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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?”
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Maybe Teracina’s coping mechanism is just to ‘keep a lid on it’. I hope a bit of deep sleep helps her.
can’t poo-poo the lid to quickly.
Love the Starwars connection, oddly enough it is playing in the background as my grown up husband is playing the lego starwars wii. So I have the swishing light saber and theme song- very timely.
To me, it is a gut feeling when I look into a friend’s eyes that I can sense depression- then I wonder if it is my paranoia or a true read and unsure what the approach should be. I always want to fix things, but sometimes, friends/people don’t want to be fixed & stew. A self care thing that works for me is music- it never fails to eventually lift my mood when I am feeling in the dumps. Love your posts, all thought provoking and helpful!
hellooooo secondtime! welcome back! (da-nu-daaaaa, da-nu-daaaa, da-nu da-de-de da, da-nu-daaaaa, dananadanaanaaa – oh wait, that’s Rocky darnit!) ok, erase that. start over. swooosh! thanks for coming and commenting and complimenting. big virtual hug.
Somehow this post has forced me to see myself in a mirror…dimly. I’m fine. I’m just tired. I’m just in a little pain. I’m just slightly stressed. Give me a little time…but no more meds. Please, no more meds!!!
I’d like to believe that my connection with the Holy Spirit, as Carl said yesterday, will keep me connected and re-connected and on my personal journey to health. I’d like to believe that’s all I need…all my daughter needs…but I also have to believe that God gave us those who can guide us through the medication (if necessary) process to health. I’m thinking that connection – with God and His helpers (angels?) – is what has helped me, recently, to understand that, even though I’ve come a long way from being curled up in a dark corner away from everyone and everything, to where I am now, I still have a way to go. All I need to do is put my hand – and my heart – out and receive the help offered. Amazing how difficult that is for me…and even more so for my daughter.
Ah you. what a girl u r. can u tell this crowd your age? i think we all might learn a little something from a womanly woman fighting for self-care, never stopping, unconcerned about clock or calendar and who doesn’t think of stopping. u r all that nancy. keep on.
I’ll be 70 in three weeks. I took my first Valium when I was 30 and my first antidepressnt when I was 39. I had a total breakdown when I was 52. And, Carl, church and prayer have been my refuge (sometimes quite literally. I hid from a stalker in the sacristy of my church several times!) since I was in early elementary school Were it not for my connection with God and the Holy Spirit I don’t think I’d be alive today. I’m glad you have that connection, too. Thanks for the comment.
so there she is folks. Nancy.
NANCY : I think your comment contains a great deal of wisdom and if you listen to yourself you will be strengthened. The Holy Spirit invites us to its embrace and healing. I just make myself available.
Thanks, Carl. You have no idea how much I value your comments. I’m happy to be on this journey with you.
It can be more apparent in what is not said…when I was depressed it was the absolute last thing I wanted to talk about. I evaded the subject, and if forced to talk it was about anything but what “I” was feeling.
oooh. this was “said” seriously so well. thank u suzi.
“…her neighbor shared some with her…” RING,RING, BOOM BZEEEEE !!! I am sure you read T the riot act. Re Star Wars. I think the series had a social impact far beyond what most sociologists and psych professionals and clergy realize. Re “The Force” I think this concept enabled many atheists and agnostics to identify with a higher power even if they refuse to call it God. “The Force” is a universal part of our common vocabulary now. It is recognized as something that gives empowerment in a spiritual and rational internalization. Just as it empowers Luke in the struggle against Evil. When I am in the grip of deep depression I know what is going on. It is an imposition of a reality that is not real and I can fight back knowing the dynamics of depression and know my perceptions are temporarily influenced by depression. Even if it is chronic. I think that gives me a fighting chance knowing that these handcuffs are just handcuffs and a combo of meds and talk therapy are the “key” to unlock the handcuffs to get rid of or at least reduce the effects of captivity or enshacklement. .
Yes God is bigger than His name.
I am so far out of touch or distrusting of my intuition that I always second guess if I think someone is depressed (clinically, rather than just emotionally). Are they just having a bad day? Are they really just tired? Does it look more like an atypical presentation of an anxiety disorder? And so on. Many times, I can’t even tell if I’m depressed, which is why I created my Daily Self-Check.
folks this Daily Self-Check is worth the energy. good self-care
By the way, “Foreign foods and smells to her, a girl who liked home” is a wonderful line. Thank you for it.
yay! thank u so much saying that! Believe it or not, those kinds of things really get me happy
negative thoughts come to mind people who are depressed allways talk loads but all negative some people are the opersite but not allways i get a good sense to people who are down i useually feel it a bit like when there has been an argument and you walk in you feel it with out saying anything
i bet u do. high EQ so to speak. blessed people, i’d say, to hv u around connecting even on this level. keep on.
Depression . . . a deep dark soul sucking hole, with no ladder rungs to climb out of it. Hopelessness, despair, exhaustion, fear, anxiety, sadness, insanity, addiction, LONELINESS, huge loneliness, isolation, rejection, abandonment. I could write more. Been there and have done that. As I write this I realize who far I have come and continue to journey. But when you are in that place, Wow. I have suffered from depression since I was a child. I turn 50 this year. I am beyond blessed to be able to say, I live today a joy filled life, with the ability to have deepest sadness and despair and grief when my father-in-law recently died, and to have absolute joy and gratitude at the same time. The capacity in our humanness to be whole is astonishing. Prayer, Faith, God, Jesus and the Holy Spirit, are for me profound places to rest. I didn’t always have God, and I am truly blessed to have not. Because I have the ability to look at both sides. With and without God. Way better with! : ) With God, if have faced and worked through my sexual abuse, drug addiction, still working on food addiction, abandonment by my father (my abuser) my violent multi-personalities mother (5 personalities) well the list goes on. I have remained married to the same man for 25 years, and have raised 3 children to the ages of 20, 17 and 12. I have survived and helped my family survive an accident 6 years ago that almost took our eldest’s child’s life. I understand insanity inside and out. Panic attacks, fears all of it. What I learned was to walk toward it, not away from it. Embrace it and bring it close, because then it sighs and goes away.
Unless I drag it back! I know in my deepest deepest part that depression is very hard to watch as I watch my 17 year old work her way through. Its her journey and I walk beside her. It makes me sad to watch her go through this and yet its her journey and I cannot walk it for her. I love her and let her know I am always there for her. Depression is very hard and we as a society need to keep those lines of communication open as best we can.
I Love God, I Love Jesus, and I LOVE The Holy Spirit. I am truly blessed.
dear col, i hear u. many of us do. u r so not alone though the disease dims our vision from seeing those with us. i celebrate your faith w u too. thank u for sharing w us. keep on.