What ’10 Signs of Depression in Men’ Won’t Tell You

In this video, I discuss the most common signs and symptoms of depression, offering advice for how to make sense of all the information available online, with suggestions about the different treatment options.

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If you’ve been searching the Internet for information about how to recognize depression, either in yourself or in someone close to you, this post will introduce you to the 10 most common signs of depression that appear on many mental health websites, with little variation; I’ll also discuss how to understand and make use of them.  These signs of depression derive from the Diagnostic and Statistical Manual IV issued by the American Psychological Association; the DSM-IV is the official manual of the mental health profession and is used by psychiatrists, psychologists, social workers, etc. who must provide a diagnosis to insurance companies before the insurer will  issue reimbursement.  Here are the 10 most commonly recognized signs of depression: Continue “What ’10 Signs of Depression in Men’ Won’t Tell You”

The Rebelliousness of My Inner “Brat”

You’ve heard mention of that “inner child,” the needy, vulnerable part of you that you neglect or criticize.  We therapists often talk about “the baby part of you” or “the child side of you” as a way to address dependency issues.  You know you’ve got a kid inside of you, right?

A lot of the time, mine’s a brat.  He’s very impatient, impulsive and demanding, and when he doesn’t get his way, he gets angry.  He sometimes throws a fit in there, which can be very unpleasant, usually for me alone though sometimes he can be unpleasant to unfortunate bystanders.  [Think Veruca Salt in Willy Wonka and the Chocolate Factory:  “I want an Oompah-Loompah, Daddy.  I want an Oompah-Loompah now!”]  Managing my inner brat can be a major challenge.

Humor aside, I believe this to be a serious issue for many people, and the hardest part in therapy is getting them to realize that the reason they’re struggling is because an immature part of them — a child who can’t tolerate frustration very well and has unreasonable expectations — is having a tantrum.  Sometimes the child gets his or her way and the adult side gives in.  This can lead to impulsive, ill-considered choices followed by shame and regret.

Continue “The Rebelliousness of My Inner “Brat””

Hopeless Problems, Perfect Answers in Bipolar Disorder

It’s difficult to discuss depression because that word describes a whole spectrum of experiences.  People often say, “I’m so depressed,” when they mean they’re disappointed, frustrated or sad.  I got a ‘C’ on my midterm – I’m so depressed. Then there’s the kind of depression that occurs with loss, what we might think of as part of the grieving process.    Further along the spectrum and we have the clinical disorder with true signs of depression.  While these various experiences have some features in common, they are very different psychological states of mind.

Many of my clients over the years have suffered from personality disorders, often with severe depressive features.   At some unconscious level, they all felt as if they were so damaged that their psychic life was a catastrophe, a kind of post-apocalyptic wasteland, and there was no hope that anything could be done about it.  When I was able to understand this and could articulate it to them, it brought a kind of relief:   until then, that feeling of being damaged-beyond-repair was so agonizing as to be intolerable, impossible to acknowledge; the fact that we could think about it together made it seem a little less hopeless, at least for a moment.

Often when the hopelessness became unbearable, they’d take flight from it.  One day, a client might come in so depressed he or she was practically mute; the next, giddy, talkative and full of optimism.  They often made no mention of the prior depression, as if it were a thing of the past.  A sudden industriousness had come over them and they began to tackle each and every item on their to-do list.  They were going to do everything, change everything, conquer the world.  When they were in this state of mind, I often had the feeling that they were keeping me at an emotional distance; if I said anything that called this new enthusiasm into question or tried to remind them of their recent depression, they could easily turn against me and the treatment, as if now I were the problem.