My client today was well aware that she has depression. She is on prescription drugs for it. We had a long talk about how it is affecting her life and what she is able to do about it.
We talked about how she has All or Nothing thinking and how this affects her moods and her behaviours. She is aware that she sets unrealistic standards and get annoyed with herself when she does not reach them. She also told me that she also gets annoyed when other people at work do things that she doesn't like.
Disphonia
She described how it affects her when people do things that are not the way she thinks they should be done. So people eating in the workplace annoy her. People whistling or humming as they work annoy her. They annoy her intensely. She in fact has disphonia, an excessive almost rage-like reaction to ordinary harmless noises.
I had heard of this but never come across it before. I had thought about it, but could not imagine any mechanism that would explain it.
Disphonia is a symptom of depression
However this client may offer the key to the mystery. It seems in her case that it is an extreme case of Black and White thinking. People are doing things not the way they should be and that is what gets her annoyed. Eating, humming, whistling annoy her. It seems to me that disphonia is in fact a rather odd but understandable outcome of having internalized standards that you expect other people to live up to, and you get justifiably angry when they don't.
I imagine that at some point my client was told not to make a noise when she ate, and that became an internal rule for her. In her world, rules have to be obeyed. If they are not then anger arises. I can also see how she might have been told not to hum or whistle etc., and they too became must-obey rules.
Do you know someone with disphonia? Leave your comment below.