Bipolar Thoughts

The More You Know

I recently fielded a question about depression that I thought I could turn into a very helpful blog post.

The question was this: I sometimes get sad for maybe a week or more, like really sad. Am I depressed? Is my depression the same as yours?

The easy answer is, yeah you probably are depressed or experiencing depression as an emotional state. And yes, your depression probably feels like some of the depression I have felt in my life as well. People with mental illness don’t experience a different set of emotions than you, they just experience them differently.

Here is the first problem, depression is a word used to describe an emotional state (a very common one that probably most every human has experienced) as well as being a word used to describe a disease (still common as far as mental illness goes, but down to something like 15% of the population experiences). So while you and I may experience the same state, I doubt you have experienced it to the depths that I have or for the length of time I have. It takes a depressed person to experience severe symptoms of depression for a minimum of two consecutive weeks in order to meet the minimum diagnosis for depression (and I doubt any doctor would give you that diagnosis based on that).

But most of you probably understood that already. Here is the part that shouldn’t, but probably will, open up your eyes:

There are several different forms of depression.

Now I’m sure if you thought about it you would say, ‘well, yeah! I know there is depression, I know there is post-partum depression, I recently heard of premenstrual dysphoric disorder because that was in the news and a big joke for some reason’. You may be clued in (since you read this blog) and know what seasonal affective disorder is (a form of depression).

So, you know there are types of depression. But you probably still hung that big one out there and not thought anything of it: depression, like ‘regular’ depression, right?

It is there that you can break it down into a number of things.

First, the mildest form of depression, the one the person asking me questions might have been experiencing, Situational Depression. Basically, being in a depressed state but probably not affecting your life much, onset came from a situation (i.e. breakup, job loss, fighting with spouse). This is the most common form of depression. It happens to people with mood disorders, depressive disorders, personality disorders, and just your average everyday weirdos. You have probably experienced this in your own life. Me too. If this is something you experience often, you may suffer from Adjustment Disorder with Depressed Mood. That is exactly what it sounds like.

Then you have two sides of the same coin: Melancholic or Atypical Depression; basically a much deeper and darker and longer lasting form of depression. Both of these types fall under the umbrella of Major Depression. This is the most common mental illness. And it is also the most common form of depression experienced by people with other mental illnesses. These types of depression are basically when you are so depressed it really changes your life. Major Depression also has a mental illness attached to it for people who experience it “often”, Major Depressive Disorder (a common question in a psych ward is ‘are you MDD or bipolar?’ since those are the most common diagnosis). Melancholia is basically everything you think of when you think of depression: insomnia, lack of eating, no joy in activities, excessive guilt and sadness. Atypical depression is a little weirder, you don’t experience the anhedonia (inability to experience pleasure) of melancholia. In fact, you can be made happier by doing things or watching a funny movie or whatever. Also, you tend to eat more and sleep more. You experience the same emotional things, but the symptoms are very different. Also, a lot of people, myself included, experience a heaviness to their limbs.

Yes, you read that right, I have experienced Atypical Depression. In fact, it was my most common form of depression for a long time. It is hypothesized that it is the most common type of depression experienced by bi-polars. When I was young, I rarely experienced melancholia (maybe once before I was 22), and I didn’t know that atypical depression was a thing. I simply thought I wasn’t depressed because I wasn’t having those symptoms.

These days, I generally experience only melancholia. I am not sure why I shifted, or if that shift is permanent. But that is where I am at right now. And sometimes I experience a strange mash-up of the two, where I sleep like crazy but I won’t eat, or my limbs and head will feel heavy but nothing will perk me up. This is still considered melancholia, but I’m just demonstrating how not clean cut mental illness can be.

Some people like to categorize bi-polar depression as a thing separate from other forms of depression. Like the depression I experience is unique from other forms. I don’t buy that. I think bi-polar is two problems smashed into the same brain.

A type of depression very similar to Major Depression is called Dysthymia. It is generally less intense but lasts a whole lot longer than Major Depression. Some people may experience Major Depression for up to several months at a time. Dysthymia may last up to several years (in fact, diagnosis comes with a two year minimum). Often times those years are punctuated by bouts of major depression as well.

Before I got my first diagnosis of Bipolar, I was in counseling working on the idea that I suffered from Dysthymia. My depression used to last for extremely long periods of time. I would tear through six months of depression without blinking back then. These days, my mood shifts too often for me to be depressed much longer than a month or two at a serious level.

And the last form I want to talk about is Psychotic Depression. This is not very common, but it does happen with bipolars more often than other people. Basically this is a form of depression that is accompanied by psychosis, hearing or seeing or believing things as truth when you made them up.

I have experienced psychosis once before in my life and it was the most difficult and terrifying time I have ever experienced. My psychosis wasn’t even bad enough for my doctors to worry about it, though. I would often see things in my periphery, or hear my name being called from another room. It was fun!

There are a million more things to talk about on this subject but I thought I would just make one last point.

The word ‘depressed’ is not in and of itself a whole term to describe an emotional state, or an illness. Within a single bout of depression you can feel a hundred different ways and exhibit symptoms of lots of the types described above. Depression is extremely complex thing. It involves a myriad of emotions and thoughts and urges. Depression can draw you deeper into its depths or let you swim close to the surface from day to day. Depression doesn’t always feel the same. You can be depressed, and then get more depressed, just like you can get less depressed. Depression doesn’t tend to hit you all at once. You wake up one morning and you realize you have felt bad for a week already. Depression is not that easy to pin down; its symptoms are so varied. But you know it when you have it.