The little things that kill: living with depression

As humans, I think we’re programmed to believe that only the big things matter. As kids, we innately believe that accidentally breaking the TV is worse than deliberately breaking a pencil, and even though we develop a better understanding of morality as we grow older, we continue to associate damage with size. I’ve argued before that we can see evidence of this in conspiracy theories, as we mistakenly believe that large effects must have equally large causes, and so invent labyrinthine plots to fit reality to our preconceptions, rather than our preconceptions to reality.

The same is true when we look at our lives. We spend so much time looking at the ‘big picture’ – our income, job, achievements, social status, family relationships – that we miss the little details that make up the whole. So often we reduce the wondrous complexity of our individual experience to a linear sliding scale, with ‘success’ at one end and ‘failure’ at the other, and pigeonhole ourselves as monolithic entities, without appreciating that we are a multitude of successes and failures, strengths and weaknesses – we are not the sum of our parts.

Yet despite knowing better, we apply this same misunderstanding to mental health.

In the media, in fiction, among our families and friends, the emphasis is always on singular, disproportionately large and simplistic explanations. A person is depressed because they’re single, or they lost their job, or they’ve suffered a bereavement; they kill themselves because of a relationship breakdown, money worries or a sudden trauma. It’s comforting to think like this, because it means the causes can be identified, and therefore treated. Like a weed growing in our minds, all we have to do is cut out the roots, and the mental illness will wither and die.

Unfortunately, it doesn’t work like that. For most of us with lifelong depression, it doesn’t have a single identifiable cause. It’s not a weed that can be excised, but a symbiotic parasite so interwoven throughout our being that the only way of killing it is destroying the host. I’m always suspicious of people who say they used to be depressed but they’re now ‘cured’, because I don’t believe it ever really goes away. Sometimes you’re winning, sometimes you’re losing, but you never stop fighting, and just as in any war, there are casualties in this conflict that can never be made whole again.

What people don’t want to acknowledge – what is perhaps terrifying to accept – is that there are millions of causes of depression, most of them so small and inconsequential that they pass us by unnoticed as the parasite slowly winds it’s way into our bodies. You don’t suffer a shock one day and wake up the next with depression – if only it were that easy! No, it creeps up on you, little by little, so that by the time you realise how much of a hold it has on you, it’s too late.

It’s the everyday things, the little things that don’t seem to matter, that lead you into depression. It’s the family get-together you skip because you can’t face the hassle. It’s the meal you miss because you can’t be bothered to cook. It’s the text message from a friend you mean to respond to, but put off so long you no longer know what to say. It’s the hobby that you can’t seem to find the time for any more. It’s the chocolate bar you insist is a one-off treat as the empty packets pile up around you. It’s yesterday’s clothes you put on because it’s too much effort to pick out a new outfit. It’s the letter you don’t open because it looks scary. It’s the lawn that grows too long because there are more important things to do. It’s the cross word with your partner that doesn’t get resolved. It’s the walls you put up against the people you love.

And it’s the escape you sink yourself into, the dark pit where you can curl up and feel safe. It’s the irritation you feel when people try to reach out to you. It’s the excuses you use to avoid anything that might help. It’s the growing awareness of how awful you feel, and how awful you are, and how awful the future appears, and how little you want to leave your isolated little hole.

That’s depression. Not a comet landing in your neatly ordered life and leaving devastation in its wake – it’s the glacier that slips slowly and silently and unstoppably into your world, covering everything in an impenetrable sheet of ice, where you can see your friends, your family, the sun, but they’re like ghosts behind glass, drifting away in a dimension you can never reach.

And the worst part? Most of the time you don’t have the self-awareness, the reflexivity, to even understand what’s going on. You think this is normal.

It’s only rarely, very rarely, that we can see ourselves from outside, when we have what alcoholics call ‘a moment of clarity’, or drug addicts ‘hitting rock bottom’, where we understand what we’re doing, and where we are, and the damage we’ve done to ourselves and others with our self-destructive behaviours. Most of the time we feel numb, and pointless – most of the time we don’t think what we do matters to anyone else – but for a few brief moments the cloud lifts from our minds and we can see how we fit into the world around us, and the impact we have on our loved ones, and we finally feel something, albeit bitterness, pain and regret.

And then, all too soon, it’s gone.

So what should we do in these moments? We have to focus on the little things. We have to do the opposite of what we want. If we want to hide in a dark hole, we need to step out into the light. If we’ve put up walls, we need to tear them down, hug and kiss our spouse, to enact the affection we no longer feel until we feel it again. We need to play with our children to bring back some of the joy. We need to laugh. We need to respond to friends and family. We need to restart the hobby we dropped. We need to open the post, mow the lawn, and make tomorrow a little easier than it is today.

In short, we need to resume the habits we’ve dropped, set us back on the right course, and do it quickly before the cloud returns in the hope those habits will hold us together until our next moment of clarity.

The little things got us here. Focusing on the little things will get us through.

For a time, at least.