The Doctor Is In: Staying connected to your baseline self in depression

The Doctor Is In is an occasional series where JHU Press authors discuss the latest developments and news in health and medicine.

Guest post by Susan J. Noonan, M.D., M.P.H.

Often times in depression, whether it is major depression or bipolar depression, a person can feel lost to him or herself. You may have difficulty remembering just what you were like before the episode began. This can come on quite gradually during the course of the illness. I have often heard phrases from sufferers such as “I don’t feel like me,” or “I just don’t feel familiar to myself!” What does this mean? It means that you are experiencing a set of feelings, emotions, and behaviors that are not typical of your usual self—these are driven by depression. This experience feels quite odd, alien, and uncomfortable when it happens.

Depression takes away your sense of self as a whole human being, leaving you with the feeling that there is nothing in life BUT depression. Your baseline self seems to fade into the background. Your usual characteristics are still there, they are just hidden down deep and over-ridden by the stronger symptoms of depression. This adds to the distress of the illness. In addition, the new feelings may impair your ability to regroup and gather your lifelong coping resources to manage your depression symptoms. If you cannot grasp who you are as a person, what defines you, you may not have access to the skills and strengths you have always had to get you through the difficult times, including this episode. You may also lose sight of your hopes, dreams, and goals in recovery. So, it is very important to try to stay connected to your sense of self, to your underlying sense of who you are as a person. When you have a connection to who you are and what you are about, you feel more stable and grounded. Then you can draw on the skills and strengths you have had all along to cope with and manage the illness. Remember: you are not your depression!

How do you stay connected to your baseline self in the midst of depression? This requires some effort. As I describe in my soon-to-be-published book Managing Your Depression: What You Can Do to Feel Better, you should start by remembering your positive qualities, strengths, skills, interests, preferences, likes, and dislikes relating to everything around you. Try to recall what makes you you. Start to paint an internal picture of yourself when you are well and at your baseline self. Then, using these qualities, construct a statement for yourself (only) that describes who you are, what you are about. Keep that in the back of your mind and use it to boost yourself at times when you are down or overwhelmed by your circumstances.

noonanSusan J. Noonan, M.D., M.P.H., is a physician and certified Peer Specialist who works as a consultant at Massachusetts General Hospital. She is the author of Managing Your Depression: What You Can Do to Feel Better, forthcoming from JHU Press.