What not to say to a depressed person

A few days ago I posted on "epistemic humility," or the idea that we can't really know what it is like to go through many of the things, especially the difficult things, that other people experience. That post was motivated by, and was primarily a longish quotation from the blog Crooked Timber.

Today there was a very sad follow-up by Crooked Timber poster Maria, consisting only of a long list of things that get said to people who are trying without success to have children. As you might imagine, the things that people say in this context tend to cluster on the negative end of the spectrum, from the merely useless to the outright hurtful. Random examples:

You know, a friend of mine tried for ten years and then they gave up. And then it just happened like that. And they’ve had two more since.

You know, I have a good feeling that it’ll work out for you. I just know it.

If you could just relax a little, you know? Sometimes that’s all it takes.

Maybe it just wasn’t meant to be.

These are all prima facie evidence that the speaker has no idea what sort of suffering is experienced by those who want badly to conceive but have not been able to do so.  And, to bring up again the theme of epistemic humility, these are also evidence that the person uttering such things is unaware that he or she does not know the depth of the suffering, or even of that suffering's existence. That person does not know, and does not know that he or she does not know.

In the comments someone with the tag Widmerpool brings up depression:

Same thing for depression — think how lucky you are, this will pass, have you tried working out, I was really sad once, do something for other people, lots of famous people were depressed.

Yes, this is the same dynamic, which is exactly why I linked to the original Epistemic Humility post to begin with. People who say those sorts of things don't know what depression is like, and they haven't the slightest idea that they don't know. These people are not necessarily bad people, nor evil people, though of course some of them are. In many cases they just don't know what it is like. They have never had to deal with childlessness or depression or (insert your personal hell here). Nor have they ever had cause to think about it. This, of course suggests that many of them lack empathy, and I would not be too eager to draw too stark and thick a line between the unempathetic and the evil. But I have known very warm, emotionally generous and generally empathetic people to say things like "You've got so much going for you" in response to my depression. Or the time after a breakup when I was probably more mopey than was strictly necessary (I was a teenager, after all) and was told, "There are other fish in the sea." There may be more useless things to say to someone who is mourning the end of a relationship, but nothing comes immediately to mind.

So in the spirit of Maria's post at Crooked Timber, here are a few links to places that have listed Things Not To Say To a Depressed Person

Here is a list of 10 as a good place to start. 
And 10 more.
This list of 100 things is pretty comprehensive.

And, How Not To Be A Dick To A Person With Depression.

I'm not sure which of these Things Not To Say annoys me the most. For now I think I will go with the inevitable jerk who showed up in the comments to Maria's Crooked Timber post with the following, which perhaps deserves some sort of asshole award for hitting the main themes with such clueless heartlessness: 

ezra abrams 11.14.13 at 12:31 am

When I was young (<10) and used to complain, my dad told me of a snippet from CBS news:
On camera, they interview an old lady on thestreets of Tel Aviv, and ask her, isn't inflation awful, the price of butter has gone through the roof ?!
And she says, I was in Auschwitz, this isn't so bad…..
so stop whining: you could have been born in Biafra; life sucks; pick yourself up and do soemthing

Because nothing cheers up a depressed person/cancer patient/childless couple quite as much as knowing that children somewhere are starving or maybe shitting themselves to death with cholera while their mothers look on helplessly. (MPA Victoria responds appropriately to ezra abrams)

That is probably enough for now on What Not To Say. Which  leaves us with the little problem of what TO say.  But Maria has this one covered. There is one short, sweet, and safe response, and it covers a multitude of situations:

"I'm so sorry."

We should use it more often.

Armistice Day

Here in the US we have called it Veterans Day (officially it should have no possessive apostrophe) since 1954, but I am not on board with the name change. Armistice Day was meant to be a day to mark the end of the The Great War and to pause to consider the fates of the millions who died in that eruption of violent European tribalism. In the US we have subtly shifted the emphasis to the soldiers, which takes us away from the horrors visited on civilians and closer to a glorification of the soldier and of war, the sort of glorification that Mark Twain depicted well in his War Prayer. The ceremonies we conduct on this day, usually in military cemeteries, are all about honoring the soldiers, and there is little talk anymore about the utter futility in which they died in that war, since the conventional wisdom that has settled across the land has it that to discuss the futility, idiocy, or infamy of any of our wars is to dishonor the soldiers. Nor is there any talk of the huge cost to civilian populations; and in a war with 7 million  civilian dead alongside the 10 million million  military dead, this seems a major and shortsighted lapse. The sort of lapse that I have to think will lead to more war and more dead.

But let's get back to my usual subject, which is mental breakdowns. In the case of war we have the well-known example of what we today call Post-traumatic stress disorder. I am far from knowing much about this, but I do know that in this clip comedian George Carlin makes a few essential points on the importance of the names we give to "abnormal" mental conditions.



The effects of war on minds need to be taken as seriously as its effects on bodies. In each case the young, the healthy, the fit are mangled, broken, destroyed, crippled. It is well known today that field and emergency medicine has advanced a great deal since the days of MASH or even Vietnam. Our ability to heal minds lags sadly behind.  And though the economic cost of this destruction can be tabulated, there is no way to tabulate the cost in psychic trauma,  the cost of promising young lives dumped into a maelstrom of psychological dysfunction, and the price paid by parents, spouses, children, siblings. If we were to apply a psychological cost-benefit analysis to our wars we might find most of them to be grievously expensive.

I have no solutions for any of this, nor any comforting words. Someday, I would like to think, we will honor our soldiers by not sending them to die for empire or for lies. And in the meantime, until that day arrives, we might honor them by facing up to the full cost of their service, by honestly addressing their conditions, and by putting as much money into healing their souls as we put into perfecting ways to kill.


Bonus: Armistice day poem

The poppies used across the Commonwealth on Armistice/Remembrance day are taken from the poem "In Flanders Fields" by Canadian Lieutenant John McCrae. It was written in 1915, before the full, grinding horror of the war became apparent. It is, we might say, practically a product of the pre-war era, when one might with no shame raise up war as a noble endeavor. But the war was to produce a new generation of poets and poems, many of whom, like McCrae, would not survive the trenches.  These would depict the war in more realistic, graphic and horrible ways. One of the more potent of these is Wilfred Owen's "Dulce Et Decorum Est," the name of which is taken from the poem's last lines, which contain a quote from Horace that translates to "Sweet and fitting it is to die for one's country." Horace clearly meant it. Owen, whose poem is based on his own experience on the receiving end of gas attacks (in the poem the gas seems to be mustard or phosgene) places the Horace quote in the title with bitter irony. By 1917, when the poem was written, it was no longer possible to discuss the glories of battle.

Wilfred Owen
Dulce Et Decorum Est
Bent double, like old beggars under sacks,
Knock-kneed, coughing like hags, we cursed through sludge,
Till on the haunting flares we turned our backs
And towards our distant rest began to trudge.
Men marched asleep. Many had lost their boots
But limped on, blood-shod. All went lame; all blind;
Drunk with fatigue; deaf even to the hoots
Of disappointed shells that dropped behind.

GAS! Gas! Quick, boys!-- An ecstasy of fumbling,
Fitting the clumsy helmets just in time;
But someone still was yelling out and stumbling
And floundering like a man in fire or lime.--
Dim, through the misty panes and thick green light
As under a green sea, I saw him drowning.

In all my dreams, before my helpless sight,
He plunges at me, guttering, choking, drowning.

If in some smothering dreams you too could pace
Behind the wagon that we flung him in,
And watch the white eyes writhing in his face,
His hanging face, like a devil's sick of sin;
If you could hear, at every jolt, the blood
Come gargling from the froth-corrupted lungs,
Obscene as cancer, bitter as the cud
Of vile, incurable sores on innocent tongues,--
My friend, you would not tell with such high zest
To children ardent for some desperate glory,
The old Lie: Dulce et decorum est
Pro patria mori.


Wilfred Owen died one week before the end of the war; news of his death reached his parents on Armistice Day, the eleventh day of the eleventh month.

"Epistemic humility"

Yes, to this from Ingrid Robeyns at Crooked Timber:

A colleague who lost his teenage son due to a traffic accident 3 years ago, told us about the ‘black halo’ which remains above his head, and which only others who have lost a child are able to see. I do not doubt for a second that this is the case – that people who have not lost a child are, perhaps a very few exceptions aside, not able to truly understand what it means to lose a child, and how it changes the person you are. It reminds me of a friend who lost her father about a year after I lost mine. She had been very supportive when my father was terminally ill and died, but told me after her father died that she had no idea how hard it was until she experienced it herself. Good intentions are simply not enough to understand certain experiences.

I think it’s not just with experiences, but also with varieties of ‘differences’ and with social practices, being ill, and other features of human life. It is not just the death of someone near and dear that we have a hard time to understand if we haven’t experienced it ourselves; or what it means to have autism, or to live with and/or care for someone who has autism (in my experience, most people don’t understand, despite what they believe themselves about their understanding); or what it is to be constantly subjected to racism. I am confident that I have no clue what it means to grow up in abject poverty, or to live through a civil war, or to be the victim of domestic abuse. 

My worry is that this category of experiences, differences, practices, and other features of human life that we cannot understand without first-person experience, is much larger than we generally tend to assume. And that as a consequence, we believe that we know much more than we actually do know. And, as a further consequence, that we too often are wrong in our judgements of aspects of the lives of people significantly different than ourselves.
Somehow it strikes me as wise, and possibly even as a precondition for social justice, if we would rehabilitate epistemic humility at the core of our educational and social practices.

There is nothing wrong with acknowledging that we don't fully understand what others have gone through or are going through. We should in many cases also acknowledge that we maybe don't want to know. For example, I don't know what it is like to have cancer, and I am grateful for that. That is knowledge I would prefer to never have.

But I do know what it is like to go to bed every night for months on end wishing to never wake up. I am certainly not grateful for that, but it does, I think, give me an insight into the dynamic Robeyns is discussing here. I know what it feels like to suffer through something that others clearly do not and cannot understand. Recognizing that inability in others, I hope, makes it easier for me to recognize that same inability in myself. And that recognition may be the origin of empathy.

"I wanted so badly not to be me"

The Guardian has an interview with Neko Case, in which she discusses her depression, in particular the depression in which she wrote her latest release "The Worse Things Get, The Harder I Fight, The Harder I Fight, The More I Love You." Her description of depression will be familiar to those who know it, though she can perhaps express it better than most of us can:

But it was the mundanity that struck her more than anything. "Depression, there's no grand excellence to it," she says. "In my experience it was just almost the gulaggy boringness of it that'll kill you. You're just in this murk. And you're with other humans, but you lose all your human skills and it's just like you're in this plastic bag and you can't quite connect with people. You lose your ability to transmit electricity or something, and to receive it. It's just like this 'bzzzuh'." She makes a feeble, disconnected sound. "It isn't sparking."

"It isn't sparking"
That is quite perfect. Depression dulls those inter-human connections that we need to maintain our affective equilibrium. It leaves us surrounded, especially in the most social of situations, by people who seem to move around us as through water, slowly and seemingly distantly and with no possibility of communication.  We can watch and observe, but we never feel fully present and we can never connect. We cannot spark.


A chill ran through me
And I grabbed on tight
That was when I left my body for good
And I shook off all the strength I'd earned

I wanted so badly not to be me
I wanted so badly not to be me
I saw my shadow looking lost
Checking its pockets for some lost receipt

Where did I leave that fire?





Bonus: Neko Case performing in the studio on NPR's World Cafe

Sorrow kills sorrow

A few weeks back I was in the car headed to the high school track where I run (because I'm an American, and that is what we do: we jump in our cars and drive to the places where we exercise) hopping from radio station to radio station, and finally settled on Prairie Home Companion as the least annoying thing. My timing, for once, was spot on: as I pulled into the parking lot, the band  Joy Kills Sorrow started into an exceptionally compelling  performance of an old country song.

Later that night I went hunting for their version of the song on the internet, and found a live performance on YouTube. The next day the Prairie Home Companion performance was put online. And since then I've been listening to the two versions quite alot. Over and over, in fact.

And over.


Here is my favorite version from YouTube:

Linkapalooza

All links, no editorializing.
Well, not much editorializing.

The doors of perception

More evidence is in that hallucinogens may have some value in treating some mental disorders, particularly anxiety and depression. This post at the Smithsonian covers the latest research, in this case into the use of psilocybin (the active ingredient in psychedelic mushrooms) to ease anxiety.