I was first aware of being depressed when I was six. I was watching my grandmother putting out washing, and was overcome by a feeling of great sadness. Of course I didn’t know it was depression then; it took me almost two decades to work out what was going on. But even before that I’d been a nervous child, scared of the dark, pneumatic drills, and television aerials.
My mother is depressed, anxious, and has OCD; so did her mother, and my great-grandmother before that. My father was very odd, as was my mother’s father. They all said that my father’s father was odd too. It makes no sense to talk about genes and environment, the two are so closely entangled. Some of us grow up in families that have been dysfunctional for generations. What chance do we stand?
People who aren’t seriously depressed think of it as being sad, only a bit worse and lasting longer. But it isn’t: severe depression is acutely painful. It is like having a hot knife twisted in your soul. You just want it to stop. You just want some peace. You’re incapacitated by the pain, and consider suicide in the same way that someone with some excruciating terminal physical illness would. You get no pleasure from anything, the future seems pointless, you just have to sit there and suffer. You either don’t sleep at all or sleep too much, and usually end up sleeping at all the wrong times. Depression is rarely your only problem: I am also extremely anxious and obsessive.
I felt there was a stigma associated with mental illness, which put me off seeking treatment for years. The stigma has recently lessened but is still there. Some people think that if you are depressed then it’s because you’re weak: we are told to pull ourselves together. Of course they wouldn’t dream of saying that to someone with cancer. Eventually things got so bad I had to do something. It took me years of experimenting to find a drug regime that worked for me, so if you’re starting off on the pharmaceutical route, have patience. Anti-depressants can take weeks or months to start working, and they have side effects (always including constipation or diarrhoea). I now take 120 mg of duloxetine (Cymbalta) a day. Last year when I was feeling better I experimented with reducing the dose to 60 mg, but that was a disaster. My mood plummeted, but within a few days of returning to the usual dose I started to feel better. I also take quetiapine for anxiety.
I have a psychiatrist and a therapist, and with the benefits of them and the medication I have felt able to confront my life history and make changes to my life. These in particular have enabled me to adapt to a lower dose of the anti-anxiety drug.
- The biggest change was to change careers, going from being an employed academic, a professor of psychology, to a self-employed freelance writer. I know there are worse jobs than being an academic, but I crave freedom and independence. I want to do only what I want to do. Anything else makes me anxious, and I have to eliminate all sources of anxiety in my life.
- I started taking regular exercise. I’ve always been pretty lazy, so I signed up with a personal trainer and go to the gym at least three times a week. I need the commitment with the trainer or else I wouldn’t bother. I am now fitter than I’ve ever been. I can’t say I enjoy exercise, but immediately afterwards I do feel good about myself.
- I changed my diet. I have eliminated all processed foods and added sugar from my diet. I eat mainly fish and lean white meat, with plenty of vegetables, fruit (particularly berries), and nuts. It’s a fairly low-carb diet. Being obsessive I weigh and list everything I eat and drink. I aim for under 2000 Calories a day, but try to ensure that I get as many nutrients as possible, with 85 g protein, under 100 g carbohydrates, and 25 g of fibre a day. I take several daily supplements, particularly fish oil.
- I try to meditate and be mindful. I find meditation difficult because it’s almost impossible for me to eliminate the nagging inner voice of obsession. Trying to be present in the world, and appreciate what is happening now, helps. Most of the future that I worry about never happens.
- Having a routine and a list of things to do gives my day structure. If I deviate from the routine my mood suffers. A rigid routine comes easily to a person with OCD, and there is a danger that it will take over and become a hindrance rather than a help. I don’t know what to do about that. I try and plan for some spontaneity.
- All things pass. I have been bad in the past and recovered, and when I feel bad now I remind myself of this fact. But like the patient in great physical pain, there’s a limit to how much it helps. How much suffering can I take?
I thought these changes, with help from my therapist and the support of drugs, meant that I would stay relatively well for ever. I even posted a blog on how to cure depression. What hubris! Within a week I had suffered a catastrophic relapse.
It is so exhausting fighting mental illness. I might have an obsessive thought up to a thousand times a day, and turning each one away, “kindly but firmly”, wears you out. It also uses a lot of time. And when you’re sitting in a chair, staring into space, wrapped up with your misery and pain, that’s time you can’t have back. The worst thing about mental illness is how it wastes your life. My life has been stolen by depression.
Written by Trevor H. To see Trevor's other work go, "HERE"
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