Although this article relates to depression, the valuable lesson taught applies to all illnesses, issues and aspects of our life.

Our Masks Confuse Our Family And Friends

The other day I talked to a family whose daughter was in a lock-up psychiatric ward due to a suicide attempt. The patient (a young woman in her early thirties) was sitting with her father, mother and sister in a private visiting room when I arrived there with my wife, Melissa. My first impression when we walked into the room was revealing. The patient, let’s call her Julie, was sitting in a chair talking, smiling and laughing. I immediately identified one of Julie’s major obstacles toward achieving the help and support she needed to get better. 

Although Julie had experienced prior depressive episodes, as well as prior suicide attempts, this was the first time she had ever stayed overnight at a psychiatric hospital, and the first time clinical depression was ever considered the cause of her suicide attempts. In other words, both Julie and her family were all quite new to this idea that she suffered from a brain disorder call depression. Her prior experiences were blamed on outside causes: adolescence, turbulence in the home, the divorce of her parents, etc. Now the truth had made itself known and the family was lacking in knowledge as to what it all meant. 

I knew immediately, as the conversation centered on weather and sports, that Julie hadn’t opened up much to her family. How could she? It’s like when I talk about the Internet with my father. The lights are on, but nobody’s home. Julie was dealing with her family’s lack of understanding about her brain disorder the easiest way she could—by putting on her happy face and talking about everything but what she needed to talk about—her depression and her suicide attempt. 

This really hit home for me because I was just like Julie when I was depressed. Not everyone is like this, but many patients have learned to get through life wearing a mask to hide their disorder-related symptoms. Since most patients with clinical depression and bipolar disorder live with their brain disorder for years before being diagnosed, we develop these masks as a tool for coping. And the longer we live with our masks to hide our true feelings, the thicker these masks grow. Before long, we put our masks on automatically, and it takes a conscious effort to take them off—if that is even possible. 

I never learned to show my true feelings in front of anyone other than Melissa. If you knew me during my deepest most chronic depression, all you would have seen was an act. I would have appeared happy and full of energy. You would have been very surprised to learn that I was spending about eighteen hours a day during the week sleeping in a depressive coma—partly due to my lack of energy and motivation, partly due to my need to escape from my hellish and suicidal thoughts. 

Express Verbally What You Are Hiding Physically
 
Masks are obstacles that we need to acknowledge in ourselves and explain to other people. The depressed patient who sits in a chair slumped over with her eyes focused nowhere does not have to explain to her family, friends or doctor that she is depressed. Her body language explains that pretty well. But the Julies and Bobs, who mysteriously change from Jekyll to Hyde depending on who they are with, have some explaining to do. We have to express verbally what we are not revealing physically. 

Doctors understand these masks, but they still have difficulty seeing past them. It is vital that we look deep within ourselves to find our true feelings so we can explain these feelings to our doctors. If we do not, we may eventually become that patient who is slumped over with eyes focused nowhere. It does no have to come to that stage. 

Sometimes we become fooled by our own masks. I remember when I was staying in the hospital waiting for my first shock treatment (ECT), I began comparing myself to the other patients and the way they interacted with the doctors and nurses. I realized that I was not like them. No moaning, no groaning. My step was quicker and lighter. I was more polite and friendlier. My conclusion was that I didn’t belong there. “There must have been a mistake,” I thought. “I shouldn’t be getting these treatments. I probably don’t even suffer from bipolar disorder. I’m a liar, a fake!” 

Thankfully, a talk with my doctor reminded me of all the evidence. Sure, I wasn’t like those other patients. But my life was a mess because of my disorder anyway. Everyone is different. We feel many of the same symptoms, but we react to them differently, much the same as we react to different medications in our own unique way. There is no right or wrong way to be depressed or manic. If we have been correctly diagnosed, then we are suffering from one of these brain disorders. We need medical attention. We need help in our own unique way. 

A Major Cause For Misdiagnosis 

One has to wonder if these masks are not a major cause for misdiagnosis regarding mental illness. I can still remember the faces of some people when I told them of my severe depression. “Perplexed” is the best word that comes to mind. It was obvious they were having difficulty believing that the person in front of them was legally disabled due to depression. 

I can only wonder what would have happened if I went to my general practitioner complaining of fatigue, sore muscles, a loss of appetite and confusion. How many depressed people who are only able to pinpoint these types of symptoms, and do not understand the signs of mental illness, have been misdiagnosed because of the happy masks they wear on their faces? We will never know. 

Open The Lines Of Communication 

To conclude my story about Julie, my suspicions were correct. She did not know how to start communicating with her mom, dad and sister; and her family did not know how to respond. Her sister was a little suspicious and confused about the whole situation. She found it difficult to understand how Julie could be depressed to the point of suicide when she appeared so happy and fully of life. Our discussion concerning masks brought it all together. Soon we talked about the suicide attempt, and Julie opened up right there in front of her family, even with her mask still on. Good job, Julie! Now the lines are open. Let’s hope the communication keeps flowing both ways. 

If you have a mask that you put on when you are around other people, remember to explain it to your doctor and those who support you. Always be truthful about your symptoms verbally, even if your mask won’t reveal them physically.

(Excerpted from Win The Battle: The 3-Step Lifesaving Formula to Conquer Depression & Bipolar Disorder)

__________________