Prior to this weekend, I had never rolled for initiative, made a perception check, fired a magic missile [no jokes, please], or had any exposure to this classic tabletop role playing game other than through movies and television, and an occasional #DungeonsAndDragons hashtag on twitter. After this weekend, it had helped lift my most recent depressive episode.
For the last several weeks, I had been suffering from a depressive episode. But at the suggestion of my husband (who loves the game) and my therapist (who wanted me off the couch), I participated in my first ever Dungeons and Dragons game, with real people over a real tabletop, and a Dungeon Master narrating our adventure. As of this writing, I have not snapped out of it, but I do feel better. And not because I performed particularly well in the game [I did not], but because it got me out of bed, off of the couch, and interacting with others.
My Bipolar Disorder and My Depressive Episode
As my last post on this blog indicated, I was recently diagnosed with Bipolar Disorder. Check it out if you want to know more about the illness, but in a nutshell, it is a mood disorder (not to be confused with a personality disorder). One’s mood can swing from very elevated to very depressed, sometimes in a rapid amount of time. I was diagnosed during a particularly elevated period of hypomania. Through a mixture of different medications, and the natural passage of time, mood has shifted out of hypomania. But it did not land in a neutral resting position; rather, it swung into a major depressive episode. [Editor’s note: “Depressed” does not mean “sad” in a clinical sense, although depressed people are often do feel quite sad.]
After about a week and a half of depression, with no indication of it lifting anytime soon, I had my regularly scheduled appointment with my therapist. He asked me, “So, what is your plan for snapping out of this depression?” Somewhat surprised by the question–I thought I was there to learn his plan–I responded, “Well, I guess I should develop one if that’s what you’re suggesting.” Indeed he was.
So, as circumstance would have it, my husband Ezra and I had already planned to meet with friends this weekend for a game of Dungeons & Dragons. I won’t say I was dragged kicking and screaming, but it was definitely out of my comfort zone. But I had cautiously agreed to check it out, and so I mentioned it to my therapist. He suggested that this might be an excellent activity to not only have some fun, but also to stimulate my mind in ways that would lift my mood from depressed to something at least approaching content.
Treatment of Depression vs. Bipolar Disorder’s Depressive Episodes
One important thing to understand, and the reason for this post’s tagline, is that treatment of depressive episodes in persons with Bipolar Disorder is not the same treatment that is available to the rest of the population that, at one time or another, struggles with depression. With bipolar disorder, most antidepressants either simply do not work, or in fact can induce states of mania or hypomania and are therefore actively contraindicated.
And regardless, studies routinely show that treatment of depression with antidepressants alone is less effective than treatment with medication combined with psychotherapy. In my case, antidepressants typically are not an option. The usual treatments for depression in Bipolar Disorder involve mood stabilizers rather than antidepressants. While these medicines can be very effective at reducing the mood swings characteristic of Bipolar Disorder, who wants a in a “stabilized” mood if their mood sucks? In my case, once my doctors confirmed my Bipolar Diagnoses, they actually took me off antidepressants entirely. While I have medicine to help with mania, I have only a mood stabilizer to deal with my depression. I must rely on primarily behavioral therapies for depression.
Furthermore, studies show that physical activities such as exercise and social interaction are also effective at helping to treat depressive episodes. And I can tell you, after now having experienced it, a ten hour session of Dungeons and Dragons is not only mentally taxing, it is physically exhausting [but fun!]. [Editor’s note: these strategies apply not only Bipolar Disorder, but are also effective in treating Major Depressive Disorder].
The Game Begins
So I got to it. I created my character: a High Elf who is a Wizard. He’s middle-aged Sage about 485 years old who, unlike many other elves, had no natural talent for magic. However, through sheer force of will, he studied long and hard and is now one of the most respected, and occasionally feared, Wizards in the Multiverse.
And so, after ten hours of rolling for initiative, making perception checks, and firing my magic missiles, it is now Monday and I can say I truly am feeling better as my medications continue to work their course. [Editor’s note: my diagnosis and initiation of treatment are very recent; we are not even sure that we have found the right regimen yet]. While I elected to still take a sick day from work, I am eating, shopping, paying bills, cleaning, and otherwise more functional than I have been in days.
With my Depressive Episode Somewhat Lifted, the Game Continues…
Prior to this weekend, I knew of Dungeons & Dragons through obscure references, schoolyard jokes, and Netflix’s Stranger Things. Now I have discovered an active community of gamers (and gaymers–the only time I expect to cite to Wikipedia, ever) with whom I can occasionally interact either in person or online; interactions which, even when not actively bringing me out of depression, can still be just plain fun. Even though we played for ten hours, we only barely advanced through our module. Due to scheduling limitations among all involved, we will be picking up where we left off. In the meantime, I may create a second character and find an online game to invite myself to. [If you want in, let me know by contacting me through the home page or by emailing me at IShouldHaveBeenASpy@gmail.com].
Today is better, and tomorrow will be better still. And with a little luck I’ll soon be “stabilized” in a mood at least approaching content rather than depressed, as I continue to learn how to correctly navigate life as a person with Bipolar Disorder.