• Thoughts About Thoughts

    A friend of mine shared out an article on Facebook this week discussing that everything we think about depression might be wrong. My comment on her thread after reading it was, “I’m having many thoughts about this.” And this was the best way to describe my feelings: MANY THOUGHTS.

    How do we know depression is even caused by low serotonin at all? When he began to dig, it turned out that the evidence was strikingly shaky. Professor Andrew Scull of Princeton, writing in the Lancet, explained that attributing depression to spontaneously low serotonin is “deeply misleading and unscientific”. Dr David Healy told me: “There was never any basis for it, ever. It was just marketing copy.”

    There is a lot to the article, and as someone who has been trying 14 thousand different meds in the last year to manage her depression, I had to fight off a lot of initial shame and defensiveness because the majority of the article was saying that certain meds might not help as much as we thought.

    And as I do with anything that makes me feel a little uncomfortable, I sat on it for a few days.

    And here are my many thoughts.

    THOUGHT #1

    Meds have not been working for me. I’ve been on many SSRIs and SNRIs and I’ll feel good for a little while but then: NADA. So a lot of this spoke to me in a way that said: DO NOT LOSE HOPE. Some of the other lifestyle type triggers he mentioned could apply in my life so maybe meds are not going to help me because low Serotonin may not actually be the cause. Maybe I’ll feel better by focusing on other things.

    THOUGHT #2

    BUT DOES THAT MEAN MY DEPRESSION AND ANXIETY ARE NOT REAL?! That is the shame spiral I immediately fell into after thought #1 and THAT is where I spent a few days and then it hit me:

    THOUGHT #2.B


    Whether your anxiety and depression are caused by chemistry in your brain or circumstances in your life: THEY ARE REAL AND MUST BE TAKEN SERIOUSLY. Just because meds aren’t helping doesn’t mean my problem is any less real or any less serious. Maybe my Serotonin levels have always been fine, but that doesn’t mean my depression or anxiety are fake or non-existent. I AM FALLING PREY TO OUR TWISTED SOCIETAL VIEW ON SADNESS.

    THOUGHT #3

    No one wins a competition of sadness. I don’t need to figure out where I fit on the “severity” spectrum in order to justify various treatments. I need to focus on MY mental health ALONE and not compare it or the treatment to other people.

    THOUGHT #4

    There’s a large part of our culture that says: JUST GET EXERCISE AND YOU WILL FEEL BETTER or JUST EAT RIGHT and this attitude can make someone who feels like shit and very defensive because I CAN BARELY GET OFF THE COUCH, DO NOT TELL ME TO EXERCISE.

    But the lifestyle causes analyzed in this article are even more difficult than getting out of bed if you’re sad. Oh, maybe your marriage is shit? Or your job is shit? Or you don’t have a great friend network? You WISH all you needed was exercise! Maybe you need an entire new career path to feel better!

    Yes – a lot of these things mentioned in the article can make you depressed but IT IS NOT LIKE YOU CAN JUST FIX THEM OVER NIGHT. Changing your career is a luxury most don’t have, fixing a bad marriage requires energy and commitment from two parties or it doesn’t work, and building a friend network of support is one of the hardest things I’ve ever done. So, yeah, maybe those big things could make someone depressed and yeah, messing with their Serotonin won’t fix it, but how do we help that person when those big problems are not easy to tackle?

    I’m glad my only problem is Stop eating cake for breakfast – that’s way easier to fix than How do I build a supportive network of friends.

    THOUGHT #5

    Mental illness is damn overwhelming. All you know is you feel terrible and it’s so hard to motivate yourself to find help. Even saying for the first time out loud to someone like a doctor or a therapist or even a friend, “I’m really anxious/sad,” is nearly impossible. But then to discover that it may take lifestyle changes or medication or it could take BOTH or you could do everything right and still feel terrible and then maybe it’s more big picture stuff like your family is shitty or your career is sucking out your soul or maybe you need to not be alone so much and OH MY GOD I JUST WANT TO DRIVE ACROSS THE BRIDGE WITHOUT FANTASIZING ABOUT HOW EASY IT WOULD BE TO JUST SWERVE INTO THE RIVER.

    (That’s not my particular suicidal ideation, by the way, I’m too terrified of bridges.)


    Being mentally unwell is difficult and our culture is not always supportive and sometimes the causes are too big and the fixes feel impossible and I am just proud of people who get off the couch or out of bed every day amidst that overwhelming feeling of sadness and dread.

    Here’s to fighting the good fight with whatever tools we have, no matter how tired we are of fighting. Here’s to not turning mental illness into a contest of who has it worse by comparing tools used. Here’s to not shaming people who use different tools, and here’s to be open to using other tools if the ones we have are not helping us as much as we hoped, or as much as they once did.

    But mostly: HERE’S TO NOT GIVING UP.