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Saturday, February 24, 2018

Diagnosis Focus

Posted by fxckfeelings on August 19, 2013

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It’s easy to know and describe what it’s like to be physically out of sorts—usually, Nyquil or a triage kit are in order—but when you’re losing it mentally, things get a lot more complicated. In some cases, it’s uncomfortable and can’t go away soon enough, while for others, it’s great and not something they even see as a problem. Good or bad, however, it’s easier to identify and understand, at least to the person experiencing it, if you remind yourself that a state of mind is only a state of mind. So whether or not you can change it, or believe it’s worth changing, it’s always worth remembering that there are more important things. Your job is to make the most of your state of mind, even if you can never fully make sense of it, without letting your brain run your life (and body) off the rails.
Dr. Lastname

I don’t know how to begin…It’s really strange because I’ve never felt like talking to a psychiatrist, but now that I’m trying to, I realize how much I may need one. I’ve been trying to find one of my, of what I realize now, many fucked up aspects to talk about. Why do we bottle things up? Why do we make the bad things the deepest parts of our lives? Happy moments are like listening to the Beatles, short and like being on acid or running through a meadow…or both. But melancholy sits inside like Joni Mitchell or Jeff Buckley, if you let it. I guess my point is that I am terrified that I am going to have Virginia Woolf or Sylvia Plath’s life. Almost everyone in my family has mental issues. My brother tried to kill himself this year, my grandparents are the lovable nut-bags, my father had anger issues during my childhood… and I got the diagnosis from my doctor this year that I am depressive with bipolar tendencies. It’s terrifying to get a name for the way you are. I have so many. I wish it was duchess sunshine awesome, but you know… I guess what I came here for was to say that I don’t know how to express my emotions, should I bottle them up? Or should I just let myself go? My goal is to be a little clearer.

We don’t have the power to diagnose people over the internet, but when we get letters from people fretting over psychiatric diagnoses we usually feel comfortable diagnosing those diagnoses.

So, assuming you do have the familial tendency to be depressed, have mood swings, and, presumably, be creative, you don’t have to have a fucked-up life, nor do you have to stifle your creativity.

What you will have to do, however, is work at keeping your perspective when you’re hurting with depression and everything seems to suck while not letting your diagnosis frighten or shock you. After all, a doctor has merely put a label on what was always there, meaning you now know there are techniques that can help you deal with what’s been ailing you.

Prepare for depression by experimenting with activities that may stop or reduce it, like exercise, keeping busy and possibly trying medication. Don’t experiment with activities that reduce it in the short run and then have the unfortunate side effect of making it worse later on, like drinking or using drugs. If you can turn depression into creative art and are good at singing the blues, more power to you. Just make sure you get paid in money, not drink tickets or compliments, and that you remember that being a good person and keeping your work commitments are more important than acting like a tortured jerk.

Don’t make a depressed state of mind more meaningful than it really is. If you can’t help being depressed, too bad, but that doesn’t mean your life is meaningless because you can’t feel happy, just that you’re someone with painful mood swings who has to work harder to stay on track and be a good person.

If a doctor thinks medication could help your mood or improve your focus, it may be worth trying. Remember, however, that it’s just a brief experiment, it can’t cause lasting damage, and you’re the one who decides whether it’s doing enough good to be worthwhile. Sometimes medication can improve your mood without interfering with your creativity, sometimes not. You’re the judge.

Never assume depression can beat you, even if it keeps coming back. Fear and negative thoughts about the future are part of a depressive state of mind, but as long as you remember that it’s just a state of mind, you can learn to manage it without letting it control your actions or beliefs about life.

Neither depression nor a diagnosis need ever define you. Knowing what’s wrong, while scary, can help you avoid having a life like Sylvia Plath’s while making your own life that much better.

“I may feel depressed but my values haven’t changed and I can use them to direct my life while fighting off the feeling that I’m doomed.”

My son is in a weird state of mind and won’t listen to anyone. He’s in college, but has stopped going to classes and instead stays up night after night writing a novel he says is the greatest thing ever written. He’s done 900 pages, I’ve read it, and it makes no sense. He talks a mile a minute if you speak to him but otherwise doesn’t bother anyone, so no one has reported him to the dean. He’s gone past the date when they’d give him a rebate on his tuition, so he’s lost a lot of money. I’ve begged him to get help but he says he’s never felt better in his life and that I’ll approve his choices after his novel is published and recognized for its greatness. How do I stop him from self-destructing?

As you know by now, there’s not much you can do to change your son’s strange mood and, in all honesty, psychiatric medication doesn’t always correct a mood like this or work quickly when it does. In addition, if you seem anxious or pushy to your son (from justifiable worry), you’ll have even less influence on him than you do now, which seems like zero. If he’s manic, and it sounds like he is, then his confidence is god-like, and the opinion of a mere mortal like you won’t carry much weight.

In reality, however, there’s much you can do to help. Putting aside what you’d like to do and can’t—persuade him to go to classes and see a shrink—trust your own observations and beliefs. Consult a psychiatrist, describe the facts as you’ve observed them, take advice, and decide for yourself whether your son is ill or competent to make his own decisions. Then, if you think it’s necessary, call the college and ask them to step in, offer him an evaluation, and return his tuition.

Don’t put college administrators on the defensive by blaming them for not knowing about his illness. Instead, treat them as caring people who want to be as helpful as possible once they are informed, and have a chance to confirm, that he has symptoms. Of course, it would be great if they could persuade him to get help but, assuming things are too far gone for him to resume his courses, have a plan for easing his return home.

You don’t have to be emotional or pushy to offer clear, confident advice; in your opinion, there’s something wrong with his mood and his judgment sucks. You have nothing against his feeling good or his novel, but his priorities are mixed up.

Since he’s probably going to be finished with school soon and out of money, tell him he has a bed at home, but he won’t have much, beyond the basics, unless he can get it together to search for work and help out around the house. That will probably take time and require treatment, but that won’t happen unless he agrees and decides it’s worth a try. You’ll wait as long as it takes.

Stick to your message while doing what’s necessary to protect him, hiding your sorrow and fear and being patient. There’s a good chance he will eventually hear your message and that events will push him towards treatment and recovery. In the meantime, work with the school and take it day-to-day with your deity of a son.

“I can’t get my son back to a normal state of mind, but I can help clean up the mess his illness has caused, protect him from danger, and steer him towards healthy behavior and recovery.”

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