Sunday, October 11, 2009

Identity

I have some friends who use labels to characterize and summarize their behaviors. ("Oh, that's my OCD kicking up again.) The labels can be diagnoses, astrological signs, regional descriptors (I'm just a Yankee and so ...), birth order, or any of a number of things. The labels are useful because they quickly package a set of attributes into a manageable chunk. They're unhelpful because the labels might have only a 60% fit; the other 40% has to be discarded as irrelevant.
We're often coached in therapy to refer to ourselves as people with mental illnesses, not as mentally ill people. I am a person with depression; I'm not a depressive.
Further, as we know, the diagnosis of depression includes a very broad array of symptoms. When we take screening tests, the results are often reported as "If you answered 'Yes' on five of seven, 13 of 19, " or somesuch.
And even if we arrive at a diagnosis based on the presentation of enough symptoms at enough severity, that doesn't typically get us very close to identifying a cause. Depressive symptoms are serious enough that they warrant treatment, irrespective of the cause. (As we know, left untreated, depression can be life-threatening.) Finding treatments that work (i.e., relieve symptoms) can take a lot of time and experimentation.
[Another time, I'll explore what seem to be the two camps of treatment - medical vs. behavioral. There's a lot of interesting science coming out in both areas.]
So what? Well, I backed into these ideas as the result of an old theme, that revealing one's depression is a great conversation stopper. I've had the chance to reconnect with several friends from long ago. When they ask what I'm doing these days, I try to calibrate my response. If they were work acquaintances, I say that I'm retired. I might say that I've retired for medical reasons, leaving the topic open. If I knew them well, I will often go into a fairly brief description of leaving work, receiving treatment for depression, and living now. Some people will respond with an "I'm sorry that that has happened to you." Others might related their own experiences or that of family or friends.
Often as not, the response is crickets.
That's led to reflection on how we present ourselves to friends, family, and others. Most people, I believe, are prepared to hear that everything's fine. They may not be prepared to hear about some complicated hardship. Nevertheless, to present myself in the camp of everything-is-fine is not fair to me or to the relationship.
As a result, I wind up missing these old friends more after I've made the contact than before.
One final wrinkle that helps little: we generally use the word identity to describe how we define something or someone. In mathematics, however, an Identity describes the behavior of the integers 0 or 1. If you add 0 to any number, you get the original number. If you multiple 1 by any number, you get the original number. See how much that helps?

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