Psychology and Depression

[Callie]

I decided to create this topic after a Calamity Refuge discussion about depressive issues. Mental illness is accompanied by a great deal of stigma, so I'd like to examine ideas and awareness about mental health. This poll is focused on unipolar depression, but any aspect of mental health is open for discussion. Here are some questions you might consider:

 

What is your experience with mental health issues? Have you ever had a friend or loved one struggle with mental illness? How did it make you feel?

 

What are your impressions concerning mood disorders?

 

Do you think society needs a higher level of awareness in regards to mental health?

 

Most importantly, please remain civil and respect the opinions of others. Remember that anyone can read your posts, so don't name names or post anything you're not comfortable sharing with an online stranger.

[Lilith]

while we're posting disclaimers: this thread and forum are not a substitute for professional help. if you think mental health issues may be interfering with your life please seek out a clinical psychologist, and if you're worried that you may harm yourself in the near future please contact a mental health crisis helpline in your area. thank u

[Luca]

Sure, I'll go first.

 

Most people (at least at CR) are aware that I've had quite a battle with depression, but I usually don't contribute much to conversations on this subject anymore - because of that, ironically, not in spite of it. Going through it raised more questions than answers with me, because I like trying to understand things by breaking them down and analyzing them. Part of what depression does is that it distorts your views, what you perceive to be real and what is a threat. What is an unfortunate coincidence and what is actually your fault. Severe depression changes your outlook to indicate that everything is hopeless with no way out, even to someone who relies primarily on logic instead of instinct. It's a monumental challenge to overcome by yourself. So, naturally, when I was living on my own in another state, trying to get my life together when depression was at its worst, all of my plans and strategies with work and interpersonal relationships were failures. This was the most frustrating part, because the logic they were based on was false, like asking someone what color their surroundings are when you're holding up a green piece of glass in front of their eyes - perception is wrong, so all things based on it are wrong.

 

Oh yeah, and the intensely painful self-loathing meltdowns. Those were fun too.

 

Consistent human contact was what I needed most and probably the only reason that it's no longer an issue for me now, nor likely in the future. But it's definitely changed a lot about my personality. I'm far more serious, I hardly genuinely smile at all, a bit more cynical, but ultimately more well-rounded, and able to handle bad situations more than ever. A deal of that can be attributed to my other experiences at the time, but it's still the most significant and challenging thing I've been through. But I also know enough to say this solution isn't for everyone and there likely isn't any one universal cure for it. But it is something that people have to work through with a great deal of support.

 

One way depression and other mental conditions needs more attention is that it doesn't seem like a lot of people understand what it would be like - they can't relate. When I was in high school, it went something along the lines of "just stop being depressed. Just stop." Okay, I'll get right on that. That's like saying to someone who's been shot, just take the bullet out and put the blood back in. That's not how it works. That said, even now, I doubt I have the ability to fully convey what it was like for me, even to a psychologist who probably already knows half of what I'm going to say. But ignorance is the source of fear and hatred and therefore where I'd point a finger for the source of the stigma around mental illness. No person I've worked for has regretted hiring me, but having a history of depression is a significant disadvantage in a job market where people compete over who is more perfect on paper.

 

Amusingly, most everything I entered into the poll would have been exactly opposite three-four years ago. I'm not depressed. I'm also not brimming with joy either. I feel a lot less, overall. I tried to use something along the line of Rand's void and the flame mental techniques in WoT, except with strong negative feelings. And that helped a great deal at, for example, preventing breakdowns at work, but it's like a bit of that stuck and is permanent. It's...weird. But I spend a lot of time thinking and I may reach some new understanding in the next five years where everything I do isn't acting. That'd be nice.

 

I'm not sure, but I don't think I can be affected by depression anymore at this point. Mostly because I've learned to accept most things as they are, even if they're bad. Which also allows me to see more things that are good. That is probably the most valuable knowledge I have. But probably only because I needed it more than most.

[Forget it]

Maybe I was not meant to post in this topic - I started typing a response and lost it to a very unusual accident - a small explosion that I surely hadn't anticipated, and in its wake, I managed to lose my browser tab among other things.

 

Sluggish/Low Energy: Some of the time. I think now and then it will happen to anyone even who is not struggling with depression.

 

Blamed Yourself: None. I'm privileged to be in a position as such that I am the primary influence on my own quality of life. THere are some things that are not completely as I'd wish but, I don't wallow on it. In the end, many things in life are a compromise. My younger self would have a quite different answer to this one, more on that later.

 

Trouble Falling Asleep: Sometimes. I'm not sure my circadian rhythm has ever quite recovered from my adolescence. I often don't fall asleep when I should, or do fall asleep when I oughtn't, and so forth. That said, if I'm being honest I could probably correct most of it with discipline of routine.

 

Felt Hopeless: None of the time. I can usually find something to look forward to.

 

Little Interest/Pleasure: Now that I'm going through answering these I can't even remember whether I answered "None" or "sometimes" - I'd say somewhere in between those two. Sometimes I get into a dull routine or, for sure, am not in the mood to do the particular thing that I need to. But it's all a means toward something better.

 

Worthless: None of the time. This is something I spent a lot of time ruminating about in a younger day. Several years ago I managed some kind of philosophy shift and even when I am not pleased about a particular thing, I manage to be generally content.

 

Difficulty Concentrating/Decisions: Some of the time. I am easily distracted or disrupted, especially by noise - I can't read if there is noise, and if I get interrupted I'll often have to start the entire paragraph over. I'm pretty good about being decisive about things which matter... but small details? Classic indecision. I've made waitstaff angry at restaurants spending so long on the menu. I've spent an entire summer trying to decide what colour to paint something and as a result, it didn't get painted at all. Silly, no?

 

Mental Disorder: Yes. I have Asperger's.

 

Suicide: I went back and forth on this one, and went ahead and answered no. From 14 to 19-ish I certainly thought about it, some times more woefully than others. I was a bit dramatic in my day. But I don't think I probably worked myself into a state where I would have actually gone ahead and done it.

 

Past two weeks down/depressed: None/Little of the time. There was a point on Monday where I was upset about a particular thing for a short time. In general I am somewhere between stoic and chipper and, as some close to me would argue, I probably worry far too little about things.

______________________

 

To tie it all together, I'm 31 years old today. In my teenage years I was quite emotional, depressed, even unbearable at times. During my 20s things leveled off quite a bit. I know it's not quite this simple, especially for someone suffering a real bout of depression but, several years ago I just decided to be content. At first I adopted stoicism; perhaps waffling between stoicism and mild cynicism... then I decided something a little different: life is a comedy. It sounds absurd but it's helped me stay in pretty good spirits even during negative events. It also makes watching certain world events more bearable, but I digress.

 

Something else besides age and forcing an attitude shift though - I significantly altered my diet. I won't proselytize but to sum it up I was struggling with weight, health, mood, and other issues, and I switched full-stop to the Paleo Diet about four years ago, which essentially is eliminating grains, legumes, processed stuff, sugars, junk... it's somewhat low carb, not on purpose (I still eat tons of fruit for instance), just as a result of cutting out junk. Today, despite my astounding resistance to working out, I'm in the best shape I've been in - feel great, plus have a very stable, even mood and temper, which is a real step forward for me. I don't get depressed anymore and I can keep a very stable train of thought - so maybe that won't work for everyone but in my case altered diet had a very positive biological response.

 

As far as the Asperger's - well, I still have a lot of social issues. It may even be debilitating where certain social contexts are expected me. Fortunately I can perform at work, in class, and other places where I feel like my interaction is "already expected" - but going out and meeting people, networking in-person? Going "out" to try to meet people? Taking the initiative to socialize with people I know from work... outside of work? No, it's not going to happen. I also tend to want to go on and on talking about things or ideas that I realize others will have absolutely no care about... textural aversions to cardboard, the need to count patterns on the ceiling in a particular order before I can close my eyes in bed... an information processing latency that most people can't identify with (as in, hey, I'm not stupid - in fact I'll probably be better at this than you are. I just need to churn it in my head for a moment before I "get it"!) which, incidentally, makes me really bad at playing an instrument unless I memorize the entire song... haha.

 

That used to contribute a whole lot to my insecurities and depression when I was younger, especially before I was diagnosed or knew that I had the Asperger's. I've since simply written it in as part of who I am and that's that. Time has a funny way of mediating perspective.

[Callie]

I grew up in a fundamentalist household. My father indoctrinated me to a great extent with his tenets of guilt and condemnation. He was also emotionally abusive. I had no choice but to adopt his view on life, and for many years, I held it to heart. Guilt and ignorance was my life. As the years passed I grew older and more rational, slowly discarding my father's views in favor of my own. It's jarring to abandon a dogma; dogmatism provides a great deal of purpose. I had nothing left.

 

College came as a shock. I've always had the ability, but never the motivation. I struggled with the responsibility of classes and at one point I missed a final exam. I seriously contemplated suicide. My sophomore and junior years passed at a grinding pace. Senior year approached and I began to slide even further. Someone stole my bike. I didn't deserve that bike, I told myself. At that point, I no longer cared about life. I devoted as little time as possible to classes.

 

That's when I jumped off the slippery slope. I stopped enjoying things. I doubted I'd ever succeed. My entire perspective was warped: I was worthless, I was that hateful person, I would never feel better. I began to isolate myself and ceased attendance entirely. I was alone in the dorm room for two weeks: I kept the blinds closed and subsisted on cheap junk food. I was depressed. I was depressed about being depressed. I was useless. I deserved to die.

 

I affixed a noose to the fire pipe. I pulled up a chair, tightened the bed sheet around my neck, and cast off. My head felt like it was going to burst; it was terrifying, but somehow, also exhilarating. A thought struck me: I haven't written a note. What will people think? I stretched my toes to the chair, relieved myself of the noose, and began thinking. I slowly clambered into my desk chair and pressed the final keys of my life. Writing that note was exhausting. Then I decided, hey, I can always kill myself tomorrow. So I slept.

 

I awoke to the resident director knocking on my door. "Are you there? Nobody's heard from you in two weeks." The door opened, but I remained motionless. She called my name out. Over. And over. And over. I didn't move. "We have a situation," she said to the operator. Someone touched my shoulder. I jolted. I wearily turned my head to the sight of two police officers. The paramedics rushed in with a stretcher. Everything was so blurry and unreal. I claimed I was just sleeping, but I could barely speak. "We need to take you to the hospital." No no no, I'm fine. Then I realized I had no choice. They escorted me out. The sun had never been so bright.

 

The emergency room light glared into my inner being. I didn't sleep; I just stared at the light. My mother came in tears. Did you really try to kill yourself? I don't know, I replied. A day passed. Two paramedics shuffled me out into an ambulance. It was a cage to me. The lines of the freeway passed by. I was a hostage. I stared bleakly at my new home. This is purgatory, I told myself. I accepted the pill reluctantly and violently threw up.

 

Something happened, not suddenly, but with a whimper. I shuffled to group therapy, did puzzles, and charted Pascal's triangle. They let me walk outside and caress the gentle wind. I walked with my eyes closed, amidst the trees, amidst the breadth of the universe. The day came: they let me out.

 

---

 

That's me. Depression is who I am; I've never known a different life. I'm certainly not content, but I'll get there. I'm on a great quest — a quest to escape from the pit.

[Sudanna]

Man, I dunno. I tried to write this post a lot of different ways. I think I settled on "boring and simple". I'm sad a lot. My strongest feeling has always been self-loathing. I've been in and out of several therapist's or psychologist's offiices. I've cut myself since I was, like, twelve. Got lots of scars everywhere. I tried and failed to kill myself in late October. No better since then. I'm okay with all of that. It is as it should be. Don't want any help, not interested in pathologizing my own personality, never going to take any medication, and I refuse to engage with anyone who wants to contradict any of those. Too stubborn for any of that. It's how I am, and I am far more interested in the integrity of my self than in happiness. I've gotten flowery about it more than enough over the years.

[Vexivero]

I've never been extremely depressed to the point where I wanted to end my life. I used to be bullied a ton though, and hated my position in life. I feel like I used to always be depressed, but masked it and never thought about it by keeping busy. It even caused me to start doing stupid [censored] and I got arrested 3 weeks before graduation. After high school, it was like a reset button. I took a year off to decide what I really wanted to do with myself and more importantly changed my mindset and outlook on life. I realized I was suffering from identity crisis (basically all I did my entire childhood was play videogames) and I started looking at everything as an accomplishment, no matter how minor. Even things like completing a video game or watching a TV show/movie I had never watched before, I considered those tangible achievements. I began exploring things I might be possibly interested in and made a commitment to follow through. As I became more successful and accomplished more things, it gave me more energy and drive to keep going. And here I am today. Far from done, still making every day count. I now tie my self worth to my knowledge base/skillset, so as I get older I get better and enjoy life even more.

[The Almighty Doer of Stuff]

I've struggled with mental illness my entire life: My diagnoses are ADHD, Asperger Syndrome, Bipolar Disorder, and anxiety, in chronological order of diagnosis. I'm a clear diagnosable case of Generalized Anxiety Disorder, Post-Traumatic Stress Disorder, Obsessive-Compulsive Disorder, and Chronic Overeating/Binge-Eating Disorders, and on occasion I've asked for such diagnoses, but my psychiatrist refuses, based on the fact that at heart those are all just various shades of anxiety issues and the treatment for all of them is exactly the same as what I'm doing now. And he's right.

 

"What I'm doing now" is kind of interesting and unusual, I suppose. Since September of 2013 I've been a student at a school that teaches self-help, coping, symptom management, and life skills. It's been rather eye-opening.

 

I have and continue to suffer from periods of severe depression, including suicidal ideation and, on one occasion shortly after my diagnosis, a half-hearted attempt, due to my bipolar disorder and generally my situation in life (living with an overbearing mother at 26 years old, limited social life due to inability to drive, limited financial resources, etc.), but with the skills I'm learning at my school I'm able to minimize their effects or just roll through them when I can't. I can cope with my anxiety, social awkwardness, manic symptoms, and short attention span effectively as well. I was distraught when Ashley, my first love, broke up with me last April, but with that broken relationship dynamic out of the way I've recovered from my symptoms by leaps and bounds. I'm now at the point where the staff are enthusiastically preparing me for a highly-competitive certification course to become a Certified Peer Specialist, which would basically allow me to do much of what they do for money. Massachusetts law mandates that organizations and agencies which work with people with disability, especially mental illness, must occasionally hire "peers", people who are not just "ivory tower" college-educated professionals but who rather have lived experience recovering from their disabilities. This is partly because it makes people in recovery feel more comfortable, like we're not being "studied" and as examples showing that yes, it IS possible to feel better and do something with your life. In days gone by, someone like me would be thrown in a cage forever and forcibly drugged or lobotomized. We as a society are trying to move past those days, which is good.

 

So I'm getting closer and closer to moving from strictly "patient-status" into "therapist-status". It's kind of frightening, but exciting. It's also frustrating, when my friends accuse me of psychoanalyzing them. I just happen to be very self-aware and I want to help them be self-aware too, because I care. The staff are helping me navigate these feelings in a way that allows me to offer help when it's welcome but to step back a bit when it's not going to be helpful. I'm not all the way there yet and I'm still a student, not ready for the certificate course, but I'm getting closer.

 

Part of what I attribute my success to is that my treatment team don't let me "play the victim". I have autism but I was never simply allowed to indulge the associated neuroses; I was forced to socialize, forced to do things in ways that are not neat, standardized, and totally arbitrary, and my brain actually rewired itself to get used to uncertainty and a bit of chaos. I have bipolar disorder but I was never allowed to just say, "Oh, I'm depressed, it's not my fault and I can't totally control it, therefore I'm hopeless and should be allowed to do nothing all day until it goes away;" I was forced to be med-compliant and learn ways of managing my emotions and continuing on with life regardless. I was never allowed to just accept the limitations that my illnesses set, because as it turns out very little of what seems like limitations, really are limitations; they just need to be worked around and compensated for, and as a result of the no-BS approach, although it took a LONG time and a LOT of persistence from my treatment team before the rewards became apparent, I can live a mostly functional life. I'm going to be working some day! People think I can do it and I think I can too, and that's liberating and it feels great.

 

It can be pretty frustrating seeing my friends and family saying and doing things which I've learned are "unskillful" (that's the word people working in mental health recovery use for behavior that is unhelpful for a person's wellbeing and life goals, such as hair-trigger tempers, substance indulgence, self-pity, blaming others, etc. because there are "skills" that can be learned and practiced to mitigate these behaviors). I complain to my treatment team that such-and-such friend is telling me I have to censor myself all the time to avoid "triggering" people with PTSD/lack of societal privilege/addiction problems or such-and-such relative is refusing to use assertive communication, and in days gone by when I would complain about something someone else was doing, they'd get an exasperated look on their faces and try to indirectly coax me to change. Now they just say in hushed tones, "Yeah, you're right, you're not responsible for other peoples' triggers because like you say they're not permanent scars but obstacles to be worked through even if they think otherwise, and you're right, your mother isn't being respectful of your need for privacy and recuperation, but the thing is you're here learning and other people don't have that opportunity or are just not as far along as you are. You're operating on such a higher level of functioning than most people despite your so-called disability, and it may be worthwhile to keep that in mind and try to be subtle."

 

That shocked the hell out of me the first time they said that: "operating on such a higher level of functioning than most people" and directly acknowledging that people have a lot fewer "excuses" than they think they have, after a lifetime of everyone telling me I was somehow "broken" or "doing something wrong" like there's a right and wrong way of doing things. I had idly daydreamed about helping people before but when I heard that hushed acknowledgment that few people in recovery are really ready to hear, I realized I have something to offer, the aforementioned "lived experience" successfully working through mental illness (a neverending process mind you, not a finish line) that people want to see when they're struggling. So I'm working hard toward that. My treatment team has a lot to be proud of, because I definitely didn't get here by myself; in fact I was the one obstructing myself most of the way.

 

But I definitely do still have symptoms that overwhelm me sometimes. It's a constant struggle and always will be, but it's a struggle I'm gradually getting used to maintaining sure footing in.

[adc.]

I don't know if this is called depression or such, but I'll share mine anyway

 

Last three days, Jan 28 we received the results of our college entrance exams. It was one of the top universities in our country and the entrance exam was easy, in general. Back about 4-5 months ago, just after we took the test, me and my classmates cheered and laughed that we'll get a sure pass on the exam. I even boasted that there's a 99% that I will pass, probably because I left no answer unshaded, it left me full of confidence, hope and pride.

 

Where my classmates were anxious about the results, I simply laughed at them and stated how easy it was. But I was wrong all along, so wrong.

 

At dismissal, I gave my applicant number and my surname to my classmate since they brought their router to school (it was free time, no classes) so I checked my results if I passed.

 

I didn't. The dreams I have formed and imagined were all crushed. I chose no other university since it is a 'sure pass'.

 

Yet I failed.

 

I came home and my best friend comforted me with words. I forced myself not to cry because it's the worst thing I could ever do. When I tried to cry anyway since no one is looking, I couldn't. I couldn't even hate anything, I just felt despair helplessly without a thing to do or say. I lost my dignity, my confidence and pride. I lost thoughts of good life of my future.

 

But no suicidal thought or anything, I don't want to lose what my ancestors had started a hundred years ago. So I will persist on that university.

[The Almighty Doer of Stuff]

Doesn't sound like depression to me. When something negative happens that we don't expect, it is normal to feel sad. Sadness is not bad. It becomes depression when it starts to color your whole life for an extended period of time, but as you said you've decided you're going to pick yourself up and persist and keep trying to move forward. That's a good thing.

 

As for crying, it's not the worst thing you could ever do. You could be engaging in serial murder or something. Even that would not be the worst thing you could ever do, awful though it would be. Crying is normal although what is also normal is that people grieve in different ways and at different paces (and that grief can follow any loss, whether it be a spouse or just a bit of pride), so it's not necessarily something to worry about if you don't cry exactly the way and at the time you want or expect to.

[Tyranicus]

I have Asperger Syndrome as well and have dealt with varying degrees of depression for years. Because I was unable to interact socially in the "correct" way when I was younger, I was often regarded as a freak and shunned by my peers. This led to a very low opinion of myself which has never really gone away. Despite the fact that I have since developed better social skills and coping mechanisms to deal with my neuroses, I continue to harbor a deep-seated fear that my friends will realize I'm not worth the effort. In recent years, my depression has been relatively minor. I haven't taken any medication for it in a decade, and it's been a long time since I have considered any kind of self-harm. It's never gone away completely though. I'm not sure I could tell you the last time I was truly happy, if indeed I ever have been. That said, the worst my drepression seems to do anymore when it rears its ugly head is prompt me to stay in bed not doing anything for a few days.

[Dikiyoba]

Dikiyoba doesn't want to disparage anyone's life story or anything, but remember that depression is often a cyclical disease, that resolves itself on its own but reoccurs later in life. So just because you beat it once and are doing fine now doesn't mean it won't be back later. Don't let it sneak up on you the second (or more) time around, okay?

[gem helper]

there are a lot of things extremely wrong with me and i struggle to live by my own lights and resist a lifetime of abusive training to be normal and functional and existing in general on other people's terms. having control over my behavior and environment has been important to me and only partially possible under the best of circumstances. the best thing i've been able to do for myself has been to live with, make friends with, and love people like myself, not in spite of what we are but because of what we are; not in the hope of getting better but in the hope of being happy together, and safe together, and alive together.

 

this hasn't really meant shunning diagnosis or treatment, just decentralizing them from how i live and not seeing myself or people like me, even people like me as i am at my worst, as broken, as lost, as incomplete - as in need of things outside of ourselves and one another.

 

this and my similar/linked attitude towards trans stuff makes interacting with doctors... a little excruciating. a lot excruciating, to be honest. it's something i've managed to survive for a little while, though, and don't expect to stop surviving any time soon

[Hyena of Ice]

I have Asperger's, which came as a package deal with ADHD, clinical depression, OCD (albeit minor), generalized anxiety disorder, along with non-disorder specific symptoms such as maladaptive assumption, bipolar-like symptoms (common comorbidity with autism spectrum disorders-- sunlight and exersize both have a manic-like effect on me, though thankfully it doesn't result in risky behavior-- lack of the two have the opposite effect), a sort of jekyll-and-hyde complex where I become a completely different person when upset and agitated, paranoid delusions when I become agitated...

Clinical depression was latent until I turned 8, at age 9 I started having suicidal ideations.

 

Do you think society needs a higher level of awareness in regards to mental health?

Yes x infinity. I've ranted about it plenty of times, as has my soulmate.

 

Going through it raised more questions than answers with me, because I like trying to understand things by breaking them down and analyzing them.

Yup, me too. I'm also into medical stuff, which contributes to that.

 

Part of what depression does is that it distorts your views, what you perceive to be real and what is a threat. What is an unfortunate coincidence and what is actually your fault. Severe depression changes your outlook to indicate that everything is hopeless with no way out, even to someone who relies primarily on logic instead of instinct.

Yeah, but it can go a bit beyond that-- I sometimes get the whole "everyone else is crazy or a gullible idiot, I'm the only one who is sane and sees the world for what it is" thing going.

 

One way depression and other mental conditions needs more attention is that it doesn't seem like a lot of people understand what it would be like - they can't relate.

There's a lot of logical fallacies regarding psychiatric disorders, which results in ignorant people viewing them as character flaws resulting from bad parenting.

They include:

--Appeal to Ignorance (Schizophrenia did not exist as a diagnosis before the 18th century, therefore, schizophrenia didn't exist before then)

--Fallacy of Relative Privation (kids in Africa have it way worse, and they don't kill themselves, so get over yourself)

--You also have the Cum Hoc logical fallacy about rampage killers (most of them were on psychotropic meds-- so some people assume that the meds drove them to murder, rather than, you know, they were on meds because they were already messed up of course even if these same people realized that, they'd still rail against psychotropic drugs for "not working". The exact same logic is used by those who claim that violence in media leads to serial killing, pointing to the child killers' obsession with it-- when of course in reality the kid was likely drawn to it in the first place due to sociopathic tendencies.)

[Rya.Reisender]

I have physical issues (permanent pain for months over a large part of my body and nobody really knows what it is) that cause mental issues (feeling exhausted all the day, unable to move, wondering if it makes sense to even carry on with all the pain and if it'll ever go away, unable to concentrate, etc.), but I'm pretty much immune to mental issues themselves as I have a quite strong psyche.

[Zaego]

I have physical issues -- permanent pain for months over a large part of my body and nobody really knows what it is...

 

It's a complete shot in the dark (and also goes beyond the thread for psychology and depression, for which I apologize) but have the doctors ever tried to search for spinal disorders? A spinal cord strained between two or more dislocated bones could cause such symptoms of permanent and crippling pain around a large portions of Your body.

[Euroclydon]

I've been somewhat sad for a while, probably as long as I can remember. Not sad, actually; it's more that I have a wedge of nothingness lodged inside my mind that often causes sadness. It's tiring, mostly. I'm always tired and slowly my waking hours grow reduced, whilst I can sleep almost at any hour for any length of time. I went to see a doctor once - about my lethargy - and she said that it was likely due to diet. My diet probably doesn't help my problems, but when my budget can only just stretch to a loaf of bread, milk, and a little tea there's not much I can do about that.

 

I work, and I try to act happier in my interactions with my colleagues and the public, though inside I am just miserable. I get anxious a lot, at work, and because my job isn't challenging my mind often finds itself circling the nothing that is wedged inside my mind. I've spent the last 18 months trying to find a more rewarding job. I just want to do something that'll utilise the degree I fought really hard to earn, but I'm convinced that I picked the wrong subject, or that - worse - the mental effort it took to complete a degree, whilst working full time with all this nothingness crammed inside me, was just too much. Certainly, at times, it feels like too much to even get dressed.

 

Unfortunately, I also feel guilty fairly often. Guilty that I have an education, and that I'm bright. Guilty that I can't use those gifts to help other people. Guilty that what little I've got would be better spent making other people's lives better. When I'm sad or empty - I'm empty more often than sad - it's crap. When I feel guilty, its worse.

 

Sometimes I'm pretty good, though. I can be happy, or have moments where I'm alright at least. These are rarer, and it's hard for my friends, and my partner, who are either exhausted by me, or who just think I'm moody. It's just such an effort though, not to let my mind go to the nothing, the sinking feeling, because if I do that I don't get out of bed. If I do that, I feel tears welling up, and then I have to think of something else - even if that something else is nothing. Even thinking about nothing is something, and that's better than the nothingness that's locked inside my brain.

 

I'm not sure this is how I'd choose to write this if I were to sit and write it again, but it's certainly how I'm feeling right now. I think most of the time, I'd just consider that me, and being myself isn't the worst thing. For the last two or three weeks, though, I've been infinitely worse. I sort of have lulls, where I'm alright for a stretch of a few weeks - never good, but good enough - but after those, I'm worse than the last time. I'd consider speaking to another doctor, but I don't know if I've the energy. I actually feel better for saying something, even if it is in writing, and even if it's anonymously.

 

I am only somewhat saddened that I had to waste this account's first post on this, as it isn't quite the handle I'd want.

[Goldengirl]

I take a great deal of issue with the psycho-pharmaceutical industry and the constant pathologization of mental abnormality. I think society is probably sick more often than people; anorexia nervosa can only come about in a society obsessed with the equation of thinness with beauty.

 

With that salt thrown in, there's definitely some mental stuff going on with me. The only time I've been properly diagnosed, it's come up as mood disorder, not otherwise specified, and I've never felt like any one descriptive set fit me. Major depression, variants of bipolar mood disorder, gender dysphoria, and others all have some aspects that seem to fit the bill, but nothing is ever a satisfactory fit, let alone perfect.

 

That said, I've got enough symptoms to be sure that something is up. I've had a history of self-harm, suicidal ideation, weight issues, crippling apathy... So I suppose I'm just not otherwise specified. That didn't stop them from writing me a prescription, though. Counseling helped, and the drugs give me some reasonable baseline without too many negative side effects.

[Randomizer]

Many things that were once considered a normal part of growing up have been reclassified as mental illness. Last year the industry added a not otherwise specified diagnosis for people that don't fit under any previous classification. Not to belittle your problems, but the industry thrives on classification so they can pick a treatment for your problem even if the diagnosis is wrong.

 

In general counseling is the best option as long as you are getting good advice. Insurance companies prefer drugs since they are cheaper. Keep watching the negative side effects because doctors rarely believe they are from the drugs. This in spite of clinical studies showing some people may be genetically more likely to have negative side effects and not benefit from several drug classes.

[Slawbug]

Last year the industry added a not otherwise specified diagnosis for people that don't fit under any previous classification. Not to belittle your problems, but the industry thrives on classification so they can pick a treatment for your problem even if the diagnosis is wrong.

Actually, the DSM has had "not otherwise specified" conditions since 1994, and both the DSM and ICD have had "unspecified" classifications and subclassifications since at least the 1970's. (Probably further, but I got tired of digging through old PDF's to confirm.)

 

Although I agree with some of your criticisms of this "industry" -- specifically, the psychopharmacological industry -- I think you're casting your criticism a little wide. Today, most mental health practitioners are not psychiatrists; and while views towards medications (and individual medications) will vary, they have specifically chosen a career that revolves around a non-medication treatment. (Also, psychological counseling does not typically mean giving "advice".)

[Alorael at Large]

Most prescribers of psychopharmacological medications are not psychiatrists. They're overwhelmingly primary care doctors, and they have very varied background in psych, from rock-solid training to basically no training at all, and very short visits with which to make a diagnosis and prescribe treatment. As you might imagine, the results therefore are also quite varied.

 

And this article, too.

 

The "not otherwise specified"/"unspecified" categories in the DSM are related to the problem, but they aren't the problem. Those categories exist for a reason, but they're an easy lazy shortcut for "I think there's a problem but can't be bothered to do a proper diagnostic workup. I'll just pick the category that kind of feels most applicable, stick NOS on the end, and write the prescription." That seems kind of reasonable; after all, the DSM is full of subjective assessment rather than hard number cutoffs used for a lot of medical diagnosis. But there's also some evidence behind a lot of the DSM, and "just eyeballing it" does not lead to good outcomes.

 

—Alorael, whose opinion is that antipsychotics and antidepressants are simultaneously underused in those who have the illnesses for which they are intended and who would benefit most and widely overprescribed for either the wrong problems or for normal life. Which is also how he feels about medications for ADHD, incidentally.

[ĐªгŦĦ Єяŋϊε]

Oh, you find that sitting behind a desk for ten hours a day at the age of six is hard? You obviously have ADHD. Here's Ritalin.

[Randomizer]

@Slartibus - the 2014 DSM handbook added a new not otherwise specified for people that are assumed to be mentally ill, but don't fit any recognized disorder. The equivalent to "other" in a multiple choice list, but without specifying what makes them mentally ill.

[Alorael at Large]

Oh, you find that sitting behind a desk for ten hours a day at the age of six is hard? You obviously have ADHD. Here's Ritalin.

Which is why a diagnosis of ADHD requires dysfunction in more than one setting. School alone doesn't count!

 

But what also happens quite often is that kids pay no attention, get angry and act out. ADHD, right? But those are also symptoms of depression in kids.

 

—Alorael, who again sees this as an area where the "fuzziness" of diagnostic criteria and the lack of hard lab values makes it more important for someone with time and training to do the diagnosis, not less. Everyone has symptoms of all kinds of mental illness. Most people aren't actually ill, but sometimes the distinction between disease and symptom gets lost.

[Slawbug]

@Slartibus - the 2014 DSM handbook added a new not otherwise specified for people that are assumed to be mentally ill, but don't fit any recognized disorder. The equivalent to "other" in a multiple choice list, but without specifying what makes them mentally ill.

"Not otherwise specified" is language that is used by the DSM-IV, which is the 1994 manual, not the new one. It does not appear in the 2014 DSM-V, which goes back to "unspecified" instead. It's true that there are more "unspecified" diagnoses, including one for "unspecified mental illness" -- following the lead of the ICD manual used by the World Health Organization.

 

I'm the first to agree that some diagnoses are vague, inaccurately applied, or tend to imply more than is true. But the purpose of the "unspecified" diagnoses is actually to move away from that, by encouraging practitioners not to state more than is actually known.

 

Multiple choice lists have "other" on them for a reason. People are complicated. There is something new under the sun. Those classifications have no impact when it comes to labeling people as mentally ill on the strength of an assumption -- you could do that already, with the old diagnoses! The new ones, on the other hand, make it easier for practitioners to use the labels for conscientious communication, and make it easier to avoid overstating a diagnosis.

[Hyena of Ice]

Keep watching the negative side effects because doctors rarely believe they are from the drugs.

That is absolutely not true. You can look at the symptoms listed on the bottle/pamphlet and bring them up with your psychiatrist the next time you see them. I have had little trouble getting input on them or convincing them (in some cases) that it might be a listed side-effect, unless it's one that isn't always listed (such as amphetamines -- dexadrine, adderall, etc. having a diuretic effect)

 

In general counseling is the best option as long as you are getting good advice.

Only if the person is willing to change their problem behaviors. For example, Dialectic Behavioral Therapy probably wouldn't work for me because I am not willing to give up my paranoia-- it protects me, and people who don't have it are gullible.

 

That said, I've got enough symptoms to be sure that something is up. I've had a history of self-harm, suicidal ideation, weight issues, crippling apathy...

That sounds chronic depression right there, and you should see a psychiatrist about that. Those are all hallmark signs, including the weight loss which is probably due to bad eating habits.

 

I think society is probably sick more often than people; anorexia nervosa can only come about in a society obsessed with the equation of thinness with beauty.

Anorexia nervosa is different than most disorders. You really can't chalk anxiety disorders, obsessive compulsive disorder, bipolar disorder, or schizophrenia up to a screwed up society. The same cannot be said with eating disorders and body dysmorphic disorder (which BTW is one of the causes of eating disorders)

 

Most prescribers of psychopharmacological medications are not psychiatrists. They're overwhelmingly primary care doctors, and they have very varied background in psych, from rock-solid training to basically no training at all, and very short visits with which to make a diagnosis and prescribe treatment.

I believe you are referring to the use of antidepressants for physical disorders, primarily chronic pain. There has been some evidence, to my understanding, that this does have some benefit-- not because their pain is a result of depression, but because the effect of SSRIs on seratonin and dopamine seem to have some effect on pain, IIRC.

 

Euroclydon: I can understand that sort of guilt. However, there is no reason to feel guilty that your first post on these forums is in this thread.

[Lilith]

Most prescribers of psychopharmacological medications are not psychiatrists. They're overwhelmingly primary care doctors, and they have very varied background in psych, from rock-solid training to basically no training at all, and very short visits with which to make a diagnosis and prescribe treatment.

I believe you are referring to the use of antidepressants for physical disorders, primarily chronic pain.

 

nope, i mean that also happens but GPs can and do prescribe psych meds for psychological conditions as well. maybe not wherever you live but certainly where i do

[nikki.]

nope, GPs can and do prescribe psych meds for psychological conditions as well. maybe not wherever you live but certainly where i do

 

The same is true in the UK.

[Randomizer]

Some places like Arizona let registered nurses (RNs) prescribe medications. What's worse is when FDA safety warnings are ignored because the person prescribing is unaware of them.

 

@Hyena of Ice - My grandmother was in a nursing home where the physician prescribed a new drug that caused her to suddenly appear mentally ill. My father had to bring in copies of clinical research papers showing that this was a possible side effect before the doctor would change the prescription and the mental illness went away. The doctor kept saying the mental illness was just normal for her age.

 

Some side effects don't get listed for years because the safety clinical tests are only for 6 weeks and it takes longer before they appear.

[Euroclydon]

Euroclydon: I can understand that sort of guilt. However, there is no reason to feel guilty that your first post on these forums is in this thread.

 

Actually, the above was not my first post. I didn't - don't - want my post to be linked to my primary online persona. The internet is forever, and this is the kind of thing I want to share with my friends and peers, NOT anybody who might google me over the next 20 years. I wanted simply to share my state of mind. After this thread dries up, I will lay this account to rest.

 

Reading my earlier post back, I definitely would not write it like that again. The "nothingness" is absolutely depression, and I'm constantly apathetic, and apathetically contemplative of suicide. I don't think I'll act on it - certainly not in the immediate future - though I don't know how much of that is down to my own feelings of apathy and guilt. Mostly, I just isolate myself completely and sleep for several days. An absolutely tangible sense of hopelessness haunts my consciousness. The thing that brings me down most, though, is that I know that I think differently now. I've been depressed, or sad, or whichever, for years, but I always had a sense of who I was, even when I evolved naturally. Now, when I think, I sound different in my head; when I write and look back on my writings, my tone and style are not my own.

 

I'll stop there, anyway. I spent too long time working on this post already. Sorry to hijack the thread from the discussion of medicines and treatments. I wasn't happy (ha!) with how I left my post before. .

[Nephil Thief]

Euroclydon - that sounds a lot like some of the stuff I went through, after I dropped out of college. And am stilll going through, really. That sense of not knowing who I am is familiar. Likewise the apathetic contemplation of suicide.

 

Please do stay with us. I know it's hard to see, but you are worth something.

 

*hugs*