Depression hurts

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My exhaustion is all-encompassing, and I can’t stay awake. I thought it was just residual exhaustion from not sleeping enough during the week, and that my body was demanding that I pay back my sleep debt. But when I told my therapist, she said, “You use sleep as an avoidance mechanism.” Without even realizing it, my body had translated my depression into exhaustion.

My mental illnesses often manifest in physical symptoms that can be just as debilitating as the psychological ones. Depression not only makes me easily burst into tears but also gives me headaches and stomachaches. Anxiety leaves me with constant pins and needles, especially concentrated in the palms of my hands. Everything from the food I crave to the amount of acne on my face is influenced by my mental state. 

Depression is a disease of the mind, but it manifests in the body. Many of our body’s neurotransmitters are actually located in our guts, not in our brains.  Mental illnesses can wreak physical havoc on our bodies. There is evidence that gastrointestinal issues such as irritable bowel syndrome can be significantly influenced by one’s emotional state. When dysregulation of neurotransmitters occurs, it can lead to both depression and physical pain. It’s hard to comprehend that a chemical imbalance can have debilitating physical side effects. A physical illness is no more valid or real than a mental one, but I think physical symptoms are easier to understand and identify.

When I have a panic attack, my body reacts by having a visceral physical reaction to emotional turmoil. As soon as I begin to sweat profusely, I realize that I’m losing control over my anxiety. Burning face, uneven breathing, diarrhea and tingling hands are all more noticeable reactions to me than the racing thoughts and fear associated with a panic attack. Anxiety is not just a mental state; it’s a physiological disease.

My physical symptoms of depression are often intensified by the bizarre side effects I’ve experienced from taking antidepressants and medication to treat my mental illnesses. Sometimes these medications make me feel emotionally worse, but more often, they make me feel physically worse. I am currently taking half of the smallest dose of Abilify that can be prescribed, and I am throwing up nearly every day. During freshman year, I threw up nearly every day because of my raging anxiety that would ensue upon leaving my room or engaging in social situations. Although I’d rather throw up from a medication that’s working than from a debilitating illness, neither is really ideal.

From January to June, I suffered from a cold that turned into a bout of the flu. This flu transformed into a debilitating case of pneumonia with lingering effects that stayed with me for months. On the surface, this seems like a purely physical illness. No one catches the flu because they’re depressed; I probably got it from someone sneezing on me. My immune system was so weakened from the four different medications I tried over the course of that month that my body couldn’t fend off the flu. My pneumonia and my depression compounded each other. Pneumonia made my brain so foggy that I couldn’t think, and my mood plummeted. I was so weak and depressed, I couldn’t drag myself to a doctor for days. My depression has had real and dangerous physical effects on my body. They have been not only terrifying but also destructive. 

Although I did not know I had depression in high school, I noticed that I was losing clumps of hair and dropping weight rapidly. I have been able to track how severe my depression has been by observing my fluctuations in weight. At the worst point of last semester, I weighed 96 pounds. Now that things are getting better, I’ve been able to gain all of the weight I lost back, and for the first time in my life, I am in a healthy BMI range. Having a physical marker of my improvement has been significant in recognizing my success in managing my mental illness.

In order to gain an understanding of how well I’m doing mentally, my therapist often has me check in with my body to see how each part of me is feeling. She’ll have me breathe in so deeply that it feels as though the breath is reaching all the way to the tips of my toes and fingers. Only in those moments do I realize and feel the pain I so often ignore. My limbs are numb. My jaw is clenched. My chest is hurting. My body is tired. It can be easier to confront how we physically feel than to confront how we emotionally feel. Looking to our physical symptoms and letting them guide us to their root causes is an effective way to begin to look at the distress our body is feeling and holding. 

Salwa Meghjee writes the Thursday column on destigmatizing mental illness. Contact her at [email protected].