Enjoyable Depression

scootertrash nurse · Sep 27, 2009

most people who are bi polar don't take their meds because they spend more time in the manic phase which is more enjoyable than the depressed phase

JomoNurse · Sep 27, 2009

I've noticed there seems to be a good chunk of bipolar nurses. I don't know why that is. What's a manic phase like? Do you really think you are fantastic? I usually have to go sit in a tanning booth and go get my hair did for that lol.

emmalou* · Sep 27, 2009

A couple months ago I posted a question asking if it were possible for someone to more or less enjoy depression [or for depression to feel like a comfort zone]. Rather than anyone answering the question, all I received were personal experiences and extreme flaming...

I didn't see your previous question unfortunately - it sounds interesting.

I'm not sure if this is what you mean, but I've observed a certain type of person with depression (and in fact chronic illness, psychological and physical overall), who use the illness to their advantage and appear to be complacent about having the condition. They might, for example, use the illness as an excuse not to work, or to not make an effort with relationships, or to deal with difficult or challenging situations, or when they behave badly or inappropriately and someone reacts to that, they might say something like "I'm depressed, I can't help it". They might also like talking about their condition constantly, drawing attention to themselves.

Please don't misunderstand - I have a lot of empathy for people with chronic illness but I think most of us know people who might 'use' their medical condition to their advantage somewhat, manipulating others to get their own way at times.

From the research I've read, personality type is significant in diagnosis of depression or anxiety - negative, depressive type personalities have a higher risk of being diagnosed with depression, and people who are highly strung tend to have a higher risk of being diagnosed with anxiety. That's not to say that other personality types can't become depressed, for example, but it's thought that some people have better coping skills in terms of depression diagnosis and can avoid a depression diagnosis, or recover quickly from it, in terms of a traumatic or sad event.

While I think it's possible for people to use their condition to their own advantage, I think this might be more possible when the condition is mild or moderate, (not, for example, in severe depression). Also, I think rather than enjoying the depression, I think it could be that some people become used to it and even comfortable with it, and this is probably more likely in a manipulative and/or attention seeking personality type.

Just my thoughts. Not sure if this is what you meant though so if I'm off the track completely I apologise!

PostOpPrincess, BSN, RN · Sep 27, 2009

Thanks for the information!

rn/writer, RN · Sep 27, 2009

Someone with Bipolar disorder that experiences a 'mixed state' in which they experience some manic symptoms like euphoria, heighten creativity, or grandiosity while simultaneously experiencing a depressed state [or milder dysthymia] could consider that "depressed state" rather enjoyable [particularly when compared to their other moods/states].

Yes, there can be some relief from the heady rush of hypermania if the patient is in a mixed stated, but that combination isn't common. More frequently, a "crash" follows the a manic state and many patients find this frightening and very uncomfortable.

I think you hit the nail on the head when you mentioned comfort zone in relation to depression.

Let me make a distinction between chronic, low-grade depression that is characterized by lethargy and malaise and the acute, crushing, debilitating depression (by itself or in bipolar disorder) that causes excruciating emotional pain and distress. The former saps energy and disables ambition, but the latter can rob a person of all pleasure and perspective and, in the most extreme cases, can lead to suicide. There is no comfort zone in that condition.

If acute, severe depression is a trapdoor through which a person can plummet, milder forms would function more like thick quicksand, working to engulf its victims, but taking a good long time and an almost non-eventful way to do it.

Many practitioners believe that much of what is behind depression is anger that is misdirected or repressed. Relocating the anger to the real source or letting out what has been held in and denied for years takes a lot of courage. Things almost always get worse before they get better. As was mentioned earlier, it can be easier to resign yourself to living in the land of low expectations than to own your "negative" emotions and risk the loss of other people's approval. Rocking the boat internally leads to making waves externally, and this is not always greeted with love and support, especially if the people you have been angry with are friends and family.

Change of any kind involves counting the cost of the shake-up, and for many folks, they either can't find a believable vision of success, they don't know how to make it happen, or they just aren't sure it's going to be worth the pain.

Depression can serve as a buffer against real feelings, but the catch is that you can't repress and dampen selectively. It takes a bundle of energy to keep that stuff at bay. And a slow-down is a slow-down across the board. If you numb yourself to things you don't want to deal with, you end up muffling everything.

In some ways, the milder forms of depression are more insidious than the acute crises because they are far less likely to be taken seriously. Millions of people function fairly well with this vague kind of inner drag, so they don't get help. Depression feels normal, but it's like watching TV with about 75% of the color leached out of the picture.

If depression feels normal and change feels scary and unbalancing, it should come as no surprise that many people opt to keep the status quo. Of course, they don't see it in such clear terms, but that's the way it plays out.

Interesting concepts.

jessi1106, BSN, RN · Sep 27, 2009

Florence Nightingale was bipolar?

Years ago I studied her life but do not recall reading any info on that.

she was an amazing statistician and mathematician.

She even created/invented the "pie chart".

GilaRRT · Sep 27, 2009

I have herd of Flo bipolar theories; however, it is pretty hard to make any conclusions. I think she most likely had to deal with PTSD as her experiences of the Crimean war were horrific.

Regarding the topic: depression can be similar to chronic pain. It simply becomes part of everyday life, and people may not be aware of it's presence. It effects them and may cause problems; however, it is so integrated into day to day life it becomes "normal."

allnurses Guide · Sep 27, 2009

That is not what you asked in your last thread. You asked how would a nurse go about "consoling" a patient with depression or "the blues", regardless of the reason for their hospital admission.

You were advised that depression is not "the blues", and that it's generally not appropriate to discuss it if a patient is hospitalized for an unrelated issue.

Jules A, MSN · Sep 27, 2009

I think people become comfortable with their current status and can fear the unknown especially when it comes to psychiatric medication and the fear of it changing them or them losing what little control they feel they have. None of my bipolar patients have expressed relief with the depressive phase but as someone else stated they usually love the manic phase even though it often results in trouble.

pinkiepie_RN · Sep 27, 2009

Speaking as someone with manic depression, mixed episodes for me resemble sadness coupled with irritability, which is no relief. Hypomanic episodes are fun while they last, but the roller coaster ride must always come down.

Speaking as a nurse that works in psych, I definitely think it's possible to become comfortable with depression because it becomes the status quo. But I agree, this isn't quite the same thing you asked a couple of months ago. Depression, be it acute or chronic, is serious business but can become something that a person become accustomed to and when it's chronic and treated, it's like any other chronic illness in remission when it happens.

NightOwl0624 · Sep 27, 2009

Speaking as someone with manic depression, mixed episodes for me resemble sadness coupled with irritability, which is no relief. Hypomanic episodes are fun while they last, but the roller coaster ride must always come down.
Speaking as a nurse that works in psych, I definitely think it's possible to become comfortable with depression because it becomes the status quo. But I agree, this isn't quite the same thing you asked a couple of months ago. Depression, be it acute or chronic, is serious business but can become something that a person become accustomed to and when it's chronic and treated, it's like any other chronic illness in remission when it happens.

I think this is a very good explanation.

I had a family member who was in a mixed state for a period. It was not enjoyable for him or anyone else. The depression was severe, and the mania was more like uncontrollable negative energy => scary, destructive, painful. Mania is not necessarily "fun".

And I do believe some people become so accustomed to their depression that they use it as a crutch, or an excuse. I don't think it is appropriate to describe it as enjoyable.