I think one of the most misunderstood characteristics of Bipolar Disorder is depression. I’ve talked about it a number of times, and I will continue to talk about it numerous more times.
Basically, the question is: when is normal depression no longer normal?
We have all experienced depression, it is a normal human emotional state of being, right? But very few of us get ‘depressed’, as in, medical. Where is the line? I would say that, clinically, it comes down to length and severity. Longer than two weeks, bad enough to interfere with your life is the rule of thumb.
A lot of things in the psychological world come down to ‘interfere with your life’ types of analysis.
What is the difference between a heavy drinker and an alcoholic? Interference with life.
What is the difference between hallucinations and psychosis? Interference with life.
What is the difference between hyper and ADD? Interference with life.
What is the difference between the breeze and the wind? Okay, that’s not psychology but it illustrates my point. The breeze makes a summer day nice while the wind is the bane of my existence.
I personally detest the barometer of ‘interference with life’, simply because a lot of people are able to put up with a lot more before it starts to interfere. Some people can’t work while in high school because it interferes with their studies, some people can’t listen to music while typing because it interferes with their thinking, some people can’t pat their head while the rub their belly, you get it. On the flip side, some people can work 16 hour days, sleep less than 5 hours a night and none of that interferes with their gym schedule.
My personal aptitude for dealing with shit should not be a factor in determining whether or not I have a disease. Cancer doesn’t magically become cancer once it starts to interfere with your life. Why do we insist on being classified as a medical condition and yet stick to whackery like this?
The whole process seems to have way too much of a ‘you know when you know’ vibe to it. I like the hard sciences, I like math, I like to know. The idea of a guy staring at you until you betray some information that gives away your secrets gives me the heeby jeebies. This isn’t how doctors are supposed to operate.
But with depression, that is a lot of what it is. “how long have you felt depressed”
“a month, I guess”
“and how often do you think about it?”
“well it pops in and out of my head all day at work. I’m sad all the time”
“do people notice? Has anyone said anything to you?”
“no, I’m good at hiding it”
“ever consider suicide?”
“not really, no”
“okay, I’m gonna put you on an extremely low grade anti-depressant. This will probably ride itself out, but I want to give you a little kick in the pants. As soon as you feel better you can stop taking the medication”
“okay. Is there something clinically wrong?”
“oh, no I don’t think so, just taking precautions”
“okay great thanks”
And so begins this person’s journey into the near constant cycling between depression and medication. The doctor assumes it isn’t MDD because the person is working and able to hide it and is not suicidal. Meanwhile, five years later this person cannot understand why they have been on so many different meds and none of them work and they feel like garbage. All while harboring hatred towards the system and vowing to themselves to just be free of it at and stop even trying to get better.
It is crazy that we operate this way! Alcoholics get diagnosed all the time without missing work or beating their kids, ya know? We have a term for it even! Functioning alcoholic! What, no one thinks it is possible to function while depressed?
I’m here to tell you that you can absolutely be functional while depressed! Not all the time or with each experience or for every person, but I can go months of being terribly depressed and be perfectly functional. It is easy to know when it is breezy or windy outside, but it is extremely difficult to tell where the crossover is, and a lot of that is a matter of opinion.