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.

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.

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    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.

    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”.

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

    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.

    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.

    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.

    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.

    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.

    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.

    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 :)

    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.

    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.

    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. :)