When I was diagnosed with bipolar disorder, no one was more surprised than I was. Depression was always my personal demon. The highs of bipolar disorder were conspicuously absent from my symptoms.
How do I describe depression? It feels like I am walking through quicksand, and the harder I try to escape from it, the more entrenched I become. There is an invisible but powerful weight pressing down on my shoulders.
With depression, there is always a “before” and “after” for me. Darkness has descended. When I wake up in the morning, I count minutes until I can go back to sleep. But “before,” I can shake it off enough to get out of bed and function.
When depression has me in its clutches, my ability to choose disappears. That’s when “after” creeps in. I may force myself out of bed, but my functionality is limited. At first glance, it may seem nothing is wrong with me until you dig deeper and look into my dead eyes.
My First Taste of Depression
When I was in college, I had my first serious bout of depression after a car struck me in a crosswalk on campus. The accident happened in March 1990, just a few days shy of my nineteenth birthday. My physical injuries were minor, but the impact on my mental health was significant.
I finished the semester without further incident, but then summer ushered in a new season in my journey. I slept the summer away. When I wasn’t sleeping, I was blaring dark music. I wasn’t suicidal. I didn’t care enough about life to commit to living or dying.
When the new semester began in August, the flip switched, and depression was in control. My feet would not take me to class.
According to the Mayo Clinic, depression “is a mood disorder that causes a persistent feeling of sadness and loss of interest. They also call it major depressive disorder or clinical depression, and it affects how you feel, think and behave. It can lead to a variety of emotional and physical problems. A person may have trouble doing normal day-to-day activities, and sometimes may feel as if life isn’t worth living.”
- Feelings of sadness, tearfulness, emptiness, or hopelessness
- Angry outbursts, irritability or frustration, even over small matters
- Loss of interest in pleasure in most or all normal activities
- Sleep disturbances—including insomnia or excessive sleeping
- Tiredness and lack of energy
- Appetite changes leading to weight loss or weight gain
- Anxiety, agitation, or restlessness
- Slowed thinking, speaking, or body movements
- Feeling of worthlessness or guilt, fixating on past failures or self-blame
- Trouble thinking, concentrating, making decisions, and remembering things
- Frequent or recurrent thoughts of death, suicidal thoughts, or attempts
- Unexplained physical problems—such as back pain or headaches
Difficult to Diagnose
To be diagnosed with depression, a person must have experienced a depressive episode lasting more than two weeks. It’s difficult to get a clear-cut diagnosis because depression presents in so many ways. Adding to the difficulty, patients may mask their symptoms to keep up appearances.
It is important to remember that unipolar (depression with the absence of other bipolar symptoms) and bipolar depression are highly treatable in most cases.
Patients with bipolar disorder are often misdiagnosed and given less effective treatment because their first presentation of symptoms looks like unipolar depression.
It took seven years after my initial bout with depression to be diagnosed with bipolar disorder. Every episode of depression I had occurred side by side with a traumatic life event—causing my treatment practitioners to believe that I had situational depression.
If not for dental work and a reaction to two pain pills, I may have never been properly diagnosed. Read my story to see the full picture of how I was finally diagnosed with bipolar disorder.
Unfortunately, when people are face to face with someone who battles depression, their ignorance leads to damaging statements that push the person away from treatment rather than toward it.
There are three things you should never say to someone who is depressed.
1. You don’t look depressed.
I am always confounded when I share I have bipolar disorder, and someone tells me I don’t look bipolar. I am not sure what bipolar looks like. Those battling depression face the same dilemma.
Depression is an invisible disease. A person’s smiling face often hides their secret. And for those of us who have been battling mental illness for years, we have perfected a facade of normalcy because we don’t want to burden others with our struggles.
2. Medication is for the weak.
If you have been following my blog since the beginning, you already know that people refusing to take their psychiatric medication without a sound medical reason is one of my soapbox issues. Be sure to read my blog post about the reasons the mentally ill quit taking their medication.
We live in a society that still doesn’t accept that mental illness requires the same medical interventions as physical ailments. There is no shame in taking medication. When the mentally ill are conditioned to believe they are weak because they are depressed and receiving treatment, it leads to tragedy and needless suffering.
3. Snap out of it. It is all in your head.
If only curing depression were that easy. Depression is not a condition a person can turn on and off like a light switch.
Depression is a complex disease. Brain chemistry, genetics, hormones, reactions to medication, traumatic life events, chronic mental or physical illness are all factors that create the perfect storm that is depression.
Depression is not all in your head. Thinking happy thoughts will not help you snap out of it. Often, it takes a combination of medication and talk therapy to lift the depression.
What You Can Do
Educate yourself about depression and all of its categories. The National Institute of Mental Health’s fact sheet is a great place to start. Familiarize yourself with the differences between unipolar and bipolar depression. Research treatment protocols so you can become your own advocate.
Depression—like all mental illnesses—can be sneaky. Often, by the time you realize there is a problem, you are in crisis. If you have a predilection for depression, designate a friend or loved one to be your advocate when you can’t fight for yourself.
If you are in a suicidal crisis, call the National Suicide Prevention Lifeline at 1-800-273-8255, or text TALK to the Crisis Text Line at 741741. Help is available 24/7.
If someone you know is experiencing a suicidal crisis, here are five practical steps to help them.
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