When a sense of joy is paused

I have been through several phases in my life when I thought my world had just stopped, and I was sure I would never be able to laugh again. Whether after a loss, a betrayal, thwarted belongingness, burnout, or being forced to follow a sign that reads ''Unknown'' as our next destination, none of us is immune to experiencing a state of low mood and motivation, sometimes with hopelessness and lack of aliveness. Some call it depression, but I sometimes hesitate to use the word depression; as a psychiatrist, I know too well that this existential phase has been overly pathologized and medicalized, and many have mislabeled as such the very normal experience of people mourning for instance. To a certain extent, it can be a good sign to go through this at least once (it means you are human, and you have sensitivity, unlike a robot). Yet, it still carries some level of stigma, and I don't think the word fully captures the very unique expression of this experience that depends on conditioning, beliefs, support system (or lack of), self-concept (how one views oneself), cultural and religious backgrounds etc. But when I hear this word or someone report they are or feel depressed, I go on full empathy mode and I become even more attentive.

It is a complex journey and should not be brushed off. We cannot simply tell people to "just think positive and you'll feel better". It is a very common yet multidimensional experience. It is important to try to understand where it is coming from in order to get appropriate help and find solutions that aim to improve the situation. When I think of adolescence, I see countless scenarios leading to depressed mood: parents divorcing, having to move away from school and friends, relationship breakup, feeling unseen or neglected by one's parents, feeling a pressure from parents to choose a specific career (for instance, your parents want you to study business but you want to go to drama school), going through a medical illness, being the victim of bullying, having conflict with siblings, feeling alone and misunderstood, living in poverty, having a family history of depression, etc. If you are going through something like this, I recommend that you tell someone you trust, and if need be, seek evaluation by your pediatrician or counselor.  Know that you are not alone, and there is nothing wrong with you. There is no right or wrong when it comes to feelings, especially with this almost universal experience of depression. We shouldn't judge anyone to feel a particular way. It is not emotions that have harmed people, but often the lack of awareness or acceptance of said emotions and the subsequent acting-outs to not feel them.

I already alluded to the good omen it is... As a physician and a woman with lived experience with low mood episodes, my conceptualization of depression has undergone a series of permutations to make me able to see even more positive aspects to it. For a while, I had a hard time with the script that "we need sadness to appreciate joy'', as if depression was a punishment somehow for enjoying life or as if everything needed to be evened out like protons and electrons, like in a zero-sum type of paradigm. Now I see this differently. I found at least a few significantly positive elements to this mental state that can be very unpleasant, even frightening. It might be accompanied by not wanting to live anymore. But it is important to take time to decode all of those thoughts, experiences sensations in order to see that, in fact, it shouldn't be taken literally. What most people I have had the honor to work with made me realize is that no one wants to suffer and by stating a wish to die, they in fact mean they just want to stop the suffering. Once we can see that, then we have something to work with. It is important to self-validate that aversion to suffering. But it is important to resist the urge to numb it or run away from it, because within the suffering can be found hidden treasures. Don't worry, I am not some kind of masochistic proponent of eternal suffering. I am just saying that a low period can hide deep wisdom and growth. For instance, being depressed forces us to look inside and reconnect with our true self. Having morbid thoughts often means we are about to enter a new developmental stage, we are about to grow and evolve, and maybe we feel scared of the unknown and we are grieving our old self, or some illusions about the world. To say it differently, wanting to die might simply mean that a part of us is dying, only to be reborn in whom we are meant to become.

I had a very busy, draining week last week (including giving a lecture to medical students on... depression ! Which I have done for over a decade). I didn't even have time to sit down to write this blog like I used to on Wednesday. I even felt a drop in my energy on a few occasions, and I tend to find this rather unpleasant, as I am very fond of my creative energy and all the things it helped me accomplish so far. But while I was behind the wheel at the end of the day on Friday and felt another wave of exhaustion sweeping over me, I approached it differently. I paused and realized something. As aversive as it is, mostly because feeling sluggish has sometimes been associated with deep sadness and depression, which led me to try to escape this in the past, I had an epiphany I would like to share with you, in case it may help. Beyond the gratitude for the good moments, the dark hour of the soul makes us feel, beyond the transformation as we come out wiser and more enlightened about human condition after experiencing suffering, what the fatigue (with or without depression) made me realize is that fatigue of the body (and by extension, fatigue of the spirit, like depression), because of the slowing down it imposes (low motivation, low energy), allows us to sharpen our perceptions. Our body-energy is a sensory modality that transcends the senses we are most aware of on a daily basis, like sight, sound, touch, smell... Our whole being has other senses, like proprioception (the ability to know where specific parts of your body are in the space at any given moment, even with eyes closed), or intuition (an ability to perceive truths at a deep, intangible level), and our whole body because a great antenna that can be more and more attuned to the environment as we go through hardships and situations that crack us open. It is a whole field of perception. And this is what was going on for me last week. As I was sitting, feeling the rebound stress coming out as fatigue throughout my whole body, I was in awe of seeing a new expression of the good in this: when we slow down, either by choice or when forced to because of an illness, we can start paying closer attention and noticing interesting aspects in ourselves and in life in general. It is basically life's invitation to gather data about this wonderful, unique experiment called life. It helps us approach life differently. It prevents us from living life mechanically. It is like seeing the wind for what it is: not merely an invisible movement or empty pocket of air, but the force behind the small dead brown leaves that are lifted and swirled around like the foam of a autumnal wave or a murmuration of birds... It is a good time to seize (carpe diem !) and become a kinder person: being gentle first towards oneself by expressing self-compassion ("gee, no wonder I feel this way, I had a loaded week), self-congratulation (and, guess what, I made it all in one piece !"), and then towards the rest of humanity, and every living being going through something similar. This pause becomes a precious space or workshop towards self-understanding and solidarity as we soften our heart to bond with the world and help improving it. It reminds us of our growing power to perceive reality beyond words and moment by moment, and of our gift to interconnect.

Sometimes I see reality like in a black and white movie. But I know that if I go beyond the lack of color palette, I will notice interesting stuff. Until I see life (inner and outer) in color again. Everything is impermanent, including sadness or suffering. Eventually, joy, our true, deep nature, can't help it and asks to be un-paused.  Sadness and joy are always full of teachings. Sadness and joy can also co-exist at times. We can highly benefit from becoming more fluent in the emotional language as we are eternal students at the school of life.

What have you discovered about yourself, your life and humanity when you felt low ? What can you tell yourself in the future if you experience this again, or how can you express kindness, compassion and acceptance beyond words, with your body-antenna, to another soul going through this at this moment ? 

"Connecting the dots of love..."