The desire for relief from anxiety and depression is so great that there are now lots of forms of therapy for it. Retail therapy costs more. But what do you do if retail therapy is more symptom than treatment?
I promise you I won’t say the taboo word until the very end of this blog post, like the verb coming at the end of a two-volume German novel.
The language of depression is mysterious, some would say vague. What’s becoming increasingly clear is that it also has dialects.
When it speaks to its owners, it mostly grunts. Words of one syllable stuff. “Oh no.” “Not again.” “Why bother?” “Must I live?” Untreated, depression knows who’s boss. The owners’ sole hope is that that somehow, unimaginably, they’ll make it until the next time sleep takes them.
Looking in from the outside, the language about depression, always cooler and using longer words, has become ever more inflected. There is now a vigorous taxonomy of depression—clinical depression, chemical depression, psychotic depression, post-partum depression, situational depression, bipolar disorder, even healthy depression. It’s hard to keep up, perhaps especially if depression’s your thing.
When will they—as they already do with travel books—stop issuing the DSM-5+ between hard covers and publish it solely in the more malleable—if, like Wikipedia, worryingly hackable—digital domain?
Something that came across my browser this week got my attention. As you’ve become accustomed to on this blog, there’s a backstory, or two.
Scott Berry PhD | Counsellor and Life Coach
When you 'bottom-out' in the cycle of depression there's very little you can do but reach out for medical help. But once you get it, and you begin to emerge from that horrible place, that's when you can actively work to improve your life and create resilience strategies that help should you start 'falling' again.Learn More
The days of manic depression
I have a friend who worked his way through college and grad school doing hospital jobs. At Berkeley for his master’s the hospital was a semi-private hospital with three psych wards. He did his time on the locked one. Like the rest of the people on the staff, he was often surprised that he was one of the people with the keys.
It was not his first exposure to what was then called manic-depressive disorder, but it was the first time someone else had a vocabulary for it. Being Berkeley, they had what you could call a high class of “manics” (including celebrities with prizes you would recognize). Wouldn’t you know, they all gravitated to him. Some of them, the women in particular, refused to deal with anyone else on the staff even though he was, in terms of professional bona fides, the least qualified to work with them.
If you’ve ever been around someone in a full-blow manic episode, you’ll understand why no one else on the staff minded that he was the chosen one. Just to give it a time frame, Nixon was President, in itself not a national mental-health booster.
“His” ladies all arrived with police “escort.” The one who gave him what was truly the best education he got at Berkeley (though the job had long ago fallen off the bottom of his resume simply by attrition) was a well-known writer. She had, that day, bought three expensive pieces of real estate in Marin County, which at the time had the highest per-capita wealth in the U.S.
She was in the most floridly psychotic manic state he had seen up to that time. She was also as (screamingly) brilliant and unsparing with her language as, hours earlier, she had been with her credit card. She was work, but in a few weeks, she left the ward with her dignity and his awe both intact, and he hasn't seen her since.
Among the things he thought she had taught him was what a “manic-depressive” was. He'd found it hard keeping up with her. Envy more than identification, really.
Fast forward a number of decades and the woman in his story died. Her death made the papers in obituaries of unqualified admiration. But it moved her closer to the front of his mind.
Bipolar 1 or bipolar 2?
I heard this entire story this morning while having breakfast at Dean & Deluca - our favorite spot for catching up in Bangkok.
He then told me another story (and you can tell he's a story teller, right?). He told me about another friend of his. From the beginning he and his friend have been comrades in arms in dealing with depression, helping each other get through it but also making sure that both were doing things they needed to be doing to get it dealt with. People who know depression will understand.
His friend recently wrote and he said he'd been experiencing a “drop-out” in the effectiveness of a medication regime that had worked for him for years (in psych language we call this "breakthrough depression" because the mood problem breaks through the protection the treatment is meant to provide). They shared a chuckle about the Trump Effect, but his friend also had news.
His doctor had sent him to a colleague for a consultation, there was testing, and the friend’s diagnosis was “updated” to bipolar 2. The friend has responded to the diagnosis with audible relief, “It explains everything.”
Coolly, calmly, collectedly, my friend ransacked Google. His own knowledge had not been updated beyond the change in terminology from “manic-depressive” to “bipolar.” Bipolar 2 sounded to him both like another of those head-scratching DSM-5 revisions, yet somehow less scary.
That’s a bigger statement than it may sound. When, two decades ago, he began what became seven years of talk-therapy for what had first manifested as “fight-or-flight” clinical depression, his therapist raised the idea that perhaps, maybe, he should consider some drugs used to treat bipolar disorder, just to see if they might help. Even he himself was startled at the velocity and vehemence of the “No!” that came out of his mouth.
He didn’t, at any point, “try” those drugs and he responded well to a standard SSRI and was even able to get off it, for years.
But this morning, he told me he has an appointment with a psych specialist next week. This time he says he's sure he’ll be more level-headed. He joked that he may even let her do the diagnosing, if she’s very very nice and, ideally, soft-spoken.
Scott Berry PhD | Life Coach & Counsellor
Coaching for self-mastery is a coaching program that makes real change in your life. The program raises awareness of your natural gifts & strengths and focuses you on the areas of yourself you find hardest-to-hold. It helps to gain more self-control and create more happiness in your life.Learn More
Bipolar 2 sounds like “bipolar lite.” It’s not, but it’s not bipolar 1, either, hence the change in numbers.
My friend has been ploughing through the gobs of information on the Internet about bipolar 2. And a lot of it has spoken to him, and some aspects of his denial—for example, that he'd never bought three expensive pieces of real estate in Marin County on a single Sunday—started, if not to completely go away, at least to begin to give way.
But there are two important “lessons” about living with depression that it's important never to forget, and they are: 1) Don’t self-diagnose (and definitely don’t self-medicate), and 2) You don’t have to be a slave to your symptoms.
So there he was, minding his own business on his Twitter timeline
… when along comes this link from bipolaruk.org to one of their posts, “M**** and mental health—a relative’s experience.” It’s short and easily digestible—if, that is, you have the stomach for that sort of thing.
The relative was the mother of a woman with bipolar disorder, one of whose symptoms was out-of-control spending. At its worst, it did not include buying three pieces of real estate on a Sunday in Marin County, but an inexplicable number of parcels were arriving at the house, and her daughter was regularly in financial straits that only increased her anxiety and depression. A lot of the buying was online and, if not exactly in secret, under the cover of late night.
My friend heard bells.
What became obvious about the daughter—once noticed and acknowledged, that is—was that the role the compulsive spending was playing in her disorder was part of her engaging in risk-taking behavior. It turns out risk-taking behavior does not have to go as far as looking for company in alleys that smell of urine where the denizens wear hoodies. Plus, the only no-m****-back guarantee about compulsive spending is that it will enhance your anxiety and depression.
My friend realized that spending and depression
…is a thing for him. And a behavior in which he engages in less when he takes measures not to. He has not spent a single second watching a TV shopping channel because he's smarter than that. Instead he has a close personal relationship with a company owned by the man just named the world’s richest. It’s amazing how many things the Amazon man sells that are sure to enrich your life and make it better, particularly after 10 pm.
So, because he doesn't have to be the victim of what really might be symptoms—but that do require action on his part—he has large-size post-its on his computer screen, in places he can’t overlook them, or quite ever get used to them.
One says, “No same-day online purchases!”
Another says, “[You know who] owes you, and he’s not going to pay up.”
A third reminds him, “When the sun goes down, your life is perfect just the way it is.”
This morning he told me he's considering one that says “There are no Joneses to keep up with.”
What I realized as we drank our morning coffee today is that, when depression and spending are linked, denial about symptoms and what may underlie them is literally costly. And paying attention instead is actually fun—eventually, anyway.
After breakfast, as I walked home, I found myself sending up a message to the sky - take care of my friend please (as if the sky has anything to do with it - but you know what I mean).
Stay tuned for more and let's see what the nice doctor says.
https://www.ncbi.nlm.nih.gov/pubmed/9164428 (Research study; here’s from its “Background section”: “Compulsive buying is defined by the presence of repetitive impulsive and excessive buying leading to personal and familial distress. Patients with this disorder also suffer from mood disorder in 50% to 100% of the cases studied, and antidepressants help to decrease the frequency and the severity of uncontrolled buying.”