Mental illness is fun. It’s fun to deal with persistent and debilitating symptoms that screw up my life. It’s extra fun to hear how much you understand what I’m experiencing because of that month you were extra sad. It’s super fun to know many people think I’m lazy and faking everything for sympathy.
I can’t show you how I broke my brain, but I can start to explain how my life is different because of it. To that effect, I’ve compiled a little FAQ. However, these aren’t frequent questions at all. I think people are afraid to ask me how I’m doing because they’re afraid of mental illness and don’t understand. I’m afraid of it too. These questions represent the questions I’ve asked my doctors, google, and myself on my path to understand this illness
Q: What’s wrong with you?
A: According to more intelligent people, I have Major Depressive Disorder with atypical/mixed features. In regular-person terms, it means I enjoy all the fun crippling apathy and lethargy of atypical depression mixed in with bipolar-like mania. Mixed features and atypical form are both pretty good indicators of bipolar disorder. While I haven’t fully met the criteria for true bipolar disorder, the path of my illness, my lack of response to traditional depression treatments, and the odd behaviors I display between depressive episodes point in that direction. As much as I’d like a concrete diagnosis, I do seem to be responding to a mixture of meds and therapy aimed at both conditions, so I’m not complaining.
Q: Then why did you tell me you were depressed/bipolar? Were you lying?
A: Maybe, but not because I was trying to trick you. First off, my diagnosis has changed a lot through time. What I told you depends on what I knew at the time. Second, would you want to explain all that complicated stuff to everybody? Since nobody really wants to know about my condition, I try not to burden people with more than they want to know. Lately, I’ve stuck to the bipolar label because in one word it describes my reckless highs and crippling lows. I’ve also been told I better learn to live with bipolar disorder since all signs point that direction – so I might as well accept it. Depression and bipolar are both mood regulation disorders and tend not to be as clear-cut as we’d like. Many cases of bipolar disorder are mistaken as MDD, creating a huge problem for treating mental health today.
Q: What does it feel like?
A: On a clinical level, my most prominent symptoms include sleeping too much, loss of interest, appetite changes, lethargy, feelings of paralysis, difficulty concentrating, inability to make decisions and take action, self-harm, and suicidal ideation. This also comes with a host of unpleasant physiological symptoms like digestive irritability, muscle aches and weakness, nausea, and wicked headaches. Since depression is my main problem, this is my reality more often than not. However, I am often somewhere on the mixed/hypomanic spectrum too. Those symptoms have included over-abundant energy, inadequate sleep, unbridled enthusiasm, extreme talkative-ness, racing thoughts, and reckless behaviors. At their worst, these episodes have included mild hallucinations.
Q: But what does it really feel like?
A: On the depression side, other authors have captured it better than I ever could. The endless negative thoughts, rumination, soul-crushing exhaustion, hiding, feeling alone, battles of treatment,horrors that could lie ahead, “logic” behind suicidal thinking all resonate with my experience. In my own words, depression slowly eats away at my sense of self. It steals my enthusiasm, my passions, my personality, my strengths, and tries to take my life. It makes me redefine who I am every morning. Where I was once a strong student, I now struggle to read or form ideas. Where I was a warm and loyal friend, I now struggle to give a damn beyond my own problems. Where I was a dream-driven passionate person, I am now fearful and pessimistic about my future. It’s crushing to accept that at 23 years old I will likely struggle with these overwhelming issues for the rest of my life. Depression steals everything from you until you feel like you have no options. At that point, suicide feels like a reflex (link worth reading).
On the more manic side, it feels like I’m no longer steering the ship. While I’ve been lucky enough to anticipate most of the worst symptoms and get to safety, it’s scary to lose control of your mind and body. I’ve charged another driver up the wrong side of the road. I’ve spent gobs of money I don’t have. I’ve jumped in the car and ended up 400 miles from home. I’ve cut, bruised, and burned myself for fun. I’ve forgotten to eat or sleep for days. Sometimes I feel the regret for these actions moments after, sometimes it takes days for the full consequences to sink in. In these states, I do not consider myself lucid. It’s my brain overriding me. It feels like waking up when these states end. This is the scariest part of my illness because I’m not sure what trouble I’ll find.
Q: What can I do to help?
A: Well, if you’ve made it this far I might as well give you an answer to this question. I’m not very good at answering this one, but people on the internet have done a pretty great job. I might also have some suggestions for helping me:
- Checking in to see if I’ve eaten and taken my meds recently. If I haven’t eaten, suggest something I could have for dinner (because without working intuition I don’t really want anything). If I haven’t taken my meds, ask me what I should take next (I know my meds schedule, I often just need someone to help me make the decision to take them). I’m better at following orders than making decisions. If you are concerned about my mental state, please suggest I call my doctor or go to the hospital (important names, numbers, insurance, and instructions are in my wallet).
- Feeding me, taking me for walks, running errands, socializing, etc. I’m basically a ten year old that occasionally remembers to be an adult. As I re-learn to care for myself, occasional help is appreciated. Grocery shopping takes about 4,000 decisions from start to finish. Having help with a few of those is a much needed hand up.
- Give me an excuse to put on pants before noon. Luckily, going out in public still motivates me to keep up appearances. I can function fairly well in reasonable bursts in the outside world. Getting me out of the house is 90% of the battle, so please make morning plans with me.
- Understand that my symptoms are not me. Sometimes I can be cranky, forgetful, inept, and all sorts of annoying. Please call me out on it; I’m still responsible for my own behavior. However, please give me a moment to collect myself and correct the behavior or to excuse myself to a better situation. Please understand that I still do love you and appreciate all you do for me.