Keeping a Journal Can Help Lead to an Accurate Diagnosis
For far too many years, I made an egregious mistake. I did not keep a journal.
In my October blog entry, "Admitting That You Have a Mental Illness Is Essential to Recovery," I recalled that for years I had a condition, known as anhedonia. This is a state in which individuals with a mental illness do not recognize that they have a disorder and do not, therefore, seek treatment.
The results for those persons with severe mental illness can be catastrophic. Indeed, I self-medicated with alcohol while tenaciously working to achieve success in a number of areas. In retrospect, I was considered to have a high-functioning bi-polar II disorder. I was able to be ambitious and detailed in my work, but in my private life, I often, except for periods of remission, was in a state of anhedonia, which is an inability to experience joy, happiness or pleasure.
In many respects, anhedonia overlaps with depression. My lack of understanding that my general incapability of enjoying my personal life -- and manic disruptions in my work life -- was an unnecessary burden that I carried with me for decades. I thought it was normal to be "uncomfortable in my own skin," except for rare times that the cloud of despair lifted, and I was able to be in the moment.
In looking back, I am sorry that I did not keep a journal. Frankly, I didn't have the discipline to write down the details of my private life because I was so often irritated, angry and ruminating about my fears, particularly when it came to relationships.
If I had kept a journal, I might have discovered my shifting and painful moods. In bipolar II, like many mental disorders, documenting the chronology of your behavior can lead to increased self-knowledge and recognition. Such self-probing can offer a perspective other than being entrapped in anxiety and despair. That, in turn, can lead to seeking treatment.
Another reason keeping a journal can have a significant impact on improving one's mental disorder is that it allows a therapist to understand your history without having to wait for it to be revealed in therapeutic sessions, which might take a rather long time. This is particularly true of the current increased pressure on therapists to see more patients with more limited amounts of time, either as authorized by insurance or due to a large case load. A journal can provide a road map to your shifting mental states and lead, hopefully, to more accurate diagnosis in significantly less time.
A journal, even after diagnosis, can offer more documented self-insights and behavior, which, in return, can often further assist in recovery.
For some individuals with mental health disorders, there may appear to be insurmountable obstacles to begin writing. Obtrusive thoughts and the vicissitudes of one's disorder may prevent developing the discipline to record one's thoughts and moods. This was certainly the case with me for many years.
However, there is a solution.
Just start writing, perhaps only a few sentences at first. Develop an ability to dive inward into recognizing your behavior and thoughts and distance yourself from your disorder as much as you are able. This may be difficult, at first, to achieve. After all, it is not easy to write about yourself when you are not in control of your thoughts and behavior. With determination and tools like meditation and yoga, you may, however, succeed in beginning a journal.
The most important step is to begin writing daily without expectations. Let your mind take you wherever it goes. In a while, you will probably be able to start honing in on recording the details of your daily life. This, in turn, can assist in the process of healing.
Mark Karlin is retired, after a long career in advocating against gun violence, as a hospital executive, an online journalist, a consultant, and founder of a progressive website. He graduated from Yale University, cum laude, with an honors degree in English and received his MA from the University of Illinois.