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Before I begin, I will say that what I write below does contain some suggestions on how to cope with depression. In the specific criteria, Ciao is treating the review as if advice on depression is a marketable product. In this instance, I am going to hang in there with what I feel is essential in coping with depression and possibly preventing it from recurring, and that is counselling/therapy with a good and well-trained, properly qualified professional. That costs money, so I shall be giving the specific criteria on that, and not an over-the-counter or prescription drug.
DISCLAIMER: I promise what I say below isn't intended to be an exercise in self-indulgence or a sympathy-fishing crusade, even though some of it may read that way. It's an attempt to give a little hopeful insight into depression, what it feels like, and possibly even help those who don't suffer from it themselves but are close to someone who does. Also, my own discoveries and enlightenments regarding the condition are greatly at odds with certain other bodies of thought, so it's highly likely some people out there may disagree with at least some of what I say.
I also make no apologies for this being a very long piece, as it's something I feel should be taken seriously, and not skimped on. It is a far more complex subject than some people realise, and what I say below really only skims the surface.
Depression is something I've drifted in and out of for most of my life. As I've grown older, I've learned to live and cope with it, and the suffering from it for me is thus minimised as far as I'm able to manage. Recognising it, understanding it, dealing with it and making friends with it, has made me a much stronger person.
With hindsight, I can pinpoint the exact period in my life when a grey mist began to form around the edges of my sense of being....sometimes just staying marginally outside the perimeter of my inner vision, and sometimes enveloping me completely. That pivotal time was when my parents split up, just as I was coming up for my 6th birthday. Before that, I had been a bright, bubbly, fun-loving and largely carefree child - then, as I watched my beloved dad walk out the door, down came the grey mist. I was left to be brought up by my loving, but rather snappy, and sometimes depressed mother, with my dad visiting to see me as often as he was able and allowed to. My mum tried hard (sometimes harder than other times) to replace the light that had vanished for me from our home, but as far as I was concerned, things were never the same again.
During the years that I was growing up, I was always aware of an underlying melancholia in my personality that hadn't been there when I was a tiny child in the days when our family was whole - but I had no idea what this melancholia was, so found it confusing. Everybody else seemed to be deliriously happy all the time, so why wasn't I? Though people noticed my changing moods, nobody seemed able to pinpoint any cause for it, despite me now feeling that it was obvious, and it was viewed as something I'd grow out of. I didn't grow out of it though.
Life went on, and I'd have high times and low times - but even during the highs, I never lost awareness of the grey mist which was always just off to the side of me, threatening to envelop at any moment. I spent all of those years in denial, despite that awareness, and took solace in my music during the bad times.
To cut many long stories short, I eventually went on a huge bender of rather bizarre and sometimes self-destructive behaviour - especially during my marriage - which I now realise was my quest to inject some solid meaning into my life, and to connect with my own rather complex subjective sense of myself and the world around me. This spell of strange behaviour lasted quite a few years, and culminated in me doing something especially stupid which I was powerless to extricate myself from, until it fell apart around my feet of its own accord. Everything then boiled over and came to a massive catalyst; the catalyst drove me into some sort of a depressive breakdown. My mind, rather than my body, had just gone into overload, and the hovering grey mist turned into a thick black fog, totally obscuring my psychological vision for around two and a half years.
The main factor of those early breakdown days for me was a form of stress, in that I felt so very uncomfortable in the world, and merely being alive. It felt as though wherever I looked, wherever I went (even if it was just sitting alone at home on the sofa), I was faced with sharp shards of glass thrusting and jabbing in my direction....everything seemed gritty, dirty and threatening. My sleep at night would be fitful, disturbed with some of the most awful and repetitive nightmares imaginable, until I eventually became totally exhausted. I felt I couldn't go on and was unable to see any way out of what had become my inner, private prison; so, I opted for what some people with depression see as their only solace.
This option may read back as drastic to most people, but it's something I can now look back at and even have a little giggle over. I beg of you all to try and dig into the black side of your sense of humour as you read the next couple of paragraphs, as it truly was a laughable catastrophe.....not funny at the time, as the depression had killed off all traces of my sense of humour, but rather amusing now. Incidentally, my humour isn’t directed at the desperate state of depression as I truly feel a deep empathy for any fellow sufferers. I laugh, because I messed up, but messing up actually turned the tables around in my favour.
I waited until my now ex husband had gone off to work, having carefully chosen a day when I knew he was doing a long shift. The house was empty, and I'd made my plans. I watched my ex walk up the road to the bus stop, then waited until I saw the bus pass by - which he would have been on. I then gave it a few more minutes just in case he for some reason came back, e.g. maybe he'd forgotten something, then when satisfied I was to be alone for the next ten or so hours, I disconnected the phone and dug out a carrier bag I'd been hiding away from everybody. The bag contained a pack of razor blades and two bottles each containing 50 paracetemol, plus another bottle containing 15 prescription valium tablets. I took them all into the bathroom, turned on the tap, and filled the bath. Whilst the water was running, I arranged the tablets in little piles of 5 each on a tray, making sure I had plenty of liquid to wash them down with, and opened the pack of razor blades. Once the bath was full, I immersed myself in the water, fully clothed, and laid the tray across the top. I noticed that the radio was on the floor of the bathroom, so I reached out and switched it on. If I was going to die, what better way to do it than with music?
I didn't feel nervous at what I was planning to do - all I could feel was a calm relief, in that it soon was going to be all over, and I'd be suffering this awful state of mind no longer. I also believed that I was doing other people a favour, in that if I wasn’t around, they'd no longer have to put up with me, and that they'd be far better off without me once they'd got over the initial shock of what I'd done. I took five of the valium tablets, planning to take the remainder plus the paracetemol while I bled to death, then I rested the corner of a razor blade approximately where I thought the main vein in my wrist was, just holding it there for a few moments. Then, eerily, the DJ on the radio played a golden oldie - Blue Oyster Cult's "Don't Fear The Reaper", which is one of my all-time favourite tracks. How ironic! I almost felt as if it was a "message", assuring me that it
was OK to do what I was doing, and that I should continue. I felt that I had to listen to the song all the way through before tearing away at my veins...and, that was the last thing I remember.
I don't know how much later it was, but I woke up. I was lying in a bath of cold water, still with my clothes on - and in front of me was a tray still with the remaining valium tablets, plus all the paracetemol....the razor blade was floating on top of the water, and I looked down at my wrist....there was no cut, no scar, no blood, nothing! I hadn't even managed to do that right, as I'd fallen asleep almost immediately "Don't Fear The Reaper" had ended playing on the radio.
The humorous part for me about all that was the sheer ridiculousness of it. I now know that it is virtually impossible to dig deep enough into one's wrist to cause bleeding to death with a mere razor blade, and I now know that it takes several days to die from the effects of paracetemol overdose - an overdose which I hadn't even got around to administering to myself. So, there was all this drama-queen style behaviour that amounted to nothing. Once out of the bath water and dry, plus vowing always to keep the failed incident entirely to myself, I felt more hopeless and helpless than ever.
The months wore on, and my ex husband who has quite a lot of medical knowledge due to his job and thus knew I was suffering from severe depression, urged me to go to my doctor for help. I refused, so he offered to accompany me. He almost had to drag me there, and I was prescribed anti-depressants, which I religiously took as instructed - in the vain hope they'd make me feel all bright & bubbly again! They didn't. All they did was distance me from everything around me, and I just slipped further and further into the murk - but, the nightmares vanished, as did the psychological sensation of shards of glass pressing against my consciousness.....as I tipped over into nothingness, with 100% blunting of all feeling and emotion. Refusing another visit to the doctor, my ex called him out to see me - and I was prescribed anti-psychotic medication, which I now feel was inappropriate, but looking back, maybe it did help a bit. I was also given four weeks sick leave from work - I'd been taking so many ‘sickies’ anyway, due to not having the wherewithal to cart myself to and from work each day.
The four weeks' sick leave was spent lounging in the living room, smoking like a trooper, and living on very strong coffee. The weather outside was truly glorious, right in the middle of a long hot summer, and I was stuck inside with the curtains drawn, mindlessly staring at children's programmes on the TV. I found that the coffee lifted my mood just very very slightly, yet not enough to give me the energy to walk to the kitchen to make the required endless copious amounts of it - I got my ex husband to bring the kettle and coffee making stuff into the living room each day and evening, depending on what shift he was on, before he went to work.
Then, one evening at the end of the four week sick leave period, something odd happened. The TV was on and I was just staring at it as usual, not taking anything in from the programmes....just using it as a focus, something to rest my eyes on other than the walls. A film started, and about ten minutes into it, I actually found myself waking up mentally and taking a little interest in it - something I hadn't done for months and months. I watched the film right to the end, and when it was over, I was in floods of tears. Though I can't remember what it was about, it was a very sad and emotional film - and, it had contained the power to dig down and reach something inside of me that sparked a bit of life into something or other. I'd always visually created an image of me being at the bottom of the pit of depression as lying on the floor of a huge chasm, with a dead rose, a string of pearls and a dead scorpion lying beside me. I suddenly had a mental image of the scorpion beginning to move, wriggling its sting around. I was coming alive - slowly, but surely - feeling the first movement inside the lifeless bundle that I'd become. That night at was the first time I'd cried or been able to feel any emotion, or anything at all, for a long long time, and it did me a lot of good. It wasn't until much later though, that I began to have a proper and accurate insight into everything which had happened, and why I am prone to depression.
It was a long and sometimes hard road climbing back up and out of the pit, but I eventually made it - then, went on a massive, massive high afterwards. I changed my life, and doors opened wide - instead of slamming them shut, I walked through them with a renewed energy. The depression had gone! I still had one or two isolated off days, when I felt I was sliding down the pit again, but I then realised those off days were merely how I'd been before this breakdown type situation, and that I'd returned to normal rather than become a different person.
Those times when I was at the end of my tether, then down at the bottom of the pit of despair, were very difficult for the people around me to cope with. I can't even remember a lot about those times, nor how people generally reacted to me - other than a few work colleagues trying to cheer me up and jolly me out of it. My ex husband just left me in my own space, which was the very best thing he could have done. He allowed me to work through it in my own way, and emerge from it in my own time. He'd have been a listening ear if that was what I'd wanted, but I was unable to connect with him - all the same, I'm grateful to him for handling it in the way that he did.
As lots of time has passed by (all of the above happened well over 25 years ago), I have still had my down days whereby it’s not that I merely get fed-up; I actually plummet straight down into the black pit, but with the help about 10 years ago of some quite intensive counselling by a wonderful psychotherapist in London, I have learned to recognise what triggers my depression, and it's all very much linked to my childhood experiences, which gave me a rather low self-esteem. The most important thing of all for me to learn, was that in our household particularly after my dad had left home, my mother (quite unintentionally) kind of reserved all expression of emotion connected to negative happenings, for herself. It was as if I was there to make and keep her happy, and I was rarely allowed to complain about anything or voice any kind of discontent, without sparking off a huge display of somewhat manipulative emotion pouring out of her. I thus felt that I had to block my own emotions off, in order to keep the status quo. My blocking-off also happened at school, in that a crybaby type of child was frowned up on and teased, so I kept all my fears, feelings, emotions etc. locked up inside.
This cutting off from my true self, caused me to make some bad life choices during my teenage years and early 20s, thus resulting in the strange behaviour that led to the breakdown.....that breakdown too was caused by blocking off of feelings and emotions, and believing that I had to put other people's needs ahead of my own.
What I have said above is just my own experience, and a very brief description of it - so, what en masse causes depression in other people? Well, there are two bodies of thought, and I belong to the latter group. The first body of thought believes that there are two types of depression; reactive, and endogenous. Reactive depression is as it states - a reaction to a powerfully stressful situation in life, or to a series of ongoing smaller stressful situations. Endogenous depression is stated to be a chemical imbalance in the sufferer's brain - maybe I've worded that a little too strongly, but you get the picture. It means that no cause can be found for the depression, and it's sort of free-floating....already there in the person, and just attacks as and when it will. The second body of thought believes that all depression has a root cause, though that cause may not be immediately obvious.
The reason why I fall into the latter of those two groups of thought, is that once I was healed from my own breakdown, I did a long spell of voluntary work, a lot of which involved dealing with depression sufferers. I personally found that if the person suffering from depression, yet seemingly without cause and thus being diagnosed as endogenous, is approached in a certain way, eventually a cause or a cluster of causes for that so-called endogenous depression can be found, thus turning it into reactive depression - therefore, it's my view that if you hunt hard enough for the cause or causes, all depression is reactive. Those causes can be very deeply buried inside the sufferer's psyche, and difficult to locate - hence them often medically being described as having a free-floating, endogenous depression that has no root cause. I do believe though that untreated depression can actually change the physical makeup in the brain (even if only temporarily), thus giving the impression that the cause is biological.
The symptoms of depression can vary from person to person, but most sufferers will have what I call the standard ones - such as apathy, loss of interest in previously favoured hobbies/activities, inability to communicate, loss of sense of humour, deterioration in concentration levels, overwhelming feelings of deep guilt about anything and everything, sleep problems (either sleeping too much or suffering from insomnia), eating problems such as under- or overeating and appropriately losing or gaining weight. Other symptoms can be lack of personal care regarding hygiene, appearance etc., blunting of emotion or possibly outbursts of inappropriately expressed emotion (such as going into hysterical laughter during a church service or at a funeral), a need to isolate oneself from others, great difficulty or even complete inability to carry out basic tasks such as housework - the sufferer simply won't have the energy, mentally or physically. The sufferer's voice will drop a tone or two and sound flat, he or she may be very tearful and cry at seemingly nothing. Those are just a few of the very many symptoms to watch out for when trying to work out if a person is suffering from depression.....there are a lot more, too many to list here.
Most depression is fairly moderate and can pass on its own - this is typical when the depression is a reaction to an obvious event in a person's life, such as a broken relationship or a bereavement which for the most part sufferers cry their way through to the other side, but when the cause is less obvious and no major downturn in life event can be pinpointed, the depression is more chronic and can in some people become extremely severe, to the point where they will become suicidal, and later (if they don't attempt to or succeed in taking their lives) they can even become completely catatonic, doing no more than just staring into space, seeing, hearing and feeling nothing at all - totally having lost all awareness of anything and everything. When depression reaches this stage (and it's less common than moderate depression), the sufferer is usually hospitalised in a psychiatric unit for a period of time.
Anti depressant medication can help some people, but it doesn't help everyone. I personally see anti depressants as being very helpful to those who are coming to terms with something like a bereavement, in the sense that the medication can distance the person from the worst of the pain until they feel a little stronger and perhaps more able to move on, but in people where the cause of their depression is not obvious and far more difficult to pinpoint, I feel drug therapy merely numbs down and closes off the avenues that need to be explored in order to identify the causes and help the person work through them, thereby hopefully reaching a more stable place inside of themselves.
Living with someone who suffers from depression must be a nightmare, and no doubt friends and family could even reach the end of their own tether, just wondering what on earth to do. I can't tell anybody what TO do when in the midst of a loved one with depression, but I can recommend what NOT to do:
Please don't ever ever ever.......
Say "smile", "cheer up", "pull yourself together" or "snap out of it". If the person could, they surely would, as it certainly is no fun suffering from depression.
Try to tell people how they should be feeling. They feel how they feel, and there's nothing they can do about it.
List to them all the things which they should be happy and grateful about. It won't work, and will make them feel worse. They are incapable of happiness when in depression, and as for feeling grateful and counting their blessings, to get them to do that would merely compound their deep sense of guilt about everything.
Say to them "you aren't going to do anything stupid are you?" - by "stupid", I mean self-harm or self-destruction. If the sufferer is feeling suicidal, ending their life doesn't feel at all stupid to them at that time. For them it seems the most sensible thing to do, often being the only option available.
Ignore signs that a person could be trying to reach out, or is becoming suicidal. Always take verbal hints at feeling suicidal very seriously - and, get help for yourself on how to cope with it.
Try to jolly the person out of it by suggesting evenings out, parties, social activities etc. This will make the sufferer 100 times worse, as you will put them in a state of fearful panic whereby they feel they ought to do what you're suggesting in order to keep you happy, but they just don't have the wherewithal or energy.
Make the person feel guilty for what they are going through. They already feel guilty enough, and don't need another barrel-load of it dumped onto their already sagging shoulders.
Try to emotionally blackmail the person, by telling them that they are making you feel bad, and that you don't like to see them in the state of mind that they are. They can't help it or do anything about it, until the depression lifts.
Tell them that their behaviour is pissing you off. They know that already, and the knowledge is adding to their burden.
Keep throwing yourself upon the sufferer, with gestures such as cuddles, hugs, kisses, sexual advances. They will be unable to respond, and will feel under intense pressure to give you what you want....chances are high that one cause of their depression is very much to do with having spent a life of giving rather than taking, and pandering to other people's desires in order to keep the peace.
Now, onto the last bit I have to say about depression - and it's probably for most people, the most alarming piece. Suicide!
I have my own rather complex feelings and opinions about suicide which are personal, and I won't detail them here. What I will say though is that it takes a tremendous amount of thought, planning, energy and courage to come to a place whereby a person makes a decision to end their own life. Even in the depressed, the life force can still be quite strong, but some people do find themselves in such a terrible place inside their heads, that ending their life seems the only way out of their despair.
Because it is still surrounded by taboo, many people feel that suicide is something which is used merely as a manipulative tactic by the depressive, or is the coward's way out. If you are someone who believes that is so, try doing a little tester on yourself. Sit on your sofa, and hold a knife at your wrist, or look over the edge of a high multi-storey car park or stand too close to the edge of a station platform as an express train is passing through. How do you feel? Panicked, no doubt. There's no way you'd consider chucking yourself off that building or in front of the train, or plunging that knife into your veins. The reason for your panic, would be that you are looking death in the eyes, and you don't want to die. You have the life force, healthily up and running - the seriously depressed person doesn't have that life force, but still has to summon up astronomical amounts of courage to perform an act which will put an end to everything for them. The seriously depressed person sees the knife, the multi storey carpark, the bottle of tablets, the speeding train or whatever, as a way out of a misery that is too bleak, dark and awful to accurately describe, and they quite likely feel that their act of self-destruction will benefit their family and friends. The decision to end that misery in such a way is never made lightly, and is often reached after much agonising consideration, thought and planning.
Having been there, I personally don't consider suicide attempts in general to be drama-queen behaviour, as I really don't think they are. A muffed or half-hearted attempt I see as a veiled cry for help, and a successful attempt I view as the person simply is just not able to continue living, and is administering a form of self-euthanasia, putting a dignified end what truly is terrible suffering.
Suicide attempts rarely occur when a person with depression is at the bottom of the pit, as right down in the lowest depths of that hole, the energy isn't present in the sufferer to even think of ending their life, let alone being able to muster up the colossal amounts which are needed in order to actually carry out the act.
By what I’ve said in the last few paragraphs, I'm not for one moment in any way suggesting that if someone close to you appears to be edging towards a suicidal act caused by severe depression that you should just let them get on with it - far from it - I'm merely trying to convey how the sufferer is feeling when they are that close to the edge, and that whether they are just having suicidal thoughts, or are in danger of actually ending their life, it’s something which should always be taken seriously and not pushed aside, criticised or belittled.
Of course there are some people who will make overtures towards having suicidal feelings perhaps without truly intending to take their lives. These people are often resorting to dramatic means as a desperate attempt to simply be listened to.
Some signs that a person can possibly be contemplating suicide:
Tidying up of personal affairs
Verbal signs during strained conversation, such as "it won't matter after Tuesday" (or whatever day)
Appearance of things in the household such as large quantities (stockpiling) of over the counter or prescription drugs, hosepipes, cutting instruments, ropes etc.
A slight calming and lifting of mood in a chronically depressed person (this of course could also be a sign of impending recovery, so needs great care in interpretation)
Paying great attention to things like train timetables and speeds, heights of buildings, toxic properties of over the counter and/or prescription drugs
Saying things like "I can't go on" or "nothing matters any more" or "I may as well end it all" - this needs to be taken seriously, and is rarely someone simply adopting attention-seeking behaviour. Even if they are attention-seeking, it still needs to be taken very seriously, as if they aren't actually thinking of suicide yet wish others to believe they are, there is a big problem which needs to be addressed.
If you suspect someone close to you may be on the verge of suicide, I would urge you seek help and advice. You can speak to Samaritans 24 hours a day, every day, and you don't have to be suicidal to call them. They will listen to you if you are concerned that someone close to you is suicidal, and discuss your options with you - they don't give advice though. You will find the telephone number, local or national, either on The Samaritans website ( www.samaritans.org ) or in the phone book.
If you are feeling down, depressed, have lost your light and sense of hope, The Samaritans will offer you a gentle, non-judgmental listening ear, and will put no pressure on you - so please phone them before the black curtain totally descends. They will give you the time and space....which is sometimes virtually impossible to find anywhere else, and that could be the pathway out of your despair - simply being listened to and accepted for where you are inside your head, and who you are can make a lot of difference to your sense of self and worth. No Samaritan will ever shy away from listening to you speak of your suicidal feelings, and it is that which makes them unique. Sometimes it’s easier for some people to talk to strangers – after all, how many of us could knock on our mother’s or sister’s or best friend’s door, and say “I’m going to kill myself” ??
As well as or separately from contacting samaritans, I personally would strongly recommend seeking out some form of in-depth counselling. It is true that it can be expensive, but most counsellors will adjust their fees according to your income. It is important for both counsellor and client to feel a rapport with one another, though I can appreciate when in a depressed frame of mind, it is difficult to stand up and say you’d prefer to try somebody else if you are uncomfortable with a particular counsellor who is assigned to you. I truly recommend a counsellor who has been trained by the Westminster Pastoral Foundation, as they for many decades have been considered the best counselling school in the country. They do have a website you can visit – just Google the term ‘Westminster Pastoral Foundation’ and perhaps add a couple of keywords such as ‘therapy’ or ‘counselling’, and search through UK records only. There is a wealth of information on their website.
A lot of people have felt counselling to be of no help to them. I agree, that it might not be for everybody, but can I offer a couple of reasons why that could be so? Some people feel that a counsellor should be making the world better for them, providing solutions, cures, giving advice etc. That isn’t the nature of counselling. In order to benefit from counselling, the client and the counsellor need to work closely together, gradually unravelling the often extremely deep-rooted causes of conditions such as depression. The whole idea is that the client is given the time and space to explore their deeper issues in a place of safety, where they won’t be judged, and that together, the counsellor and client can both work towards finding a pathway in an upward direction. It is very common for a client to go into ‘avoidance’ mode. This often happens when their counselling sessions reach the stage when the deeper, more complex, probably very uncomfortable issues are about to emerge; the client often then will clam up and declare that the counselling has been of no help, and quit. It’s at that very point the person really needs to hang on in there with the counselling, and not walk away from what more often than not turns out to be a very positive, life-changing experience.
Just as a final point....for the 'Would you recomment this to a friend?" yes or no answer, I've clicked 'no', as largely my piece is about depression itself.....but, if the yes or no answer could be directed at seeking help from Samaritans or a counsellor or therapist, then my choice would be a definite, huge, resounding YES!
I could go on and on and on, but I think I've covered the key points.....thanks for reading!
~~ This is an adaptation of my piece on DooYoo under my GentleGenius user name ~~
This is an absolutely outstanding piece of writing Jackie and I'm so sorry to read what you have been through. You have been totally honest in opening up to others about your depression and the advice you have given is extremely helpful. I was in tears reading this and I wish you well for the future. Alyson x