The Experience of Depression
You need to know: what depression and mania feel like.
by Nan Dickie
Before you say, “I know the symptoms of depression. You don’t need to remind me,” please consider this. It’s not good enough to know the words that describe the symptoms of clinical depression and bi-polar disorder. You need to imagine what these gut-wrenching experiences feel like. Give it a try.
Before getting into the symptoms, some important preliminaries: Symptoms for both depression and mania may vary in length and intensity from person to person, and can be different from episode to episode. As well, symptoms do not occur in any particular sequence. The onset of symptoms may occur abruptly (literally overnight, as is my case) or gradually, over a period of weeks. It is unlikely that any one individual experiences all possible symptoms for the duration of an episode. (I shudder to think of that.) Despite this variation and complexity, we can actually group symptoms into categories – mental, physical, emotional, social and spiritual.
A few months ago I conducted a survey with 14 participants in the depression support group (DSG) I facilitate. I listed a wide range of 28 clinical depression symptoms, and asked participants to identify their three worst symptoms – not an easy task, as many of us experience five or six different symptoms during an episode.
The most common and intense symptoms reported were self-loathing and feelings of worthlessness. It’s worse than it sounds. For many of us, self-loathing takes the form of extremely negative, top volume, relentless, inner insults to ourselves. Feelings of inappropriate guilt, shame and self-blame compound this with statements hurled at oneself such as: “I don’t deserve to be alive;” (of course you do). Or “I’m despicable;” (never true) . Or “I’ve never done anything worthwhile in my life;” (faulty memory caused in part by faulty chemistry).
Does this sound like exaggeration? I assure you, it’s not.
You cannot talk someone out of these self-deprecating thoughts. Depressed people cannot control this thinking. People with mental disorders have NO CHOICE about experiencing symptoms. They are inherent in these disorders, these illnesses. To say, “Look on the bright side,” or Pull yourself up, man” do not help one bit. In fact, comments such as these make depressed persons feel even worse. With these illnesses, when one is in an episode, one cannot remember one minute of feeling well. This being the case, what can we strive for?
The next most prominent symptom reported was that of pervasive fatigue and lethargy, both physical and mental. Feeling like dead weight. Arising from these primary symptoms, or occurring on their own, may be difficulties concentrating, think being “as clear as mud,” indecisiveness and lack of interest in daily activities.
The symptoms are piling up here, but my worst symptoms are next: feelings of despair and dread. These feelings are epitomized by thoughts such as, “I can’t do this any more;” (we somehow do). Or “There is no hope;” (we can only live through this). Or “This hell will never end;” (it does: depression is eventually self-limiting).
A few other of the high-ranking depressive symptoms were intense feelings of emptiness, isolation and helplessness; uncontrolled irritability and agitation; appetite, weight or sleep changes. Anxiety and fear inevitably join in: anxiety over relationships (“Will she abandon me?”); fear about one’s work (“What if I can’t do my job?”)
With bi-polar disorder, the down-side of the cycle is similar to clinical depression. The other “pole” of bi-polar disorder is mania. Manic symptoms may include agitation, aggressiveness, and sometimes paranoia (“I know my husband is cheating on me,” when you have no evidence); feeling extremely and intensely high; increased and uncharacteristic confidence and self-esteem; a reduced need for sleep; increased talkativeness; soaring creativity and racing thoughts. Some people who don’t understand mania may think, “Must be nice, feeling high.” No. Manic symptoms often cause significant impairment, and total disregard for others. In mania, a person may spend money they don’t have, drive recklessly, drink excessively, and exhibit very poor judgment (e.g., have sex indiscriminately). Some individuals who have bi-polar disorder are rapid cyclers – feeling manic at one moment, depressed the next, and back to mania. This is extremely exhausting and totally outside the control of the individual.
So, that’s what the experience of depression and mania is like. Symptoms can go on 24/7 for months at a time. Although you may not be able to relate to our experience, but now having immersed yourself in the realities of our experience, I hope you can empathize with us, feel compassion (not pity) for us, and support us as lovingly as possible.
[Nan Dickie is the facilitator of the local depression support group (DSG). Meetings take place at noon on the first and third Mondays (including Mondays of long weekends) at Askews Uptown conference room. Everyone welcome! For more information email Nan or call her at 250 832-3733.