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.

You probably recognize the dynamic – a kind of high-low functioning that characterizes manic-depressive illness or bipolar disorder.  Either everything is hopelessly damaged, beyond redemption, or life is wonderful!  In mania, it’s as if a kind of magic has occurred:  the depression has abruptly and permanently vanished.

I believe a similar dynamic occurs in many people who would never receive a diagnosis of bipolar disorder or major depression, people who are occasionally depressed like many of us.  The change isn’t as dramatic and extreme, but often when the depression begins to lift, a kind of “magic” has occurred.  Serial romantics demonstrate this the most clearly.  You probably know someone like this, the one who’s always falling in an out of love, on top of the world when in the throes of a new romance, in the depths of despair when the affair ends.  These people aren’t interested in having an authentic relationship, not with themselves or another person, but instead are using the romance drug as a magical cure for hopeless depression.

There are other kinds of “magic”.  A different job or career.  Move to a new city!  My next vacation!  The variety of magical solutions is endless, but the problem they are meant to solve is always the same:  a feeling of hopelessness, the conviction that one’s internal world is in such bad shape that nothing can or ever will make it feel better.

Finding Your Own Way:

If your depression is severe, you may need to consult a professional.  If your intermittent depressions are simply part of a familiar internal landscape, some of what I’ve written above may hold meaning for you.   Do you ever feel hopeless?  What are your familiar magical solutions?

“Retail therapy” has become a familiar joke, a witty description that makes light of the dynamic.  Many people turn to shopping as a way to cure a mood or state of mind which they feel can’t be met head-on, can’t be made better in any realistic way.  Indiscriminate sex can be used for the same purpose.  Gambling, alcohol, drugs – all the addictions may function in just this way, as a magical antidote to a problem felt to be hopeless.

What’s your drug of choice?  Next time you feel the “craving”, see if you can resist and get closer to the feeling you want to escape.  Is it unbearable?  Does it feel hopeless?

One of my favorite theorists once said that many people in therapy refuse to suffer their experience – in the old sense of the word, to “submit” to it – and want to be free of it instead.   As I’ve said before, you can’t get rid of any part of your psyche; all you can do is try to develop other internal resources to cope with it.  Try to stay with your experience, face it head-on and gain some small bit of understanding.  If you can bear with it long enough, you may find your way to some imperfect, small but truly helpful way to make yourself feel a little better.

I’ll have more to say about the roots of that internal catastrophe in another post.

By Joseph Burgo

Joe is the author and the owner of AfterPsychotherapy.com, one of the leading online mental health resources on the internet. Be sure to connect with him on Google+ and Linkedin.

35 comments

  1. Great post Joseph. I agree with you that the term depression is used far too readily to describe a number of feelings and issues. Sometimes when we accept what’s going on for us and sit with it we can grow so much more than attempting to push the feelings away.

  2. Having been surrounded by clinical depression and bipolar disorder in family members all of my life, and having worked as a residential counselor in various group homes, I do notice that in the “outside” world the self-diagnosis of depression is tossed around as frequently and as insincerely as “love ya”. It’s an easy crutch to fall back on … “yeah, I was depressed at the time” or some such. Working through the moment will greatly help to alleviate your fall-back positon of indulging in your drug of choice, be it alcohol, narcotics, shopping, sex, gambling, etc. The problem is the working through it part, as our society has been so transfomed into one of the “quick fix”.

    1. The “quick fix” is a huge problem. Take a pill, buy this car, try this get-rich-quick scheme. It’s everywhere.

    1. You’re welcome, David. Sorry for not replying to your comment earlier. It’s very nice to feel people are reading and appreciating the posts.

  3. I’m one who had felt hopelessly damaged since I was a child, but never knew why until the memories came. Now I use different coping skills to function. Some of the time life is OK & my grandchildren fill me with joy. Other times my addictions were a way I would escape from it all. I think your right on with coming to terms of acceptance with our emotions. That feeling them is how you can release some of the tough times. I also appreciate the affirmation you give about there are other parts to a person which can develop and experience life in a different way, henceforth your not hopeless.
    Thank you for being here & reaching out to others. This post was like a mini refresher course for me. Love & Light to everyone.

  4. I have had some form of depression all my life. Right now in this phase of my life I have lost a thriving real estate business, a husband who did not take car of his responsibility with the IRS, and I am ill. I have degeneration of the spine and neck and am on welfare, medicare, housing, food stamps and all. I have been agoraphobic and am on the verge. I do not want to go anywhere. Mostly, because of pain. I have had 2 back surgeries and am getting an MRI on my neck tomorrow. I found an attorney to help me with legal issues pro bono. I do not know how far she can go as I have to wait for a meeting that will bring up my case on Monday. I am assuming they can only take so many. I have no not heard from my husband since he left three years ago with no advance warning. So I suffer mostly alone. I would like to hear from all of you maybe twice a week. I also have Fibromyalgia and that keeps me aching almost every day. I meditate every night to try and sleep. This man that left me I was in love with him and married 7 years. I never thought he would leave. He lost his 2 jobs and could not pay bills and I was waiting for SSDisability that came throu last year after he was gone. For better or worse what a laugh.

    1. Marie, it sounds as if you have a lot of very legitimate reasons to be angry, and I can hear it in your posts. I’d just be careful not to let anger take in the direction of self-pity, which is another subject altogether. Hang in there.

  5. Marie –

    I am sorry to hear of your trials. I, too, went through a period of 4 years with more than I could handle in, it seems, in a lifetime. I would suggest trying to contact someone who knows EFT (Emotional Freedom Technique its emofree.com online); this can at least help with the severity of the emotions you are feeling. I would also suggest the help of a trusted naturopath who can guide you to greater health naturally. It has saved my life.

  6. I have suffered with Bi-polar borderline personality disorders. I started a class called DBT and was in phase 1 six moonths and phase 2 I think 9 mos to a year. I am very thankful to Marcia Linnahan(sp) for her dedication and her sharing of information to help people like me with the border-line personality disorder. I first learned about my behaviors, then took the DBT classes and therapy, where I learned the skills and heard how others dealt with their behaviors using the skills. I figured out why I have the behavior then worked on it. Some went away others lessened. I have found that my illness is manageable and I have a descent life now. My medications are less because I chose to try to deal with my feelings and such rather than run away and cover it up with heavy medications.

  7. Joseph, how do you know for sure that you have bipolar disorder? It seems so easily and quickly diagnosed. I have been diagnosed in the past. Does it go away without medication? Can you understand it and deal with it alone? When diagnosed, I was thrown 5 different medications that I took home and never started. Although I didn’t listen to that person because of the 15 minute diagnosis, I do know that I have been dealing with the “ups and downs” all of my life. And yet feel that I have mastered the silence of it all, but know it highly holds my potential in many areas. What medication do you find to be the safest and have the best results? It seems they all come out later to have problems. Thank you for reading 🙂

    1. If you’re able to manage without medication, despite the fact that you have to deal with certain limitations, I think that’s your best option. The benefits of medication are highly over-sold in our society, mostly pedaled by big pharmaceutical companies who stand to make a lot of money from people on lifetime maintenance regimes. I’m glad to hear you have “mastered the silence of it all”; maybe you need to find a therapist willing to explore the emotional meaning of your difficulties (somebody with a psychodynamic perspective), rather than an m.d. who wants to write you a prescription.

        1. I guess that’s why you never see a pharmaceutical add for Lithium. No money to be made, even if the docs are still prescribing it.

  8. Thank you very much for your reponse. It is very kind of you to offer your perspective and your time on comments posted to you. I take your response with me on this decision that has weighed on my shoulders for so long. Thank you. 🙂

  9. I enjoyed this excellent article. In our society, it is all too tempting to go for the quick fix (the shopping, drugs, etc.) instead of going for deep healing of problems. It seems that one of modern human’s most basic needs, that overshadows almost everything else, is to be constantly entertained. People spend their last dollar gambling, shopping or getting high to be momentarily entertained. And the more entertainment that is at our disposal, the further away we seem to become from experiencing genuine pleasure.

  10. What a refreshing change to read your views on medication, when today a pill is prescribed for every tiny twitch in your body. I too am into counseling and feel awful for those who suffer from mental illness. I would like to recommend Yoga–the authentic type–for overcoming these disorders. It is of great help. I have been able to halve my B.P and thyroid medicine because of Yoga only. It has also granted me greater patience, understanding and better memory.

  11. This is so true – you have described depression – or certainly what I have experienced so accurately. I have now had three ‘melt downs’ and it is only since the last one which I am now thankfully coming out of, that I have honestly looked back over my life to review my highs and lows with depression. Four months of weekly counselling has provided a suggested diagnosis of Cyclothymia – the little sister of Bipolar, and I can also and in addition to, recognise the regularity of a plummetting mood over the winter months with a marked improvement as Spring starts – so for me it is like coming out of hibernation. I will not be surprised if I am also a SAD sufferer – all of which has been going on for around 20 years. Add to that Bereavements that were never properly dealt with and Post Natal Depression which was only diagnosed five years after the first birth – and you get a picture of a graph with at least 4 lines for the different ‘styles’ of depression which have and do affect me. In the midst of my latest ‘melt down’ which occured following about a year of a gradual decline of which I was in denial about, I decided I could go on no more battling with it, and so went to my GP and demanded that it was taken seriously and that I receive a formal diagnosis. From that I had a Psych assessment with a social worker with the Mental Health Team, and having had them confirm I have been suffering with long term Severe Depression, I am now seeing the Psychiatrist for the formal diagnosis. My counselling is continuing and I aim to avoid any medication other than natural remedies. I have learnt a lot about my mental health over the last 6 months, and it is recognising that the problem exists and also the two extremes which I believe is the key to battling and possibly even befriending Depression. Once befriended, it is easier to find a balance. I am currently on ‘the up’ – coming out the other side – but I consciously keep myself in check, to ensure that I don’t ‘get too high’ so as not to be irrational whilst in this happy uplifted state.
    I believe that Mental Health issues and Depression is a journey of discovery, which is a lot easier to walk and battle if it is done in a state of acceptance rather than denying the problem exists and fighting the diagnosis. I also think it is important to ‘come out’ with regards to mental health, simply because it ‘explains a lot’ about behavour which without acknowledgement, explanation and discussion – friend and family may not have understood. I don’t know if you would agree with this, but it is the conclusion I have formed from my own experience and having observed others. Regards and Bright blessings to you for your Blog.

    1. Yes, I would agree with you. There’s too much hidden shame about feeling depressed or struggling with pain; it’s hard enough to bear without feeling it must be hidden. I also support your efforts to avoid medication. Later this week, I’m going to begin writing about the research on psychotropic medications and how they do much more harm than good.

  12. Psychiatrist Tom Fogarty defined depression as the existence of hope: Success is getting what you want. Happiness is wanting what you have.

  13. Again, i must say, your writing is fascinating me. it really seems to make a lot of sense and ‘ring true’.

    …you must be so full of shame to put so much time and effort into being so damn good! haha kidding. i will now cease from future comments because i desperately dont want to keep you from doing such good work and from replying to more meaningful comments.

  14. Joseph,
    I love your blogs! Your insight and way with words make me look forward to your daily articles . ( I feel like I’m back in graduate school with the best professor in town)
    Love your stuff on personality disorders especially. Your clarity on the subject is very educational.
    I am a director of a counseling center and I’m using your blog to train my staff.
    Thankyou again .
    Ellen

  15. “These people aren’t interested in having an authentic relationship, not with themselves or another person, but instead are using the romance drug as a magical cure for hopeless depression”. That is so true, wish I could have read this then, it was so hurtful when this person came into my life with such force and with such passion only to switch into this emply and cold person with no hope for anything. Pushing me farther away leaving me in shambles, with the simple answer “sorry”. Then anger and resentment when I tried to help. Currently Im the enemy. Its something Im trying to understand, and Im sure living it must be a battle, but it hurts when you fall victim to being a temporary fix.

    1. It sure does hurt. It’s hard not to fall prey to such people because they make us feel so good. I suppose a healthy skepticism at the beginning of a relationship helps. Like, “How can you feel so strongly about me and think I’m so incredibly wonderful when you barely know me?”

  16. I too have had a major depression which then ‘turned’ into a mad craving especially for human contact and sex! i put myself in predicaments because of this and my colleagues even labelled me cyclothymic

  17. Hi, I’m kinda like that. I realise that the internet is hardly the place to ask for a diagnosis and cure but do you have any advice?
    There were times during my optimistic periods that I kept pushing at something that I knew deep down wasn’t going to help, because I was terrified of the bubble bursting – though of course it always did.
    I seem to have come to terms with it at the moment; I’m not manic, but I avoid people and work (which is hardly a success) because there’s a general heaviness I feel every day. Not as bad as when it was a “low” mood, but bad anyway. It’s stable but it’s a rut, and I’m not sure what I can do other than counselling and researching things to think through.

  18. I’ve been in exile for 21 years now. Away from my home in a foreign land where I have no one. My youth went past through abuse by caregivers who I trusted my life with. Whatever I found here I lost in a moments due to an impulse decisions to make my life better. I walk the streets by day and get home by night. I have no money and I owe debts. Make no mistake I am the best in what I do. But for the last year I’ve hidden away in a tin shed without food most times trying to reason with the demons of my past. The adolscent child who cries out in rage and still wants to go home. He destroys whatever I try to build. He keeps me wandering. Never letting me get out of this suffering. Forcing me to corners where I should just end it all.
    There are no specialists here. There is no hope here, no salvation. It’s a wasteland where those who have others survive and those who don’t break day by day. Not one intelligent soul that can understand me. I am alive somehow. That’s all I know. Still waiting to go back home.
    Today I found this site. My Old PC is the only asset I have left. It has guided me to this place. I guess I have left to see the end of my journey yet. That old rafter is going to have to wait. I’ll keep coming back. It is here after so long I have found Hope.

  19. What if I don’t want to feel just a little bit better? What if I want to be NORMAL altogether, healthy happy..?! I’m depressed, have obsessive-compulsive disorder and deep problems with emotion regulation. I should just accept that I’m disabled to work or study? I’m 27 now and have always suffered from anxiety, even when I was a child, and depression hit in teenage years.

    You write a great blog but I find myself very irritated every time you highlight that healing processes are imperfect and slow, that our problems in our psychic life never leave us but can be made a bit easier to life with – I don’t want that. I want to be healthy. I feel angry and hopeless in the face of this sort of pessimism! I hate life! And yet I believe it might be just reality instead… What’s the point of living then?

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