Having Difficult Conversations: Depression Edition

The last couple of days have been hard for me. I’m moving out of my apartment and the whole “leaving the country” thing is starting to get real. That means my emotions have been all out of whack, and I’ve been trying to rely on the coping skills I’ve built up in the past year to deal in a healthy manner. One of the things that I’ve really been trying to practice is asking my friends for help when I’m in a bad place, particularly if I think I’m going to use symptoms. But as I experiment with this, I’ve noticed that there are some serious potential pitfalls to asking for help. As someone who wants to be a responsible adult who manages their emotions without demanding things from other people, I want to be able to ask for help without being manipulative, obnoxious, or clingy.

The first issue I’ve run into is that when I tell someone that I think I’m about to use symptoms (especially self-harm), it can come across as extremely manipulative. “Pay attention to me or else!” it screams. “If you’re actually busy and can’t make time, it is ALL YOUR FAULT if bad things happen” seems to be hiding under “I think I want to hurt myself”. Partially this is your support person’s responsibility: they need to learn that they are not responsible for your behavior, and that a request for help is not the same as foisting off responsibility. Oftentimes when we think we’re going to use symptoms we have to pull out every coping mechanism we have, and even when we do everything right we still slip up and do the thing we’re not supposed to do. That’s ok. Part of being a good support person is knowing that you can’t fix the other person or control their behavior.

All of that being said, there are better and worse ways to ask for help. Any “if…then” statements should probably be avoided (e.g. if you don’t talk to me then I will hurt myself). If you are capable of letting your support person know what it is you want from them, that’s also preferable (instead of just saying HELP, say “I want to talk to you/I want someone here/I want a giant hug and a bowl of ice cream”). One of the hardest parts of this for me is giving the other person a way to say no if they legitimately feel as if they can’t help in that moment. It comes across as super passive aggressive when you say “well it’s not important but…” or “don’t worry about me, I’ll be fine…”. These things seem to imply that you really really actually do want and need the other person you just don’t want to be pushy about it. I have yet to find a really solid method of signalling to my friends that it’s ok for them to say no in nasty jerkbrain situations, but thus far the best method has been to let them know that I do have other people I can go to.

But there is some tension in trying not to put too much pressure on someone while also letting them know that you are really truly struggling. This does actually make a difference because a. if you want help it’s best to be honest about that rather than just trying to chat with someone and then halfway through sliding your problem into the conversation and b. your friend might be a lot more willing to make themselves available if they know what’s up. There’s a balance to be found between signalling that you really could use some help and that your support person should probably prioritize this interaction higher than any old chat, but also signalling that they have the space to set boundaries and take care of themself. I suppose this is just a microcosm of the struggle that is all human interaction, namely finding ways to get what you yourself need while allowing the people you interact with to get what they need as well.

So even asking for help is extremely difficult, but let’s say that you ask your friend for some time and they say yes: one of the other things that is extremely difficult is that when you’re in the midst of a depressive episode, your honest to god feelings are things that are not deemed socially appropriate. They’re things that no one knows how to respond to, they’re things that are ugly and gross and embarrassing. And quite often, they come with an intensity that means it can feel as if you’re beating your friend about the head and shoulders with your Sad!feels.

I have been on the receiving end of an interaction in which one party just throws all of their depression at me. It’s overwhelming and leaves the support person fairly incapable of doing anything useful or helpful. It feels icky and like the individual is fishing for compliments and over the top. Especially when the depression feels are of the self-hating variety, it’s like walking through a minefield (often because the person with the self hatred feels both wants to be contradicted and validated).

The problem is that when you are in the midst of feeling incredibly depressed, you really truly feel that you are the least lovable human being on the planet, and that you’re ugly and horrible and stupid and disgusting and cruel and selfish. And for me personally, I often just want to be able to say those things out loud to get them out of my head. But what do you and your support person do with those ugly words once they’re out in the open? How do you make them something that is ok to talk about and acknowledge and validate while also letting your support person pull you back onto the solid ground of facts and reality?

I mean, if I knew the answer to this I’d probably be making a lot of money off of an innovative therapy technique, but it seems to me that it might be a good idea to ask your support people to set up some ground rules with you before you’re in the midst of a shitty headspace. These might include: no invalidation (I get to feel however I want), if you have evidence that might change my feelings, please present it, or here is our secret signal for when I just need you to listen to how I feel. Conversations in which someone who has a mental illness can actually tell another person what they feel about themselves without being judged and without putting pressure on the other person to fix or reassure are few and far between, but they also have the potential to be transformative. While they are difficult and terrifying and vulnerable, they also illustrate to someone with mental illness that those bits they feel the most shame about are acceptable and wanted. I’m still working on my scripts for these conversations, but hopefully we can share them as we make them.

Changing Habits: The Reaction

In the process of treatment and trying to recover from the grab bag of mental health issues I have, I’ve made a serious effort to change many of my habits. Everyone knows that changing habits is hard: adding a meal where there was none requires a fair amount of effort and planning, adding in more socialization requires thought and energy, changing emotional habits is one of the hardest of all. Everyone knows that in order to change a habit you need to do something consciously for many months before it will begin to become ingrained (generally experts say 1-3 months).

And yet despite the amount of personal effort that I’ve put in to changing my habits, the thing that has actually been the most difficult has been the reaction of those people who are closest to me. People act confused, they tease, they joke, and often they make a big deal out of small changes. I’m going to take one example that’s a little bit trite, but sticks out to me as an example of how difficult it is for others to see you in a different light and how that can affect your ability to make changes long term.

I have a sweet tooth. I love chocolate, I love cake, I love ice cream. For most of my life I have never passed these things up. In the process of dealing with my eating disorder, I’ve made an attempt to make my eating more even and balanced: to pay attention to my hunger cues instead of simply eating if something tastes very good or if I force myself to, to stop when I’m full, to eat when I’m hungry. This means that I’ve also been trying to be more careful about not simply asking for ALL THE CHOCOLATE whenever it is offered to me. When I do that, I often feel guilty, unwell, or just angry at myself, and I often feel as if I’m binging if I eat sugar simply to eat sugar.

The other night I said no to a piece of cake at a family gathering. I got stares, exclamations of “Are you ok?”, people feeling my forward as if to imply that I were sick. Needless to say, this was not helpful in affirming my decision to listen to my body that it was full and didn’t want cake. Of course in this situation I didn’t feel I could explain my choice so I muttered something about not liking carrot cake and tried to make myself small.

Obviously it makes sense to comment on something that has changed, or to continue treating someone based on their past behavior if you don’t have an indication that they have changed. However over the top reactions really can make someone feel singled out and belittled for their changes, as if they’re weird or wrong for trying to make those changes.

In general, people don’t want to hear your negative comments about their changes.  Not only do they have to be mindful of making the change, but they have to continue to justify it to themselves every time it’s pointed out, and even if they don’t it certainly feels as if they do. Ideally, changing a habit is about simply doing something different without even noticing that it’s different: it’s habit when you do it without thinking. Drawing attention to it makes it so much harder to have it become second nature.

People expect you to be the same always. When you change habits, you are changing your identity to some degree, and people don’t always take kindly to that. Other people also have to learn to see different things about you, and it’s easy to fall into the mold that others expect of you. You see this when you hang out with someone you haven’t seen in a long time and act in ways you haven’t for years. So if others continue to expect something of you, it requires extra resolve to do something different, to be clear that what you want now is not what you wanted in the past, and to communicate to those around you in a polite fashion that you are different now. Each time someone remembers the old version of you, you’re left grappling with that self as well.

An added difficulty is that oftentimes family and friends may not realize how difficult or serious a choice that you’re making is. They may joke or tease, when you feel you’re doing something important and hard. When that happens, it can feel like you’re stupid, oversensitive, or just wrong about the importance or difficulty of your choices. It feels like you’re going crazy, as if your reaction to things were totally irrational and you should be ok with joking or light-heartedness. Imagine if you made a choice to improve a serious physical health issue and people teased you about it: it certainly would not feel easier.

So this is a general plea: if you know someone in your life is in the process of making some big life changes, let the little changes slide too. It may be better to ask someone about a change when it’s not in the exact moment so that they don’t have to go through the momentary personal crisis that is reminding themselves why they’re not eating that piece of cake. A quiet comment or question when someone makes a decision out of the ordinary is one thing, but it is unnecessary to make a big deal, and can make the person feel as if they’ve been put on the spot or as if they have to defend their actions to you. And for those who are making changes, letting others know ahead of time can take the pressure off of you in the moment, even if you just tell one or two trusted people. It makes it easier for them to run defense and change the subject.