The Nonlinear Library LW - Anxiety vs. Depression by Sable
Mar 17, 2024
04:54
Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Anxiety vs. Depression, published by Sable on March 17, 2024 on LessWrong.
I have anxiety and depression.
The kind that doesn't go away, and you take pills to manage.
This is not a secret.
What's more interesting is that I just switched medications from one that successfully managed the depression but not the anxiety to one that successfully manages the anxiety but not the depression, giving me a brief window to see my two comorbid conditions separated from each other, for the first time since ever.
What follows is a (brief) digression on what they're like from the inside.
Depression
I'm still me when I'm depressed.
Just a version of me that's sapped of all initiative, energy, and tolerance for human contact.
There are plenty of metaphors for depression - a grey fog being one of the most popular - but I often think of it in the context of inertia.
Inertia is matter's tendency to keep doing what it's doing, until some outside force comes and overturns the mattress. An object at rest will stay at rest until someone tells it to get out of bed, and an object in motion will stay in motion until it's told to calm the f*ck down.
Normally, inertia is pretty easy to overcome, for one's own self. Want something done? Just get up and do it.
When I'm depressed, though, inertia is this huge, comfortable pillow that resists all attempts to move it. Want to do something? Does it involve getting out of bed? If so, no thank you, that sounds hard. Hungry? Meh, I can eat later. Have to go to work? That sounds exhausting, and there's this big pillow that just won't move between me and ever leaving this bed, and maybe I'll just call in mentally ill today.
The funny thing is that this inertia appears at every level of movement and cognition.
On a normal day, 'get out of bed' is a single action. I think it, then I do it.
On a depressed day, 'get out of bed' is a long, complicated string of actions, each of which has its own inertia and must be consciously micromanaged. I have to life this arm, maneuver this hand, flex that finger, push with shoulder, bring knee up, twist body, and so on. Each action is distinct, and each has its own inertia to be fought.
On a really bad day, each of those actions must be micromanaged, until I'm literally flexing individual muscles one at a time in sequence to move, as if my body were an anatomically correct puppet my brain had to steer one nerve-impulse instruction at a time.
Of course, this applies to thoughts, too - deciding to do anything that isn't exactly what I'm already doing suddenly requires substantial effort. Goal-seeking is a challenge; forget about things like abstract thought and metacognition. Too complicated, too many moving parts, and not enough energy in the system to work any of it.
It's not a whole lot of fun.
Anxiety
I'm still me when I'm anxious.
Just a version of me that's convinced I'm permanently unsafe and on the verge of losing my job and everything I hold dear and becoming homeless and all my friends secretly hate me and only tolerate me because they're too nice to say anything.
If depression is inertia, anxiety is gravity.
The thing about gravity is that it always pulls things as low as they can get. From the perspective of height, gravity is always about the worst-case scenario: objects fall until they literally can't anymore.
When I'm anxious, everything becomes precipitous, as if I'm always skirting the edge of a cliff or crossing an old, dilapidated bridge over a dark and fathomless chasm. A single wrong move, one wrong step or tilt or breath, and I could be sent screaming over the edge. And once I fall, there won't be a way back up (the chasm wouldn't be very fathomless if there was, would it?).
If any move could be my last, any action lead to disaster if I get even the slightest thing wrong - then surely the correct choic...
I have anxiety and depression.
The kind that doesn't go away, and you take pills to manage.
This is not a secret.
What's more interesting is that I just switched medications from one that successfully managed the depression but not the anxiety to one that successfully manages the anxiety but not the depression, giving me a brief window to see my two comorbid conditions separated from each other, for the first time since ever.
What follows is a (brief) digression on what they're like from the inside.
Depression
I'm still me when I'm depressed.
Just a version of me that's sapped of all initiative, energy, and tolerance for human contact.
There are plenty of metaphors for depression - a grey fog being one of the most popular - but I often think of it in the context of inertia.
Inertia is matter's tendency to keep doing what it's doing, until some outside force comes and overturns the mattress. An object at rest will stay at rest until someone tells it to get out of bed, and an object in motion will stay in motion until it's told to calm the f*ck down.
Normally, inertia is pretty easy to overcome, for one's own self. Want something done? Just get up and do it.
When I'm depressed, though, inertia is this huge, comfortable pillow that resists all attempts to move it. Want to do something? Does it involve getting out of bed? If so, no thank you, that sounds hard. Hungry? Meh, I can eat later. Have to go to work? That sounds exhausting, and there's this big pillow that just won't move between me and ever leaving this bed, and maybe I'll just call in mentally ill today.
The funny thing is that this inertia appears at every level of movement and cognition.
On a normal day, 'get out of bed' is a single action. I think it, then I do it.
On a depressed day, 'get out of bed' is a long, complicated string of actions, each of which has its own inertia and must be consciously micromanaged. I have to life this arm, maneuver this hand, flex that finger, push with shoulder, bring knee up, twist body, and so on. Each action is distinct, and each has its own inertia to be fought.
On a really bad day, each of those actions must be micromanaged, until I'm literally flexing individual muscles one at a time in sequence to move, as if my body were an anatomically correct puppet my brain had to steer one nerve-impulse instruction at a time.
Of course, this applies to thoughts, too - deciding to do anything that isn't exactly what I'm already doing suddenly requires substantial effort. Goal-seeking is a challenge; forget about things like abstract thought and metacognition. Too complicated, too many moving parts, and not enough energy in the system to work any of it.
It's not a whole lot of fun.
Anxiety
I'm still me when I'm anxious.
Just a version of me that's convinced I'm permanently unsafe and on the verge of losing my job and everything I hold dear and becoming homeless and all my friends secretly hate me and only tolerate me because they're too nice to say anything.
If depression is inertia, anxiety is gravity.
The thing about gravity is that it always pulls things as low as they can get. From the perspective of height, gravity is always about the worst-case scenario: objects fall until they literally can't anymore.
When I'm anxious, everything becomes precipitous, as if I'm always skirting the edge of a cliff or crossing an old, dilapidated bridge over a dark and fathomless chasm. A single wrong move, one wrong step or tilt or breath, and I could be sent screaming over the edge. And once I fall, there won't be a way back up (the chasm wouldn't be very fathomless if there was, would it?).
If any move could be my last, any action lead to disaster if I get even the slightest thing wrong - then surely the correct choic...