“It’s a bit like walking down a long dark corridor, never knowing when the light will come on.” –Neil Lennon
There’s Depression – which is the type of Depression most people with Depression have. And then there’s Psychotic Depression, otherwise known by its clinical distinction; Major Depressive Disorder with Psychotic Features. The second type of Depression is far less common than the first – My Depression is Major Depressive Disorder; Recurrent with Psychotic Features.
Psychotic Depression is characterized not only by the symptoms of Depression itself, but also by hallucinations (seeing things that aren’t really there) or delusions (irrational thoughts and fears). At the time of my diagnosis, I had irrational thoughts and fears my behavior reflected — yet even in those moments when I was truly crazy, I had an awareness that I was. I knew what I thought and believed wasn’t right, I knew my behavior was out of control and wrong , but I was powerless to change any of it; I literally had no control over my own mind and knew that I didn’t. My feelings of victimization (now not by my parents, but by my own mind) and guilt over what I was doing to my family caused intense self-loathing which did nothing but fuel the depression – the cycle was endless and utterly surreal.
I have had two full-on psychotic periods – the first was actually horrific; the second led to my hospitalization before it became horrific (thankfully) because my wife just couldn’t take anymore. Going through my life retrospectively with my psychiatrist, we know that I’d actually been having occasional mild psychotic episodes since my teens. With Recurrent Psychotic Depression, each recurrence tends to be increasingly more severe than the last, making the illness and subsequent need for care more and more obvious – mine should have been diagnosed long before it was.
I will never know for sure how my parents missed all of this — probably a combination of our having no bond or relationship; I certainly did not trust them or share my life or feelings or problems with them, and their own detachment; they existed within their own problems and screwed-up lives. We were the classic Dysfunctional Family.
When I left that toxic environment, my life got better – I was happy. Eventually, I had a successful career and a wife and kids and all the benefits of an upper-middle class existence. Stability and happiness offered a respite, a kind of very real remission.
Yeah, I was cyclically moody and challenging to live with every once in while – aren’t we all? My wife suggested I see someone – a therapist, occasionally – but the period of moodiness would pass and life would return to normal very quickly. I was emotionally stable so I was able to care for her feelings and make right anything I had made wrong during my moodiness, thus closing the cycle; normal adult behavior in an emotionally mature and healthy marriage …
But when you’ve been abused, there are potential triggers everywhere. And when you closed the door on that abuse as I did, without working through it fully, those triggers fire automatic weapons …
And when all of that is combined with hormones that are suddenly imbalanced due to the onset of middle age and Metabolic Syndrome – a common middle age ailment in Abuse Survivors, the automatic weapons morph into time bombs …
All of a sudden:
the remission was over.
The respite had ended.
My life did not work.
I was psychotic.
It is my understanding that when a patient who has been diagnosed with Major Depressive Disorder; Recurrent with Psychotic Features subsequently receives a diagnosis of Bipolar Disorder, the first diagnosis is dropped. Bipolar Depression is the new designation, but this hybrid diagnosis typically occurs during late adolescence, not in middle age. Maybe I should inquire about an updated diagnosis …
In the end though, it’s just a label – and since I don’t let my illnesses dictate my life, I don’t really think it matters what anyone calls it.
Just as long as it responds to treatment, I’m good.