Mental Illness

All Alone in a Crowded Room: Depression and Isolation

These days, it seems like half of everyone I know is on anti-depressants, and I’m a little conflicted about that. On one hand, I’ve personally been on the receiving end of the stigma and all of the worst judgmental attitudes that accompany mental illness, and so anything that de-stigmatizes depression, mental illness, and psychiatric care is a good thing in my book.

On the other hand, the cynic in me thinks that out of all of those people, there surely must be some hasty or incorrect diagnoses. And on a third, anatomically-incorrect but especially wise hand, I realize it’s none of my business; I don’t know these people, their lives, their doctors, or their brains. And just as I’d hate to have anyone judge me for the way that my illness manifests itself, I really can’t impose my own experiences on other people regarding what is an intensely personal situation. And that’s the problem with depression. It’s so personal, so isolating, that we think no one else can possibly experience what we have.

In the seventeen years or so that I’ve been actively dealing with my mental illness, I’ve had six different diagnoses. I was diagnosed as bipolar while still in high school, and was put on lithium and Valium. That’s when we figured out I was misdiagnosed, big time. Since then, I’ve had a variety of treatments, some of which worked, some of which kind of worked, and some of which made me worse than when I started. My current doctor is a firm believer in the patient having input into their own treatment, and since I’m somewhat of an obsessive researcher, this works out well for me. I’ve been seeing the same doctor for about eight years, and we have a good routine, and he knows my brain pretty well. Our treatment plan consists of treating my symptoms, rather than a particular diagnosis, and that’s been working well. I’ve been in therapy a number of times over the years, which has been helpful, but I haven’t been in a long time, as my illness, as I experience it now, is far more chemical than situational. I also have an anxiety disorder (or possibly a panic disorder, or maybe both- we’re still working that one out), and this is my “visible” illness: the social anxiety, the sudden sensitivity to noise and crowds and too many things going on, the paralyzing fear of walking into a public place I’ve never been before, the decision that it’s easier to stay home than to go somewhere new; all of that is out there and hard to hide. Depression, though, is harder to spot if you don’t know what you’re looking for, and so it becomes a secret illness, one you try to hide and one others can’t really see.

In the beginning, I tried my absolute hardest to keep my illness and the fact that I was medicated hidden, but it wasn’t a secret to my closest friends and my family, and I received some surprisingly harsh reactions from those who were closest to me. I had one parent who was completely supportive of my treatment plan, and one who wasn’t. My supportive parent had been diagnosed with a similar illness a few years prior, and was a strong proponent of medical treatment, even though it was not the norm at the time. My other parent, while very clearly wanting the best for me and having had a difficult time with seeing me in the worst stages of my illness before medication, made pretty clear that they thought I was just having “moods,” and that psychiatric care and medication was an unnecessary crutch, especially in a teenager. (Ironically, fast forward about fifteen years, and that parent is now medicated and extolling the virtues of psychiatric medication. I’m more glad that it’s working out than I am upset over the shift in opinion. It took me a while to get there.)

Meeting other people who have been diagnosed with and are being treated for mental illness is a relief, in a way. Depression, especially, is an inherently solitary illness, and though knowing that other people are suffering it doesn’t make you any less depressed, it does go a long way in feeling a little less isolated. Hearing other people talk about their depression, though, sometimes perplexes me, because I’ve been living with it for so long that I sometimes forget that other people’s experiences can be so different from my own. I hear others describe their depression in a way that sounds very much like me when I’m in a slightly melancholy mood. I rarely meet anyone who can identify with me when I talk about what a depressive episode is like for me.

My depression manifests mostly as a complete lack of drive, motvation, and energy. While that sounds pretty common (I mean, doesn’t everyone sometimes feel like not doing anything?), this lack of drive means I can’t gather the energy or desire to lift my head from the pillow, to get out of bed, to take a shower, to eat breakfast, sometimes to even pull the blankets up after they’ve fallen to the ground. A trip to the kitchen is unfathomable. Summoning the ability to have a conversation is impossible. My mind seems incapable of creating new thoughts. I’m thinking about nothing, in the scariest sense possible. When a thought does enter my head, it’s generally self-defeating and negative. I’m convinced I’ll never snap out of it, that it’s not worth it to even move to the next room. I cut off all interactions, whether in person, on the phone, even online. I avoid my usual Internet communities. I convince myself that I have nothing of value or worth to say, and that even if I did, no one would be listening. I frustrate my friends and family, who want nothing more than to see me happy, but often don’t realize what an impossibility “happy” can be. In the midst of a depressive episode, I’m completely alone, no matter how many supportive people are around me. And I want to be alone. I want everything to be quiet and still and I don’t want to have to try to spend any of my tiny reserve of energy on trying to act normal for the people around me.

So when I say that knowing other people with depression and other mental illnesses are all around me is reassuring and makes me feel more “normal,” I say that with the pretty major caveat that I know I’m not exactly normal. It’s not that I just get sad sometimes. I shut down. I turn off. I lose my ability to function in any sort of way that’s productive. And I just can’t believe that there are other people, with my diagnosis, on the same medications I take, who are going through this, too. I feel like they must handle it better. They must have it all managed. And then I realize that they’re making that part of them invisible, too, just like I do. So there’s a whole bunch of us out there who are all feeling completely isolated, totally solitary, due almost entirely to the fact that the very thing that we have in common makes us think we’re all alone.

And that’s why I feel it’s important to talk about it. Maybe someone will read my description of my depression, the same situation I find myself in, over and over again for the better part of two decades, and that person will have a name for the things they’re feeling. They’ll know someone else is going through it, too. Because no matter how well you manage mental illness, it’s still always there. And I’ll admit I’m guilty of thinking that many of the other people who say they’re depressed, who take anti-depressants, who carry that label around with them, aren’t really depressed. And I think this because their experiences are different from mine. But having lived for so long, going through things that other people can’t or don’t understand, trying desperately to make it clear that I’m not just sad or upset or having a bad day, well, you’d think I’d be more understanding.

But just as depression is inherently solitary, it’s also inherently selfish, in the strictest sense of the word. You withdraw so far into yourself that you are unable to think of other people. So I feel I owe it to myself, when I’m at a point when I can articulate myself and share my experiences, that I talk about it. Sometimes just knowing that someone else knows exactly what you’re talking about can make all the difference, even if you aren’t interacting with them. So while a support group for people with depression wouldn’t be a viable option for me, if only for the fact that when I’m having a depressive episode, it would be a physical and mental impossibility for me to get up and go to a place where I’d have to interact with other people, just knowing that my experiences are shared by others is a little spark of support. And sometimes, a little spark is all you can hope for.

8 replies on “All Alone in a Crowded Room: Depression and Isolation”

Some great stories in response to the original post. May I say, AW, what an excellent piece of writing, as well as a very interesting one. You were/are nicely articulate – so thank you!

I was diagnosed a few years ago with Bipolar II (although depression really reared its head a few years ago just after the birth of my son/first and only child). I am very lucky to have a wonderful psychiatrist who is excellent on the psychotherapy as well as the meds. I also get to see him as my consultant psychiatrist when i have to go into hospital (a public hospital at that – so covered by Medicare and effectively free).

While your depressive episodes sound like they could be classified as at least “profound”, mine have been, at worst, “major” (major, major depression). And while I haven’t had it ‘as bad as you’ in terms of severity of ‘dysfunctionality’, let me say that nonetheless I have experienced some of those major symptoms of anergia (I think it’s called) etc where the effort required to get out of bed or have a shower or engage in otherwise very ordinary activities is so immense as to be unachievable or virtually so. Before depression I would never have thought that you need ‘psychological energy’ to get on with every day tasks – basically because it had never before been an issue.

I like your honesty about sometimes feeling like judging others for having depression that’s nowhere near as bad (esp if they don’t seem to have a clue about the kind of symptoms you’ve had). Tho’ my postnatal depression (PND) was definitely made worse by the fact that I’d constantly say to myself – “these other mums have it far worse off than me, so I have nothing to complain about and should be coping at least as well as them!” And we all know where beating oneself up (and feeling guilty) lead you when you’ve got depression….

In desperately trying to find out more about the kind of bipolar II I have, I have managed to come across some material that speaks more about the kind of experiences I have with my depression. In particular, a couple of papers which talk about experiences of Bipolar II as a chronic depression with little if any normal spells between classically major depressive episodes – that 60% or more of the year most people with BPII suffer from some level of depression which is debilitating and affects functionality. These ‘lesser’ depressive times might seem far less severe but in fact, they are equally dangerous times for sufferers in terms of suicidal ideation etc.

I really liked the way your put the ultimate reality of MI, even with excellent interventions etc – “Because no matter how well you manage mental illness, it’s still always there.” I’m slowly making significant headway in being able to take on more. For example, being able to continue with study once again; being able to cope with having to look after my son a couple days a week after school without going into a blind panic & feeling totally overwhelmed; being able to, with support, advocate better for myself. My psych. and I are slowly improving on and tweeking my medication regime to give me more freedom, energy and motivation.

I am so glad that you wrote this story. I have been writing something similar in my head for awhile now. I have always been a short tempered stressed out person since the day I was born….that is my personality. It wasn’t until the birth of my youngest son that the depression hit. I had severe pre-eclampsia and was put into the hospital to begin the labor process. I had told my Dr. about how fast I deliver and how crazy it was when I had the same diagnosis with my first child. She promised me it was just a one off and everything would be fine. WRONG! I had extremely high blood pressure and was given the Cervidil. Contractions started right then and there. A few hours later I was given an epidural. For whatever reason my BP fell to record lows. I might as well have been dead. My Dr. came in at 8:40am to break my waters because I was at 6cm. I could barely open my eyes for this. At the same time my husband decided this would be a great time to go downstairs to the coffee shop for breakfast. My Dr. left and all of a sudden I could feel everything and baby was coming down QUICKLY!! I only had a nurse and she was rushing around like a fool. 9am my son was born without anyone there to catch him, without a Dr., without his Father present. He literally shot out onto the table and what should have been the most precious moment of my life turned into a horror story in my head! My Dr. and husband rushed in about 2 minutes too late. I couldn’t believe that they missed my baby come into this world. What I stressed to my Dr. that I DID NOT want to happen….well, it happened! You ask how my depression started from this……???

Well, from the moment I came home from the hospital I had this horrible empty feeling and grieved that my son was no longer in my belly. A feeling I never had with either of my two girls. I figured it was just down to the stress of the birth because I wasn’t ready for him to enter the world as he did and that I also had 2 older daughters. I am a Mom of 3 now. Get a grip and move on. No one knew what was going on in my head. As time went on I now realize that close friends could see a HUGE change in me but of course I was in DENIAL! I started hanging around “friends” that were down in the dumps and brought me down with them. Not good for someone who is down themselves already. I ended up losing quite a few of my good friends a few months later because I was an ass….a totally depressed ass! For some reason one them decided to stick by me and eventually help me realize what was going on. She suggested going to see someone and I did. I have literally taken most anti-depressents out there. I get what my Dr. called the Prozac poop out. His words exactly. After 6mths or so they decide to STOP. Not fun…let me tell ya! I get to a point where I shut the world out, extreme temper, and read suicide quotes and think about dying non-stop!

I did eventually go to talk therapy and she helped a lot. We found a medication that (knock on wood) hasn’t pooped out on me! Made me realize that a lot of things stemmed from my childhood that were finally coming out. I deal with this everyday and I do find it reassuring that I am not alone in this world with these feelings. I wish there was a way we could all reach out and help each other. Maybe these writings will do that. Just to know we are NOT alone. To know that we all “cope” in extremely different ways.

I will leave you with one of my favorite quotes about how I feel living with depression and when I get tired of pretending…

“You say I’m always happy, and that I’m good at what I do, but what you’ll never realize is, I’m a damn good actress too.”

I am struggling with depression too and am being treated for it. My family has a history of mental illness. My dad’s depression was SO severe it brought on early onsest dementia. He is 60 years old, and the symptoms started years and years ago. The doctors said he had been in a deep depression for a very long time and never came out of it. Never got treated for it. Never acknowledged he was depressed. I guess he saw it as a “weakness” and didnt admit he had a problem.
I KNOW I have a problem, and have sought help for it. I have been through counseling and am taking the right medicine, but what is most important is that I have an excellent support system. I won’t end up like him,…60 years old, unable to speak, in diapers and having to be monitered in a home 24/7 by a staff of nurses.
Sometimes, though, I still want to just be by myself, to sort through my thoughts and feelings on my own. To be allowed to cry and be sad, without someone asking “whats wrong?” and me having to explain the multitude of thoughts and emotions in my head. Your article was just what I needed to read. Thank you.

I have depression and ADHD so at any given moment I have about 1.000.000 thoughts whirring in my head. This comment may not make a lot of sense by the end of it but I’ll give it a shot.

I’ve noticed that with my depression, one of the dominant thought cycles is that everyone else is coping with life so much better than I am. They can do it. Why can’t I? Therefore, I must isolate myself to figure out just how I can function like those people. It only makes sense in my warped depressed mind, and it’s a great way to convince the mind to stay depressed. I also heavily mask it with a sardonic sense of humor when I do have to interact with people. I find that people who crack the most jokes often are masking some deep emotional pain. Better to laugh than cry in the company of others!

Turns out that everyone I know has some sort of problem they must deal with, especially related to physical and mental health. We as a society expect people to behave well and especially at work, which is where most of us end up interacting with people. And as a woman especially, you can’t show up to work crying if you want to be seen as productive (whatever that means in the first place). Loss of self-worth, hope, and anxiety are never supposed to show. Good luck with expecting all people to behave as automatons.

For what it’s worth, I have very similar symptoms when I’m in a depressive episode. For about two months earlier this year I had to write myself notes that said “You must eat today.” I was hungry but didn’t have the energy to boil a pot of water. I’d eventually have something like a meal around 4:00 p.m. but the urge to eat didn’t come back until allergy season. Then the urge to eat was masked by the urge to self-medicate with sugar, something I am just now trying to get over. What I find most agonizing about depression is that little revelations can take months to figure out, or even years, and then reversing them can take just as long. Now that I am improving I am trying to push myself in little ways every day until eventually I become a not-so-depressed person. Time is the enemy in depression too, because I’ve been able to convince myself that I’ll never get out of a depressive episode EVER because this is how life is supposed to feel. And the more an episode drags on, the people around me lose patience that it’s still going on and start asking what I’m going to do about it, when I have no energy to do anything about it.

Recently I remembered, though, that life isn’t supposed to be like that!

I’m lucky that my best friend in the world is so loving and understanding. She as well has had her share of depressive episodes, so we know how to help each other out. Getting the energy to reach out is the first step.

I think you’ve struck the nail right on the head when you say that depression is so personal and isolating that we find it impossible to believe that other people are going through the same stuff. I have also found myself judging people who say they have depression thinking that they are coping way too well to really have it. This is obviously not OK to believe and I am sure people might say the same about me. I also found it interesting that you mentioned the anxiety and social anxiety- you’ve described exactly what I feel. I know I’m not alone! Sometimes I look around and wonder how EVERYONE else is able to enter into different situations so easily. It is nice to know that, as you said, someone else is going through it too.

And lastly, this part really struck me:

And I want to be alone. I want everything to be quiet and still and I don’t want to have to try to spend any of my tiny reserve of energy on trying to act normal for the people around me.

There are so many days where this describes me. I just want to be alone; sometimes to wallow in my misery and sometimes because I just don’t want to deal with people.

Thank you for writing this.

I wonder how other people do it, too! I feel like such a failure when everyone else can do all these things that I just can’t. It makes me just want to quit. I’m in therapy now for my social anxiety for the second time. The first time seemed to help, but it definitely didn’t do what I needed. As far as depression, I could get out of bed and “function” as far as go to work and go my job, but I was miserable and took it out on everyone. I have never been so mean in my life. And weekends were spent comatose in my bed. Sometimes crying, but most of the time just not even caring anymore. With the help of medication, I was able to get myself out of that situation that was enabling my depression, but I know it’s always there and can be triggered. It definitely makes me more conscious of what I put myself through.

I’m also really happy we (in general) can talk about these issues so openly. When I began dealing with my depression and, later, social anxiety, my parents began pouring out all these stories about my family’s history I never knew, that no one ever talked about. I wish they had felt like they could be honest about difficult things – maybe I wouldn’t have felt like such a failure when I had to take a pill to fix my own life.

I do know where you are coming from. I struggled with depression and anxiety my whole life, but never put it into words. My parents were very emotionally unavailable people and I was taught from birth that ‘stepping out of line’ was NOT acceptable. So I learned to hide my anxiety and depression. As I got older it got worse, and my symptoms manifested themselves in more damaging ways, but always ways that could be hidden. No one ever knew about the dark turbulence inside me. My last pregnancy was life-threateningly complicated which challenged the privacy of my anxiety so much I had a breakdown in the nicu after my son was born. I started on a downward spiral of depression so severe I knew I needed to get help or things would get really bad.
Getting help was the best thing I ever did. I learned that I have OCD, I was suffering from PTSD, and I was clinically depressed. I was in serious therapy for 2 years. I learned to recognize the stain of anxiety on some of my earliest memories. I came to terms with my illness, and started opening up about it. Like you said, it helped me so much just to be able to talk about it. To find others who felt the same way. To not have to feel like I had to hide that part of me because no one would understand. In fact, some of my friends have told me that they would not have come to terms with their depression if I hadn’t shared mine. It helps, in unspeakable ways, to know that you are not alone. The demons that we have may not be the same, but knowing that I’m not the only one with demons makes me feel better.

I will say though, the one thing that pisses me off the most, is the people who know me who just don’t get it, and don’t want to try. When I explain that I have an anxiety disorder they say things like “Well, yeah, I’m stressed out too. Who’s not stressed?” Or even worse “Really, I just don’t see it….you seem so, well, like you’ve got your shit together. How bad could it be?” Makes me wanna bitch slap some one!

I think that’s the worst thing in the world to say and it’s what everybody says. “I get sad too, sometimes,” or “In college I was so depressed after my boyfriend dumped me. But then I got over it!”
They’re trying to be helpful, but it’s so awful. I tell them instead, OK. Imagine feeling that way All The Time, for no reason. No reason at all. Your job is fine, your relationship status is okay. There’s nothing you can point to that explains your sadness, but you still feel like jumping off a 10-story building, all the time. Imagine that. Because that’s what it’s like for me. And then I get blank stares, just blank stares and an uncomprehending nod. Meh.
None of my friends or family ever knew how I felt, and so it’s impossible for them to believe that i could be this way. And after a few conversations like that, I learned not to tell anyone about it at all.

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