7. Major Depression

Writer's note--add other symptoms and referral sources

7. Major Depression: Some Symptoms

Since I was diagnosed as bipolar several years ago, I now try to personally document the unusual or extreme experiences I am aware that I go through. When not symptomatic, my life is as regular as anyone else’s. However, I do experience drastic mood swings for no particular reason. Sometimes I am overly happy for no particular reason. Now, I am definitely depressed, for no particular reason. This is not an environmental response. It is in my biochemistry, my blood.

I force myself out of bed to feed my pets when I am able to realize they haven't been fed for a day. My German Shepherd has started getting into bed with me when she’s been all day without food. She teaches me new tricks all the time. Bipolars are eligible for disability dogs. Shadow isn’t trained, but she takes care of me as if she were.

Without my family of pets, I would have no motivation to get out of bed at all. Nothing brings me pleasure, not even the old standby by activities like painting or writing. There is no music to life. It is quiet, cold, and dark. I cannot turn the lights up in the house high enough.

I want to crawl into a hole and bring the top of the hole in with me. I have anxiety about being around other people. Because hibernation mode now rules my life, schedules, and routines have fallen to the side. I don't know or care when I last checked the mail or took a bath. Food does not sound good, nothing sounds good, and I go for long periods without eating. If nobody is going to see me, if I am not going out of the house, I have no reason to pull my looks together. I don’t care. It doesn’t matter—though it should matter to my pride. Usually, by the third day, I realize I have let my personal grooming slide, and I’ll get in the shower and change clothes. Then, it’s like I’m a new person, starting with a fresh attitude.

Nothingness and sadness overwhelm me. I can’t even hear a sad song in my head to make me cry. I’d feel better if I could cry, or it feels like it. I don't feel able to do anything. Big things and little things overwhelm me. I am irritable for no particular reason. Moods of anger or despair arise from nothing. My pets react to my moods as I talk to myself. If I notice that they are getting upset, I tone myself down if I can. If not, they can always go outside.

It is not that a person wants to feel this way. It’s not a choice. The best-meaning friends will say, "Pull yourself out of it," as if there were some switch one could turn on to brighten depression away. Depression has a biochemical basis. That’s why a person who has had depression symptoms for over two weeks should see his family physician for medication. That applies to people who are not bipolar also. Two weeks indicates a state that needs treatment because depression will not always go away on its own. It’s a chemical imbalance in your nervous system.

My depression seems to be seasonal and is called Seasonal Affective Depression, or SAD. For me, it begins in October, when Daylight Savings Time takes effect. I come out of it in the spring, as hours of daylight become longer and I'm able to spend more time outdoors.

If I start taking an antidepressant in October, I can have only mild depression. I did not have an antidepressant this winter, or a psychiatrist to treat me, so depression is controlling my non-existence. It's not a good life, and I'm anxiously awaiting spring, and my appointment with a new psychiatrist. One can’t always get in as a new patient right away, which is a damn shame in some instances. But I hang on.

When the sap rises in the trees, and the hormones rise in the kids in middle school, so will my mood. Waiting is hell. Fortunately, I have something solid for which to hope and believe—my experiences. Sometimes, people get tired of waiting to feel better--and end it all. This should never happen. Suicide is not an option. With bipolars, there is about a 20% chance that one will become a suicide statistic.

Anyone may discover that at some point in their life, they have become depressed. Depression may come on for no reason, or from some big stressful change in life. Getting married, having a family, getting divorced, moving, or changing jobs are only some of the environmental factors that may bring on the blues. However, depression is more than just a blue feeling. The chemical basis for depression relates to the amount and bioavailability of the chemicals serotonin and norepinephrine. Which comes first, the chemical or the feeling is a chicken and egg question.

Another medical option that may need to be investigated is your thyroid function. Many symptoms are similar to hypothyroidism and mimic those of depression. Your family doctor may check your thyroid function before starting antidepressant medication.

Symptoms are physical and some are emotional. The person has a total loss of interest in things that use to make them happy. Appetite is often affected. The person may become pale or sallow. Their speech may become slower, even labored, because their thought processes are running slower than usual. The person may withdraw from friends and activities, staying at home alone most of the time. If symptoms last over two weeks, medical professionals suggest you seek treatment. Antidepressants come in many forms and from many different pharmaceutical companies. A doctor can speak with you and decide which medication best suits your symptoms. Usually, you will have to take the medication ten days to two weeks before you feel a change in your attitude. It’s amazing when the fog of depression lifts.

Because the symptoms of depression are often emotional, either the person or their family and friends may not easily observe them. Often other people will point out changes they notice in a friend. You can tell if a friend has been crying by noticing red eyes and nose, and puffy eyes. When I get depressed, it seems like I get puffy bags under my eyes if I spend time crying or not. This has happened enough that I have a short-term cure for puffy eyes—hemorrhoid cream if you can stand the smell or the thought of it. Apply under concealer and make-up. Alternatively, you can apply cool tea bags to your eye orbs. Your eyes will feel better and the puffiness goes down.

Physical symptoms include:

Loss or gain of weight without dieting or trying to put on weight.

Change in sleeping habits, sleeping much more than usual or much less than normal. While depressed my "nights" run from 18-26 hours.

Trouble concentrating on normal tasks, like watching television or reading is a symptom of depression. Difficulty making decisions is also a sign to watch for. The depressed person may withdraw from a normal active life, and not want to leave the house, or even a room in the house, or even the bed.

A slower pattern of speech may become the norm for this depressed person. In addition, one may notice slower body movements, as if their life were moving in slow motion.

The depressed person may feel physically out of sorts, with vague general discomforts, like pains in the joints or back. They may experience headaches or digestive problems. They may have chest pains or dizziness. Friends may notice a sallow color in the person's demeanor, or perhaps swollen eyes (from crying), or some change in facial expressions or lack of facial expressions. The person may have a blank look on their face.

Emotional symptoms are less easy to note because they happen on the inside of the person, who may not even be aware of the changes. The person may feel like something is wrong but with no particular specific symptoms. They may let uncomfortable symptoms go by without speaking of them.

These symptoms include:

Feeling empty, void, a nothingness

Feeling overwhelmed, with no motivation for even daily activities, feeling worthless, feeling guilty, hopeless

They may say, "nobody understands" them; they may be irritable over nothing

The person may have thoughts and speak of suicide. If you have a friend who talks about their own death, or if they have made plans for their death, or speak of plans for ending their life, DO SOMETHING QUICKLY. Once a person has given away possessions, or written a suicide note, it may not be long until they act on their feelings. Do something to help.

If you, or someone you know, experiences several of these symptoms, do seek immediate medical help. Don't procrastinate, because the person may not have what it takes to see the sunrise on their misery another day. You can make a difference--the difference between life and death. If you think you are depressed, seek medical help before you get to a frantic and possibly final situation.

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