Oh...uhh...well...have you...have you tried...going for a walk?
And it’s at this point you realise just how painfully asinine RUOK Day really is.
Because, while I appreciate the sentiment behind the recent drive to ask the question, most of us are woefully unequipped to deal with any answer other than “yes”.
I’d like you all to try something. The next time someone asks you if you’re OK, even if you are - especially if you are - say ‘no’. Then see what happens. Because nobody has a fucking clue what to do next.
RUOK Day isn’t about caring for other people’s mental health, it’s a massive, nation-wide exercise in choreographed mental masturbation to make everyone asking the question feel better about themselves and themselves only.
I tried to make someone feel less sad, I’m a good person!
Never mind that you didn’t actually do anything to help, in fact you probably made it much worse, but you tried. Good for you, pat yourself on the back and go belt one out in the name of mental health.
Anyone who suffers from depression knows just how complicated an issue it is. Depression is a Gordian Knot of multiple factors, many of which are extrinsic - depression might occur in your head, but the causes are not necessarily exclusively intrinsic. The circumstances of your life play just as much of a role, if not more, in the propagation of depression as the chemistry in your brain - and no amount of hollow platitudes are going to change either.
Through no fault of your own you might be in pain, have an injury, lose your job, be unable to find a new one because of the painful injury, be anything other than a magazine's view of the perfect body shape, be something other than an ideal presented on television, have a slow metabolism, have a weird looking head, have a bad breakup, have a good breakup - but still have your heart broken. There are dozens of reasons for crippling depression that can't be changed with talking or medication, no matter how much serotonin you throw at it.
And anyone who doesn’t suffer from depression has not got the faintest fucking clue of just how bad it is. If you don’t have it you simply cannot comprehend it, it’s much like trying to comprehend the size and scope of the universe.
The thing is, anyone without depression is utterly incapable of comprehending what it feels like and anyone with depression will understand the futility of trying to bridge that gap.
Depression isn’t “feeling a bit sad”. It isn’t being “down” or “blue” or “upset”. It is one of the most painful and debilitating illnesses one can suffer. In my experience (which is subjective, and I’m no doctor, your mileage may vary) there are three types of depression, each with its own perils and each beyond the ken of the well-meaning but ignorant body public:
Catatonic: you are so depressed you can’t do anything. Quite literally. It’s an effort for you to breathe. You lie there and your body feels like it’s being crushed by an incredible weight. Every muscle, every pore on your skin feels like it’s both freezing and on fire - the pain is indescribable and is only made worse by the fact that your rational brain knows that the pain doesn’t even exist. But it’s still there. It’s still painful. You try to move and you just...can’t. You can’t bring yourself to move your body, to raise your arm, to swing your legs over the bed. You know, logically, that it’s possible, but you just can’t do it. So you just lie there, in pain, hoping for sleep or death and not caring which comes first.
Transmutative: while you can get up and move around, you don’t really want to. Because you’re so depressed that you’ve lost the capacity for enjoyment. It isn’t even that things aren’t fun anymore, you find that the things you’d usually do to enjoy yourself are now toxic to you. The very idea of happiness is now repellent to you. You can’t watch a movie without feeling a resentment towards those who made it - why should they be doing jobs they like? You can’t eat something nice because why should everything tasty be bad for your health. You can’t go outside because why is the sun so fucking bright and happy? Everything good about life becomes a rumination on your own failures and shortcomings. You become Captain Barbossa from Pirates of the Caribbean - cursed to an eternal hunger and thirst, but for everything you consume to become ash in your mouth.
Suicidal: this is, naturally, the most dangerous. But not for the reasons you might think. You find that you’re at your most suicidal when you begin to feel a little bit better. When you’re paralysed in bed you simply can’t do anything. When you’re in such a transmutative state that every speck of happiness on earth is an insult aimed at you personally you find a reserve within yourself to continue existing just to spite every happy being on the planet. But when you start to come out of that, that’s when the true danger begins. Because you’re at that fulcrum where you have enough depression to not want to live any more and enough agency to do something about it. You realise that what you’re feeling right now is probably the best you’re ever going to feel again. This, right now, is the best day you’ll ever have for the rest of your life. You know what a slide back into depression is going to feel like and you don’t want to feel that again. So you’re willing to do something to prevent that.
What do you say to that?
If you ask someone if they’re OK, knowing full well that they’re not, and this is the reply that they want to give but they’re too damn polite to say it, that they care about YOU too much to tell you the truth, what the fuck do you even say?
Go for a walk? What if your depression is brought about, in part, by a crippling injury that means you can’t walk? Congratulations, you’ve just made things so much worse. Even if that isn’t the case then walking is, at best, a period of time spent with your own undiluted inner-monologue. The absolute worst thing anyone with depression can be forced to deal with is the voice in their head and no witnesses.
Do something fun? This is the hardest for someone without depression to grasp. You can’t do something fun. Because depression means that you’re incapable of fun. It poisons fun for you. You are no longer even capable of enjoying something. You watch people being happy and it makes you sick that they should have that happiness. If you can’t have it then nobody should.
“Other people have it worse”? Ah, the fallacy of relative privation. Diminishing what somebody feels because of a mysterious third agent that only exists in a theoretical state. Render unto Caesar that which is Caesar’s, but my pain is my own. It’s the worst that I feel, that I am capable of feeling. I pity the poor bastard that has it worse, but that doesn’t make me feel any better. It just means that there are two of us now.
Get professional help? Ah, this one is the true laugh. I’ve sought professional help dozens of times in my life and not once, not a single time, have I come out better for the experience. I genuinely believe that at some point in the near future psychology will be treated as a pseudo-science, alongside phrenology and homeopathy. At least psychiatry has a chemical cause and effect, even if it is little more than throwing neurotransmitters at a wall and seeing what sticks.
Ring one of those hotlines they stick on the end of every news article where someone killed themselves? Try it some time, I dare you. Even if you aren’t depressed, just call up and pretend you are. Those hotlines are an absolute joke. They’re beyond that, they’re an insult. They are nothing more than someone googling your post-code for nearby therapists, telling you that you’ll feel better tomorrow and checking to see if they need to trace the call and send cops to your house to stop you from killing yourself. That’s it. Every interaction I’ve had with them has left me feeling worse than I’ve started, as some bored imbecile ticks boxes and reads off a flow-chart of empty platitudes that is laminated on their desk somewhere.
One time I got so depressed, so suicidal (and this wasn’t even one of those times when I actually attempted suicide) that I went to the emergency department. From my experience, from my direct, personal experience - DO NOT EVER FUCKING DO THAT.
A doctor whose credentials only extended to the tactile human body quizzed me from a booklet that he dusted off from under his desk, like a slightly less discredited version of a Rorschach Test. He then asked me if I’d like to participate in a program designed specially for people with crippling depression. This sounded great, so I agreed. It was much later, as the doors locked behind me, that I discovered that this program was a fiction he’d invented so I wouldn’t kick and scream as I was involuntarily incarcerated in an asylum for a mandatory 72 hour observation period. (Of course, none of this was expressed to me either - I was told for three days that I’d be seeing someone “in an hour or two”).
The things that I saw there...scarred me. It’s been six years and I’m still nervous being anywhere near a hospital.
Never, ever tell anyone just how depressed you actually are.
Know that the next time you feel like asking someone if they’re OK. Because they’re going to tell you they are. It’s easier that way. It’s much less dangerous. Because if someone cares about you enough to ask the question, you’re going to care about them enough to not unleash the absolute broadside barrage that is an honest answer to that question.
And even if feelings aren’t in play, there’s always the complication of what consequences might occur from an honest answer. Will you be living with the scars of that decision for the rest of your life? (I have a chronic pain injury, something that will never heal and can only be managed. I have my medication for this doled out on an almost dose by dose basis, instead of an easy and convenient to manage amount, because on my permanent record is a visit to a mental facility I never wanted to go to.)
If, knowing all this, you still feel like asking RUOK? - then congratulations on being a good person. I truly hope you’re prepared for whatever comes next. But don’t be surprised if the answer is an Uncanny Valley level of enthusiastic thumbs up - because people with depression truly dread the annual EVERYONE PRETEND TO GIVE A FUCK DAY.
Until mental health care in this country receives a MASSIVE boost - both in resources and respect, this day is nothing but a wank.
P.S I once had a much more optimistic view of mental health, awareness days and life in general. Then I participated in a television show where comedians would lay themselves bare and tell their own stories of struggling with mental illness, for the benefit of all. Ultimately I was left on the cutting room floor so that another, more well known, comedian - who needed this a lot less than I did - could get a fraction more exposure. There's a reason I'm as bitter as I am.