The last week was rather busy. Between job hunting and everyday life (for me still more than a handful to handle), I had an interview with a psychologist last Monday – the MADRS (Montgomery-Åsberg Depression Rating Scale), which is especially sensitive towards changes in symptoms brought on by antidepressants or treatment. I’m already familiar with the MADRS as I used to do the same interview before starting treatment and during the first weeks of therapy. Basically, it consists of similar questions as the self-report questionnaires I usually fill out, except that the interviewer rates each statement according to what you report and on how you appear.
I had also gotten a stack of different diagnostic assessment sheets and questionnaires to fill out at home over the past week, all of it in the name of tracking the progress of the psychotherapy. I did them before starting sessions too, so any difference will become immediately obvious.
Lastly, I also got a new questionnaire, for partner, family and friends of the patient. They are asked to judge the changes in 13 different points, as they perceive them in the patient: visible sadness, communicated sadness, inner tension, sleeplessness, loss of appetite, concentration problems, apathy, lack of emotions, pessimistic thoughts, suicidal ideation, helplessness concerning everyday tasks, hopelessness and worthlessness.
At first, I was going to give it to my boyfriend only, since he has the best insight, but then my therapist said I could also hand it to others additionally, if I wanted to. So I let my mother and my sister fill out a sheet too. I would give them to some of my friends as well, but they don’t see me that often, so points like “visible sadness” – which relates to posture, facial expressions and tone of speech – are hard to judge for them.
All three people stated significant improvement of visible and communicated sadness, the rest very much mirrors how much insight into my thoughts and emotions I allow them: I tell my boyfriend a lot more about my private feelings, for example, and so he reported a more significant improvement in the categories “worthlessness”, “hopelessness” and “inner tension” than my sister and mother did.
Overall, nobody rated any topic as worse than before the start of therapy, though.
When I got the above-mentioned questionnaire, the psychologist said I didn’t have to do it if there was nobody I could give it to; that many people had not told anybody about undergoing treatment. I was well aware that a lot of people don’t talk about it publicly, but it’s hard to imagine keeping it from your partner even. Myself, I have told most people in my personal life: my boyfriend, all my friends, my parents, sister, niece, my maternal grandmother and my aunt – pretty much all the people I would have a personal conversation with.
It took me several years to come out in regards to my sexual orientation, and back then I vowed to myself that I would never go back into the closet. Hiding who you are costs so much energy that I am not willing to do that in my private life: putting on masks for strangers is demanding enough and I want to save whatever little energy I have.
That doesn’t mean I have extensive discussions about my emotional and mental state or that I make public what I am doing in therapy to all of them (quite the opposite), but they are aware that I am suffering from chronic depression and that I am seeking treatment for it. Especially in the beginning, I’d be at the hospital so frequently that it would have been hard to come up with new excuses for every single time I was occupied this way.
Lugubrious Layara 
Disclosing mental illness, if you want to call it that, is a difficult subject. I think it’s important for some people to know–those closest to you who you trust and are open with should know, like your boyfriend, close friends, and family. But you don’t want to reveal too much to too many people. We all need some boundaries with people. It sounds like you’ve found a good balance.
I’m struggling with disclosing things to my family. I’m good with my girlfriend, and with friends, I can email them. My nuclear family doesn’t really use email and they live across the country, so I have to communicate over the phone, which causes me great anxiety. It’s been hard. I’ve sent them a letter and I’ve also talked to them in the midst of a crisis before. The day-to-day stuff is much harder for me to talk about with them. Like today, I just want to tell my mom how lonely I’m feeling. But I know when I talk to her I’ll just say I’m fine. I wish she would press me more to open up, especially considering how my mental and emotional state has been as of late. In the end, though, it’s up to me to change.
Yes, disclosing depression is certainly a step one needs to consider carefully as there always is the possibility of being judged negatively afterwards. For me, there are different degrees: most of those who have been informed about my depression and treatment know just that, the bare fact, but I never talk about it to them. Then there are those who I reveal select facets of the illness to, but never the full extent and never all the symptoms. And finally, there are those where I don’t hold back.
My mother, for example, falls in the second group and I have a very hard time talking about my emotions to her, so I can relate really well to what you mentioned. It is a constant fight against one’s established behavioural patterns, because it usually takes a crisis to push you over the boundary, and once that kind of force isn’t there anymore, it can become a hurdle you just do not get over…
I hope you feel better soon. Loneliness is one of the most crippling, painful feelings, and I really wish I knew some kind of trick to make it go away or make it easier to talk about – could use it myself. But the only option I really know is starting with the least difficult and working your way up from there. Two steps forward, one step back… perhaps it helps knowing you aren’t the only one struggling with this?