“It is not pleasant to experience decay, to find yourself exposed to the ravages of an almost daily rain, and to know that you are turning into something feeble, that more and more of you will blow off with the first strong wind, making you less and less. Some people accumulate more emotional rust than others. Depression starts out insipid, fogs the days into a dull color, weakens ordinary actions until their clear shapes are obscured by the effort they require, leaves you tired and bored and self-obsessed- but you can get through all that. No happily, perhaps, but you can get through. No one has ever been able to define the collapse point that marks major depression, but when you get there, there’s not much mistaking it.”
― Andrew Solomon, The Noonday Demon: An Atlas of Depression

A friend of mine feels they may be in a depressive spiral, and said something along the lines of: “I’m depressed because I’m not doing anything, and I’m not doing anything because I’m depressed.”

Whether someone has fallen into the downward slope of depression by way of genetic or environmental factors, the results are remarkably similar:

• Less energy

• Eating too much or too little

• Sleeping too much or too little

• Little to no excitement for activities that previously gave pleasure

• Irritability

• Restlessness

• Trouble concentrating

The spiral isn’t the worst part — knowing that you’re in the spiral is the worst. From my own experiences and conversations with fellow depressives, one constant in our experiences is that our logical faculties remain intact through the worst of the spiral. I liken the feeling to being in a pressure vessel slowly descending into the depths of some anonymous ocean trench. We feel isolated, and we’re always aware of the increasing pressure as we miss deadlines at work, calls with friends, and instead resign ourselves to an eventual fate of being crushed from all sides. Through all of this, we’re painfully aware of a giant red button marked, “EMERGENCY ASCENT,” that is well within reach, but we’re unable to press it.

I’ve lost count of the number of times I’ve been in a steep depression and been fully conscious about what actions will make my immediate circumstances more bearable, but completely unable to do a damn thing. It’s a strange mental paralysis, and it’s infuriating.

Depression is sometimes described as “anger turned inward” because a person in a depression doesn’t get angry at anyone but themselves. Oh, we may lash out and be more disagreeable to our friends and family, but we reserve our harshest criticisms for ourselves:

• “You’re pathetic. Just get out of bed.”

• “What’s the point in finishing that project? Your work is already awful enough; might as well stop.”

• “You know what to do, but you just won’t do it. You’re lazy!”

These thoughts repeat endlessly on the playlist from hell in the mind of someone sliding down the depressive spiral. Fortunately, there is a solution: other people. I’ve crawled out of every one of my depressive spirals with the help of medical professionals, friends, and family. Currently, I rely on weekly (sometimes daily) check-ins with my mom, dad, and sister. I have a few friends that I’ve given explicit permission to ask me how my mind is if they feel something is off during any conversation. I live alone, but my family has the code to my apartment door to come in if I’m not answering calls or texts. I have my therapist on speed dial, and the contact information for the Emory ECT department saved to my phone.

I maintain this level of support because I live with a permanent condition. I will have another serious depressive episode in the future. It’s merely a matter of when. I’m more likely to survive because of all these preventative measures, but what about someone who is spiraling into depression for the first time, and doesn’t have these built-in safety measures? Here’s the best I can offer:

• Early Intervention

  • Call or text someone.

  • Get to a doctor or therapist. If you don’t have the energy to drive, ask someone to get you there.

  • Do anything. If you can’t get out of bed, roll to the other side. Minimal action is still action, and action tends to breed more action.

  • Play some upbeat music. This helps compete against the repeating internal thoughts.

  • Watch something funny. Doesn’t matter what. If you can sustain your sense of humor early on, you up your odds.

• Crisis Resources

  • If you or someone you know is in an emergency, call 911 immediately.

  • If you are in crisis or are experiencing difficult or suicidal thoughts, call the National Suicide Hotline at 1-800-273 TALK (8255)

  • If you’re uncomfortable talking on the phone, you can also text NAMI to 741-741 to be connected to a free, trained crisis counselor on the Crisis Text Line.