depression support / survival
TABLE OF CONTENTS • part 1 • steps for being supportive support network / a template for outlining your needs / steps for being supportive / concepts for understanding • part 2 • tips for surviving / thriving fatigue tips / how to get anything done / doing it on your own / writings from the sludge pit
• quinn milton • • www.quinnmilton.com/zines •
support networks a support network is comprised of people you turn to for emotional support regarding your mental health. don’t deal with it alone. that’s what friends are for – specific friends who you have negotiated with. 1) identify who you want to have in your support network. friends you trust, who are emotionally available, good to talk to, easy to get in contact with, & who can understand what you are experiencing. there’s a reason it’s called a ‘support network’ & not a ‘support node’: relying on one person for all your emotional support is unhealthy for both of you. 2) establish needs & boundaries. (the people who are in my support network are also neurodivergent, so this step is especially important. co-support with someone who is also depressed is amazingly helpful when done right!) determine the best way to contact this person. 3) respect their time & emotional reserves. preface intense conversations by asking for informed consent.
informed consent looks like “I need to talk about today “I need affirmations “I need someone to distract me “I need reassurance “I am feeling anxious “I am having an anxiety attack “I feel very low “I am having obsessive / intrusive thoughts “I want to talk about this bullshit “I’m not sure what is going on “I need someone who understands are you available to talk?” can you give me some advice?” can I just rant at you for a bit?” can you check in with me every hour today?” can you help me figure this out?” can you walk me through this?” can you be present with me?” can you come over?” can we netflix and chill?”
my needs & boundaries (co-support model) I need: ☐ someone to check in with me / my self care ☐ positive affirmations ☐ to complain / rant ☐ sympathy / empathy ☐ advice / guidance ☐ to build trust ☐ I would like to communicate through these means & at this frequency: when I’m providing support I need: ☐ limited self-hate talk ☐ to establish time limits on conversations ☐ to check in before each conversation ☐ I need content warnings around: ☐ self harm ☐ suicidal ideation ☐ abuse ☐ weight / eating I do not want to talk about:
4) check in with them before things go wrong. ask if the support dynamic needs revisiting without fishing for affirmations or using negative self talk. instead of saying “I’m sorry for always being such a drag” say “I want to check in to make sure these conversations aren’t taking too much from you.” 5) resepect “no”. if your friend is not available to support you, it does not mean that they dislike you or that they do not want to remain a support person. 6) be invested in their lives, & share mundane things about your life. if you only talk to them when you need them, that is a weak friendship & support dynamic. 7) don’t lie. be straight up. if there’s something you don’t want to talk about, admit that. 8) thank & appreciate them. 9) if you are in a really bad way, such as experiencing suicidal ideation, or have a habit of self-neglect, consider making an emergency plan. ask permission for every non-professional support person you include in your plan.
steps for being supportive
I started writing this guide for my (now ex) co-habiting partner so that they would know what to do when I am depressed. it is specific to me, but maybe there’s content here for you: if you want to be a better support for someone with depression, or need someone to be a better support for you. in that vein, feel free to steal these ideas for your own use. I can only speak from my own experiences and needs. depression varies widely for different folk. I am diagnosed with dysthymia, which is characterized by constant mild depression with occasional episodes of major depression. I am fairly high-functioning and I take two SSRI medications. I have a psychologist & am in the process of finding a therapist to help me get better. please seek professional help if you are depressed. please encourage your friends to seek professional help. psychiatry is not the only solution, of course, but neither should you & your support network do this alone and without guidance. quinn milton www.quinnmilton.com www.quinnmilton.tumblr.com
how to tell if I’m depressed • ask me specifically “how is your mood?” “are you depressed?” • that’s the only way to know for sure. • if I complain about fatigue, probably ask me about it. • my mood is always low. questions like “how is your mood compared to yesterday?” are helpful.
why do you need to know if I’m in a period of depression? so that you know how to relate to me, & so that you can help me recognize patterns in my own mood. also so that I don’t feel isolated. de-stigmatize depression by talking about it!
often I do not “seem” depressed • I laugh & smile. • I am productive / working on something. • I can converse on familiar / specific topics. • disengagement can be mistaken for normal quietude. • I am clean & put together.
things you can do when I feel down suggest things for us to do together like: • • • • • • • •
take a walk go get coffee snuggle and watch a show play a video game hang out with others in a low-key way look at photos of cute animals buy a new plant make yummy food.
if I decline, it’s not a rejection of you, & it doesn’t mean that I wont want to do it in the future or don’t want you to ask. remind me that I have interests: • watch a piece of media I care about or have wanted to see • replay a videogame that I love • play a funny game • hang out with cats • remind me of things that I’ve made
little things to help me with self-care • • • • • • • •
bring me water offer to make tea little massages clean common spaces ask me if I’ve eaten remind me to take breaks remind me to get fresh air remind me to exercise
if we’re not in the same place • check in with texts (“how are you feeling” AND tell me what you’re up to / send cute animals or emojis) • suggest I reach out to other friends • send me articles or videos I might be interested in
don’t / instead do not instead
expect or demand me to explain anything “I am confused about X / I want to know more about X. can I bring it up later?”
do not
ask me to make plans
do not
treat my depression with utmost gravitas / give me a sad face / say “I’m sorry you feel that way.” treat it like a cold. “oh that sucks, do you want some tea?” “that seems really frustrating. shut up, obsessive thoughts!” “I hear you. do you want to talk about it, or do X ?”
instead
instead
instead
do not
instead
dismiss my feelings as irrational. “I know you know that’s ridiculous.” “I know you know your friends care about you.” hearing that is not helpful, it’s frustrating. give positive affirmations. “you are fun to be around.” “your art is awesome” “you are strong” “you work super hard to take care of yourself ” “your feelings are valid” “I value X about you” “I am here for you”
do not instead
instead
instead
instead
make the conversation about your feelings. if when I talk about my depression or needs, you feel uncomfortable / hurt / defensive / scared, wait to respond. end the conversation by saying “I can’t have this conversation now. I need to take some space / time before I can listen compassionately.” ask yourself “is what I’m about to say supportive?” ask yourself “do I have an emotionally available person to talk to instead of my depressed friend?”
concepts & understanding
obsessive thoughts obsessive thoughts are like a swarm of flies constantly swirling around my head saying “I hate myself ” “hurt yourself ” “you are stupid” “I am alone”. sometimes they say totally innocuous or nonsensical things like “what’s for dinner” or “porcupine”. sometimes they say sometimes they say totally innocuous totally innocuous sometimes. I have these all the time, except for rare moments of tranquility on top of a beautiful mountain or after really good sex. when the obsessive thoughts are bad enough, they physically hurt all over my body, causing me to spasm.
spiraling thoughts like obsessive thoughts, spiraling thoughts are repetitive, painful thoughts that prevent me from feeling safe in my own head. spiraling thoughts are narratives. they are conversations I’ve had with myself so many times over the years that they are engraved in my mind. it’s easy to fall within these grooves and difficult to get out. example: “what you’re feeling isn’t real. you are a faker. you orchestrate all your own problems because you hate yourself. I hate you. how could you do this to me / yourself?” “this isn’t so bad. I’ve been through worse. it’s so much effort to talk to other people and I can deal with it on my own. I should just not talk about it. why am I making such a big deal?”
fatigue all I want to do is sleep. I sleep for 10 hours and wake up tired. I sleep for 5 hours and freak out about insomnia. my dreams wreck me, & I can’t shake them for a whole day. I feel dull & have a headache all day. I am not productive enough to justify my self-worth. holding a conversation is difficult, so I feel uninteresting & isolated. my eyes ache. I feel like I must be starving but when I eat I seem to get no energy from it.
(at this point in writing, I feel like giving up. I am thinking about cases of severe depression, & my own struggles feel inconsequential in comparison. this is needlessly dramatic, I think. you don’t need anyone’s help. to get support, you’re going to have to force yourself to spiral more. anyway – )
what does it feel like? today* my friend N asked me what my depression would look like if it were a landscape, or a kind of weather. “it’s a cave,” I said. “it’s an opressively enclosed space. there’s water, but it’s stagnant. it’s a dark, moist, moldy cave.” I worry that people try to understand me by relating my experiences to their own. it can be great to talk to someone who has been through something similar. but understanding, respect, & support do not hinge on personally relating to my depression. my experiences & needs are valid whether or not you have been through something similar.
* June 2015
tips for surviving / thriving
it’s easy to convince yourself that depression is a moral failing because that means it could be better if you were better. in our continual efforts to understand the world, depression, especially chronic depression, demands center stage. everything becomes about that sludge. it is both the blinders & your only tool to navigate.
swap out caffeine swap in alternative energy
teas that use the above ingredients. if you like brewing potions, buy bulk raw ingredients and make your own teas! the above also come in concentrated capsules.
drink water drink all the water! eat
give your body a fighting chance to combat depression fatigue. figure out what foods give you energy. stock up on easy snacks like nuts, dried fruit, protein bars, jerky, juice.
omega-3 take fish oil capsules daily for a good boost. keep moving at least once an hour, stretch your body, or switch tasks. keep your brain out of a rut.
exercise working out increases vitality, & improves sleep. start easy with a long walk to good music.
my favorite bedtime drink
protein & sugar before bed give your brain the energy it needs to recouperate during sleep.
alarm clock
waking up at the same time each morning stabalizes your sleep cycle.
see a doctor
there are other conditions that cause fatigue besides depression & stress. talk to a doctor to rule out or identify other causes. your doctor can also help you find experts to improve sleep hygene & nutrition.
how to get anything done the world demands much of us. go to school, find work, hustle, socialize, keep a roof over your head, feed yourself, consume, spend. capitalism does not demand that you be healthy; it demands that you be fit & productive. so much advice for depressed folk is about returning to a productive state, or doing unhealthy work regardless of the harm it causes. not every neurodivergent person can be highfunctioning. every person has the right to health care, & food & shelter security. but saying that doesn’t change the current socioeconomic reality.
depression degrades my memory & focus. since I have trouble multitasking, or going through multiple steps, I break everything down into its components. I have a spreadsheet with all the information of what is going on in my life & what I have to do. each day I track what I’ve done – it’s usually more than I feel like I’ve accomplished. this way, I don’t need to remember everything. I also make compromises. I say to myself, “this has been a bad day for caring for my body. but it’s been a good day for making art, & that’s okay.” nearly all people I know, including neurotypical folk, are hard on theirselves for not accomplishing “enough”. we will never accomplish “enough”. maybe the issue isn’t how much we accomplish but what we consider accomplishments. take small steps today to make tomorrow easier.
doing it on your own / doing it on the go public places to be alone for cheap • a church when there isn’t a sermon. most will be open to the public. no one will talk to you & it’s a quiet, peaceful environment to be alone. • kill time in a bookstore or library. there’s plenty of material to distract or ease the mind. • buy a cheap drink at a cafe. they’ll allow you to hang out there for hours. • cemetaries
public crying etiquette • grab a seat on the subway perpendicular to a window. lean against the window with your hand over your eyes. stare at your reflection. noise is unacceptable, but tears & shaking are fine. • always carry sunglasses & tissues.
free / cheap activities • go for a walk • fill a tube sock with dry rice, tie it off, microwave it for 3 minutes. instant warm friend! • read a comic book, YA book, or picture book at the library or bookstore • scribble with crayons • buy or steal a small plant friend
apps I use the app Pacifica to keep track of my mood & health. it also has basic cognitive behavioral therapy techniques.
other recommended apps
ACT Coach
Breathe2Relax
MindShift
PTSD Coach
Stop, Breathe & Think
eCBT Calm
SAM
writings from the sludge pit
depression is the enemy of writing. depression can reduce the size & damage neurons in the hippocampus, the part of the brain associated with memory recall & emotion. it can lead to loss of verbal memory in particular. thankfully these are areas of the brain that can be regrown. writing while depressed is a struggle. my horizons are narrow, I can only see ten inches ahead. when I break free for a gulp of air, I want to shout: all the things I can’t feel, can’t say; all the confessions of myself, of love, of what this pain feels like, of what I know to be true.
desperate & urgent, I need to throw myself at the feet of my friends & be witnessed. what if it’s my last chance? what can I leave behind? is there anything to be gained from this toxic sludge? all I usually manage to get out are snippets that, in retrospect, seem insufficient & juvenile. in a lot of ways, my sick brain is dumb. but it also feels sharper, more essential. part of that is a trick, but only a part. I wish I could say that the link between artistic creativity & depression is fallacious, just dangerous romanticization. that sounds like the correct thing to say. my artistic drive, dreams, & depression, if not inexorably intertwined, are the constants in my life. I cannot separate them. to do so would mean a life where I deny my sense of reality. & as feeling unreal is a persistent symptom, I need to feel reality. depression is the enemy of creating, but warring with myself has fueled much of my art. it’s a bitch. if being permanently cured of depression meant losing any of my artistic sensibilities, I don’t know if I would go for it. having never really experienced happiness, I’m skeptical that it’s all it’s chalked up to be. although on most days I would probably make that trade. it’s just hard to imagine who I would be after that. I think it’s easier for my friends to see who that person is.
if your leg was broken, no one would tell you to pull it together & walk. you need a cast. you are impared, but life still goes on. you have to use crutches to get around, your muscles ache. hills you used to be able to take in stride now seem impossible. take different paths. get your friends to drive you around. even if your leg is broken, you have to manage your life. you can’t do everything you could do before. with help, you can still do a lot. it’s okay to only do the bare minimum until you recover. after the cast comes off, your bones & muscles may be weak. be tender with yourself. be patient.
the moment of action there comes a moment when you decide to implement self care. you’re so tired of the bullshit that anything is worth a shot, even being kind to yourself. you don’t necessarily believe that you’re worthy; you always thought it was crap when they said smiling was supposed to make you feel better. you decide to eat, sleep, & bathe every day, & generally care for your flesh sack as you drag it through the world. you roll your eyes at the bad thoughts. you start nurishing yourself with positive thoughts instead, at first flat and cliché. it’s almost enough to make you believe. you seek professional help. as long as you are rigorous every day, you won’t slip back into the sludge pit. & then you fuck up. you fuck up again & again, & it seems like the payoff of self care will never come through. each time you misstep you have to crawl back out of the mud, not realizing that your legs grow stronger. the fear of inevitably failing makes the regiment of self care itself stressful. it goes on. self care is imperfect. it’s okay to slip up, and each fall bruises less. the work of self-care is valid work regardless of the outcomes.
1/4/16 I keep discovering what isn’t normal. overtime, people disprove the qualities of living that I take for granted as universal. everyone does not experience daily manic highs & crushing lows. everyone does not feel unreal, as if they are puppeting each action from a remote cavern. everyone is not always sad. to me, these realizations were groundbreaking. whenever my pediatrician asked if I experienced feelings of depression, I would reply, “nothing out of the ordinary.” I did not mean nothing besides circumstantial sadness. I meant nothing besides the constant low baseline I assumed we all shared. after a certain point, it just seemed too much of a hassle to address the depression that weighed down every aspect of my life. it was my burden to bear, & I bore it alone for over a decade. I hardly ever cried as a baby. I was a quiet, observant child, always imagining, remote, & pensive. I possessed an unwavering conviction to make art. they called me sensitive, creative, & self-composed. when I was a teenager they called me rude & ungrateful. I spoke to God when I was four & knew it wasn’t real; I was an ameateur nihilist in middle school; & in high school I thought I was dying. none of the adults in my life really noticed. for a depressed kid, I was high functioning. my coping mechanisms divided me from myself. I wove elaborate
mental structures to perform normalcy with relative ease. I forced myself to go to school & get good grades (though I took many sick days). as long as I functioned & no one noticed, I was in control. there was a gulf between how I experienced myself & how I acted in the world. trying to turn my sadness into a coherent story only deepens that gulf, because my depression is just as complicated as any other part of my life. I wasn’t simply sad, though I was always sad. I had many moments of jubilant excitement, raucous laughter, & dramatization. I always got my words mixed up & said stupid shit, & felt both ashamed & loved when my friends laughed at me. I had crushes on boys & girls. I made a lot of art. I was ungrateful, & rude. I lied. beneath all that, the foundation of my experience was depression. I wish I could preface every interaction with “by the way, I am always mildly depressed.” dysthymia is different from chronic depression because it doesn’t arrive in periods of debilitating symptoms & then ebb away. it is constant & moderate. I am always wading in shallow waters, watching for the larger waves.
12/15/15 12:35am I have been working on sludge zine for half a year. I wrote “steps for being supportive” back in June & thought I should share it. throughout the fall I have added, illustrated, & doubted. (is it too heavy handed? what should I reveal or keep close to my chest? what resources can I offer? what does my audience know?) simultaneously I have been trudging through depression, new anxieties, new meds. I wonder how to finish this, & the scope of the zine expands as does the edge of the pit I am trying to crawl out of. I prop up my dignity with my ability to be high functioning & produce artwork. I don’t know what to do without that crutch. & it is a crutch, or worse, a corset: making of me someone palatable, form fitting, back straight. my elegant body is not healthy. the corset takes sweat, breath, & days off my life to wear. I’m writing at 12:30am in my friends’ apartment. the lights are off, I’m supposed to be asleep. I’ve been a sleep monster. I couldn’t get much done today. classic depression: can’t get out of bed. but I’m up looking blearily at this screen because I have searched all day for my fighting spirit, & this is what I found: just fucking do it. finish the zine. it shouldn’t be perfect, it should be bold & uncomfortable & written now while I’m deep in the muck. send it out before the new year. fuck shitty December & all the silt the past dragged on your doorstep. just write in this moment.
write to make you cry. write out of a spiral or back into one. write all the confessions you are desperate to give. write artifacts of yourself to leave before time’s cruelty. while you have a breath of air. while you still care enough about yourself to give pieces of yourself away. it’s been a tough week for a lot of people I care for deeply who have depression. we have variously leaned on each other, leant strength, left others alone. it feels both mundane & catastrophic. I’ve been crying a lot, which is not typical. from this point, I don’t know how it will go for us: one friend has a great support system, another has next to nothing. one is low-functioning, another has suicidal ideation. we’ll all make it to the new year, maybe unscathed & with love & patience; but maybe it will get worse. maybe this is all I can write this year. there is no direction, just swirling, shifting swamp; here, footing is solid, here I fall through. this area is tangled with roots & debris I might trip over or cling to. hard to say how deep it gets or how wide the pit. slowly, I sink. imperceptibly, the terrain shifts. there’s no solution either, except knowing when to struggle & when to be still. sludge has no point, it just is – & I learn to wear it & make it my own & tend of it a garden where both muck & vegetation grows. when I walk on dry ground, not dedicating every day to this illness, my clothes will be heavy, my skin coated in dry mud. some will crumble away, more will need deep cleaning. I’ll make art about other things.