My doc says I'm depressed. Why doesn't that label seem to fit??

Listless Lotharios! Graham here.

My big feelings just got an unexpected new label

I had to have a mental health assessment the other day, so I could keep getting subsidised therapy. My doctor pulled out a little questionnaire and proceeded to ask me a bunch of questions. 

Questions like:

Doc: How often do you feel tired out for no good reason?

How often do you feel hopeless?

How often do you feel like life is meaningless?

And I gave her a bunch of answers. Answers like:

Me: What’s a “good” reason to feel tired? Life is exhausting!

Hopeless?! It’s 2018. Do you even read the news?

Mmmmm, I’m an armchair Buddhist. I feel like life is meaningless all the time! ...is that bad?

We were chatting away while she tallied up my score. Then all of a sudden she paused, looked down at the piece of paper, then back up at me, concerned.

Doc: “So... this says you’re severely depressed… Do you, uh, feel… severely depressed?”

Me: “Huh… No? I mean, I don’t know. Yeah... maybe?”

This was actually the first time a real live doctor had suggested I was depressed. I’ve picked up a few other labels over the years - usually more exotic - but never depression.

So how did it feel?

Weird. Kind of validating, but also like she was talking about someone else entirely, not me.

This week, what happens when your feelings get a label that doesn't totally fit? And does it even matter if you don't connect with the label you're given?

Sometimes the answer is an answer. Sometimes it just leads to more questions. 

We sometimes think of mental health labels as a kind of answer. I know I have in the past.

When I got my first diagnosis at age 18, it was a total rush. It was the perfect storm of my desperate need for answers (why am I like this??) and my adolescent longing to be different. In my art-school, everyone's-in-at-least-one-band social circle, I could even wear that label like a badge. I felt like I'd unlocked a level of human suffering and levelled up.

For a couple of years, that first diagnosis really felt like an answer - or at least, a way of explaining things I couldn't explain (to myself, to my friends). I don't know when exactly it stopped being useful. But over the years that followed, that first label slowly seemed less relevant to my life. Like an old friend I never see anymore, I remember it fondly enough, but have no desire to get back in touch.

In the doctor's office the other day, things were different. I didn't feel like I'd been given an 'answer' at all. Instead, I left with a whole lot of questions.

I'm severely depressed? How long has this been going on? What does this say about my life choices? My future?

And when I went home and told my partner, she had many questions too.

What does this mean? What are we supposed to do? Should I have noticed sooner??

I couldn’t answer a single one of these questions (and neither could my doctor). Being told I was depressed was kind of validating (see? my pain is real!) but it was also deeply disconcerting.

Instead of levelling up, this time I felt like I'd lost something. And it took me a while to figure out what.

Some words are louder than others

I felt I'd lost the ability to talk about my inner life in my own words. And for someone who's all about words, that was kind of a big deal.

Mental health labels tend to be big, impressive words. They are technical terms that carry a certain gravitas. And that can be very useful - especially when you want someone to take your pain seriously.

But it also means these official labels can take up a whole lot of space in your head. To me, the language of mental health has a certain cold, hardness to it, that doesn't always sit well with the gooey-ness going on inside my mind and body. I start to wonder if every new feeling, every new sensation is really me, or if it's the depression. And I find that a lonely experience.

When I'm low, I am *full* of feelings

Part of what was going on is that I've never really personally connected to the word "depression". The way doctors talk about it, it seems to me they’re often describing an absence of something, an emptiness. The absence of happiness or meaning.

But in my periods of profound despair, I am generally overwhelmed by feelings that are achingly *present*. Urgent, pressing feelings - of shame, of anger, of sadness.

Even the feeling of unworthiness has its own unique substance, when it comes. It is not simply a *lack* of self-worth. It churns tightly in my chest, it sits heavily in my guts. It blankets my world.

Sometimes you want more than just an explanation

Does it matter what words we use? Does it matter if I don’t connect to the word "depression"?

I think so.

Because here’s the thing. When I’m searching for the words to name my experience, what I’m looking for isn’t just an explanation of what’s going on. What I’m looking for is understanding. 

I want to understand what’s going on. And most of all, I want to *be* understood by those around me. 

For me, that means finding words that do a better job of communicating what’s going on here. Words that hint at the *substance* of my overwhelming experiences.

Labels describe our feelings from the outside in

What is a mental health label anyway? Essentially, it’s a shorthand, a way of quickly communicating something big and complex.

So of course any term we use is going to be imperfect, it’s going to leave things out.

But if we give some terms greater weight, even in our own brains, do we risk losing our own more nuanced, more personalised ways of describing our messy stuff? If we insist there’s only one ‘right’ way of describing feeling like a piece of shit for prolonged periods, does that actually get in the way of understanding each other?

Diagnoses offer a framework for describing and categorising some of the messier parts of being human. And because they come from researchers - professionals who typically did not experience this messy stuff themselves (or didn’t own up to it) - they are really descriptions from the outside.

So what about describing this stuff from the inside, what words do we use for that?

"Deep-rest"

“People talk about depression all the time. The difference between depression and sadness is, sadness is just from happenstance, whatever happened or didn’t happen for you.

Depression is your body saying ‘fuck you, I don’t want to be this character anymore. I don’t want to hold up this avatar you’ve created in the world, it’s too much for me.’

You should think of the word ‘depressed’ as ‘deep-rest’. Your body needs deep rest from the character that you’ve been trying to play.” -- Jim Carrey

Has anyone else noticed that Jim Carrey is becoming some kind of life guru?

I’ve been seeing Twitter posts saying he’s lost his mind, but I went on a deep dive of recent interviews with him, and some of what he’s saying really struck a chord. He’s definitely spent some time navigating life’s existential tunnels - these words above are his thoughts on how we might talk about depression, as "deep-rest".

Many of us wouldn't mind if the 'character' we had to play in real life was a rich, successful movie star. But I think Jim's point still applies to the rest of us.

For me at least, even when I think life’s not going so well, there’s still a character I’m trying to play. Whether people believe me, or I'm playing it badly, it's tiring just the same.

The best labels help you connect

This is what I do when I’m deep in the goo. I scavenge for other people’s words, their turns of phrase, their attempts to make sense of the messiness. Whether it’s Hollywood actors who've suddenly started being weirdly honest, or fellow Big Feels Clubbers sending me their takes on the life + feels equation.

Sometimes I try these words out for a while and then let them go ("severely depressed"). Sometimes they stick around ("big feels").

I don’t think there are any ‘wrong’ words to use, and of course we use different words with different people, depending on what we think will make sense to them. (I might not tell my boss ‘hey I’m taking today off because I’m deep in the existential goo.' Although, if you *can* say that to your boss, that's pretty awesome!).

The word "depression" can be a useful shorthand in a whole lot of settings. It's just not what I use when I want to be deeply understood.

If I can find words or a phrase that can capture the substance of my deep, dark dives, then those words will be more useful when I’m trying to communicate just exactly what is going on to other (carefully selected) people. You know, those rare and precious conversations where you're not just explaining what's going on, you're *exploring* it, together. Whether you're lucky enough to have those conversations in real life, or whether you have them online, there's something magic about knowing you can use whatever words make the most sense to you, to try to connect with people who've been there too.

And that, my friends, is still the only way I know to feel a little less alone in the existential goo.