Delan Azabani

Depression

Being in a permanent state of melancholy is a very damaging predicament because it’s an almost insurmountably difficult loop to identify, accept and break. I’m now acutely aware of this because I’ve been depressed for nearly a year now. I’ve decided to materialise some of my thoughts because it might help organise them.

Preface

Some of these thoughts may be relevant to you, but I suspect that many of them are simply auxiliary manifestations of the illness. They are thoughts that I continue to have today, and even though they are certainly unwanted, I remain poorly equipped to deal with them. For months I could not recognise that they were abnormal, and I am still unable to clearly isolate the causes.

A level of introspection and perhaps even selfishness is inherent to the nature of an essay such as this, so please feel free to read something else if you find it narcissistic, pointless or otherwise. As it may become evident, I am no expert on mental health. If anything, take how I have handled depression so far as advice on what to avoid doing.

Complacency

Speaking out as early as possible is apparently important for those suffering from depression, but there are several reasons why I have let my problem fester until today. While many of these were based on my irrational fears, facts did not quell my inaction.

I see a lot of public debate about whether or not our society and medical professionals excessively attribute certain behavioural problems to mental illnesses, and it makes me afraid of declaring that I may have a certain condition, particularly because a small subset of my visible symptoms include a lack of time management, motivation, physical and mental energy. All of these could easily be dismissed as indolence by a critical observer.

Depression afflicts a significant portion of the population, as evidenced by the 11% of Australians who experience an affective disorder at least once during their lifetime (ABS, 2008, p. 27). I felt that speaking up would sound frivolous to others, because somehow I got the idea that everyone else had been through this just fine, without talking about it publicly, and I would be annoying others with something that they would see as trivial.

I was intensely averse to bothering other people with something as insignificant as my own mental and emotional health. After all, whether the scope of discourse is global, communal, institutional or otherwise, the troubled mechanism of my mind seems to be objectively unimportant — what benefit for others could possibly come of hearing me whinge about that which does not affect them?

Mental illness not only appears to be poorly understood, but also to a certain extent a taboo among many people in society, close to me and otherwise. There are very few people who I feel that I can speak to about it. One very helpful friend tried to work through some of my issues, eventually recommending that I see the counsellors at my university. I feel very uncomfortable talking to new people though, I have sadly since quarrelled with this friend, and our relationship has yet to recover to the point that I can confide in them.

Perhaps one of the most significant obstacles to dealing with depression is that it’s easier in the short term to ignore it and avoid thinking about it. I couldn’t speak to anyone about it in any serious capacity, because as a result of having invested no effort into processing the problem internally and discussing it with myself, I had no idea how to discuss it with others who might care. It would end up being a case of ‘I’m sad, I have no motivation to do anything, and I don’t know why’. Having been on the supporting end of conversations with people seeking technical support, I knew that this would be futile.

Lethargy

An intense lethargy has hounded me for most of this year. This has manifested itself not only in its most literal sense, but in three additional ways. I’ve completely lost the motivation to do anything other than that which will sustain my life, income and present level of academic achievement. Removed too was any of my passion for and positive emotion gained from activities and occupations which I previously enjoyed. More subtle was the disappearance of all of the ambition that I once had, as it’s difficult to notice during busy semesters at university, during which I was engrossed in the present.

The most painful result of this is my unprecedented ability to throw away countless entire days without having achieved anything significant. After each episode of the absence of any activity lasting between a day and a month, I would realise that I had not studied, developed any of my projects, or even entertained myself with new film, television, music or games. I simply had done nothing — and while I would certainly be the first to recognise the value of conscious downtime where one can calmly reflect, this was a different beast altogether. This was a pathological incapacity to do anything at all.

As I write this, my desk is in atrocious disarray. There’s no space to read or work under the piles of paper and water bottles that litter it, and yet I can’t bring myself to clean it up and put the space to better use. My list of tasks to complete grows steadily, with at least thirteen essays to write, six television series to watch, dozens of video games to play, four programming languages to learn and ten incomplete software projects to finish. I even wanted to branch out from prose into creating illustrated videos about technical topics, but I don’t see that happening any time soon.

Cognition

I see the brain as a muscle. It’s easy to maintain a healthy volume for this muscle by engaging in a normal level of socialising, thinking critically, reading, writing, debating, creating and developing. An extreme amount of exertion isn’t even necessary, beyond what one would normally find themselves doing. If one does nothing at all but check their email and social networks, briefly read the news and do the minimum level of work as expected by others, this muscle will atrophy. I have noticed this happen to me, and it’s terrifying.

Politically, mathematically, logically, socially or otherwise, I now find myself unable to effectively reason about anything that isn’t a trivial matter. My ability to fluently write concise prose has been severely impaired, as I grow to rely on a thesaurus as a poor substitute for intelligence, wit and understanding of context.

I can once again look at a file of code and often despair at my bewilderment in place of being able to parse and understand what it does and how. I frequently wonder how poorly I will do in an interview, and whether or not I will become one of those computer science graduates who can pass their exams but be unable to read or write code.

Culture

The questions I am asked by my friends so many times recently include those along the lines of ‘What music are you into?’, ‘What games do you play?’ and ‘What do you do in your spare time?’ — and they’re questions that I have dreaded answering the most, lest they betray how uninteresting this depression has made me. My most frequent response is that I haven’t found the time to explore any art or hobbies recently, but such a response is a lie. I had more than enough time unoccupied, but none of the motivation to even casually entertain myself. I couldn’t even tell you what video games or music I enjoyed if I tried, because any of my passion that I could’ve had is being blocked out.

I once played the violin for eight years until three years ago. It was one of my greatest devotions, and while I thought I needed to give it up to dedicate my time to my high school exams, 1 the only thing stopping me from continuing to be a violinist is not something like a fear of losing skill, but simply the aforementioned lethargy that poisons all of my desires to achieve, develop myself and do what pleases me.

Life

I have entertained suicidal thoughts repeatedly and thoroughly, including detailed mental planning of methods which I can employ, while weighing up their effort, pain, efficacy, risk of failure, shock to others and more. Nonetheless I don’t see myself committing harm, because I don’t have a will to die nearly as much as a lack of will to live. From my current standpoint, suicide would be an irrevocable and irrational reaction to diseased thoughts, and it might upset a handful of people who ostensibly seem to care about me. I continue living simply because it allows me to work charitably for my friends and community, and because I may find and rediscover purpose in life should I be relieved of this depression.

Causality

Kontaxakis, et al. (2009) reviewed the literature surrounding the psychological effects of isotretinoin and found a strong association between its consumption and conditions including depression. That said, neither association nor correlation imply causation, and I’m sincerely thankful for isotretinoin’s remarkable ability to relieve me of the cystic acne that I had suffered for over three years. 2 Although I haven’t taken it for about a month now, perhaps I’ll never know whether or not it was a contributing factor.

Some may suggest that I’m simply burned out. I’m not sure that this is the case, because I don’t see my set of responsibilities as ever having been particularly large. Whenever I felt stressed, it was a natural consequence of procrastination, which in turn appears to have been caused by my total apathetic lethargy. Thus I continue to search for a cause.

Coda

It’s far too early to say that I have a planned route out of this deep well, and as it stands I’m still trapped here. Writing this entailed a significant amount of effort, as it involved asking myself some serious questions which I neglected to think about in the past.

I don’t want to become that guy to whom you feel obliged to extend a hand, because you fear that it would be the end of me if you don’t; it will not. This is merely a medium through which I can begin to sort my thoughts as the first step towards tackling my own instance of depression. Hopefully what I’ve written may provide you with some value.

References

Australian Bureau of Statistics. (2008). National Survey of Mental Health and Wellbeing: Summary of Results, 2007, 4326(0). Retrieved from http://www.abs.gov.au/ausstats/abs@.nsf/mf/4326.0

Kontaxakis, V. P., Skourides, D., Ferentinos, P., Havaki-Kontaxaki, B. J., & Papadimitriou, G. N. (2009). Isotretinoin and psychopathology: a review. Annals of General Psychiatry, 8(2). doi:10.1186/1744-859X-8-2

Footnotes

  1. Incidentally, the level of effort I invested into doing well at high school was essentially meaningless, as the university I chose accepts any candidate from the top 30% of students. My resultant ranking provided me with a handful of additional opportunities which I knew I couldn’t afford to relocate to pursue, so it was ultimately moot except for a number that I could show off.

  2. Prior to being prescribed with isotretinoin, I had tried topical salicylic acid, benzoyl peroxide, erythromycin and oral doxycycline, as well as oral trimethoprim, sulfamethoxazole and topical adapalene, all with no discernible effect.