Yes. I admit it. I am a recovering angry youth. The symptoms of this disorder include wearing a disproportionate amount of black, having an inner adolescent who still wants to sometimes flip the bird at people who tell me what to do and feeling like I can’t live without music. “Paula, why do you wear so much black” my older brother asked when I was 17. “It is not what I wear, it is who I am,” I answered dramatically.
I recently saw a patient, a young college student, struggling with her classes. Within the first few minutes she had called herself “lazy” and a “loser”. As she kept talking she described a classic depressive episode, which seemed to hardly be the first in her life. She’s isolating from friends, not picking up her cell phone, struggling with making decisions, can’t seem to eat or sleep. She denies feeling like killing herself but admitted frequent thoughts of “it would be a lot easier to just not wake up one morning.” When I reflected to her that she sounded depressed she said “I don’t think so, that is just my personality.” So many people confuse depression with just being a lazy, unmotivated person.
You know the story of the frog? Supposedly, if you put a frog in boiling water it will jump out. However, if you put it in cold water and slowly bring up the temperature it will allow itself to be boiled to death. This happens with depression: you get so accustomed to living this way that it becomes normal: miserable, but normal. You may even think it is who you are.
Sometimes, people confuse being depressed with being philosophical. If I had a dollar (well, maybe $2) for every time I hear “I am not depressed, I am just realistic”, “Anyone who isn’t depressed isn’t paying attention”, or “Life has no meaning and I am going to die, how can I be happy?” I could likely support a hardcore latte habit. Depression can have such an effect on your worldview.
There are a few basic existential realities we all confront: mortality, aloneness and meaninglessness. Most people are aware of these things. A friend dies suddenly, a coworker commits suicide or some planes fly into tall buildings-these events shake most of us up and remind of us of the basic realities. We deal, we grieve, we hold our kids tighter, remind ourselves that life is short and therefore to be enjoyed, and then we move on. Persistently not being able to put the existential realities aside to live and enjoy life, engage those around us or take care of ourselves just might be a sign of depression.
We all get sad sometimes, struggle to fall asleep, lose our appetite or have a hard time focusing. Does this mean we are depressed? Not necessarily. So how do you know the difference? The answer, as with most psychological diagnoses comes down to one word: functioning. How are you sleeping and eating? Are you isolating yourself from others? Have you stopped enjoying the things you used to enjoy? Difficulty focusing and concentrating? Irritable? Tired? Lack of motivation? Do you feel hopeless? Feel excessively guilty or worthless? Experiencing some of these things may be a sign of depression.
Depression can range from mild to severe. People sometimes minimize how they are feeling by saying, “anyone would feel this way in this situation” or “it isn’t like I want to kill myself”. You don’t have to be suicidal to be depressed but is a symptom of depression. Thinking a lot about death or wanting or even planning how you might die is serious and needs immediate attention. Call a friend, a crisis center, your doctor, call 911 or even show up at an ER.
So, as I sit here at the coffee house in my black turtleneck and chunky black boots listening to Ani Difranco, Indigo Girls and The Cure on my ipod I am acutely aware that yes, one day I will die. Ultimately, no matter how close I am to any other person, in some ways I am alone. However, I realize that life is not meaningless: I love my husband, children, family and friends; through my work I get to help people help themselves and yes, most importantly, I blog. What could possibly be more meaningful than that?
10/08/2009
Comments
7
10/22/2009
Wow, it's really sad how much depression can affect some people. Things can tend to build up on me, and get to me too, but never anything crazy like this. I really admire you helping out so much though Paula. It's very admirable!
(I do some writing for a probiotics website resource)
11/10/2009
Hi, Paula. You really got me thinking, thinking deep. Oh crap, now look what you've done. Anyway, here's my take on the conversation you started, from my blog, "Knowledge is Necessity":
http://knowledgeisnecessity.blogspot.com/2009/11/depressed-or-thinking-d...
11/11/2009
"If I had a dollar (well, maybe $2) for every time [...] I could likely support a hardcore latte habit."
really?! where do you meet those people?! i'm so desperate and lonely because there just seem to be so many shallow, ignorant, egocentric people out there... it's probably been three years since my last relationship and i'm down to one friend with whom i don't exactly have a satisfying relationship. but let me guess... you meet those people in your office, right? maybe i should study psychology just to meet people... but... i suppose that would be just as frustrating as everything else because with interesting people it always seems like "look but don't touch" - in this case meaning... you can read or hear what they're thinking but they will not talk to you "as a person" (discussion about a subject, sure - but if that discussion is done, it's done) because that's not the way our society works.
11/11/2009
... oh and... i do think that not all depressed people are automatically deep. walked into that trap more than once (thinking people were thoughtful when they actually just were depressed). still, i have never encountered somebody deep AND optimistic at the same time. most people who i've met who were truly thoughtful simply were realists - or what you'd probably call mentally ill...
12/29/2009
having been diagnosed borderline, with general anxiety and...not bipolar but i can tell you, i have episodes of mania over the long course of heavy depression, it's very frustrating that there really is very little help available to someone with no insurance nor a fat wallet. as i move into my late 30's, it's getting worse. for the past two years, i sleep maybe 3-4 hours a night, or less. i may binge eat or not eat at all. i'm neglecting financial matters, have risky sex with a 'safe' partner...safe physically but certainly mentally damaging, soul damaging, i feel largely invisible, and when invisible, inappropriate and of little value. my only escape, is through art. i do visual art and i write. and i've had success there. i manage to hold a full time job and most people who know me, believe me to be functioning. they just don't know what's constantly happening inside my head at any given time, all the time. it's like a carnival. i'm a little combative to therapy but still...i recognize i need some help. when i contacted the bpd group in my area to ask if there were group meetings or group therapy, they attempted to corral me into organizing it. so i ducked out. once again, i appeared to be together enough on the outside to be in charge of something like that. but really, i just wanted to be there and receive. i needed that. i live in tampa. and you'd think there's be some kind of resource around here but there just is not. i can't afford a therapist and, as you know, it has to be the right therapist. someone that can call me on my bs and also know when to listen. i can be a real challenge....i am self aware. but obviously, don't know how to fix myself. since my divorce, 13 years ago, i have not had a real relationship. and in the last 7 years, not even the pretense of one. i've gone on maybe 5 dates. i am lonely. but i isolate myself completely as much as possible only going to events where i read or show my work. thank you for an article that at least shows there's one dr out there i could relate to...who's not going to tell me life is butterflies and ice cream. but it's also a reminder that i will probably flounder here until i die.
01/06/2010
Great post Paula. It is sad the amount of denial one can muster to explain away depressive symptoms. Another level to this relates to people (myself included) who when in a depressive period can well acknowledge it for what it is but when they experience a break or a mood swing they look back and wonder if it wasn't all a sham. A convenient excuse for laziness and irresponsibility. Honestly, because when the depression breaks for a time, be it a few days or even weeks I have very little recollection of its severity. I can't relate to or even remember the thoughs or feelings that had me near paralyzed just the day before my mood changed. Questioning the validity of the depression and not being able to identify with the feelings I can easily start to slide on the self care strategies that would be my life line when depressed. Sometimes the time and attention to self care becomes so ownerous and consuming that when the depression breaks its as though I just want a vacation from all of that work and the strict routine. Consequently it isn't very long before I flip back into a depressed state again. Or sometimes I just figure no amount of disciple or routine will prevent another episode of depression so might as well enjoy the vacation while it lasts. It doen't take depression to cloud my good judgement obviously. lol.
01/06/2010
medusascur ..... I can relate somewhat to your issues with accessing mental health services. I live in Canada so cost is not an issue but long waiting periods and red tape are and as a result I have opted out from trying to access those kinds of services and supports. I was fortunate to be able to access some counselling and support from our local mental health centre when I was in a real crisis situation a few years back but beyond that the system is pretty plugged up. I also experience extreme anxiety particularly with doctors and the medical system so its very easy for me to make excuses not to turn in that direction. It can take me 2 days to recover from the stress of an appointment with my GP to confer about my thyroid levels so I limit even those visits as much as possible.
I do have alternative places and treatments that I utilize to fill the void of medical and psychological resources. I also do a lot of self help type work on my own from books I buy or from on line material and resources. I also participate in on-line support groups like one available at psychcentral.com where I can talk with other people about what I am going through and support others going through similar things. I would encourage you to join. You don't have to flounder until you die. There is help and there are places you can turn for support.
Wishing you well and I agree it would be nice to have Paula in my neighbourhood too.
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