Control, or Lack Thereof : 30 Days of Truth

Day 12 : Something you never get compliments on.

One of my more recent posts eluded to a crisis in my life.  I haven’t revealed it yet, because in all truth, I am rather ashamed of some of the realities of my life.  In personal writing lately, a rambling piece entitled “Write it Out, Right it Out“, I went on say:

I’ve always been caught in my own world of the mindf***, you know? And when I’m drunk, I am more susceptible to mindf***ery. I don’t like it. I start to lose grasp on my reality, and sometimes it disappears completely – my grasp, that is.

I have made references to my alcoholism in the past, but never with much detail or emphasis.  I neglected to mention that alcoholism is a real part of my present, mainly because I didn’t consider recreational drinking to fall under that category.  I was sorely mistaken.  I wrote to a friend:

Somewhere along the way, I stopped taking substance abuse seriously, like it wasn’t a fact in my life. I’m going to guess that mania had a little to do with it. Like I was above it all because I had gotten away with it.

And another in the same piece, “Write it Out, Right it Out”:

I don’t think I actually believed myself when I have described the seriousness of my alcoholism in my past. Or maybe I thought that it was somehow different, because this is a different situation. Or maybe I thought I was just too young and immature to handle myself.

The fact of the matter is this.  I have been suffering from terrible alcoholism from the age of 19.  At the age of 17, I took up drinking as a recreational activity.  When life events sent me into a tailspin, I spent the last six months of my 18th year in a state of perpetual intoxication.  By the time I was 19, alcohol was a regular fixture in my life, and was a part of every recreational activity.  Finally, it progressed the point of functional alcoholism by the time I was 21.  I described it to a friend as:

Except, I know that there was two years that I spent drunk every single night. I made excuses, like friends and parties, but I would drink by myself. I remember there were nights I’d drink until 4am, and have my boss call me at 6:30am to ask where the hell I was.

During the two years, I had a solid schedule. Wake up at 2pm, leave for work at 2:30pm, work three to nine, drink and eat nine thirty to four or six in the morning, and do it again. I had even devised strategies to avoid vicious hangovers and physical withdrawal. Occasionally, I would venture out with a bottle in my purse, just in case there wasn’t any alcohol where I was going.

Since my son was born, there have only been a handful of what I consider to be benders, which were periods of time where I would invent a reason to have friends over for drinks.  I never intended on getting wasted, and I usually didn’t.  But, there were occasions.  Some relatively benign, ending with me waking up with a vicious hangover and swearing off alcohol entirely for awhile.  Others, they ended disastrously with an altercation, and I would find myself resolving the situation by dumping all of the booze down the drain, with a certain satisfaction at my self-restraint and determination.

Here’s the truth.  I never get complimented on my resolve.  Because, everyone knows that I will always go back to the same old, same old.  No matter how much I appear to change.

I am not always forthcoming about my weaknesses, especially the ones that spark shame.  I am embarrassed by my lack of self-control, especially in matters that are extremely frowned upon.  There are a lot of bad character traits that I can identify, and openly and honestly admit to.  However, lack of self-control is not one of them.  I’ve never considered myself as impulsive, and people often view it as immature and juvenile.  I have always considered myself to be mature and responsible, with certain exceptions, like during college, because impulsive actions and lack of restraint were commonplace, and socially accepted.

Many can argue that impulsivity is not necessarily a character trait of mine, rather, a feature of Bipolar Disorder.  Maybe that is true, because there really was a brief period in my childhood that I recall being very responsible, consistent, and mindful.  And yet, there are still incidents that I recall as being not well thought out before execution.  A condition of childhood?  Maybe.  Facet of personality or symptom of psychological disorder, it stands as probably the weakest trait I have.

A Spectrum of Depression

Blank.

Each time I go to write, I get a blank.  Is it a blank, because I feel as if I don’t have anything important to say.  Or is it a blank, because if I make a certain statement, then it is real.  It becomes something tangible in this world, not only for me, but for others, and I will eventually have to come nose to nose with it.

I’ve grappled with this before.  Making certain admissions.  I do not lie as much as I turn a blind eye.  I rationalize.  I attempt to will it out of existence.  But, it is just not that easy.

Simply – I am in the midst of a depressive episode.

Why was that so hard?

There is a certain hesitation for me to use the word depression.  It is not a word that I use loosely; others use it as a part of their regular vernacular to describe sadness.  Depression is not sadness.  Depression has a depth beyond that of sadness, loneliness, isolation, self-loathing, or any other word.  No amount of words arranged in any way can accurately depict depression, and do it any kind of justice.

The hesitation to term it as depression stems from the idea that, if it doesn’t feel like the worst I’ve ever felt, then it’s not depression.  I have faced more gruesome depressions than this one.  With the admission comes a certain fear.  If I am to term it as a depressive episode, then it really will be such, in the worst sense of that word.  It could worsen the episode itself by acknowledging it.

Blank.  Again.

I have found it so interesting that Bipolar Disorder has this grandiose spectrum to encompass so many different types and symptoms.  However, they are exclusive to mania.  Depression is just depression, and it by itself is MDD, or unipolar depression.  Except, now psychologists are starting to recognize symptoms that are related to atypical depression.  However, by reading through these symptoms, it seems as if it may be exclusive to unipolar depression.

How much research has been done to distinguish unipolar depression from bipolar depression?  So far, the only thing that separates the two is the existence of hypomania / mania.  In theory, there wouldn’t be a difference.  I get the feeling that there is, and it is significant enough to have a separation between the two.

So far, the mood spectrum looks like this:

But, I really think that’s being too broad about it.  I fall smack dab in the middle of Bipolar II, no full on psychosis equals no full on mania, even if I have delusions.  I wouldn’t even suspect that I have full on mania, anyway.  Even with delusional thinking, I can honestly say that there has never been a time where I have been hypomanic where I lost touch with reality.

People with mood disorders are familiar with the depressive symptoms.  But, I’ll sum them up:

Sadness, anxiety, irritability,  Loss of energy,  Feelings of guilt, hopelessness, or worthlessness,  Loss of interest or enjoyment from things that were once pleasurable,  Difficulty concentrating,  Uncontrollable crying,  Difficulty making decisions,  Increased need for sleep,  Insomnia, Change in appetite causing weight loss or gain, Suicidal ideation, and / or Attempting suicide.

Symptoms of atypical depression:

Increased appetite, Unintentional weight gain. Increased desire to sleep. Heavy, leaden feeling in the arms and legs, Sensitivity to rejection or criticism that interferes with your social life or job, Relationship conflicts. Trouble maintaining long-lasting relationships, Fear of rejection that leads to avoiding relationships, Having depression that temporarily lifts with good news or positive events but returns later

These are all familiar.  I’ve bolded the ones that I’m experiencing at the moment.  It seems that I’m bordering on the more atypical part of depression.  This is the kind of depression that no one really tells you about.

I had mentioned my diagnosis of Bipolar II, resulting from non-psychotic “manias” clinically termed “hypomania”.  Fair enough.  Let me put a question out there.  Has anyone ever experienced a psychotic depressive episode?

I have.  And I have mentioned this to doctors on several occasions.  I will have breaks with reality when I am depressed.  I have severe delusions, almost completely the opposite of delusions of grandeur.  I will have severe paranoid episodes – in fact, I just had one.  I can have myself convinced that everyone hates me and is out to destroy my life.  It makes me combative.  I will sometimes invent conversations that never happened, just because my brain contorts a criticism.

Mayo Clinic appended this in fine print below their list of classical depressive symptoms:

When a person with psychosis is depressed, there may be delusions of guilt or worthlessness — perhaps there is an inaccurate belief of being ruined and penniless, or having committed a terrible crime.

Perhaps?  I’m nearly positive that exists because not enough research on bipolar depression versus unipolar depression exists to accurately differentiate between the two.

There are a few questions that remain.  Again, not to just the bipolar population but the unipolar population as well, have you ever experienced a psychotic depressive episode?  Is this more commonly found in MDD, BP II, or BP I?

Because if this is common amongst all populations, then the mood spectrum should look more like this:

Perhaps a more accurate model