Lady Dr. Shrink says she is comfortable with me not being as heavily medicated as most of her clients because I have great insight into my bipolar disorder. Lack of insight is a common problem. I should know. I had my share of it for many years when I stopped going to doctors because I felt too good, too energetic, too on top of the world to be bothering with them. But now I do better.

I am particularly aware of manic symptoms. I’m sure this is good. Mania is when I tear my life to shreds. I sometimes  enjoy it along the way, but when the manic tide passes I find myself sitting in a bad living situation in a different state, with a pile of debt beyond my eyeballs, and generally some man in my life I’m wondering why I put there. I’m thoroughly tired of putting my life back together from chaos like that, so I have worked hard to have excellent insight into manic symptoms since I was diagnosed with manic depression. So far so good.

I realized yesterday, though, that I don’t have nearly as good insight into my depressive symptoms. I realized that after spending most of the day just feeling uninterested in anything and sort of lost. It didn’t occur to me until late in the day that it might be depression. Maybe that’s because they’re so passive in comparison to manic symptoms. Maybe it’s because I’ve spent so much time in depression over my life that it just seems normal to me. Depression is more insidious, and I don’t find myself in a different state with some man when I come out of it, but it does make my life generally cruddy. So maybe I need to work on this one.

Symptoms of  depression according to NIMH are

  • difficulty concentrating, remembering details, and making decisions
  • fatigue and decreased energy
  • feelings of guilt, worthlessness, and/or helplessness
  • feelings of hopelessness and/or pessimism
  • insomnia, early-morning wakefulness, or excessive sleeping
  • irritability, restlessness
  • loss of interest in activities or hobbies once pleasurable, including sex
  • overeating or appetite loss
  • persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
  • persistent sad, anxious, or “empty” feelings
  • thoughts of suicide, suicide attempts

Some of them seem pretty obvious, like uncontrollable crying and the death and suicide stuff. But some are so subtle and so tangled in a mind moving like sludge that they’re not obvious at first.  I think I’ll print a copy of this list and stick it nearby until I have it in my head what I’m looking out for as far as depression.  That way when it’s not so obvious as uncontrollable crying, I can work to make my life better.


Babbled by Immi.


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10 Responses to “Lack of Insight”
  1. Laura says:

    I’ve actually been blind-sided by depression in the past. I didn’t connect the dots very well and slipped into a psychotic depression because I missed symptoms that perhaps another would have noticed immediately and attributed to this condition.

  2. I have been told I have great insight, and that’s nice to know (thanks, Doc), but seriously, at the time he told me that all I wanted was some effing symptom relief! Insight is nice, but sometimes it’s not quite the ticket – if you know what I mean. I felt quite patronized when the doc told me this.

    On an off topic note – I know you have been having WordPress issues lately, but I was wondering if it’s at all possible for you to turn on the comments RSS option, or whatever it’s called – you know, follow-up comments get emailed to commenters. Just an idea!

  3. Immi says:

    Laura – Depression is a sneaky thing. Ah well we do the best we can.

    WC – Oh it’s a pain in the ass to be told you have insight when you’re looking for symptom relief. Docs can be so patronizing sometimes. I’m lucky that mine very seldom (I can’t remember any times) is.

    And off topic, you can pull comments RSS from the link at the bottom of the page. I will consider the option of having them emailed, but I think my webhost will choke on that as they have strict limits of how much email can be sent automatically via sites they host.

  4. Oh, I didn’t even see that link waaaaaay down there! Thanks for pointing it out! I’ll try that and see how it works!!!

  5. Ah, it sends the comments to my Google Reader! Good enough for me! Thanks again!

  6. Immi says:

    I’m glad that works for you, WC. I added a link to the Comments RSS up near the top too so other folks can find it. Thanks for pointing that out!

  7. As unhelpful as “insight” is, tis somewhat of a relief to know it’s supposed to replace medication since I don’t have medical care. ~_^ I like your past approach of not needing insight or doctors better tho’. What to do with us now that we’re so damn insightful?! My health issues are primarily physical so I’m not sure how much insight even helps but, then again, I suppose that’s an insight; DAMN.. ^_^

    (|_|*ch33rs*|_|)
    “The trouble with always trying to preserve the health of the body is that it is so difficult to do without destroying the health of the mind.” -G.K. Chesterton

  8. Normal Outlet says:

    Immi,

    I can soooo completely identify with your entire disposition. I’ve moved over 16 times in just as many years. I’ve gone abroad, come back home, moved back away, moved into “compromising” living situations, almost got MARRIED and am still here to tell the tale.

    Mind you, from the outset of my diagnosis my doctor, and some thereafter, championed my intelligence and accomplishment. Meanwhile I was a cross between a bat out of hell and an insurance company’s nightmare (feel free to read into that). Thus, in the same way I would digest what anyone says, I take the good of it (what works) and remain indifferent to the rest.

    As to the depression, I’ve been told my “normal” is a 2-3 on a scale from 1-10. Well below average. So I have the same issue you have with identifying what is just feeling down and what is downright depression. I actually left a pretty promising career because I thought it woud send me into the throws of depression! (Teaching inner-city kids.) So now I monitor my sleep patterns, my appetite and how often I make an effort to contact others. I know the last one isn’t on the list, but I tend to withdraw a lot when I get really down. So while the list NIMH has compiled is great and all – you might want to try reading your own natural bodily rhythms.

    BTW – Love your blog and am ecstatic to find there are so many bi-polar connected through twitter. Technology actually is good for something :D

  9. Immi says:

    Dorian, Insight is the most useful for making lifestyle changes as needed to keep things from getting too out of hand. Well, that and running for help when things are already too out of hand.

    Normal Outlet, Gee all that sounds familiar. The list is just a guideline. I track my sleep, meds, moods, and all that to see how things flow for me. Sometimes being down just makes sense. Other times not so much.

  10. [...] « Lack of Insight Jan 12 2010 [...]

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“We're all crazy and the only difference between patients and their therapists is the therapists haven't been caught yet.” ~~Max Walker
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