How to Deal with a Depressive
In the DSM IV, the technical term for chronic depression is "dysthymia" in which a person must suffer from the clinical symptoms of depression more days than not for at least 2 years. I usually refer to myself as a "depressive" someone not only given to major depressive episodes (I've had four already-and two to three is normal in the span of a lifetime-the two disorders are not mutually exclusive), but I also suffer from a chronic mood disorder.

Did I scare you off with all that technical language? What it comes down to is this-the majority of the time I'm depressed. I feel hopeless, I have low self esteem, I have trouble sleeping, I starve myself, and I don't have a lot of energy most days. There doesn't necessarily need to be a stressor or incident to trigger these feelings, or there maybe a trigger and an unnaturally sensitive response.

And I'm not alone in this.

So I thought I would continue my How To series with some tips on how to approach someone who suffers from this particular disorder.

1. Never say anything like "Oh just forget it", "Don't think those thoughts", or "It's not a big deal."

It's just plain insulting to think I've never tried that before. If I could just not think these thoughts, I wouldn't. In fact, I've spent thousands of dollars trying not to think these thoughts-I've spent money on everything from psychotropic medication to tylenol pm and corona. I could buy a house with all the money I've spent trying to "forget it" whether it be through gym memberships or therapy sessions. It's bad enough having these thoughts but having friends who don't fully credit how much dealing with chronic depression is a constant struggle-who are dismissive about how much effort one has to put in on a daily basis just to get up and do simple things like shower-doesn't help an already difficult situation.

2. Never quote Oprah, Dr. Phil, or the author of any popular self help franchise.

While it's reassuring to know that Armchair University is still giving out honorary degrees in psychology, dysthymia is an actual disorder which needs professional attention. You wouldn't allow some schmendrick who sort of knows about medicine kind of to set a broken leg. Well the composition of my neurons and the delicate balance that is my psychological disposition is even more complex, nuanced, and difficult to treat than a broken leg. If you wouldn't trust your leg to a pseudo professional, don't trust my wellbeing to one.

3. Don't be critical
Depressives often fall into a "helpless-hopeless" cycle, and critical comments can have a much more severe impact. Often such comments are offered in an attempt to give "tough love" or to jar the depressed person out of his/her state (in the same way an intervention is designed to catapult an addict into the revelation of the reality of his/her behavior). Unfortunately, tough love can be dangerous for a chronic depressive and may sink him/her even further into the helpless/hopeless cycle or augment his/her already skewed sense of self esteem. Depressives rarely need help seeing things that they have "done wrong" or "screwed up." Although you maybe trying to spur them to act, you may inadvertently be giving them another reason to see everything as a lost cause.

Or, in other words, not the time to say "I told you so."

4. Do not suggest that depression is the sufferer's fault.
You wouldn't suggest that schitzophrenia is a choice so why assume depression is one? I am often confronted with the idea that I am "in love with my own misery" or that I "don't want" to be happy or well adjusted (see number 3). Again, a fairly insulting premise. Where is the upside in being miserable all the time?

I certainly don't see this as a choice. How all you all don't feel this way most of the time is as mystifying to me as how I feel this way a majority of the time is to you. Doesn't mean I think it's a choice. There are many possible explanations. One of which is the administration of chemotherapy in infants has multiple long term side effects INCLUDING MOOD DISORDERS. So don't assume that my depression is a choice, it could be the result of a constellation of environmental and heriditary stressors.

5. Do what you can
The best advice I was ever given about how to deal with my depression was to keep busy, active and in the company of others. The more you can involve the person in activities, even if he/she seems hesitant or resistant, the better. Even if it's something simple like just stopping out for a cup of coffee or inviting the person to just come and sit on your couch. Even short one line emails are better than radio silence which may give the impressive that no one cares.

6. Offer to help (teamwork)
Depressives are often overwhelmed, even by simple things, like getting the mail or going grocery shopping. As a result they may neglect the activity altogether which can further depress them. Instead of being critical, "Why can't you just pick up the mail?", offer to help-"Do you want me to come with you?" Even if it seems unnecessary to you, it can be a huge aid to a depressive.

7. Just listen

Friends of depressives often offer advice because they feel that they are expected to do something without realizing that simply listening might be enough. Depressives are usually aware that their feelings and perceptions are abnormal and are embarrassed about sharing these ideas. In fact, their depression might be linked to a feeling of isolation because they are inhibited about sharing those feelings and ideas with others. Making it clear that you can sit and just listen without rushing judgement or trying to "fix" the situation is often enough one of the best and most effective ways of helping a depressive.

So now you know, any questions?

Spit: Revisited
* A different version of this post was originally published on 8/12/04. I have modified it from its original form.

After the attacks on the Trade Center I only lived in fear of one thing-seeing him again. The idea of dying didn't bother me much, and I certainly wasn't concerned about terrorism, torture, the erosion of civil rights, or anthrax laced mail. When the worst thing you can imagine happens, the world holds aboslutely no fear. The only thing I was afraid of was seeing him.

It was a legitimate concern. Not only was I on campus for my job most of the time, but my office was just one floor above the communications department. I talked on my cellphone whenever classes changed to distract me from possibly glimpsing his face in a crowd. I took cabs as soon as classes were over to keep from spotting him on the walk to the subway.

I sat down one night and thought, what would I do if I saw him again. What would I say? If ever I have felt the deficiency of language, it was that day. Tell him he should be ashamed. Tell him I'm disappointed, that he's worse than a christian puppy rapist, that unlike himself even Hitler had redeeming qualities. As if he didn't already know. If he didnt feel shame over doing these things, there was no speech so powerful that could induce it him. I thought about writing letters. Even started a couple. I tore some up. Others I still have. I wrote speeches, scenes, journal entries. But I couldn't even decide on a general theme of disgust or heartbreak or rage or entreaty. And even if I did, all of us who have practiced dramatic confrontations know that those speeches always end up in the garbage. I needed something easy to remember. Something simple. Something that didn't depend on a perfect lead in from the other party.


I was supposed to spit when I saw him again. That was the plan. He knew how much I hated it when men spit in public. He saw me recoil everytime a glob of spit hit the sidewalk even if it was blocks away on the opposite side of the street. While we were dating, he would always spit into a napkin or a cup. With his back turned to me. Several feet away. The only thing that could properly display my disgust, my contempt, when I saw him was to spit at him.

A year and a half went by. Didn't run ito him on a crowded elevator or bump into him on a stairwell. He didn't stop by my office or call or write or email or inquire by carrier pigeon or mutual friend about my wellbeing. I began to stop fearing every blind corner, every class change, every knot of students. I took the subway to work. I stopped incessantly calling friends on the phone.

It was a snowy morning a week before the finals. I hadn't wanted to go to classe. I knew my students would show up late, and the majority would take a "sick day" even though I would be reviewing for the exam. I took my time getting ready that morning desperately hoping that NYU would cancel classes. I took my time applying a dark red gloss and liner while eyeing my cellphone. Despite the blizzarding snow, I looked good that morning in my green and black velour hat, my new black coat from Bergdorf's, and my green pashmina wrap thrown over my shoulders.

It was one of those quiet mornings that only happens when it blizzards in NY. It wasn't that I was the first person to walk down Waverly that morning, but their footsteps were quickly effaced by the snow and the wind. I was enjoying the feel of snow packing beneath my feet and fantasizing about drinking hot chocolate and curling up on the couch watching the snow with my cat on my lap after class. I was trying to think of what movies I would watch that night while I made soup.

He was walking the opposite way. The only two people on the street. Everyone else at home hoping for some excuse to stay home, nursing their morning coffees just a little longer, waiting for a delayed train.

It had been 117 days since he had last called, 183 since I last saw him, 234 since his last email. And somewhere in that vast expanse of absence I had forgotten that he was real, that he continued to walk around and wear coats and, perchance, get frostbite in the snow. In his absence, I had made him incorporeal, a ghost, an illusion. Hard to pick up a phone and call when your body has no substance. But now he was struggling in the snow like me, probably a thin sheen of sweat on his skin. I could remember the scent, if I got close enough. As I passed, he gave me an unecessarily wide berth. As if he expected me to become violent. To yell or scream or punch. As if I had even kept my head up to look him in the eye.

But I kept my head down, watching my boots crunch in the snow. The last thing I wanted to do was fall on my ass in front of him, and the snow was deep here. Nine am and the visibility was already bad. The winds shifting the ground with every step.

It wasn't until I reached the end of the block that I stopped. Stopped and stood in the falling snow.

I turned around to see where he was going, to see if he had really been there, to see if he continued to exist outside of my gaze. He was gone already. Not evaporated. Just turned a corner. Or perhaps hiding in a doorway until he thought I had passed, until he was "safe" to continue on his way.

At first, I stood there wondering if it was really him. I hadn't looked into his face, his eyes. It had been at a distance. And the visibility was so poor, I could barely see to continue on my way to my office. But as I stood there, I began to wonder if all of it had happened. Or any of it. How do you walk past someone who less than two years ago was the love of your life and not flinch? How do you keep walking? How do you pass by the person who saved you like she was a less than a stranger? Maybe it wasn't just that it wasn't him that walked by, or maybe none of it happened. Maybe I had blanked out those two years, invented this alternate version and just pinned a random face and name to it. I'd read about psychosis and breaks from reality. I'd read William S Burroughs and watched Cronenberg. Why not? Maybe I was just a girl in the snow staring after the emptiness left by a stranger.
And then I let out a loud yell which echoed on that empty street because I was so surprised by the sight of him, phantom or not, that I had forgotten to spit.

The Future Mr Speigelman
So Thursday I was so over the teaching thing. In one class NONE of the students had done the reading and that's just the beginning. There's no point going into details. I've never seen so many kids pay so much money to leaqrn so little.

So I called Rabid for one of our beer and wing nights at the Back Page. We haven't had one since December so we went and luckily the men's olympic figure skating was on. Nothing like having a couple of beers while watching men with great butts on a big screen TV. Let me tell you that NBC wishes that it Rabid and me as commentators because we would be a lot more fun. A lot of it included a "What the Hell was that? Was the choreographer inspired by a dog at a hydrant?"

Of course, there were disagreements. For example, while I thought that Johnny Weir's costume looked like a tribute to H.P. Lovecraft's a Colour Out of Space, Rabid thought it looked like Flashdance meets Barney.

Luckily there was one man there to win my heart and make my day not a complete loss, the future Mr Speigelman. He's no Ilya Kulik, but he'll do.

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