Shades of Depression: Anhedonia, Anxiety, Anger, and Alienation

            Depression has been described in many ways. Through my experiences and my reading and discussions with others, I think that while there are some common experiences, the details of each person’s experience with depression are unique, and vary even among multiple experiences of depression for the same individual. I’ve felt terrible sadness, apathy, hopelessness, helplessness, and these things I thought were all normal. Yet I’ve also had other experiences less well-associated with depression, and I’m not alone.

Anhedonia

            “Anhedonia is defined as a loss of capacity to experience pleasure. This inability to enjoy pleasurable things is associated with a number of mental health problems including depression. The word anhedonia comes from ancient Greek and means without delight. The individual who is experiencing this condition will find that their life is emotionally empty.

            “…A world without pleasure is a grey place indeed. Without this emotion, life become monotonous, and there doesn’t seem to be much point in doing anything. Day to day living becomes an endurance race, and there is no motivation to try to improve things. The inability to experience pleasure means that life can feel pointless, and that is not a satisfying form of existence. It is a particularly dangerous way to feel if people are trying to recover from an addiction.

            “…Pleasure is a vital component of the internal reward system – it helps people grow and learn. If the individual is unable to experience rewards they will fail to make any progress.” —‘Anhedonia in Recovery’

            Anhedonia sucks. It sucks away your motivation to recovery, to do anything at all. “What’s the point?” you may think.

            “I know nothing. I can do nothing. I understand nothing. I know nothing. Nothing. And all this misery does not even make me particularly unhappy.” —Gerhard Richter

            I go through the motions, but get no pleasure, and soon may not have the energy or motivation to go through the motions. I wander through a twilight fog where everything has lost its color.

            In this state, anytime I feel a glimmer of feeling for anything, I grab it, fiercely, and hold on as long as I can, until that fleeting joy is gone. I feel as though I am hopping from melting ice floe to melting ice floe over a killing-cold lake, and I wonder if they will sink, or get too far apart, or run out before I reach the other side I’m hoping is there.

            “I tend to find the ecstasy hidden in ordinary joys, because I did not expect those joys to be ordinary to me.” —Andrew Solomon

Anxiety

            “If you told me that I’d have to be depressed for the next month, I would say, “As long as I know it’ll be over in November, I can do it.” But if you said to me, you have to have acute anxiety for the next month,” I would rather slit my wrist than go through it. It was the feeling all the time like that feeling you have if you’re walking and you slip or trip and the ground is rushing up at you, but instead of lasting half a second, the way that does, it lasted for six months.” —Andrew Solomon, ‘Depression, the secret we share’ TED Talk

            Living in terror or panic for a prolonged time affects your body. Your adrenal glands wear out. You’re hypervigilant. You can’t sleep, and your body doesn’t recharge. The cortisol soup your whole system is swimming in takes its toll. Your brain rewires. Your sense of the future becomes foreshortened. Anything can trigger you to fight, flight, or freeze. It can become too much to leave the house, into a world of unknown variables and overwhelming stimulation. It can feel like having no skin.

            You develop learned helplessness when nothing you can do stops the source of fear and panic. It wears you out when you feel you have to keep this vulnerability hidden, which if you are living with someone or something that is threatening to you and more powerful than you, is highly likely. You feel small, disempowered. You are liable to lash out at the smallest trigger. It is as though the gain has been turned up on everything—a whisper is a shout, a simple word is a hammer blow.

            It is hard for me to tell, having lived with terror all my life, what is a genuine assessment of a threat, what is a childhood flashback, what is either causing or a result of depression. What I do know is, regardless of cause and effect, terror is the most debilitating of all. With anhedonia, even at its worst, I still can connect to the idea that I haven’t experienced absolutely everything, and perhaps there is something out there in which I can take pleasure. Anger, even frustrated and helpless anger, urges me to action against that which is intolerable and unjust.

            Fear chases me into a corner, binds my chest with invisible iron bands so I cannot even dare breathe or make a noise, lest someone notice I am here and take more from me when I have nothing to give, or beat down someone so beaten down by life I feel paralyzed.

            “Suicide is really more of an anxiety response than a depression solution: it is not the action of a null mind but of a tortured one. The physical symptoms of anxiety are so acute that they seem to demand a physical response: not simply the mental suicide of silence and sleep, but the physical one of self-slaughter.” —Andrew Solomon, ‘The Noonday Demon’

Anger

            “First, you are faced with an experience that seems wrong or unfair. Second, you don’t feel able to calmly correct it. And yet, in order for you to feel okay, the situation must be successfully resolved because leaving it as it is does not feel like an acceptable option (the third factor). You feel a strong desire to right a situation that seems wrong, yet you also believe that, at least for now, you are unable to do so. When this set of circumstances occurs, your normal, built-in, human response is anger.”
—Marcia Cannon, ‘The Gift of Anger’

            “A lot of painful things happened to me, and I just wanted to forget. I would wake up in the mornings and just be angry that I woke up. I felt like there wasn’t any help for me, ’cause I was just on this earth wasting space. I lived to use drugs and used drugs to live, and since drugs made me even more depressed, I just wanted to be dead.” —Sheila Hernandez

             “It’s like a hurt. It’s just like they raking your heart out your body, and it won’t stop, it’s just like somebody’s taking a knife and keep stabbing you all the time.” — Danquille Stetson

            It’s been said that depression is anger turned inward. I think depression can have in it anger both turned inward and outward. In depression what I have felt is helpless anger.

            I’ve been angry at hurt I could not prevent or defend against, angry both at the source of the hurt and at myself for my impotence or weakness.

            All this anger is exhausting and demoralizing, and without effective ways to express all this anger non-abusively and feel heard, it becomes a hopeless, angry despair. Loneliness is not just the absence of people but the absence of compassionate understanding.

            “I meet people and I know that they don’t have the level of experience that I have.” —Bill Stein

            Despite a lifetime of painful interpersonal traumas, I have come to believe there are some out there who aren’t habitually, mindlessly hurtful. Yet the absence of a flaw doesn’t indicate the presence of a virtue.

            We humans are rarely comfortable with the expression of emotions like anger and fear and shame, even when we are only bystanders. It takes awareness, effort, investment, and a willingness to learn from inevitable failures to practice empathy, compassion, validation, and humility in the face of these things; with emotional boundaries that don’t trend to self-protective insensitivity. Too often we rely on comparison and pity in the face of others’ pain; or unwanted and inappropriate judgment, advice, and humor. Intellectual understanding blocks empathy.

            “Generosity and love demand great expenditure of energy and effort and will.” —Andrew Solomon, ‘The Noonday Demon’

            Prolonged anger can also have physical health consequences—heart attacks, hardening of the arteries, strokes, hypertension, high blood pressure, heart rate and metabolism changes, muscle and respiratory problems (Dr. Herbert Benson, The Relaxation Response, 1975).

Alienation and the Struggle to Overcome it

            Depression is an alienating experience. Anhedonia, acute anxiety, and anger are alienating experiences.

            “You can’t measure in objective terms how sick people are or what their symptoms are. You can only listen to what people say and accept that that’s how it feels to them.” —Deborah Christie
 

            “There is an interaction between illness and personality; some people can tolerate symptoms that would destroy others; some people can tolerate hardly anything. Some people seem to give in to their depression; others seem to battle it. Since depression is highly demotivating, it takes a certain survivor impulse to keep going through the depression, not to cave in to it.” —Andrew Solomon, ‘The Noonday Demon’

            Compassionate understanding isn’t something we’re automatically good at, nor empathy, nor non-judgment, listening skills. Capacities for these are there, unless you’re a sociopath, but it takes mindful work and perseverance, and humility, to build and practice these skills. It’s not easy, it’s not always fun, and it requires uncomfortable self-examination and self-honesty and a willingness to fail and try again.

            Becoming a brain surgeon is hard work and you would (I hope) not presume to try brain surgery without that work. Yet many people try to offer support who have underdeveloped humility, awareness, and trustworthiness necessary to be effective. We do this because we don’t know what we don’t know. We also do this because shame shuts down genuine human connection and vulnerability (see Brené Brown’s work for more on overcoming these issues).

            I’ve been there. I’ve not only bought the t-shirt but run the t-shirt stand. But having had the experiences I’ve had, I can never return to not-knowing. Sooner or later I think most everyone is touched by tragedy or trauma, and ignorance is no longer an option. The choice is, what do you do then?

            “You cannot draw a depressed person out of his misery with love (though you can sometimes distract a depressed person). You can, sometimes, manage to join someone in the place where he resides. It is not pleasant to sit still in the darkness of another person’s mind, though it is almost worse to watch the decay of the mind from the outside. You can fret from a distance or you can come close and closer and closest. Sometimes the way to be close is to be silent, or even distant. It is not up to you, from the outside, to decide; it is up to you to discern. Depression is lonely above all else, but it can breed the opposite of loneliness. …So many people have asked me what to do for depressed friends and relatives, and my answer is actually simple: blunt their isolation. Do it with cups of tea or with long talks or by sitting in a room nearby and staying silent or in whatever way suits the circumstances, but do that. And do it willingly.” —Andrew Solomon, ‘The Noonday Demon’

            “Our needs are our greatest assets. I am able to just be there with people because of the stuff I’ve needed from people. I guess I’ve learned to give all the things I need.” —Maggie Robbins

Sources and further reading:

            ‘Anhedonia in Recovery’ article

            Hyperbole and a Half: Adventures in Depression by Allie Brosh

            Hyperbole and a Half: Depression Part Two by Allie Brosh

            ‘Depression, the secret we share’ TED Talk by Andrew Solomon

            ‘The Noonday Demon’ by Andrew Solomon

            ‘The Gift of Anger’ by Marcia Cannon

            ‘Honor Your Anger’ by Beverly Engel

            ‘Healing Through the Dark Emotions:The Wisdom of Grief, Fear, and Despair’ by Marcia Greenspan

            ‘The power of vulnerability’ TED Talk by Brené Brown

            ‘Listening to shame’ TED Talk by Brené Brown

            ‘Suicide: Read This First’ on metanoia.org

            ‘What can I do to help someone who may be suicidal?’ on metanoia.org

            Emotional Intelligence information on EQI.org

            ‘EQ for Everybody: A Practical Guide to Developing and Using One’s Emotional Intelligence’ free PDF by Steve Hein

Keys to Motivation

Get excited and make things

            Cultivate curiosity. Explore what excites you. Express that excitement in your work and in your play.

            Regularly practice play without expectation. Find others who are equally willing to explore and experiment, without imposing external goals or rules or structures.

Love the process

            Learn to love the work itself, not the rewards. Cultivate a capacity to value the act of doing something above others’ response or external reinforcement. When your goal is praise, positive feedback, accolades, being liked, or money, you giving away control of your self-worth and motivation. If your goal is intrinsic, you’re much more likely to achieve it, and you’re much more in control of figuring out how to achieve it.

            Brené Brown, author of ‘Daring Greatly,’ recommends not attaching your self-worth to the thing you have done. It is your work, and you have invested yourself in it, but the work is not you.

            “Intrinsic motivation is conducive to creativity; controlling extrinsic motivation is detrimental to creativity.” —Teresa Amabile

When you fail, celebrate your successes

            It’s important to learn from failure, but if you focus on failure, you get in the habit of thinking about those times. Share your successes with people you trust to share in your excitement without envy or bitterness. Remember times when everything clicked, and everything felt right. Remember times you have loved the work. Take time regularly to bask in those memories, to call up the confidence and enjoyment those memories inspire in you. Confidence and enjoyment counter fear of failure, rejection, humiliation, and shame.

Do Something

            “…we’ve all slacked off for lack of motivation before. Especially in times where we shouldn’t.  We feel lethargic and apathetic towards a certain goal that we’ve set for ourselves because we lack the motivation and we lack the motivation because we don’t feel any overarching emotional desire to accomplish something.

Emotional Inspiration –> Motivation –> Desirable Action 

             But there’s a problem with operating under this framework. And that is that often the changes and actions we most need in our lives, are inspired by negative emotions which simultaneously hinder us from taking action.” —Mark Manson, ‘The Do Something Principle’

            In behavioral therapy circles it’s well-understood that behavior can prompt changes in cognition and emotional responses. The brain, that master rationalizer, will eventually come up with an explanation for why you’re doing what you’re doing, a story that puts the behavior in context with your life. And your emotions will respond both to what you’re doing and the story your brain tells you about it.

            Mark Manson proposes this behavioral-therapy-worthy hack to overcome the problem of lack of motivation:

“Action –> Inspiration –> Motivation”

            Even the smallest of actions can prompt you to do something else. Taking small steps, doing one thing at a time, and celebrating successes can boost confidence, and higher confidence makes it easier to do something and to take bolder risks.

            “My math teacher used to tell us in high school, “If you don’t know how to do a problem, start writing something down, your brain will begin to figure it out as you go.” And sure enough, to this day, this seems to be true. The mere action itself inspires new thoughts and ideas which lead us to solving the problems in our lives. But that new insight never comes if we simply sit around contemplating it.” —Mark Manson, ‘The Do Something Principle’

            “The only way you’ll find out if you “have it in you” is to get to work and see if you do. The only way to override your “limitations, insecurities, jealousies, and ineptitude” is to produce.” —Dear Sugar, ‘Write Like a Motherf***er’

            Rinse. Repeat. Especially on days when you don’t feel like it. Especially on days when you have a hundred excuses not to. Train your schedule and your brain to the habit of doing something, anything. And do it again. And again.

Ignore Everybody

            “I feel like I’m on my back, and there’s the Sistine Chapel, and I’m painting away. I like it when people say, ‘Gee, that’s a pretty good-looking painting.’ But it’s my painting, and when somebody says, ‘Why don’t you use more red instead of blue?’ Good-bye. It’s my painting. And I don’t care what they sell it for. The painting itself will never be finished. That’s one of the great things about it.” —Warren Buffett

            “The professional cannot allow the actions of others to define his reality. Tomorrow morning the critic will be gone, but the writer will still be there facing the blank page. Nothing matters but that he keep working.
            …Remember, Resistance wants us to cede sovereignty to others. It wants us to stake our self-worth, our identity, our reason-for-being, on the response of others to our work. Resistance knows we can’t take this. No one can.
            The professional blows critics off. He doesn’t even hear them. Critics, he reminds himself, are the unwitting mouthpieces of Resistance and as such can be truly cunning and pernicious. They can articulate in their reviews the same toxic venom that Resistance itself concocts inside our heads. That is their real evil. Not that we believe them, but that we believe the Resistance in our own minds, for which critics serve as unconscious spokespersons.
            The professional learns to recognize envy-driven criticism and to take it for what it is: the supreme compliment. The critic hates most that which he would have done himself if he had had the guts.” —Steven Pressfield, ‘The War of Art’

            “Try advice that appeals to you, and ignore the rest.” —Jason Hough

             “The more original your idea is, the less good advice other people will be able to give you.” —Hugh MacLeod, ‘Ignore Everybody’

             “My advice? You don’t need my advice. You really don’t.” —Hugh MacLeod, ‘Ignore Everybody’

Quo Vadimus?

            You’re not always going to succeed. Edison famously found a thousand ways not to make a light bulb before he found the right way. You’re likely to fail a lot of the time, especially in those crucial times when you’re just starting out, or you’re taking new risks and you don’t have a lot of support. That’s when it’s important to support yourself with memories of your successes, and focus again and again on what your goal is.

            There are a thousand ways to get there. Find new ones, and if there aren’t any, forge them yourself. Leave the beaten path, ignore everyone, and cut your own way through the resistance. You’ll figure out what works, and keep doing it.

“Just keep swimming.” —Dory, ‘Finding Nemo’

“Around here … we don’t look backwards for very long. We keep moving forward, opening up new doors and doing new things, because we’re curious … and curiosity keeps leading us down new paths.” —Walt Disney 

Sources and further reading: 

            • ‘Get Excited and Make Things’ by Wil Wheaton

            • ‘The Do Something Principle’ by Mark Manson

            • ‘Flow, the secret to happiness’ TED Talk by Mihaly Csikszentmihalyi

            • ‘Flow’ by Mihaly Csikszentmihalyi

            • ‘The puzzle of motivation’ TED Talk by Dan Pink

            • ‘Drive: The Surprising Truth About What Motivates Us’ by Daniel Pink

            • ‘The War of Art’ by Steven Pressfield

            • ‘Ignore Everybody and 39 Other Keys to Creativity’ by Hugh MacLeod