the following post notwithstanding, Iām doing quite well btw!!
Today on my psych rotation, a resident explained to me that even high-functioning educated employed people can be depressed--even severely depressed!--and you would never know it from seeing them at work. āThis is a great case with a lot of teaching points, because this is what real depression often looks like,ā he said. āThese patients can be extremely good at hiding their symptoms when theyāre out in the world. You can feel the depression just radiating off him, itās palpable when heās at the appointment, yet if you passed him on the street, you would never know it.ā
I didnāt know what to do--I couldnāt start laughing hysterically like I wanted to, because then I might have never stopped--so I just said this was really interesting, mm-hmm, yeah, makes sense, interesting.
Itās a little hard for me to understand the never-depressed (you mean, youāve never wanted to die? really??? when the morning arrives, do you just, like... get up? but, like... how?). Even though Iāve only experienced pretty garden-variety stuff, never mania or psychosis, mental illness in general almost makes more sense to me than, idk, bopping along through life with a sunny tune playing in your head, or whatever the heck these forever mentally well people are doing. The world is tough, life can be hard, we donāt know why weāre here, and I try to avoid reading about celebrity suicides because itās just a little bit dangerous for me. Psychiatrists should know better than anyone that people with mental illnesses come from all walks of life, look all different ways, even pass among us undetected (!), and yet so far everyone I talk with firmly puts Patients in one category, Us in the other. Even though my life-saving psychiatrist (who moved on to the Pacific Northwest like so many of my faraway loves; miss you, Dr. V) and my therapist both said they see a lot of medical students specifically.
Do psychiatrists seriously think weāre immune? What would happen if I told that resident, āYeah, it was really interesting hearing how that patient had some of the same reasons for not seeking committing suicide that I did!ā (Attempts fail more often than they succeed, thankfully, and while inpatient serves a purpose, itās pretty miserable in general, I didnāt want to have to get all my work stuff in order so someone could cover my projects, and most of all, in case I did survive and someday feel better, I didnāt want to have missed the 30 Rock live show that we had tickets for... so, you might as well live, you know?)
Sometimes I think I should become a rogue psychiatrist, but then other times I think that Iām really more suited to being a rogue internist, so weāll see.
P.S. I just finished this book today and it was terrific! The Center Cannot Hold: My Journey Through Madness, by Elyn Saks. Sheās a highly intelligent and educated law professor with schizophrenia, and writes about it all in a very straightforward and vivid way that helped me understand the experience of having paranoia and psychosis a lot better. I feel like this is what we should be reading instead of yet another variation of First Aid, no? https://psychcentral.com/lib/the-center-cannot-hold-my-journey-through-madness/
