When You're Depressed, Do You Feel Ugly?

Patient Expert

Quite a while back, there was a TV series about a group of nurses in the Vietnam War. It was called China Beach. In one episode of this powerful drama, a soldier who had lost a leg from the knee down is back home, feeling lost and depressed about his life. Desperate for a loving human bond, he drives a great distance to find the home of one of the nurses who'd taken care of him "in country."

He finds her and talks stumblingly about his hopes to be with her, and it's clear he feels like an ugly reject whom no one will have anything to do with. She sees at once that what he's looking for is an emotional crutch, not a real relationship and gently explains that she can't be with him. Then she does something amazing. Understanding what he feels about himself, she wants to give him the one message above all that he needs to hear and believe.

Taking him into a room with a full-length mirror, she tells him to stand in front of it and to take off all his clothes. He does that numbly, mechanically, revealing what's left of his leg, and she tells him to really look at himself, not just the leg. Then she says, in so heartfelt a way:

"You are beautiful."

Whenever lost in deep depression, I could never even hear, let alone accept a statement like that. I felt ugly inside and out, certain that everyone could see that obvious fact. I winced if anyone pointed a camera at me, especially if they asked me to do the impossible and smile. What I wanted to do was disappear. I couldn't bear to look at a picture of myself - if I did, I just saw this ugly, overweight mess and wanted to rip it up.

I remember the story of another depressed Vietnam veteran whose struggle with PTSD was featured in a documentary film. In one scene, he was showing the interviewer around his small apartment and stopped by his bed. He said that he often needed to get into it during the day (acting this out as he spoke), reach down for the blanket, and "pull it up - over - my - head. Now, I'm invisible." That was exactly what I felt so often, and here I could see how terrible it was - to hide your spirit away when you need it most.

It gets that bad when the voice of depression seems like your own, and the beliefs it puts into you are as real as anything in life. I never limited that conviction just to me, but I projected the ugliness onto the physical things I owned - especially around my home. I could only see the shortcomings, the disorder, the mess, and I had to clean it up, improve it with a furious energy to keep it all - and myself - from complete disintegration.

Once in a group therapy session, sitting in a circle of people, all of us in different ways ashamed of who we were, someone mentioned in passing, quite matter-of-factly, that I was handsome. I literally turned around to see who he could be talking about. Then I asked him, "Are you talking about me?" - as if to say, "Man, you really and truly need an eye exam." Others tried to reassure me, and it was clear that they weren't just talking about looks - it was about an inner quality they could see that I could never imagine - a kind of beauty. I just thought - OK, this is a group and everyone affirms everyone else so we'll all feel better. New Age BS Nevertheless, I felt close to tears and couldn't get another word out.

Looking back, I think that was the first time I started to question all those depressed beliefs about being a mess, inside and out - doing everything wrong, judged by all the people around me, and on and on. Gradually, I started thinking - Well, maybe all that stuff I keep repeating about how bad I am in every conceivable way is partly depressive thinking - at least a little bit of it.

It took many years for me to see how pervasive depressed thinking was and how convincingly it twisted my mental self-portrait. A lot more of those years went by before a recovery I could hardly imagine finally happened - though I can't say exactly why or how

These days, I can go outside in the sun and see how beautiful everything around me is. And I can think, I am a part of all this, and I don't have to listen to what depression is saying. That voice used to be the loudest sound in my mind, but now it's an occasional nuisance that I know how to get rid of.

Getting better started with that glimmer of doubt about all the negative beliefs and a reminder that there was something still there that others could see, even if I couldn't.

So I'll say it to you, even if you can't believe it, because it's true, really true.

You are so beautiful.