ANXIETY & DEPRESSION

Notes On Life With Depression.

Sometimes I read back over my past writing and I find that I’ve been fairly prescriptive when talking about depression. As in, if you have X problem, try out Y and Z and you may feel better.

And to a certain extent, I think it’s appropriate for me or for other medical professionals to offer up suggestions, particularly if addressing the topic of dealing with depression.

After all, multiple and varying clinical studies have shown that psychotherapy and/or medication and/or other behavioral modifications can be a tremendous support.

And I’d be remiss if I didn’t encourage exploring this with clients in my office or in writing here on the blog.

But what can sometimes get lost in those more prescriptive writings is an acknowledgment that perhaps, for many, depression isn’t something that will ever be “fixed” but rather is something that has to be lived with, either consistently or cyclically. And then I think it’s less helpful to talk about depression as a thing to fix and solve, but rather to simply acknowledge what life can be like when depression is something you have to bear, when depression is something you have to live with and tolerate and it can’t be so easily “fixed.”

And so what can help with this bearing, this tolerating? Perhaps – sometimes – just reading words that make you feel less alone, that make you feel seen.  

And so today I want to offer a less formal post, a collection really of thoughts and musings about what life with depression can feel like in case this helps you feel less alone, more seen, and even just one bit more supported to go about your day while living with depression.

Notes On Life With Depression.

Depression can feel like a settling in, a slow, gradual creep on you that you didn’t quite see coming.

Depression doesn’t announce itself like a sprained ankle after a missed Zumba move; it’s so much more subtle than that. It grows and grows layer by layer until you wake up one morning filled with dread about the day, afraid to put your feet on the floor and even to check your phone because the thought of emails and notifications are too much.

You realize you don’t want to open your eyes and come out of sleep, not because you’re still tired, but because sleep helps you avoid life. Depression can feel like this when it settles in and arrives one morning.

Depression can feel like forcing yourself to move through the motions of human life.

Of brushing your teeth, putting on your makeup. Drinking water to stay hydrated, responding when your partner calls out to you.

Depression can feel like going on autopilot. Being there but not fully being there because so much of your mental and emotional energy is consumed, sucked inward by how badly and hopeless you feel.

Depression does not necessarily feel like sadness.

Sadness is characterized by a surge of emotion, a strength of feeling. Depression, rather, can feel like an absence of feeling. Like numbness. Like coldness. A blanket of heavy draped on top of a general state of vibrating fear and dread.

Depression can make it hard to find any ounce or spark of excitement about the things that would normally excite you. Plans in the future, looking at old vacation photos, texts from your best friend. Depression is characterized by a void.

Depression makes you will yourself.

Like willing yourself to get out of bed, willing yourself to leave the house, willing yourself to eat a square meal and drink water, willing yourself to show up at work. In depression these things don’t come easily, they take effort. They can take so much effort! It’s like that scene in The Matrix when Trinity is lying at the bottom of a stairwell after escaping and says to herself, “Get up, Trinity. Just get up. GET UP.” In depression, it can feel like that but with less motivation and energy.

And speaking of energy, depression can rob and drain you of energy like few other things in this world can.

So much energy is consumed inward just trying to maintain some small sense off equilibrium, of trying to be a functional human, that you can feel a bone-deep weariness and fatigue thinking about anything beyond surviving moment to moment. Prospects of walks can feel overwhelming, a gym workout impossible, lasting through a dinner party and making pleasant conversation laughably unrealistic. Depression can make you feel that all you have energy for is to curl up on your bed or couch. Hidden by blankets, with a TV show to get lost in.

Depression can make you wonder why your life has to involve contact with other humans. When clearly you are so not up for that.

Depression can make you doubt photographs or memories of times when you seemed happy.

Depression is seductive and makes you question whether that will ever be possible again. When you will ever feel joy, energy, or happiness. Depression can be amnesiatic in that way, making you forget prior versions of yourself. Thinking (falsely) that this is the only true version.

Depression laser focuses time. 

Depression makes thinking about the future impossible. The past unbearable. And depression begs us to live in the smallest slice of time we can possibly manage. Which isn’t much, honestly. But the clock ticks on, and so in depression, we conquer another ten minutes of pretending to be functional.

It can rob us of our stalwart coping mechanisms.

30-minute workouts, chats with girlfriends, some solid sleep, being outside… all of it can fall flat when depression arrives and says, “Those won’t be good enough. They won’t even make a dent.” Depression is hard that way, the good self-care stuff we’ve learned through therapy, personal growth reading, or just being human suddenly is inadequate to face this new level of feeling. Depression unmoors us.

So what do we do if we are living life with depression for the first time, this most recent time, or all the time?

I do think it’s important to reach out for help.

Call your therapist, your doctor, your clergy, your mother and best friend. Isolation fuels depression and the self-imposed shame many of us add to the hard feeling states of depression don’t serve us at all.

Ask for help, allow help in whatever form that may take for you whether this is connection, professional psychotherapy support, medication, or some combination of all of it.

But also, consider this:

Depression invites us to act like people who have religion and faith do: trust.

You may not be able to imagine a future where you don’t have these feelings, but keep acting as if and putting one foot in front of the other. Fold the laundry, take your vitamins, show up to work, tuck yourself into bed. Have faith that these repeated, compounding moments of good self-care (on autopilot they may be) will add up and the tide will turn.

Depression can feel like the loneliest, scariest slog in the world.

Like a trek through some proverbial Mordor minus the fine companionship of Samwise Gamgee. Depression is a trickster who says, “You’re all alone in this and it will always be this way.” Both things are untrue. Even with the most chronic and persistent depression, there may be moments of levity again. And all around you, though you may not know them and they may not open up about it even if you do know them, countless other people are struggling with depression, with their own proverbial treks across Mordor.

Depression doesn’t mean you are flawed or broken.

Depression, from a purely biological lens, says our brain chemistry is imbalanced. And we’re feeling the physiological impacts of it. Depression, from a spiritual lens, may say that there’s a wound in our soul that needs tending to. And there are countless other lenses and perspectives of depression out there but the one I don’t buy into in the slightest is the idea that depression signals that something is wrong with us.

I hope this felt helpful and maybe a little soothing to read.

So often in the world of psychotherapy and personal growth, we and our experiences are reduced to “problems to be solved.” And I don’t think that’s very helpful.

Instead, what I think can be more helpful, is more truth and sharing and connecting around the experiences we find ourselves having – particularly if they are painful or isolating in the way depression can sometimes be. This sharing, this connecting, this truth-telling is, in my professional opinion, a powerful healing force. So please, reach out and connect with someone if you’re feeling depressed. Read the stories of others who have journeyed through depression. Take life moment by moment and care for yourself in the same way you would for a precious child or beloved pet.

Before you close this tab.

And so now I’d love to hear from you in the comments below as a way of helping our other blog readers feel less alone:

Please leave a message in the comments below so our community of blog readers can benefit from your wisdom.

Here’s to healing relational trauma and creating thriving lives on solid foundations.

Warmly,

Annie

Additional Resources:

• Best Products for Anxiety
• 5 Important Things to Remember If You’re Experiencing Depression.
• Four Effective Tools For Managing Anxiety.
• 11 Signs of High-Functioning Depression: Do You See Yourself In This List?
• The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness.*

Frequently Asked Questions

You deserve a life that feels as good as it looks. Let’s work on that together.

References

• American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Publishing.
• Nestler, E. J., & Hyman, S. E. (2010). Animal models of neuropsychiatric disorders. Nature Neuroscience Reviews.
• Heim, C., & Nemeroff, C. B. (2001). The role of childhood trauma in the neurobiology of mood and anxiety disorders: Preclinical and clinical studies. Biological Psychiatry.
• Cuijpers, P., Karyotaki, E., Reijnders, M., & Purgato, M. (2020). Psychotherapies for depression: A network meta-analysis covering efficacy, acceptability and long-term outcomes of all main treatment types. World Psychiatry.
• Williams, J. M. G., & Broadbent, K. (1986). Autobiographical memory in suicide attempters. Journal of Abnormal Psychology.
• Gotlib, I. H., & Joormann, J. (2010). Cognition and depression: Current status and future directions. Annual Review of Clinical Psychology.
• Pargament, K. I. (1997). The Psychology of Religion and Coping: Theory, Research, Practice. Guilford Press.
• Schildkraut, J. J. (1965). The catecholamine hypothesis of affective disorders: A review of supporting evidence. American Journal of Psychiatry.
• Schore, A. N. (2001). The effects of early relational trauma on right brain development, affect regulation, and infant mental health. Infant Mental Health Journal.
• Bowlby, J. (1980). Attachment and Loss: Vol. 3. Loss, Sadness and Depression. Basic Books.
• Kaufman, J., & Charney, D. (2000). Comorbidity of mood and anxiety disorders. Depression and Anxiety.
• Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., & van Straten, A. (2014). The effects of psychotherapies for major depression in adults on remission, recovery and improvement: A meta-analysis. Journal of Affective Disorders.

Both/And: A Clinical Diagnosis and a Full Life Can Coexist

When a driven woman receives a clinical diagnosis — whether it’s depression, anxiety, PTSD, or any condition that disrupts the narrative of “I have it together” — the response is often split. Part of her feels relief: finally, a name for what she’s been experiencing. Another part feels threatened: this label could undermine everything she’s built. In my work, I find it’s critical to hold space for both responses.

Jordan is a tech executive who was diagnosed with complex PTSD after three years of therapy. She’d always known something was off — the hypervigilance, the nightmares, the way her body went rigid during conflict — but putting a clinical name to it made it real in a way that frightened her. “If I have PTSD, does that mean I’m damaged?” she asked me. What I told her is what I tell every driven woman who sits with a diagnosis for the first time: the diagnosis describes what happened to you, not who you are.

Both/And means Jordan can carry a diagnosis and carry on with her life. She can take her mental health seriously — medication, therapy, lifestyle changes — and still be the competent, driven professional she’s always been. She can be a woman with complex PTSD and a woman who runs a $50 million division. The diagnosis doesn’t diminish her. If anything, it explains the extraordinary energy she’s been expending to function at the level she does, and it points toward a path where functioning doesn’t have to cost so much.

The Systemic Lens: Why Your Diagnosis Exists in a Cultural Context

When a driven woman receives a clinical diagnosis, she enters a healthcare system that was not designed with her in mind. Mental health research has historically underrepresented women, particularly women of color. Diagnostic criteria were often developed based on how conditions present in men, meaning women’s symptoms are systematically misidentified or dismissed. The gender pain gap — the well-documented phenomenon of women’s pain being taken less seriously than men’s — extends directly into mental health, where women’s distress is more likely to be attributed to personality, hormones, or stress than to legitimate clinical conditions.

For driven women specifically, there’s an additional systemic barrier: the assumption that high functioning equals low severity. A woman who shows up to work, meets deadlines, and maintains relationships while managing a debilitating condition is often told — explicitly or implicitly — that she “can’t be that bad.” Her competence is used as evidence against her suffering, which is not only clinically inaccurate but deeply invalidating. High-functioning presentations of clinical conditions aren’t milder. They’re just better disguised, usually at enormous personal cost.

In my work, I hold the systemic lens because it affects treatment outcomes. When a driven woman understands that the healthcare system’s failure to see her clearly isn’t a reflection of her severity or validity, she can advocate for herself more effectively. She can seek clinicians who understand high-functioning presentations, insist on treatment that addresses the full picture, and stop internalizing the system’s limitations as her own.

Medical Disclaimer