The Depression Checklist

Figuring out you're depressed shouldn't be so hard.

[alt-text: hallway with light coming in from windows and shadows near a doorway]

CW: honest, hard-to-read descriptions of depression

For years, I have contemplated creating a depression checklist, a list that I could use to determine if I am depressed or not. A list of all the things that show I am in yet another depressive episode.

The list could include small things or bigger things, which would signal I was depressed. Again.

I have a hard time telling that I am when I in the midst of an episode.

And the list would be specific and concrete. It would move beyond the doctor's generic questions about lost interest in the things that bring you joy or feeling down for more than two weeks. It would include examples of what happens to me when I’m depressed.

So, I finally pulled together a "do I have depression again?" checklist.

Here it goes:

• I stop singing along to the radio. One of my favorite songs could come on, and I won’t even care. Eventually, I stop singing. Period.

• I find it hard to convince myself to get off the couch. Or when it is time to get up in the morning, I have to force myself to get out of bed.

• I am exhausted but can't sleep. Or I am tired all the time when I can sleep.

• Showering becomes a chore that I want to put off. It's hard to remember to brush my teeth and somehow I still manage to. Grudgingly.

• Everything makes me angry or irritable. It's like my skin is too tight. I feel constantly emotionally itchy, as if at any moment I could Hulk-smash the world.

• I cry and cry and cry.

• Or I don't cry. I hold it all in and become numb.

• I stop texting folks or don’t respond to their texts or respond with one-word answers. I ghost people altogether.

• Other people start to seem exhausting, so I want to be left alone and have no one ask anything of me.

• But I also don't want to be left alone with my thoughts because my brain becomes an asshole who tells me I'm not worthy of friends or loved ones. My brain encourages my isolation and makes me feel like a waste of space, who no one loves.

• When my thoughts turn on me, it takes effort I barely have to fight them. But they remain, even as I fight them, as constant noise that punctuates my days and nights.

• I stop laughing. Okay, I stop really laughing. I fake laughter. I smile less and less and less until they are all fake brittle smiles.

• I want to do nothing. And sometimes, I do nothing.

• Nothing interests me or if it does interest me, the interest is fleeting, there and gone.

• I like people less and less because I don't like myself. I start to hate the shape of my face. I hate what I see in the mirror.

• I feel like I am a burden and that other people are stuck with me. I wish they weren't.

• I try to escape into TV shows, but it doesn't work because they can't hold my interest. I do escape into books with happy endings because I can't handle anything more than that.

• I feel detached from everything happening around me. I watch the world pass me by. I wonder why I am even here.

• I feel stuck and unable to do anything about my situation.

• I come to a point where there's no joy, only stagnation.

• I resent myself and my brain. I'll wish I wasn't me.

There are other signs too. The list is by no means exhaustive, but it reflects what most commonly happens to me and how I feel when I’m depressed.

Now, you might think after years—decades really—of suffering with depression, that I would be better at knowing when I’m depressed. You might think it would be easy for me to tell when depression camped out in my brain yet again. But, it’s anything but easy. It’s hard actually.

The reason I need a checklist is because I still can't tell I am depressed until I am really depressed. Depression is stealthy and sly, for me anyway. Hardly ever, do all of things on this list hit me at the same time. They generally happen one by one by one.

I stop singing or stopped wanting to shower. I find myself laying in bed realizing it’s yet another day, in which I don’t want to get up. I start avoiding the mirror. I ghost my friends again. I isolate myself. I smile less and less. It's the pile-up that I finally notice after a little while, if I’m lucky, or after a while, if I’m not. No matter how much time it takes to notice, I’m suffering through it.

Even knowing that my symptoms manifest in similar ways each time is not enough for me to recognize a depressive episode when I am in it. My depression doesn’t always present in the same ways or similar patterns, it is sneaky like that.

It creeps up on me—time and again. It’s cyclical and unavoidable.* I know that depression is something I’ll live with for the rest of my life, but recognizing when it is happening remains hard.

So, I made the checklist as another tool to manage my depression. I hope that it helps me identify when I’m depressed more quickly, so I can deploy my coping mechanisms a little earlier and start to work against the lies that depression tells me sooner rather than later. Then, I can turn to another list my therapist had me make after our first session. It’s the list of everyone who loves me and cares about me that reminds me that I’m not a burden and that I’m loved deeply. Depression just makes me question and sometimes forget both of those, but that doesn’t make them any less true.

I use checklist and that list to help me get by. And they do.

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*Depression is cyclical for me. It’s part of a disorder that I have. I work closely with my doctor and therapist to keep it managed the best it can be through medication and therapy. But, it still happens. The episodes just aren’t as long or as life-impacting as they could be. So, please don’t pass on any advice on how to manage depression. I have that covered. Thank you.

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