Depression, Dissociation and the Hospital
I finally understood that I have depression. The first tip off was that when I was admitted to the hospital on Friday, I happened to notice the intake sheet that the doctor was writing on. The alphabet soup jumped out at me: PTSD, DID, MDD. I knew the first two, but filed away the last one. A few minutes later, "major depressive disorder" came to mind and I thought that they were perhaps just pulling out old diagnoses from old charts. Well, sure, they were doing that. But it actually turns out to be valid.
I've now confronted a problem. My wife has been telling me for a while now that I really haven't been there for the family in the ways she would like. Since she hasn't said that in the most tactful way, I've kind of been in defense mode about it. I'm not sure if it was a change in her tone yesterday or just the reality setting in, but I've suddenly realized she has some very valid points.
I quickly considered depression a couple months ago. The warmer weather was here in New England and I didn't seem motivated in the things I was motivated by last year, mainly having to do with my landscaping efforts. This extended to other areas of family life. Yet I was able to have periods of full interest. These are my "rallies". One could say these were like mood swings, and through some lens they probably are.
I now think this is depression masked by dissociative coping strategies. Certain areas of my life, dominated by certain parts of my self, are very rich and active. Certain other areas of my life aren't so lively. My initial thought was that this wasn't the same depression I had several years ago. It wasn't that all encompassing heavy depression that permeates every aspect of one's life. I brought this up with my psychiatrist, wondering if this needed to be treated. But he, too, brought up the fact that, according to my reports, this wasn't an overpowering depression.
But, I am different now than I was a few years ago. A few years ago, even though I knew I had parts, all of me was more or less lumped together. Now, I can imagine the thought of parts of me not being depressed and parts of me being depressed.
So, as I enter the second day of being inpatient, this is what I learned. On Monday I will ask the treatment team about all of this and have them consult with my psychiatrist. Unless someone gives me a reason otherwise, I'm planning on asking to start an antidepressant.
I'm not sure how much I'll post about the current hospitalization. Given how I need to focus on myself, I may not post much since this site is not really about my day-to-day experiences as it is about the broader picture of trauma and dissociation. It's very hard being here. There's a great deal of activation of parts and I'm working very hard at staying grounded and present. But I'm okay. Every hospitalization is so completely different and I learn so much about myself from each. So, while it's immensely difficult, I'm looking forward to, in the words of my therapist, "having an authentic experience".
15 Comments
Welcome
"Healing from Trauma and Dissociation"
I'm Paul, a father, husband, scientist, educator, photographer and musician. I'm also a survivor of childhood sexual abuse.
Mind Parts consists of my own insights on the aftermath of childhood sexual abuse, namely trauma stress and the full spectrum of dissociative coping mechanisms, including dissociative identities. Through a blog, I explore the healing process in a variety of ways—using creative contributions of original art, photography, poetry, and music as well as, hopefully, though-provoking essays. Mind Parts is also home to two support services. The quarterly Ezine Trauma Recovery Highlights is a look at some of the best online resources. Also, the monthly Expressive Arts Carnival makes available activities which are published as a group "Carnival."
Comments are welcomed, but if you prefer, you may contact me offline. My belief is that sites like this one can contribute by offering unique perspectives and knowledge, thereby enhancing opportunities not only for survivors but for readers and society as a whole. Namaste!
Depression can present in odd ways at times, especially when it is hidden beneath the dissociative coping strategies. Be as honest as you can with your treating team and yourself Paul.
Please let us know if there's anything at all we can do to help.
Sending you lots of positive thoughts and warm safe hugs to those who want them...
Michelle
Paul,
Thinking of you and sending you many good and positive Vibes from AZ.
I am proud of you.
Vicki
Just to play the devil's advocate, I will ask - How can you have an authentic experience if you drug the messenger?
Do you trust your therapist? How deep is that relationship? Can you make it better or safer somehow for the depressed part? If he/ she takes the lid off the box, will someone really and truly be there for you emotionally? Can you ask this part what it needs? WHY is it depressed?
That said - you are going to do whatever it is that you need to do right now and I'm on your side. Hang in there, Paul. You're going to be okay.
Wow, I am so sorry this is happening. I hope the process is productive and positive for you. Since I've not been hospitalized for depression/DID, I can only sympathize with you and pray for you. I truly hope all is well...
Good and healing thoughts to you.
Kate
I appreciate all the well wishes and concern. I play devil's advocate too and can appreciate the apparent disconnect between being on an antidepressant and having an authentic experience. For me, authentic means experiencing what I am meant to experience and what I deserve to experience. I haven't even talked to anyone about the antidepressants, so I'm not sure this is a route we will be going. I have not ever encountered the situation of parts of me being not depressed and parts of me being depressed. So, I wouldn't know how to handle that. Obviously, you are right, I want all of me to remain authentic. This is really important to me. I thank you very much for taking the time to provide this perspective and I will take all that into account.
I'm thinking more about this authenticity comment from Ethereal Highway. One way to look at it is that there is a chemical imbalance at work and that the medication can help with that. So, in some ways its about making my experience more authentic. Another way to look at it is that different parts of me seem to have different realities when it comes to depression. I don't know how you medicate that when things are partitioned like that. I don't want to help one part of me struggling with depression to have a more authentic experience, only to do something to another part of me to create an environment for a less authentic experience. See, I take all your comments seriously. I am humbled that anyone comments here in the first place.
Paul, I've had severe depression twice in my adult life. I think I also have DID although it's not been diagnosed. When I was in the worst of the depression last year, psychotic, disintegration of myself and my reality I really prayed one night. When I woke up I heard a very strong voice tell me I had to go for a walk. I knew immediately I had to go for a walk in nature even though it was winter, I'd never gone walking on my own before and hadn't been for a walk in nature in quite some time. I went and it had an incredible effect on me. I cried, I had lots of comforting thoughts, I laughed, I was strengthened. I went home and wrote a very long poem. It was very healing for me. It led to me reading ecopsychology books and I want to become a horticultural therapist.
I had a very bad experience with the anti-depressant seroxat/paroxetine it has awful side effects and is addictive. I had to reduce my dose gradually over a year and then switch to prozac which is easier to come off. I took it to cope with anxiety for a holiday overseas.
I'm thinking of you and hope you're ok.
I also relate to how you suddenly realised you have depression. I was depressed for a long time before I realised I had depression :) I read a very good book called Shoot the Damn Dog by Sally Brampton. A very honest account of her depression and hospitalisation.
http://www.shootthedamndog.com/
I am concerned that if you take medication you will lose touch with your internal healing voices.
Please email me anytime.
Paul, please know that I'm thinking of you.
I also have major clinical depression as an adjunct to DID, and it's really a tough row to hoe. I found that, for myself, meds only exacerbated the dissociative tendencies, but I know that they can be very helpful for some people. It may be possible to have the inner who need it be the ones who take the medication, if you have a very aware and creative treatment team. Your internal communication seems pretty good; you might try asking around in there and seeing who actually is depressed, and how they feel about meds.
Thanks everyone. We are looking at a couple options. We'll see how things go. Haven't tried anything new yet as they are waiting to talk to my outpatient psychiatrist. One thing that has been suggested is 4 grams of fish oils per day. This would probably be in addition to an antidepressant.
Knowing all too well the depression roller coaster, I just want to say that there is a time and place for medication. Just because you may need this "tool" now, does not mean you need to stay on it forever or have it define who you are. I think living with DID, we have so many labels put on us, that we sometimes lose touch with the fact that there are useful tools out there for us to access. If the depression is getting in the way of the "authentic self", the moving forward on this healing journey, then perhaps it is time to take a breather and welcome some distance and in fact take the edge off of a state that keeps the PTSD activated and in full force.
Hi Paul,
I know that many survivors who have gone through periods of using anti-depressants are anti-meds based on their experiences. I too have used meds and had lots of bad med side effects. They helped me through some very tough times in my healing process and were an adjunct to healing. I tend to avoid them. But I tend to encourage someone to use them if they have a need for them, with careful monitoring by professionals. I encourage you to do what is right for you. Good and healing thoughts to you.
Kate
Hi Paul,
Here's Dr. Weil on depression:
http://www.drweil.com/drw/u/ART00696/depression-treatment
I've been taking the fish oil for years now as well as trying to follow the rest of his advice and it really has helped with the depression part of the bipolar.
Wishing you all the best...
For me I needed an anti-depressant and anti-anxiety to get me stabilized to where i was in any frame of mind to deal with anything. I needed to be able to cope to talk and sort things out. Then when the heavy stuff had been "brought out into the open" so to speak, I could try to get off the medication and deal with all the emotions in an authentic way.
Hope you find a solution that works for you.