Perfectly Hidden Depression by Margaret Robinson Rutherford

No one knows the real you because you never let them in. You’re not comfortable with the reality of you so you pretend it doesn’t exist.  If this sounds all too familiar to you, then you need this book.

5/5 stars.
ARC, ebook, 232 pages.
Read from May 29, 2019 to May 31, 2019.

You always meet your deadlines regardless of how you’re feeling, you push forward through difficult circumstances and hide behind a facade in order to keep an appearance of having it all together. All because you don’t want to be perceived as incompetent or weak, yet inside you’re constantly battling with yourself, your feelings, and your self-worth. You’ve tried to line yourself up with the standard definitions of depression yet you never fully fit it due to your heightened sense of responsibility, your inability to recognise or share your feelings, and the high sense of control you constantly try to implement in your life. No one knows the real you because you never let them in. You’re not comfortable with the reality of you so you pretend it doesn’t exist.  If this sounds all too familiar to you, then you need this book.

After some harrowing experiences with patients, the author of this book noticed a pattern and began to put together the shape of this unique type of depression that often goes unnoticed and undiagnosed. Coined by the author, Perfectly Hidden Depression (PHD) can be the result of a variety of factors such as upbringing, ingrained beliefs, and personality traits. The author states that there isn’t anything in the Diagnostics and Statistics Manual (DSM) on this type of depression but that this is an acknowledgement and an observation from her own professional experiences (which she details and provides resources for). The author believes PHD is a subset of depression that many practitioners miss because it doesn’t present the way the DSM has listed. The author gives this list of defining features that make up someone with PHD:

  • Are highly perfectionistic and have a constant, critical,
    and shaming inner voice
  • Demonstrate a heightened or excessive sense of
    responsibility
  • Detach from painful emotions by staying in your head
    and actively shutting them off
  • Worry and need to control yourself and your
    environment
  • Intensely focus on tasks, using accomplishment to feel
    valuable
  • Focus on the well-being of others but don’t allow them
    into your inner world
  • Discount personal hurt or sorrow and struggle with
    self-compassion
  • May have an accompanying mental health issue, such
    as an eating disorder, anxiety disorder, obsessive-compulsive disorder, or addiction
  • Believe strongly in counting your blessings as the foundation of well-being
  • May enjoy success within a professional structure but
    struggle with emotional intimacy in relationships

Think of some of the shocking celebrity suicides that have happened recently, Anthony Bourdain, for example. Everyone thought he has this dream life and that he seemed like a generally happy and satisfied person. What if Anthony was the epitome of PHD? In that, he felt his personal value was only in his accomplishments, driven by how grateful he thought he should feel, and then feeling burdened and overwhelmed by the mask of achievement and perfection that he felt he had to wear. He also had addiction problems. If we knew more about people that presented with this perfectly masked depression we could provide them with better treatment and save them and those around them an immense amount of suffering.

“Anthony Bourdain was apparently not physically ill, not financially destitute, not concerned about getting his next meal, and not lacking in fame. In fact, he remarked he had “the greatest job in the world.”” – Toronto Sun, July 7, 2018

It’s hard not to get personal in reviewing this book as I picked it up from Netgalley out of my own personal interest. After reading The Gifts of Imperfection eight years ago I worked through my own PHD, which at the time was just learning to be vulnerable again. I started talking and writing about my issues and the condition, dermatillomania, that still plagues me, something that would have been unthinkable before. I made steep headway with Brené Brown’s book but it wasn’t enough. This book feels like the acknowledgement and the validation I need to press forward in my own personal growth and happiness in terms of the regressions I have made at this point in my life.

The author of this book is shedding light on an area of depression that requires some serious attention. Her writing is personable, concise, insightful, informative, resourceful and clinical. I have already recommended this book to at least three people I know and I anxiously await its publication as I look forward to adding this to my permanent bookshelf.  At this time, I have not done the reflections recommended in the book as I was excited and anxious to get through all the content because of how alarmingly relevant I found it. I am now looking forward to re-reading the book and diligently doing the reflections which I believe will be immensely valuable. I’ve already started recommending this book which is due to be published on November 1, 2019. I highly recommended this book to anyone who feels they fit this description, and if you do, chances are you’re reluctant to reach out for help, so start with this book, no one has to know.

The Bell Jar by Sylvia Plath

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4/5 stars.
ebook, 272 pages.
Read from May 27 to 30, 2015.

This book has been on my to-read list since the beginning of my university days. I recall reading some of Plath’s poetry during this time but having known so little about her at the time and not having the maturity in regards to her situation, I never found the poems as potent as they were intended to be. Without getting into too much into literary theory, I will state that I do believe that with some pieces of literature it is important to know the history of the author and how their history can intentionally be placed into their work. I believe that Plath’s work fits for this circumstance.

For those that don’t know, Sylvia Plath was an American writer who was born in 1932. Her father died when she was just a girl, an event that would change Plath and affect her writing substantially in the future. Plath attended college and was a promising student with top marks. She was offered a guest editing position at a top women’s magazine but it was not what Plath hoped it would be and this is when her mental health issues started to show. She survived her first suicide attempt after overdosing on her mother’s sleeping pills and crawling into a hole outside. She was hospitalized and given psychiatric treatment which, at the time, included insulin shots and electric shock treatment. Plath seemed to make a decent recovery after 6 months in treatment and returned to college. It was here where she meets her future husband, Ted Hughes, who ends up becoming a famous and notable English writer.  During their marriage she gave birth to two children and had one miscarriage, an event that also presents itself in her writing. Plath was also in a car accident, which was likely another suicide attempt. Shortly after, Plath and Hughes separated after Plath discovered that Hughes was having an affair. After the separation is when Plath wrote some of her most important pieces, but sadly she committed her final act of suicide and died on February 11, 1963, just days after being prescribed anti-depressants. Plath died of carbon monoxide poisoning. She barricaded herself in the kitchen and placed her head inside the oven with the gas turned on.

Plath’s life was tumultuous and tragic and The Bell Jar is a semi-biographical story that reflects the beginning of Plath’s life and illness before she meets Hughes.

Esther Greenwood is a young, smart and ambitious woman who has just started the beginning, of what she is hoping to be a prominent and promising career in writing. She has been awarded the opportunity to intern at a popular women’s fashion magazine in New York, which is a dream come true for Esther. However, Esther slowly watches her ambitions drain away as an unstoppable depression begins to take over. As her ambition fades and the depression takes its toll, so does her once in a lifetime chance of making it in New York, in which, at this point Esther is so numb with depression she nearly doesn’t care. She almost marries, she is hospitalized and nearly dies. The ending does give some hope that perhaps there is still a chance for her.

The events Esther lives through are nearly identical to the ones Plath went through herself. Esther is pragmatic and brave. Esther wanted something more for herself so she is brutally honest about aspects of relationships and her refusal of a what would have appeared to be a perfect match for marriage. She is also honest with her depression, while not naming her condition, Esther describes perfectly what it feels like consumed by depression:

“The silence depressed me. It wasn’t the silence of silence. It was my own silence.”

“To the person in the bell jar, blank and stopped as a dead baby, the world itself is a bad dream.”

“…because wherever I sat—on the deck of a ship or at a street café in Paris or Bangkok—I would be sitting under the same glass bell jar, stewing in my own sour air.”

“I couldn’t see the point of getting up. I had nothing to look forward to.”

Even though it was written long before I was born, this book will always be timeless for its honesty with depression and mental health and particularly because it comes from the perspective of a woman. Even some of the social issues in this book are still relevant for women. Esther’s thinking on marriage was very forward for its day and age:

“So I began to think maybe it was true that when you were married and had children it was like being brainwashed, and afterward you went about as numb as a slave in a totalitarian state.”

“That’s one of the reasons I never wanted to get married. The last thing I wanted was infinite security and to be the place an arrow shoots off from. I wanted change and excitement and to shoot off in all directions myself, like the colored arrows from a Fourth of July rocket.”

I wonder if these were Plath’s own views and what changed her mind later in life to marry Hughes? There are many aspects in the book where Esther, despite protesting that she will never marry, still indicates that she wants it all: love, a family, but also her freedom. However she knows that she cannot have it all. Perhaps these are the same thoughts that brought Plath to succumb to her own marriage?

Plath’s short life feels like a story unfinished, which also contributes to her still present popularity. Feminists have taken her under their wing and are devoted to her prose and the continuation of her legacy. It makes me curious to what kind of woman Plath would be now and what she would have become. This book has made a lasting impression on me and is a hugely important book for the continuation and understanding of mental health issues.

Get It Done When You’re Depressed by Julie A. Fast

3/5 stars.
ebook, 270 pages.
Read from August 26 to October 07, 2014.

As I usually do with most of the self-help books I read, I took my time. What was refreshing with this book is that it helped me to realize that some of my thoughts and even behaviors are not actually who I am. That when I wake up in the morning and that cloud is lingering over me, I know that I may have difficulties with what I expected to get done that day, that my negative thoughts are a result of my depression and that my brain is lying to me as a result. In recognizing when I’m struggling, I know that I can put out the extra effort to push past as much as I can and still be productive or at least be kind to myself that day if it’s particularly bad.

The author’s main suggestions are in regards to self-recognition and knowing when your depression is taking hold and when your thoughts and behaviors can’t be trusted,  along with suggestions to stay focused and organized. The author also provides plenty of exercises to help the reader along. Additionally, she lays down the science behind getting enough sleep, the importance of exercise and the effects that alcohol and caffeine can have on a depressed brain. What was also very interesting was that at the end of each chapters she poses a question or scenario that relates to the content that was just discussed so that you can get the scientific explanation to that question.

Many people have complained that this book is too straight forward or that if they had tried the author’s suggestions it would have made their depression worse for them but I disagree to an extent. I believe that this book is directed to people with mild to moderate depression, so those of us who are held together enough to not be hospitalized and are of no harm to ourselves or others. While depression sucks all around, no matter how bad you have it, the less severe it is the more we are able to deal with it and I feel that this book is a great aid for the milder situations. The information may be straight forward in some areas but how many of those complaining have willingly tried and put forth positive energy into applying the authors methods? Everything is harder when you’re depressed so it takes more effort to try the exercises and recommendations but, like anything in life, the hard stuff is often worth it.

I think that there are a few stages that a sufferer goes through with depression. The beginning starts with the unawareness which is the pre-diagnosis, the second stage is that recognition and the diagnosis, and the third is how the person chooses to deal with the situation. Depression has a horrible way of making the sufferer very negative and more often than not during the third stage, the sufferer victimizes and feel sorry for themselves at some point. I think many people sadly, are not able to move past this victimization. With this victimization the sufferer believes that they are their condition and that nothing will ever change, therefore handing over all of their power, control, and ultimately their life over to the condition. This is why, I think some people scoff at the exercises and suggestions that the authors makes.

The suggestions, I think to a person in this position, seem to mock their suffering in that they didn’t ask for depression so they don’t need to be accountable for it. However, nobody asks for depression and just like a lot of things in life you have to learn to adapt and to deal. One of the most difficult things I’ve done has been recognizing my own depression for what it is, stop being angry that it’s there, and learn to manage my life with it. Nothing happens over night, so repetition and practice are key to leading a life with depression which, is where this book comes in handy. Everyone is different to so not everyone’s coping methods will be the same. Some people require more compassion while others need a tough love approach.

I believe that people who are dealing with mild to moderate depression don’t have to let it consume their lives. Depression really blows and the effects from it can be overwhelming but the best plan of action is recognizing its presence and not giving up your control to it. It’s a matter of trying to alter our focus and knowing that we have choices and we have options.

My one complaint with the book is that the chapters seemed a bit repetitive after a while in that the relayed very similar information. I mean, if practice and repetition are key I suppose this isn’t a terrible thing, it just made for some tedious reading.

Overall I really enjoyed the books message and I have noticed a difference in my own work flow since reading this book. I highly recommend this book to anyone dealing with depression.