Dissociation and Depression: An Unholy Matrimony
While not everyone with Dissociative Identity Disorder also has a diagnosable depressive disorder, I’d wager at least 50% live regularly with some type of depression. As for me, I have Major Depression and Dysthymia. The former is a real pain; the latter is far more manageable. I’ve never taken either one very seriously and I think the magnetic relationship between dissociation and depression is the primary reason why.
Dissociation and Depression Exacerbate Each Other
Dissociation is the process by which we move things – thoughts, feelings, information – out of conscious awareness. It’s essentially a form of self-hypnosis and those of us with Dissociative Identity Disorder are experts at it. What that means when it comes to depression is that we're capable of recognizing that we’re hurting, but may fail to do anything about it because we're constantly separating ourselves from that very reality. In other words, depression triggers dissociative coping, and dissociative coping allows depression to gain momentum. And it’s not just that dissociation and depression exacerbate each other. They're like dysfunctional soulmates, coming together in unholy matrimony.
Dissociation and Depression Work in Tandem
Depression does all kinds of nasty things to my mind. It warps my perspective and makes even the simplest of tasks seem utterly insurmountable. It saps me of energy, motivation, even interest. It makes me believe I cannot cope. And that, my friends, is where dissociation and depression dovetail.
The habitual use of dissociation ... as a defense is based not only on perceived threats, but also on an individual’s perceived ability to cope. Consequently, as your stress level rises, due to present circumstances or triggers related to past trauma, the key issue becomes whether you believe that you have the resources available that will allow you to cope. – The Dissociative Identity Disorder Sourcebook, by Deborah Haddock
Dissociation and depression are perfectly suited for each other - the former specializes in carrying you when you cannot cope, and the latter specializes in convincing you of your inability to cope. It's a match made in mental illness heaven and, if you have Dissociative Identity Disorder, a difficult partnership to dissolve.
Dissolving the Relationship between Dissociation and Depression
Picture dissociation and depression as the angel and demon on each shoulder, only let’s make them both demons for the sake of this discussion. Depression whispers, “Oh no, you can’t possibly do all that laundry. Let’s face it, you don’t care if your clothes are dirty anyway.” Dissociation whispers from the other shoulder, “It’s okay. The laundry doesn’t even exist. You don’t exist. Relax.” The laundry pile gets bigger, becomes even more difficult to deal with, depression deepens, dissociation numbs, and so on. It's difficult to recognize the voice of depression before dissociation casts it's spell, but I suspect if I could do that I might be able to remember that I'm depressed long enough to do something about it. Living with Dissociative Identity Disorder is challenging enough without the toxic relationship between dissociation and depression making things worse.
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Gray, H. (2011, March 7). Dissociation and Depression: An Unholy Matrimony, HealthyPlace. Retrieved on 2020, April 7 from https://www.healthyplace.com/blogs/dissociativeliving/2011/03/dissociation-and-depression-an-unholy-matrimony
Author: Holly Gray
I have only just gotten a diagnosis of major depression the kind that is atypical but I don't remember the exact name of that the therapist is using. I have never thought of myself as depressed. Unmotivated at times sure. But, it's taken on a life of it's own since 2007 and I am unable to do most things that I had no problem with before that like household chores, going to work, and hanging out with my children. I don't "think" depressed like telling myself bad things. But, then maybe I have alters doing that that I can't hear, but keep me from having the energy to do what I need and want to do.
I hope this makes some sense. I am very new to this idea that I am depressed. I just found out in September about the fact I lived in a house that I don't remember living in. I gave it as the my living address when I went to a doctor for a sore throat, so I am sure I lived there.
It's great to see your comment, thanks so much for sharing it with us all. :)
Thank you, Holly. What you said is actually very helpful to me. I hadn't considered dissociative coping vs. denial. I am pretty sure I can see where I do a bit of both. When I see glimpses, or have a vague awareness of my depression, but continue to go about my days distracting myself as if nothing is wrong... that probably is dissociative coping. Makes sense. When I am sitting in front of my therapist knowing full well that I am depressed, and I tell her I'm doing fine, I think I may be denying. When I do the latter, I rationalize it in my own head by telling myself that so many people have it much worse than I do, so I don't count....or I don't matter. Just my thinking that sort of speaks for the depression itself, I suppose.
"It’s so innate, so instinctual, that is isn’t even a matter of choice for the most part." Yes....how very true! And because it's so instinctual, it's difficult to recognize when we're doing it. It can be very confusing, and very difficult to untangle. As far as being judgmental, I do acknowledge that I judge myself harshly, so explaining dissociative coping might help me be a little easier on myself. It will definitely help me to try to be more aware of what's really going on with me, and awareness is certainly something to strive for. :)
And now I thank YOU! Your example illuminating the distinction between dissociative coping and denial is very helpful for me. Both denial and dissociative coping can be so difficult to recognize. But the way you described both helps clarify the difference between the two.
"When I see glimpses, or have a vague awareness of my depression, but continue to go about my days distracting myself as if nothing is wrong… that probably is dissociative coping. Makes sense. When I am sitting in front of my therapist knowing full well that I am depressed, and I tell her I’m doing fine, I think I may be denying. When I do the latter, I rationalize it in my own head by telling myself that so many people have it much worse than I do, so I don’t count….or I don’t matter."
Ah yes, I do know the "other people have it worse, I've no right to complain" thing for myself as well. Of course, if you asked my partner I'm sure she'd tell you I do just fine in the complaining department. ;)
Awareness sure is something to strive for. I'm taking my own advice and re-dedicating myself to the tools that have been so helpful for me in increasing awareness. Hopefully in the coming months it will pay off.
I know my dissociation effects my depression and vice versa... I've forgotten what it's like to live without suicidal ideation.
Hi jc, for me the way to minimise the conflicts are to increase the levels of communication - easier said than done, I know.
This inner conflict is one of the more frustrating realities of life with Dissociative Identity Disorder. I'd be interested in hearing how others respond to your question but for my part, the answer is empathy and gratitude. Negotiating with alters, in my personal experience mind you, always boils down to genuinely understanding where they are coming from. I don't believe much will change if I cannot empathize and find appreciation for how an alter's behavior is benefiting me. So I think if I were in your shoes, I'd ask myself, "How does this pervasive inner conflict serve me? What is it protecting me from?" You mentioned that you float through your days to avoid the conflict. Perhaps floating through your days is cushioning you from the discomfort of daily life? Keep in mind these are just my immediate thoughts and may not reflect your situation at all.
Working through DID means increasing awareness and moving towards a more cohesive sense of self. So your awareness of the inner conflict and of your dissociative response to it is positive. You're aware of a dynamic that happens within your self-system. You may find that you don't have to try to get parts to agree if you continue to focus on increasing awareness in general.
When it comes to my mental health, I have a really bad habit of denying, and avoiding which means my emotional laundry pile is growing enormously with each day that goes by. When my therapist mentions any sort of treatment for depression, I tend to minimalize it, and then dismiss her suggestions.
"What that means when it comes to depression is that we’re capable of recognizing that we’re hurting, but may fail to do anything about it because we’re constantly separating ourselves from that very reality."
That's exactly it!! Like right now, I know I'm in a downward spiral. I've seen glimpses of this downward spiral all week, but I separate myself from it. It really does seem as though someone else is feeling the depression, but I'm watching it from the outside, and choosing to ignore it. What happens next is that I will frantically grasp for any kind of distraction I can find. It's great for a quick fix, but I that is just what it is....a quick fix.
Even as I write this, and acknowledge that I'm spiraling, I'm denying it at the same time. It's pretty confusing. I often tell my therapist that it feels like a war inside my head.
I also was confused by the whole "we" and "us" thing. I usually refer to all my parts as "I". I do that even when I feel more than one part present at the same time. I think I confuse my therapist when I do that because I can be talking about totally different perspectives on a subject, and still be saying "I" throughout the entire conversation. I try now to correct myself by saying "I feel this", and then saying "this part of me feels that".
Laurie, I like the light that you shed on this subject. It really makes sense, and give me more food for thought. I always learn so much when I come here.
Until I read this, I never thought about the relationship that Dissociation has with Depression. This really explains a lot about what goes on with me.
Thanks for your comment.
"When it comes to my mental health, I have a really bad habit of denying, and avoiding which means my emotional laundry pile is growing enormously with each day that goes by."
You are the expert on you, but I do want to mention something that may - or may not - resonate for you. And that is that sometimes what we think of as denial, a refusal to accept things as they are, is really dissociative coping. I see how that can sound like splitting hairs ... after all, separating oneself from one's reality is, in effect, denying its existence. But the connotations of the word "denial" sometimes don't with how dissociation works in people with Dissociative Identity Disorder. If someone has DID, their primary coping mechanism is dissociation. It's so innate, so instinctual, that is isn't even a matter of choice for the most part. So, for instance, if I feel uncomfortable enough, my brain will move whatever is causing me discomfort - including awareness of the discomfort! - out of my conscious mind without me ever recognizing that that's what's happening. It isn't that I am choosing to ignore my depression, it's that I'm quite genuinely unaware of it.
Which isn't to say those of us with DID can't get into denial. We can and do, no doubt about it. I just wanted to offer that thought as it's a distinction that has helped me to see my coping in a less judgmental way. (To be clear, I'm not suggesting you're being judgmental ... I simply mean that when I say I'm in denial, I'm being judgmental.)
I don't think I ever considered the relationship between depression and dissociation before either. It really has helped to think about it.
I think the relationship between depression and dissociation is, as you point out, closely related. Your evaluation of the dynamic between the two is interesting. I have experienced that the two go hand in hand. I’ve read that along with the depression is the constant hue of suicidal ideation – in part my experience would support that. What I’ve learned is, as each of my parts has addressed their unique concerns, the generalized depression has lessened and I’ve become aware of non-depressed experiences. There continues to be a hue of suicidal ideation that comes and goes in strength and depression continues to present itself. What I have noticed, however, is that as each part heals I experience increasing unusual experiences of feeling contented and without depression on some levels while at the same time hear this voice that says “I want to die, can’t I just die?” There’s a black cloud of depression underlying life’s experiences while at the same time a perception of everything being okay in the world.
You say “It’s difficult to recognize the voice of depression before dissociation casts it’s spell, but I suspect if I could do that I might be able to remember that I’m depressed long enough to do something about it.” It could be that a depressed part or alter does not want you to remember long enough to do something about it. It could also be, as I experienced it early in my treatment, that many parts or alters are depressed and until some begin to heal their issues the depression and dissociation will continue to dance and be illusive.
It becomes easier to recognize and work with more severely depressed parts as the individual parts heal. There really is an unusual feeling of lightness and weight at the same time because separate parts experience the world differently. Better than all of me being depressed but strange, very strange until I understood what was going on. When I first experienced this, and finally shared it with the therapist, she was able to help me sort out which parts were struggling with depression and which were feeling better about life.
Hope this adds a further explanation of your experience and maybe hope that in time it will become less illusive.
Thanks so much for sharing on this topic. You bring up some important points:
"It could be that a depressed part or alter does not want you to remember long enough to do something about it."
There are often so many layers aren't there? Many dynamics coming together at once. And I'm glad you brought up this one - that parts may be experiencing a depression that affects the rest of the system; and, in fact, may actively be preventing anyone from doing anything about it. I think it shows in my writing that checking in with my system - asking inside, as they say often say - is not my strong suit. Despite the fact that I talk about DID day in and day out, I sort of forget that I am a member of a system. (Which could also be, come to think of it, due to parts not wanting my awareness of that fact.) I operate from a very "I" place. It's funny ... I remember all the talk about "we" and "us" really throwing me for a loop when I was first diagnosed. I definitely do not think of myself as "we." I think of myself as "I" and other members of my system as "they." Anyway, that's a tangent. ;)
"It becomes easier to recognize and work with more severely depressed parts as the individual parts heal."
That makes a lot of sense. And it's great to hear. Gives me hope!