Guest Post by Orion Abrams, Member of the OCA Advisory Board
Everyone who has a mania, is hospitalized until it ends, and then goes home struggles with getting their life back on track. Okay, so maybe not everyone, but everyone I’ve met has this happen. It is far too simple to blame this on depression. “I had a mania, and now I’m depressed. It’s because that’s what happens when you’re bipolar and that’s that.” Attributing the depression 100 percent to the illness can be a valid coping strategy, because then at least there isn’t guilt of being depressed because of choices one could be making that one is not making.
A week ago, one day I was feeling great, and then the next night I was very depressed. I automatically blamed this on my bipolar disorder, even though my manic and depression episodes are historically months long instead of lasting just one night. I accepted the thoughts as true until talking with my therapist about it. I realized there were actually valid reasons for me to feel down, such as having negative thoughts about my marriage, wanting to start creative projects but preventing myself from doing them because of low self-esteem, and a sense of loneliness (probably because of the marriage, my wife is in Australia and hasn’t been able to get a Green Card to move here yet). I was able to work on the issue of stopping myself when I want to do something creative, and in dealing with that and starting some creative projects, I have felt less depressed. I don’t think depression is entirely a chemical thing.
Besides a diagnosis that supposedly makes the “mentally ill” more susceptible to depression, why would someone feel depressed after an episode in a mental hospital? There are many valid reasons, but let’s use the example of Jane’s story:
Jane is bipolar and she gets triggered around the anniversary of her mother’s death, August 4, and feels especially sensitive around that time. She has been having a rocky relationship with her fiancé for the last three years (why won’t he marry her already) and they have broken up and gotten back together many times. She and her fiancé finally set a date to get married and the next night she catches him texting a girl that he has been having an affair with for a year. She immediately ends the relationship and moves out. He tries everything to get her back but she puts a restraining order on him. She begins to feel depressed, goes off her meds, start to lose all inhibitions and common sense, has 3 one-night stands, loses her job, and eventually walks around her block naked for hours until the police pick her up. She is hospitalized for 3 months, until the mania wears off. In the hospital, she has no real control over anything, she is treated as an illness instead of as a person, she is told nothing will help her except taking meds for the rest of her life, she is offered no recovery programs to help her deal with negative self-talk or goals, and she is sent home to her parents to figure out the next part of her life.
Jane’s story isn’t that different from my own story of a hospitalization for mania, and I suspect it isn’t too different from anyone else’s story, either. Who wouldn’t be depressed after losing everything and having to start over? Who wouldn’t be at least somewhat depressed after 3 months of having no control? I have the greatest respect for people who can stay positive while in prison for years. I wonder if these prison inmates have gotten past the self-hatred that comes with identifying with being a criminal, and they identify with just being a human instead, prone to making mistakes.
I’m not saying that it is completely pointless to identify with a mental illness. I need to identify with my bipolar, at least to a degree, or I will stop taking my meds. I’m saying that identifying with a mental illness deeply and making the illness the reason for everything that is wrong is harmful. Self-esteem can already be abysmally low after returning from a mental hospital, but it makes it much, much lower to say, “It’s all my bipolar. There is nothing I can do about it except keep it under control with meds. I have no power to change anything.” This is the line of thinking leads to an even deeper identification with the illness, to the point of doing, saying, or thinking crazy things on purpose for no other reason than to maintain the idea of oneself as being crazy.
I am a peer support specialist and I work with a client, diagnosed with paranoid schizophrenia, who has voices. One day, I asked why he doesn’t just send love to the voices instead of fighting with them, and tell them they don’t have power over him anymore. He said, “But then they might go away, and I wouldn’t be able to talk to [the voice of] my ex-girlfriend anymore.” Wait, what? Really? Keeping the ability to talk to his ex is more important than saying goodbye to all of these voices, which are constantly putting him down and making him feel like crap?
This is an extreme example but I have seen plenty of individuals who either stay institutionalized because they don’t want to stop seeing themselves as a powerless crazy person, or have a years-long habit of going off of their meds because it’s easier to be cared for than raise their self-esteem. Raising self-esteem is hard because it contradicts the ingrained ideas of oneself as worthless, but also allows one to be more creative, driven, and powerful: and with great power comes great responsibility (according to Spiderman).
Strongly identifying our problems is not something that is unique to people with mental health diagnoses. For some reason, it is just easier to blame everything on our problems than to change our lives in a way that would make us happier. “I’m an alcoholic, I can’t hold a job.” “I’m not smart, I can’t learn in anything, I’m not going to college.” “I’m bad at relationships, so I can’t try anymore.” “I’m lazy, so I can’t exercise.” There is an endless list of these negative ideas about ourselves that seem to have the power to prevent us from getting the things we want. The common thing in all of these is the word “can’t.” But what we CAN do is stop blaming our unhappiness on our problems, stop identifying with the things that make us hate ourselves, and begin to identify with something else instead. Some people say to identify with our positive qualities, but I think that identifying with absolutely anything besides the things that make me hate myself is all that matters. Personally, I work on identifying with a feeling of peace instead when I find myself identifying with one of my low-self-esteem-generating problems. What you identify with is ultimately who you are. Who are you?