This Is What Depression Can Look Like

Depression.

Depressed.

Someone curled up in bed, hidden under the covers. Sunlight peeking in through the drawn curtains. Phone calls and voicemails ignored. Text messages unread. A dirty plate, and empty, coffee stained mug on the bedside table.

That sounds like fairly stereotypical depression, right? It is. The trouble is, not everyone with depression struggles like that.

What about the person who smiles, and chats happily to friends and family. Who cleans the house, keeps up with chores, and pays all the bills. The dishes are done, there’s food and leftovers from a home cooked meal in the fridge, and the fruit basket is full.

Is that person depressed? If that person is me, then right now, yes. It’s just so well hidden.

I smile and chat with family and friends because I adore them, but I also don’t want to burden them with my sucky (technical term!) mental health. I busily keep up with chores  so I have less time to think about how much I detest myself, my life, and everything about me. Keeping busy keeps me safe. Leftovers in the fridge are from a meal I cooked when I felt like eating. I swing between having no appetite and comfort eating.

No one sees the tears that slip out when I’m finally alone, or on the way home from visiting friends and family.

No one sees the self-hatred, pain, hopelessness, and defeat that flood my mind when I finally stop doing chores.

No one sees the torment that fills my mind over needing to eat, having no food, then ordering groceries, and not wanting to eat.

I usually manage to function until I’m extremely depressed and suicidal. On the way down into that pit of doom very few people know or see that I’m struggling.

Not being able to see it doesn’t mean that I’m not depressed.
Not being able to see it doesn’t mean that I’m not struggling.

Depression looks like many things for many people. Ask before you pass judgement on whether someone is depressed, or how depressed they are.

Can One Alter In A DID System Have A Mood Disorder?

We were diagnosed with DID (Dissociative Identity Disorder) in 2009 by our psychologist, and had the diagnosis confirmed by our psychiatrist in 2010. Since then our psychologist has also diagnosed Bipolar II, but our psychiatrist seems hesitant in confirming that diagnosis.

I think DID can look a little confusing from the outside. If we’re rapidly switching, and everyone is in a different mood, has different energy levels, different concerns, and different priorities it could look like our mood is rapidly changing.

However our system generally isn’t like that. Overall each of us seem to have a relatively stable mood and way of perceiving the world. Except me. As far as I know I’m the only one that has ongoing mood issues. It’s true that, at times, other parts have been unsafe and suicidal, but that’s been related to specific trauma, not mood issues.

I’m struggling to manage my mood with medication. My mood is still up and down no matter what medication I’m taking. Up can be fun if I’m happy and not agitated, but that hasn’t been the case lately. Down is crushing and soul destroying. I’m currently trialling one last medication regime before I go back to my psychiatrist to discuss other options.

What’s interesting is that when my mood is elevated, other alter’s moods are not. Even when I’m severely depressed it’s unusual for other alters to also be depressed. Their moods, thoughts, and perceptions seem entirely separate from my own.

When I’m hypomanic we don’t switch. It seems like I’m so busy, excited, and happy that other parts simply do not get a chance to come out. I also feel much more confident and capable, and experience no anxiety so there seems to be less need for switching.

When I’m depressed we switch more often than when hypomanic. I think that’s because I become so overwhelmed and unsafe that I don’t want to be out, or other parts become so concerned for our safety that they come out to keep us safe. When that happens, whoever comes out is not depressed. They express obvious concern for me and my mood, and our safety, but they do not share the overwhelming depression.

It’s quite confusing. I’m not sure if that’s common or ‘normal’ for people with DID and a mood disorder, but that’s how it works for us. I don’t know if that makes a Bipolar II diagnosis more plausible, or just more confusing. I think I have Bipolar II, but I don’t think other parts do.  Does it mean that I do (or don’t) have Bipolar II? I have no idea.

What Are Your Warning Signs?

Mondays are therapy days. The one guaranteed day each week that I drag my exhausted, sore body (thanks ME/CFS) out of bed, and out of the house. Today was no exception.

I spent my time in the waiting room chatting to a friend on Facebook. I hadn’t given the upcoming session much thought. Things seemed fairly on track. Stable mood, no suicidal ideation, no self-harm, eating enough, and generally coping. Plus allowing more internal communication and switching.

One hour later, and I had a completely different perspective. My psychologist did a very good job of pointing out the warning signs I hadn’t yet seen, and expressed her concern for the behaviours I’m engaging in.

It’s made me think about the relapse prevention work we did in group whilst in hospital earlier this year. In one group session we had to identify relapse warning signs, and work on strategies to prevent. I dutifully filled in the worksheet and participated in the group discussion. When I came home the worksheet went away, and I haven’t thought about it since.

However, I do know my warning signs. It’s just that this time I’d forgotten to keep an eye out for them. This isn’t a complete list, but these are some of my warning signs.

Eating Disorder
Increased concern and worry about body shape, size, and weight.
Avoiding or restricting specific foods or food groups.
Significantly reducing portion sizes.
Swapping meals for low calorie protein shakes.
Skipping meals.
Ignoring hunger.
Using fibre supplements to avoid eating.
Abusing laxatives.
Bingeing.

Depression
Decrease in social activities.
Decrease in enjoyable activities.
Failing to see the point in engaging in the above activities.
Feeling like there’s no point to life.
Feeling hopeless.
Not seeing a future for myself.
Feeling like a failure.

Hypomania
Increase in enjoyable activities.
Talking more quickly.
Multi-tasking to the extreme.
Starting new creative projects.
Laughing much more than usual.
Swearing a lot more than usual.
The urge to buy things, or actually buying many, many new things.

Dissociation
Increased switching and associated memory loss.
Losing chunks of time (more than several hours).
Increased occurrence of flashbacks and body memories.
Difficulty falling or staying asleep.

Knowing the warning signs isn’t enough to prevent a relapse into unhelpful behaviours. Being aware of them, or having others point them out to you certainly helps, but it’s not enough on it’s own. Awareness is only the first part of preventing a relapse.

My task for the week is to work on tackling some of the symptoms that make up my Eating Disorder warning signs. I haven’t relapsed. This is about staying on track and preventing a relapse. I’ve been warned by my psychologist that a relapse will only lead to another hospital admission. Having already spent 7 weeks in hospital this year, another admission is the last thing I want.

Behind the Facade (and a note to myself)

You all know what I mean. That smile you force when all you want to do is curl up and cry. The “Yeah, I’m fine, just tired.” response you give when others ask if you’re okay. We all do it. Sometimes it’s not appropriate to tell people we’re not okay. Sometimes it’s no one’s business. Sometimes though we all wish people would see through that and ask “Are you okay? I mean it, are you really okay?”

Sometimes this (picture below) is what we present to the world, and sometimes that’s necessary.

Facade_happy_fine_fake_faking_emotion_not_okay

 

However, to keep presenting this bundle of positivity to the outside world is exhausting. It’s draining, discouraging, and disheartening to continue to lie day after day. Every time you lie, every time you tell someone that you’re okay, you become a little more isolated. You slowly build a wall between yourself and those who care about you.

It’s easier this way, you tell yourself. It’s better for them, I don’t want to hurt my friends. They won’t understand, and they can’t help. There’s nothing anyone can do, so there’s no point telling people. If they knew how bad I felt, they’d panic and run a mile. I don’t want to lose my friends.

Being in that space is hard. It’s painful, it’s isolating, it’s soul destroying.

People aren’t made to do life in isolation. We’re created to need people. We’re social creatures, and to live life in isolation is painful.

I have good friends. Perhaps only a handful of people that I trust. I don’t give people a chance to care, to be there for me, to support me when I need it most. I’m so terrified of people hurting me, and even more scared of me hurting them that I don’t give anyone a chance.

My mood has plummeted from hypomania into depression, and that alone is painful. Add that we’re now in a time of year that’s filled with trauma anniversaries, and associated flashbacks, I’m not in a good space. I’m using unhealthy coping strategies to get through each day. I don’t want to sleep, yet I don’t ever want to wake up. I’m emotionally exhausted.

Have I reached out to my friends? Mostly no. I keep quiet. Sometimes I start a conversation, wishing that I could tell them how not okay I really am, but I tell them I’m fine. Then I ask about them. I take interest in their lives to avoid talking about my own.

This (picture below) is what my friends don’t see.

sad_not_okay_emotion_depression_depressed_reality

 

Take a chance. People need people. We can’t do life alone. It’s not appropriate to reach out to just anyone, but there are people who care, and who will walk this journey with you.