hear you out, I might not walk away changing anything.

Speaker 2: 19:58

Agreeing with you or whatever, but like I have enough respect for you, I care enough about you to want to hear at least what you have to say about the topic and I think like we've lost that ability to really try to dive into that. I think, again, covid put everyone in this same position where, like we, we use depression, but the amount of people who were like truly going through depression in COVID and the amount of people who maybe it was difficult or lonely, like there, there was a difference there. But there was this like very common shared experience that we don't always usually get right. A country doesn't always shut down or, you know, give people this, but, like you said, I think it's, it's your trauma, it's the way you process it, it's honest, quite literally, chemical imbalances, you know, and all of that leading into also stress management, you know, like I, know that I'm someone who gets super, super overwhelmed, especially around not feeling like meeting expectation or something of that nature.

Speaker 2: 20:52

And having to manage that stress is a huge part of managing my depression, Right? Also, managing my OCD is a huge part of managing my depression, you know, when I start to feel obsessive thoughts again. This is why the organization one always makes me laugh because you know it's like cute when it's like, oh, my OCD looks like this. But the difference is I can't move from like the bottom. I'm like draw of my draw. She's saying drawer, she's saying drawer, that's what I mean. But I will get stuck for hours because it becomes an obsession and then that a compulsion comes from the obsession and I cannot, it's so, it's not. Oh, this is cuter, this is like I like being this organized, like freak. It's the difference between, yes, I like it because it's really, if I didn't like it, I don't have a choice. But you know Carrie will always say I will go for aesthetics over function and I will. Every time it's a matter of I will obsess over the way something looks in my fridge if it's because it doesn't all look the same or it's not all facing and that's a hindrance in my life. It's fun and all. When you're looking at you know it's become trendy on, like you know, TikTok and stuff to have like these or like restock of clocks. But I've been doing this, like I mean, but for as long as I can remember.

Speaker 2: 22:07

My sister and I we wanted to share a room when we were both out of the house, but it was the transition period in college and so you were living at home, but you were not living at home kind of thing, and so we like had this great idea to live together. She literally moved upstairs, the smallest bedroom of the house, because I was folding her underwear, because I just I couldn't open her drawers and like look at them, Like yeah, and she's like I just can't, I can't live with someone who's like I was like well, you don't have to do it, Like it's not affecting you, and she's like I can't. But like and like this was like a serious thing, Like and to this day, like I fold them a very specific way that is so funny and like all tucked in nicely, like in, like again in the most ridiculous way possible. But it's just, it's the only way like I can function, you know. But but much like depression, like I thought that you know, because I didn't count how many times I did something that was an OCD, so it took me a really long time, even as a clinician, to be like, oh, wow, when, when I remember, like when I was getting TSM, which, like I called it, one flew over the cuckoo's nest like type of thing, but it wasn't, um, but to me it still feels like it was, but like put all these things on your head and like essentially like hit certain spots of your brain to try to like re rewire it. Yes, essentially, obviously not as crazy as one. It was a cool business, but that's what it felt like. It was like very like. Now it's kind of common. I've seen ads all over the internet for it but when I was getting it done in 2020, it was like very new and I was like, sure, mom put me in one.

Speaker 2: 23:41

Yeah, I get it, but it was through that process. Did we? Did we find that, like, the root of my depression was actually OCD and so they actually didn't know if it was going to help me. But just having the right diagnosis and therefore the like shift in medications, even under the same umbrella, was it was so, yeah, it matters, it definitely matters. It does, and I think that just us having this conversation in general starts to hopefully allow us, like, check in with ourselves, not be afraid to ask for help or seek professional treatment. You know you're not alone and there's nothing wrong with you. You know it's okay to need a little help out of the dark even if, like you know, your best friend doesn't need that same help, Right, 100%. So anything else on this Cece, what do you think?

Speaker 3: 24:29

I think, just for people that are struggling, if you don't feel like you have people around you, like go on. I don't know, like if there's groups or you would probably know more, christine, about that kind of stuff, but I think, if you're struggling, just to at least voice it to someone so you're not struggling alone.

Speaker 2: 24:49

You don't have to struggle in silence. There's places like Cabana that are here to help and, again, there's 17.3 million American adults who are going through this at any given time. The numbers are in your favor. That somebody's kind of experiencing this, but also suffering in silence alone, Right? So you know? That's it for this episode of You're Always Fine. Join us next time as we explore another taboo topic. If you enjoy the show, please leave us a review. We love hearing from you guys, and until next time, mind your health. Seriously, you're fine. You're fine because you have the power to access your place of peace anytime you need it. However, if you get stuck, we're right at the palm of your hand to help. Check out our show notes for this week's source list, recommended content and Cabana live group schedule. We'll catch you next week for a brand new episode of You're Always Fine.