enter label: when to use a depression survey, and when to throw it away
& some psych, evolution, and Dead Internet theory
Dear Companions,
Throughout my journey—especially in the deepest abyss (for which another guide is coming)—the world didn’t quite dull. If anything, the grass became hyperbolic green, the birds multiplied, and the blue sky swelled. I dreamed of walking beach trails in St Johns and of history—Hannibal, one-eyed, leading his elephants. I posted stuff like this for the love of simple things, like sprinklers.
But I could have no part of it. How was it possible to become so dysfunctional so as to be unable to take a phone call? The world was deadly from a sensory perspective. But I loved her still. I swore I would embrace her, even in her simplest form—a walk in the park, time with family, the shower. Any inch of functionality. Just please, one second pain-free.
As I sat crying at every appointment—neurological, ophthalmological, or therapeutic, you name it—doctors insisted I was massively depressed. Like, don’t let the door hit you on the way-out kind of assessment. And indeed, I had one top neurologist quit—not just on me but his profession mid-appointment. He said, there were too many of people like me, and not enough of him, due to Covid.
But the truth was more complicated. I had to resurrect an old term, not in use anymore, to pin it down, and start to crawl out.
Burn’s Check list
When I found Feeling Good by David Burns, I was confronted with a truth about my condition. Burns, a Cognitive Behavioral proponent, identified common negative thinking patterns, like all-or-nothing thinking and catastrophizing, which contribute to anxiety and depression. He provides a structured approach to changing thoughts through behavior.
He starts the book off with a checklist to help you evaluate your depression.
Scoring:
0-5: No depression
6-10: Normal but unhappy
11-25: Mild depression
26-50: Moderate depression
51-75: Severe depression
76-100: Extreme depression
I discovered my rating in the Abyss wasn’t just depressed; I was extremely depressed. Extremely depressed is worse than severely depressed. I had to fight like hell to get to Severely.
I felt affirmed but also shocked. I knew my situation was bad, but as someone who had never been depressed before, it was hard to take in. In nearly any time in life, in any multiverse, I’d be rated no depression, or at worst, normal but unhappy.
Was this really me?
The answer is, yes and no.
Yes, I was one question away from being instructed to call 911. Fortunately, when it came to the ones that truly mattered—suicidal urges—I was holding on. On the final question about actively planning to harm myself, I answered "Not at all" regardless of Google searches. That confirmed for me on an intellectual level at least, that I was not in immediate danger.
Yes, this was a useful survey for me as I was flying blind in the sky. But once I found the horizon, I began to seek something that fit me better.
Reactive Depression
All my answers had a but for the pain added to them. Only one therapist, who trained under Dr. Sarno addressed that.
She evaluated me differently. She said I wasn’t classically depressed, but suffering from reactive depression—a response to the pain and trauma of my experience. This insight proved to be a fruitful line of thinking for me. And it made intuitive sense. I was feeling extremely depressed because I was sick.
The concept of reactive depression was developed in the field of psychiatry to describe depression that occurs in response to a specific stressful or traumatic event. It contrasts with endogenous depression, which was thought to arise without an identifiable external cause, possibly due to internal biological or genetic factors.
This tiny pivot in thought was instrumental to reducing the cognitive dissonance with my reality, without undermining the extent of the difficulty of my situation.
Modern diagnostics don’t include reactive depression
But modern psychiatry doesn’t make the distinction anymore. Perhaps this is why no other therapist mentioned it.
Today contemporary psychiatry recognizes that most forms of depression involve a complex interaction between environmental triggers, personal experiences, and biological factors. Modern diagnostic manuals like the DSM-5 no longer make this strict distinction, though the concept of situational depression (a form of adjustment disorder) remains similar to reactive depression. Now they might refer to reactive depression as major depressive disorder (MDD) or adjustment disorder with depressed mood, depending on the severity.
I get that too. If you wake up with a pounding heart because the day feels impossible to face, these nuances can be totally unhelpful.
Either way — the Burn’s advice
Either way, the Burn’s book applies. Once negative thoughts or emotions are identified through this rating system, CBT encourages challenging these thoughts through techniques such as:
Cognitive restructuring: Replacing distorted thoughts with realistic ones.
Thought records: Writing down thoughts, feelings, and evidence for/against them.
Behavioral activation: Engaging in activities that improve mood.
In my opinion, reactive depression was simply the healthier story.
No matter how depressed I felt, or actually was, no matter how much rage I had, or the volume of tears, I kept that seed protected in the back of my mind.
I would love to share it with as many people as possible because I know it might not be shared at the modern therapist’s office. Then I would direct them to more TMS references.
Now here things get tricky. What happens if:
You fail to progress
Or the pain heals, and you find that the life which awaits you at the end is disappointing.
Or you forget your appreciation for life, because you are human.
Or you never had any pain to begin with, no bogeyman, so you don’t even know what to overcome.
What if such depression wafts in unannounced? No vaccine. No clear moment. Just blowing out your 40th birthday candles, and boom, you’ve blown all the light out of the universe.
I think back to the sci fi novel Wool, where futuristic windows distort reality, leaving the outside world looking blurry, unwelcome. Perhaps here finding the negative thought patterns becomes trickier.
Back to Burns.
This week has been depleting for several reasons, most notably my last post.
I hope you don’t mind this conversation. It’s a little bleak, but maybe some of it is helpful.
Now, let’s move to some nuggets.
💛⭐️🌟👑
HEALINGVRSE NUGGETS
Epigenetics might be getting more attention than they warrant from an evolutionary standpoint. According to Dawkins, their influence primarily affects only the next generation, rather than contributing significantly to long-term evolutionary changes (because they don’t alter underlining DNA sequencing).
Psychosocial stages of development by psychologist Erik Ericson found in a discussion by Dr. Tara Swart. He proposed that individuals go through eight distinct stages across their lifespan, with each stage involving a conflict or crisis that must be resolved to develop a healthy personality. I would recommend looking into this further if you struggle with any of these.
Trust vs. Mistrust (Birth to 1 year): Learning whether to trust caregivers and the world around.
Autonomy vs. Shame and Doubt (1 to 3 years): Developing independence and confidence in self-control.
Initiative vs. Guilt (3 to 6 years): Starting to take initiative and make choices, while managing feelings of guilt.
Industry vs. Inferiority (6 to 12 years): Mastering skills and feeling competent or struggling with feelings of inferiority.
Identity vs. Role Confusion (12 to 18 years): Exploring personal identity and finding a sense of self.
Intimacy vs. Isolation (18 to 40 years): Building meaningful relationships or experiencing isolation.
Generativity vs. Stagnation (40 to 65 years): Contributing to society and guiding future generations or feeling stagnant.
Integrity vs. Despair (65+ years): Reflecting on life with a sense of fulfillment or regret
Bathing releases oxytocin - my girls who bathe know what I’m talking about. Do men take baths besides ice ones? If you don’t have a bathtub do what I do and just sit in the shower and heat up. This at least creates a very immersive experience.
Takeaways from the Menopause conference- this was interesting because it highlights broader shifts in the wellness world.
reports that what used to be just a handful of doctors has now expanded to 50-60, all reacting to patients armed with online medical advice. The post-COVID patient is a different demographic indeed.McKinsey Consumer Trends 2024 projects the women’s wellness market to reach $1 trillion by 2040. There’s a significant gap to be addressed.
4 hours on the Roman Empire with Lex - irresistible.
Dead Internet - is a conspiracy theory that suggests much of the content on the internet, especially social media and forums, is generated by artificial intelligence (AI) bots, rather than real humans. It argues that after a certain point in time—commonly pinpointed around 2016 or 2017—the internet shifted from being a space for organic human interaction to one dominated by bots and AI-generated content. Hey whatever gets you through the day, right?
I’M ALIVE! If you are too, leave a comment of the human variety.
If you found something superfluous, or would have liked to see more info, please drop a comment.
With much love from the Healingvrse,
Rebecca