Life, only moderately messed up: understanding high-functioning depression

My wife is one of the bravest people I know.

Almost six years ago, Rachel got pregnant. When we found out, she was in Colorado and I was home in western Massachusetts, and in phone calls and emails we giddily planned for the future. Five days after discovering she was pregnant, she miscarried.

Rachel mourned the end of her pregnancy by writing, processing a set of crushing emotions into a slim volume of poetry, Through. It’s not one she often turns to when she reads in public, but women who need the book seem to find the book, and she hears often from readers for whom the book was a lifeline in a very difficult time.

Not long after, Rachel got pregnant again and gave birth to Drew. In those first weeks of the sleepless, fumbling process of learning how to parent an infant, it was hard to notice Rachel falling into postpartum depression. It was months in, when Rachel was finding it hard to do anything more that nurse and sleep, that friends and family urged her to get help. She did and she got better, producing another book of poetry in the process, Waiting to Unfold.

(When Rachel reads poems from that book, some of the darkest lines get loud laughs from the audience. The level of despair associated with acute depression is hard to understand when you’re not personally plumbing those depths – it’s easier to understand those images as jokes about the dark night of the soul rather than actual dispatches from its depths. I suspect those that really need the poems read them as written.)

In a funny way, Rachel’s bouts with depression and her profound honesty in writing about her experiences have made it harder, not easier, to write and talk about my own depression. Having someone you love go through acute depression can make it easier to see the symptoms of depression in others, but may make it harder to see moderate, high-functioning depression, which is what I appear to be prone towards.

I was depressed for most of 2013, from roughly March through December. (I’m doing much better now – thanks for asking. One way you can tell is that I’m writing about the experience, something I could not have done last year.) Much of the depression coincided with the release of my book, Rewire, which was unfortunate for two reasons. One, I did a lousy job of promoting the book, and two, smart friends counseled me that publishing a book often leads to feelings of loss and mourning, which may well be true, but isn’t the best explanation for what happened to me during those nine months.

I didn’t understand that I had been depressed last year until a natural experiment came along. Every six months, MIT’s Media Lab holds “members week”, where principal investigators open our labs to the corporate, foundation and government sponsors who fund our work. Members week in the spring and fall of 2013 was an utterly miserable experience for me. It took physical effort to haul myself out of my office and talk to the folks who’d come to discuss our work, and I was exhausted for days after from the effort. I’d decided that this was normal – MIT is a high-stress place and members week is one of the higher stress experiences at the Media Lab.

But then I went through members week this spring, which was… fun. A really great time, actually. I’m proud of the work I and my students were showing, excited to see what my colleagues were working on and excited to see friends I have at the companies and organizations that sponsor the Media Lab’s work. I got a second chance at a natural experiment with Center for Civic Media’s annual conference, which we run each June with the Knight Foundation. I remember virtually nothing of 2013′s conference, and I spent a week in bed afterwards. 2014′s conference was a good time intellectually and emotionally, and not only did I manage to feel better after the conference was over than I did on the first day, I also managed to get in a four-mile walk each day before sessions started.

Objectively, there’s a lot that’s harder in my life this spring and summer than there was in 2013 – illness in my extended family, uncertainty about financial support for my research. If mental state were purely a reflection of life circumstances, these meetings should have been harder in 2014 than in 2013. But that’s not how depression works. While depressed, everyday tasks are hard, and social tasks that challenge my introverted nature are extremely hard. They’re not impossible, just highly draining, which is why high-functioning depression is hard to see in others.

These natural experiments have forced me to think about my depression and why it’s been hard for me to see. In retrospect, I now think I’ve had several periods of significant depression since college, and twice have sought professional help. (That I’ve never been put on medication for depression is more a function of my obstinacy and ability to talk my way out of treatment than an objective evaluation of my psychological state.) As I’ve been “coming out” to myself about depression, my closest friends have offered sympathetic versions of “well, duh!”, noting that it’s been clear to them when I’m having a hard time and am not my normal self.

My guess is that my depression is significantly less visible to people who know me only professionally. I’ve never missed work or another professional obligation. I teach classes, give talks, advise students, attend meetings. The difference is almost entirely internal. When I’m my normal self, those activities are routine, easy, and leave a good bit of physical and emotional energy for creativity and expression. When I’m depressed, the everyday is a heavy lift, and there’s little space for anything else. The basic work of answering email and managing my calendar expands to fill any available time in the day. I’m far less productive, which triggers a voice that reminds me that I’m an unqualified impostor whose successes are mere happy accidents and that my ability to write a simple blog post is proof positive that I’m in the wrong place, doing the wrong thing, in need of walking away from my life as currently configured and starting over. It’s an exhausting dialog, one that crops up for moments at a time when I’m well, but can fill weeks and months when I am not.

I think what’s made it hard for me to identify my own depression is having close family and friends who’ve dealt with severe depression. What I’ve experienced isn’t anywhere as serious as what friends have gone through, including bouts of near-catatonia. The problem with having experience with the harrowing and dangerous extremes of mental illness is that the experience of being moderately messed up may not even register on the spectrum. (I’m going to use the term “moderately messed up” to describe only my own experiences, so please don’t give me any crap about the political incorrectness of the term – moderately messed up is how I best understand my experiences.)

There are cases where it’s harder to find help as someone who’s moderately messed up than someone dealing with a more acute illness. About three months into this bout with depression, I decided to give up drinking. I theorized that I might have an easier time navigating this tough patch if I wasn’t rewarding myself for getting through a hard day with a few drinks every night. Thankfully, alcoholism isn’t a forbidden topic anymore, and twelve step approaches like Alcoholics Anonymous have been tremendously effective for many people, including friends and family. (My friend Wiktor Osiatynski’s remarkable account, “Rehab”, helped me understand why many people describe AA as having saved their lives.)

But powerlessness in the face of addiction doesn’t accurately represent my situation. I came up as a “sensible drinker” on the AUDIT questionnaire and other screening tests for alcoholism. While the Denis Johnson fan in me is vaguely disappointed in my largely undebauched lifestyle, the main consequence of my drinking history is an ample beer belly.

I ended up taking a year off from drinking, with very little difficulty, and have gone back to moderate drinking and haven’t found it particularly hard to stop drinking after reaching the limit I’ve set for myself. I recognize that I am deeply fortunate, and I gratefully acknowledge that many people who have trouble with alcohol do have a disease for which abstinence and support is one appropriate response. (New research suggests that cognitive behavior therapy and harm reduction may have at least as positive results.) But it’s harder to find advice and support for the moderately messed up; detox and recovery wasn’t what I needed – I needed help changing my habits and drinking less. (Talking about this question with friends, one pointed me to Moderation Management, which might well have helped.)

As with my drinking, I am deeply fortunate that my depression is something that’s not life threatening. But that’s allowed me to gloss over long stretches of my life when I’ve not been my best, where daily life is a heavy lift. Identifying the past year as a period of high-functioning depression hasn’t led to the miracle cure or support group, but it’s allowed me to have incredibly helpful conversations with friends who are taking proactive steps to cope with their own depressive tendencies. A dear friend, a brilliant and productive programmer, uses meditation to help him manage depressive spells. I’m finding that walking is critical to my psychological health, as is finding a way to put firmer walls around my work life. (Turns out that the upside of drinking is that makes it very hard to do academic work, forcing an end to your work day. A year without drinking helped me see how flimsy my work/life barriers are.)

So why write about depression? One set of reasons is practical, and selfish. I process by writing, and much of my processing right now centers on these issues. I write better in public than in private, and so this is likely a helpful step for me, independent of whether reading this is helpful for you in any way. And writing about depression here, on the record, makes it harder for me to delude myself the next time I find myself writing off a bout of depression as just “a rough patch.”

It’s possible that writing about depression is also the responsible and helpful thing to do. Rachel talks about her decision to open much of her spiritual and emotional life to her congregation and to her readers, acknowledging that it would be a sin of omission if her congregants didn’t know that her experience of offering prayers of healing was deeply informed by having loved ones in the hospital who she was praying for. There’s a balance, she notes, between sharing emotions and making herself a three-dimensional human for her congregants and leaning on them to shoulder her troubles. My hope is that there’s a way to write about these issues that’s less a call for support (not what I need right now) and more an invitation to talk.

So far, talking about my experiences this past year has led three friends to talk about their own struggles with depression and others to talk about anxiety, mania or other issues they are coping with. The only way these conversations have altered my friendships is to deepen them: I am more likely to turn to these friends the next time I am struggling and hope they will turn to me as well. It turns out that depression is remarkably common in the US, affecting as many as one in ten people in any given year. As Ian Gent observed, nearly everyone in academia is high-functioning. As a result, there is necessarily a large contingent of high-functioning depressives at MIT, likely including some of my students and colleagues. If I can be open and approachable on the topic, perhaps it makes it easier for people to seek me out for help at a university where stress is epidemic and sometimes celebrated. (In the first semester I taught at MIT, two colleagues told me stories of professors who ended up hospitalized for overwork. These stories weren’t offered as warnings – they were celebrations of an admired work ethic. That’s an environment that makes it hard to talk about depression or other mental health issues.)

I’m writing about depression because I can. As John Scalzi has memorably noted, “straight white male” is the lowest difficulty setting in the game of life. Add to that the fact that I’ve got a good job at an institution that is trying to do the right things on work/life balance, with a boss who’s written openly about his relationships with alcohol and other health issues, and it’s simply easier for me to write about these issues without fearing professional consequences than it is for many others. I believe that speech begets speech, and if more people are talking about working through depression, it becomes easier for the next person wrestling with these issues.