[Brentus]

I'm in kind of a weird place right now. My depression has lifted a lot and for the first time in a very long time for me. Thinking clearer, and more positive has left me to realize I have a lot of ingrained negative thoughts and feelings about myself. They are no longer "just depression" but literal pieces of how I think and feel. I feel like anyone who goes through multiple bouts, or even prolonged bouts of depression can relate.

Honestly, I feel 1000% better from where I was, but I caught myself today saying things like " There's no reason to try to deal with other people -- no one wants to be around you. You aren't attractive, you aren't charismatic, you offer nothing and suck up so much resource. Just leave everyone else out of your crap."


While I feel that way, that stands a large problem between reintroducing myself to a quality life. I am in therapy and things, so I'll be working on it -- but I was wondering have any of you ever thought about the long term effects of depression? It really does alter more than just a mindset in the midst of an episode.

[Yaowen]

You are very insightful.

As for myself, I have thought about what you mention for quite a long time. I have tried to introduce some element of clarity into my reflections and this is what I have come up with. Not sure it would be useful to you or anyone else though.

Generally speaking, in a depression I get "stuck" in a "could be better, but isn't better" frame of mind. I look at myself and think "could be better, but isn't better." I look at others and things and events in the world in the same way.

This "could be better, but isn't better" attitude has huge benefits. It creates a certain sense of dissatisfaction. Without that we wouldn't have cures for diseases, elevators, air conditioning, heating, refrigerators, airplanes and so on.

But "could be better, but isn't better" all by itself, if it is not relieved by anything else leads to chronic feelings of dissatisfaction, frustration, aggravation, anger, sadness and guilt. It would be odd if "could be better, but isn't better" didn't engender these feelings and moods.

But there is another attitude which provides balance. It is the attitude "could be worse, but isn't worse, thank goodness!" This attitude has certain benefits. It tends to produce feelings of appreciation, gratitude, peace and joy of living.

It could be that the "could be better but isn't better" is sort of humanity's default attitude. Without it, perhaps we would still be living in caves. Don't know.

A heavy "could be better but isn't better" attitude is sometimes called "perfectionism." It tends to equate goodness with perfection and denigrates anything that falls short of perfection as "bad" in some way.

One problem with this is it destroys the range of values involved in good and bad. For a perfectionist, getting a poor grade in school can seem to make that person "bad" and engender guilt.

But take, for instance, people like Adolf Hitler, Stalin and others who caused the destruction of tens of millions of people through genocide and campaigns of forced starvation. If only the perfect is good, then we lose the entire range of good and bad. It can seem as though getting a bad grade is just as bad as causing genocide, which it isn't.

Most human failures do not result in the destruction of tens of millions of people. But for perfectionists, good is never good enough. And the same level of guilt that we might expect a genocidal dictator to have can attach itself it us for things that are far, far, far away from the badness of genocide.

There have been some studies, limited* of course, that have linked the brain's exposure to excessive amounts of stress hormones to depression. We tend to think of stress in terms of traumatic events. But "perfectionism" is a huge stressor. None of us are all powerful, all knowing, all-seeing, all perfect, Infinite Beings. But the effort to be perfect can be hugely stressful on the brain.

Sometimes, I think, when we recover from an acute episode of depression, if we don't modify attitudes that got us into depression, we will slowly or quickly slip back into it.

One can't unlearn a lifetime of perfectionism in few days, weeks or months. I have little post-its all over my house that read "could be worse, but it isn't worse, thank goodness." By seeing these throughout the day I have a kind of balance against my perfectionism and it gives me some needed perspective and breathing room. This helps me.

Like I said, I don't know if this would be of any use to anyone but me.

I hope you find something that helps!

*Note: All medical research is subject to limitations, such as size of study, duration of study, quality of study, objectivity of study, cofounding factors, new discoveries and so on.

[imchet]

I'm 48 and have had multiple major depression episodes. I've noticed that my peers without depression have continued to move forward and grow in many different areas whereas I've had to start over so many times that I find myself further and further behind my peers when it comes to life's achievement benchmarks.

I really don't relate all that well to people of my age, even though I made it a long way through life pulling myself up by my bootstraps and believing that I could get by by working harder than other people and by making the most of the opportunities I've had.

So, for me there have been significant long term working, social consequences. I've been able manage some of the physical outcomes to an extent, but that seems to be catching up to me at this point as I am significantly heavier and less fit than I've been most of my life. I take responsibility for that but, it's important to recognize the significant role depression and medications has played in that.

So, long term effects? Isolation, lower achievement, poorer physical health, and lower life expectancy that comes with poorer health. Pretty brutal, I guess. Still, I'm proud of what I have done and will continue to mitigate those long term effects as much as possible.

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