I Have a Dialogue With Myself in My Head

Reader’s Question

Can you provide a clinical diagnosis of certain symptoms? I constantly have a dialogue in my head with myself; it’s something that has been increasing over the last 6 to 9 months. When I close my eyes I see images (cartoon caracters) and colour in my head as if it’s a clear vision. I have suffered from depression in the past which was untreated, and about 4 years ago had post traumatic stress after some medical problems and in close succession to this became a carer for my mother, which left me in a terrible state.

My libido has been low/non-existent for years and I am unable to keep a job at this stage, but it’s not my major concern. I’m wondering if the above symptoms are of manic depession. Can you point me in a general direction please?

Our Consulting Clinical Psychologist’s Reply

From your description, you are experiencing a clinical depression. The constant dialogue in your head is called “rumination”, a common symptom in depression. While we often think of depression as related to an event such as the death of a loved one, it’s actually more common in individuals who have been under a high level of stress for a prolonged period of time — as when being the caregiver for your mother. As you discovered, depression can be incapacitating and is one of the top 10 conditions that create a work disability.

I would recommend reading about depression on this website. I’d then consult with your family physician. When we have the physical symptoms of depression (loss of libido, fatigue, sleep/appetite problems, etc.), we are more likely to respond positively to antidepressant medications. Remember that while antidepressant medications are helpful, the best recovery from depression combines an antidepressant and psychotherapy or counseling.

Your symptoms are very treatable so I’d get moving in the direction of professional treatment.