Do I have depression or bipolar disorder? Does it matter? Stigma suggests that mental illness fuels creativity, but after 25 years of living with depression, I know that’s a lie.
It is true that my experience with mental health (and the lack of it) inspires some of my artmaking. However, romanticizing mental illness until it morphs into a muse is insulting. Mental illness takes. It never, never gives.
So as far as my artwork goes, it doesn’t matter one way or the other what mental illnesses I have. It only matters that I treat each one in a way that inhibits its control over my life. But that is difficult to do without a diagnosis and treatment regimen that shrinks can agree on.
“Why the confusion?” you may ask.
Why the Confusion?
See. I knew you wanted to know.
In the world of mental illness, the symptoms of many mental health disorders overlap and exist on a spectrum. For example, depression or bipolar disorder, whichever you choose, both include depressed mood. But that’s not where the similarity ends.
Bipolar Disorder
Bipolar disorder is major depressive disorder plus mania or hypomania. So bipolar has very low moods and very elevated moods (sometimes at the same time, which is called a mixed episode).
- Mania is the most severe form of elevated mood because it tends to exaggerate your thoughts in unhelpful ways – anything from thinking you’re better than anyone else to psychosis.
- Hypomania is the ho-hum version of mania. Hypomania tends to elevate your mood, sometimes it will make you think you’re better than anyone else and sometimes can include psychosis.
Huh?
Yes. All the same symptoms can occur in both mania and hypomania. However the psychosis part of mania can make you think you can fly off a building and the psychosis part of hypomania can make you think you’re talking to angels (as in my case and the symptom that started all the bipolar talk).
“While both states involve periods of elevated mood and increased energy levels, they vary in severity, duration, and impact on daily functioning. Manic episodes are more severe and may require hospitalization, while hypomanic episodes are milder and typically do not cause significant impairment.”
Excel Psychiatry
Major Depressive Disorder
MDD does not include elevated moods. If you’re lucky you can experience periods of relief where you feel more like yourself. However, those periods of relief are underlined by the knowing that “The Depression” will return. It always does.
And, like bipolar disorder, MDD can cause psychosis. Yes, depression can include psychosis.
Mental Illness Is as Clear as Mud
After the explanation of the similarities/differences between depression and bipolar disorder, you probably will reach the same conclusion as I did. I don’t know what the hell I have. It is hard for me to believe my shrinks know for sure either.
What would I guess between depression or bipolar? My psychiatric self leans toward the diagnosis of major depressive disorder with psychotic features. But I do communicate with angels and other entities, so I don’t believe that I have ever experienced psychosis at all. (Which, by the way, is something someone with psychosis would say.)
The Symptom of Impulsivity Is Messy Too
Additionally, I am very familiar with impulsivity, a symptom that is not typically known to occur with depression. However (you knew that was coming, didn’t you?), “depression and mania are differentially related to impulsivity”1 meaning simply that both illnesses can create impulsivity that makes a person do stupid stuff. For example, impulsivity during mania could make you think you could float on air currents if you jump off a building (and alas, you have the energy to go for it). In major depression, impulsivity plus hopelessness can equal the suicides that no one sees coming.
My impulsivity has revealed itself a few times during my life. The most consistent problem with impulsivity that I experience is also called shopping addiction. I have a spending problem. But I don’t know if it’s there because of the symptom of impulsivity or because my brain reacts with spurts of dopamine when I buy things. Wait. Is that the same thing? .
Some other impulsive behaviors have leaped into my life when I least expected it, turning everything around. Or rather, turning everything upside down. That’s the thing about impulsivity – it isn’t like spontaneity when you do something on the spur of the moment but can change your direction just as suddenly if you want to. No. Impulsivity is when you start to do something that you kind of figure out isn’t a good idea, but you keep doing it because you can’t stop.
Impulsivity and Suicide
I don’t blame anything but myself for the shopping addiction. Like any addiction, if I really wanted to stop … But I have nothing except the illness to blame when I ask my mom to hide the rifle from me or ceremoniously arrange a nice nightie beside the plastic bag I intend to suffocate myself with later. I do not blame myself when I check to see if I could make myself die from any of the meds I take, or think of ways to die by suicide that would look like an accident so my children won’t follow in my footsteps (statistically speaking). For the suicidal ideation and plans to die by my own hand, I blame depression.
Does It Matter if I Have Depression or Bipolar Disorder?
To me, no. The diagnosis of depression or bipolar isn’t important to me. Depression symptoms, being depressed, having depressive episodes, those are the things that waste my time and my life. I know I will be consistently depressed regardless of what the psychiatrists decide. It feels like I lose more life to depression than I get to live.
If I have bipolar disorder, I experience hypomania, not mania, and I experience it off and on. If this illness is bipolar, it doesn’t “cycle” for me. It pops in with whatever magical dust it has on hand. I can have four depressive episodes before I have one episode of impulsive, life-threatening decision-making. (And, you guessed it, this is also normal for both mood disorders.)
It’s the depression that gives me dark ideas that I want to put on paper, and it is the depression that keeps me from doing so. Depression sucks away my energy. It makes everything feel pointless. It makes me feel like a failure, and worse, like I don’t deserve the love my family offers me. It makes me feel like I don’t deserve my grandchildren.
Depression makes me want to die. It literally wants to take my life. Whether I have depression or bipolar disorder, I know this: Depression is not my shadow, it is my mortal enemy.
Depression Resources
In the United States and Canada, dial 988 for any mental health problem or question. You do not have to be suicidal to reach out for help, and the service is as anonymous as you want it to be.
Additionally, the SAMHSA website could be of some help.
Sources
1Swann, A. C., Steinberg, J. L., Lijffijt, M., & Moeller, F. G. (2007, September 5). Impulsivity: Differential relationship to depression and mania in bipolar disorder. Journal of Affective Disorders. https://www.sciencedirect.com/science/article/abs/pii/S0165032707002649
Leave a Reply