“I thought I needed to replace my friends.”
This is how one of our patients described her experience of a several week period of mania last summer.
Her friends insisted that she needed to get help and that something had to be done about her energized state. But she had just emerged from a many year depression and felt that when they said she needed to come down from her mania, what they really meant was that she needed to go back to being depressed. It felt to her then as though they wanted her to stay unhappy.
Looking at this period now, many months later, and after a period of prolonged good, but not manic moods, she is able to laugh about the experience, but she also vividly remembers the urgent sense that suddenly her friends were not the people that she thought they were – they were not on her side.
That same week, I was talking with a patient who is in the midst of a depression and she told me that she had just ended a 20-year relationship with her best friend because that person had shared information about her treatment for depression with other friends.
We agreed that that sounded like very bad behavior, but I was also aware that it is often a bad idea to make big decisions in the midst of a mood episode, whether to start or stop a job, start or stop a long-term friendship or relationship, etc.
It’s not always possible to put off these decisions, but mood has such a powerful effect on how we interpret people’s actions and behaviors that it’s very difficult to know, when one is in the midst of a severe mood episode, whether one’s perceptions are accurate. In fact, one of the strong recommendations that we make to all of our patients is that they really must have one or two (preferably more) people that they are in close contact with, who can help them to maintain a sense of perspective about what’s going on. At that they should try to hold off on judging other’s behavior until they can get feedback from trusted friends.