I realize I've been having to explain the nature of depressive episodes to different people over and over. I thought of composing this entry as a ready page to refer to whenever they ask me about it.
For one reason, some people just have never experienced depression and have no idea what it is like - which is exactly the case with my oh-so-loving Hubby, and most of my very sanguine friends.
For another, most people think that depression is just "feeling sad", so they can't quite forgive me for ditching an event or arriving late or skipping church service or withdrawing at a party for "being depressed". They'd say insensitive things like, "So what? You just stayed home all day," or sarcastically ask, "You arrived late because you were feeling sad?". So far, the most insensitive thing ever said to me was "I expect you to shape up, bipolar or no".
Sometimes I wish those people would be stricken with my depression even for a day so they'd know just how hard it is to even do the simplest things. How difficult it is to even just get up from bed in the morning, and how choosing clothes to wear can be something to cry about. It's more than just "feeling sad".
I have to do a bit of defending myself before I get further misjudged regarding the nature of my condition. I happen to be a responsible person, a goal-setter, a good leader, a fast worker, creative and highly productive. I was raised in the household of a strict military man (that is, my father), so I am used to doing things that I don't like doing (including going to school with a high fever at age seven). I am even used to not getting things my way; I know how to suck it up and deny myself of comfort whenever necessary. I am very disciplined and have a good work ethic - my former coworkers can attest to that. I have never used my mood as an excuse to myself or anyone to bail out on anything; in fact I've learned to suppress emotions from childhood just to perform as needed. So establishing the above mentioned things about myself, I cannot and should not be accused of being lazy, spoiled, demanding, mood-driven / emotion-driven, unmotivated, or anything of that sort. I am not the kind of person who has to be told to "shape up" or "suck it up", because I don't think anyone else is more qualified than I to say those words to me. I just happen to be bipolar. I simply have depressive episodes form time to time. Meaning there will definitely be some periods of the year in which I cannot - repeat, cannot - perform as I normally do, and thus should not be expected to.
And that is not the same as "just not in the mood".
Having a depressive episode is not the same as "feeling sad" as most people suppose. First of all, a depressive episode is not caused by external factors as sadness is (although it can be worsened by them). It's primarily chemical. It just happens, even with no apparent reason. And I can't just make it go away; I have to wait for it to go away.
It's not like I can switch it on or off at will; all I can do take my meds, avoid triggers and wait it out. I can suppress the emotion, condition myself to function as needed, but the depression is still there and will get in the way of my life, depending on its severity.
There is also this wrong notion that it only has to do with the mood. I kinda think "Bipolar Mood" is a misnomer (Besides, "mood" is such a subjective word; it can mean anything from "current disposition" to "general ambience"). Depressive episodes also heavily affect thought patterns, alertness and physical energy. It's more than just a feeling.
When I try to explain bipolar depression to non-bipolar people, I usually explain it this way:
Think of the worst ever day you've had.
Imagine it coupled with a lot of physical and emotional discomfort (like having PMS, if you are female).
Throw in a lot of mental restlessness, a feeling of heaviness (both physical and emotional), tiredness and maybe some muscle pains and headaches.
And then, because you're tired and heavy, your passions and interests and the things you love doing suddenly become uninteresting.
Then add a lot of insecurity and feeling of inadequacy.
Put in some sense of aloneness, purposelessness and utter hopelessness.
And then because of all those various feelings, everything is upsetting, everything is a big deal. You get obsessive, but you feel a bit dull and you find it real difficult to make decisions.
Now stretch all that to a duration of several days - a minimum of four days to a maximum of four months, and there's not much you can do about it except wait until it's over.
Top it off with the knowledge that people around you can't understand it nor are willing to. You feel like a burden to yourself and others. Then you have a growing paranoia that your loved ones don't care and the people around you are against you.
You feel like the best way to end your suffering is to just end your life.
By the way, the suicidal feelings that come with depression are real. They aren't some emo-type masochism for attention-grabbing shock-value without any real intent of suicide. They are an honest-to-goodness desire to end one's life so as to end one's suffering. I actually think wrist-slitting is for wusses. I personally obsess over sure-kill (but artful) ploys that involve direct cuts to main arteries or the use of guns.
Although a depressive episode has to be waited out, it isn't totally out of control. One's behavior is controllable, although the emotions and energy levels are not - and that makes it difficult to carry on with everyday life like you "normal" people do.
There are also some drugs and coping skills that can be applied to help pull mood up. They don't make the episodes go away, but they help to make things a bit more manageable.
About the drugs: People around me seem to think that everything is perfectly hunky-dory because I am taking meds. They say thing like, "But you're medicated, aren't you?," or stupidly insensitive things like "You're okay now, aren't you?" or "When will you be okay?" Dangit. The truth is, this condition has no cure. The meds are just for treatment. I still experience the episodes, with or without the meds. It's just that the Lithium helps to muffle the symptoms, but the symptoms are still there, big time. Furthermore, Lithium is not the only prescription for BMD, and it's prolly not even the best, but it's the primary one. Besides, it's what's available in my country, and it's the one I can afford.
Another thing that annoys me is that people think that I've had a meltdown. A depressive episode is not a meltdown, darnit. I did not "lose it", "go crazy" or "break down". It's just that when stressors and / or triggers come one after the other, it becomes harder and harder for me to manage my stress levels, so the episode becomes worse and I go deeper into depression. When this goes on for a period of time, I go into a severe depressive state (which has happened only twice in my lifetime, and only before I started taking the meds), in which I become a totally useless, self-destructive human being. But whether the depression is slight or severe, it doesn't affect much my logic, intelligence or memories; that means I don't have to be treated like a psychotic, retarded amnesiac.
Furthermore, bipolar isn't a psychosis. It's NOT a psychological disorder; it a biological disability that just looks like a psychological disorder.
Lastly, this condition is not a sickness. Considering my Bipolar Mood Condition as a sickness would be like calling your gene-related baldness a sickness, or your color-blindness, your retroverted uterus, your heredetary predisposition to obesity an illness. You don't want to hear me praying to God to "heal" your disproportionately big nose, do you? Bipolar is actually more like a birth defect - like dimples, or a cleft chin. I was born bipolar, born with a predisposition to cycles of depression an elevation. I inherited it from my mother's side of the gene pool and I've had symptoms of it from childhood. I hate it when people ask my husband or my counsellor things like, "Is she healed now?," or "Can she be reliable now?". Truth: This isn't going to go away, ladies and gentlemen. I've already had it waaay before we even met, so don't suddenly treat me like I turned into a vegetable after you found out about my so-called "meltdown". I still have all my faculties, skills and high IQ, and you can bet I can still whoop your asses at Scrabble.
How to tell if i am in a depressive episode:
- I have less energy than usual. A good indication is I am often sleepy, or take naps at awkward times and places.
- I don't talk as much and I withdraw. People who know me quite well know that I talk a lot and am very witty. When I seem "shy" or disinterested, or when I suddenly answer in short sentences, that's a sign.
- I can't make decisions. I'm normally decisive and opinionated, so being indecisive is an abnormality.
- I won't be very nice to look at. At depressed times, it is extremely difficult for me to smile (so please, don't try to jolly me up), and i won't likely be the best-dressed person anywhere.
- Whenever possible, make sure I am never alone. This part here is important.
- Don't try to jolly me up, though you may try to cheer me up indirectly (see below). Don''t say things like, "Why the long face?," or "Smile!". It's really upsetting.
- Drop some cheerer-uppers like little gifts, visits, rabbit-toys or things you think i will appreciate, or suggest some activities you think will distract me.When I talk about suicide, take me seriously.
- Don't expect anything from me. Don't give me a list of thing to do or ways to act. Don't try to "shape me up". In this situation, YOU are the normal person, so YOU have to be the one to understand me. I know it sounds demanding, but trust me, it's for the better. You can ask my doctors about it if you don't believe me.
- Don't force me to do things i don't want to; don't wheedle, don't argue.
- Don't make fun or make jokes at my expense.
- Listen more than you speak. For that matter, keep your sentences concise, because it's tiring to have to entertain people.
- Be a friend. This is a time when I need tons of acceptance, belonging, understanding and ice cream. Make me feel important to you. But don't overdo it as I can easily feel smothered.
