Monday, September 26, 2016

It's not binary


Where I first started thinking about the word "binary", was related to its use in issues of gender and sexuality, where non-binary is used to express not fitting within the standard easy definitions. In its more mathematical use, binary is 1 or 0. Yes or No. The switch is on or off.

Some people get very uncomfortable with anything beyond that, wishing everything fit neatly into simple boxes, but life has a way of being more complex, with multiple interactions and variations, and nuances. Truthfully the difficulty is often more with the reaction than with the complexity itself. Is it really so terrible that there can be more than two answers?

Keeping that in mind, and returning to depression, I have dealt with people who will tell you that depression is strictly chemical, and medication is the only answer. These have primarily been young girls dealing with depression, and they have their reasons for seeing it this way.

However, I also know someone who said pretty firmly that the only real cure for depression is therapy, and medication is just something that can help you as you reach healing through therapeutic means.

So, as long as we are being anecdotal, let me throw out a few more. I have one friend who has a tendency toward depression, especially in winter as it is combined with Seasonal Affective Disorder. He still was able to manage it without medication until a really difficult divorce. It took him about three years to get back to where he didn't need the medication anymore.

During that time, there were people who told him he should be able to manage without the medication - that he should be using faith and prayer to overcome his difficulties. I still get mad thinking about the ignorance involved, and the casual cruelty that kind of ignorance makes possible.

I have another friend who was dealing with depression as a result of childhood sexual abuse. Medication did not help her; it only made her feel numb. This was a while back, and that was a common complaint for a lot of patients back then. I think medication has improved, but what she took away from that was that the problem was not her brain chemistry. She would have to heal from her experience and manage the after-effects in non-chemical ways.

When the young girls cling tightly to the chemistry-only definition, I know why they are doing it. They know that there is something chemically wrong that needs help, and yet they are constantly being told to get over it or suck it up or to be stronger. Their understanding of depression becomes part of their defense of their selves, and their right to have their problems recognized and treated.

What I also know is that they often have high Adverse Childhood Experience scores. When they were supposed to be developing their strength and resilience they were having supports kicked away and wounds inflicted that not only make emotional resilience harder but pose threats to their long-term physical health. So yes, there could be some emotional factors there, where counseling might be helpful, or workshops or lots of other things, but that is in no way any justification for putting them further down and calling them weak.

I do not doubt that the one counterexample needs talking therapy, based on his childhood experiences and his ways of dealing with things now; that doesn't mean it's the only way.

Another friend who was sexually abused had a specific issue with normal arousal causing feelings of disgust with herself, because of the associations with abuse. Yoga was helpful to her for that, giving her a different way of approaching her mind-body connection. I am glad that helped her. That does not mean that you can tell any abuse victim to just do yoga.

I am thinking of one more friend who was abused as a child. She went through therapy then, and was doing well, and then in her early twenties, in a different location and life situation, some reminders came up, and triggered her, putting her mentally in a bad place.

She needed to go back to therapy. It wasn't even for that long, but she needed to check back in, and have someone help her take another look.

There are a lot of different ways that mental health can work or not work. It is foolish of us to try and oversimplify it, or to think that we know better than someone else what will help them heal or cope. It is horrible that so often we respond with arrogance instead of compassion. That helps no one.

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