Depression is not about feeling sad. It is really difficult to describe, and even to remember, between episodes. When gone, it dissolves and weakens, the same way that dreams disappear, becoming just a pallid description that in no way evokes the experience. But for me it is does not conjure sadness or tears; in some ways I wish it did, it might be easier to recognise and manage. The most obvious symptom for me is probably a lack of energy, but this can come on quite insidiously, such that it can be explained away, or seem normal in the circumstances. After a while, though, it becomes impossible to function, or carry on, and the simplest tasks become impossible challenges. My thinking is without doubt slower, and more ruminative in form, with a focus on negative outcomes. I am tired and sleep more, but it doesn’t help. I can’t eat much, and don’t enjoy drinking alcohol. Often I have a feeling of unnamed dread, that something bad will happen, and it will be my fault. I worry hugely about terrible things happening to people I love, although this tends to be brought back to the selfish consequences for myself. For example, should my husband fail to return from a work trip, I will be left forlorn and unable to cope. Even petty practicalities seem unsurmountable at these times.
Elevated mood is pretty much the opposite, with lots of energy and ideas. I write a lot, and am convinced at such times of my work’s importance. Sadly, this is often followed by a low, and any outpourings tend to be disposed of in the associated self-disgust, so it is hard for me to confirm this. But I suspect my ramblings about philosophy (of which I know little) and the universe (of which I know less) are perhaps rather less brilliant than I think at the time of writing. I always thought raised mood would make me more sociable and outgoing, and it possibly does, but it also makes me far more likely to rant on about my general dislike of the human race. This not a particularly attractive trait, although it feels good at the time, and may well relate to irritability – which for me is probably the defining trait of that pole. I am more physically active – sadly a bout of excessive running at one of these times (excessive for me that is, we’re hardly talking marathons) triggered recurrent sciatica, which has literally been a pain in the backside. My alcohol intake will also increase, and I enjoy it more. I also buy too much. I’m fond of shopping normally, and have been trying to see if I can identify any warning signs – I think one might be buying the same item in several different colours.
The trouble is that it’s not always possible for me to recognise either of these mood states. Sometimes they are more pronounced, making it easier, but even then it can depend a lot on the context. If work is hard, then looking and feeling low could be viewed as normal. At a social gathering, especially fuelled by alcohol, many people can seem somewhat elevated.
Most of the time I am lucky enough to have a mood range that probably counts as normal. My husband, who has to live with it, says that I am usually on the cheerful side (although prone to extremes), unless unwell, and I think that is true. I would say it floats around the centre – I can have a week or so of mildly flattened feelings and depleted energy, followed by the same of happy productiveness and physical vigour. I wouldn’t describe these as illness in any way. Sometimes they develop into more of a problem, and sometimes they don’t, and I have no idea why.
I think after many years I can accept the depressive side, although I still wonder if it is different from the experience of others. This is something I can never know. But the added complication of a bipolar diagnosis has been difficult – it makes some sense, yet I can’t really believe it. It seems to make sense to my husband, which I can’t ignore, and I have recently looked back over the years to try to understand it better. When I was first depressed, before and after my daughter was born, I remember feeling very wound up a lot of the time. I was irritable and anxious, and I remember pacing the floor. A lot of my memories have been obliterated by ECT, but I think that at least some of this episode was more “hyper” than other subsequent ones. Some of it wasn’t, but I have found myself wondering if at least some of this fitted into the slightly odd mixed category. I have never understood this well, and don’t really get what is different to agitated depression, but it’s just a thought. I’ve got better at recognising depressed mood, and most of my more severe episodes have undoubtedly been on this side of the spectrum; but, looking back, I have always had a tendency to periods of slightly irrational “enhanced”, and sometimes irritable, mood, when I tend to get very focussed on something at the price of everything else. Usually not a problem (to me, anyway), but sometimes it is.
At the end of the day, like everyone else, I can only see things from my own point of view and my own experiences. I can imagine what others may feel and think, but I can’t possibly know it. I think I have described how mood slippages feel to me; but given my history of poor insight, there may well be other aspects, unrecognised as yet. I think I’m normal, the set point around which everyone else varies, but it’s not the same as your set point. Both of these views, yours and mine, have their own merits.