Insidious & pervasive, depression voids vibrant personalities of motivation, interest & pleasure until it becomes them. The high to depression's low, mania is characterized by elevated, expansive or agitated states as impulsive as they are dangerous. The cycling of moods that swing between the two is bipolar disorder.
Often showing up as absence and loss, depression is the "nothing" in "nothing's wrong." You may feel down or low for no apparent reason. You may feel tired or unmotivated, seeing life as a series of futile struggles that make it tempting to want to give up hope and find it challenging to do the things that you know might help.
Reaching out to friends or colleagues may be difficult. Perhaps you don’t want to be seen this way or you feel you don't have anything to offer or you are convinced that you are broken beyond repair. Unfortunately, these thought processes only intensify the isolation and loneliness that has likely taken over your world.
You may notice yourself taking a lack of interest or pleasure in things that you would ordinarily find engaging and enjoyable. You may indulge in negative self talk, calling yourself useless or lazy or ungrateful as you grieve the person you once were.
You may feel constantly fatigued. Some days it may be hard to get out of bed. You may find yourself overeating or unable to eat much at all. Like changes to your diet, you may experience changes in the way you sleep. You may find yourself sleeping all the time, regularly waking from nightmares or struggling to fall asleep even when you are otherwise exhausted.
Trouble eating and sleeping exacerbate mood swings, creating heightened emotional reactivity that strains relationships and makes everyday encounters with the world unpredictable. You might blame yourself for not being “normal.” All of these symptoms are incredibly common to varying degrees for people living with depression.
Chronic depressive states have a way of settling into the contours of your life in a way that takes over, making it hard to separate yourself from the depression or imagine life in any other way. Perhaps one day you overhear yourself telling someone "I am depressed" and realize you have come to identify with your condition. As debilitating as it may be, it's become familiar, perhaps comfortable, and even harder to let go.
When all your usual strategies are no longer working or you cannot access them to begin with, it's time to reach out for help.
In individuals with cyclical mood disorders such as bipolar disorder or cyclothymia, a depressive episode may last for several weeks and then, almost out of nowhere, emerges a feeling of uncontainable, manic energy that builds until it urgently needs to be released, creating an elevated or irritable mood, hyperactivity, hypervigilance, hypersexuality, racing thoughts, pressured or rapid speech, exaggerated perceptions of self, grandiosity, impulsivity, risky behaviors and violence.
In contrast to an extended period of depression, mania may seem like a preferable alternative. Many people living with bipolar disorder choose not to seek treatment for this reason - manic episodes are the times they feel most powerful, productive, energized, and filled with a sense of limitless possibility.
Individuals with "artistic temperaments" sometimes believe that their manic states put them in touch with their muse, allowing them to access the inspiration, creative flow states and talents they consider to be the gifts that make them unique and valuable - gifts they may secretly fear don't belong to them otherwise. From that perspective, it's easy to see why someone would resist diagnosis and treatment.
The truth is that both depressive states and manic episodes can be equally destructive, ruining careers, relationships and putting those who are suffering at risk of addiction out of a need to self-medicate for a low that feels too deep to crawl out of or a high from which they can't come down.
The idea is to step off the rollercoaster long enough to see that those talents belong to you, not the muse. Perhaps then you will see that you don't need to get perilously high in order to avoid the dark abyss. By creating balance in your life, you can integrate productivity and rest in equal measure, bringing a light into the dark instead of staring directly into the sun.
Often what creates change in psychotherapy is a loving, supportive relationship where you can feel safe to explore those areas that you have repressed for fear of being judged or misunderstood. Allow me to hold your suffering with compassion and help you heal from your pain.
As your therapist, I will help you understand where your moods originate, identify your triggers and find patterns in your cycle so you can begin to anticipate times where you need more support. Over time, I will help you process repressed or latent emotions, create coping skills, rebuild your sense of self, and learn where to make changes in order to restore balance to your life.
In the context of a supportive therapeutic relationship, you will begin to see yourself differently and, after some time, may begin to notice that you are different - the haze has lifted, you are finding ease in the things that once felt so hard, taking enjoyment in simple pleasures, re-connecting and repairing relationships with your loved ones - even flourishing. I am here to help you see that all of this is possible. You don’t have to suffer endlessly and you don’t have to find your way through the dark alone.
Fill out the form below to schedule a call or text me at 415-857-5560 to set up a time to meet. I see clients for therapy in person at my office in Tiburon and online anywhere in California.
Marriage and Family Therapist License #114969
1805 Mar West Street, Tiburon, California 94920, United States
Portrait by Danny Dong
Artwork by Kahn & Selesnick
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