{"id":16122,"date":"2013-01-10T09:00:35","date_gmt":"2013-01-10T17:00:35","guid":{"rendered":"http:\/\/www.goodtherapy.org\/blog\/?p=16122"},"modified":"2024-05-14T17:20:21","modified_gmt":"2024-05-14T21:20:21","slug":"what-its-like-inside-a-depressed-persons-head","status":"publish","type":"post","link":"https:\/\/www.goodtherapy.org\/blog\/inside-head-depressed-person-0110134","title":{"rendered":"What It’s Like Inside a Depressed Person’s Head"},"content":{"rendered":"

\"GoodTherapyWhile not everyone\u2019s experience is the same, when people have a major depressive episode<\/a>, generally the world looks, feels, and is understood completely differently than before and after the episode. During a major depressive episode, the world can literally seem like a dark place. What was beautiful may look ugly, flat, or even sinister. The depressed person may believe loved ones, even their own children, are better off without them. Nothing seems comforting, pleasurable, or worth living for. There’s no apparent hope for things ever feeling better, and history is rewritten and experienced as confirmation that everything has always been miserable, and always will be.<\/p>\n

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When this reality shift happens, it’s difficult to remember or believe what seemed normal before the episode.\u00a0What the person believes during the episode seems absolutely real, and anything that conflicts with it is as unbelievable as a memory or message telling him or her that the sky is purple.\u00a0For example, if the person is unable to feel love for a spouse, and someone reminds the person that he or she used to feel that love, the person may firmly believe he or she had been pretending to himself\/herself and others\u2014though at the time he or she really felt it.\u00a0The person can’t remember feeling the love, and can’t feel it during the episode, and thus concludes he or she never felt it.\u00a0The same process happens with happiness and pleasure. Attempts to tell the person that he or she used to be happy, and will feel happy again, can cause the person to feel more misunderstood and isolated because he or she is convinced it\u2019s not true.<\/p>\n

What was challenging feels overwhelming; what was sad feels unbearable; what felt joyful feels pleasureless.<\/div>\n

Even if nothing was wrong before the episode, everything seems wrong when it descends. Suddenly, no one seems loving or lovable. Everything is irritating<\/a>. Work is boring and unbearable.\u00a0Any activity takes many times more effort, as if every movement requires displacing quicksand to make it. What was challenging feels overwhelming; what was sad feels unbearable; what felt joyful feels pleasureless\u2014or, at best, a fleeting drop of pleasure in an ocean of pain.<\/p>\n

Major depression feels like intense pain that can’t be identified in any particular part of the body. The most (normally) pleasant and comforting touch can feel painful to the point of tears. People seem far away\u2014on the other side of a glass bubble. No one seems to understand or care, and people seem insincere.\u00a0Depression is utterly isolating<\/a>.<\/p>\n

There is terrible shame<\/a> about the actions depression dictates, such as not accomplishing anything or snapping at people.\u00a0Everything seems meaningless, including previous accomplishments and what had given life meaning. Anything that had given the person a sense of value or self-esteem<\/a> vanishes.\u00a0These assets or accomplishments no longer matter, no longer seem genuine, or are overshadowed by negative self-images. Anything that ever caused the person to feel shame, guilt, or regret grows to take up most of his or her psychic space. That and being in this state causes the person to feel irredeemably unlovable, and sure everyone has abandoned or will abandon him or her.<\/p>\n

It\u2019s difficult to describe all of this in a way that someone who\u2019s never experienced it can make sense of it. I can\u2019t emphasize enough that when this happens, what I am describing is absolutely the depressed person\u2019s reality. When people try to get the person to look on the bright side, be grateful, change his or her thoughts, or meditate, or they minimize or try to disprove the person\u2019s reality, they are very unlikely to succeed. Instead, they and the depressed person are likely to feel frustrated and alienated from one another. I do believe cognitive therapy has an important place, but generally not in the throes of a major depressive episode.<\/p>\n

Support for People with Depression<\/h2>\n

So what does a person whose reality has shifted in this way need? Please keep in mind that I am talking about a major depressive episode\u2014severe depression that has lasted more than two weeks. I would take a different approach for someone with milder depression, or one that is a response to a terrible loss<\/a>.<\/p>\n

For some people in a major depression, psychotropic medication<\/a> works and is the only thing that works.\u00a0The same could be said for electroshock treatment<\/a>, though it\u2019s not for everyone. Many people will emerge from major depression in time, though episodes seem to make more episodes more likely, so if medication works to end the episode, it\u2019s usually prudent to take it. Nutrition, acupuncture, and other body-based treatments as well as therapy can help without the side effects of medication.<\/p>\n

What Loved Ones Can Do<\/h2>\n

Loved ones can gently hold and show love and commitment to the depressed person, try not to take on the person’s reality, but also not argue with him or her about it. They can also gently remind the person that depression causes his or her perspective on everything to change, and he or she is unable to think outside of depression mode at the moment. It is a time for the person to avoid making decisions, or avoid doing anything significant that requires a nondepressed perspective. If this is a repeated experience for this person, it can be helpful to discuss all of this between episodes so he or she is more prepared when caught in the quicksand.<\/p>\n

As someone who loves a person with depression, it can be emotionally difficult or stressful at times to support that person. It can be beneficial to focus on your own needs and self-care, and to reach out for help if you need it such as seeking the support of a counselor or therapist<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

A major depressive episode can alter not only a person’s mood and sense of belonging but also impact their reality.<\/p>\n","protected":false},"author":2390,"featured_media":43129,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[1],"tags":[31,161,406,534,408,405,25,115,383,111,410],"class_list":["post-16122","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-psychotherapy-practice","tag-depression","tag-emptiness","tag-irritability","tag-isolation","tag-mood-swings","tag-psychotherapy-issues","tag-self-esteem","tag-self-love","tag-shame","tag-worthlessness"],"_links":{"self":[{"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/posts\/16122","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/users\/2390"}],"replies":[{"embeddable":true,"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/comments?post=16122"}],"version-history":[{"count":0,"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/posts\/16122\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/media\/43129"}],"wp:attachment":[{"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/media?parent=16122"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/categories?post=16122"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.goodtherapy.org\/blog\/wp-json\/wp\/v2\/tags?post=16122"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}