Friday, January 20, 2017

High Functioning Depression, Part One: What Is It Like?

High functioning depression: A form of depression that is hidden from others, thus allowing a person to function in a seemingly normal manner.

I've contemplated writing this post for quite some time, but some recent events compelled me to talk about this largely unknown problem afflicting many of us. Most people are familiar with depression, especially given that it's exceedingly common. So much so, it's sometimes referred to as the "common cold" of psychological disorders. One type of depression is especially worrisome - high functioning depression.

Typically, this version of the disorder is experienced by relatively high-achieving people who seem to really have their shit together. They usually have an education, a steady job, can maintain relationships, have a circle of friends, and usually seem to lead happy, fulfilling lives. 

And it's often a facade. 

In reality, these folks often go through significant periods of time where they can barely hold it together. When they're experiencing a strong depressive episode, the smallest, most mundane daily tasks become Herculean efforts. But they can still sorta get through life because the depression symptoms aren't severe, they have developed phenomenal coping mechanisms, or some combination of the two. 

I rarely if ever talk about it, but this is an issue I've struggled with mightily in the past and is still with me today. Most of the time I'm completely normal. Sometimes, though, I fall into a chasm of depression. It's kind of hard to explain the experience to someone who has never experienced it, to the point where "non-depressed" me has a hard time empathizing with "depressed" me. The experience goes something like this.

I don't experience some of the more common, stereotypical symptoms of depression. I don't feel sad. I don't cry uncontrollably. I don't feel overly emotional. My eating isn't significantly disrupted, nor is my sleep cycles. Instead, I experience severe apathy (I don't care about anything), lethargy (I do not want to exercise), anhedonia (things I normally enjoy are no longer enjoyable), and irritability (small shit gets blown up to big shit.)

When I feel normal, I'm... well, normal. I worry about the welfare of those I care about. I have concern for the world around me. If there are tasks I need to do, I have no problem doing them. I thoroughly enjoy exercise, socializing, and experiencing new things. I'm laid back, calm, and even-tempered. I'm usually warm, marginally funny, playfully antagonistic, and charming. I have tons of energy, I'm creative, I welcome challenges, and I'm excited to learn new things. Today, this describes me about 80-90% of the time. In the past, this described me about half of the time. I consider myself lucky because my experiences with this ebb and flow. Most of the time I really am happy and fulfilled. Others aren't so lucky. Their experiences with depression are persistent.

My typical day goes something like this: I wake up without an alarm somewhere between four and six in the morning... maybe put the moves on Shelly. I have no problem getting out of bed. I make coffee, start breakfast, and check email and social media. I get the kids ready for school. If I'm subbing, I get ready for work. If I'm not subbing, I usually do a little writing, hit the gym to lift, then head to my real estate office. If I'm subbing, I joke around with the students. If I'm going into the office, I joke around with my coworkers, talk shit, talk about jiu jitsu, and sometimes actually do real estate stuff. I look forward to going to lunch and love trying new restaurants. After work, I pick up the kids, chat with them for a bit, then cook something for dinner. If there are chores that have to be done, I'll do them now. After Shelly gets home, we often train jiu jitsu at night. I look forward to seeing my training partners and thoroughly enjoy honing my skillz on the mat. We go home, have a glass or two of wine, watch some TV, then go to bed. It's a lifestyle I love.

When I'm in a depressive state, my behaviors change radically depending on the severity. Most of the shit I normally care about falls into the "I don't give a fuck" bin. Any task, no matter how menial or important, becomes almost impossible to do. I want to avoid people, especially if it involves driving or shopping. The smallest, most insignificant annoyance becomes exceedingly irritating and I have great difficulty letting minor shit go. 

My typical day goes like this. My alarm goes off at 5:15. I hit snooze three or four times, then reluctantly roll out of bed. Sometimes I make coffee, but most of the time I either go without or drink whatever's left over in the pot. Instead of cooking something, I eat leftovers or some kind of pre-packaged food. Sometimes even opening a banana is too much. I drop the kids off at school, get annoyed at other idiot parents dropping their kids off, then either go to school or go back home. If I'm subbing, I go through the motions. Luckily, I'm good at teaching and "autopilot" still better than the vast majority of my substitute teacher cohorts. I'll usually talk myself out of lifting by convincing myself I have more important matters to attend to. If I'm going to the office, I kill time mindlessly surfing the Internet. When I get to the office, I do whatever needs to be done, then mindlessly surf the Internet or play games at my desk. I usually avoid going to lunch because I do not want to socialize, even if it's just the waitstaff. I'll usually go home for an hour or so before picking up the kids. I'll avoid doing chores, but may do something trivial like fold a towel just so I don't feel like a complete lazy ass. I don't care if the house is a disaster. I'll then pick up the kids and give them a task to do so they won't bug me. If they're hyper, I usually yell at them, then feel guilty. After Shelly gets home, I'll often come up with a reason to skip jiu jitsu. Sometimes we go out for a drink or two, but most times we just veg on the couch until bedtime. 

The real key to this - I simply do not care about almost everything, and I cannot will myself to care. I have zero motivation to do anything. I can force myself to do the necessary shit like grooming, eating, taking care of the kids, and work responsibilities, but it comes at a steep cost. Whenever I'm in a depressive state, doing anything produces a degree of anxiety. The more I have to do, the more anxiety I develop. Irritation and anger also increase with anxiety. Eventually I'll reach a breaking point where the anxiety is physically and mentally crippling and I simply cannot continue doing what I have to do. I can't focus, I can't think, and my coordination goes to shit. The slightest things will annoy the hell out of me, and I'll dwell on them forever. This becomes even more difficult if people expect me to do stuff for them and insist on it being done immediately. It's kind of weird.

An example - a few weeks ago, I was having a pretty severe depressive episode (which is rare these days.) I had a ton of forced socialization throughout the day, which included having to run a bunch of errands during the holiday shopping rush. At my last stop, I was in a self-checkout lane at Walmart. The dude in front of me couldn't figure out how to insert a dollar bill into the machine. I already felt like I was on the verge of a panic attack. It was EXTREMELY irritating, which turned to anger. WHAT KIND OF FUCKING MORON DOESN'T KNOW HOW THESE WORK?!? It was like the dude was clubbing one of my cats. It took a good three hours for the anger to pass. 

Had I not been in a depressive state, that dollar incident wouldn't have even registered as something that would irritate me. I would have just perused the candy or picked up a copy of Cosmo and read about the latest orgasm techniques. 

The difference between the two conditions is dramatic. In the past, the outside observer, even those closest to me, probably would never see the difference between the two conditions. When I was in a depressive episode, I went to great lengths to hide it. I'll explain that rationale in a future post. Over the last 12 to 14 years, though, I've made a conscious effort to live as authentically as possible and no longer go to great lengths to hide the depressive episodes. Of course, I also don't talk about them, but they would be obvious to anyone who has even the faintest ability to read people. 

Part of the reason I don't talk about it is because I really hate the inevitable reactions, which are either a) pity, b) people treat you like you should be involuntarily committed, c) they say something dumb like "just get over it", or d) they don't believe you and assume you're making excuses for being lazy and/or grouchy. 

My answers to those: Fuck pity; this issue does not make me a not a danger to myself or to others; if there was a way I could "get over it", I would have done it already; I hate being lazy, which should be evident by the shit I do when I'm not in a depressive episode (travel extensively, write books and a million blog posts, run ultras, train bjj and mma, etc.)

The other reason I don't talk about this is because it often invites others to ask for advice, guidance, or to treat me like an emotional tampon. I am not a therapist. While I have a psych degree, it's experimental, not clinical. I was trained to fuck with people, not help them... which is pretty much what anyone should expect if they're coming to me in place of a qualified therapist. 

Anyway, this is a brief explanation of what it's like to have high functioning depression. In future posts, I'll talk about how this has changed over time (spoiler - I've gotten far better at handling it to the point where it's now a slightly-annoying-but-now-useful state.) I'll also talk about the specifics on how I learned to deal with this by identifying the triggers and developing effective coping mechanisms. 

In the interim, I'd be happy to answer any questions about what the experience is like. For people who do not experience this, it's hard to empathize. Hell, "normal" me has a hard time understanding "depressed" me. So if you have a question, leave a comment. 

PLEASE do not leave a comment seeking help from me if you or a loved one is suffering from depression. As I said before, I am not a therapist and am not qualified to help people. More importantly, I do not want to help individuals with depression. I have enough shit on my plate and I do not have a compassionate personality. However, I don't mind if you share experiences in the comments. 


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