Monday, 14 November 2011

Depression

I was asked to write a blog about depression, in response to the ongoing victimization of the vulnerable, as I knew a thing or two about Spenser's monster demon. Thing is, having no perspective, I can only take about it if I talk about myself. So, with that said:

My name is Michael, and I have depression.

Well, that's that cat out of the bag. Not much of a bag to have a cat in, I admit. It's never been much of a quiet cat, either. In fact, most people reading this either knew about the cat or knew it probably existed.

There are several different types of depression. MIND claim that approximately 1 in 4 people in the UK will suffer from some type of mental health problem at some time. There's mild depression, the most common affliction, which can strike for hours, days or weeks at a time. There's moderate depression, which may need pills to aid in the recovery, and can take months or more to recover from. Then there's severe depression, where the person is in need of immediate medical treatment, and recovery can take years, if they do recover.

On the NHS's little 30 point test, I score 24. In the more American Goldberg test, I've been doing quite well lately, and my score has gone down to 90 (out of 100, with 52 the cut off for serious depression). Well, that's certainly higher test scores than I've had in some time!

There is the belief that depressed people should just "snap out" of it, that they are being weak and just can't face up to the realities of modern life. That'd be nice, wouldn't it, if you could just snap out of major illness. I'd quite like to snap out of my asthma too (as suggested in the Sod Off book) and for my sinuses to snap out of being shit too. That'd be lovely. No one chooses to be depressed after all.

But that's thinking of mental health issues as a personality trait, and not of ill health. True, some depressed people can work full jobs, socialise and you'd never even guess they were depressed. But that's just some cases. Every case is unique. In many other cases, people's lives are at risk, not through outright suicide, but through being unable to look after themselves. Even the ability to eat properly, or get out of bed, or even turn on the heating during a cold snap...all dies away, and without outside help, the person will die. Each individual case of depression will lie somewhere in between those two extremes and thinking of it as an "all or nothing" thing isn't helpful.

Me? I was diagnosed in 2002, after becoming very ill at school. I've managed to lose my memories of most of this, and rely on friends and families recall on the matter. When we (me and the pyschologist at the time) traced back those feelings of depression, the earliest case I could recall was from the age of five. My mum had malaria shortly before becoming pregnant with me. Malaria causes neurological problems - as seen with mums polyneuritis. Does it then effect children born after? There was research done on this years ago, but I've seen no results, so it is mere supposition here. Either way, child here was most likely born with mental health issues, that became more noticeable with time.


And if you are born with something, I guess you can't just snap out. Though you can be treated. Aha, pills, you say! Well, not every pill will work for every person. Pills that have worked for Mandy wont work for me and vice versa. I was tried on three seperate pills, one of which had the adverse reaction of making my asthma worse. Pills were then taken off the agenda, and CBT, after a few false starts, was applied. There may be examples of CBT thinking throughout this.


Clinical depression being an umbrella term of lots of potential and actual symptoms. Many of them are quite common symptoms of depression, some are customised just for me.

Some of these symptoms - though not all, if we take the second one into account - include:

- Listlessness
- Memory trouble
- The "Nobody Likes You" issue
- Severe social anxiety/panic
- Confidence issues
- Stress/Temper
- Balance/co-ordination
- Psychosomatic Symptoms
- Insomnia
- Concentration
- Suicidal Thoughts
- "You're Going to DIe"
- "Or someone is"
- Perspective

We can focus on one at a time.

Listlessness: Don't know what to do. Read a book. Can't. Listen to music. No interest. Get out of bed. Muscles aren't going to agree with that. Food. Can go without. So on. It's that moment when you feel like you ought to do something, but can't summon up the energy or will power to do anything. Instead, you just lie there, your mind might not even process many thoughts, time just goes woosh past. You will still need the loo, or get hunger pains, but they are numb, and feel unimportant. At times like this, it can take the energy to lift weights, just to get out of the bed.

But it can manifest in many different ways. It can also be a disinterest in everything. Disinterest leads to further depression. There's nothing worse for a book lover than being unable to pick up a book. You can pick the book up, flick the pages, but the words just remain print on the page. They don't translate. There's a bit in the rather dreadful Doctor Who story The Satan Pit where the Doctor finds some very old writing that "even the TARDIS can't translate" (a plot point subsequently utterly ignored). Well, same idea here. The bits in the brain that translate printed writing into words that I can laugh over and UNDERSTAND goes for a holiday. It's hard to completely describe the internal fury and worthlessness that comes from having books all aroumd, having read them most of my life, and being unable to read the damn things at moments in my illness. Same with music, in better moods I can tell you every single different instrumental section in Metallica, but then, in the listless phase, it's just noise. So it feels pointless, like you've been barred from the essential magic at the heart of, well, everything

Food, we can go entire weeks where I wouldn't eat if Mandy didn't force me to. It's not even a deliberate "I shall starve myself". The inclination or thought about eating just doesn't come about.

Memory troubles: Who said that? Always keep your sense of humour. My memories always been shit anyhow. Can I remember historical notes, family traits, scattered memories? Yes. Can I recall what I did an hour ago? Nope. This is countered by unexpected flashes of great recall of specific events, but they are the minority to the vast quantities of forgotten stuff.

Here, for example, are my memories of the year 2002, as it pertained to me:

Andy Reid taped the Royal Rumble for me, and spoiled Eddie Guerreros return to the WWE.
Granda Bob took ill with his MRSA, and nearly died.
I did some Standard Grades.

That's it. It was also the year I was diagnosed with mental illness, after apparently announcing to my entire English class I planned to kill myself (sixteen year old Michael wins no points for subtlety), but I remember none of that. Just a vague "yeah, it happened". No details.

I suppose with memories you (or I do at least) link them to emotions. How did I feel at the time? That triggers memories of the events. I don't recall feeling a single thing, bar amusement at Andy's Guerrero gaff, and all the sadness at my granda's final illness. The rest is just an empty section, and so are the memories.

That's just an example. My history is full of these large gaps.

"Nobody Likes You". We deal with this in CBT. It is an example of negative thought, but one that is very prevalent. In CBT, we learn we cannot stop negative thoughts, we can only challenge them.

There is a difference between feeling and knowing. I know my wife loves me, my family the same, and my friends like me. There's evidence of it, it can be rationalised. The feeling is different.

"Nobody likes you, Michael, you stupid idiot. They all HATE YOU!" is the single most common thought that runs through my mind. Countless CBT sessions dealt with coping with this particular thought in general.

By nobody, I mean nobody. My wife hates me. My friends hate me. My family wish I was dead. The shop owners hate me. Everyone else in the street hates me. The other people on public transport hate me. Someone on Twitter I've never ever met hates me. Everyone.

It's not very helpful, and it can be deconstructed very easily. Mandy is a very strong person who knows her own mind, nobody is forcing her in a corner, and there is no way she'd have married me without utterly meaning it. If friends hated me, they wouldn't be hanging around to be my friends. My family have never stopped backing me. Compared to other tragic cases where people have been dumped, I am very lucky. And I know I am supported by many loving people. There's the knowing. The depression controls the feeling and argues differently though.

And it gets very stupid.

It gets to the point where you think a pal who is reading your book for you hates you if he doesn't respond to an email in time. A person who has a job, young family, internet issues and health problems. A person who actually keeps in touch. There's no evidence whatsoever of those kind of people hating poor old me, yet depression will eat away at you and try to convince you otherwise.

I guess if it can cause doubts about my wife, the woman I love more than anything in the world, and the one who loves me "lots and lots and lots and thinks you are very intelligent" (poor soul, she must be mad!) then no one else has a chance. Doesn't make it right, or less frustrating though.

It then has the adverse effect of making the depressed person bottle things up. Why tell people how you feel if you think they all hate you anyway? So you don't tell your parents, even though you have loving parents who would do anything to fix things if they could. You don't tell your wife, even if she can spot it a mile away. You don't even tell Shim, even though he has a witticism and a piece of good advice for element of black doggedness there is. Recently, when I was feeling bad, he made me laugh myself hoarse, saying that "Soon we'd have a black chihuahua instead!" (And in my only public criticism of Shim, he is JUST as bad as me at this, and if he opened up with problems at the time, they'd be sorter faster and he'd be a lot happier. I am allowed to be a hypocrite here, I recognise it.)

Instead, it bottles up. And becomes internal loathing.

Severe social anxiety/panic: This then manifests itself in the social anxiety. You fear going out of comfort zones. The comfort zone can be your area of town, all the way down to a bed. CBT challenges the comfort zone to make it larger, but this is hard work and takes a while to work.

Confidence: What's that again? I am apparently a fairly talented writer. People with actual talent in the field have mentioned it, various times. This is just as well, as I wouldn't see it otherwise. Just words, put together in a vaguely humourous way to convey meaning. I know I must be decent at it, as writers and editors are not fools, and few are known to sugar talk hopelessness. I'm not as good as other writers I know, but then I need to put my age into context: they have had decades more life experience and writing experience to get where they are. Being decent isn't bad at such an early stage, with practice, I've still got three decades before I even hit my peak. I talk about writing, because it is the thing I am most confident about in the world, and yet even then, I lack confidence.

When talking to people, I can get full sentences formed in my mind. Getting them out is another matter.

Confidence is all important in functioning, and when it zaps, everything goes.

Stress/Temper: My wife calls me Grumpy, as an affectionate nickname. Irritability is a key symptom. Small things like a bus running slightly late, or things not going exactly as planned, and grumpyness flares up. My temper is a lot better now than it used to be, you mellow with age, but even so it will flare up at stupid things. Even attempting to control it, it will still explode randomly. Best I can do is apologise for it.

Balance/co-ordination - I have none. I walk into walls and door frames, having misjudged where they are in comparison to where I am. My grip is terrible, I often need Mandy to get things in and out of the oven for me, as I can't work out the angles in getting it done. I don't like to hold our pets, as my grip is either too lax or too strong, and I can never control which it is. (Yes, Mandy has also had to remove my hand from something if I've overgripped and can't work out how to let go) I have trouble using my own laptop at times, as I can get my fingers to exert enough pressure to make the keyboard working. At times walking down the street, perspective, which I have trouble with at the best of times, goes utterly wonky. It's not sight issues, I can see everything down the road in front of me - I just lose track of where it is next to me. One footstep could take me into the corner 50 metres down the road if my eyes are to be believed. I often wind up walking into things, injuring myself, and then, as you can imagine, this affects confidence and anxiety for doing these things in the future.

Insomnia. What's sleep again? It's all over the place. Some folk have insomnia, some folk have hypersomnia, where you sleep most of the time. Mine is mixed. Most of the time, I have insomnia, and can't sleep for love nor money. Other times, seemingly to catch up, I don't know, I get long sleep sessions of well over 14 hours to "catch up". I have ruminatory thought (those thoughts that circle in your mind to prevent you sleeping) so rarely get any deep sleep and so will wake up knackered.

Concentration: has gone to sleep with the fishes. Reading, writing, debating, everything needs heavy doses of concentration.

Suicidal Thoughts. Yes, they exist. It's not a case of going "Hmm, I think I'll go top myself today". If it was, it implies choice, and that is far easier to deal with. Thoughts is a problematic way of looking at too, the thoughts are "Could I do it?" and "How do I do it?". It's the suicidal urges that are the problem. Those moments where without even thinking of it before, your body throws you in the direction of suicide. It's the killer beast to fight, because if you don't fight it, you will die. It can occur anywhere, in the bed, in public, on transport. It takes massive amount of effort to fight off, more than anything I've mentioned before on this list.

In full disclosure, yes, I do have suicidal thoughts - they come with the territory. Have I tried to kill myself? Yes. But, as for next month, not for six years. Serious attempts, but I just wasn't very good at the whole killing yourself thing. In fact, you could say I was a complete failure at it. Thank god.

I don't believe I'm any better than those poor souls who do kill themselves over this horrid illness. I just survive. Mostly through the Sin of Omission. If the urges try to take over, I just fall back and let the listlessness stage take over, and lie there till it passes over. It's a fight, because the urges are strong and can possess over the rest of the illness, but I've had several years practice now. Plus, even if you don't think it will in the moment, the urge passes. Sometimes it can be there for hours and it is Hell, but it does go. So just hang in there.


Lemmy said the key to survival was to keep breathing. I'm not quite sure how I keep surviving. When I was sixteen and diagnosed, I never thought I'd see seventeen. Twenty seemed a pipedream, twenty-one even more so. Twenty five not out? And married? The mind boggles. And yet it never learns. I wont see twenty-eight now, it reckons. Take each day with this illness as it comes, and I became amazed at how long I spend not dying. It goes hand in hand with the suicide bit, one might suffer from suicidal urges, but that doesn't mean one wants to die. Quite the opposite here. I want my telegram at 100!


But as I mentioned before, it's a confidence killer. And there in lies the rub, when politicians and media will attempt to blame people like me for problems in society. I'm very good at defending people. Say anything bad about my family, denounce my family for their Catholicism (I am lapsed religious and secure in it, but ones family is ones family) and I shall defend their rights to believe without harming. Attack my darling wife, and I will be like the proverbial attack dog. Attack asylum seekers or any of the vulnerable in society, and I am a man possessed.

But moan about people on ESA for mental health, and I freeze. That's me after all (and now the DWP have put me on DLA, due to worries my condition might be deteriorating, so that makes me TWICE as horrible!) After all, I do think I am a horrible person, who deserves everything, so if the government or Express attack that, well, it's just confirmation bias. I don't know how to respond to defend myself or people like me, when I feel just the same about myself internally. There is nothing anyone could say badly about me, that I haven't heard internally. One is ones own worst enemy.

And this is exactly why they do the attacks. On disabled folk, mentally or physical. Easy targets. Too trapped by their own insecurities. Not all, but enough.

Which is why we need to fight. Not just the internal enemies. While someone believes "there's no such thing as mental health problems", or a victim should snap out of it or is being lazy, or people think it is a shameful thing, or lacks internal toughness, then these myths must be fought, for they are as harmful as misunderstandings of other illnesses and even homosexuality over the years.

So, 1 in 4 folk, hi! You're not alone. Think of Winston Churchill. Buzz Aldrin. Eliot, Dickens, Christie, Chandler and a thousand other writers. They suffered depression for large chunks of their life, and were still greats. So can we all be.

Keep strong.