Depression – Page 22 – How do you eat an elephant?

What not to say

Posted on May 10, 2012May 17, 2012 by WeeGee

Yesterday I was having a nosey around the Depression Alliance’s website and found an interesting list of ten things not to say to someone who is depressed:

There’s always someone worse off than you are.
No one ever said that life was fair.
Stop feeling sorry for yourself.
So, you’re depressed. Aren’t you always?
Try not to be so depressed.
It’s your own fault.
I think your depression is a way of punishing us.
Haven’t you grown tired of all this me, me, me stuff yet?
Believe me, I know how you feel. I was depressed once for several days.
Have you tried chamomile tea?

(full list here – also includes 10 things to say)

With the exception of ‘stop feeling sorry for yourself’*, I suppose I’ve been lucky in that no-one has said any of the above to me. Still, it got me thinking about the way people have responded to me when I’ve told them I suffer from depression, or more rarely, when I’ve been talking about the impact it has on me…

In my experience the most common and the most frustrating thing people say is one of the many variations of ‘but why are you depressed’ or, in other words, ‘depression itself isn’t a real thing; what’s actually the matter with you?’ Sometimes it seems that it is impossible for people to grasp that this is a question that a depressed person can rarely answer. Sure, some bouts of depression are triggered by an event or experience (the kind of event that everybody finds difficult to deal with – redundancy, relationship breakdown, bereavement). However, even when that is the case (bearing in mind that many episodes of depression have no identifiable trigger), by the time the illness has taken hold the starting point has almost completely lost its relevance and the thing that is the matter is simply the fact that you are suffering from depression.

At this point, I do feel I should point out that over the years a lot of fantastic people have said a lot of fantastic and helpful things to me. Often people recount their own experiences of recovering from depression and I’ve always found this to be an extremely encouraging thing to hear when I’m in the pit. There’s a lot of re-assurance to be found in knowing that people you know (or people that know people you know) have found a way to climb out and put their lives back together – it’s a little bit of hope to cling on to.

At the same time, I have received a great deal of practical advice (put your shoes on and leave the flat being a particularly valuable one) and recommendations for resources and support material (this one being my favourite so far). Above all else, people have been kind enough to offer a wealth of helpful words of wisdom which have helped me keep my head in troubled times. For example here’s a particular gem that a former counsellor passed on to me years ago and which still means a lot to me ‘Everyone who got to where he is had to begin where they were’ (R.L. Stevenson)

Having given the matter some thought I have been reminded that actually, the people around me right now are pretty fabulous and the people I have shared my secret with, both recently and in the past, have almost always responded with genuine empathy and compassion.

And that there is a reason to be a teeny tiny bit cheerful.

*To be fair, I think there was a certain amount of justification at the time and under the circumstances!

Moving forwards

Not drowning but waving*

Posted on May 9, 2012May 10, 2012 by WeeGee

It’s been four weeks since I hit rock bottom and started making my way back up to the surface again and four weeks seemed as good a time as any to step back and review how things have been going so far.

As I have mentioned elsewhere, my last episode involved a rather spectacular unravelling of the practical and the ordinary. I wasn’t just an emotional wreck (which is bad enough) I was also a practical wreck and for a person who is usually Mrs Organised** this felt doubly distressing. Still, if I’ve learned only one thing recently it’s that the only way to deal with practical problems is to take practical steps. Dealing with this side of the chaos was about rolling my sleeves up and digging deep (there’s a line in a Maximo Park song which sums this up quite neatly (to me anyway) “what happens when you lose everything? You start over again’). And so ensued an impressively thorough spring clean of the flat, a session of opening three months worth of post, a trip to the supermarket, a meeting at the bank and some robust financial planning. I’ve definitely had some notable successes in putting the practical aspects of my life back together, and this is definitely helping with the anxiety and (utterly terrifying) panic attacks that had been creeping in.

On a daily basis I’ve been splitting my tasks up into the things I need to do, the things I should do and the things that I want to do and in following these lists I feel I am achieving a good balance of sorting things out and taking care of my interests. The last part, taking care of my interests, has already started to have a positive impact. We’re not talking major things here – just a bit of reading (I finished Death at intervals and commend it to anyone and everyone and have now stated reading Philip Pullman’s The good man Jesus and the scoundrel Christ), plenty of music in the background (thank you Radio Six Music) and a spot of exercise (this week wii fit, maybe even running in the outside world next week!). All of these things seem to be coming together as a useful reminder that I am a proper person who cares about and has an interest in things – I’m sure also sure that the exercise has an impact on my mood day to day. There’s also been this blog which has been a welcome distraction and a good way of refocusing the mind away from the darkness that threatens to consume me.

As has been mentioned elsewhere I’ve spoken to colleagues about my difficulties and am definitely feeling a bit more like myself at work. I’ve had my first psych appointment so have a really good crisis plan in place. I also had my initial CBT assessment this morning – I think it went quite well and I’m interested to find out what the next steps will be. This type of contact is important to me. If nothing else it serves as a check and balance preventing me from withdrawing from the strategies that have been serving me well in recent weeks. It will also be good, in the fullness of time, to get different perspectives and different ideas about managing the symptoms right out of my life.

Of course the dark passenger is ever present and I’d be lying if I said there hadn’t been some tough times. On the upside, the tough times have felt a little shorter lived and a little less severe of late – there was a time when I wasn’t able to contemplate getting through the next few minutes, now, if I’m struggling at all, I’m struggling to think about getting through the next few hours. I’m taking this as a big positive because whilst you can do quite a lot of harm to yourself in a few impulsive, wrong-headed minutes, a few hours has (so far) been long enough for me to take a few deep breaths and reach for the crisis plan.

Insofar as that the last few weeks have been about me managing better rather than me being completely better I think it’s fair to say that things are working out okay at the moment. I’m almost looking forward to what the next four weeks might bring.

* With apologies to Stevie Smith for indulging in a small spot of kind-of-plagiarism.

** It took me ages to decide to capitalise both Mrs and Organised and fear I may still have got it wrong.

About today

That sinking feeling (post script)

Posted on May 8, 2012 by WeeGee

I neglected to mention in my last post that I cancelled my plans to meet up with a friend on Saturday because of my ‘down day’. This was a bit of a shame, because it would have been another thing ticked off on the small things lists. Nevertheless, thinking about it now, I feel that I made the right decision in postponing the visit. I wasn’t at all at my best on Saturday – notwithstanding the hangover I felt small, quiet and insignificant. Rather than forcing myself through the stressful and unpleasant experience of trying to pretend that everything was okay, I think it was better to take a little time to get myself back on track.

It’s far nicer spending time with people when the fog isn’t crowding in and I think I’ve decided that a better experience is available if you are honest and realistic about what you can and can’t do on any given day. With this in mind I’m looking forward to catching up with my friend when I’m more myself instead of (as would normally be the case) beating myself up about past failures.

About today

That sinking feeling

Posted on May 7, 2012May 10, 2012 by WeeGee

Weekend number two and a weekend of rather mixed fortunes from a mental well-being point of view.

It started badly – I was suffering from my first hangover in ages, so not only did I have the usual residual feeling of self-loathing to deal with I had post alcohol self-loathing to throw into the mix. I woke late, and spent the first few hours of Saturday pacing around with that familiar sinking feeling persisting in bringing itself to my attention.

Thankfully, the memory of my achievement last weekend (I seem to recall saying I enjoyed it) was a potent one and I became quite determined that a repeat of that success was within my grasp. I left the flat and took a walk down by the river – one of the best things about my flat is that it’s a stone’s throw away from a particularly pleasant part of the Thames – in attempt to clear my head.

When I returned I donned my trusty elastic band. I wear it around my wrist when the thoughts are coming thick and fast and I don’t have the capacity to deal with them. Every time a thought comes in I snap the band (gently) to banish it. There is something about the action and noise combined that I find useful. The point is that whilst I can’t stop the thoughts from coming, I can choose what to do with them and when I’m feeling overwhelmed the best thing for it is to send them away for a little while.

With a strategy in place for dealing with the thoughts I felt able to tackle the challenges I had diligently listed out for myself. As I’ve already said, it’s not about big things at the moment, but about building up layers of small things until I’m ready to move on to some of the bigger challenges ahead. On balance, and looking at the lists, this weekend has been another success, despite the shaky start:

The process of splitting up my tasks in to the categories of need, should and could has been positive one for me. In the past, after I’ve unravelled, I’ve always tried to put things back together starting with the easiest and building up to the most difficult. Whilst this has worked, to some extent, it has always left the worry and guilt associated with past ‘failings’ hanging over me. Tackling things this way allows me to get into routines, whilst also dealing with the anxieties.

So after weekend number two, I’m pleased to say that things are still getting ticked off, one by one, day by day, and in dealing with the practical and habitual I feel much better able to hold on to myself. Long may it continue…

Moving forwards

This train terminates here

Posted on May 3, 2012May 11, 2012 by WeeGee

Until recently I was avoiding getting the help I needed. It wasn’t that I didn’t want help, or even that I didn’t think I needed help, it was just that I felt so completely beaten by everything that I didn’t know how to start thinking about where to start. To some extent, I suppose I had decided that I was beyond help – that this really was it, and there was nothing that I, or anybody else, could do to stop it. Over the course of the piece, there had been a few abortive attempts to get help but I always managed to straighten myself out just enough to be able to think I could manage my symptoms on my own; the lesson I learned during the months I was managing on my own was that I couldn’t actually manage on my own.

When you’re in the middle of an episode it’s incredibly hard to admit that you are having problems coping with yourself and that life has got too much for you. Nevertheless you need to try to focus the mind so you can reach in and grab yourself by the scruff of the neck; in the end, all you’ve done is take a wrong turning somewhere along the line and what you need to remember is (motivational quote warning):

“When you board the wrong train it’s no use running along the corridor in the opposite direction”

Eventually I found the strength to stop running and get off the train.

Step one in the right direction was booking an appointment with my GP. Over the years I have been fortunate in almost always receiving excellent care from the GPs I have been treated by (when I eventually engage) and my recent experience has been no different. Quite aside from the relief of getting in place the interventions that I knew I needed, just getting to the doctors’ surgery felt like and achievement and a baby step towards a better place. I left the surgery with a psychiatric referral and a referral for a refresher course in cognitive behavioural therapy (CBT) as well as a prescription for the anti-depressant Citalopram. Anti-depressants aren’t new to me, but are a form of treatment that I have tended to resist in all but my bleakest times. It felt like it was a big thing for me to decide that an anti-depressant was right for me at the moment. Although I had a few concerns, they were quite easily dealt with in the end:

Anti-depressants aren’t prescribed in the short-term, so I knew that if I decided to go down that route I would have to continue taking them over a period of months and that a managed withdrawal would be necessary – on balance that didn’t seem like a significant reason not to take them
I haven’t always had a good experience with anti depressants, on occasions becoming numb and more withdrawn and on others experiencing a significant worsening of my self-harming problems – I chatted this through with the doctor and we agreed that I would continue regular appointments with her throughout the course of treatments so that my state of mind was properly monitored. We also spoke about my strategies for managing any crisis intervention that might be required, and I felt a little better knowing I had a plan.
I’m only too aware that medication alone is not the answer to depression – this isn’t a real concern if the other things you need are being put into place
I was worried about short-term side effects having an impact at work – this one didn’t really fly, because my symptoms were already affecting me at work

Once I’d had the chance to talk and think things through, it seemed like a good idea. At the heart of my decision to medicate was the simple fact that I needed to get from a to b and that once I’d dragged myself through the motions I didn’t have any energy left to make that particular journey.

I’ve been taking the Citalopram for just over three weeks now and feel like it is helping to clear the fog. I did experience some early side effects (restlessness, heightened anxiety and difficulty sleeping) but these passed in a fairly quickly. I was also a little bit too ‘up’ for a couple of days, with a ridiculous number of disjointed ideas and plans flying around my head but this also seems to have passed – I wonder if I just wore myself out?!. Now I’m starting to feel a little bit more like myself at last; Citalopram hasn’t been, and isn’t likely to be, a miracle cure. Still it feels like a tiny chink of light is shining into my dark space and I feel able to think about what I can do next to support myself and manage my symptoms.

To return to my train analogy, it feels like I might be about to board the right train…… I suppose this is where the hard work starts.

Moving forwards

You don’t have to be mad to work here

Posted on April 30, 2012May 10, 2012 by WeeGee

Throughout the ups and downs of my illness I’ve always managed to keep myself in work or study and this is something I’m actually quite proud of (which is pretty big in itself, because I don’t say things like that very often). In saying so I don’t mean to cast any aspersions whatsoever on those with similar difficulties who can’t manage work during their bleak times. Perhaps I just count myself lucky that things have never got quite so bleak for me.

Work is incredibly important to me, both professionally and personally. In terms of the struggles I’ve had with myself working has had a huge role to play. Being at work brings shape and focus to the disorder; it gives me a reason to get out of bed, paint a smile on my face and laugh at the (not always) hilarious office japery; most importantly of all, it provides company in an otherwise lonely place. Being at work is part of my strategy for making sure I never unravel completely no matter what’s going on.

As noted in previous instalments, during my recent ‘bad patch’ I started carrying some of my chaos to work with me. This was the first time that had happened and was a big cause for concern. So much so, that I began to wonder whether it was time to do something I had never considered before and let my employer in on my secret. It seemed like a sensible idea. I was reaching out in every possible direction to put in place as much support in place as I possibly could (which is exactly the right thing to do). At the same time, the decision to tell an employer something like that about yourself is huge and not one that should be undertaken lightly.

Suffering from depression is nothing to be ashamed of, let’s be quite clear about that. At the same time, it is a private matter (said whilst blogging, I see the contradiction) and certainly not an easy thing to disclose to colleagues. People have a variety of views and opinions about mental health difficulties, and there is still a considerable amount of stigma attached. I knew that I worked in a good place with good people but still felt there was something of a risk associated with discussing my problems in the workplace.

In the end I weighed up the risks and balanced them up against the risks associated with the place that I was heading to – essentially becoming too ill to work. I’ve already mentioned how important the structures associated with working have been to me over the years and in the end I decided that if I had a choice it was something of a Hobson’s choice.

And so, I took deep breath and referred myself to our Occupational Health team. My aim was to ensure that I was well enough and stayed well enough to stay at work. At the same time I sent my sent my referral form to my line manager and the senior manager responsible for my team – it seemed important that I spoke to some of my more immediate colleagues about the practicalities of my day to day work which had become a little chaotic.

Fast forward two weeks and I’m pleased to say that far from taking a risk I absolutely made the right decision. My colleagues have been incredibly supportive without treating me any differently ( a big concern me) and, have been willing to work with me to review my workload and get some support in place to make sure I continue to contribute without becoming overwhelmed.

The fact that you suffer from depression isn’t ever going to be something that you want to shout from the rooftops. At the same time it shouldn’t become a dirty little secret. Support is out there, you do just have to find the courage to start reaching out and taking it.

Welcome to my world

How to lose friends and alienate people

Posted on April 30, 2012May 1, 2012 by WeeGee

As I’ve already mentioned somewhere, things have been pretty desperate for me for a while now. I’d done a remarkably good job of building walls up around myself and was well and truly stuck at the bottom, spinning wildly and reaching for calm but finding none. Things had got so bad that I’d forgotten everything I knew about managing my ever-present dark passenger: I was at the end of my rope, and had a very strong and persistent desire to end my life.

Somehow though, I carried on getting myself to work and getting through each day, and for a little while it continued to be a distraction between the hours of nine and five. As time went on, the gradual creep that had characterised my depression ‘behind closed doors’ started to crowd in during the working day as well. Rather than work being a distraction I started to feel distracted at work. I became slower at doing things than normal and far less organised, started putting off difficult tasks, and even began to avoid conversations with colleagues.

That I should come unstuck at work filled me with familiar and self-perpetuating fear, guilt and blame. I felt beaten and didn’t know what to do next (An old maxim for me at my worst being ‘I simply cannot see where there is to get to’ (Sylvia Plath)). It seemed to me that decline at work was the beginning of round two in me versus me, and I wasn’t at all sure I was up for the fight, which in my mind was another reason for giving up the good fight altogether.

I limped on for a little while through the second wave. I was aware that things were going badly wrong, but was impotent in the face of it. It was all I could do to get through the motions (the motions being getting up, showering, getting to work, doing my work, coming home and getting to bed) and I felt I had become incapable of doing anything beyond that. When at home I cried a lot, did a lot of pacing around and spent the rest of the time lying in a prone position waiting for the darkness to pass. That was the story of my life for about three months.

And then came a particularly gruelling day when I finally hit the bottom of my pit. I’ve thought long and hard about whether the details of my ‘rock bottom day’ are suitable material for my blog and have decided that all I’m willing to say is that it was gruelling and it was rock bottom. It was bad and beyond that, I guess I’m what saying is that you can take my word for it.

I woke the next morning with the usual feeling – part guilt, part dread, part regret but over the next few hours the feeling began to change. It was still guilt, dread and regret, but it started taking on a new quality. It was directed not only at myself but also at the two significant people who had been on the receiving end of a very frightened, desperate and selfish me the preceding day. Worth noting, I think, my view that empathy is an unusual feeling in the depressed, not because depressed people are bad people but because depression is so personal and inward that thoughts of its impact on those around you are simply not available.

My descents into the pit have almost always followed the same pattern from start to finish, but particularly towards the finish. In my experience you eventually hit absolute zero and are faced with a simple fight or flight decision, after all, you’ve decided you can’t get any lower and it’s a blatant and straightforward choice after that. Don’t take this the wrong way, but it’s as if sense finally kicks in.

In terms of how I was feeling about myself, I think I’d been flat-lining for months, so there was no bottom to be found there (those who know me well, will know it was all I could do not to squeeze a lame bum related joke in there*). Instead it was in terms of my relationships with others that I eventually found the bottom. Knowledge of the distress that I was causing, and let’s face it, the damage that I was doing to two very important relationships forced me to think about the potential outcomes. Either these people were going to receive a very unpleasant piece of news and I was never going to see either of them again, or I was going to try to get back to myself and then get to know them over again with a well head on my shoulders and plenty of other things going on beyond an illness that has dogged me too long.

When I started writing this blog I was simply sending some thoughts into the ether – I wasn’t writing to or for anyone but myself. Nothing’s changed, except that the last little bit of this post was written fondly for people I know well. It’s a thank you and apology rolled into one. It’s a little nod towards what they have done for me and an indication that I’m finally ready to start taking over the reins again. And now normal service will be resumed.

I’m aware that this one is a little meandering, but I got to where I was going in the end, and the back story was important, I think.

*But then I went and did it anyway, in a roundabout kinda way

The small things lists

Being boring

Posted on April 26, 2012May 9, 2012 by WeeGee

One of the songs I heard on the radio this morning – courtesy of the rather marvellous Sean Keavney on the equally marvellous Radio Six Music – was one of my guilty pleasures: The Pet Shop Boys, Being Boring. If you’re not familiar with the song all I’ll say is that I suggest you acquaint yourself and leave it at that. I should confess to having something of a soft spot for the Pet Shop Boys (it’s a camp thing I think), but beyond that, the song has always resonated with me partly because it’s sad and sad always resonates, and partly because ‘being boring’ can be an outcome of depression for me.

I was a shy child and I grew up to be a shy adult; that’s just my character, and it isn’t much of a problem for me in normal circumstances. When I’m well, shyness is an obstacle I can overcome fairly easily – I can get out to do things and socialise, I can even, on occasion, bring myself to try new things and meet new people. But when I’m not so well, the low mood and shattered confidence I experience exacerbates the problem to epic proportions. I suppose you could say that the two things – shyness and depression – come together to form a perfect storm. Here’s why….

When things get bleak, I don’t like myself very much at all, and to be fair, my company sucks. That’s barrier number one – if you can’t bear to be with yourself why on earth would anyone else want to spend time with you (not an altogether illogical thought process). After a little while with my dark passenger on board, I start to resemble what my mum would describe as ‘death het up’. I’m not eating well and I’m usually not sleeping so I look tired and drawn. Being bothered about my appearance is beyond me and even getting a haircut is a challenge too far so I also look dishevelled and worn around the edges. That’s barrier number two because I don’t want anybody to see me like that, or for that matter think that I’m really like that (this one not quite so logical, granted). Barrier number three is the big one for me, because eventually I lose all interest in the things that usually interest me. Put bluntly, I don’t actually have anything to say apart from ‘life is unbearable for me right now and I wish I was dead’… not much of a conversation starter, eh? So, for me, all of the barriers seem to conspire to knock what is already a slightly fragile sense of confidence and increase my shyness tenfold.

By the time I’ve landed in my pit it really does feel like the only thing I can do is stay there and hide for a little while because I didn’t have the confidence to do the things I was doing in the first place. All of which just makes the barriers bigger and more difficult to break down. The challenge, of course, is to do something about all of this.

We’ve already established that I’m a little shy so I think it’s safe to say I’m not taking up speed dating any time soon. Some things, however, are more realistic and I’ve started by devising myself a couple of good old lists!

Three things I need to do:

Visit my friend and her new baby
Get a hair cut
Make a new Spotify playlist

Three things I like doing:

Walking in pretty places
Wii Fit
Reading

Three things I’d like to do:

Join a book club
Get a manicure
Join a gym

Finally I’m armed with some achievable lists and I can forget about the other things that crowd my thinking for a little while. There are lots of things I could do, but right now, these are the things I’m working towards. When I start pulling them together, I’ll be socialising again, taking care of myself and maintaining some interests. Feels like a plan. I’ll let you know how I get on….

Welcome to my world

Why would you eat an elephant?!

Posted on April 25, 2012May 11, 2012 by WeeGee

I was 15 years old when I was first diagnosed with depression which means I have lived, side by side with my dark passenger for more than half of my life. The symptoms come and go, over a matter of days, or weeks, or latterly, over a considerable number of months.

Managing the symptoms of depression can be an all encompassing experience. When you can barely bring yourself to get out of bed or switch the kettle on, living any kind of ‘normal’ life can seem to be completely unachievable. Sometimes the worst of it can be the frustration found in the knowledge that the things you have withdrawn from because of depression – even the simplest of things, like going for a run, cooking a meal, reading a book, or, for that matter, writing a blog – are the very things that will help get you started on a path towards a better place.

Over the years, I’ve gathered a great many motivational quotes (perhaps one day I’ll post a list!). It might sound a little daft but my treasured phrases and sayings have helped drag me through some pretty low times. My favourite of all is to be found in the title of this blog: ‘how do you eat an elephant?’ The answer of course, is ‘bite by bite!’ To my mind, trying to beat depression is a lot like the thought of trying to eat an elephant. It seems like a gigantic, overwhelming and impossible task in its entirety, but perfectly digestible when approached in bite sized chunks (no elephants were harmed in the writing of this post).

And so this is the story of my attempt to eat an elephant; my story about living with, and in the fullness of time, perhaps beating depression. It will certainly be a blog about my efforts to make some positive changes to ease the symptoms, and in honesty, might also be about some of the setbacks I experience along the way.

Most of all it will be about me: a person who is much bigger than the illness I suffer from. It often seems to me that at the heart of the stigma still associated with mental ill health is an assumption that a person in mental distress is nothing more than the manifestation of their symptoms. I think this is an unfounded and completely wrong-minded notion and hope that maybe my blog can play a small part in challenging it.

Wish me luck. I’ll see you on the other side.