Fatal Mistake

Though my experience with being a therapist has been relatively short, I have already come to the conclusion that there are going to be certain conversations that I will have about 3-kabillion times over the course of my lifetime. Of course, because they will happen with different people, I'm hopeful that they won't get old (they haven't yet). Over the last several days I have had one of  these conversations a few times, and in light of recent events in my life the topic has taken on new meaning and I thought it might be interesting to share. The topic is what I have come to term: THE FATAL MISTAKE. This title is certainly intended to be shocking, as to catch the attention of a patient/client, but is also quite literal as the consequences of making this mistake could, and has, led to lives ending far too early.  I want to discuss this mistake in terms of how it fits into mental illness and then generalize it to those of you lucky enough to be able to have skirted by without being diagnosed :).

 Have you ever asked anyone to describe themselves? Unless its for some sort of online dating situation, how often do people default to talking about their strengths? "Well, I'm tall. I have beautiful blonde hair and a cute butt. I am really responsible and understanding, and all in all I do the best I can everyday." This, unfortunately is not common place for most people, I know it isn't for me (except for the cute butt part...I mean...obviously). Unfortunately, it seems that the descriptions of one's self become more and more negative the more depressed or anxious a person is, which makes sense right? Someone who is feeling really crappy about their lives is going to see bad things about themselves much more readily than average. Life's problems often times seem to highlight a person's weaknesses and magnify personal negative traits.  But here is where the Fatal Mistake comes in: 

DON'T MISINTERPRET SYMPTOMS  OF A PROBLEM AS PERSONAL CHARACTERISTICS. 

When working with people with depression, especially someone who has struggled with depression for a long time, it is really common for them to become over-attached to the illness and they start misinterpreting symptoms of the illness as negative personal qualities. They will talk about feeling like a lazy person, or being a loner or introvert. They will describe themselves as boring and that they don't even really want to have fun anymore. They will say that they are just a really negative person. Well guess what? All of those things you just described are symptoms, written in the holy book of psychiatric symptoms, of depression! It's not you, It's depression!  To illustrate my point, lets look at the official diagnostic criteria for a Major Depressive Episode: 

At least five of the following symptoms have been present during the same 2-week period and represent a change from previous functioning: at least one of the symptoms is either 1)

depressed mood or 2) loss of interest or pleasure.

1. Depressed mood most of the day, nearly every day, as indicated either by subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful)

2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated either by subjective account or observation made by others)

3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day

4. Insomnia or hypersomnia nearly every day

5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)

6. Fatigue or loss of energy nearly every day

7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)

8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed

by others)

9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or specific plan for committing suicide

 
Ok, so that is a lot of words, and you may have just skipped over that, and that's alright. But if you'll notice, if someone says that they ARE any of the a previously described things above (lazy, a loner/introvert, boring, negative) those can all be attributed to one of the criteria listed here.

Whats the big problem here? You might say. Well, if YOU are all of these things, then depression  just became a bajillion times harder to get rid of because you are you no matter where you go. For those struggling with mental illness, I believe it is a vital skill to learn to be able to distinguish between "me" and "the illness" and to not get the two confused. Because if it is outside of me than it is a solvable problem...if the problem is me...well...shoot.

That isn't to say that people aren't responsible for their own feelings or actions or anything. It is a common and good practice in therapy to help people to take ownership for what is theirs to own, in that way helping them to have more power to change what is wrong. Attributing your issues to an illness doesn't make them any less "yours" it just makes the problem not you.  It is attributing the negative experiences to the illness as opposed to thinking that I'm just innately an awful human. 

If you don't have a "mental illness" this is just as applicable and I hereby give you permission to title whatever your struggles are as "the problem" (you're welcome). Attributing your weaknesses and shortcomings to "the problem" can sometimes help to gain a better perspective of those weaknesses and make them seem like something solvable. Rather than, "I'm kind of a boring mom and I don't get involved in church nearly as much as I should." It becomes, "the 'problem' makes me feel like I'm a boring mom, but I know that inside of me is a really amazing mom and a faithful, active member of my church. I'm going to make decisions that I would make, not what 'the problem' would want me to make."

The difference is subtle and maybe seems kind of stupid but...hear me out: 

As soon as I start explaining this concept to someone, almost always I get the question "Well then what can I attach to myself? What can I determine is really me?"  My conclusion is this: if it is something that is going to be there and stick with you as you become who you want to be...than you can go ahead and start attaching it to yourself now, everything else is a symptom. 

We are all trying to become the best versions of ourselves. In my faith, the LDS church teaches that to gain a fullness of happiness we are to become like God because he is Happiness Complete. Everyone in one form or another really desires to be the best they can be because they have had experience with tastes of this and it always tastes good.  Whether its symptoms of a mental illness or simply weaknesses we struggle with from day to day...I see these as temporary, and really not worth using as a description of who you are.

I'm Blaine Hickman. I can be really impatient. I judge lots of movies really harshly even before I've seen them. I procrastinate things all of the time. I don't play with my kids enough. I CANNOT get through a chapter of scriptures without falling asleep. I over-eat a lot, and swear all of the time.

But at some point between now and eternity or as I become who I want to be...those things will fade away and I will still be empathetic, kind, awesome at giving gifts, and able to see good in anyone. 

What will you be?