Author: Ivory Smith Causey
On a clear midnight sky there are stars twinkling and the moon shines bright in the vast expanse. It is dark but not black. However, in a severe depressive episode, unlike the midnight sky, there are no stars or no moon. There is only the blackness. This is blacker than tar, sticky and heavy. This type of blackness causes even the entire body to ache. Moving in it is like walking in a pool full of resistance. Also, having the knowledge that life responsibilities must carry on in spite of the dark. Bills come in to be paid, dishes need to be washed, and bodies must be washed. Someone may say look out and say “look see how pretty and sunny it is today!” Someone else may say, “Happy Friday, what a beautiful day!” No, I say I see the dark and it is black and with it carries dark thoughts.
This past spring through the mid summer I was in a full blown manic episode. My doctor had to emergently titrate medication to keep me psychiatrically safe. The side effects initiated a low grade depressive episode. I had to take leave and felt embarrassed upon my return to work. I had massive job related issues in which I questioned my inherent worth as a person.
During this low grade depression, I was able to function with the basics. That is get up, make coffee, go to work, eat dinner, take medication, go to bed then hit the repeat button. However, I had an “off” feeling. Routines that I was accustomed to and were important took a back seat. Gym routines changed and began to “miss” major muscle groups or shorting myself five, then ten minutes off of my walk. I felt more fatigued and want to be at home more. The mania infused “energy” was no longer there. Next hygiene routines began to change. Showers were becoming more difficult again. Meal prep for the week does not happen. Eating out occurred more often because I felt too overwhelmed to make a turkey sandwich “dinner”
Also, I began to ruminate. Rumination involves repetitive thinking or dwelling on negative feelings and distress and their causes and consequences. Rumination is a repetitive thought process that can involve obsessing over a situation, idea, or choice. I call it going down the rabbit hole. Like a link in a chain, one thought lead to another host of negative thoughts.
For me dark thoughts are a rumination that leads to suicidal ideation.
Some examples of dark thoughts are that:
*I personally failed at reintroducing a mood stabilizer and if I tried harder the medication would have worked for me.
*I made some mistakes at work during a manic phase which progresses to what am I good at? Maybe I should file for social security disability?
*Every fall comes with these mood changes like clockwork especially at Thanksgiving and Christmas and I don’t want to keep experiencing depression again.
*The knowledge that bipolar disorder is chronic illness and not if but when episodes occur is a continuous journey of acceptance.
Since I have experienced dark thought in depression multiple times in my life I have found some consolation of these activities.
The things that worked for me is:
Practicing Radical Acceptance: This is a part of DBT (dialectical behavior therapy). I accept situation that are outside my control for right now. However I acknowledge my emotions of anger, frustration, even disgust with circumstances. It is accepting reality but not approving. It is not giving in but starting the healing of letting go of resentment, pain, and trauma.
Exercise: Once I get to the gym I feel the energy of the other patrons and people I know. When in a depressed episode I have learned what my best time of day is. It is early am between 5:00 am and 10:00am. I encounter no dark thoughts and rumination during strength training. During strength training breathing, counting repetitions, and making sure I don’t injure myself helps with rumination. In a study by Lafer, B et al, patients diagnosed with bipolar disordered showed substantial improvement in depression symptoms at 12 weeks of exercise( aerobic and resistance training). The subjects had aerobic training on the treadmill and strength training with specific equipment.
Nature: I go to a local river park with trails, picnic pavilion, and benches overlooking the river. The first sunlight sometimes prevent me from going into the deepest depression or starting negative thoughts for that day. It is there where I get quiet, read inspirations, and use universal affirmations for myself. I affirm to myself I am loved, I am safe, I am in the present here and now, or I am unique. Today is a great day before the day starts. I say them out loud even if I don’t believe it or think it sounds ridiculous.
Calling my providers and the on call numbers: In the past, I was ashamed of calling my psychiatrist office because I felt I was “bothering the staff”. Even though I seldom called between appointments, I falsely prided myself on not having to call my provider on call number for emergencies. Then it happened to me, that I had to call 988 crises number and provider at 4:00 am in the morning.
Calling the 988 crises number: I have had suicidal ideation thoughts without a plan. The dark thought were so encompassing I knew no other way away from them and stop the painful feelings inside.
It is important to me to write these blogs to inspire others. If just one person feels less alone through reading blogs and exploring how others cope with dark thought s of depression then that is enough. I believe in being an advocate for myself and others. I believe in being assertive and politely professionally aggressive when it comes to healthcare and my loved ones. If I am having side effects of a medication I will discuss. I believe that this is my body and it takes time to get to my your body. Learn how your reacts to five hours of sleep verse seven during episodes. Learn how your body reacts to eating processed foods verses a whole food diet to combat depression.
The second drive to inspire others is my professional calling as a nurse. I see my duties outside of my employment to educate others on the rumination and dark thoughts that lead to suicidal ideation. Having the knowledge that low grade depression can spiral to devastating results is important.
As a person who experiences dark thoughts I identify with others. I can identify with others who are not grateful that there is a new day because all around is heavy blackness. I ask my loved one’s in distress “Are you safe”, which means are you having suicidal ideations. And “is someone with you.” Likewise when I am in the dark thought I affirm to others that I am safe or I am calling the 988 number for support.
Dark thoughts are real but I have learned they are not permanent. With outside support, self awareness of symptoms, and the things that make dark thoughts worse desperate feelings can ease. We are not alone
The content of the International Bipolar Foundation blogs is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician and never disregard professional medical advice because of something you have read in any IBPF content.
