“[Major depression is] immediately detectable to people who know what they are doing. It is an advanced psychological state of despair that one can see in the patient’s eyes, in their slow movements, in the sense that they are in physical pain…” “There is no covering up; they exude naked and pure pain, like a wounded animal. There is absolutely no pretending that everything is okay. All pretense of normalcy goes out the window.” “Comfortably Numb: How Psychiatry is Medicating a Nation,” by Charles Barber
The title is not exactly true. I’m not really apathetic. I’m hopeless.
Anyone who’s ever studied depression has come across the maxim: depression is anger turned inwards. I beg to differ. I believe that the major cause of depression is the loss of hope.
Anger is a feeling. Depression is about the loss of feeling. I know. I’m in it right now.
I can’t write to save my life. Nothing matters. And if there is anger, perhaps it’s caused by the hopelessness. A dozen topics swirl through my head but I can’t choose one to write about. None of them matter. Nothing I have to say on the subject will make any difference to me or to anyone else. I don’t matter. And that makes me feel hopeless, which, yes, makes me feel angry (but not the other way round.)
If given a choice between angry and hopeless, I’ll take angry. Part of that is not a choice but a symptom of being bipolar, irritability, which can easily escalate into anger.
I watched it happen this past weekend over something stupid: a walk with the dog. My ADD was acting up and while I was doing my best to get ready and out of the house, my partner got impatient. He made a couple of comments (and a few exasperated facial expressions) and a switch was flipped in my head. Literally an on/off switch. I got as angry as a person can get and I refused to go. And there was no turning back, nothing he could say or do that would change my mind, that could fix it, that could flip the switch the other way. I became “invested” in my anger.
I have seen that over the years, that willingness to “cut off my nose to spite my face.” Why? Because the anger feels good. It feels great. It’s HELL, but it’s better than apathy. If you’ve been walking around like a zombie for weeks or months, the opportunity to feel anything is a welcome respite. And anger can be delicious. Intoxicating.
I spent the rest of that day by myself nursing that anger. Not because I wanted to, but because I couldn’t control it.
I think suicidal thoughts are like that too, when you suffer from chronic depression. For me, suicidal thoughts were never so much thoughts of suicide, but the idea that, if it ever “really got bad,” there was an option. Just knowing that I could end it if I needed to was like having Xanax in my side pocket (knowing it’s there can reduce the anxiety and thus the need to take it.)
I always looked at suicide as a free-floating life raft, never seriously contemplating it because it was always there in my side pocket. But ever since taking Lamictal*, another switch has been flipped, one that put suicide on the table as a real option. It’s like those images—vase/face or young woman/old woman.
Once you’ve seen both you can never go back to seeing only one. And once you’ve seen suicide as a real-life (pun not intended) tangible option, a way out of the hell that you are in, you can’t go back to pretending it isn’t. You can’t go back to the day when taking your own life was like a pill in your pocket because you’ve tasted the sense of relief lingering in those thoughts.
Today I am stuck in a state of mind(s) I’ve been in for a couple of weeks now, somewhere between hopeless, depressed, angry and suicidal. And occasionally manic. Thank God (I can’t believe I’m saying this) for mania, otherwise it might have been several more weeks before I was able to make another post. So please pardon my brain-dump, but I felt that after a two-week hiatus, a rambling, nonsensical post was better than none. And I wanted to make sure that those kind people who worry about me when I disappear for a period of time know that I’m still kicking. Thank you for your support. You are the reason I got out of bed today.
*Note: From the Lamictal website: “Like other antiepileptic drugs, LAMICTAL may cause suicidal thoughts or actions in a very small number of people, about 1 in 500.”
Dear Marco,
Sorry it’s been a while for me to get back here. I have a 3 year old.
I’m sure you have your reasons for not wanting to continue meds, but in my experience, that is a really common and huge problem for bipolars (Many of my friends have it) They feel as thought they are being drugged out or washed out and sleeping all the time, etc… because they are so not used to having regular and normal sleep habits.
Also they seem to really miss the highs. They feel as though there is a conspiracy to control them.
Anyway, I just thought I’d throw that in there because what you have can be VERY treacherous to navigate on your own. And although I’m sure you already know this, it bears repeating… Both a shrink that fits and also medication that fits is more of an art than a science. It’s frustrating as hell….
Will be sending good wishes whatever you do!
Take care,
Mia
Marco,
Please keep kicking.
You are loved,
SB
You have really hit the proverbial nail on the head with this post. All the emotions – and lack of them – experienced by someone suffering from bipolar disorder are very well conveyed. The depths of depression are a sort of living death, as you clearly know and which I have attempted to illustrate in my recently released novel, Broken Saint. It is based on my forty-year friendship with a bipolar man, and chronicles his internal and external struggles as he battles for stability and acceptance (of himself and by others). I suspect you would see much within its pages that mirrors your own life. More information on the book is available at http://www.eloquentbooks.com/BrokenSaint.html.
Mark Zamen, author
Mark,
Thanks for the comment and the link. Congratulations on the book and well done for being willing to tackle such a difficult subject.
Marco
Hello,
Sorry to hear about you depression… it’s good that you are writing about it though.
I have several things that come to mind that may be avenues to explore. One thing I’ve noticed (I have ADD also, inattentive type) and I have recently discovered that at the root of ALL my issues (depression/anxiety, OCD, ADD) is PTSD. Perhaps there is something(s) in your past that you may not have been conditioned to think of as trauma, but that technically causes trauma, biologically and psychologically speaking. You may want to investigate that and see if you can figure out what your triggers are. (I know that “switch” you are talking about) and that’s what makes me think you may have PTSD. If you can figure out what your triggers are, you can begin to manage them more effectively.
For me, sudden changes or being pressured/over stimulated is a HUGE trigger for me. Huge. A more gradual approach works better. Also if a person will ask me if it’s a good time to “talk” about something that requires concentration rather than just launching into a conversation when I’m doing something or not in the mindset. I need time to switch gears.
You also may have to experiment with those meds. It’s super hard to find the ones that work. We’re all so individual.
And the final suggestion that everyone hates….. diet and exercise.
You may want to check out this website: http://faithallen.wordpress.com/
She blogs about DID, PTSD, ADHD, child sexual abuse, depression and all that goes with those. HOWEVER, it is a great site for: resources, inspiration, healing techniques, books, blogs, cyber healing communities, etc.. I highly recommend it. If this woman can heal, anyone can. Seriously. Hang in there and good luck!
Mia
Mia,
Thanks for reading and thanks for the advice.
Yeah, it’s complicated. Rarely is anyone afflicted with just ONE disorder.
Kind of hard to treat depression & mania & ADD &………….
I’ll check out the website you suggest. But there really are only a few basics that can alleviate some of the symptoms.
One of them is medication, which I refuse to take any more. Another, as you say, is diet & exercise.
That is something I need to get better at. That won’t “cure” anything, but it will certainly help.
Be well, Marco.
Marco,
Thank you for your comment. When I wrote this piece I assumed that it would generate dialogue. There is no question that any medication has side effects, particulary mood stabilizers. However, in my clinical experience, the benefits far outweight the downside. By your own admission, you indicate that you struggle to keep it together without taking medication for your mood. I commend you for all that you have accomplished without its benefits. My point in writing this article is to indicate that many therapists, in my opinion, are categorically ignoring the fact that some of their patients may benefit from psychotropic medications. All mind-altering medications certainly should be monitored by the appropriate medical providers. Let’s have some balance regarding this issue, that’s all I am implying. jamespkrehbiel
jamespkrehbiel,
There is no doubt that certain medications seem to work for some people (although unfortunately, not for me.) I find it interesting that in your experience, there are more benefits than downside. I have been reading a lot of blogs lately by people who are thrilled that their latest prescription is working, only to read a month or two later that they are on to something new. But you are absolutely right, it is not only important, but imperative to have the conversation, and that is why I parade my disability to the world by blogging. Thanks for your post and your comment, Marco