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Seasonal depression always catches up to me slowly and sneakily. But by February, I am deep in it. I have found medication and routines that help, but I can still feel the pain of it.

I watched a show on Amazon Prime the other day – Raising Bipolar – about children who have been diagnosed with bipolar disorder and the challenges faced by them and their families in living happy and healthy lives.

I was particularly struck by the story of a 10-year-old girl, one of the older kids featured. Video of her as  a preschooler shows her growling and clenching her fists, throwing furniture, and hitting people.  After years of therapy and medication she seemed much more stable, so her doctor tapered down her meds, which resulted in a relapse; yelling and crying uncontrollably and retreating under the covers of her bed.

She’s more stable these days, and she can recognize her symptoms of depression.  The cameras show the girl’s sweet younger brother standing outside her bedroom asking, “Can I come in?” Her answer from behind the door is a calm and sincere-sounding, “I don’t want to hurt you.” It’s not said as a threat but as an acknowledgement that she sometimes can’t control her behavior.

I often think of an anecdote about a doctors conference concerning depression.  An Indian doctor gave a presentation in which he described how most depressive patients in India present with physical symptoms, compared to American patients, whose depression is most often presented with mental symptoms. At the Q&A part of the presentation, an American doctor commented that people in India tend to somaticize depression. He said it as if that was the inferior way to be depressed. But the Indian doctor’s response was that Americans seem to psychologize depression, implying that maybe Americans have it backwards.

That made a huge impression on me, because, of course, the mental and the physical go together. A mental illness may have its origins in the mind or in the brain, one of which is thought-based, and the other which is body-based. But we conflate the body and mind together, when sometimes it might be good to look at them separately.

For example, one of my winter depressions was particularly harsh. Getting out of bed was a struggle. I would drag myself to work, but when I came back home, I would fall onto the couch, cover myself with a blanket and shiver, unable to get warm, sleeping my only relief.

I was feeling terrible about myself, knowing there were things I should be doing, but being unable to move. I starting thinking my character was faulty, that I should have the will-power to push through. These negative thoughts would form a mental cloud over me, until I thought about the somaticize versus psychologize concept. It seemed clear that I was in physical pain; my muscles ached, and my body felt stiff, heavy, and cold to the bone. It was one of the first times I acknowledged that my depression might have its origin in physical pain.

With an additional medication, those particular symptoms of depression abated considerably. And in the meantime, before the meds kicked in, I reminded myself to be nice to me, to recognize that my body was having a hard time, and that it was no excuse to berate myself.

When I have a cold, or I’ve twisted my ankle, or I have a painful sunburn I don’t tell myself I’m worthless. Why should I do that when my body is suffering from some other condition, like depression?

Sometimes my depression seems to have more thought-based origins. Disappointment, anger, twisting of thoughts into complete negatives.  In that case, I need to recognize that my mental challenges don’t have to prevent me from participating in what physical things I can handle and might help pick me up.

I was touched by the girl in the documentary film, by her maturity. Instead of yelling at her brother to go away, some part of her could appreciate that he loves her, cares about her, and that she cares about him, too. Instead of going to anger to protect herself, yelling at him to go away, she had the skills to make a decision that protects her and others when she knows her limitations. “I don’t want to hurt you.”

I’ve been able to do that more as I get older. I know that I can handle a situation within certain parameters. For example, I can go shopping when I’m depressed, but not just any kind. Depressed me can shop for food with a list in my hand. But if someone would ask me to go shopping for clothes, maybe go out for coffee, check out a few different stores, depressed me might have to decline. I would want to say yes, and maybe worry that the person who invited me would feel rejected, but I know that the unknown, the socializing, the having to relate on an emotional level, the need to project empathy, and sorting through lots of stimuli, would get to me after awhile. And though I might be able to keep my pain from affecting other people, the toll it would take to hide it would wear on me and do some sort of damage.

I’m glad I can recognize the pattern now. February is always difficult for me. But I try not to let the physical pain of depression, so sneaky and hard to recognize, soak into my mental/ emotional state. I practice modified hibernation and wait for spring.