Barking with the Black Dog
I lived with depression, after being diagnosed in my early twenties, and for five years took medication. I was put on a drug which helped balance me out enough to aid in taking the other steps to recovery. It was my plaster cast for the brain to enable the mind to mend. After all, if a leg is broken it won’t get better without support. That’s all depression medication is, a plaster cast for the mind.
I don’t know why there is such a stigma about mental health issues. It might be because there is no easy cause, no obvious symptom, and that makes people feel uncomfortable and scared because there is no way they can take steps to avoid ‘catching’ mental health problems. The fact they are not contagious is irrelevant. Without an obvious cause, there is no way to remove oneself from the possibility of developing some form of mental health issue. That’s scary.
The lack of information and understanding about mental health issues doesn’t help. That’s why awareness campaigns such as those currently happening are so important. That’s why I’m telling my story. It’s hard, it hurts to remember, and it feels a little bit arrogant to do so, but if I can help anyone then it’s worth it.
Looking back I know I had depression long before the diagnosis. I would date the start to my teenage years. At the time I put my extreme emotional swings down to the usual teenage hormonal rollercoaster – every teenager I am sure bursts into tears at random and inopportune times, unable to pinpoint a reason why.
It carried on throughout college and university, affecting in particular any attempt at a romantic relationship I might have tried. My particular symptoms manifested themselves in an inability to trust in my own worth and therefore any person who seemed to express an attraction was automatically suspect and could not possibly mean it. I am sure I hurt people; unaware and unknowing. I don’t know that I did, but looking back, it seems impossible to me that I didn’t. I believe it may have affected friendships at school, but by this time I was more able to believe in myself as a friend. It fluctuated though, and I now know the early signs of a more distressing symptom was on its way.
After University I moved to a housing cooperative, a very supportive environment. The depression came in waves, and each nadir would be a little worse. There were no zeniths, no extreme highs; only just paralysing, debilitating lows. I developed a form of agoraphobia. I lived in a shared house but would be unable to leave my room to go to the kitchen to cook food. My unshakeable belief was that I had no right to be anywhere unless I had a specific reason, that I was invited to perform a specific function for example such as Secretary for the Coop or a friend had asked for help or asked me over for a meal, extended to my own home. It didn’t discriminate as a symptom – I couldn’t visit friends in other houses spontaneously, I couldn’t leave the street to visit anyone unless specifically invited, I could not do anything without a reason to do so. I could not imagine that I could possibly be wanted anywhere.
I recognised this was a problem, and took the first step to seeking help by visiting a psychiatrist my firm employed. Four visits only, not much help, but the visits gave me objective proof that I was not being self-indulgent and that it was not a character flaw, fears I had had.
I went travelling solo for four months shortly after these visits, partly because I wanted to discover the world and partly because I needed to discover myself. It was an amazing experience and gave me huge amounts of confidence in what I could deal with; travelling for 13 hours back through Thailand and then on the plane back to London whilst suffering with dengue fever being a particular highlight. The isolation was a boon and a curse though. My introspection staying at The Sanctuary in Ko Pha Ngan was almost unbearable and my symptoms didn’t abate – I got a part-time job working in the bar to give myself permission simply to be there. It was also to ensure I did not go into debt over my travels. I am and always will be overly worried about finances. The worry is irrational, but is part of my depression and need for control. I was able to speak with others both working and staying in the well-named place, but only to a certain extent. I could never be totally open. Not with anyone, not even those closest to me, not at that point in time.
I returned, and again the depression took me down. I found myself leaking from my eyes, not crying but leaking, for no reason that I could ascertain despite hours of introspection. My perspective was completely screwed up. My reality did not match what my senses and logic was telling me was true. The agoraphobia was coming back with a vengeance. I had regular thoughts of wishing I could just leave, walk away, not be anywhere anymore. I had suicidal thoughts also, and it was only the knowledge that I could never leave my loved ones in such pain that stopped me. When you are that deep in depression, the reality is that you think they would get over it, and that you are so peripheral to everyone’s life (because of course you are peripheral to your own) that it wouldn’t really cause that much upset and in the long-term everyone would be better off. It absolutely isn’t true, and it is a selfish act to kill oneself, but it is not a balanced judgement a person makes when making an attempt. It is an accidental selfishness. It is no-one’s fault.
I also think I was probably particularly good at hiding my feelings and my symptoms. I was always very good at work, depression did not affect my ability nor the standard of that work. In fact, the need to prove I was worthy of employment and my need for control is probably a very desirable attribute in any employee.
I had a fairly well-paid job at the time and a reasonably low rent so managed to pay for a few sessions of private therapy; I began the course of medication I was to take for 5 years around this time, and it levelled me out to a point where I was able to deal with the symptoms. The therapy stopped when I could not afford it anymore, the savings ran out, but I had managed to recognise where some of my problems were coming from and was better equipped to deal with what was happening. Although there were low periods, it was quite some time before the next nadir.
I was not symptom-free in the meantime. I was still suffering, but was better able to cope. It didn’t just go away, depression doesn’t work like that. Intellectually I could always understand what was going on, that the feelings I had were irrational and not real, my brain understood the facts, but the connection necessary to truly believe the facts was misfiring or entirely absent. I could not ‘pull myself together’. I had no together to pull.
I managed to be referred to NHS therapy, and found myself in one session with a throat paralysed so tightly and painfully that I could not speak and I could barely breathe. I wanted to cry so badly but even my body would not let me. It’s remarkable what your mind can do to your body. That paralysis lasted for the entire hour-long session. I had 12 sessions then the NHS funding ceased, but the talking had done a lot of good and I felt I understood how my depression had developed and how to recognise the symptoms.
Then something happened a couple of years later which triggered previously existing issues and I knew the 12 sessions had not been enough. I took myself back off to counselling, this time seeing a specialist counsellor who dealt with Cognitive Behavioural Therapy as well as the issues which had caused the depression. I got the tools to counteract the worst effects and the understanding to deal with the issues. I also managed to see a counsellor for as long as I needed to, not till the money ran out (mine or the NHS). That was very important. Being cut off early had left me half cooked, with the symptoms abated but not fully addressed.
I managed to come off the medication shortly afterwards and am happy to say that I have not needed any medication since that time. That doesn’t mean I might not need it in the future. Depression never goes away completely, it always hovers in the background. I still feel the need to be invited or to have a role before I can visit anyone or anywhere, although I am much better with that and now understand (most of the time) my own worth. I am far more confident, and the leaky eyes moments are much fewer and farther between. My perception of reality seems to be in sync with those around me. I can ask for help and I can talk about my experiences, which is a massive step as anyone who has had or still has depression will know. I have managed to deal with the issues which triggered my depression and found the tools to cope through various therapies; trial and error until I found the one that suited me. Just as we are all different so the treatments available are different and it may take a while to find one that suits you.
Mental health issues are real illnesses, but are treated as if they are the fault of the sufferer. That exacerbates the health problems and compounds the illnesses. They are very real, as real as a broken leg, the flu or hay fever. They are no more the fault of the sufferer than any of those problems are. No-one chooses to have a mental health problem. That would be mental (sorry, couldn’t resist)! The very nature of mental health illness means sometimes the sufferer may not realise they are ill. It can be hard to accept you have a mental health problem, and the blaming and disbelieving exacerbates the problem exponentially.
There is so much that hurt in my depression. The sense of isolation, of being utterly alone and lonely, of being unable to bear your own company, of being worthless, of having no reason to be, of having no understanding of or belief in my own identity or of even having an identity, of being unable to have any meaningful connection with anyone except for what I could offer and give (making any relationship unequal and unfair), the crippling guilt at the way I was feeling and how I imagined it was affecting others and the crippling guilt at even having a mental health problem (the unacceptable face of illness, as it still seems to be for many). The level of anger I had at myself for even feeling this way was tremendous. I felt desperation, frustration, so many feelings I could not hold on to them. I couldn’t concentrate to read, nothing interested me but the more time I had, the more I thought and the more I thought, the worse I felt. I overanalysed absolutely everything. I developed a talent at externalising everything. Nothing was ‘me’, it was a coping mechanism which damaged more than it helped.
I managed to get through it in the end. I found the right treatment for me, and it worked. I understand it may come back but I also understand how to cope with it. My mantra is “this too shall pass” and I know it shall. Instead of thinking that bad times are coming, I think that good times are coming. I had to retrain myself to be positive. I still have to practice all the time. Depression never goes away fully, but it can abate for long periods of time and it is probable I will never reach the nadir previously visited. It took me about 15 years to find the right treatment and methods that worked for me but there really is light at the end of the tunnel, and it isn’t a train.
Edit: This was first posted on 29th July 2012. Earlier this year, and in consequence of various personal matters, my depression reared its annoying, ugly head again. I asked to go back onto my antidepressants at the same dose as before, because I need it to help me both live with and hopefully recover from this bout. It’s not easy. It’s never easy. I’m not seeking therapy this time, because I am still able to remember the tools I learned last time, and understand why I have been triggered. However, I still feel the guilt, the self-doubt, the fear. I can say the words to myself which help towards recovery, but it isn’t there yet. My mantra reaches my head but not yet my heart.
Depression is a part of me, as much as my epilepsy and arthritis, and just as much not my fault. It is not anyone’s fault. It is nothing I am ashamed about nor should I be. Mental health issues are still stigmatised. They should not be. Stigmatisation exacerbates mental health problems. To my mind the stigma like sticking your leg out in front of a person struggling with crutches on a broken leg. Cruel, unnecessary and a clear indication of the lack of respect any person or institution that would show such dehumanising behaviour is deserving of.
I know I will recover. I also know I will probably suffer again. That much is clear to me know. But I strive to keep to my mantra, and know that each day, every day, is a step closer to recovery. Think positive, live positive and I will be positive.