I have anxiety and depression.
The kind that doesn’t go away, and you take pills to manage.
This is not a secret.
What’s more interesting is that I just switched medications from one that successfully managed the depression but not the anxiety to one that successfully manages the anxiety but not the depression, giving me a brief window to see my two comorbid conditions separated from each other, for the first time since ever.
What follows is a (brief) digression on what they’re like from the inside.
Depression
I’m still me when I’m depressed.
Just a version of me that’s sapped of all initiative, energy, and tolerance for human contact.
There are plenty of metaphors for depression—a grey fog being one of the most popular—but I often think of it in the context of inertia.
Inertia is matter’s tendency to keep doing what it’s doing, until some outside force comes and overturns the mattress. An object at rest will stay at rest until someone tells it to get out of bed, and an object in motion will stay in motion until it’s told to calm the f*ck down.
Normally, inertia is pretty easy to overcome, for one’s own self. Want something done? Just get up and do it.
When I’m depressed, though, inertia is this huge, comfortable pillow that resists all attempts to move it. Want to do something? Does it involve getting out of bed? If so, no thank you, that sounds hard. Hungry? Meh, I can eat later. Have to go to work? That sounds exhausting, and there’s this big pillow that just won’t move between me and ever leaving this bed, and maybe I’ll just call in mentally ill today.
The funny thing is that this inertia appears at every level of movement and cognition.
On a normal day, ‘get out of bed’ is a single action. I think it, then I do it.
On a depressed day, ‘get out of bed’ is a long, complicated string of actions, each of which has its own inertia and must be consciously micromanaged. I have to life this arm, maneuver this hand, flex that finger, push with shoulder, bring knee up, twist body, and so on. Each action is distinct, and each has its own inertia to be fought.
On a really bad day, each of those actions must be micromanaged, until I’m literally flexing individual muscles one at a time in sequence to move, as if my body were an anatomically correct puppet my brain had to steer one nerve-impulse instruction at a time.
Of course, this applies to thoughts, too—deciding to do anything that isn’t exactly what I’m already doing suddenly requires substantial effort. Goal-seeking is a challenge; forget about things like abstract thought and metacognition. Too complicated, too many moving parts, and not enough energy in the system to work any of it.
It’s not a whole lot of fun.
Anxiety
I’m still me when I’m anxious.
Just a version of me that’s convinced I’m permanently unsafe and on the verge of losing my job and everything I hold dear and becoming homeless and all my friends secretly hate me and only tolerate me because they’re too nice to say anything.
If depression is inertia, anxiety is gravity.
The thing about gravity is that it always pulls things as low as they can get. From the perspective of height, gravity is always about the worst-case scenario: objects fall until they literally can’t anymore.
When I’m anxious, everything becomes precipitous, as if I’m always skirting the edge of a cliff or crossing an old, dilapidated bridge over a dark and fathomless chasm. A single wrong move, one wrong step or tilt or breath, and I could be sent screaming over the edge. And once I fall, there won’t be a way back up (the chasm wouldn’t be very fathomless if there was, would it?).
If any move could be my last, any action lead to disaster if I get even the slightest thing wrong—then surely the correct choice is to take no action, right? If I don’t move then I can’t fall.
Gravity only applies to those who look down.
So I don’t look down. I shut out every possible reminder, everything that could bring movement to mind. I drown it all out in the few actions I know for sure are safe: eating, breathing, sleeping, reading, watching videos on the internet. None of them are movement, in the sense of a life. They’re just…existing.
That’s good. Existing is good. Existing is safe.
Living, on the other hand, involves moving—forward or back. And if I move, gravity might notice me, like a dinosaur in the movies.
And then I’ll screw up or slip up or fall down, and gravity will drag me screaming over the edge.
Not fun either.
Conclusion
Though they have very different methods, both anxiety and depression tend to have the same result, at least for me: I don’t do anything.
I don’t move forward, I don’t make progress or accomplish goals, I just…exist.
It’s very frustrating, and not a whole lot of fun.
I don’t have a conclusion to draw or a lesson to learn hear—just a little bit keener of a sense of which condition happens to be hamstringing me at a given point in time.
It’s better than nothing, I suppose.
Hey Sable, I am sorry about your situation. Perhaps I am pointing out the obvious, but you just achieved something. You wrote a post and people are reading it. Keep ’em coming!
Thanks Anders! That means a lot, I really appreciate it.
Thankfully I’ve seen my psychiatrist and I’ve switched to the next medication, which is doing a better job. I’m also looking into getting Ketamine treatment; I’ll probably make a post about how that goes.
Glad to hear you are doing better!
Ok, that is an interesting route to go. Let “us” know how it goes if you feel for sharing your journey
May I ask which medications?
You may!
Zoloft managed the depression but not the anxiety, and Lexapro the anxiety but not the depression.
For what it’s worth, I have zero expectation that anyone else would share my exact response to the medications; both have helped plenty of people in the past.
Are you interested in receiving any advice from someone who used to have OCD/GAD but now lives with almost not enough anxiety?
Sure—I’m always interested in hearing other perspectives.
What’s your secret?
Is it yoga?
(I bet it’s yoga.)
Haha no yoga. Some combination of the following:
- Meta cognitive therapy + CBT with this guy for 4 years
- Lots of exercise (resistance training and cardio)
- Sleeping lots
- Found meaningful work + less a stressful industry
- Stable relationship (monogomous)
- This one is the curved ball, as I had already cured my OCD/GAD by the time I found it, but it definitely lifted my wellbeing a lot https://lochkelly.org/
I’ll add that for some period I was on 100mg of sertraline, but I dont think that cured me of anything.
Nice, these are interesting descriptions!
The inertia metaphor for depression is interesting because dopamine is associated with both mood and movement. So you see dopamine deficiency in mood disorders like depression and movement disorders like Parkinson’s disease or restless leg syndrome. When you’re depressed and it takes enormous effort to move each muscle, that might be your brain searching for sources of dopamine because the usual sources aren’t working.
I’ve personally had the experience of lying motionless on my bed because I felt like I had exhausted all my options and I couldn’t see anything beneficial to do about my situation. It almost feels like the energy that would let me get up has been sucked out, and my body is just limp. I think in times like these, my brain isn’t able to find a promising action to take, and so it can’t find a source of dopamine to generate movement.
If Scott Alexander is right that depression is a “trapped prior on low mood”, maybe the brain rejects options that would produce dopamine because that would disrupt the expected low mood, which would be surprising and uncomfortable. So we actually maintain the conditions for low mood because our brain thinks it’s necessary in some way.
If there’s a non-chemical way to combat this, I think it’s by finding the cause of that prior and working with it until the brain is convinced it no longer has to maintain the low mood. I think that’s what therapy, meditation, or lifestyle changes are actually doing when they work. The brain gets enough evidence that the low mood is unnecessary, and it stops expecting it.
In my case I noticed that I was punishing myself with negative emotions because I had high expectations that I wasn’t meeting, and I felt like I could transform myself into that ideal if I just felt sad enough. Over time I gradually convinced my body that this didn’t help, and that I was more productive when I let myself relax into a kind of neutral, default state. This involved going back and forth many times between a low baseline and a neutral baseline until my body decided the neutral baseline was better. When my brain wasn’t automatically rejecting every plan I came up with, then I found I had plenty of energy and motivation.
But that’s just my model of how it happened, and I don’t expect my experience to replicate for everyone else.
Thanks for sharing! I definitely like Scott’s take on depression being a trapped prior.
When I’m depressed, sometimes a friend will make me go do stuff anyway and it usually makes me feel better, although I never expect it to make me feel better. Even when I know that it will.
Brains are weird.
Interesting! Thanks for sharing. What you describe as inertia sounds more like apathy to me than depression. But rather than a comfortable pillow which resists attempts to move it, it feels more like there’s nobody home in my body. I say “Move” but there’s nobody to hear, nobody to care. There’s no feelings, just the last bit of rational thought going “huh, that weird, something seems to have broken.”
Right now I’m feeling that “meh” at everything, just barely excluding the things that I need to stay alive. So by your description, I’m currently depressed, but my mood is strangely alright.
Depression to me changes my worldview entirely. Reality gains substance, it feels much more real, less superficial. The world becomes much larger, more serious and heavy. It feels cold, lonely and dark, even around people, in warm places, and with my face right next to a 1500 lumen LED light.
I’m fairly sure that my vision actually loses some of its color, and even strong people seem pitiful and weak. Another interesting note is that my ‘territory’ shrinks. My environment, even my own things, become hostile and unfamilar, rather than tools which are mine to manipulate for the sake of my goals. I don’t feel sad when I’m in apathy, but I feel terrible when I’m just depressed. Just awful. At times I’d have a “good day” and only score mild to medium on the depression scale, and feel like that level of negative emotion wasn’t even worth mentioning. It’s like going from passing a kidney stone to having a mild headache.
Anxiety feels like standing at the edge of a cliff, or like there’s a sword hanging in a hair above my head. There’s a sense of impending doom, confusion, and the feeling that I’m forgetting something important. And everything feels fragile, I get this sense that everything is decaying right before me, that it can break at any moment, that everything is scarce, rare, limited.
I like depression more than anxiety, until the depression gets bad enough, anyway. I think the two blend together at some point. When I’m a bit depressed I might casually think about suicide, but when I’m even more depressed, the idea of suicide becomes extremely scary. It suddenly becomes all too real. Like I’m forcibly immersed/grounded in a nightmare or psychological horror. But the worst of them all for me is apathy. It’s worse than suffering. I have very little respect for nihilistic philosophies.
By the way, in Nietzsche’s Zarathustra he talks about “the spirit of gravity” and about how you kill it with laughter. When he says “I could only believe in a god who could dance”, what he means is a god who is light on the feet, i.e. “above” that gravity. The book feels a bit like it was written by somebody with mood swings, moving between depression and hypomania. From “Forgive me my sadness!”, forgive me that evening came!” to “Now a god dances through me”.
That’s a fascinating description of your own state, and I hope you’re working through it with your own resources.
For the post I was focusing more on a behaviorist approach to depression and anxiety, explaining what the resulting state/actions were by metaphor of how it felt internally, but I do also get the low mood and the feeling that everything is terrible.
I think I also get the ‘lose the ability to perceive gradations of color’ thing, which I think Scott’s talked about before.
(I also had a nihilistic phase I grew out of. There’s only so much ‘depressed French people complaining’ I can take!)
Thank you! Yes, I am. I’ve grown bored of suffering, and the victim mentality has lost its appeal. At this point, even being negative is difficult for me. I’d have to put effort into taking myself seriously.
But it’s a balance. Being humble and allowing oneself to be small is also important as it increases the felt weight of the world. So I should allow myself to be “just human”, i.e. a little weak. If I don’t allow myself to be weak I won’t be able to cry, and I won’t be able to feel other peoples sympathy since I can’t take it to heart. This is similar to being unable to feel other peoples compliments, which is the case when the standards you hold youself to are too high. Many people recommend stoicism or “not giving a fuck” to combat depression, I just want to warn against that. It’s better to have courage (the ability to face ones fears) than it is to get rid of the fear. If “fear > courage” one should flip the inequality instead of destroying the entire equation by reducing both sides to 0 (nihilism).
The correct alchemy here is “negative → positive” not “negative → nothingness”. Reducing yourself to rubble leaves a lot of rebuilding work (nihilism → meaning)
Speaking of which, I have a friend who doesn’t get embarrassed, she gets angry instead. I think there’s a layer of responses. If she had not allowed herself to be angry, she’d go to the next layer, which is apathy. So the ordering goes from “receptive” to “jaded”.
Somebody does something which hurts you → Brain protects you from pain, it’s converted to sadness. → The brain protects you from sadness, so it’s converted to anger. → The brain protects you from anger, so it’s converted to apathy. This picture seems quite right: https://oasisenergyhealingcenter.com/wp-content/uploads/2016/03/Emotional-Energy-Compass-Graphic.jpg
I guess I cope well with my issues because they tie into my hobbies so well. I’m not motivated by the idea that I will stop suffering once I improve my life, but experimenting on myself is fun, and this actually motivates me.
It’s not the bad things in life which get to you, it’s the lack of good things :)
”He who has a why can bear almost any how”. As long as good things are working out for me, I don’t think it matters very much whether I’m suffering as well. But society doesn’t think like this, so it keeps trying to reduce negative things, which also reduce good things. So the mental health of society keeps getting worse despite “things getting better”
Really interesting! (and, just as everyone said: kudos to you for having written an interesting post while anxious and depressed :-) ).
But I notice it makes me confused. I used to be depressed (although I should probably say ‘used to be in a depressive episode’, these things never 100% go away, do they?), then my depression got better, but there still was/is weird stuff going on with my mental health. No longer being glued to my bed by despair, I called it anxiety rather than depression, but now I’m not so sure anymore?
Of course, my depression clearly looked like a depression: can’t get out of bed, why would it matter anyway, what on Earth is wrong with me, etc. (NB: what you say fits well with the point I’m trying to make here, but I’m surprised that the only thing you say about metacognition is that you don’t do much of it. First because writing a blog post on what’s going on in your brain probably counts, and second because imho overthinking about your mind is imho a big part of the experience of being depressed, something also described very well by this guy.).
Then I got better: I made more friends, took a few steps to get to do less depressing stuff, got involved in a couple of cool projects, etc., etc.
Not being very sad all the time is good for you, 10⁄10 recommend.
So, I’m not depressed anymore. And yet, when I go to my therapist, it’s to say stuff like ‘Inertia is blocking me from doing stuff, I need to feel more motivated, I want to procrastinate much less, my behaviour is clearly not goal-directed enough, etc.’. If it were just anxiety, I would indeed have a similar behaviour in the sense that I would focus on ‘safe’ activities, but why would I then spend so much time feeling terribly anxious about my inability to go beyond those ‘safe’ activities?
I suspect that, at least in my case, it started with the anxiety (‘I feel like I can’t do this thing, or that thing, or that other thing’ – interesting to note that it’s rarely obvious what exactly I am fearing, although it’s often easy to tell when thinking about it), the anxiety caused inertia (‘well, if I can’t do it well, why bother’), and then the depression came from that? I am not sure this actually makes any sense. Probably the root causes of something are to be found in the symptoms of ASD: executive function and social cognition issues ⇒ belief that I’m crap at dealing with social situations or working hard, anyway. But I’m not sure where exactly that would fit, either.
Anyway, like I said, great post!
Just me following up with myself wrt what the post made me think about: it’s as if there are two ways of being anxious, one where you feel sort of frazzled and hectic all the time (‘I need to do more of that stuff, and do it better, or something bad will happen’), and one where you just retreat to safety (‘There’s nothing I can do that wouldn’t come with an exceedingly high risk of something bad happening’). It’s quite clear that the former could lead someone to being an overachiever and doing masses of great stuff (while still, unfortunately, feeling like it‘s not enough), whereas the latter could lead to boredom, and probably from there to being depressed (which I like to conceptualise as the feeling that ‘there’s nothing I can do’)/maybe it‘s a propensity for depression which makes one’s anxiety work in that way?
I’m not sure to what extent it’s actually useful to see anxiety in that way, though?
Words to live by, right there.
I think everyone has some experience with anxiety and depression; the alternative is literally ataraxia. The distinctions come with things like, “is it transitory or chronic?” and “is it ruining your life?” I’m glad you’re not in that state anymore, though.
With regards to anxiety, I’ve had thoughts recently along the same track; maybe I’ll write them up at some point. It’s almost a case of “the dose makes the poison”—some amount of anxiety is natural and can motivate you, but too much and it prevents you from doing anything.
I appreciated the distinction you make between anxiety and depression and can see that in myself, but had not previously made the distinction. I’m wondering now if that might help with addressing problems of procrastination—that seems to be something of a symptom. Perhaps looking into why I am procrastinating to see if it fits more with a depression mood or anxious mood might help overcome the inertia.
As a fellow procrastinator, I’m right there with you. I’ve found, for instance, that downers (alcohol, barbiturates, etc.) can allow me to be productive if anxiety is the cause of the procrastination, but if it’s depression than the downers don’t help at all.
I find that stimulants help if the cause is depression, but that they don’t if the cause is anxiety. Stimulants make anxiety worse (but it’s not so simple—since stimulants also increase your confidence). But if you’re anxious, then you crash even harder once the stimulants stop working, and you might release too much adrenaline, so that you become numb instead of “fired up”. I also find that being in “flight or flight mode” doesn’t help much against deadlines. You’re alert, but not in a way which is good for thinking.
For chores and physical work, stimulants are great, but you should take care not to overexert yourself, remember to drink water, and take care of your blood pressure.
Great post! Is
possibly a typo? Based on the context and video It feels that you might mean “Gravity only applies to those who look down.”
Fixed, thanks.
There’s a joke in here about getting negatives wrong when depressed...
Both gravity and inertia are determined by mass. Both are explained by spacetime curvature in general relativity. Was this an intentional part of the metaphor?
Call it...unintentionally intentional? It makes sense to me that the mechanisms between them are related in some sort of Unified Field Theorem of the Mind sort of way.
I also have mental metaphors involving thermal mass and emotions...
Huh.
These are really good descriptions! (Going by my own and friends’ experience). For me I might just tweak it to put anxiety as the height rather than the gravity. Thank you for writing these up!
You’re welcome!
Thank you for writing this—it’s a really useful and accurate view, I think. I too deal with both of these mental bastards and you’re right, it can be hard to see them separately; but this is almost exactly how it is for me too and I’m glad you shared it.
Reading this also made me have a bunch more thoughts about monotropism, which I’ve been studying with great interest lately. The depression physical movement thing you describe (which yup, hard same here) feels like it must be related to my high monotropism somehow, and I’m looking forward to looking into the link more. (You may look monotropism up if you’re interested, but i just wanted to share that your post gave me a good lead on a useful idea, which i appreciate!)
You’re welcome! I’m glad it was helpful.
I also just looked up monotropism—I haven’t run across the term before—and was like, yeah, that seems about right for me.
Interesting.
Been there—well not exactly the same but depression, panic attacks, all that, yes a long time. Try a mixture of patience and looking at your fears.
If the fear is too big, don´t look. Try existing, try doing something nice or even something necessary and concentrate on that.
Try looking at your fear again.
What is the worst that can happen? You fear beeing overrun by a car?
Your fear is solid, don´t try to fight it with bravery, just train yourself to be EXTRA careful.
You fear you could fall into a thorny bush by the wayside? Go that way anyway, fight your fear with bravery at a time you have the nerve for it.
Perhaps take a tetanus shot before.
Have a lot of patience with yourself.
Still fighting myself.
I am proud of me. I had a long fight. I exist. And at the moment it is even fun existing!
Tomorrow—who knows?
Finding your way between scylla and charybdis, be proud of yourself.
Just curious, how related do you think your symptoms are to social interaction?
This reminds me of the post I wrote about my own depression: https://chipmonk.substack.com/p/depression-was-useful
They both tend to limit my (already limited) tolerance for it and make it much harder, although the depression makes it harder in general while the anxiety only makes it harder in higher-stakes situations, such as at work with a boss.
Your post is another interesting perspective I haven’t delved into as much as I’d like. It reminds me of the parts work some of my friends are fond of—taking something negative in one’s brain and asking, “but how is this useful? What is it doing for me? What is this piece of me trying to protect me from?” and then running with the result.
I’ll have to give it more thought.
yes yes this!
The Coherence Therapy Institute case studies are great for this btw
Thank you for sharing this. I’m sorry that anxiety and depression continue to haunt you. I’ve had my own, less extreme, struggles, so I can relate to some of what you wrote. In my case, I was lucky enough to find some good personal development resources that helped me a lot. One I might suggest for you to check out is: https://www.udemy.com/course/set-yourself-free-from-anger/. You can often get this course on sale for <$20. From what you’ve described, I think the “Mini Me” section might be most useful to you. Hope this helps you in some way.