feb 1 2025: cue the depressive episode…

One of the downsides of having a mood disorder, like depression and anxiety, is that you have to be very careful. A single event can tip the scales on months of progress and land you further back then you’d like to admit.

This used to happen to me a lot… a relational breakdown, trouble at work, a perceived failure, any major mistake on my part, are a couple reasons I’ve emotionally spiralled in the past. These episodes were often characterized by emotional dysregulation, intense self-doubt, anxiety, hopelessness, and eventually, suicidal ideation. There is no choice, only instability, and an incredible amount of aftermath to clean up.

Emotions hit harder when you are affected by trauma. Add on this, Autism and ADHD, which amplify rejection sensitivity and misunderstanding in interpersonal relationships. Mental illness keeps you on your toes, rearing it’s ugly head when you least expect it, and somehow always when you lack the energy to deal with it.

Interpersonal issues, including the hopelessness that surrounds losing an important relationship, are one of the reasons that people commit suicide (Fallahi-Khoshknab, M., Amirian, Z., Maddah, S.S.B. et al., 2023). There is a strong correlation between emotional dysregulation and suicidal ideation and attempts. The cry of pain model by William’s (1997) suggests that suicide is the result of feelings of defeat and entrapment, coupled with the idea that there is no escape. If someone hasn’t developed the tools to deal with intense emotional turmoil, suicide can feel like the only way to escape this pain. A phenomenon referred to as ‘psychache’ (Fallahi-Khoshknab, M., Amirian, Z., Maddah, S.S.B. et al., 2023).

One of the upsides of having a mood disorder (oh now, she’s really lost it!) is the resilience that you build when you have no choice but to navigate this tumultous landscape in order to continue surviving living. Grief, sadness, depression - these are all things that I’ve become well-aquainted with. Now, I have a reference guide of life experiences in my mind. The depressive downturns are not hopeless anymore, I’ve navigated this before, and returned to a state of equanimity once more. I know what tools I need to help myself rise from this depression. I will do it again, and often I return with greater speed and ease, a testament to the work that I’ve done on myself.

However, one of the greatest challenges with depression, for me personally, is that I can easily miss the signs that I am not feeling well. I experience a phenomenon called alethymia, which involves an inability to sense and describe the emotions that I am feeling. This is very common in autistic people, those with PTSD, eating disorders, and other conditions. One study found that over 30% of prisoners in China experienced alexithymia (Legg, 2023). I believe the origins of my own alexthymia are within the childhood abuse I suffered, and the messages I received to shut down my own emotions and needs.

What this means is that I have to look to my environment for cues that I am not feeling 100%, otherwise, I will keep pushing myself as if I am. Clothes are more likely to land on the floor, I keep myself indoors for longer periods of time. My hair stays greasy for more days than I’d like, and it becomes incredibly hard to make myself food. I often rely on langar at the Gurdwara during this time (the best depression meal imo). I maintain striking functionality during each of these episodes, in my personal life, at work, even when I was in university. But, I am not okay. And there is no pretending anymore.

In the past, I would have ignored these signs and kept pushing forward at full speed. However, those habits have landed me close to burnout, and I’ve learned. Now, I look around me, and notice the differences I’m experiencing. I spend more time in quiet, focusing on the sensations in my body, rebuilding the awareness that I was taught to shut down. Now, I give myself immense grace and self-compassion. I don’t let myself fester in the suffering, I am mindful, aware, and determined to get right back on track. And remarkably, I always do.

If you suffer from emotional dysregulation and suicidal ideation, I’m offering free appointments. Send me an email, and let’s meet. You don’t have to do this alone. :)

-immy, age: 28

Sources

Fallahi-Khoshknab, M., Amirian, Z., Maddah, S.S.B. et al. Instability of emotional relationships and suicide among youth: a qualitative study. BMC Psychiatry 23, 50 (2023). https://doi.org/10.1186/s12888-023-04534-0

Legg, T.J. (2023) Alexithymia: Symptoms, diagnosis, and links with Mental Health, Medical News Today. Available at: https://www.medicalnewstoday.com/articles/326451 (Accessed: 01 February 2025).

Williams, J. M. G. (1997). Cry of pain: Understanding suicide and self-harm.