Dragon of the Scribe

{June 24, 2012}   What does High Risk Acute Depression mean?

This is one of the first things I tell new people I meet when they ask questions about myself.  I’m going to spare you from as much back story as I can.  This also probably does not apply to a vast majority of sufferers in any way, though there might be some similarity’s that others can relate to.  This also holds NO MEDICAL information in regards to self-diagnosis and treatment!  I hold no responsibilty for another’s actions based on what I write.  This is also written from my own point of view, and subject to change.  I also understand that what I’m writing could be false in terms of what I’m trying to understand.

Basically my depression is caused by my neurons not firing signals to my brain appropriately.  My emotions are erratic, unstable and very difficult to control on a day-to-day basis.  My condition is very similar to Bi-Polar, but differ in a way that most of my system is triggered by events on the outside, rather than the inside.  This often means I can be awesome for weeks or months at a time, and when something (big or small) triggers an attack – it’s devastating and debilitating.

This condition is rare, only accounting for about 1% of all people diagnosed with depression or Bi-Polar disorder, and difficult to diagnose and treat.  They account for a large majority of suicides, self-mutilation and other self-harming activities.  Because of how dangerous Acute Depression is, I MUST at all times have a cell phone with emergency contacts, regular medication and a strict scheduled day (which never happens 😛 )

So, what does this mean for me?  What are my symptoms, and how does it affect me day to day?

I can’t feel hunger. My stomach will growl and whatever, but the actual NEED to eat is unknown to me.  Sometimes, RARELY I’ll tell my husband “I’m hungry.”  I don’t feel hungry, but I know it’s been so long since I’ve eaten something, and I have to eat to live.   We don’t know how the depression affected this, but my theory is that my brain has a hard enough time trying to figure out what emotion is what – that it ignores the pains of hunger because it’s not an emotion per say.  Thirst, being related to that, is only noticed by me because of having a dry mouth in the morning for example.  There are physical cues still present, but often ignored.

The other big thing is my lack of being to understand what emotion is what.  Confusion, anxiety, anger … these emotions are often clumped together and I’m unable to figure out what the appropriate response is. This inner confusion often has me on edge, and I lash out because I don’t know what the proper social way to communicate whatever it is I’m feeling.  If I’m confused, I often act aggressive – if I’m angry, I act sad, if I’m sad – I act confused …. it seems strange doesn’t it?  I’ll confuse anger for sadness and then act like I’m confused.

Here’s an example: I’m mad because … I can’t get a math problem right.  <– Anger + confusion.
My outward response:  “I’m scared of getting in trouble for not doing it right.” <– Anxiety + self-doubt.

What the hell?  Doesn’t make sense does it?  This is what my husband has to figure out every day when I say something in regards to how I’m feeling.  It’s not that I’m stupid for not understanding the math problem, it’s that my brain cannot understand the appropriate responses to stimulus.  I should also note:  My husband, or any of my friends have EVER gotten mad at me for something like this.

What about the positive emotions?  Happiness, Pride, Joy?  This is where it gets more confusing.

I’m generally a person that when people see down the street, I’m smiling.  I’m extremely intelligent, observant, thoughtful and I take my time to visit friends and help those who need it.  Very few people have actually seen my depression in the negatives, and most can’t even understand how someone like me could have this condition.  Happiness, pride, joy…. all of these positive emotions are treated just like the negative ones – my brain doesn’t understand that these are separate feelings and uses the same response for each one.  Basically, instead of having a symphony of expression, I have one.  I smile, giggle, and generally very bouncy.  A 3 year old with a lollipop basically.

To simplify.  I have the emotional range and control of a 3 year old.  This does not mean I’m immature or idiotic.  To show myself SOME kind of pride, I’m a borderline genius.  If I took the time, I would be an actual genius and doing something with it.

Now, what I described above is the ‘minor’ every day stuff I go through.  What makes this so dangerous is what happens when, what I call an ‘episode’, happens.

An ‘episode’ is when something triggers a massive attack of negative feelings that causes my body and brain to go into a state of uncontrolled emotional destruction.  These are unpredictable, extremely hard to manage and dangerous to not just myself, but others around me.  I often lose all reasoning, the ability of speech, thought continuity, and common sense.  I cry uncontrollably, nothing makes me happy, I can’t sleep, I can’t eat – I can’t even remember what love is, and that I actually DO love my husband. In my head, during that period of time – EVERYTHING is impossible.  These have a range from moderate to severe – moderate being it lasts a few hours, severe meaning it lasts a day.  A MAJOR episode is when an episode lasts up to 3 days, and in which case I need to see my doctor.

During an episode, I often forget past experiences that made me happy.  I lose all the positive outlooks, including how I feel about myself, my accomplishments, my love for my friends and family – and the joy of being alive.  Episodes can quickly spiral into suicidal thoughts, and then to self-termination.  After an episode has passed, I often forget everything about it.  For this reason, my husband often accompanies me to doctor visits so he can tell them what happened.

What do I do for Treatments?

Medication is my first line of defense from having an episode.  I take Paxil for the depression, and Concerta for the ADHD.  The ADHD is also severe, but not the basis for this article, hence I’m leaving it at that.  This has helped me sort out what emotion is what, and helps me understand the stimulus of my enviorment to make proper judgement and responses.  As a good example:  Instead of feeling angry for being hungry – while my brain is still angry, I know that I have to eat.  I’m still snappy and aggressive, but I’m now able to go ‘why do I feel this way?  Oh, I remember, when I feel THIS type of anger it means I’m most likely hungry.’  Of course, this isn’t perfect. There are still times when I’ll try to eat something, but I’m still angry for some reason.  These minor mood swings aren’t fun, but not unmanageable.

My second line of defense?  My husband and my friends.  I’ve been with Christophe (note: there’s no R!  Chris-toff!”) since March of 2005.  I met him during my last year of highschool when he was a freshman the previous December during first semesters final exams. We started dating in March, and been together ever since.  This has been 7 years.  This has given him a lot of time to perceive  my emotional fragility, try to understand it – and get me help.  He took the time to ask questions about ‘what do I do?’.  His dedication to my well being is probably the only reason why I’m able to talk to you right now.  He has also taken the time to explain to people how to react, respond and treat me when I’m having a severe episode. Explaining the difference between a ‘temper tantrum’ which I also have, and a serious and dangerous episode where I have no clue what a friend is.

As an example:  The other day I came home in tears.  I’m not going to tell you why or what happened, though I might in a later date.  Our friend who has been with us for a few months now, ordered me to do the dishes.  I told her I couldn’t do them and I went back in my bedroom to cry some more.  My thoughts during that time was “OMG my friend is so mad at me now, I knew I had to do them, but I can’t, I have no energy, and now she’s pissed…” and this went on until my husband came back.  He explained to her that during these episodes – your actions and tone of voice and expectations of me could mean the difference between getting out of it, or going deeper.

Very few people have seen a true episode, and they’re very confusing to those who have never seen one.  In the eyes of my friend, I don’t think she understood what I was feeling during that time. I think what she saw was a girl crying for no reason at all, other than feeling sorry for herself.  My friend couldn’t comprehend why I was self-destructing myself when I had everything in the world – and showed me this picture.

Then why can’t I do more, if I’m so lucky?

“My friend showed me a picture that said “I’m part of the 1% more fortunate than anyone else on earth”  and I’ve been crying and shaking since I got home
“I told her it hurt me, but I don’t think she understands exactly WHY it hurts… I can’t speak”

This was an insult, a slap to the face for me.  It basically told me that I am so lucky to be part of the 1% when there are children DYING every second.  That I should be PROUD to be part of that 1% who have everything!  I took it as insulting, condescending, and more reason to hate myself.  Here I am, crying my eyes out – and there’s a child dying every second – just because I’m a little “stressed.”

It’s hard for people on the outside to understand how powerful emotional pain can be.  Another friend of mine, Skivon, managed to explain how people try to help depressed people.

“Imagine the worst physical pain you’ve ever felt.”  He asked of me.  I replied with having my left wrist basically shattered, and two hairline fractures in my right wrist.  “Now, how often have you stubbed your toe?”  I said not that often, but often enough that I curse at it.

“Why curse at it?  You’ve felt worse before.  Pain is pain, and this is NOT something you’re just going to get ‘over’ for thinking happy thoughts.  Pain doesn’t care WHY it hurts, it just hurts.”

This is all the time I have for now, but I hope this gives you a larger understanding of what Acute Depression might mean for someone you love.  Thank you, and good night.


There’s a lot of truth in that graphic, but like almost everything else, context matters. There’s a brief exchange from Franzen’s novel “The Corrections” about this. I think that all this “you have more than everyone else” either silences people suffering from an illness or blinds others to what the suffering are experiencing. We do have more, but that doesn’t mean any of us is suddenly immune to pain!

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