Comorbid anxiety and depression plus psychic powers?

Hello,
So I'm working on a character with comorbid (simultaneously occurring) general anxiety disorder and major depression who also is telepathic. I wanted to avoid the common trope, which I know people with mental health issues often dislike, of the psychic who people think is schizophrenic because of their powers. This character has actual mental health issues and they are aware of their own powers, rather that being convinced they are merely deluded until told otherwise.

Nonetheless I was if wondering people had any thoughts or suggestions on the best way to handle this? Do's and don'ts? I'm also curious about the details of people's experiences, if you have any first-hand knowledge of this area of mental health, what is it like? What medication might you take? How does it affect your life?

 

I cope with this by sitting in parks and reading the dogs' minds.
With telepathy the temptation is to constantly read everyone's minds because you think they secretly hate you. So everyone's eating a meal, and you're always last to finish, and all you really find out is how everyone chews differently, but you keep doing it.
Suicide is illegal in my country,but if it gets too much for me, I'll telepathically control Chuck Norris and painlessly kick my own head off.

 

Very funny, I'm sure, but I am interested in actual answers on the experience of comorbid anxiety and depression. Or at least writing-centric answers about the best way how to handle the overlap.

 

I've struggled with both depression and anxiety disorders (no telepathy, sadly), and they tend to feed each other in a vicious cycle. That is, my anxiety was the root problem, with depression following mostly from my avoidance of life. I would feel anxious about something (usually socializing), so I didn't do it, then I felt bad about not doing it, which ate at my self-esteem and made my depression worse, which made me more anxious about taking the next chance, and so on. It's a hard cycle to break, but it can be done.

I did try several antidepressants, but found that they either had no effect or made me feel worse (perhaps because my anxiety was the major problem). Some made me lethargic and drowsy (one basically knocked me out for 36 hours - I didn't even try a second dose of that one), and others made my anxiety worse to the point that I started having acute panic attacks (Prozac was terrible for that), which I never did without the meds. These days I don't take anything; I've found therapy and gaining life experience to be much more helpful.

As for writing, I do think the idea of getting the wrong meds would be interesting to explore. We don't really know enough about medications to predict exactly how they'll affect each individual patient, so the process involves a lot of trial and error. The psychiatrist will prescribe one popular medication after another to see which one(s) work best for the patient. How would your telepath respond to a medication that made their own anxiety worse? Would they start keying in on other people's negative thoughts even more than usual and get paranoid? And some antidepressants can cause suicidal thoughts. How does a telepath deal with that?

Also, anxiety disorders are a wide class with a lot of behavioral variety, so you'd have to decide how your character's anxiety manifests itself. My family includes a few hoarders, who are anxious about getting rid of things that someone might want and hold on to anything and everything that gives them comfort. I have some minor tic behaviors and OCD; sometimes I'll touch something with one hand and then have to touch it with the other because I feel anxious and "unbalanced" if I don't. It's weird, but doesn't really cause me big problems.

I hope this helps! Feel free to DM me if you want to talk in more detail.

 

One of the things I dislike is the portrayal of depression and anxiety as something dramatic and even vaguely romantic. I also don't like seeing characters whose entire psyche and personality are based on mental health issues. Chronic depression and/or anxiety disorders are inconvenient conditions that spoil stretches of one's life, but those thus afflicted are more than the disorder. My best suggestion is to regard depression and anxiety as challenges in your character's life and not as defining characteristics of that person.

 

I would focus on showing skewed thought patterns and an impact on cognitive ability and reasoning. That character might be catastrophizing small problems (I spilled coffee and my day is ruined), thinking he's a complete idiot for one simple mistake (maybe all day, maybe all week), being certain that other people don't like him in spite of evidence otherwise (oh she only got me that gift because she pities me), substance abuse (food, alcohol, recreational drugs), and genuinely making a few more mistakes or being more forgetful than the average person because his mind is so preoccupied by the illness (anx/dep take a ton of processing power when the spiral's happening). Physically you might see fatigue, low sex drive, a lot of time spent in bed. Emphasis on might. The character won't come across as genuine if he exhibits every symptom in the DSM.

If you want to go deep on depression in particular, I can't recommend Jack Kerouac's Big Sur enough. It will give a taste of that headspace for sure. I literally had a depressed person recommend it to me, for whatever that's worth.

And to echo Catriona, yeah they are definitely still people too. Just because the are depressed/anx doesn't mean they entirely miss out on hobbies and good friendships. Good to show that, especially for the sake of contrast.

The interesting thing which is going to require some decision is: how does telepathy affect that? To what extent does he have telepathic ability? Honestly, how it would change those situations is entirely up to the writer. I think he would have a complicated relationship with it, where he's reluctant to use his power because he ends up feeding off of the negative emotions of others at the cost or possibly benefit of actually knowing what they think of him. A sign of improvement being he does not feel the need to check? I don't know.

Selective serotonin reuptake inhibitors are the most commonly prescribed due to them having generally fewer or less severe adverse reactions (Prozac, Cipralex, Zoloft), but like others have said it's a process where the prescriber has to pay close attention to the patient's needs and find the medication that works for him. Benzodiazepines (Ativan) are somewhat common as well in spite of their label use being more for anxiety. I think it's because one tends to feed the other in a nasty spiral. The patient is the expert on his own body in a lot of ways. When changing meds, one ramps down as the other one ramps up, with the idea being a smooth progression with no gaps in therapy. They usually cannot be stopped abruptly for fear of drastic changes in mood, and are of course only a part of the therapeutic picture. I think it's common for them to be prescribed with lifestyle changes as well. Sometimes the hormonal route is taken, as low sex and thyroid hormones can result in depressive symptoms.

If you want to add some complexity, give him societal/physical limitations that therapy cannot treat. CBT or meds can't also treat impoverished, ugly, disabled, micropenis etc...

 

It might cause a spiraling downwards, but it wouldn't show itself as empathy.

Depression makes you feel dead inside. All painful feelings are denied. Part of the pathology is not allowing yourself to experience feelings. So you would also deny the feelings of others.

 

Yeah, I'm certainly avoiding the poetical mental illness mad-because-of-their-genius sort of angle. I don't want to romanticise or villainize it, I want to portray it in that way as a more mundane style of problem. It will be a relatively significant part of the plot, but I do very much want to give the character broader depth, agency and other issues to deal with. Indeed, in some ways the main plotline of the story is character working not to be defined by illness, he wants to control his symptoms in the same way he wants to control his powers. It's all about taking control and finding clarity. So I will have that in mind.
In terms of other stuff going on it's also important that Caleb is an imaginative kind of character who feels limited, and the plot also involves him getting a better situation to outlet his creativity.