Depression vs. ennui
June 26, 2011 8:07 PM   Subscribe

How to tell the difference between depression and regular sadness/ennui, especially if you've struggled with depression/bipolar previously?

I'm 23 and was diagnosed as bipolar 2 last year, after having spent probably seven or eight of the past 10 years being moderately-to-severely depressed. I have never been on medication -- about a year ago, once I finally admitted to myself that I needed more help than therapy could offer, I decided to talk to a doctor about meds. But the process of getting a doctor to help me felt both overwhelming and painfully slow and finally I ended up coming out of the depressive episode, and in a more or less stable/euthymic condition, before I even finished the process of getting prescribed medication.

So that's been nice. Presently, however, I'm working in a dead-end job, and stressing over some mild family- and friend-related issues that have flared up (partially related to said crappy job), and generally feeling lost and confused in life. And now, for the past month or two, it seems like some aspects of the depression are coming back (the flattening of emotions, the slowness of thought, the hateful self-talk, the irritability and emptiness and lack of ability to enjoy much), but to a much lesser degree than I've experienced in the past. Keeping in mind that I've almost *never* in my adult life not been depressed, and therefore don't really know how non-depressed people deal with these sorts of situations, does this sound like something I should be concerned about, or is this just how it *is*? How do I know the difference between feeling consistently down and being depressed, if it's the beginning of a depressive episode, or if it's a mild depressive episode? How do I know if this is "go to a doctor" territory or "stop being a whiny bitch" territory?

Thanks for your answers.
posted by anonymous to Health & Fitness (12 answers total) 26 users marked this as a favorite
I am not a doctor, but it is completely normal to feel depressed about having a dead-end job and relationship problems. If you feel trapped where you are and helpless/hopeless about making positive changes to your current situation, that could be related to more serious underlying depression issues that may prevent you from moving your life in a better direction, only compounding the problem.
posted by wondermouse at 8:29 PM on June 26, 2011

I have never had depression but people close to me have. However, I HAVE had crappy dead-end jobs, family problems and relationship problems and I have not had the flattening or other symptoms you mention. You dont have to feel that way, please seek professional help to get past this.
posted by saucysault at 8:37 PM on June 26, 2011 [1 favorite]

Take it seriously. That doesn't mean go to the Doctor, unless taking it seriously warrants that as a response (if you need the assistance of a Doctor, by all means go). Even if it's just ennui, ennui can lead a depressive person back to those dark places if they are not careful. It's worth being careful.

Here's how it works for me. I think of depression as being like the way alcoholism is popularly understood. Being a recovering depressive is a bit like being a recovering alcoholic. Somewhere inside my own mind, there is a bar, and all of my old friends are there drinking, all the regulars. It's comfortable there, and I know it well. Being an alcoholic means I can't go there any more, as comfortable and familiar as the place is. More to the point, it means I have to be careful when I find I'm even in that part of town. Maybe I'll walk through the old neighborhood and see how it is now. Maybe I can even look in through the window and see the old faces. Next thing I know, I've had a few shots of loathing & despair with a self-destruction chaser, and I'm in the gutter again.

For me, the battle is won or lost before I even turn the corner to go down that street. Once I start walking down the road, it gets harder and harder to stop.

For me, Cognitive Behavioral Therapy was a real help, particularly Mindfulness-based therapy. There are quite a few books out there on this topic: I recommend this one. Part of the reason I recommend it is because it fights the battle where I need to fight it, long before I'm actually depressed, when I'm just starting to repeat to myself how worthless I am and how I will never accomplish anything and how it will always be this way. That's when I need the help, because what comes after that is too powerful for me.

The other reason I recommend the book is because it's not as expensive as therapy, so you don't really have to worry whether it's "just" ennui or really really real depression.

tl;dr: It's never a bad time to develop healthy ways to cope with ennui. You don't have to have a big scary capital-letters Mental Illness to need a new way to feel. Good luck. Know that we're here for you.
posted by gauche at 8:46 PM on June 26, 2011 [21 favorites]

I have both depression and a dead-end job, family issues, etc. When you feel worse than you should in the situation, get help. Meds/therapy sometimes give you the motivation to change your situation.
posted by Lovecraft In Brooklyn at 8:53 PM on June 26, 2011

The way I personally can tell for certain is via my thoughts, not my feelings. Very depressed thoughts of mine go like this: "there is some terrible, shameful thing that is wrong with me and that cannot, cannot be fixed." Less depressed ones are about having done things that are embarrassing, that I feel guilty about. Or just a lot of worry.

Anxiety, for me, was more whiny. It's hard to remember because that was a long time ago; I think my anxiety shifted more and more into depression over time.

(Like you, I have a bipolar 2 diagnosis, but I'm not sure if that's really relevant)
posted by kitcat at 9:02 PM on June 26, 2011 [1 favorite]

For me the difference between depression and sadness is the presence of hope. Do I have hope that things will get better? Not depression. Hopelessness brings sadness into depression.

I don't think that feeling sad makes one a "whiny bitch". Its important to acknowledge feelings of sadness even if they are not full-on depression.
posted by bearette at 10:02 PM on June 26, 2011 [1 favorite]

This is from a lay person's view; a neurologist's view may be different. For me, they are a spectrum of the same stuff, but it has to do with how habitual that mental groove becomes, and therefore how deep it is and how hard it is to climb out of it. What I catch that makes me say "okay, I have to really stop getting grouchier and grouchier and start taking care of myself here" is when I start to feel very tired, like everything is just so hard. But that's a fairly early symptom for me since I'm normally fairly high energy; others who are naturally more slow-paced might need other signals. I think this is good question and look forward to the other answers.
posted by salvia at 10:21 PM on June 26, 2011 [1 favorite]

It could vary for everyone. My cue is the flatness. If I feel the flatness, even if it's say not enjoying my morning coffee as much as I was a month ago, I go back to my strategies of choice (stuff I have learned to implement on my own). I think of it as being like a diabetic who monitors their blood sugar levels.
posted by skermunkil at 12:47 AM on June 27, 2011

You need to treat your illness .
posted by St. Alia of the Bunnies at 4:13 AM on June 27, 2011

When I first went on antidepressants, one of the big and life-changing differences was that I could explain my negative feelings for the first time. I still had bad days and got bummed about my awful job, but when I did, I would think:

"I am feeling (mood) because (situational factor). I will feel better when I (non-destructive action)."

If you can't fill out that sentence at any point without judging yourself (a statement about your worth, or perceived lack thereof, should never go after "because") or identifying something you are willing and able to do to improve the moment, or if you can't bring yourself to complete that sentence at all, it's a safe bet your brain could use a hand.

Bipolar and cyclothymia can be hard to manage, since your mood can improve and stay elevated without treatment. It can feel like you've recovered, so you won't see any use for continuing to see a doctor. Next time this happens, keep the appointment anyway, and use it to talk to your doctor about how to figure out when you're not feeling well, and what action to take. Your therapist and/or psychiatrist will also see what "fine" looks and feels like to you, and it can help build a rapport that may make you feel more comfortable going back to them when things aren't so fine anymore.
posted by Metroid Baby at 4:56 AM on June 27, 2011 [5 favorites]

My previous post was on a smartphone so let me elaborate now that I have a real keyboard....bipolar 2 according to my old pdoc can be a progressive disease and if you don't treat it it can get worse.

Do your docs recommend you do the meds? Then you need to do the meds. They have great ones out there now-lamictal in particular is becoming a med of choice and does well for bp depression.

As to the question you pose, even if your sadness is situational it can and probably will trigger into the bipolar stuff.

Go get treated!
posted by St. Alia of the Bunnies at 12:47 PM on June 27, 2011

I am bipolar type 2 as well.

The thing that stood out to me in your post was "the flattening of emotions". If you're feeling emotionally numb, where *any* emotion (positive or negative) seems hard to come by, you need to see the psychiatrist as this could be a sign of over-medication, or the wrong medication. Meds are supposed to help us regulate emotions, not get rid of them altogether.

Your symptoms, as you describe them, (the flattening of emotions, the slowness of thought, the hateful self-talk, the irritability and emptiness and lack of ability to enjoy much) are, in fact, symptoms of depression, regardless of them being to a lesser extent than before and should be discussed with your therapist and psychiatrist.

I really like what Metroid Baby had to say about filling in the blanks:

"I am feeling (mood) because (situational factor). I will feel better when I (non-destructive action)."

For me, (mood) can be sad, angry, disappointed, upset or just plain down. It *shouldn't* be helpless, hopeless, worthless, self-destructive or hateful toward myself. If it is: time to see my pdoc.

I also try to keep (situational factor) at least somewhat specific. This is the "trigger". If I can only fill in this blank with "my life sucks" or "I suck" or a re-phrasing of what (mood) shouldn't be, it's time to see the pdoc.

(Non-destructive action) - this is the tool-box, our coping skills. Taking a walk, riding a bike, reading a book, some job-hunting (for me, as I'm unemployed), spending time with good friends, etc. Basically, whatever cheers you up. This is also where I'd put "working through DBT" If nothing in my tool-box seems to help, it's time to see my therapist and/or pdoc.

I'm sorry to hear you're going through such a rough time. Please feel free to MeMail me if you need to chat.
posted by MuChao at 8:06 AM on June 28, 2011 [2 favorites]

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