There’s another aspect of the divide between patient and care-provider when it comes to mood-disorder treatment; People with mood disorders see things — everything — differently than “normal” folks do. Depression is not merely a mood, or emotional, disorder; it’s a perception disorder. Depressives sometimes appear to have poor judgement, or obsess over unimportant things. Well, this is all part of the illness they have.

When someone gets the courage to go to a doctor for a mood disorder they think they have, it’s very likely because someone has talked them into it, not because they genuinely think it will do any good. Or, if it’s on their own, they do it simply because they know that “something” is wrong, “something” which makes them unusual; they don’t know what it is, and usually expect it to be something physical, such as an ulcer, migraines, etc. since depression can manifest as stomach and headaches (among other things).

Once the diagnosis has been made, though, that’s only one very small step. In many cases the depressive is relieved to know that the “something” which is wrong, has been identified, and can be fixed, they’re commonly told; but typically, they don’t actually “feel” any better. The provider, though, sees it in a different way: He or she has made a diagnosis, started a treatment, and expects the person to be “fixed.”

As treatment progresses, the provider expects steady improvement, and in fact, often sees it. But the depressed person, even as his or her emotions come under control, knows that he or she still isn’t the same as other people. Often they express dissatisfaction with their progress, which the provider, having learned this is a common pattern, doesn’t take seriously; they take this dissatisfaction as a symptom of the disease, rather than as an actual marker of progress, and downplay it. Instead, the provider simply assures the patient that progress is proceeding normally — because as far as s/he is concerned, that’s exactly what’s happening! In the meantime, the patient continues being in misery despite being told, by a person s/he is supposed to trust, that everything is better.

One can see, therefore, how the gulf separating patient and care-provider not only starts out wide, it can widen as time goes by, to the point that patients and their providers arrive at totally different views of their treatment. What’s more, the “perception-deficient” portion of depression is left substantially unchanged by treatment. Patients often still see life through the sunglasses of depression; all they’ve done is simply learn to compensate for the darkness. In fact, the manner in which the patient sees his or her own progress, is colored by those very same sunglasses.

No provider, however, can remove those glasses from their heads. And the patients themselves don’t know how to do so. This keeps patients and providers apart and keeps them locked into very different beliefs about what is happening in front of their eyes.

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