I pledge my commitment to the Blog for Mental Health 2015 Project. I will blog about mental health topics not only for myself, but for others. By displaying this badge, I show my pride, dedication, and acceptance for mental health. I use this to promote mental health education in the struggle to erase stigma.
I mentioned my depression and anxiety last year. I’ve been meaning to post more about it for a while and taking part in Blog For Mental Health 2015 seemed like a good way to do that.
One thing that’s become very obvious to me over the years is that there are a lot of misconceptions around depression and indeed mental illness in general. In this post I’m going to attempt to address some of them, from the point of view of a mostly-recovered depressive. A lot of these things do wind me up quite a lot, so this post may come across as a bit strongly worded… but hopefully you’ll appreciate that there’s a good reason for this; namely, when you’re already struggling daily with an illness that makes your life feel not worth living, the last thing you need is to have to deal with other people’s ignorance on top of that.
Anyway. On with the things!
Sometimes mental health issues don’t have any identifiable cause. But sometimes they do.
For some people, depression and anxiety just seem to appear for no obvious reason, maybe caused by chemical imbalances in the brain. But in other cases they can be caused, or at least aggravated, by life events. My own illness was definitely in the latter category.
I’ve seen both sides of this belief put forward by people in the past… on the one hand, the belief that no-one has the “right” to be depressed unless they’ve gone through something truly horrendous; and on the other hand, the idea that depression is 100% caused by random chemical changes in the brain and has nothing to do with your life experiences, so you should just suppress it with drugs and forget about analysing your past. I don’t think either of those tells the whole story.
In fact, this is the same for many physical illnesses. Some people get lung cancer from smoking twenty a day or working with asbestos for decades; others have led apparently healthy lives but just seem to get it anyway for no identifiable reason.
The amount of psychological suffering isn’t necessarily proportional to how bad your experiences were.
Again this is the same with various physical ailments. Some people get struck by lightning and survive while others die after getting a much lower voltage shock from their household wiring. The result doesn’t necessarily correlate with the apparent severity of the accident.
It’s the same with mental health issues. Some people go through the most horrific experiences and only seem to have mild problems afterwards. Others go through something less extreme and end up severely depressed or anxious. There isn’t necessarily any rhyme or reason to it, at least not one that can be ascertained without doing a lot of soul searching. I used to beat myself up constantly for being in such a bad state when others who’d been through worse than me were coping much better, but eventually I learned that there’s no point in thinking that way. Mental illnesses are complicated and often unpredictable things. They don’t follow a nice neat scale where if you get stung by a wasp you feel mildly depressed for exactly one day but if your entire home town is destroyed in a hideous disaster you get twenty years of severe depression and anxiety.
Different treatments work for different people.
One of the things that made me feel the most hopeless over the years was the fact that it felt as if I’d tried every treatment on offer and nothing was working. Medication, Cognitive Behavioural Therapy (CBT) and exercise are often touted as being good for depression, but they did almost nothing for mine. It wasn’t for want of trying either… in despair I filled several notebooks cover to cover with CBT exercises and spent many years taking various different drugs that were giving me nothing but side effects.
This wasn’t helped by the attitude of some of the people I talked to. Some of them seemed to assume that if these treatments didn’t help me, it had to be my own fault… I wasn’t trying hard enough, I had a negative attitude (I’ll come back to that particular accusation later on), or even that I “didn’t want to get better”. I’m sorry to say, a few of these people were former sufferers themselves… you’d hope they of all people would be more understanding, but I think they had a bit of a “zeal of the converted” thing going on and were determined that what had worked for them had to work for everyone else too.
Thankfully I eventually discovered things that did help me, and gradually I recovered. It wasn’t that I didn’t want to recover or wasn’t putting in the effort before, it was the simple fact that not all treatments work for all people. So if you haven’t found what helps you yet, please don’t give up hope… the next thing you try could be the one that helps you finally turn the corner. And PLEASE don’t listen to anyone who tries to tell you that the fact you haven’t got better yet is your own fault… they have no idea what they’re talking about.
“If you’re well enough to do X, you’re well enough to do Y” is a nonsensical statement when it comes to mental health.
This often seems to come up in the context of someone who’s claiming some sort of sickness benefit for mental health issues, and when it’s revealed that they went to the pub/went on holiday/did some other leisure activity, there’s a chorus of people proclaiming, “If they’re well enough to do that, they’re well enough to work!”.
It really doesn’t follow, though. Different situations present very different mental challenges and it’s perfectly possible (indeed common) for someone to struggle with some of these but not have much trouble with others, sometimes in combinations that seem to make little sense to an outside observer. For a while I was fairly comfortable with giving presentations at work, even to quite large audiences, but at the same time the thought of dating or even having a relaxed conversation with someone at a party terrified me. For some people it’s the opposite.
Even “simple” phobias can often be strange and seemingly contradictory things. For example, I’ve handled tarantulas before (in fact I think there’s even a picture of me holding one on a very old post on this blog) and they didn’t bother me in the slightest… but if anyone tried to get me to hold a large house spider, you wouldn’t see me for dust. It doesn’t make any sense, but that’s just the way it is.
Being fit for work is not a binary thing.
I’m fortunate in that I’ve been able to carry on working throughout most of the period when I was depressed. But at the same time, I’m not under any illusions about it; I know it’s only been possible because I was lucky enough to find a very understanding and enlightened employer. They’ve supported me when I needed it and made a few adjustments to help me cope more easily. I’ve been with them over ten years now and am very happy with how they’ve treated me.
But I also know it could have been so different, and for many depressed people it unfortunately is. If I’d ended up in an environment where I was pushed into things I wasn’t ready for, where my time off sick was held against me, where the employer wasn’t willing to compromise an inch to help me, I don’t think I would have lasted long in work. I could easily have ended up on benefits and in a worse state than when I started. I’m not being negative here, just realistic… I know what a close call it was at times even with a very good employer, and I know that if I’d been placed in one of the nightmare situations I’ve heard about from other sufferers, I simply would not have coped.
Unfortunately the medical profession and the government don’t seem to take this into account. In their eyes, you’re either fit for work or you’re not. You’re either fit to handle any gruelling, draining, high-pressure situation that life might throw at you, or you’re not fit to do anything productive at all. This seems ridiculously black and white to me… surely almost any person, depressed or not, will be able to cope well with some jobs and not at all with others? And surely it would be better for everyone concerned if the government would actually recognise this fact.
I remember once at a particularly difficult time, I realised it would help me a lot if I could work from home some days, as being around people was making me stressed, and most of the tasks I do in my job can just as easily be performed at home. I went to the doctor and explained this and asked him if he could write to my employer and recommend that I be allowed to work from home for some of the week. The answer was no… if I felt I wasn’t coping he could sign me off sick completely, but there was seemingly no middle ground. I didn’t want to be signed off completely, I felt I was still able to do my job but that more time to myself would give me some breathing space and help me recover faster. Thankfully in the end my employer was willing to do this for me even without a letter from the doctor, but I know a lot of other people who might benefit from something similar would not be so lucky.
“You won’t get better without a positive attitude” is the last thing you want to hear when you’re depressed… and I don’t think it’s necessarily true, either.
In all sorts of areas of life, you often hear about how important it is to have a positive attitude, and how you won’t achieve anything without one. A lot of self-help books will tell you it’s the most important thing that you need in order to get better. I used to hate reading things like that. I think it’s supposed to be motivational and inspiring… and maybe it would be if your goal was to lose 20 pounds, or start your own business, or overcome your fear of flying, or whatever. But when you’re suffering from depression, having a positive attitude seems like literally the last thing that’s ever going to be achievable. People who are depressed have trouble thinking positively, almost by definition in fact. So reading that I needed to have one would reliably make my mood sink even further and make me think “Oh great, in that case I’m going to be stuck like this forever”. I honestly think that I’d have felt less despondent about my chances if the book had said “The most important thing is to build a rocket out of household items and fly to the moon in it”.
Ultimately, though, I don’t actually think a positive attitude is the be-all and end-all that some people make it out to be. I got better eventually and I don’t think my attitude through most of my recovery could really be described as “positive”. I was pretty pessimistic about my chances of ever getting better, but I reasoned that it was better to keep trying anyway, because maybe I was wrong and I would get better some day, and that would be so amazing that it was worth trying for even if the chances seemed slim. I was probably 95% convinced that I’d be depressed and miserable for the whole rest of my life… I wouldn’t call that positive by any reasonable definition. But that 5% of doubt was all I needed to stop myself from giving up completely.
Don’t get me wrong… I’m not saying that a positive attitude isn’t a good thing… it most definitely is. My recovery would have been a lot quicker and easier if I’d had one, no question. But it annoys me to read “advice” that talks as if you can just conjure one up from thin air, no matter how bad your experiences have been, no matter how badly depression is dragging you down. It’s nowhere near as simple as that, and it’s misleading and damaging to talk to people as if there is no hope for them unless they can manage to do that.
Some problems have to be dealt with by accepting them. Others can (and probably should) be changed.
I sometimes feel as if there’s too much of an emphasis on accepting things the way they are, even when it’s not the way they should be. Now, obviously in some cases there is no other choice – if someone close to you has died, for example, there’s no way in the world anyone can change that. But some problems are less clear cut.
One of the things that kept coming back to haunt me over a period of many years was the idea that I’d missed out on a lot of social experiences that most people have in their teens and early twenties, because that’s when my depression and anxiety were at their peak and I’d spent much of those years isolated. When I talked to counsellors and therapists about this, their “solution” was usually the same: I needed to “mourn the loss” of what I’d missed out on. I also read a number of self help books that said much the same thing.
But I didn’t want to mourn the loss. I wanted to find a way to have those experiences. To me, a life where I couldn’t have the same social experiences as other people wasn’t a life that was worth working towards and was never something I was going to willingly accept. And with hindsight I’m very glad I stood my ground and didn’t accept it, because over time I managed to find ways to get what I felt I’d missed, to a much larger extent than I ever dreamed would be possible, and I’m a lot happier and healthier for that. (I also found one brilliant self help book whose author agreed with me wholeheartedly that this was the right way to tackle the problem; it’s nice to have your feelings validated!).
To an extent I suppose I can understand my therapists’ response to this issue. Their role is mostly about helping people deal with their feelings… helping someone to find (sometimes unorthodox) ways to do things most of their peers did a decade earlier is not really in their remit, even if that happens to be the most helpful course of action. “When all you have is a hammer, everything looks like a nail” and all that.
That’s all for now. I had more things to write up but this post has got long enough already. I’ll probably write a follow-up at some point with some more items in the same vein.