Welcome to the Jungle, Revised Edition. Hilary T. Smith

the same “ruling-out” clauses as for mania and hypomania: that your symptoms aren't better accounted for by drug abuse, a medical condition like hyperthyroidism or chronic fatigue, or bereavement following the death of a loved one. The depressive symptoms must represent a marked change from your regular functioning and persist over at least two weeks.

      The key words are “change from your regular functioning” and “persistent.” If you feel like the world has become inherently more depressing and your prospects in life fundamentally bleaker—and these feelings last for a long time and deplete your functioning—it might be depression. If you're just having a bad day and temporarily feel down on yourself, it's probably run-of-the-mill sadness. If you're just not hungry one day, it's probably nothing. But if you lose all desire to eat, have sex, or go outside for two weeks, that's depression. Sometimes you might have a couple days of real depressive symptoms, but manage to pull yourself up before they develop into full-blown depression (tips on doing that later!). In some ways, depression is like the common cold: you can feel it coming on and try to stop it from developing if you catch the symptoms early enough. But once it sinks its teeth in, it can stick around for a long time.

      Just like mania, depression can make you do stupid things. On one end of the spectrum, there's suicide, which we'll talk about later. Way on the other end of the spectrum are the stupid thoughts you have when you're depressed. One time when I was depressed, I burst into tears at the sight of a normal white fence and insisted to my boyfriend that it was the saddest fence I'd ever seen in my life. (If you want to see the world's saddest fence for yourself, it's located at 2761 West Seventh Avenue in Vancouver, British Columbia.) Depression can also lead you to lash out at people around you, make poor decisions, and sabotage your life in a hundred different ways. We'll talk more about those in a later chapter.

      On the other hand, depression can also be harnessed for good. Maybe you take advantage of your reduced energy to spend time reading, or maybe your experiences with depression lead you to write great poetry. Or maybe you embark on a mission to catalogue the world's saddest fences. Who knows?

      TRIPPING THE LIGHT PSYCHOTIC

      When I first told one of my friends I was taking antipsychotics, she smirked and said, “Oh, you're a psychopath?” Psychosis and “psychotic,” its accompanying adjective, are some of the most misused mental-health words out there. First of all, antipsychotics are commonly used for reasons other than psychosis (such as sleep and mood stability), so don't be freaked out if you get prescribed an antipsychotic if you've never been psychotic. Secondly, being psychotic is a totally different thing from being a psychopath. “Psychopathy” means the tendency towards violent, antisocial behavior. Psychosis is when you have delusional beliefs and hallucinations; it can range from experiencing a completely different reality from other people and having no insight, to experiencing voices and visual hallucinations and having some insight into the fact that this experience is not being shared by people around you. Psychosis is on a continuum: some experiences are very close to “normal” reality and some are quite far away. In some cultures, what we call psychosis is associated with shamanism and celebrated as a connection with the underworld. I'm just sayin'.

      HALLUCINATIONS

      Hallucinations can be auditory, visual, tactile, or even olfactory. You might see people who aren't really there or hear voices giving you commands. Hallucinations can be more or less scary, and they can also be caused by lack of sleep. Like the other aspects of psychosis, hallucinations are on the spectrum of normal human experience and can range from interesting to terrifying and dangerous.

      DELUSIONS

      Delusions are tricky, because there is such a fine line in our society between which beliefs are considered acceptable and which are considered insane. For example, millions of people hold the same “perfectly normal” religious beliefs that would be considered bizarre and outlandish if they were held by a single person. The DSM-V defines a delusion as “a false belief based on incorrect inference about external reality that is firmly sustained despite what almost everybody else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. The belief is not one ordinarily accepted by other members of the person's culture or subculture.” A good example of a delusion is the belief that you're being held captive by kidnappers, when really the “kidnappers” are your stoner roommates who wouldn't even notice if you left the house. If you're delusional, it can be hard to believe friends who tell you your delusions are false. You might believe they're lying, thereby interpreting their comments in a way that confirms your version of reality.

      THOUGHT DISORDER

      Thought disorder is easiest to identify in a person's speech or writing. It's characterized by a person not making sense from one sentence to the next or making associations that don't make sense to anyone else. For example: “The plane left the airport at three o'clock, and therefore the daisies in the bowl were put there by the dragon.”

      LACK OF INSIGHT

      In psychiatry, insight means the ability to recognize when your behavior and thought patterns are coming from your mental illness as opposed to your regular self. For example: “I realize that the voices in my head aren't coming from real people, even though it really feels like they are.”

      Insight can vary drastically in psychotic episodes. A person experiencing a full-blown episode of psychosis may not realize that the person sitting next to them on the bus can't also see that the bus is being driven by the Hindu deity Ganesh. Another person experiencing psychosis might slip in and out of insight, alternately realizing that their reality isn't shared and believing that it is. A third person might be aware the whole time that nobody else can see what they're seeing.