Battling Depression

Dear Dr. Darcy: 

How do you be happy when part of you fights against it? For the last year I’ve been coming out of what I term “walking depression.”  I met my obligations outside, but inside was pretty bleak. My life is actually pretty good, although my job is soul sucking (child welfare worker).  I’ve experienced depression before (cycle every 5 years or so) with some suicidal ideation when things got really tough.  I usually just wait it out; however, this was pretty bad and lasted for about a year.  I got to the point that wishing/fantasizing wasn’t enough. Fortunately my brain wasn’t working that well and my suicide plan sucked.  Even though I’m no longer actively suicidal, I find myself wishing that it had worked because coming out of this sucks. I’m working with a therapist because I figured I needed some new/better coping skills but it has not been as simple as that. Shocking, I know.  I hate therapy and it’s been harder and taken longer to get out of this dark place than any previous time.  One of the hard days I mapped out an “exit strategy” because I’m not going to go through this recovery process again.  I figure I have 5 years before/if it gets really bad again.  In the meantime I can’t rely on my old coping mechanisms because they obviously weren’t that effective, but I kind of suck at all the new ones I’m supposed to be developing. I’m trying to take care of my body through good nutrition, exercise, sleep, etc, but I’ve discovered that part of me is just fine staying here in this place where it’s not so bad but it’s not so great either. I hate being half assed but that’s where I find myself.

ANSWER 

When people have been depressed or anxious or [insert struggle here] for many years, the ailment becomes familiar. And humans crave familiarity because it helps us feel certainty, which is a basic human need. In trying to rid yourself of the depression, you’re essentially threatening your nervous system with uncertainty, which your body is going to fight against. The depression is like an old friend. You know what to expect. Change sort of blows. Especially in the beginning when all you feel is the discomfort of the unknown and little benefits that will eventually come from sustained change.

All of this means that you cannot rely on how you feel to guide you on which actions to take. What will feel better is the old pattern of thinking and behaving, which, as evidenced by your suicide attempt, has not worked. Essentially, the less comfortable it feels, the greater the confirmation that you’re on the right track.  

You’re going to suck at your new coping mechanisms because they’re new. Stick to them anyway. Stop considering how you feel before taking action and just do it. Just eat. Just drink water. Just exercise. Just call or visit a friend. Just take the shower. Just do your journaling. Just do your meditation.  Just go to therapy. Just do what your shrink told you to do. At the end of the day, your best thinking got you where you are today, so it’s OK to rely on someone else’s thoughts for guidance. At least for a while.

PS: You should be on meds.

Gender & Orientation: Female, Straight.

Dirty Little Secret

Screen Shot 2014-08-21 at 11.32.38 AM

Dear Dr. Darcy:

I spent my childhood in and out of hospitals and therapists’ offices because I was diagnosed with bipolar disorder. The amount of medications that I was on is too high to count. There were times when I was so drugged up that I was literally drooling and hadn’t noticed.

When I went to college I met a therapist who thought I was misdiagnosed and with his help I came off all my medications. That was 10 years ago.

I’m now in my late 20’s and in a very loving relationship with a man who has no knowledge of my former diagnosis. The problem is this: In the last year, I’ve come to think that I probably do have bipolar disorder, but I’ve been managing it by making sure I don’t give in to the manic impulses (I make sure I sleep even if I’m not tired, I don’t spend money I don’t have, I don’t cheat on my boyfriend even when I’m feeling super sexual) and by making sure I take really good care of myself during the dips in mood (I eat even when I’m not hungry, work out regardless of how I feel, never miss work).

I recently learned that my boyfriend is going to propose to me. My question is this: Do you think I need to tell him about my diagnosis? Even if I’m managing it OK?

ANSWER

Let me start by saying that what you’re doing to manage your disorder is 100% spot on. It takes enormous self-love and self-discipline to do what you’re doing without the help of medications and I’m deeply impressed by your commitment.

With that said, there is no shame in being properly medicated. If you’ve come to believe that you truly have this disorder, I would suggest seeking out a psychiatrist who is very conservative in what they prescribe (I can give you names in NYC if you’re local) because a rogue cycle could really put your relationship at risk. Which brings me to the boyfriend.

I think it’s bad for your self-esteem and for your relationship to keep this a secret. The message it sends to your self-esteem is that having bipolar disorder is something to be ashamed of. And it pretty much sends the same message to the boyfriend, who will eventually learn of the diagnosis, probably after you’re married – at which point he’ll feel lied to. Trust in him enough to tell him. He deserves to know your medical history. If you’re going to marry him, it’s his right.

Writer’s stats: Female, Straight.