In the thick of it

I began sharing my personal experiences of mental illness, specifically, depression, earlier this year. Prior to that I mentioned it once or twice, but didn’t feel comfortable to talk about it any further.

I’ve subsequently reached a point where I felt less uncomfortable, and the more I talk and write about it, the easier it seems to get. And it helps that so far, the reception has been positive. It also helps that in the time I’ve been sharing, I’ve been depression-free.

But I know I won’t always be free of depression, and I wonder…

Will I still be able to talk about it when it’s no longer in my past or my future, but in my present?

Talking about historical depressive episodes, or the likelihood of future episodes, sometimes feels like being akin to an ‘immaculate illness’; i.e. an illness that is not tarnished by the stain of the messy reality of pain and distress. The passage of time seems to act as a filter, making the subject more palatable – easier to both talk about and listen to, free of the suffering and unpleasantness that accompanies mental illness.

But I have learned that some people can and do talk about their own suffering when they’re in the thick of it. And some people can and do listen. And to those people, I really admire that about you.

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Please don’t tell me I’m loved…

Recently on social media, I’ve seen numerous posts, reaching out to others, stating ‘remember – you are loved’. I appreciate these are well-intentioned, but here’s a contrary view. Here’s how I might experience that.

How do you know?

You don’t know me.

I don’t need platitudes.

I need real, honest, authentic.

Not patronising.

Even you don’t understand.

My suffering must be different.

Now I feel more isolated.

More lonely.

More hopeless.

Micro-depression?

It doesn’t fit any diagnostic criteria that I’m aware of, but occasionally I suffer from something akin to a ‘micro-depression’, lasting a day, maybe two…

I know what depression feels like, and it’s definitely that, but without the duration…

Perhaps it’s simply the low-point of an otherwise less intense, but longer depressive episode?

Depression Lesson no.2 – May the Force Be With You

So everyone knows that in Star Wars films, ‘the force’ is like some kind of mystical energy, right? Well, in this post I want to talk not about a type of energy that we can harness to lift X-Wing fighters out of swamps, but the type of energy that we can harness to help our emotional well-being.

Don’t we just get energy from food? Or drinks?

No. Think about it – remember a time when you were doing something you really enjoyed doing; having a really engaging conversation; or had a really good workout – you feel energised, right?

Yeah… what’s your point?

My point is that our energy can be impacted by activities and people, but other stuff as well, such as our environment, and it’s not always about feeling more energised – being near water, for example, makes me feel calm.

So you’re saying do stuff that has a positive impact on your energy levels?

As much as possible, yes. I try and spend as much time as I can with people who energise me, or doing activities that energise me. And when I feel my energy-levels dropping, I take a break. For me, that’s often walking, and often to the canal basin, as I find both the activity and location energise me.

But we can’t always do stuff that’s energising, can we?

No, we can’t. But we can try and take regular breaks, or schedule in activities or people that energise us. We can also look at other areas of our lives, and think about how they impact us.

How do you mean?

Well, earlier I mentioned our environment. I like a more minimal environment – I hate clutter and I’ve noticed that too much stuff can have a negative affect on how I feel. I’ve also noticed that some music, films, food and people can drain me of my energy , so I try to avoid depressing music and films, starchy carbs, and people who drain me (I don’t dislike those people or those carbs! They just leave me feeling like I have no energy…)

Isn’t all this a bit self-indulgent?

No. Absolutely. Definitely. Not.

But other people can manage without regular breaks…

Other people can run 100m in under 10 seconds. I can’t. There’s lots of stuff other people can do that I can’t, and vice versa. But like a mobile device, I need to re-charge to be effective.

So how does managing your energy levels help?

Well, for me, depression, above all, leaves me drained of energy – unable to muster the energy to do basic tasks, such as getting out of bed, taking a shower, and even eating. So by taking a pro-active approach to managing my energy levels I have noticed my energy levels are not depleted as easily, and are easier to replenish when I do suffer a bout of depression.

But surely it can’t make much difference?

Well, being mindful of the music I listen to might only lead to a marginal gain, but a marginal gain is still a gain, and when combined, these little changes are, in my experience, worthwhile. All you have to do is notice how stuff makes you feel – what have you got to lose?

Depression lesson no.1 – Managing depression – The Mohammed Ali method

Managing depression? Surely you mean kicking depression’s ass?

Nope. I mean managing. In fact, sometimes I actually mean managing’s lesser cousin, ‘coping’, because at times, coping is the best I can manage (no pun intended). It’s not that I’ve never wanted to kick depression’s ass, it’s more that my attempts to fight it have been in vain.

What do you mean by ‘fight’?

I mean go toe-to-toe with it. Beat it. Quietly. And on my own. Banish it from my existence.

So, what’s with the Mohammed Ali method?

Cos Mohammed Ali didn’t go toe-to-toe with bigger, stronger, opponents – he couldn’t out-muscle the likes of Sonny Liston, George Foreman, Ken Norton & Joe Frazier – instead, his approach was skillful.

OK, so what skills did you use regarding depression?

Well, I like to think I’ve used a few, but the one I want to talk about here is an approach known as ACT – Acceptance and Commitment Therapy (see links @ bottom of page for ACT resources + some notes).

Tell me more about ACT?

In brief, ACT consists of mindfulness, values, and acceptance; and it’s the last of those – acceptance – that I have found especially helpful.

Erm, OK, but how do you fight or manage depression if you’re just gonna accept it?

I know – it took me a while to my head around it as well. But acceptance in this context is a pro-active choice, as opposed to a sense of resignation. To illustrate this point, ACT practitioners (ACTors?) refer to the ‘quicksand metaphor’.

Alright, what’s that then?

Well, imagine you’re stuck in quicksand. The more you fight to get out, the quicker and further you sink in…

Oh I like that – very clever. I’m still not 100% sure how it helps though?

It helped me because my experience was that depression sort of taunted me – “you’ve got it all…why are you depressed? You’ve got nothing to be depressed about…I bet you feel guilty now don’t you? Good – you should! You should be able to kick my ass as well – c’mon, have a go if you think you’re hard enough!”. And I did have a go. And I ended up getting deeper and deeper into the quicksand.

So what happened when you accepted it?

I was able to accept that:

  • I am prone to depression
  • That I needed medication to manage depression
  • That I won’t always be depression-free
  • That some days, my mood and energy levels will be so low that I’ll question if I want to go on
  • That it will pass
  • That it’s OK

So, what difference did that make?

Well, because I used to think I had to ‘beat’ depression, I would try this method or that method, but never make any progress. I then ended up feeling even weaker and more ashamed, even more powerless and hopeless, and consequently, even more depressed – right up to my neck in f*cking quicksand! I also felt increasingly tired, from all the emotional and mental effort. But for me, accepting it is like ‘dancing like a butterfly’ – sure, occasionally it catches me with a sucker-punch, and very occasionally it has me on the ropes, but now I dominate most rounds, and I’m ahead on all three judges scorecards. I’ve also got more energy – I can go another 10 rounds if needs be – and yeah, depression will still be stood there at the final-bell – but I accept that now, and I know it’ll be my arms that are held aloft.

Some ACT resources that I’ve found helpful:

http://www.actmindfully.com.au/

https://www.getselfhelp.co.uk/act.htm

Notes:

  • I have intentionally not attempted to provide anything even approaching a comprehensive definition of ACT
  • ACT theory can at times seem quite complex – for an accessible introduction I highly recommend Russ Harris (link above) – he has written several books with different audiences in mind
  • As a professional, I have attended training in this approach, including with one of the co-developers – Robyn S. Walser – I found it to really helpful both personally and professionally

Winter is Coming

OK, so ignore the obligatory Game of Thrones referene – it’s just…an obligatory Game of Thrones reference 😋

But while the UK summer (and hasn’t it been stunning!?) has more embers to burn, the Geese have started to fly over our house, which signifies that seasonal change is afoot, and brings home to roost a gentle, but discernible sense of melancholy. Winter really is coming.

BBC Horizon – Stopping male suicide

I’ve just finished watching the BBC Horizon documentary ‘Stopping Male Suicide’.

There is much food for thought – the statistics are both sad and shocking (suicide is currently the biggest cause of death amongst men under 50 in the UK); but what really struck me was the brave and articulate contributions of those involved, including the narrator / presenter.

Much of what was said mirrored my own thoughts, feelings and experiences, and all those interviewed were truly inspirational.

One last observation – in a previous post I referred to how I have felt when harbouring suicidal thoughts and feelings, but a significant omission, which was referenced in this program, was hopelessness. Although my post alludes to this, I didn’t mention it specifically. Nevertheless, the lack of hope at that very moment is, in my view, probably the overwhelming and single most significant factor.

Recommended viewing for everyone.

This ends. Now.

You previously mentioned suicidal thoughts and feelings – what did you think about / feel?

I felt I couldn’t go on. Trapped. Ashamed. Incongruent. Lacking integrity. Scared. Powerless. Weak.

Did you think about how you’d do it?

Yes. Pills (obviously) came to mind, either in isolation or in combination with alcohol. One time after my wife and I lost our baby Benjamin, I clearly remember driving on the northbound carriageway of the M1 motorway. There was some snowfall in the channels, and I remember thinking about letting go of the steering wheel…I also considered more elaborate methods…

But isn’t suicide selfish?

Some people seem to think so. Personally, I have never thought ‘I am so incredibly loved and needed, but I’m going to top myself anyway’ – Instead, I always felt not only like I wasn’t loved or needed, but that I was actively a burden to those closest to me and that my wider world lacked meaning. In my head, I would have been freeing people from the burden of my existence…

Looking back, do you think you were loved?

Yes. But when I was in the throws of a depressive episode, I didn’t love, or even care about myself. That can be incredibly hard for someone you’re in a relationship with, especially if you have responsibilities, such as having children together, or sharing household chores. Eventually, your partner is going to feel pissed off – depression can be hard to understand, and seeing you lay in bed day-after-day, smelling like you haven’t showered recently (because, err, you haven’t showered recently) can be difficult on several levels. Your partner’s reaction then adds to your sense of guilt and shame, and the feeling of being unloved…so in my head, killing myself would’ve been selfless…

Couldn’t you talk about it with anyone?

No. I was overwhelmed with emotions, with shame being chief amongst them. Shame about feeling weak; shame about whatever my behaviours had been that contributed to where I was and how I felt. Again, I felt I had an identity / had to have an identity, and being vulnerable and flawed conflicted with that…feeling suicidal would have been akin to being exposed as a fraud…ironic really…

Reading this through now, I wonder if I could’ve called a helpline of some sort, such as The Samaritan’s – that whole idea of how talking to a stranger can be easier than talking to someone you know. But I wasn’t in a rational, thinking place, so I would’ve needed someone to help me make that step, or held that idea in my head at that time.

Do you still have suicidal thoughts and feelings?

No, not in the same way. Sometimes, my mood and energy levels are so incredibly low, that I feel very little motivation with regard to the prospect of carrying on…it feels like incredibly hard work…it’s hard to describe. But I don’t actively think about ending my life, nor do I have any reason to. In fact, I feel incredibly fortunate right now, with a lot to live for. I know the low mood and energy levels will return from time-to-time, and in those moments I’ll wonder what the point in carrying on is, but I also know those moments will pass.

Take your medicine

OK, I admit it. I was ‘anti – anti-depressants’, and for two main reasons. Firstly, I subscribed to the much-vaunted view that they were addictive. I’ve subsequently realised that if by addictive, we mean in the same way that oxygen, food and water are addictive, then yes, anti-depressants certainly are addictive. But if by addictive we mean stealing pennies to fund our habit, then no, they certainly aren’t addictive.

OK, what was the other reason?

Well, they conflicted with my sense of identity. They ‘weren’t me’; in the same way that a certain brand might not be me. They weren’t me because I’m a bloke, and as we know, blokes don’t suffer from mental illness (see Men(Tal) health post for more on this) nevermind take medication for it. Moreover, I was a professional, and professionals don’t suffer from mental ill-health either. I mean, the service-users I was working with did, but they’d had pretty sh*tty childhoods – very different to mine. Consequently, the idea of taking anti-depressants made me feel weak… ashamed…abnormal…

So what changed?

Well, at some point during my journey, I bought a book about depression. You know what it’s like – you buy a book, but one thing leads to another (I blame the ‘customers who bought…also bought…’ function on Amazon); and before you know it you have a whole library of books on the one subject (or is that just me? 😉).

Anyhow, one of those books was ‘Living with Depression’ by Dr. Deborah Serani, and it literally changed my life.

That’s a big claim for a book – how did it change your life?

Well, I’ll write a full review of it in another post, but essentially, it made me realise that it was OK to take anti-depressants. Even as a professional. Even as a bloke. After reading it I told my G.P. that not only did I want to resume taking anti-depressants, but I wanted to continue to take them. That decision has been life-changing. My personal relationships have improved. My wellbeing has improved. My career has developed. I suffer from fewer and less intense bouts of depression. I am calmer. I am more emotionally stable. I am content. All because of that decision, which Dr. Deb helped me to make.

Owning it!

So, you said earlier that you think you probably prone to depression cos of genetics?

Yea, I think so.

And it started in your teens?

Yes – about 14-15, which, apparently is when most mental illness is established by.

But then you shared how you’d suffered from mental illness – I’m guessing some of the stuff just made it worse?

Exactly. My biology affected my biography – my story – which in turn affected my biology some more.

So, when did you stop suffering from depression?

Hmmm, I didn’t…I just suffer considerably less often and less intensely.

OK, when did things get better?

About 4 years ago.

Four years ago?! Why did it take so long?!

Because I didn’t know I was depressed. I remember a time between 2000-2005, standing at a window, crying ‘for no reason’, and briefly flirting with the idea that I might be depressed. But it was brief flirtation – it felt melodramatic even to be considering that I might be depressed, so I quickly moved on.

And then?

In 2005 my mum passed away. In March of that year she seemed all fine & dandy. By the end of November she’d gone. I took some time off work, went to the G.P., and was prescribed anti-depressants. But I didn’t take them, because I wasn’t depressed. I was grieving. I was a man. And I was a professional.

In 2010 I suffered another major loss – a baby boy – Benjamin. My wife and I were devastated. Absolutely devastated. I returned to the G.P. and was again prescribed anti-depressants. This time I took them, but only for a very short while. Because I wasn’t depressed. I was grieving. I was a man. I was a professional. And taking the medication made me feel nauseous. And ashamed…

Then about 4 years ago I finally noticed that my mood became noticeably lower at the onset of winter. So, I explored the possibility that I might suffer from Seasonal Affective Disorder. Somehow this seemed more acceptable than full-on depression, and I eventually returned to the G.P., and was again prescribed medication.

And you’ve been fine since?

No, not quite. The following Spring I stopped taking the medication, and my sense of well-being reduced significantly. It was at that point that I realised, by comparing the last 6 months of my life with the rest of it, that I did in fact suffer from depression, and I had done since my mid-teens. It was quite a revelation.