forum Advice on writing a character with depression

Started July 09, 2020 by @moss

tune

One of my characters struggles with depression and I need advice.

when i first started showing symptoms of depression, i was like 9 or 10, and i'm 20 now. the way i cope with and think about my depression has changed a lot over the years, and i don't know where this character is in their journey, but i'll just give you all the perspective i can. potentially triggering things will be put under spoilers

when it first started, in 4th grade or so, i didn't know what was going on, and where i'd previously been a really good student, i started to hate school. i got the cause and effect confused, i think ("i feel bad because school is bad now" rather than school wasn't as fun because i was depressed), and i told myself that once summer came, i would feel better, but when summer came, there was still a huge emptiness inside of me that i tried hard to ignore.

the next big episode i can remember is when i was in 6th grade, and i think i knew what depression was at that point, but it didn't click that i had it. once again, there was a huge emptiness inside of me, i started isolating myself from my friends and failed to turn in most of my schoolwork because i just didn't have the motivation, and i deliberately affected apathy to make it seem like i didn't care about what was happening to my mental health, or anything for that matter. one night, sometime in the spring, i broke down sobbing to my mom because, in my own words, i was "so bored."

looking back, i think i was manic for a good portion of seventh grade

but that was when i first used the word "depressed" to refer to myself. when i did become depressed (rather than manic) in late winter/early spring, i once again failed to turn in any schoolwork, and this time, since i had gotten out of the habit of repressing my emotions, i very openly had very low self-esteem. (i also think that since when i was manic and "felt good" earlier in the year, and i was receiving romantic attention for the first time during that period,

throughout high school,

sometimes i meant it very sincerely (and once in 11th grade i was hospitalized), but sometimes i said it because i knew it provoked a reaction from people, and i hoped that i could feel something through doing that (which is a very manipulative and mean thing to do, but mental illness can absolutely make you manipulative and mean sometimes).

my freshman year of college, i was very depressed after my first real breakup, and i mostly coped with that by skipping class (since i now had that liberty) and taking lots of melatonin and unisom to force myself to sleep all day since i didn't want to be awake. that phase only lasted about a month or two, though, and i turned to slightly healthier coping mechanisms as the year went on. i think because in college, people starting giving me more tough love when i did things that were harmful to me, i started to realize how ineffective self-destruction can be, and that's what helped me mostly grow out of it. when quarantine started this year, i was definitely very depressed, and i still struggled to find the motivation to go to class/complete work, but i mostly coped with it by incorporating manageable routines into my life.

when i go in for med checks, and i want to express to my psychiatrist that i need a higher dose of my meds, i often feel the need to emphasize that i'm not a danger to myself and that i'm not doing "horribly." he'll remind me that just because i'm not at rock bottom, doesn't mean i'm not depressed. when i was young, and first coming to terms with my mental illness, i thought of it as a very scary and powerful and private thing that could drive me to do really awful stuff (which it did, to be fair). i constantly felt like i had to be at rock bottom to justify being the way that i was, and so i lot of the time, i was at rock bottom. now, i think of my depression as more of an inconvenience than anything, and all my friends and family know i'm mentally ill, so it's not some big secret and it's not like nobody understands me. to this day, when i'm having a depressive episode, it's often hard to get things done on time, and i ask my professors for a lot of deadline extensions, need a lot of rest in between activities, feel tired all the time, and just have a generally low mood (but i'm not sad, per se, i just feel like there's sort of a wall between me and my feelings/my enthusiasm/the world around me).

sorry for just sort of rambling, but i hope some parts of this are relevant to your character's experience! let me know if there was something more specific/different you were looking for and i can still try to help.

( @ccb37 This isn't really on-topic, but I kinda want to copy and paste your whole response—especially the part about the ineffectiveness of self-destruction— just because I so rarely hear about depression from the perspective of someone who's lived with it for so long. Idk, I just thought some of the stuff you said was very insightful ^^; )

Thank you so much! This was super helpful!

*whispers * I dunno if you still need advice, but I’m open to any questions if you need any more info.

If you have any more tips to provide, then feel free to share.

Ahh, I kinda have a different type of depression/it manifests in different ways, and I wouldn’t want to lead in you a completely separate direction if you’re all set. Although I’d recommend checking out info about “Anhedonia”, which basically means like lack of enthusiasm/motivation, my therapist was talking about it the other day and said it’s a common symptom of people with depression.

I did a little research on it and its really interesting! Thanks for your help!

Hey, I have another question if that's okay. What's therapy like?

therapy's different for everyone, but i've had i think 6 or 7 therapists over the course of my life? and the one thing that's a constant in therapy is that it'll always start with an intake appointment, where they ask you why you're there, what your life is like, your history of mental illness/problematic behaviors, etc. the first type of therapy most people try is cbt, but for a while i kept getting sent back to cbt when it wasn't working anymore. i find that it's mostly only useful for providing baseline coping mechanisms for anxiety, but that's just my opinion.

i've had some sort of no-nonsense tough love therapists, and they didn't really work for me, because they doubted that i knew that i was doing something wrong, when i was well aware that i was doing something wrong. my best therapists have been very gentle and empathetic, but my absolute best ever therapist is my current therapist, who will just let me talk about how i feel and won't try too hard to steer me in a certain direction aside from little nudges like "why don't you rephrase that" or "why don't you say it again," or like when i'm explaining how i feel and i say "i don't know" she'll say "i think you do" and help me figure it out, and we stumble upon a lot of insights about my psyche that way (for instance how a lot of my self-doubt stems from having to walk on eggshells around my mom as a kid).

one important thing to note about therapy is that if your therapist determines that you're a danger to yourself or others, this is the only time they're allowed (and mandated) to breach confidentiality.

anyway, this is ramble-y again and sort of vague, so if you need to know anything more specific don't hesitate to ask!

It’s totally okay! Also some trigger warnings,

So therapy is different for everyone depending on the issues they’re going through and the philosophy of their therapist (like, for example, I know a friend of a friend who’s been going to therapy for twenty years. I think her therapist was more focused in therapy based on sense of self, but I could be wrong). My therapist said that with most people she’s had, they have the tools to help themselves prevent depressive episodes and start to feel better after about twelve weeks. I’ve only been going to therapy for about a month now, and she was telling me that there’s three ‘phases’ or ‘sections’ we’re gonna go through, so I think I’ve only been on the first section.

Also, figured I’d include this, not sure if it’s relevant to you but it might provide some clarification to why I was feeling the way I was during my first therapy session but- when me and my family first really addressed my depression was when we went to my doctor. I had told my family about the way I was feeling about a year and a half prior to this. They had me take a depression test, but the problem was the earlier I was looking on Pinterest, I think, and I had seen a post about how someone had to go the a mental hospital after answering a depression test with too high of a score. That really freaked me out, so I lied on my test at the portion about self harm/suicide, saying that I never felt suicidal or the urge to harm myself, even though the opposite was true. My doctor then talked to me, but that was a really hard experience for me too. I felt like I had to prove that I was depressed, she was asking what starting my feelings of depression and some questions about self harm (which only then I answered semi truthfully when talking about how I cut myself with a pencil a year before, but didn’t talk about how I still struggled with wanting to self harm). My doctor recommended therapy, as that’s what most people my age usually do, and said I probably wasn’t at a point of needing to take antidepressants. My doc left it up to me, though, and said that if I wanted to take medicine I just had to say the word, but my mom was in the room and I knew she didn’t like the thought of me taking drugs because she thought I would get addicted, so I said no despite how I kinda wanted to.
So anyways, I got signed up for a therapist that worked with my doctor—but the only open time she had was about three months later, so that sucked. Flash forward about two and half months, right? My therapist quit.
Cue brushing my depression under the rug for a couple months, especially when COVID came in—most of my family was more worried and focused on not getting it, and my parents were great at ignoring it until absolutely relevant to talk to me about it. But eventually my mom brought it up again and got me a therapist (apparently I was also on a waiting list for a while before being able to get in). My mom did a virtual meeting with my therapist the week before, and that really worried me, I thought my therapist was going to ask my mother about why I was feeling depressed, but you see my mom doesn’t really get the depth of depression. She doesn’t get that it’s so incredibly hard to get out of bed sometimes or brush my teeth or go exercise or interact with people, and I thought she was going to mislead my therapist about the depth of my issue.

Flash forward a week.
I was terrified, to be completely honest. I felt like I was going to start crying any minute because I really didn’t want to go and have to prove how I felt or have to talk in front of my mom about it, or that I’d have to talk around how I felt like I wanted to kill and harm myself.
There was a waiting room, it was really comfortable and homey even. My therapist, Julie, came out to lead us to her office—she brought my mom with us too, which I really didn’t like. My therapist described how everything I said was confidential, unless I was hurting someone or hurting myself—and even that came with a ‘catch’, per se. My therapist told me that she wouldn’t just immediately go tell my parents or someone else, but she’d try to work through the problem with me until I could tell my parents or someone else. That really calmed me down, honestly. And then Julie asked me if I wanted my mom there or not, and she explained that either option was okay because she had talked to my mom on that virtual meeting about my privacy and that whatever I chose was an okay thing. That was another thing making me feel so much better, and I decided to just talk alone with my therapist like I wanted, and my mom went to the waiting room.
Then, my therapist led us through a conversation, and let me tell you, I never once felt like I had to prove my depression to her because she got it. She understood how I was feeling and put it into words for me, and that was just the cherry on top of it all. I was so worried that she’d make me monologue about how I felt, but she didn’t. She just asked questions, while still offering answers too, like “Some people with depression kind of feel like this [shows her hand in a wave motion, like charting someone’s emotions of going up a little and caving down deeply] while others have it like this [shows a waving motion of going down a lot, up a teensy bit but still being in the ‘bottom half’ of this imaginary emotional scale, and going down again], and there are plenty of different variations in between from person to person. Do you think you’re more similar to the prior, going up and down but having really bad down, or being constantly down?” And I explained how in the summer it was more up and down while in the school year it was almost constantly down. It was jut relieving that she understood what it was like. Enough so, that I felt comfortable talking about how I felt like wanting to kill myself on multiple occasions. She made a clear distinction between wanting to kill myself, like absentmindedly thinking that ‘hey, I could use the gun in my basement to shoot myself’ or ‘I could drown myself in the bathtub’ versus ‘On Thursday, I’m going to get the key to the gun safe at 11 pm and unlock the guns, then I will get the ammo from this drawer and load the gun, then I will shoot myself in the corner of the spare room’ or ‘Wednesday night, I’m going to grab a cinderblock from the shed when no one’s watching and take it to the bathroom in the basement, so I can hide it underneath towels, them at 8 pm I’m going to tell my parents I’m taking a bath, and lock the door to the bathroom, so I can drown myself’. I was the former, more vague wants to kill myself, but never a specific plan to do it. I’m not sure how that session would’ve ended up differently if I had been the latter, but that’s how it went down, my therapist didn’t seem to raise any huge red flags on that.
Also, Julie was taking notes on our conversation (she made me aware before we started the whole thing, in a very polite way might I add, not like she was pointedly taking notes while I was talking as to make me uncomfortable.) I also would like to note that she really balanced how the conversation was, like we’d touch a very personal topic about how I struggled with suicide, then expertly steer the conversation to lighter grounds, like what kind of stuff I like to do that made me happy.
At the very end of that session (sessions last an hour, in my case), she told me how brave I was to open up to a stranger like that, and reassured me that she knew how hard it was to talk about depression. She also told me that some people felt better after a session, some felt anxious, some neutral, etc, but no matter how I felt, my feelings were completely valid—and saying that made me feel better too, honestly. I’ve been struggling with validity lately with my emotions and my sexuality. Overall, I felt really amazing at the end of that session. It helps so, so much to be able to talk about it to someone who understands. Sure, my depression didn’t magically go away after talking about it for the first time, but I had a good day that day, and good days are like gold to me.

Later sessions were a bit different, as we began talking about stuff to help my depression. We went over common thoughts that people with depression have, such as ‘All or Nothing’ thinking, which is when you might think “No one likes me” or “Everything is boring” or “No one cares” or “Nothing matters”. But then she talked about ways to combat that type of thinking. My therapist really focuses on using logic to combat depression, like a response to “Everything is boring” might be, “But not really? Because I used to have a lot of fun when I was a kid, swimming, so not everything is boring.” Julie went over a really good thought process to have when dealing with a negative thought: asking yourself “Is it accurate? Is it helpful?” So faced with the thought “Sandra doesn’t like me”, at first you analyze, is it accurate? Probably not, but sometimes that’s not a clear cut answer, especially for people with depression. So then you think is it helpful? And the answer to that it more obvious—of course that thought isn’t helpful! And so going through that process has really helped me acknowledge my negative thoughts, but find a way to combat them. She gave me a list of the types of thoughts, it was basically a print out of what we went over in the session, and another list of example thoughts that I might have, to help me be aware of those thoughts when I have them.

She also gives me “homework”. Each week I fill out a ‘mood thermometer’ to track my mood on a scale of 1 to 9, and there’s this list of thoughts that I go through and check off which one’s I’ve had that day, making a connection between my mood and my thoughts throughout the weeks, and I feel like that’s really helped me become more aware of my thoughts to be able to combat them.

Another small thing, Julie also addressed how my therapy is designed to help me be successful on my own. I can only be with her one hour out of every week and she feels like she’s not doing her job right if, after roughly 12 sessions of therapy (provided nothing major happens) I still feel like I can’t help myself without my therapist. Therapy isn’t only about getting better, but staying better.

Anyways, let me know if you have any specific questions or anything like that, I’d be happy to provide more insight! Also apologies for any typos haha, I just woke up.

Oh, also I think I’m doing cbt therapy, forgot to add that

^that’s important, i was really vague, but yes, for them to report you you have to have a plan not just ideation. that is all really good insight especially considering i blocked out a lot of the therapy that happened near my hospitalization

Since my got a serious back injury, is the moment I can really say that it started getting bad for my family. My dad dropped out of radiology school just before his graduation due to his back, went into medical coding for a few years, and only got one job with that degree. During this time I was about in sixth grade, and all I can really remember is him just sleeping a lot. My mom was stressed with the amount of debt she faced from hospital bills and the college loans my dad was unable to work to pay back.

I don’t really remember a lot from my childhood/early teenhood (I’m close to seventeen, now, btw), but I was always really quiet and out of the way. My sixth grade year was extremely stressful for me, though, and it’s probably where I first started being impacted by my mental illnesses. Middle school continued and things I thought were just normal grew steadily more.

It all really hit me in my first year of high school. Everything had calmed down at home in the first months or so of high school, but something must have happened, for they started fighting a lot more. I also struggled emotionally in school due to being in an incredibly hard class (APUSH) and surrounded by what felt like incredibly smart people who knew so much more than I did.

I struggled, my grades went down, I broke down a few times throughout the year (one time in my band director’s office very cool not embarrassing to look back on at all), and it felt as if everything was hopeless. I felt sick and empty all the time, I stopped doing the little self care I had been doing. When I got home I never did anything but write. I never did homework, I never pushed myself to my limit with homework. I was already stressed enough; there was no point to stress out more.

It was about March of that year in my yearly doctor’s checkup, that I got some clarity of my situation. They gave me like, one of those doctor approved tests that I took for anxiety and depression both. I scored really high on my depression one, and the anxiety one trailing behind. My doctor sat me down privately away from my dad, who had taken me, and she asked me a bunch of questions. “Do you know anything about this illness?” “Do your parents fight a lot at home?” “How often do you feel ‘empty’?” And she also asked me about my school schedule.

She recommended me to go to a mental-health facility, where we went about a week later. I went and got a more thorough diagnosis. My depression does have a tac on it (Severe Depression with minor anxiety), but the incredible woman who gave me my test said that it was probably mostly from stress; stress from school and family. Not only that, but it could be genetic.

I got close to thirty-ish sessions with a therapist named Jenna. I have really bad trust issues, so I never really talked about my depression as I did with my anxiety. When I did talk about my depression or feeling like I’m “empty” inside, it felt as if I were joking and I got too nervous to continue. However, one day I tried to talk to her about possibly being asexual and not having many sexual desires at all, and I didn’t really like her response at all, so I just stopped going without any warning.

I think for your character, you have to make it clear that it’s okay to dislike and not trust your therapist. But it’s not okay to force yourself to continue having sessions with them. If I had told myself that, I probably would be much better with my depression right now.

And depression never “goes away”. At least for me. It’s always a fight because it really influences how I feel on a day-to-day basis. Depression doesn’t go away with love. Trust me. People who believe that will cling to their s/o and get really really toxic and unhealthy in a relationship.

Right now, I only hold myself to a schedule of taking care of myself. I shower every day and eat at least two meals a day. Despite how I feel right now, it works. I changed my philosophy on life in about December of last year, where I ultimately decided to open myself up more to things I haven’t done before. I asked my crush out. I pushed myself to be a better student. I pushed myself in my workouts that I started that September to become a better boxer, a better, less stressed individual. I opened myself up to hear more people’s stories and let them bounce themselves off of me for support.

If this is oversharing that’s because it is. I hope it helps a little.

I have severe depression and this is all true for me some way or another.