It’s no secret that I value my diagnosis as a tool for self-awareness and seeking appropriate care. It’s no secret that I defend my right to love myself enough to try to appreciate what I can accomplish and structure my life in a way that helps keep me from pushing things so far that I decompensate. It’s no secret that my ability to diagnose my immediate symptoms and seek care has saved my life many times.
What is the dark side to all of this? Because there is one. Even if it doesn’t come close to competing with the light, the shadow side needs to be acknowledged.
Last week, I met with my psychiatrist again; a follow-up to my meds change of three weeks ago. As we discussed my condition in fairly clinical terms, as we tend to do, he told me he’s getting quite concerned about my level of depression. I debated this, saying that my biggest problem was hypomania lately, and he said he was observing an underlying tone of fatalism and negativity in my speech. He pointed out to me that hypomania and depression are quite capable of coexisting, something I knew but hadn’t really been applying to myself.
I’ve been thinking about what he said, and sort of monitoring my thoughts, and I’ve come to the conclusion that he’s right. It’s not the obvious, gray-curtain pulled over the world kind of depression I am used to spotting, but it’s there. When discussing my real-world problems, my emotional tone is solemn at best; I try very hard not to be dramatic but something is coming through; a feeling of hopelessness or resignation.
This needs attention, but some questions need attention too. Questions I have to ask myself periodically, no matter how much I would rather not.
Am I allowing my diagnosis to influence my thoughts in such a way as to contribute to my depression, my anxiety, or my general outlook?
Am I ever skating close to a self-fulfilling prophecy?
When it’s clear that my symptoms are, truly, elevated to a point of clinical concern–do I dwell on it to to point of self-absorption, or use it as an excuse to act more dysfunctional than I truly am?
Asking these questions is so hard, because it pushes a lot of the “stigma” buttons and the defensiveness that tends to arise after years of the world telling me that I will be fine if I think more positively, or work harder in therapy, or do a better job seeking God, or whatever.
But the questions need to be asked, because it can happen. Many studies show a placebo effect in about one-third of subjects: give them a sugar pill and they’ll feel a decrease in their symptoms. So it stands to reason that the “obecalp effect,” so to speak, is also a real thing. Tell someone they’ve entered a state characterized by certain negative feelings, and the brain and spirit could be affected by expecting them.
Even though the ability to know I’m having an episode is vital for me, I need to think about my attitude. Am I broadcasting some internal signal, some internal call to prayer, that focuses me on the expected feelings and makes me less open to contrasting input? Less open to that spontaneous laugh, that interlude with a glimpsed cloud, that sense of humor about myself? Less open to hope and to my spiritual side?
There’s no simple answer. (If I ever write what I claim is a simple answer to a question on this site, you’ll know something is really wrong with me.) I’m not bringing myself up before some internal jury who will pronounce me guilty or innocent. I’m just asking the questions.
I have some difficult things going on in my life, and it seems as if the improvements I work for get knocked down all of the time. I ask these questions out of love for myself, because I can’t afford to be feeding my demons, nor can I afford the price of hopelessness.
My old posts are sometimes useful postcards for me, so today I went back and looked at The Night’s Watch for passages like this:
“We will not “abandon our post” because we get bored, or discouraged, or think it isn’t fair that we have to be there. How we got here, or how little we deserved it, makes no difference. We will not run away; we will not drug or drink or eat ourselves into unconsciousness. We will not craft an escape with a sharp edge, or neglect ourselves and hope the cold night will do it for us.“