Depressed isn’t Sad.

One of the problems with being bipolar is that it is hard to describe what depression or mania or mood swings are.

We commonly get annoyed when friends misunderstand us, but it’s also hard to explain to YOURSELF what the hell is happening as the mood swings happen to you. Imagine that. You can’t even describe it properly to your own self!

The problem here is if you can’t come up with a correct description of what the mood swings are and what they are doing to you, you can’t come up with a correct plan for what to do next.

I always say that if you ask the right question, the answer is obvious. Asking the right question is hard, though.

Lets start at the beginning. One of the problems is that the word depressed has two meanings. There’s the English common usage word ‘depressed,’ which means ‘in the state of unhappiness or despondency or in low spirits from loss of hope or courage’ (I looked it up).

And then there’s the term ‘Depressed’ used to describe the medical condition Depression. And the two words aren’t the same at all.

When us bipolar persons say “I am Depressed”, what we mean is “I am exhibiting all the symptoms of the medical condition Depression”. If the person we are talking with hears  “I am unhappy / sad”, then there’s a huge disconnect between us and them. We and the person aren’t talking about the same thing at all. That’s why we frequently get annoyed with the suggestions from well meaning friends.

But what is Depression or being Depressed? I’ve written here about the symptoms of depression. But over the years, I’ve found that the defining features of Depression are (1) the inability to focus, and (2) the inability to get things done.

Notice that sad isn’t on that defining list, or panic attacks, or the difficulty in dealing with people, or the loss of self worth, or despondency, etc..

Those are all there as Depression features, but they don’t bubble up to the top. Here’s why. If you can sort out the focus problem and getting things done problem, the rest of the symptoms become at least manageable.

I think that’s because if you can get things done, then you feel as if you have some control over your life, and so you feel you things will more or less work out. But if you can’t get things done…well, you feel as if nothing you attempt to do will help, because you’ll just fail.

What you should be looking for are mechanisms, or drugs, that allow you to focus, and to get things done.

And when you think you are Depressed, ask yourself first – Am I able to focus? or Am I having difficulty doing things?

Do not think first on how awful your life is, or if you are a terrible person, or any of the emotions / feelings related items. Those are the wrong questions to be asking first. Remember – if you ask the right questions, the answers become clear.

Here’s how to know if you are having problems focusing. Pick a straighforward task that has a number of steps – I think about putting out clean water for the dogs. Now try visualising the steps of your task – I think about the order I will fill the four bowls of water, and steps I need to fill each bowl. Or do the task you picked – I go ahead and fill the bowls with clean water.

If you can visualise the steps of your task, or if actually doing the task is easy because it’s obvious what the next step is, then you can focus. If you are having trouble visualising the steps, or if you try doing it but you have to stop and think what the next step is or you get easily distracted, you’re having trouble focusing.

Notice that having trouble focusing affects even simple things, or things you regularly do, or habits. You’ll find if your habits are difficult to focus on, bigger plans for the day or the week are difficult too, and you’ll start to get frustrated.

Difficulty in getting things done is somewhat related to difficulty in focusing. Obviously if you can’t focus, it’s hard to get things done. But difficulty in getting things done is a more physical thing. It’s the I just can’t get out of bed, or I just can’t brush my teeth, or I just can’t make coffee this morning, or I just can’t get ready to go to my nephew’s birthday party. You know what to do, but it’s just not happening. Somehow, you aren’t getting around to actually doing it.

Together, the inability to focus and the inability to get things done will shut you down. You’ll be sitting there unable to get anything done, and unable to focus on what to do next to get you out of your frozen state.

But here’s the rub. These things don’t have to be at a 100% shutdown. In milder depression, they can run at say 40% or 60% shutdown, which is enough to start throwing a major wrench into how your life is going and substantially derailing it.

If you don’t completely shut down, and this partial lack of focus / partial inability to get things done goes on for a week or a few weeks, all of the other symptoms start to appear. You feel as if you aren’t in control of your life, you feel frustrated, you feel nothing will go your way, you feel embarrassed for letting others down, and you feel your self worth slipping as nothing you want to do gets done.

It’s pernicious.

The medical term Depression better maps onto ‘really really frustrated that I can’t get things done’ than it does onto ‘sad’.

The lack of focus is particularly damaging. Our consciousness – our self – the who we are – is, in effect, our plans for our future (and based on our memories of the past). But if we can’t properly plan for our future, then we are losing who we are, losing our self.

If you think you are Depressed (the medical version), what can you do? Well, the first thing to do is to stop worrying about the things you aren’t doing, or how badly you feel. These aren’t the right questions. Ask yourself first: ‘How well have I been doing in getting things done in the last two hours or two days?” If you’ve not been doing well, then ask yourself: ‘How well can I focus?’ If you can’t do that well either, then you are Depressed.

What do you do next? First thing is to stop and take care of yourself. You currently are undergoing a medical problem that is as severe as a very bad migraine, or a broken leg, and it’s happening now! Just because it shows no physical signs does NOT mean it’s not severe.

Get your partner / housemate / parent / friend to tell people you can’t make it to the Thanksgiving dinner, have them organise to get the kids to school and cook dinner, have them call in sick to your office, etc. Assume you won’t go for your afternoon run, or stop to pick up groceries. And this is all ok. You’re not well at all.

The next thing is to try and alleviate the symptoms.

Annoyingly, here’s where I run out of suggestions on what to do next. I suffer from major Depression, so it stops me completely in my tracks. And so far only drugs work to get me able to focus again, or to be able to do things again. If I try to force myself to do things while Depressed, it triggers panic attacks – which are even less fun than Depression. So I just sit in front of my computer surfing randomly until the episode passes – which can take anything from a week to a few weeks.

I do know enough to not worry about all the things I’m not doing. And I am lucky enough that over the years, the people in my support system have learned to work around me when I get Depressed and shut down.

If anyone has mechanisms / suggestions that work for them on how to focus or how to get things done or how to get out of minor or major Depression, write in the comments please. One person I know managed to efficiently do a high stress job for a few years while Depressed by rigidly focusing on the job to the exclusion of every thing else – which worked, kinda, but failed in the long term because it lacked balance.

Finally, remember that no matter how you feel, Depression isn’t about your capability or how good a person you are. You aren’t sad. It’s a medical problem that interferes with you ability to do things and it’s a real illness. If you can figure out your solution to being able to focus / do things, whether medication like me, or meditation, or running, or whatever works reliably for you, your life stabilises. And that’s your answer.

7 comments

  1. You remain the very best writer at capturing the essence of depression. I’m forever trying to understand myself, and to help others understand me. My tools are either culture, which embraces the abstract, or it’s your prose, which seizes the practical, the mundane, and shows the rust and bone. And for that I’m always grateful.

    This and the “Symptoms” entry are unparalleled.

  2. Your descriptions are SO helpful. The information allows me to understand how I might better help my friend, and my daughter. When you described how the lack of focus impacts everything else – it will change how I interact with both of them!

  3. Greetings, it’s nice meeting you here. I’m just now finding your blog and I’m enjoying your post. Being a suicide survivor and diagnosed with multiple mental illnesses, I too have learned many coping tools to work through my challenges. This post offers great information for those who need a deeper understanding how to help others or evaluate themselves. It took me over 20 years to find my stability and I never thought I’d accomplish so much. Thank you for an inspirational blog! – Heidi

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