Mental Health Series: March -Depression

This is the third in my series of mental health posts that will be in 12 parts – one post per month for the full year – each focussing on a different aspect of mental health that I have experience with.

My hope is that these posts can provide words that will help others who struggle with these issues to find better ways of communicating how they feel, and provide insight for those seeking to understand these conditions.

January – Anxiety |February – OCD | March – Depression | April – Anger | May – Guilt | June – Lack of Motivation | July – Grief | August – Mental Effects of Physical Illness | September – Trauma | October – Fear | November – Loneliness | December – Impact on Relationships


Depression

Cloudy skies in Melrose, Scottish Borders (the image is mine but feel free to use it)

Depression is a term that is often heard, but not often fully understood.

It is a normal part of the human experience to feel unhappiness, self-doubt and despondency. Feeling these things for short periods at infrequent intervals is not depression – it is life. Depression is so much more than that. It is an all-encompassing, suffocating and debilitating illness that is relentless in its campaign to rob sufferers of their happiness, self-confidence and hope for the future.

The stereotype of depression might involve the image of someone holed up in their house for weeks, sleeping away their days, not showering or eating properly, and generally cutting themselves off from the world. Sometimes, this can be the case, but, more often than not, you would never know someone was suffering from depression unless they told you. Outwardly, they might appear to be perfectly fine. They might turn up to work or school, spend time with friends and family, even continue to pursue hobbies and interests, while all the time their own minds are attempting to sabotage them at every turn.

There is the misconception that depression must have a reason to manifest, like a trauma or personal tragedy, but it doesn’t always work like that. This concept can be very difficult to understand. How can a person just wake up one day and suddenly feel overwhelmed by self-doubt and dejection? Why can’t they just go back to the way they were and ‘snap out of it’?

Let’s look at it another way. Mental illness can be just as debilitating as physical illness, and one should not be taken any less seriously than the other, so imagine for a moment that we’re discussing cancer, and not depression. Sometimes, cancer has an obvious cause, like exposure to asbestos or radiation. Other times, it just appears with no reason or apparent cause. One day, a person is fine and living their life, the next day everything changes and the life they knew is irrevocably altered.

Depression can be exactly like that. Sometimes there is a discernible cause, and sometimes it just appears of its own volition, unwelcome and unexplained, sending a person spinning off their axis into a world that doesn’t make sense anymore.

Like cancer, depression is experienced differently by each individual who suffers from it, and what follows is only my personal experience.

It was 14 years ago that I found myself planning my suicide one night at the age of 15, and, although I am a completely different person now than I was back then, I will never forget what it felt like.

For months prior to that night, I had been suffering from anxiety, OCD and clinical depression, although I didn’t realise how bad things were at the time.

I grew up with a severely autistic brother whose inability to speak and frequent violent outbursts made for a very frightening and isolating environment in which to grow up. In their struggle to cope, my parents inadvertently placed a tremendous burden of responsibility on me that I was far too young to bear. I operated under the misguided belief that if I told them how terrified I was of my brother, how often he attacked me and how much I wished I could just go out and play with my friends, my family would fall apart and it would be my fault.

By the time my brother was moved to a residential care facility where he could have the quality of life he deserved, the damage to mine was already done. I had become terribly withdrawn, fearful and anxious and struggled to relate to my family and friends.

As I got older and had to deal with the onslaught of teenage hormones and the social and academic pressures of high school, I developed severe OCD (described in February’s post) and a deepening depression.

I had trouble forcing myself to get out of bed in the mornings, and I can remember just lying there staring at my alarm clock and wondering what the point of living was. During one of those mornings, my thoughts wove themselves into lines of a poem that described my despondency and disconnection from my sense of self:

Poem

That poem was dated 20th July 2003, just over a month before the night I planned my suicide.

That morning had been pretty normal. I had lain in bed for a while before forcing myself to get up for school, look at the X Files episode chart pinned to the side of my wardrobe (which I had made to determine which episodes I would watch each night that would help get me through the day), then drag myself downstairs for a breakfast I had no appetite for.

My lessons went by as usual, and I was packing up after the end of a double period of Computing Studies. I have no idea what triggered what happened next, but I remember it vividly. As I was pushing my plastic chair back under the desk, I was suddenly hit by a wave of such profound despair and isolation that I felt faint and couldn’t move. The voice of my teacher issuing our next homework assignment faded into white noise and all I was aware of was the absolute certainty that nothing would ever get better and I would always feel this bad.

I wandered through the rest of the day in a daze until I got home. Dispensing with my planned X Files episodes, I put on an episode of my favourite show, Star Trek: Voyager, and sat despondently in front of the screen, a pile of prescription medications on the bed next to me (thanks to my physical health problems, there were plenty of those available).

My mind started to wander.  What would happen if I took them all at once? Would I have time to sneak into my parents’ drinks cabinet and knock back a few bottles as well before they found me?

I took the first few pills. I don’t remember what they were, little pink, innocuous looking things, and just as I was about to reach for more, I heard a powerful and authoritative voice projecting from the television:

‘In command school, they taught us to always remember that manoeuvring a starship is a very delicate process, but over the years, I’ve learned that, sometimes, you just have to punch your way through.’

It was Kate Mulgrew speaking as Captain Kathryn Janeway, and in that moment of sheer hopelessness that line was like a bolt of lightning illuminating a very long and dark night. In this episode, Voyager is trapped in the event horizon of a quantum singularity. Their only escape route is closing fast and the situation looks hopeless. As I continued to watch the scene unfold, Voyager’s struggle suddenly became a metaphor for my own. My hand remained suspended over the pills as I watched Janeway urge her helmsman to ‘keep it together’ as the ship was rocked by turbulence and structural damage.

When Voyager burst triumphantly from the quantum singularity, a surge of hope rushed through me as I began to believe for the first time that maybe I could escape too. I spoke to my parents and within a week my doctor had diagnosed me with clinical depression and OCD, and I began treatment at a centre specialising in adolescent mental health.

During one of my early sessions, the psychologists gave me a questionnaire to fill out so they could better understand how I was feeling. While they were discussing it with me, they asked me which question had been the most difficult to answer. I tried to tell them, but found I couldn’t get the words out, so they laid the questionnaire down on the table in front of me and asked me to point to it instead.

I pointed to ‘Do you think about committing suicide?’ I had answered yes.

That was the first time that I fully realised how ill I was, and I became committed to my recovery. My psychologists helped me to realise that my love of writing was a means by which I could find my way back to myself, and over the months that followed I crafted a path made out of words and metaphors that personified my depression into a force I could fight.

I sent fictional, sword-wielding versions of myself on grand quests to save towns terrorised by monsters who kept them in constant fear. Every time the monsters fell and the towns were freed, I imagined myself freed from the monster of my depression. It took a long time, but that approach is what helped me through, and, eventually, I felled my own, real-life monster.

Over the years, I have felt that monster stir to life again, but I have never let him get to his feet and drag me back to the hell I experienced as a teenager. I use every weapon at my disposal to keep him at bay – writing, my friends and family, my work, my favourite Star Trek episodes – whatever it takes until I feel grounded in the present again.

I’m almost 30 now and my outlook on life is completely different than it was then, but the fact that, at 15 years old with decades of my life in front of me, I genuinely believed things would never get better and I would always feel that kind of despair, is terribly sad and shows the power depression wields over its sufferers.

I was incredibly fortunate to have the support available to help me recover, but not everyone is able to work their way through depression and come out the other side. For some people, the only choice they have is to find a way to integrate their depression into their lives, accept it as part of who they are, and carry on. That takes incredible strength and courage. Ironic, considering that depression makes you feel as though as you are weak and worthless.

One notable example of this is author and mental health advocate Matt Haig. His book, ‘Reasons to Stay Alive’, is an illuminating insight into the mind of someone living with depression. There are also countless blogs, twitter accounts and books/magazines out there that are working towards making mental health a less intimidating and misunderstood subject, and ensuring sufferers know they are not alone.

It can be extremely difficult to relate to someone with depression if you’ve never experienced it yourself, and you may be at a loss as to how you can help them.

There are no easy answers to that, but never underestimate the power of simply listening. As someone who cares about them, you can provide a supportive and non-judgemental opportunity for them to express whatever difficult emotions and thoughts they are experiencing, without the fear that you will dismiss them or think they’re crazy. There is immense value in that, because it means they can contradict their depression when it tries to tell them that they’re a burden and no one cares about them.

Be an ally in their fight. Pick up a metaphorical sword and stand beside them. Tell them that they matter, that they are valued and that you are always there to listen. Encourage them to pursue any (safe and legal) avenue that makes them feel better, even if it seems strange or trivial.

Above all, remind them of this: where there is life, there is hope, and things can get better. I, and others like me, are proof of that.

 

Mental Health Series: February –OCD

This is the second in my series of mental health posts that will be in 12 parts – one post per month for the full year – each focussing on a different aspect of mental health that I have experience with.

My hope is that these posts can provide words that will help others who struggle with these issues to find better ways of communicating how they feel, and provide insight for those seeking to understand these conditions.

January – Anxiety |February – OCD | March – Depression | April – Anger | May – Guilt | June – Lack of Motivation | July – Grief | August – Mental Effects of Physical Illness | September – Trauma | October – Fear | November – Loneliness | December – Impact on Relationships


ocd

Up the Eildon Hills, Melrose, Scottish Borders (the image is mine but feel free to use it)

Most of you have probably heard of the term ‘OCD’. I hear it thrown around in casual conversation all the time. It’s often used to describe people who like to clean and keep things neat and tidy, who are very organised, or have a somewhat peculiar personality quirk like needing to keep their ornament collection arranged just so. I hear people remark, “oh, I’m so OCD about that”, when referring to their need to make their bed every morning or have their coffee at exactly 9 a.m. every day.

That’s not OCD. It’s not even close.

I’m certainly not suggesting that everyone who casually uses that phrase is being overtly insensitive or insulting. I’m sure it never even crosses their minds that it might be taken personally by those of us with actual experience of it. Unfortunately, whatever the intent behind it, that statement trivialises the severity of a condition that is so much more than just the desire to keep things neat and tidy.

If only OCD were that simple – or that benign.

Obsessive Compulsive Disorder is a mental illness that causes sufferers to experience unbreakable cycles of disturbing and negative thoughts that produce high levels of anxiety, usually accompanied by the compulsion to complete repetitive and sometimes bizarre rituals in order to cope. Often combined with other mental health conditions such as depression and suicidal thoughts, OCD traps sufferers into a pattern of behaviour that can cause them to believe that if they stop performing these rituals, or perform them incorrectly, something terrible will happen.

If you have OCD, it is genuinely possible for you to believe with absolute certainty that your family will die if you don’t check the soles of your shoes exactly 3 times as you walk down the street, and that it will all be your fault.

It can compel you to circle the perimeter of a room and touch objects in a specific sequence before you’re able to sit down.

It can force you to align objects at precisely right angles and get unreasonably angry if one gets knocked out of place.

It can leave you with chapped and dry hands because you feel the uncontrollable need to wash them over and over again to try and rid yourself of non-existent dirt and germs.

It can extend the length of your supermarket trips because you have to reshelve out of place products and straighten up the chewing gum displays.

It can mean that you feel so trapped in a room with closed doors and curtains that you have to repeatedly open and close them to prevent a panic attack.

In case you think these examples are exaggerated for effect, they’re not. Those rituals used to be mine. They are part of the rigid pattern of behaviour I was trapped in for over a year when I was 15 and severely mentally ill.

I recovered a long time ago, which is why I can now see them for what they really were and write about them objectively, but at the time, they formed the bars of a prison that meant I had to have home visits from two psychologists because I couldn’t manage the anxiety and all the rituals that would be required to get me from my living room couch to the treatment centre.

I can still remember how humiliating it was to have to walk around the house and show them all the bizarre and nonsensical rituals I was compelled to perform. They then had me sit on the couch with a piece of paper and a pen. When I felt the urge to perform one of the rituals, touching the mantelpiece with both hands at exactly right angles to the clock, for example, I had to draw a graph of my anxiety levels. When I wasn’t able to stand it any longer, I was allowed to perform the ritual, and then had to record how my anxiety levels dropped, and how quickly they began to rise again.

One of those graphs would have looked like this:

graph

You can see a pattern here. A disturbing thought would enter my mind, triggering my anxiety. That anxiety would continue to build, and, lacking the ability to rationalise my feelings and deal with them, I would be compelled by my OCD to perform a ritual to calm the anxiety. I would experience only a brief reprieve before the anxiety would start building again, like a wave about to break on the shore (or the mantelpiece, in this case).

Eventually, I was able to attend regular sessions at a treatment centre specialising in adolescent mental health, where I was diagnosed with clinical depression and suicidal thoughts alongside the OCD. A challenging triad, to say the least.

With the help of my psychologists, I learned to process my traumatic childhood and address the underlying reasons behind my anxiety. I found that writing came naturally to me, and I personified my OCD into a monster that could be fought by Buffy the Vampire Slayer-style heroines who were really just idealised versions of myself.

The need to perform my rituals fell away over time, until I stopped performing them almost completely. I can definitely still see elements of OCD in the way I behave, particularly in my need to organise and clean, but I can live with those traits and have accepted them as part of who I am.

As I discussed in the first post in this series, I still have an anxiety disorder and I’ve needed further counselling since my original treatment but, over time, I have learned how to channel my anxiety in productive rather than restrictive ways. The mantelpiece that used to attract my hands like a magnet is now, thankfully, just a mantelpiece.

I’ve written about my anxiety several times before, and I freely talk about it, but I never talk about my history with OCD. Maybe it’s because it’s still difficult to admit that I used to walk around performing those bizarre rituals in a desperate attempt to master feelings I couldn’t control. After all, nobody wants to admit things that might make them sound crazy.

The crux of it is, as a society, we don’t talk about mental illness in the same way that we talk about physical illness. If, instead of OCD and compulsive behaviours, I had suffered from debilitating migraines that caused me to throw up a lot, would I still be embarrassed to talk about them? No, because, generally speaking, physical illness doesn’t carry the same stigma as mental illness does. One tends to invite sympathy, while the other invites incredulity. It’s easier to accept that someone is nauseated with migraines than to accept that someone could genuinely believe they would die if they didn’t turn a light switch on and off exactly 7 times before leaving a room.

If you know someone who you suspect is suffering from OCD, the best thing you can do is show them understanding and patience. If you observe them doing something that seems strange or unusual, try not to stare or question them. Be patient, even if their need to check all the doors are locked for the third time in a row is making you late for something. Try to remember that there’s a war waging inside their mind between the knowledge that their rituals make them look crazy and the uncompromising power of the OCD that compels them to perform them anyway. They need to know that they can trust you and that you’ll be there to listen if they feel able to talk about it.

Tempting as it may be, the worst thing you can do is try to prevent them from performing their rituals. That will only serve to heighten their anxiety to unbearable levels and make the situation worse, possibly resulting in a panic attack or an angry outburst. The only way to successfully treat OCD is to address the root cause and develop alternative ways to cope, and that will most likely involve professional help, time, and a lot of patience. But it is possible.

If you’re suffering with OCD yourself, hold on to the fact that you’re not crazy. You just have a more unusual way of coping with your anxiety. OCD, anxiety and depression all feed off each other, and hiding what you’re going through won’t make them go away. Maybe you’re worried that people, even medical professionals, will think you’re crazy and dismiss you out of hand. That’s understandable, but all I can say is that not one of the many doctors and psychologists who have treated me over the years ever judged me for my behaviour or made me doubt my sanity. OCD is a real, diagnosable condition that can be successfully treated.

The combination of my OCD and depression led me to plan my suicide one night 14 years ago. I wouldn’t be here now if I hadn’t gotten help, nor would I be building a life I’m proud of. So can you. Just don’t try to do it alone.