I had a great counselor this last treatment. He was the new clinical director of the treatment facility in which I was a patient, and he started just a few days after I did. In his very first group, one of the things he spoke about was psychiatric diagnoses. He talked about the DSM, the Diagnostic and Statistical Manual of Mental Disorders, which is edited and updated every so often by the American Psychiatric Association. My counselor said something that really struck me - that the only reason for having psychiatric diagnoses is for billing the insurance company* - that the maladaptive behaviors sometimes exhibited by those of us living with mental health disorders are learned behaviors and coping mechanisms. His point was that we can take apart the diagnosis, and work on individual symptoms. What he said really struck me, and I had to ponder it the rest of the day and into the night.
I'm writing about this because I took his words to heart, and began to look at my mental health disorder, my diagnosis, in a different light. Is it possible that I hadn't made very much headway in treating my mental health disorder because I was trying to treat the whole disorder, rather than the symptoms?
As I write this, I have experienced approximately four months of what I call remission from depression. I'm not saying it's gone, but it's been sleeping fairly heavily! In these past four months I've stopped wanting to die, I've stopped experiencing suicidal ideation, and my hope, self-esteem, and motivation have increased dramatically. I will note that I am still taking the same medication prescribed to treat depression that I was taking before I entered treatment. I don't want to say the depression is gone - that would be denial that I still have issues to deal with - but I can say that I do not remember feeling like I've felt with such consistency ever. So something's going on!
Let's take a quick look at my history with major depressive disorder. As a youngster, I often thought of death, and as an adolescent, and off and on through my adult life, I often felt suicidal - I wanted to die. Growing up, I did not recognize these feelings as symptoms of anything - I thought they were me. I identified myself so closely with depression and its symptoms that what I was experiencing was virtually untreatable, until about 5 years ago. Even after receiving promising treatment for depression, I was unable to escape its grasp on me - the program was running, and I couldn't do much about it.
Now let's take a look at something I've discussed in several posts over the years: automatic thinking. For our survival, humans are wired to classify things in our environment as safe or dangerous. We're set up that way so that the 2nd time (if there is a 2nd time) we see a tiger while walking in the woods, we don't have to think about whether to fight, run, or be very, very still - the response comes automatically. This is a great setup for basic survival; however, because of the world we now live in, automatic thinking can give false positives. For instance, a person who has been to war and survived living for a time in a very dangerous environment may come back from the war and be unable to enjoy life again - say, going to the fireworks on the 4th of July - because the normal events of life can bring them right back to when they lived in grave danger, even though they are in a safe place right now. Their brain is literally stuck where events which are similar, but not the same, as they experienced during war create the same anxiety and aversion as they did during the war. This particular set of symptoms is called Post-Traumatic Stress Disorder. What makes this a mental health disorder is that not everybody who experiences the same trauma (war, in this example) will experience the symptoms of PTSD later on - part of what makes mental health disorders disorders is that the symptoms are behavior or thoughts outside the 'norm' - if everybody experienced the same thoughts and behaviors from the same stimuli, it wouldn't be a disorder; it would be life.
I experienced some things in my childhood that I wanted to avoid experiencing again. Now, some of these things I don't remember - I do not remember most of my preteen years - but I have the symptomology - the maladaptive behaviors - to have a pretty good idea that they happened. But that's not the point - the point is that my reaction was to want to avoid or escape whatever was going on, and I began to carry that reaction - escape or avoid - into just about every situation that made me feel uncomfortable. That's what makes it a mental health disorder, because not everybody who experienced stuff in their childhood developed maladaptive behaviors as a reaction. My coping mechanisms were basically dreaming of a permanent escape and, later on, drinking and using drugs as a means to avoid and escape. I also learned a lot of non-substance using ways to avoid and escape too!
Ok, what about the alcoholic part? And what about chemical imbalances that we hear so much about? I do believe in the genetics of alcoholism and addiction, and I believe I would have been an alcoholic/addict no matter what. As far as having a chemical imbalance, I do believe that I inadvertently trained my brain to be depressed. Again, if I begin to believe at an early age that I live in a dangerous world where I can't really trust others, and I have nothing contraindicating that belief, that idea can become very entrenched, and eventually the brain adapts to that kind of thinking. And I'll put this out there, too - it does not matter whether or not the belief is true. Imagine, if you will, growing up believing that the man you call daddy is your biological father, and then finding out as a teenager or an adult that, in reality, another person is your biological father. Does that change who your de facto father is? Probably not, unless you're looking for a reason to be adopted. (This is just an example for illustration; my father is my biological father).
So what's the point? I've got some cognitive dissonance going on here that I've had for a long time. On the one hand, part of me has believed for a long time that I am a defective person incapable of leading any kind of worthwhile life no matter what I try, while, on the other hand, I believe that we are children of a loving Creator made in Its image, which is perfect, holy, and in Whom nothing will be impossible. So which is it? Well, I'm going to go with the latter, which I'll talk about more in Dismantling the Program - Part II.
Namasté,
Ken
*In deference to those living with mental health disorders, especially severe mental health disorders, and in deference to those working in the mental health profession, I am not saying, "You are wrong." I invite you to look at mental health disorders in whatever way works best for you. I am simply offering my own experience for your consideration. Ken
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