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Content Warning: This guide contains discussions of the source text’s depictions of depression, anxiety, disordered eating, domestic and family violence, and suicidal ideation.
The author shares that she hopes her story will help others with dysthymia, a persistent “state of constant, light depression” (ix), to cope with their mental health. She notes that she often returns to the idea that humans are always partially unhappy, and that there are genuine reasons for their experiences of depression and sadness. Although this truth seems dire, she argues that confronting it can help people to better understand themselves.
She recalls her own experiences with dysthymia, noting how frequently she wondered if there were others like her, also experiencing challenges and in need of a support network. She hopes that her memoir will serve that function for other people: She wants to be the individual whom she hoped to find in her own time of need.
She also notes the difficulty of living with dysthymia as opposed to a more severe form of depression. She argues that the general public has an easier time understanding extremes: Individuals with depression that is debilitating or the cause of dramatic mood swings are easier to “read” as having depression than those like her, whose depression is persistent but often “mild” enough that it isn’t easily observable, even to her friends.
The author notes her long history of depression. She has always been introverted and sensitive, and realizes that even as a child, she experienced depressive symptoms. She was pessimistic and often beset by worries. She notes that her moods were volatile and would often shift overnight. She might go to bed relatively happy one night, but then wake the next day feeling despondent. Her depression began to be a serious issue in high school. It interfered with her schoolwork and even prevented her from attending university. Initially sure that she could combat depression on her own by trying harder to be happy, she ultimately realized that she needed professional help.
The author provides an account of her first therapy session. In it, she describes her low self-esteem and habit of unfavorably comparing herself to the people around her. When asked by the psychiatrist where she might have picked up the idea that she was unworthy, she tells them more about her childhood. She and her family were working class, and her mother complained constantly about their lack of resources. Her father was violent and would often target her, her mother, and her siblings.
Sehee and her older sister also had an abusive relationship. She recalls her sister insisting that she keep quiet about their family’s abusive home life, and she notes how manipulative and judgmental her sister was. Her older sister supplemented the family’s meager income, and she would threaten to take back necessary gifts like school supplies if the author did not comply with her every wish. It was not until adulthood that she was able to become financially independent and confront her sister about her behavior. While Sehee notes the relief she felt at that point in her life, she also remembers that confronting her sister did not lessen her depression or self-esteem issues.
Sehee also describes unhealthy romantic relationship patterns. She tells the psychiatrist that she is passive and does not want to risk rejection by communicating her feelings for someone. If a potential partner likes her, she goes along with it. She has had several serious, long-term relationships but feels that she comes to depend on her partners in an unhealthy manner. Her friendships, she thinks, are similarly unhealthy. She was bullied in elementary school and is now terrified to stray “from the herd” (7). She further explains that she frequently creates social media posts that make her life appear more stable than it is. It is only through her work in marketing that she finds real happiness. The psychiatrist tells her that they think she is co-dependent and urges her to begin changing behaviors gradually. The psychiatrist gives her a large personality survey in order to better understand her.
A week later, they meet again. Sehee describes the intermittent depression she has experienced since their last appointment, and they discuss the results of her survey. Sehee does not want to inconvenience other people, which leads her to remain silent when someone does something rude or unkind. This passivity fills her with rage, but then she worries that she is a bad person. The psychiatrist explains that she has cognitive distortions, moments where she bends the truth in her mind. They add that she judges herself too harshly and should stop viewing herself through the lens of what she thinks other people think of her.
During the final portion of their conversation, the psychiatrist explains that they think that Sehee has an unattainable, idealized version of herself in her mind that prevents her from feeling happiness or self-satisfaction. They also argue that many of Sehee’s symptoms are common and that she is not as alone as she thinks.
Sehee describes her condition as something called the “Hedgehog’s Dilemma” (20). Her co-dependent nature drives her towards people whom she doesn’t really want to connect with. Then, she pushes them away and experiences separation anxiety because she is alone.
Sehee shares an anecdote about her tendency to tell small lies. She does not want to appear unworthy in the eyes of others, and so she will sometimes claim to have had experiences that she has not. She also knows that she is an empath, and wants to be seen as empathetic at all times. For that reason, she often lies to people who are experiencing difficulty, claiming to have also gone through their same struggle, in order to make them feel “heard.”
Sehee shares another meeting with her psychiatrist. She has struggled with depression in the week since their last meeting and admits that, even after discussing her troubling habit of lying with them, she lied to one of her friends while drunk at a bar, she thinks just for attention. Her therapist pushes back against Sehee’s assertion that her lying is pathological and explains that alcohol lowers inhibitions and that people under the influence often lie. Her falsehood was just a “silly thing” she said because she was drunk (24).
The psychiatrist then discusses Sehee’s assertion that she isn’t kind enough. They argue that Sehee is actually incredibly kind, but because of that, she expects herself to be kind in every situation. This, they further explain, is unrealistic and impossible. The two continue to talk about Sehee’s idealized self and about her tendency to compare herself to others, becoming upset when she does not feel she lives up to their standards. This kind of comparison is rooted in her low self-esteem and her desire to be her “best” self at all times. The psychiatrist adds that Sehee would do well to realize that other people also experience difficulty and are not always the best version of themselves. She is not as alone in her troubles as she thinks.
The two discuss her medication, and Sehee admits that it has helped her to feel better. The psychiatrist asks what her weekend plans are, and she explains that she joined a movie club and has a meeting. She dislikes book clubs because she works at a publishing house, and people expect her to have savvy opinions about books, which gives her anxiety. The psychiatrist explains that, here too, Sehee is attempting to live up to a self-imposed ideal that other people do not share.
Sehee decides that getting help from a professional has been useful even though her progress, so far, has been slow.
Sehee recalls her lifelong battle with eczema, noting that when she was a young girl, it was not as common. Her classmates used to tease her mercilessly, and she developed a fixation with how she appeared to others. She is still always conscious of what anyone might be thinking of her at any given time, so much so that it becomes another key source of her anxiety.
During her next session, Sehee and her psychiatrist discuss her movie club. She tells them that she recorded the event and that she talked more than she realized. Her therapist questions her about the recording, and Sehee admits that she often records her meetings, social events, and therapy sessions. She explains that she does so in order to better understand herself during moments that, because of stress, she often forgets. The psychiatrist pushes back against her explanation, asserting that they think she records herself because of her extreme self-consciousness and that she ought to allow herself the freedom to forget some of her daily interactions.
During further discussion of the club, the psychiatrist points out that she unfavorably compares herself to other people frequently, but she changes the parameters of her comparison, usually with damaging results. She might feel that a conversation is going well, but also worry that the other person expects expertise from her because of her job. In one moment, she worries that she will fall in their estimation because the opinion she offers fails to reflect her knowledge. Then, if she finds out that this person went to a top school, she will switch gears and worry that they view her as their inferior because she went to a more average university. The psychiatrist points out that in one moment, she is worried that she is seen as an expert, but that in the next, she is sure that she is perceived as the lesser person. Sehee admits that this is a distorted way to view other people and that focusing less on comparison, in general, might help her to change this behavior pattern.
Sehee wants to tell her younger self not to try so hard, worry, or compare herself to those around her. In truth, she has achieved much in the last 15 years and realizes that she had less to fret about than she thought.
Sehee describes a new friend she recently made. She and this woman are kindred spirits, and Sehee has enjoyed spending time with her. She is, however, worried that she is less interesting and special than her new friend in spite of the fact that her friend is also plagued by worries that she is ordinary and uninteresting. Sehee recalls a college friend who ultimately came to find her bizarre and incomprehensible and cut off contact with her.
The psychiatrist explains that Sehee is once again creating unfavorable comparisons that prevent her from enjoying life and living fully in the moment. They tell Sehee to take her friend’s words at face value and not assume that the friendship will not last just because past friendships have not.
Sehee then recounts more tales of childhood bullying and social anxiety, and the psychiatrist again helps her to realize that much of what she thinks about friendship as an adult is rooted in limiting beliefs she learned as a young person.
Sehee writes to a past friend, explaining that she was never relaxed when they were together and always worried about what the other had been thinking.
The memoir begins with an explanatory Prologue during which the author clarifies her intentions in writing, introducing the theme of The Impact of Long-Term Depression on Personal and Professional Lives. She notes the difficulty of managing her depression alone and her unrealized desire to find someone who could truly empathize with what it is like to live with dysthymia. She directly addresses her readers, explaining that she wants to be an empathetic source of validation for anyone experiencing issues with their mental health. This intention presents Sehee as an empathetic individual, which will be increasingly important as it becomes evident that she struggles with self-doubt and does not always recognize how truly kind and caring she is. Sehee also shares a key bit of wisdom that she will return to in her final chapter, that happiness and sadness are equally present in most people and that it is impossible to be happy all of the time. Although she comes to this realization after therapy, she includes it at the beginning of her book, setting a hopeful tone in what might otherwise be a bleak narrative.
Sehee also explains the difficulty of dysthymia, noting that because its symptoms are less severe, it gets less attention and is not as well understood as conditions like Bipolar disorder. This observation places the text squarely within the broader tradition of mental health memoirs, which are meant to both affirm the experiences of those living with psychiatric conditions and raise awareness for those less familiar with depression and anxiety.
The psychiatrist’s first focal point is the roots of Sehee’s depression. The way that they listen, collate, and clarify what Sehee reports about herself gestures towards the importance of Therapy as Collaborative Self-Authorship within the broader scope of the memoir. Sehee comes to therapy with the desire to feel less depressed and anxious and with concrete childhood memories, but the therapist helps her to unlock the way that her abusive childhood shaped her emotional response system and created the conditions for adult mental health battles. The psychiatrist also helps Sehee to understand that she is not to blame for her parents’ behavior and that it was never her responsibility to safeguard the family’s secrets. As self-blame plays such an outsized role in Sehee’s adult personality, this moment of absolution is meant to model self-forgiveness to Sehee. The psychiatrist’s words of wisdom about Sehee’s upbringing also speak to their knowledge of her condition: It is widely understood that dysthymia is caused by both genetic and environmental factors.
Sehee has identified low self-esteem as one of her most problematic behavioral patterns, although she cannot always distinguish between what she perceives as her innate lack of self-worth and exaggeration. The psychiatrist gives her several new pieces of language to increase her self-understanding: They note Sehee’s construction of an “idealized self,” a version of Sehee that is so perfect as to be unrealizable. They explain to Sehee that rather than seeing herself through a realistic framework, she constructs an ideal type and then makes that “idealized person too specific and unattainable” (18). The psychiatrist thus urges Sehee to see her self-esteem not as a real reflection of her lack of worth, but as the product of her distorted thinking. The psychiatrist thus encourages Sehee to reframe the narratives that she tells herself and re-author her self-concept.
The psychiatrist also introduces Sehee to the term “cognitive distortion.” They explain that, during moments in which Sehee is sure that her friends and colleagues are judging her, it is unlikely that anyone is truly criticizing her. Rather, Sehee externalizes her self-judgement and projects her low self-esteem and self-criticism onto others. Another example the psychiatrist provides of a cognitive distortion is Sehee’s fear that she lacks empathy. The psychiatrist listens to Sehee as she tells them about her daily life and finds examples of Sehee acting empathetically and points them out to her. Sehee cannot see herself through a realistic framework, and at this point in their sessions, she needs the psychiatrist to gently steer her towards an undistorted understanding of who she is. Sehee will, at times, be able to engage in this kind of thinking for herself as therapy progresses, but she will also experience real moments of depression.
The Non-Linear Nature of the Therapeutic Process also emerges as Sehee describes a new friendship. She feels that she and her friend are true kindred spirits in spite of personality differences, and is happy to have found companionship. Nevertheless, she remains so mired in self-doubt and self-judgement that she is not truly present in the relationship. Rather than interacting openly and happily with this new friend, Sehee worries constantly about how this new friend perceives her. The psychiatrist has to point out to Sehee the disutility of constant self-observation without self-reflection, and both being in the moment and not subjecting herself to constant criticism emerge as early therapeutic focal points to help Sehee combat ingrained patterns of behavior.



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