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Self-Care Tip #200 – Use your emotions to sense the emotions around you or in your own self to detect depression.

Teracina came in initially for some sleeping pills.  She didn’t come to tell me about her personal life.  She just wanted the pills.  It’s understandable.  What a pain really to unveil on cue, like planned sex it was too impersonal to get personal.  She was in the category of people who weren’t pining for diagnosis, for a hearing ear or connection.  She wasn’t even actively thinking about those things.  Pushing them at her turned her stomach.  Foreign foods and smells to her, a girl who liked home.

Hearing what she is coming in for is the first part of anyone’s exam.

So what brought you in today?

What can I do by you?

What are your druthers?

In Teracina’s case, I got an answer of what she perceived she needed.  It’s my job to see if I can get more than that first answer, the patient’s chief complaint.  So we negotiated as we chatted.  Pills for history.  Only enough pills to get her in to her next appointment in a week when we can talk further.  She’ll come back ready to let me take a history or she won’t.

We talked a little more while I was writing out her secure-prescription for what she came in expecting to get, Zolpidem.  It turns out that her neighbor shared some with her a few weeks ago and it “worked.”

I was watching her too, while I wrote, while we talked.  She didn’t have much expression on her face and her voice lacked inflection.  She gave off this aura that the ground was about to open up and suck us both under.

This is a short-cut I learned early in my psychiatry residency training.  I also had extra credit because I was already hard-wired to listen to my internal emotional milieu.  I call myself the “Emotion’s Jedi.”  (Go ahead and laugh.  With these powers, I see right through you.)  When we are with someone and feel like the ground is going to open up and swallow us, we have a ladder-chute to diagnosis –> depression.

Depression is sneaky; an ebb out of our unsuspecting selves it takes bits of our personality away.  More often, many of us don’t know that we have been changed.  We are doing well enough at work, or school or the daily chores of a care-giver’s work-load.

I’m fine.  Nothing’s changed.

Colloquially we call this, “functional depression.”  Doing well on paper but inside fading, body changing, sleep changing, interest and motivation – changing.

No.  I never have thoughts of wanting to die.  I’m fine.

(Insert famous swooshing sound of my lightsaber.  You can add music too if you like.)

But who cares if Teracina doesn’t come back next week to see me?  I’m not fighting her.  No I’m not.  And that’s why I care.

None of us are fighting each other.  We are fighting these diseases, here to be tools to be used by each other and by ourselves for each others sake.  Flip it back again.  For our own sakes.  We fight that dark melancholy and are not worth much more than our posture if we don’t.

Question:  What has helped you to detect depression in those functioning around you?  Or yourself, when “everything was fine?”

Related Articles

• Staying With Your Depression Treatment Plan (webmd.com)