What does a depressed person look like?

“Everyone has a story or a struggle that will break your heart. And, if you’re really paying attention, most people have a story that will bring you to your knees.” - Brene Brown

You may look around and think, “I don’t know anyone who is depressed.” Probably most people you know look normal. Functional. Together.

We all want to look like we have it together. It might be okay to struggle because of some obvious and outward and universally understood circumstance, but not too deeply or too long. We should be able to get over it and move on. If everything is going okay in our lives, we should be okay.

Except that the outside doesn't always mirror the inside. Even when we are barely functioning, we seem to cling to this social code. We smile and keep it together because that is the appropriate way to behave around others.  And when we can't manage to keep it together, we hide away so nobody knows we are falling apart.

So what does a depressed person look like?

They may look successful.  Maybe they have awards and scholarships and smiles.  They may wonder what is wrong with them, what is this fatal flaw that makes them so desperately miserable.

They may be surrounded by friends, such good friends they even wear matching clothes!  They may socialize in the dorm and go out with friends on Friday nights.  In between they may lie on the floor crying alone, wanting to live but not sure if they can survive.

They may look adventurous and daring, striking out on their own in the world.  They may love their job, feeling a sense of calling and purpose.  They may wonder if they are worthy of taking up space in the world.

They may have the life and the family they wanted.  They may feed and clothe and bathe their children, and even smile at their antics.  They may be crushed by the weight of trying to get through another day.

Each one of these pictures represents a time when I was severely depressed. In only one of these times did someone else know that I was depressed.  How is that, when I had friends and family - close friends even, and family who cared about me?  It is because you can't always see depression from the outside.

When I look back on these pictures I feel the disconnect.  I do have good memories.  I did smile and laugh and do things with friends.  I got good grades, taught well, was a pretty decent mom.  And yet I also remember what I felt like inside. I remember the palatable darkness that threatened to swallow me, the gaping emptiness, the deep exhaustion from acting like I was okay.  I remember questioning the will - or desire, or ability - to live.

How can this paradox exist?  And how can we ever see what someone is feeling on the inside when we are so good at hiding it?

Maybe we can't see it.  Maybe we have to hear it.  We hear it because we are listening.  We enable them to be open and honest because we have been open and honest.  We fight down the urge to give advice or judge or swoop in and rescue; instead we just listen. We don't even encourage or offer solution or try to drag them out of the pit - not yet.  First we step into their pain and sit with them.  We say, "I'm here," and then we stay.


"In the deepest, night-blind fathoms you're certain that you're alone. You aren't. I'm there with you. And I'm not alone. Some of the best people are here too...feeling blindly. Waiting. Crying. Surviving. Painfully stretching their souls so that they can learn to breathe underwater...So that they can live."
- Jenny Lawson

Staying Alive

Each semester we fill out a self-reflection form on how different areas of life are going - daily responsibilities, family, interactions with the culture.  The end of the form asks you to complete the sentence, “What I feel best about this semester is…” I said, “…that we are all still alive.”

Honestly, in years like this one staying alive has really felt like a success.

I tend to have high expectations of myself. When I met with some counselors in Beijing last month, they asked me to write a list of my self-expectations as a mom, wife, person living in China. It was an easy homework assignment for me. I quickly typed up a list of very specific things I “should do” as a mom. I stopped when I reached 50 and realized this could go on or a while.

In general, if someone else is doing something healthful, useful, or admirable, I feel like I should be doing it as well. All The Things. Even contradictory things, like eating more meat and less meat. Being more organized and more go-with-the-flow. Having a spotless house and not being bothered by mess. It was helpful to think through these expectations - many of them were good ideas but completely unrealistic.

You know a pretty effective means for lowering your self-expectations? Being really sick and not able to do anything. Even as I have slowly recovered, I’ve had to focus much more on top priorities. Make sure everyone eats something. Make sure everyone has bathed in the memorable past and is wearing some manner of clothing. Dispense medicine.

The main goal has been to keep everyone alive and manage the current sicknesses. Will another day of peanut butter sandwiches and mismatched clothes reach that goal? Yes, it will.

This is what is called “survival mode,” and we have been living here so long I have almost lost sight of normal life. The kind of life where it doesn’t take a month to finally get around to taking out weather appropriate clothing. The kind of life where you don’t have to rest between each activity. The kind of life where your friends don’t greet you with cries of, “You’re alive!”

When I am healthy I can convince myself that maybe my ridiculous expectations are really possible. At least I could do better than I’m doing now. Fix more meals with the right vegetables. Do more creative activities in home school. Make an effort to interact more in Chinese.

When I am sick, when we are all constantly sick, these expectations are not even in sight line. We ate something commonly believed to be food? Excellent. We finally managed a math lesson. Good job. I went outside for a few minutes. Progress!

Of course I don’t want to stay in this sick place. It has been exhausting and relentless and ridiculous. I hardly recognize Nadia when she is healthy because her personality is so different. She runs around giggling instead of clinging to me crying all the time. Last week I looked at a picture of myself from a few years ago and my first thought was, “Wow, I looked so healthy.”

The other day when I was driving down the road I had this strange feeling of being in a foreign country. Apparently there is more to China than the view from my bedroom window. I sat in the heat under the full green trees and wondered what happened to spring. Weren’t the first buds just coming out? I think we were wearing jackets before I got sick, and now we are sweating in front of fans.

It seems like we were just getting into the rhythm of the semester. We had that one great month of health! Now suddenly we are leaving in two weeks and the whole semester seems lost. (But then, it wasn’t that great a semester anyway.)

I realize that many people live in this place. It feels disorienting to me because I don’t usually spend all my time going to hospitals and practicing breathing and trying to stay alive. Despite the constant sickness, we aren’t worried about piles of medical bills or if we will lose insurance. I don’t know how to get out of this sickness cycle, but I am pretty sure that at some point we will get better. We will get back to my vision of “normal life.” This is the privilege of the healthy.

The other day a friend was talking about the sticker charts she was using for her kids. It sounded like a great idea. I want to be organized! I want to do at least a few creative or clever things worthy of Pinterest. Heck, even worthy of a Pinterest fail. I want practically everything in life to work better than it does right now. I want sticker charts!!

But right now sticker charts are completely out of reach. There is no way I will remember to put stickers on charts. I am just trying to remember to brush teeth and get everyone to take their medicines.

The good thing was, as I contemplated sticker charts I wasn’t thinking, “I should do sticker charts. I am such a disorganized mom and my kids are out of control because I don’t do sticker charts,” Instead I was thinking, “I should not even attempt to do sticker charts right now. Sticker charts are not part of the survival plan.” Yay for lowered expectations! Long live mediocrity!

But honestly, I think it is less about mediocrity and more about realizing what success looks like in this season of life. Right now success does not look like lots of from-scratch meals and a spotless house and sticker charts. I want those things, but they just don’t fit with my priorities right now. Right now success looks like everyone eating something, taking probiotics, and staying alive.

Today we all ate, we all wore clothes, and we all stayed alive!  I guess it was a great day after all.

Good Gifts in Strange Packaging

When I texted a friend to let her know I was at the hospital, she asked “Did you bring someone to run up and down or you?” Clearly she has some experience with Chinese hospitals. I managed to avoid the hospital through one week in bed with flu, but when I started getting worse and having more trouble breathing, I knew I needed to break down and get a chest x-ray.

Fortunately, Kevin and a student were with me to help with the running up and down as well as translation. The process went like this:

1. Wait in long line to register

2. Be examined by doctor

3. Wait in line to pay for bloodwork and x-ray

4. Get blood drawn

5. Wait for x-ray

6. Get bloodwork results

7. Wait for x-ray results

8. Consult with doctor

9. Wait in line to pay for CT

10. Wait for CT

11. Wait for CT results

12. Consult with doctor

13. Wait to pay for medicine

14. Get medicine

These were actually all on the first floor, but there was a lot of back and forth and waiting in line. Fortunately the hospital wasn’t too crowded so we were in and out in three hours. The doctor seemed thorough and even told the others to wait outside the exam room. (When I saw another doctor a few days later, the small exam room was crowded with 17 people waiting to jump in and grab their turn. This is more normal.) She was willing to give me oral antibiotics to take home, instead of spending hours getting IVs or worse, having to stay in the hospital.

I was very happy to go home, but I wasn’t so happy about the diagnosis: pneumonia in both lungs. I was really hoping to avoid that. I had already been sick in bed with the flu for more than a week. I thought I was finally getting better.

The week in bed with the flu wasn’t so bad. I felt terrible, but being in bed wasn’t so bad.  Toward the end of the week, I opened my devotional book and read, “Consider what great things He has done for you.” Strangely enough, I immediately knew He was talking about the flu.

The day before I started feeling sick, I hosted a small group of women gathered here for a retreat put together by Velvet Ashes for women serving all over the world.  The main passage for this retreat was 1 Kings 19, when God provided for Elijah in the wilderness and then spoke to him through a gentle whisper.

As I read through the passage, I could relate Elijah’s feeling. “I have had enough, Lord,” he said as he laid down in exhaustion, “Take my life.” I haven’t been at the point of wanting to die, but many times this year I have felt Done. It has been such a long season of sickness, terrible sleep, more sickness, depression, anxiety, burnout. Sometimes I have just had enough.

But what I especially noticed was how God responded to Elijah.  He didn’t say, “Stop being dramatic. Get over yourself. Get on with being useful - you’re a big time prophet after all.” God just fed him. He provided food and water right where he was lying. Then he let him rest again and fed him again. He never showed impatience. He said, “Get up and eat, for the journey is too much for you.”

Isn’t it reassuring? God didn’t say, “I will never give you more than you can handle, so if you can’t handle this you are obviously need more faith.” He said, this is more than you can handle, so let me give you strength. After Elijah rested and ate - and rested and ate again - he had the strength to travel for 40 days to a place where God spoke to him.

As we contemplated this passage through the retreat, I knew that God was telling me it was okay to rest and allow him to care for me. It was okay that the journey is too much for me. I wasn’t quite sure what this would look like in practical life, but I certainly wasn’t picturing more sickness, after this year of relentless sickness.

Nevertheless, at the end of the first week in bed, when I read “Consider what great things He has done for you,” I knew God was saying the sickness was a great thing he had done for me. “In faithfulness he has afflicted you.” What a strange idea. But when else would I have the chance to stay in bed and stare at the wall, to disengage from life? I wasn’t able to take care of others; I had to allow them to take care of me. God was going to great lengths to give me rest!

The time was not easy on my family. Kevin was exhausted from taking care of the girls and doing what I normally do - on top of all he normally does. The girls were hardly showing their best sides. Okay actually they were being jerks. The house was a wreck. I was itching to get things back under control, under my control. I have some control issues.

“Thanks God,” I thought. “I’m glad I learned that lesson and am getting better.”

But I didn’t get better. Instead I got pneumonia. That wasn’t what I had pictured either.  “I’m grateful for the rest,” I said in my little talk with God, “But don’t you think this is a little overkill?? Also p.s. this is just making me weaker and more tired.”

Another week in bed, wondering if I was actually getting better. Wondering how we were going to get through this. Worrying the antibiotics wouldn’t really help. Worrying about Adalyn’s stomach problems and Nadia’s fever. Worrying about the horrible air as a huge dust storm blew through.  Getting up with Nadia every few hours of the night, as babies are no respecters of sickness or sleep. Almost forgetting what normal life felt like, the kind of normal that allows me to be out of bed for more than ten minutes.

I finished re-watching Downton Abbey. I read some recommendations from my book club. I stared at the wall. I spent too much time mindlessly scrolling Facebook. And God continued to speak to me.

Surely the Lord is in this place, and I did not know it…

In the day when I cried out, You answered me, and made me bold with strength in my soul…

Did I not say that if you believed you would see the glory of God?...

Do not fear therefore; you are of more value than many sparrows…

For he knows our frame; He remembers that we are dust…

I want to bring this lesson to a close. I want to be strong again. I want to stop being the needy one. Not just these two weeks, but these two years. Can it be my turn to have it all together now, to be the bold and daring and super-awesome-wish-I-was-her one instead of the one always going on about needing grace?

I want this season of sickness to be over. I truly do. But I have realized I don’t have to wait for things to get better to say, “Yay, he finally healed us. See I knew God was good.”

At the end of this long year of sickness, I realize God is not waiting to show his goodness through finally making us well. He is already showing his goodness through the sickness. He shows me that he cares for me even when I can’t do anything useful. He shows me I don’t have to be in control. He shows me that other people love me and want to help. He shows me he is faithful and strong and present. 

I am still sick in bed. He is still good.

Scars and struggles on the way
But with joy our hearts can say...

Never once did we ever walk alone
Never once did You leave us on our own
You are faithful, God, You are faithful

Matt Redman - Never Once

Springing from the Ground

In some years past, spring has crept up on me unawares. I looked out the window surprised to find the ground covered in fresh green grass.  This year the transformation seemed to come more slowly, probably because I was watching so intently. From the start of spring, I have looked out the window every day examining the ground five floors below. Dead yellow grass and bare brown earth. One day after a rain, I noticed the first hints of green. The next day the fresh grass had spread a little further, mixing with the dry remnants of the last year. Each day the green spread a little more until one day I discovered the whole ground covered in beautiful vibrant new life.

Spring often comes in slow, stumbling steps. One day the trees are covered with pink and yellow and white blossoms. The sky is blue and spacious. The air is warm and gentle, the world is friendly and accepting, bursting with life. The next day the clouds turn dark without the promise of rain. The wind picks up, cold and menacing. Even the flowers seem muted, disappointed. Perhaps spring was just a dream. Winter will not so easily give up the fight.

Healing also comes slowly when you are paying attention. Is today better than the last? Is anything really changing? Some days the world seems full of hope. Life is not so hard. I feel something like energy. Without great effort, my thoughts naturally turn positive. I find myself noticing the shine in Adalyn’s eyes and the softness of Nadia’s cheeks and the vivacious aura that radiates from Juliana.

Other days the world seems hostile again, irreparably broken, and I am broken in it. My thoughts swirl into darkness.  I find myself noticing the road that is torn and broken, the person in dark glasses watching me with a blank face, or a fluorescent light flickering in an empty window and think, “That is weird. Ominous. Something is not right.” I must remind myself that there is nothing inherently strange about sunglasses or road construction or dying light bulbs. But there is truth in my thoughts - the world is broken and waiting for healing.

The brokenness is real and so is the healing. Even Jesus, who saw the whole picture and knew the end of things, experienced grief and exhaustion because he was human. When his friend Lazarus died, Jesus didn’t just tell the sisters, “Stop crying guys, I’m about to raise him from the dead!” He also entered into their suffering and wept with them. He was grieved by the brokenness he saw in the world. He groaned with the weight of burden placed upon him. He was “a man of sorrow, acquainted with grief.” He understands us in all our humanness.

There was a moment all those years ago, a few days, when it seemed that death and brokenness and despair had the last word. The sky darkened and the earth shook. The people cried out in fear. The earth was torn apart, and his followers hid in despair. But it was not the end.

In fact, it was just the beginning. The day of greatest darkness birthed the dawn of greatest light. Cruel wounds brought healing, death brought life, despair brought hope, condemnation brought grace.

We look around and some days all we see is the brokenness, but we can look into it without despair. And we can also look for evidences of life - in the shimmering evening sky, in the sound of baby giggles, in a counter wiped clean, in the blessing of mercies and coffee new every morning. Each spring the new flowers and grass remind us that death does not win. Brokenness is being restored.  When we open our eyes, we see glimpses all around.

All this pain
I wonder if I’ll ever find my way
I wonder if my life could really change at all
All this earth
Could all that is lost ever be found
Could a garden come up from this ground at all

You make beautiful things
You make beautiful things out of the dust
You make beautiful things
You make beautiful things out of us

- "Beautiful Things" by Gungor

So Weak and Strong

The first pill was surprisingly hard to take.

It wasn't the first time I had been on an anti-depressant, and I was not opposed to starting again. I could understand the doctor's belief that this was more than just situational. “If you had high blood pressure or heart problems you might need to take medicine. This is no different. Your brain needs some help getting regulated again.” It was explained this way both now and in the past, and it made sense.

Still, starting medication seemed like an admission: This is bad, and I can't fix it myself. I suppose I already knew it was bad. I already went through the “ignore it and maybe it will go away” phase, and it only got worse. Eventually that word, that force I had dodged for so long was again staring me unavoidably in the face. Depression.

I tried to take care of it myself. Reduce stress, get sleep, exercise, eat well, think positive, get out of the house. But sleep has been a joke, and sickness has piled on sickness. My efforts at life change were thwarted by circumstances I could not control. Mama needs a break, but baby is crying with a fever. Mama may be throwing up, but baby needs nursing. The “self-care” I did manage was a brief pause in a downhill plunge.

I used to think depression looked like sadness and crying all the time. And sometimes it does. But actually I rarely cry. I don't feel sad as much as heavy. Hazy. Anxious. Deathly tired. It is like carrying around a giant weight everywhere you go. It is like too many programs open on your computer and nothing is operating as it should. It is like walking through thick smog – you know there is a road ahead but you can't see it. The weight of the future grips so tightly you can't get a full breath.

“You know that point in a book,” I told a friend, “When you see the person heading in a bad direction and you just want to say, 'Stop! Don't go there!' That's how I feel about my life right now. I know I am walking down a bad path and I just can't get off.”

I felt sick at the thought of heading back into the same situation with the same futile hope of fixing myself. The weight of responsibility was too heavy: I have to figure this out. I have to do something to fix this. And I am just so tired. I already have so many people to take care of – I don't want to have to take care of myself too. What if I can't make myself better and we have to go home?

So the medicine represented relief. This is something that will help me even when I can't do all the right things, even if we stay sick all the time, even if we can't get this baby to sleep. I cannot reasonably expect myself to change my brain chemistry. I can let the medicine do that, and that's okay.

And yet the medicine represented my weakness. Oh, I don't mentally believe that, but of course it feels that way. Whatever you tell yourself and others tell you, depression feels like weakness, like a character flaw. We have all heard that if you just think positively enough you can heal yourself. If you just have enough faith. If you just ate the right food or used the right oils or had the right genes you wouldn't have this problem. Even in this modern day we hear whispers of shame, shame. This is your fault.

I took the first pill. And the second and third and a couple of weeks down the line I already feel a difference, a change in my brain. Breath comes a little easier. Moments look a little sharper. I feel hope that I could climb out of this hole and enjoy life again.

I can face those whispers of weakness and say, No, that is a lie. No one chooses their genes, no one controls the makeup of their brain. I am weak, not because I am depressed but because I am human. None of us were meant to be so strong we have no need for others, no need for grace.

I am weak, but I am also strong. I am strong because I cared for my family. I am strong because I cared for myself. I am strong because I got the help I needed. I could not see the path ahead but still I kept walking.

I still cannot picture the months ahead or wrap my mind around the future. My brain becomes overwhelmed and turns away. I accept this gift of fog that allows me to focus instead on today. I look out the window at the bare trees and the cold brown earth. But I remember the springtimes of the past, I remember that one day I will be startled to find leaves in bud. The bare ground will sprout fresh green grass. Breathe in, breathe out, and watch the colors come back.

I write about my depression, even though it is very personal, because maybe you understand what I am talking about and you need to know you are not alone. I write about it because maybe you have never experienced depression, but I am almost certain that someone you know is dealing with it, whether you realize or not.  Maybe this will help you to understand them a little better.

A Weary Year

2016 almost perfectly encompassed a year of babyhood. I started the year pregnant and exhausted, just two weeks out from giving birth. I wasn't expecting Nadia to come early; from the beginning I felt like I couldn't catch up, she was growing so quickly. I wanted to appreciate these last baby moments, to not wish away my time with a toddler and kindergartener. I chose “moment” as my word for the year because I didn't want to rush through; I wanted to stop and notice the little moments.

I knew this year would be challenging, but somehow I hoped I would make this three child transition with grace and ease. I pictured myself calmly juggling their needs, taking it all in stride. I had already done two kids, surely one more shouldn't be that much more difficult.

Except that it was. I wasn't the mother that made life look easy, more the one that makes me people think, “Parenting sounds kinda miserable.” I've always been a fan of painting an honest picture, and I appreciate others who have been honest with me. Like all the ones who said three kids was stressful. I probably should have taken them seriously.

My journal this past year reads something like this, on repeat: “This is really hard. I am so tired. I am overwhelmed. Why can't I enjoy this? I am just so tired.”

After nearly a full year of “why is this so hard?” I finally recognized the other piece of the puzzle: postpartum depression. It seems obvious looking back. It's not my first experience with depression; you'd think I would recognize its familiar patterns. I guess it was a relief to realize it's not just that I'm really bad at this, that there was something more going on.

“Moment” seems like an ironic word choice for the year because looking back I don't remember a lot of moments. The year seems draped in a fog. Mostly I remember the feelings: weary, stressed, overwhelmed, irritated, discouraged.

I remember a lot of screaming – a crying baby, a tantruming toddler, a kindergartener always on full volume. I remember feeling like my head would explode. I remember losing my temper and feeling like a bad parent.  I remember the effort of just trying to get everyone through the day.  I remember lying in bed exhausted, knowing I would be awakened again in a couple of hours, night after night all year long.

That's not what I want to remember from this first year of my last baby. But as Nadia approaches her first birthday, I feel less sad at the passing of time and more relieved. Maybe she will be healthier. Maybe she will be more content. Maybe she will sleep. I don't want to wish away the time, but I'm also glad this year is over.

I know the screaming is not the full story. If I think hard, I can remember chubby baby cheeks and baby giggles. I remember Nadia crying and crying until she got me back. Then she cuddled her head against my shoulder, quietly breathing me in. She didn't care if I was being a success; she just wanted me.

I remember Juliana's pride at reading her first story. Even with all the interruptions and distractions, without a lot of fabulously inspired activities, she is learning. I think of her unflagging enthusiasm for life, which my lack of energy has never managed to destroy.

While I do remember a lot of screaming from our three year old, I also remember her sweet smile and bright, mischievous eyes. I remember the funny thing she said. I think of her crawling around on the floor and lavishing Nadia with somewhat aggressive love.

I remember Kevin taking the girls outside to play, putting in a load of laundry, or trying again to get the baby to sleep. It's not always easy being married to someone who is exhausted and depressed and easily irritated, but he has tried to be helpful and patient.

With time the fog will lift and I will look back on this year with more benevolence. I'd like to write this in retrospect, looking back on the good things I learned through difficulty, summing it up with a pretty picture. But right now I'm still in the middle of it. Most of life takes place in the messy space before tidy conclusions.

I know depression still has a bit of a stigma, and that's why I choose to be open about it. I have appreciated others who have been honest about their own struggles. There is always the risk of people discounting your story or giving advice to “just pray more.” We don't want to look as weak as we feel. We so much want to have it all together, but we all need to know it is okay to struggle. We all need to be reminded that we are not alone.