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You don't look depressed therefore you must not be depressed

By June 9, 2011 - 4:51am

Inspired by a post on WEGO Health, titled The Faces of Mental Illness, Melissa Shell at Sugar Filled Emotions is starting a project she wrote about in a post entitled I Need Your Face. Then yesterday I saw my psych, told him my depression was coming back and he said to me "Your affect is not one of depression, therefore you are not depressed." Basically, I'm not looking like I have bipolar disorder/depression so I must be fine. From the definition of affect at Merriam-Webster: a set of observable manifestations of a subjectively experienced emotion (patients … showed perfectly normal reactions and affects — Oliver Sack)

A face of bipolar/depression
Now if just anybody had said this to me, I'd probably punch that person in the nose. Well, I suppose I wouldn't actually punch them in the nose. I'm pretty non-confrontational since my mania has been under control. But I get what he's trying to say. What has been triggering my depression has been the return of many physical symptoms, or affects...lethargy, muscular weakness, and increased appetite. My psych explained those are also symptoms of too high of a dose of Nardil/phenelzine. So he's reducing the Nardil to two a day instead of three, adding back in trazodone so I get a good night's sleep, and if that doesn't work he's going to add a stimulant next month. When I told him I was frustrated because of the med wringer I've been through, he said "I'm frustrated too." Then he looked me in the eye and said "You want me to be frustrated, otherwise it would mean I didn't give a shit." It's nice to have a psych who actually cares after hearing horror stories from others. I've been going to him for almost four years.

So perhaps I'm not depressed in the same sense that I was when I went into the hospital. This time, someone telling me I don't look depressed might just be the right observation.

By August 25, 2011 - 4:12am

Thank you for your comment. I held down high level very stressful jobs for over 15 years. When I finally broke down people were shocked, had no idea that there was anything wrong. I was just discussing this with a friend yesterday. We learn to stuff away how we truly feel in order to function in everyday life, but after a while it just doesn't work anymore.

Be patient with your meds, they take a while to start working and sometimes you'll need several adjustments to get it just right. If you have any questions, I'd be happy to try to answer them.

August 25, 2011 - 4:12am
By August 24, 2011 - 10:42am

I was just diagnosed with bipolar II eight days ago, and am just at the beginning of taking meds; I have an appointment with a psychologist to start therapy the day after Labor Day (when he gets back from vacation; August is no time for a psychiatric diagnosis). Anyway, when I saw this post I thought it was something different, and came to read and write about my experience of a few friends I've told who are telling me that I don't seem like that to them; I'm always so "happy and chipper." Well, I've never exactly worn my depression on my sleeve, and seem to have developed at least some skill in presenting a facade to the world that is not what's really going on with me. There are really only one or two people who are aware of my suicidal ideation, and most people really love how I am during a hypomanic episode.
Anyway, thank you for the above post; it's heartening to read. I hope the med adjustments worked out.

August 24, 2011 - 10:42am

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