Depression / Mental Health

CHEER UP, BUTTERCUP

Are you sick to death of hearing about depression? How sad we all are now? It’s an epidemic apparently…

I know I’m sick to death of hearing about it – not because I lack compassion for those with depression, but because I AM one of those people with depression. Apparently. And how depressing is that?!

I could quote you statistics, and tell you about the significant impact of depression on individuals, families, workplaces and the economy – but why bother? There are websites full of this information – specific to the country you reside in – and as fast as I put the stats here, they will change. I will offer one (vague) statistic here though –almost half the population will have a mental health issue (depression, anxiety, substance abuse – just to name a few) at some point in their lives. Fifty per cent of us. Do you know another human? Then statistically speaking, one of you is it.

So why – oh why, oh why – is there still stigma associated with mental health?

Or do we just have a belief there is associated stigma? I am secretly hopeful the shame is abating and the vast majority of us can now offer someone experiencing depression the same compassion and empathy they would for someone “experiencing” diabetes. Even the terminology is dodgy, right? If I have a physical malady I’m sick – I don’t “experience” a cold, glandular fever or cancer, I “have” a cold – or glandular fever, or cancer. But if I’m depressed or anxious, I’m experiencing something that apparently, I can control? The only people who would ever think that, have never experienced it. I’ve yet to hear of an epileptic being told to stop having a seizure – to just display a little more control [okay… there was that really thick “meninist” guy on twitter who claimed women just need better bladder control so they won’t need tampons… but normal intelligent people don’t make such profoundly ignorant statements!] Yet even in the 21st Century, there are clinically depressed people being told to cheer up and put on a happy face.

How the fuck is that helpful?! Excuse my language…

So – just in case you’re somebody that wants to cast blame and aspersions upon those who “choose” to have a mood disorder, here’s a little piece of info for you. Depression is not sadness. Yes – I am confident that a hundred per cent of us have experienced sadness – and sadness can be an experience. It isn’t a malady – it’s a normal human emotion. Just like happiness. And anger. And all the other human emotions.

But depression is not sadness – not even a little bit. Yes – depressed people can experience chronic sadness, just like someone with Parkinson’s Disease can experience tremors – but that isn’t all it is. Otherwise, a depressed person would be able to put on a happy face and cheer up. A nice dose of Bridget Jones and a large tub of ice cream and everything would be okay again! No – depression has actual, for real, physiological and chemical changes in the brain. That is why the pharmaceutical industry has created drugs that help. If there were no brain changes, what would the drugs do? (I’m not a scientist so I can’t really answer that. But I do have a large dose of common sense, and access to the internet.)

I have no doubt everyone’s personal experience of depression is as individual as they are, but for me, this is how a major depressive episode manifested. Firstly, I look back on my 50 years and realise that – due to numerous circumstances, both nature and nurture in origin – I have most likely had a low level of depression and anxiety (hidden behind a façade of joy and strength) my entire life. Then, over a comparatively small number of years, significant major stressful events occurred – too many to name but let’s just say that a lot of people died, a lot of people needed a lot of attention and hands-on care, my marriage suffered, my identity fractured, and eventually I snapped.

What does “eventually I snapped” look like?

My energy levels plummeted – no longer was I super bouncy and hyperactive. I stopped sleeping. I was completely exhausted. My eating disorder (will discuss in a later post) worsened.  I started to self-harm (will also discuss in another later post). I cried a lot. I shook a lot. My heart raced and I had panic attacks. My breathing was frequently ragged. I couldn’t cope with the teensiest little stress (out of cat food? disaster…) I couldn’t get myself to work. I could no longer communicate with people. I couldn’t articulate what I was feeling. Yes, I was sad. But I was sad in the same way an asthmatic is short of breath – without intervention, it was going to kill me. And yes – suicidal ideation was a daily struggle and a forbidden word (yet another thing I will discuss in a later post). The future felt like a black hole – I couldn’t picture anything but death, destruction and disaster. The present felt like I was drowning in mud. The past felt like a string of bad decisions and broken dreams. I couldn’t put on a happy face – I couldn’t remember where I’d put it… I lost the ability to adequately care for myself – let alone my husband, my children, my father, my grandmother, my friends, my students and my colleagues. A lifetime of looking out for everyone else, and now I couldn’t gather the energy to send a text message. All I could manage was to get out of bed so I could lie on the couch. I stopped eating (at the time of my admission to the clinic I hadn’t eaten anything for nearly two weeks). I hoped I would die.

And yet of the many clinically depressed people I have met, I know I’m one of the luckiest ones. I have a fantastic, supportive, understanding, circle of friends and family. People who asked how I was – with genuine concern and all the time in the world to listen. People who just turned up at my house, without forcing me to discuss what was going on – just stayed and made sure I was safe. As someone with an overdeveloped sense of responsibility, I couldn’t burden anyone with my problems and stresses – I didn’t want anyone to worry. Over time I did however, divulge a little of what was going on to a lot of different people – without divulging everything that was going on to any one person. I also found a great doctor and psychologist I’m comfortable and confident with, and later came under the care of a good psychiatrist. So, there are a lot of people on my team.

I eventually spent three weeks in a mental health unit (voluntarily) – admitted with major depression and anxiety, eating disorder and self-harm. I started anti-depressants and attended daily therapy sessions. And I slept, slept, slept. I finally released four years of unresolved, pent up grief after the traumatic death of my sister. I cried a lot. I slept even more and I talked with other patients. I started to eat – not willingly… but I was determined I would not be admitted involuntarily to the psychiatric ward.

In the clinic, I was privileged to meet some of the most incredibly kind, compassionate and caring people I have ever come across.

While everyone’s story was different – and reasons for admission covered a large gamut of mental health issues (addiction, bi-polar, post-traumatic stress, anorexia – to name a few), there were two things we almost all had in common – some degree of depression and anxiety. And there were a depressing number of people who experienced judgment and ignorance regarding their diagnosis. So, in case you are a judgmental, ignorant person (unlikely I know… judgmental, ignorant people don’t usually google information on depression…) here are a few tips on what NOT to say to someone experiencing a psychological crisis:

• I know how you feel

No you don’t. Just like I don’t know how someone feels if their spouse just died! I can imagine (guess…) it would be horrendous, and I can imagine (guess) how I think I might personally feel – but we never really know how someone else is feeling.

• You’ll be right in the morning

Are you serious?! Depression is not a 24-hour stomach bug. If I’ve been slowly deteriorating over the past 12 months, statistically speaking it is unlikely I’ll be feeling any better tomorrow.

• Just think positively

Do you think I haven’t tried that? Do you consider me so stupid and self-absorbed, I would just wallow around in misery for a year and try to get a little bit worse each day? However inconvenient my depression may be for you, it’s way more miserable for me…

• I don’t get depressed because I’m emotionally strong

I’m not depressed because I’m emotionally weak. In fact, that’s just insulting. My depression is the culmination of a whole pile of circumstances – innate personality, upbringing, messages I’ve received throughout my life, stresses I’ve experienced, and maladaptive coping strategies I (foolishly) thought would work.

• You can’t be depressed – you’re up, dressed and smiling

The inability to get out of bed, get dressed, or move the corners of my lips into an upward trajectory, is the very final stage of debilitating depression. Nobody morphs from one hundred per cent happy to one hundred per cent depressed overnight – it’s a long, gradual process. And if I don’t change things before I get to that end-stage, I may be dead before I get better…

• You have so many wonderful things going for you

Don’t you think I already know that?! All those positives might be the only thing stopping me from killing myself. All those positives might be an overwhelming burden. All those positives may be smoke and mirrors. Those wonderful kids I adore – have they grown up and left home? That awesome husband of mine – have we drifted apart? Our fantastic home – is it a shattered dream or a financial pit? My wonderful career – has it become 36 years of shattered dreams and disappointments? If you haven’t walked in my shoes, don’t judge. Don’t EVER judge me.

I’m sure there are tons more – every clinically depressed person has heard them all… Want to know why these statements suck? Because you haven’t heard what I said! You’ve haven’t seen me. If I say I can’t cope, what I actually mean is, I can’t cope. If I say my life has lost meaning, to me it has lost meaning – don’t argue with me, that will make me feel worse! And don’t you dare tell me I’m looking much better if I just told you I’m feeling much worse. I need you to hear me. We all need to be heard. Instead of judging me, here’s what depressed (and non-depressed) people might want to hear: How are you? Do you want to hang out? Do you need to talk? Is there anything I can do? I’m happy to chat any time you like. Here’s a nice flower I found for you. Or better still folks, say nothing and just give me a hug…

It is nearly six months since I left the clinic – and I hope never to return. I am still learning to deal with all the stresses that landed me in such a dark place and I am not always getting everything right. I am in a much better place than I was, but I’m not in as good a place as I could be. I still struggle with purpose and hope. I still struggle with my eating disorder and self-harm. I haven’t found my identity and I haven’t repaired all the faulty relationships. I am learning to prioritise my own health – occasionally – and I remain eternally grateful for the small circle of awesome people who have loved me and cared for me when I couldn’t do it for myself. I can’t remember the last time I felt true joy – I really can’t… And some days I fear I will never experience it again. I remember contentment and laughter and satisfaction and pride – I even experience them occasionally these days. But joy? I can’t remember. Perhaps one day?

It took a long time to fall down the rabbit hole – I guess it will take some time to crawl back out.