One of the problems with being bipolar is it’s hard to describe what depression or mania or mood swings are.
We commonly get annoyed when friends misunderstand us. But it is also hard to describe to YOURSELF what the hell is going on even as the depression is happening to you. Think about that. You can’t properly describe what depression is to your own self!
Here’s the problem.
If you can’t come up with a correct description of what depression is and what it is doing to you, then you can’t come up with a correct plan for dealing with it.
In life, I always say that if you ask the right question, the answer is obvious. Asking the right question is hard, though.
Let’s start at the beginning. The biggest problem is that the word depressed has two meanings. If you check a dictionary, ‘depressed’ means ‘in the state of unhappiness or despondency or in low spirits from loss of hope or courage’. Yes, I looked it up.
But then there’s the term ‘Depressed’ that is used to describe the medical condition Depression (note the capital D). And depressed and Depressed 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”. We don’t mean sad. We mean a whole lot more than sad. In fact here are 18 Depression symptoms that I know of. Most of these symptoms are not simple or easy to deal with.
If a friend asks me how I’m feeling, and I say “I am Depressed”, and my friend hears “I am feeling unhappy / sad”, then there’s an immediate problem. There’s a huge disconnect – my friend and I aren’t talking about the same thing at all.
That’s why us depressed or bipolar persons frequently get annoyed with the suggestions from well meaning friends. We understand that you are trying to be supportive and helpful, but….you aren’t helping at all.
Because of the disconnect in understanding, while you try to provide support to make us feel less sad (which doesn’t help), you don’t provide us with the specific kinds of support that would actually help us deal with Depression.
By the way, because of the nature of Depression, trying to cheer us up doesn’t work, irritates us, and makes us want to escape from you. Just saying. In fact, efforts to cheer us up actively makes things worse because in addition to all of our real Depression problems, we now have to also worry that we are failing you by not responding the way you would like us to.
[Yes, I’m aware that here should have the list of activities that you can do to help, but I’ve not written that yet]
It’s nice for our friends to be properly understanding, but for Depressed people, what do WE do? How do we help ourselves?
Depressed persons run into exactly the same problems as our friends – we don’t properly understand what Depression is, so we get the critical problems wrong, and we then apply the wrong solutions to coping with Depression.
There are many 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 I haven’t included sad on that defining list, or panic attacks, or the difficulty in dealing with people, or the loss of self worth, or despondency, or etc..
I’m not saying that these Depression symptoms are nice or easily solvable, because they’re not. They’re pretty awful and they can be hard to cope with or solve. But they don’t bubble up to the top of the critical symptoms.
Here’s why. If you can Focus and Get Things Done, even a little, then you’ll feel as if you have some control over your life. And you’ll feel that perhaps slowly and eventually you’ll learn to manage the other Depression symptoms and you’ll get to where you want to be.
But if you can’t Get Things Done…well, you feel helpless, because you won’t get around to fixing things, or you’ll start then stop halfway. And nothing will be fixed. And you stay feeling helpless. It’s a terrible terrible feeling.
That’s why I put the ability to Focus and the ability to Get Things Done as the most critical problems of Depression, and the ones to fix first.
If you think you might be getting Depressed or if you are not sure if you are Depressed, ask yourself first (1) Am I able to Focus? or (2) Am I having difficulty Getting Things Done?
Do NOT think first on how awful your life is, or that you are a terrible person, or that you don’t want to see your friends or answer the phone or go to work. Do not think about the fact that you have no self confidence and how much everything hurts. These are the wrong things to be thinking about first. These are definitely symptoms of Depression, but they are not the most important symptoms.
Remember – if you ask the right questions, the answers become clear.
Here’s how to know if you are able to Focus:
Pick a straightforward task that has a number of steps. It doesn’t have to be a complex task – I think about putting out clean water for the dogs.
Now try visualising the steps of the task. I think about the order I will fill each of the four bowls of water, and steps I need to fill each bowl (empty the bowl in the garden, add new water). Or I try to do the task – I go ahead and fill the bowls with clean water.
If you can visualise the steps you need to do, 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 of your task, or if you try doing it but you have to stop to think what the next step is or if you get distracted and do something else, then you’re having trouble Focusing.
Notice that having trouble Focusing can affect even simple tasks, or things you regularly do, or habits that you do daily. You’ll find if simple tasks or regular habits are difficult to focus on, bigger plans for the day or the week will be difficult to focus on too. And you’ll find yourself getting frustrated.
Difficulty in Getting Things Done is related to Difficulty in Focusing. Obviously if you can’t Focus, it’s hard to get anything 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. It’s the famous “I just can’t“ depression symptom and it’s probably the most obvious signs that you’re Depressed.
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 your mind on what you should do next to get you out of your frozen state.
When this happens to me, I usually end up surfing the internet, or reading trashy Science Fiction or Victorian Romance novels, because that’s all I can do.
But here’s another complication. The inability to Focus or inability to Get Things Done doesn’t have to be at a 100% shutdown. In milder Depression, you can run at say 40% or 60% shutdown. So you can focus, but not too good, so things are harder to do than usual. And you can get things done, but you aren’t as competent or efficient as you usually are.
The partial shutdown doesn’t sound terrible, but it is. You’ll find that tasks remain undone, meetings with friends don’t happen, etc., and a whole heap of tasks start piling up. This is enough to throw a major wrench into how your life is going and can substantially derail it.
If the mild Depression continues for a week or a few weeks – which is very possible – the sheer number of things that you have failed to do can overwhelm you. You feel as if you aren’t in control of your life, you feel frustrated, you feel nothing is going your way, you feel embarrassed for letting others down, and you feel your self worth slipping as nothing you want to do gets done properly.
The medical term Depression better maps onto ‘really really frustrated that I can’t Get Things Done’ than it does onto ‘sad’.
If you think you are depressed, what can you do?
The first thing to do is to ignore for a while the things you aren’t doing or how badly you feel. Analysing these will not provide the most necessary solutions.
Remember the idea of asking the right questions? Well, the right questions are: 1.
“How well have I been doing in Getting Things Done in the last two days (or two hours, or two weeks)?”
If you’ve not been doing that well, then ask yourself:
“How well can I Focus?”
If you are not able to do that well either, then you are probably Depressed.
What Do You Do Next?
Step 1 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 Depression shows no physical signs does NOT mean it’s not severe.
Step 2 is to ask for help. 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. Get your parents / partner / roommate to make sure you take your meds. And this is all ok. You’re not well at all.
These days, I know enough not to worry about all the things I’m not getting done. 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 I am having difficulties Getting Things Done.
Step 3 is to try to alleviate the symptoms. Use whatever mechanisms or medications you have that allow you to Focus, and to Get Things Done. Some of us are lucky and will be able to use meditation, or yoga, or relaxation techniques to acquire the necessary Focus and the ability to Get Things Done.
A lot of others, like me, will NOT be able to use such techniques – they simply don’t work and we will require medication. For example, it is necessary for me to take drugs that calm me enough so that I can Focus on the steps of a task I want to do and to concentrate to Get the Task Done.
It is usually necessary that someone else give me my medication, because among the things I can’t get done is the inability to get around to taking my meds.
Remember, the techniques for Focusing and Getting Things Done do not work instantaneously – you may find it takes hours or days to get everything in place to jump start your Focus and to start to Get Things Done again. That’s normal – it is not a failure on your part.
Finally, remember that no matter how you are feeling, Depression isn’t about your abilities, or your ability to cope with stress, or how good a person you are. You aren’t sad. Depression is a medical problem that interferes with your ability to do things and it’s a real illness. If you can figure out your solution to being able to Focus / Get Things Done, whether using medication like me, or meditation, or running, or whatever works reliably for you, your life stabilises. And that’s where you want to get to.