An Experimental Life

In my last essay on this topic, I discussed the futility of telling someone with a mood disorder to snap out of it. Eventually we'll get to treatments, coping, and other stuff for people with mood disorders like bipolar disorder and unipolar depression and their friends and family, but first, I want to talk about what it's like from the inside.

I've heard people say, "Well, everyone gets depressed. I get depressed and I still manage," or, especially in the case of celebrities, "What's (s)he got to be depressed about?" These are understandable reactions, but what these people don't understand is that this kind of depression isn't just about feeling down in the dumps.

Remember, as we established in the first part of this series, these states of mind aren't by choice; they are caused by chemical imbalances, in much the same way that drunkenness is cause by excessive alcohol consumption. In the case of people with mood disorders, the body produces either too much, too little, or simply the wrong mix of chemicals at the wrong time.

So here's what chemical depression is like from the inside. Yes, there are things that can be done to help, but you have to understand the problem first. And keep in mind that when I talk about feelings below, to the person with the mood disorder these aren't just feelings; they are objective, unchangeable reality, and as certain as water is wet.

Major depression

Specific symptoms vary, and I could list them here.There is the inability or severely attentuated ability to experience pleasure, constant fatigue, and so on. Instead of a clinical list, though, I want to talk about how they feel from the inside.

Try to imagine life without pleasure. I don't mean a life without luxuries or creature comforts; I mean a life in which you could have every luxury and every positive sensual experience known to humankind, but the inability to enjoy any of them. You feel detached from everyone and everything, you... Ah, this isn't working. Let me try another approach.

You may not have all of these symptoms at once, but you'll have most of them. It is even possible to have seemingly contradictory symptoms simultaneously, or to rapidly go from one set to another. And remember, these are things that you cannot talk yourself out of, although in a later essay we'll talk about ways of getting through them.

Nights are hell. Some nights you sleep fitfully, some not at all. Still other times you go for days feeling sleepy all the time, falling asleep almost any time you sit down for any extended period of time, and spend most of your free time napping. Of course, when night rolls around, no matter how long you've forced yourself to stay awake, sleep won't come.

Part of the problem is that your inner voice keeps talking to you, and all of it is negative. It reminds you of all your failures and every embarrassing situation you've ever been in; of everyone you've ever let down.

No matter how much sleep you do get (when you're able) or how much coffee you drink or how you try to clear your head, you're constantly foggy and unable to think straight. It feels almost like the grogginess of waking up from a general anaesthetic, with all the disorientation and slowness of thought that implies.

You have a wife or husband or girlfriend or boyfriend, or someone that you care about, but you are still alone. There is a living, breathing person there who cares about you, and about whom you usually care, but you know this only intellectually, the way you know that two plus two is four and the the square root of forty-nine is seven. You don't feel connected to her.

Come to think of it, you don't feel connected to yourself, either, or anything else. It's like you're insulated from yourself and your surroundings. There is a layer of cotton between you and everything else, and no matter how much you want to, you cannot get past it.

Normally you look forward to something each day. Maybe it's your morning coffee. Maybe it's seeing friends. Maybe it's just knowing you are one day closer to the weekend. Today, though, there is nothing to look forward to. You see the sunrise, and know that you should feel something--anything. But you don't.

There's no point in getting out of bed. You should get up. You're hungry, for one thing, and you need to go to work. What's the point in feeding yourself, though? All you're doing is perpetuating an endless cycle of days in which nothing good will ever happen. The idea of getting rid of your hunger seems, well, pointless. It won't make you feel any better. No matter how good it is, you won't enjoy it. Even sex isn't enjoyable anymore. Sure, you can feel all the physical sensations that you normally would, but you can't enjoy them. They are just sensations that you experience, the same as hunger or a hot shower.

The only thing you actually desire is the ability to feel. To feel something. Anything. Even feeling bad would feel... well, good.

You don't quite go back to sleep, but time goes past somehow with no awareness on your part.

The clock says you're late for work. You've been laying there for an hour and a half. May as well stay home today. They're supposed to hand out Christmas bonuses today, and yours will be pretty big, but who cares? You can always get it later.

You should call in, but... You just can't bring yourself to face the voice on the other end of the line. When the phone rings and you know it's your boss, that's even more reason to not pick up the phone. You could turn off the ringer, but that's too much effort. Let it ring. It doesn't matter. Nothing matters.

You ache all over for no reason, too, but that doesn't matter either.

Without warning, you start feeling something. The total apathy was better, though, because now you're trying to keep from crying. What are you so sad about? Nothing has happened to make you feel this way.

That's not entirely true, though. What has happened is that it has finally sunk in that you're worthless. Your job? Hell, your boss was probably calling to tell you that you're fired. You've missed a lot of days lately, after all, and even when you're there, you suck at your job, and can't face even trying to do it. Everyone knows it, too. The only reason they've kept you on for this long is pity, but that only goes so far.

You've screwed up everything you ever attempted. Even your friends must be sick of you by now. Who can blame them? You're sick of yourself, so why shouldn't everyone else be? The fact is that you're a miserable failure and always will be, and everyone knows it.

You have to go to the bathroom. Okay, you get up out of habit to take care of it. You're not so far gone that you're going to lay there in your own filth. As long as you're up, you might as well eat something, maybe have some coffee. The coffee maker is too much trouble, though. Overwhelming. There's a frozen pizza, though, and you pop it into the microwave and go lay on the couch to wait for it.

There are no clean dishes. There's been no point in cleaning anything up when everything is spiraling toward oblivion anyway. Besides, you don't have the energy, and it all seems overwhelming. May as well just leave everything where it was last used. You can eat off of paper towels and drink out of containers or the faucet.

The microwave goes off. You'll get the pizza out in a minute, you think as you stare unseeing at the ceiling. After an hour or so you remember the pizza and get up to get it. When you get to the kitchen, you can't remember what you went in there for. Maybe it was to get food or make coffee. Nope, making coffee is still too overwhelming. You look in the freezer; there should be a frozen pizza in there, but it's gone. You could have sworn it was there.

There's a pile of bills on the table. Shutoff notices, even. You'll take care of them later. Maybe. Right now it's too much to handle.

After another couple of hours looking at the ceiling you remember the leftover Chinese food in the fridge and get up to nuke it. It's about a week old, but you can see if it's still any good. When you open the microwave, there's your pizza. You remember putting it in there now, but it'll have to be heated up again now. You set the microwave and forget about the pizza again.

Next thing you know it's evening. You remember the pizza and eat it cold while you try to watch television. None of it makes any sense, but it's background noise that distracts you a little bit.

You're supposed to get together with friends tonight, but you'd have to shower, and that would take forever. Besides, the thought of being around people--even of leaving the house--is scary. You don't know why, but the idea terrifies you. It is as though you were contemplate jumping into a pit of vipers--Yes, that scary.

You need to pick up groceries, too, but that will have to wait. Your friends call, but even though on some level you want human contact, you can't pick up the phone. You just can't.

Even if you did go to the store, and even if you knew it wasn't true, you'd feel like everyone was looking at you and judging you for the horrible person you are.

Besides, it would take so long... You know from experience that when you get like this you have to look at everything and choose which item just the right one. Not just the one you need most, or your favorite; it's just that if you pick up the wrong one it will eat at you, and you'll feel compelled to go back and pick a different one. A different product, or maybe just the third one back of the same product.

Still, you'll second-guess everything. What if you were supposed to get vanilla ice cream instead of chocolate? What if you were supposed to be at a different grocery store?

No, staying home is definitely not as bad as all that indecision.

You lay back down. You've been sobbing off and on all day, and you can't understand why.

(Note that this next part only occurs in extremely bad episodes, but it can and does happen to most bipolars at some point.)

And now you're hearing things. Just little murmurs here and there, and you know they're not real but--wait. Did you leave a radio on in the other room? No. You know that nothing is making that sound or playing that song or saying those words, but that isn't much comfort. You're catching little flashes of things out of the corners of your eyes. Was that a mouse? Did a cat somehow get into the house? No, when you look right at it, it's gone. Maybe it's something... else. No, that's crazy talk. It isn't real.

But still, you go around and turn on every light in the house. If you have to enter a dark room to turn on a light, you run, and jump back out as fast as you can with your heart about to beat its way out of your chest.

All the lights are on. Funny, but during the day you had to have them all off and the blinds drawn to make you feel safe from the world. Now the blinds are drawn for the same reason, but it's the light that makes you feel safer. A little safer, anyway.

Finally, you get settled down a bit, and go lay down on the couch. You're not going to sleep in the bedroom tonight, and you're going to wear all of your clothes. You have no idea why--You just have to do it that way.

It would be nice to just lay here and fade away into oblivion. Hm... You could make that happen. On the other hand, you'd probably screw that up just like you do everything else. Too bad you hadn't thought of it earlier, when you could have fooled yourself into thinking you could do something right.

Huh. Too depressed to commit suicide. If you could laugh right now you would.

There you have it. This is what a major depressive episode feels like, and it can get worse. In the next couple of installments we'll cover mania, hypomania, and mixed mood (sometimes called agitated depression).