Depression Versus Anxiety

June 13, 2014

by Mark Dunning

I thought I would write one last time about mental illness and Usher syndrome. Then I’m done. It’s getting too depressing, pun intended (see, my sense of humor IS coming back!). One thing I’ve always struggled with is the difference between depression and anxiety. I tried to write about it a while back but I failed miserably. Now that I’ve been through this experience, I think I can both differentiate between the two and describe their impact a little bit better. 

In the course of putting this post together, I googled the definitions for depression and anxiety. I’ll include what came up for both then give you my take. First up, depression (golf clap, everyone, golf clap).

A word cloud with terms such as "depression", "anxiety", and "medication".

 Definitions of Depression

Google (Google gives their own definitions for everything because they own the world and can do whatever they want) Anyway (ahem) Google’s definition of depression: severe despondency and dejection, typically felt over a period of time and accompanied by feelings of hopelessness and inadequacy.

Miriam Webster Dictionary: a psychoneurotic or psychotic disorder marked especially by sadness, inactivity, difficulty in thinking and concentration, a significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness, and sometimes suicidal tendencies.

National Institute of Mental Health (NIMH): Everyone occasionally feels blue or sad. But these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and those who care about you. Depression is a common but serious illness. There are several forms of depressive disorders. Major depression—severe symptoms that interfere with your ability to work, sleep, study, eat, and enjoy life. An episode can occur only once in a person’s lifetime, but more often, a person has several episodes.

My Take: First off, uh, Miriam Webster, what the heck? Psychoneurotic? Psychotic? Yikes. No wonder no one wants to talk about depression. That makes me sound like I belong in a straightjacket. Um, no, I’m not nuts. Google has it better. Despondency, hopelessness, and inadequacy. That’s how I have felt. NIMH describes the impact the best. It has interfered with my work, my sleep, and my eating habits. And, best of all, they say it is serious, but it is COMMON. Got that? EVERYONE feels blue and sad. Sometimes folks deal with bigger issues (hello Usher syndrome) and it lasts longer. It is COMMON. So why can’t we talk about it more? Oh, that’s right. Forgot about you, Miriam Webster.

My definition of depression (all humor intended): A desire to sit in a dark room with a giant bag of Doritos and eat yourself to death because who cares if you’re fat, you’re just going to die in the end anyway. You may as well die with orange fingertips and dragon breath. And your daughter is going to lose her vision. You can’t stop it. It’s hopeless. She’s going to lose her vision and be miserable. Her endless cheeriness and positivity about the future just makes it hurt that much more. She believes in you, believes you are going to save her, and you can’t. You are not up to the task. You’re not a doctor. You’re not a scientist. You’re not rich. You’re just a fat guy covered in Dorito dust. You ooze inadequacy. Look at you. You just stare in to the mirror in the bathroom. You can’t even pick up the toothbrush. Pick it up. C’mon. It’s not that hard. It’s just a toothbrush. Sure, it feels like it weighs two hundred pounds but your four year old nephew can pick it up for God’s sake. Just do it. Brush your teeth. Get rid of the dragon breath. Wash off your orange fingers. Reach for the faucet. It’s, what, ten inches away? Reach for it. You don’t even have to twist it. Just reach for it. Reach for it! Don’t just stand there staring at your orange lips! Bella is the one with the disease and she’s outside the door laughing at Modern Family after going to school all day and then riding horses. She is upbeat. She has a great sense of humor. She’s carrying you, for God’s sake! Stop feeling sorry for someone who doesn’t feel sorry for herself. Do something! Oh. Oh great. You’re going back to the dark living room again, aren’t you? Shuffling off slumped like Jacob Marley covered in chains. Hey, you already ate all the Doritos, fatso. You don’t even have that to look forward to now.

That’s depression for me. Everything weighs more than I can lift (including me). Happiness feels like daggers. Nothing is worth doing because we all end up dust in the end (Dorito dust?). Yeah. That’s about right. But, no, I’m never psychotic. That would take too much effort. Sorry Miriam Webster. 

Definitions of Anxiety:

Miriam Webster Dictionary: an abnormal and overwhelming sense of apprehension and fear often marked by physiological signs (as sweating, tension, and increased pulse), by doubt concerning the reality and nature of the threat, and by self-doubt about one's capacity to cope with it.

Google: a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.

National Institute of Mental Health (NIMH): Anxiety is a normal reaction to stress and can actually be beneficial in some situations. For some people, however, anxiety can become excessive. While the person suffering may realize their anxiety is too much, they may also have difficulty controlling it and it may negatively affect their day-to-day living.

My Take: Again, Miriam Webster. Sweating? What am I? A racehorse at the gate? Sheesh. But the part concerning self-doubt about one’s capacity to cope with it? That’s spot on. Google is too gentle in their definition. That’s just common anxiety, like wondering if you’ll make it to the grocery store before it closes. I like the way NIMH puts it. Anxiety can be beneficial in some situations but it can become excessive. I walk that fine line all the time. 

When I get anxious, I dwell on the source of the stress. It’s usually some big problem of some sort, like Usher syndrome. I run it over and over and over again in my mind, like one of those tumblers filled with sand used to polish rocks. And normally I get one of two outcomes. Either I rub all the sharp points off the problem until it is smooth and no longer dangerous at which point I can just discard it and stop worrying about it. Or I find a productive avenue to pursue to try and resolve the problem. 

So when Bella was diagnosed with Usher, I dealt with depression. I couldn’t move. Everything felt heavy. I just sat there, staring in to space. But my mind was whirring away on the problem, like a car revving in neutral. That was the anxiety. Some parts of Usher I wore smooth. I started to realize that Bella was OK right now, for example. I didn’t have to worry about her this very second. And I didn’t have to worry about her in the next month. And probably not in the next year. That took some of the sharp corners off. It wasn’t as dangerous any more.

I also found a productive avenue to address the long term implications of Usher. This blog exists because of anxiety. The entire Coalition exists because of anxiety. That’s productive anxiety. I dove in to the Coalition and writing about the issues we face. The anxiety was still there, but to continue the car analogy, it was like the car finally got some traction. I was still revved up but at least I was moving.

Depression and anxiety often get mixed together in to one lump. But they are distinctly different. Depression makes moving difficult. I get stuck in neutral. That leaves my anxiety revving. I think that’s what NIMH is talking about. Anxiety can be beneficial when it leads to productive action. But when it is unproductive, either because you’re just sitting there running through the same thing over and over again or you’re acting in a panicked, helter-skelter way, then it’s a problem.

My definition of anxiety: The feeling that your brain is running at 1000 RPM. This is a good thing when you are problem solving and turning those thoughts in to productive action. It’s a bad thing when you are sitting in traffic for an hour or trying to go to sleep.

Treatments

I mentioned in my last post about this topic some of the things that made me feel better. I thought it might help to split them up between depression and anxiety since different things worked for each. Two things. First, I don’t know anything. The last few paragraphs should have proven that. Everything I have done was suggested to me by either a therapist or a psychiatrist. They are the experts and they are the best treatment for both depression and anxiety. So start with a therapist and heed his or her advice. That’s the best thing to do. The therapist may suggest speaking to a psychiatrist, particularly if it looks like medication may help. 

Second, as you read in the last sentence, I’m going to mention medication a couple of times. I should be clear that I am anti-medication in just about every way. I take aspirin and that’s about it. But in this situation I was desperate enough to try it and it helped. So please don’t take this point of view as someone pushing medication. I’ve dealt with depression and anxiety all my life. This is the first time I’ve taken medication for it.

Treatments for Depression

Medication: And just like that, I’m talking about medication. Medication helps with depression in the long run. It does not help in the short run. It takes weeks. I am starting to feel better now because of the medication (As evidence, I’m sure you’ve enjoyed my raucous sense of humor throughout this post). But in the short run, it doesn’t do anything. You stay bummed out, heavy and difficult to move.

Accomplish small tasks: First off, you’re depressed so you can’t really do a lot anyway. Remember, the toothbrush feels like its two hundred pounds. But if you can do just one small thing every day, it helps to get you some traction. I started by making the bed in the morning. Then I tried to mix in some vacuuming. I’m serious. Stuff that small. But it gave me the sense that I could do SOMETHING. I wasn’t just a lump. And it made my world a little brighter to see the bed made and the floor clean.

Exercise: You feel good about yourself physically, you feel good about yourself mentally. I started by doing 1 pushup when I got up in the morning. That’s it. One. Make the bed, do a single pushup. I’m totally serious. The next day I did two. Then three. Then I started doing them before I went to bed. By the time I was doing thirty in one set, I was feeling pretty good about what I had accomplished. And that only took me one month.

Treatments for Anxiety

Medication: Anti-anxiety medication works immediately. You take it, you mellow out. It’s also kind of scary in that way. You’re not supposed to drive after you take it so I take it an hour or two before bed. It turns down the revolutions of my brain enough that I can sleep.

Sleep hygiene: Anxiety is exhausting. It feels like you’re running all the time. You need to sleep but your brain won’t let you. I found that slowing down my day before I went to bed allowed me to sort of ease in to sleep. Combined with the medication, I could slow myself down enough to sleep.

Meditation: Same idea as the previous two treatments. Slow the mind if only for a few minutes. I find it takes me about five minutes of meditation just to stop dwelling on things. About 20 minutes and I feel like I’m in control of my brain again. Want to hear what works for me? You’re going to laugh. My therapist told me to try it. I thought it was stupid, too. OK, so I sit down and close my eyes, preferably in a quiet place or with some headphones on. Then I say the word ‘the’ over and over again while tracing the outline of the United States with my eyes on the back of my closed eyelids. Yeah, that’s right. I wrote that. Heck, at this point how much more can I embarrass myself anyway? And I know you’re laughing. Or staring with an open mouth. Look, nobody made you read this far. It’s your own fault. Anyway, the point of drawing something simple on the inside of your eyelids is to give the mind something distracting to do. Saying ‘the’ over and over regulates your breathing and helps to slow your heart rate. That’s the idea of meditation. How you get there doesn’t really matter. So try it. You don’t have to tell anyone.

And with that, I am done talking about my mental state for a while. I’m feeling better. Time to get back to more pertinent business.

Good luck and don’t be afraid to contact me with any questions.

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