For some of us, this is a question that our families or loved ones ask us. For some, like me, it’s a question we ask ourselves. We’re taking our pills. We’re sleeping eight hours every night. We aren’t doing drugs or drinking. So why the hell can’t we just get stable?
When I published my book, one of the people who read it told me that it felt very strict, particularly in the guidelines about not drinking. Personally I haven’t had a drop for over a year now. I haven’t used any illicit drugs for many years. I religiously take my pills (since diagnosis in 2011 I forgot my pills only once) and no matter what, sleep eight-nine hours. Every. Single. Night. Yet I am still rapid cycling and finding it hard to keep appointments, because while on Tuesday I felt great making an appointment for Friday, on Thursday evening I turned into a plant and stayed in this state until Saturday, when I jumped out of bed energised by the thought of buying a new Macbook Air. (I can’t afford a Macbook Air.)
Caution: The post below may be triggering to people currently suffering from depression
Wait, you could say. There are people dying left, right and centre. Surely depression isn’t as bad as that.
Thank you for reminding us about the fact we are (mostly) privileged. We (mostly) have health insurance, (mostly) are not refugees, in our countries there is (mostly) no war. We use this knowledge to make ourselves feel worse, or, more precisely, our depression does. Marian Keyes, a famous (and brilliant!) multi-million selling writer, wrote once:
It has been like being poisoned, it’s felt like my brain is squirting out terrible, black, toxic chemicals that poison any good thoughts. I’m well aware that I have an enviable life and there are bound to be people who think, “What the hell has she got to be depressed about?” But whatever has been wrong with me isn’t fixable by an attitude shift.
To me, the worst thing about depression is that it eats at the very core of our souls. In stable, “normal” state, we are certain of some things. My boyfriend loves me. I love photography. I’m writing a novel and I’m 2/3 through. I’m having friends coming to dinner on Friday. My parents love me. Those things are so obvious we don’t even bother actually thinking about them, they are a built-in spine of our existence.
Oddly enough, one of the symptoms of both unipolar depression and all phases of bipolar disorder is the idea we aren’t sick.
In depressed phase, it is associated with lowered self-esteem. Together with all other negative thoughts comes the idea that we are just lazy, and we’re just pretending, and we don’t have depression at all. (This is greatly aided by having relatives or friends who provide us with helpful phrases along the lines of “why don’t you just pull yourself by the bootstraps” and “you know, you could just try not to be depressed”.) And so we find ourselves on the floor, curled into fetal position, thinking we’re just imagining all this and in fact don’t have any reason to feel bad, so why don’t we get up and do something. Then we don’t get up and we don’t do something, because depression won’t let us move.
This is a guest post by Rob Robinson. Used by permission.
Since I know that a number of my closest friends on here live with clinical depression and the attendant illnesses that derive from it, I thought it might be appropriate to post some thoughts on the matter, both for sufferers and non-sufferers. These are based on personal experience and also experience of working as a mental health lecturer, so they’re a mixture of life and theory.
What clinical depression IS – and what it isn’t….
Depression is not a lifestyle choice. It’s the most debilitating of illnesses and nobody chooses to suffer with it. The actual cause (as ever the medical profession is obsessed with finding a concrete, biological cause, and preferably one that can be treated with medication…) isn’t proven, though certain chemical imbalances in the brain are thought to occur in the sufferer. As with all mental illnesses, it engenders a great panic in medics because it can’t be ‘seen’ – it is diagnosed through observation, not scans or biopsies – and because it is a disorder of perception and thinking, both functions of the mind, and the mind happens to be contained within the brain, focus of research tends to treat it as a brain malfunction. The evidence for this is actually alarming sparse. Once the two clear physical conditions that might affect the brain – that is, organic disease such as Alzheimer’s, and trauma – where the organ has actually been damaged, as in taking a huge blow – are ruled out, then it all gets into a bit of a mushy grey soup as far as the most severe mental illnesses are concerned. Ironic, given that the brain might be described as mushy grey soup itself….
I often speak to people who don’t understand the nature of depression at all. They are convinced they’ve been depressed — “once after a break-up I cried for three days and listened to Nick Cave a lot, but I just pulled myself together and stopped being depressed”, which kinda suggests you’re just too weak or lazy to un-depress yourself. All it takes is pulling yourself up by the bootstraps, they suggest. Why don’t you stop being depressed? It’s easy!
Except, of course, it isn’t, and they have no clue what they are talking about. Bipolar depression is a chemical imbalance in the brain. (Apparently latest studies suggest it is a sort of inflammation.) You can’t stop being depressed any more than you could stop having cancer. There are ways to improve your mood, but when you’re in the darkest pits, those ways aren’t likely to work. For instance, physical exercise helps, but knowing that doesn’t help much when you can barely get dressed without assistance and taking a shower seems to be the same level of difficulty as climbing Mount Everest without oxygen tanks.
According to www.dualdiagnosis.org, 56% of people with bipolar disorder suffer(ed) from addiction to drugs or alcohol at some point. According to www.drugabuse.gov, the rate for general population (in America) is 8.9 percent.
Obviously there is something about bipolar disorder that correlates with high addiction rate. While I am not a medical professional or addiction counsellor, I will hazard a guess that bipolar makes you predisposed to addiction, not the other way round. There are some drugs that can trigger a bipolar episode (in particular marijuana and LSD), but they do not create bipolar disorder in a mentally healthy person. They may only make it manifest earlier.
There are a few obvious reasons why bipolars tend to become addicts. One of them is self-medication. I used to self-medicate my depression with alcohol for years – it seemed to be the only way to make the black dog go away for a few hours. I knew that alcohol is a depressant and on some subconscious level I probably realised that I am making things worse for myself long term, but at those times the only thing that counted was quick relief which the bottle provided. The same scenario happened daily: I’d be terribly depressed, I’d get drunk, depression would be replaced by euphoria, I would do some really stupid things, go to sleep, get up in the morning and scream “F–K!!!” (I never blacked out; I always remembered what I did the day before, and it was always terrible and make me more depressed.) Repeat. Repeat.
One of the reasons why it is problematic to talk about depression, mania and hypomania is that those words may mean many different things.
For instance, bipolar and unipolar depression are called the same, but they are not the same. In most cases, unipolar depression is caused by past events, and dealt with using anti-depressants and therapy. In fact, therapy is the better solution of dealing with unipolar depression, as it offers a possibility of removing the trigger that’s been hidden deep inside for years, sometimes decades. Anti-depressants deal with the symptoms, and are sometimes absolutely necessary because a person in deep depression is unlikely to respond to therapy (or to anything at all).