Tag Archives: depression

When you lose your mental health

It isn’t always obvious that you are in crisis. From inside a mental health crisis, what you are doing and feeling may well make perfect sense. Lockdown may make people more vulnerable to suffering the consequences of not knowing you are in trouble,  so I thought I’d talk about a few things to watch for, in yourself, and anyone you’re interacting with.

Paranoia is a likely consequence of poor mental health. It’s a form of anxiety, and right now it will be made worse by lack of contact with people who can offer alternatives, plus the vast array of conspiracy theories out there. If you are in a country whose government is handling the pandemic badly and people are dying because of that, then some amount of paranoia may be appropriate and reasonable. When it takes over your entire thought process, then you are in trouble, but this is hard to spot from the inside.

Catastrophising is another common consequence of failing mental health. You focus on the worst possible outcomes and start to see them as likely, or inevitable. Again this may seem wholly realistic. If you’re starting to feel like lockdown will never end, that you and everyone you have ever loved is bound to die, then you are catastrophising. It is a persuasive line of thought, but that doesn’t make it a definite truth.

Overwhelming futility – this one comes from depression, but it can pair up easily with paranoia and catastrophising. It feels like there is no point doing anything. At the extreme end, there seems to be no point getting out of bed, or eating. This is likely to turn up with, and be reinforced by overwhelming feels of exhaustion and leadenness.

The best solution I have found when dealing with this in better times, was to have people you can trust to hear you, not make you feel ridiculous and help you get things back in proportion. However, there is no knowing right now who else might be driven around the bend by what they are experiencing. If we dig in with these experiences together, we can amplify them for each other. It’s difficult to keep things in proportion when the world is such a mess. It’s hard to be certain that any kind of hope or optimism is rational at all. But in terms of surviving and being able to function, some kind of hope is essential. Hope as a deliberately chosen path, despite all the evidence that does not support it, might be the most insane and most healthy thing you can go for right now.

The other thing to always consider with failing mental health, is to focus on the practical and physical things. Look after your body, eat good food, rest, get exercise, get some sun if you can and some tree time. It gives your mind something productive to focus on and you can make a difference to yourself and those around you with a focus on bodily wellbeing. Focus on surviving and staying able to function. Hopefully there is a far side to all this where healing will be possible and we can rebuild ourselves. Human minds are fragile and damage easily, but are also resilient and can recover.


Struggling with mental health

I wrote this in the middle of the night recently, crying, unable to sleep, overwhelmed with panic and despair. The first version went up on Facebook. I’m mostly trying to out a brave face onto my online presence – easy to hide behind a screen. But, I doubt I’m the only one feeling this way and I think it needs talking about.

TW – Suicide issues.

Like a lot of people, I was suffering from anxiety and depression before the virus. There has never been much help available for us, and now there will be less.

Many of us have lost key things that were keeping us going. We may express hurt over that online – the loss of the gym, the dance class, the pub time, the live music – we may not be being super selfish when we express distress. We may be talking about the things that helped us stay alive. Depression also kills people. Knocking people back for expressing distress or difficult, really doesn’t help.

It’s really hard for me, reading people saying ‘stay in’ and ‘don’t see anyone’ with a clear message that anything other than total isolation makes you a terrible person. I’m really struggling with feeling like a terrible person, I expect I’m not alone. I don’t do much going out at the moment, and I’m being careful and have been for weeks. But I’m also not sleeping, and crying a lot, and terrified of being trapped in this flat and what that would do to my already poor mental health.

Tom has some serious anxiety issues and for him, being trapped in a building is deeply problematic.

So maybe don’t share the memes about how all you have to do is sit on the couch, it isn’t that hard. For some of us, isolation could well be a death sentence.

And yes, lots of anxiety about how selfish I am in not wanting to end up suicidal. I’ve been through periods of wanting to kill myself before now, I’m fighting not to go back there. I’m seeing people online hoping the virus will take them quickly because they’ve already lost the will to live. I see the same thoughts creeping in with me. ‘Selfish’ can be something of a trigger term for me and again I suspect I’m not alone. I think people who kill themselves often do so because they think its the best thing they can do for the people around them. What else is there, if the things you do to try and stay alive are deemed selfish?

I know many of you are new to massive anxiety, and you just want everyone else to be more sensible so you and your loved ones are safe. Of course you want that. But some of us were only ever holding on by our fingertips, and now things are worse. Please, when you go online to vent your fear, consider how it might sound to someone who is having a mental breakdown. Someone – for example – for whom going outside for a run, or a walk is the one tool they have left to manage their failing mental health.

Your suicidal friend probably won’t tell you how they feel because that’s part of how this illness plays out. They won’t ask for help, especially not if what they need is time with another human being. You won’t know who is in trouble, most likely. Yes, isolation saves lives. Kindness also saves lives, and your depressed friends need to know that their lives matter too and that they are not failing as human beings for wanting or needing things that are difficult at the moment.


Isolation and mental health

There are reasons we use prisons as punishment and solitary confinement is considered especially harsh. Most humans are social creatures and isolation is bad for us. However, we’re faced with a pandemic that requires us to at least do some social distancing, and that for some people means as much isolation as possible in the hopes of survival. Isolation is bad for mental health, and depression also kills so there is a lot to consider here.

I’ve had a lot of firsthand experience of isolation impacting on my mental health. Living with a few other people does not reliably offset it, and it puts a lot of pressure on those people to provide emotional support. They might not be well enough resourced to do that. Isolation can feed anxiety and depression because there’s not enough to counteract it. There’s not enough positive reinforcement, counter-narrative to the distress, or distraction from it. If you have mental health problems already, being isolated with your own thoughts is hell.

If you start out mentally well and are isolated, you may be ok at first. However, you can still end up feeling unable to leave the house after a while. Boredom can slide you into depression. Apathy can take over, with loss of motivation, loss of joy in life, you do less, you feel worse, you cycle into depression.

Our minds and bodies are not separate systems. Poor mental health is poor health. It can often lead to choices that further undermine health. The things we do for short term comfort may only make our situations worse. The process is likely to be slow and it may not be obvious what’s happening if you haven’t dealt with it before.

Here are some suggestions. Having a voice and a face to communicate with helps – use online tools, use your phone, get the emotional intimacy of talking directly. If you don’t feel able to ask for help with being isolated, contact someone else and ask how they are doing. Rescuing each other often works best.  If there’s no one you can talk to, I find the radio helpful – it’s immediate, and feels more personal than television.

Think about who might be unable to communicate. Consider older relatives who aren’t tech savy. Make sure you know who of your friends is vulnerable. Who is old enough to be at extra risk? Who has underlying health conditions and may need to totally isolate? Who already suffers from anxiety? Don’t wait for them to ask for help. The nature of a mental health crisis usually makes it very hard indeed to ask for help. After all, people are dying out there, how can you approach your friends and family – who no doubt have their own problems – and ask them to give you some time because you are overwhelmingly sad? Mental health conditions are good at persuading sufferers that they are making a fuss and/or don’t deserve help anyway. Make the first move.


If you can choose

It sounds empowering – you can always choose how to think about something. Unfortunately it isn’t true, and putting that idea about can add layers of blame and shame for people who have been damaged by trauma, and by design.

Brainwashing. Conditioning. Gaslighting. These are terms for processes that are undertaken with the intention of controlling how a person thinks about things. Stockholm syndrome is a consequence of experience that impacts on how you think. When people come out of cults, they need de-programming. Depression and anxiety are illness that are fundamentally about not being able to choose your thoughts. These are all familiar terms, and yet the idea that we can all control our thoughts and choose them, all of the time, keeps doing the rounds.

The human mind can be quite fragile. It can be damaged. Your ability to think rationally can be messed with in ways it will take years to recover from. We like to focus on the people who, by dint of remarkable strength, faith, or persistence are able to resist mind-control and keep their thoughts their own. That a person can do something is not evidence that everyone can do it.

To have your mind broken is to lose yourself. You don’t know who you are anymore. You don’t know what you want or need, or how to feel. You can’t make choices, you are frozen and frightened and lost. I’ve been there. I’m a person with a lot of willpower and a decent capacity for reason, and I have had that taken from me and been obliged to re-build it from scratch. I’ve spent a lot of time not being able to control my thoughts or choose what I think and I’ve had a long, hard fight to overcome that.

I don’t have words adequate to express what it means to lose your self in this way. The experience of not being able to control thoughts – of not being safe even inside your own mind – is an awful one. For anyone who was damaged in childhood there may not even be points of reference for knowing what a functional self looks like. It is hard choosing thoughts when you don’t have a range of possible thoughts to draw on in the first place.

If you can choose what to think about a situation, then you are in a position of privilege. Either you’re not going through something that is damaging you, or you are possessed with unusual degrees of inner strength and resilience. While that’s something to celebrate, it isn’t fair or realistic to assume everyone has the same experiences and resources. Like all privilege, it remains largely invisible to the people who enjoy it.


Unspeakable loneliness

How can you speak of it when it implies criticism of everyone you love? How can you say ‘I am lonely’ if you have a partner, or friends, or family, or all of those? But you can have people in your life and be lonely, and I think it needs talking about.

In any given 24 hour period, Tom and I spend something close to 24 hours together, waking and sleeping. We work at the same table. But, we work alone, usually in silence, each engaged with whatever we’re doing. Working in the same space isn’t time spent together, and it took us a while to learn that.

We both suffer from depression and anxiety. This means there are times when both of us need someone with the energy and ideas to break through our numbness and take us somewhere else. When we’re both ill, we can’t actually do that for each other. It is also a lot to ask that it falls only to your partner to wade in and rescue you when you have been kidnapped by the monsters in your head.

Depression and anxiety both, in their own ways, make it hard to ask for help. If you are feeling gloomy and worthless, how can you ask someone you like to spend time with that? How can you show up socially without a mask firmly in place to spare others? And if you socialise while masked, you will feel incredibly lonely. If anxiety is gnawing at you, then the fear of how anyone will respond to you making it visible is also going to be part of the mix.

Mental illness means you can be in a room full of people and totally unable to connect to them. It can mean you won’t let anyone see you as you are, and you experience the profound loneliness of being related to as you are not. It can mean being unable to go out at all, unable to speak, unable to reach out. So you may have hordes of lovely friends and just not know how to approach them when depression has its teeth around your throat. You probably don’t want to put them through seeing you like this. Maybe you don’t want to sabotage your own dignity by letting people see you when you are broken.

There are many potential causes of loneliness – and for many people isolation is central. But, a person can appear not to be isolated, and still be feeling really cut off. It may be very difficult to hear about loneliness from someone you think should feel close to you, but if anyone does talk to you about it, this is a sign of tremendous trust. Try not to be cross with them over how you might feel, because if they’ve come to you it’s likely because they think you are one of the few people who might not hate them for feeling as they do.


Down Days – Further

Yesterday I posted a review of Down Days by Craig Hallam. I read the book a little ahead of that and have had time to think about it beyond the reviewing process. It’s taken me some interesting places. I’ve only had dealings with the medical profession in the last decade about depression, and only in that time frame have I used the term confidently with regards to myself. I didn’t get much help, which played into my anxieties about how I make a fuss and over-react.

Reading Craig’s book, several things struck me. That he’s talking about down days, with some longer patches of being mired in depression. One of the blocks for me, to taking my mental health seriously is that I’ve always been able to keep going, to get out of bed, to push through and do whatever was important. So I’d been taking that to mean that in the grand scheme of things, I probably wasn’t suffering that much. I don’t have down days. I rarely have days where depression isn’t with me – perhaps only as a low level hum in the background, but definitely almost always there.

I’d not really treated that as meaningful.

Craig talks really well about living with depression, that it is something he’s going to have to manage for the longer term, not something he might ever be truly free from. I realised I’d been holding the belief that I should be able to fix this. If I try harder, make better choices, do the right things… that it is a failing on my part and something I ought to fix. Reading Down Days made me consider that perhaps this isn’t the size of it, and that I might treat myself more kindly if I put those beliefs down. And also that treating myself kindly might be more helpful than pushing for a fix.

When was I not depressed? Thinking about the symptoms, it goes right back for me. When was I not anxious? And when did I ever feel like my discomfort, my fear and my distress actually mattered? Even since I started trying to sort myself out and acknowledging that there’s a problem, I’ve not thought about it in terms of being entitled to feel better than this. I’ve thought about it as being less of a nuisance. And that’s probably not helping. In the background noise remains the fear that I’m making a fuss, being unreasonable, and if I act like any of this matters, it would be fair to tell me off and put more pressure on me.

For the last ten years or so, it’s been about trying harder. Being more mentally disciplined and controlling my thoughts. Risk assessing my anxiety to stop myself taking it seriously. It came as a bit of a shock to me to consider that being kinder to myself might be the key thing to being more mentally well. That maybe it would be ok to be kinder to me. That this would not make me a horrible, selfish awful person. That I might be entitled to be passably comfortable, not deserving to drown in misery. These are big thoughts, it’s going to take a while to adjust to them.

More about Down Days here – https://www.inspired-quill.com/product/down-days/


Down Days – a review

This isn’t a self help book or any kind of technical book about depression and anxiety. It is however, a very readable and useful sort of book.

Craig Hallam is best known for his fiction – which has gothic and steampunk flavours in the mix. He’s a splendid chap. I’m reviewing this book because it has considerable merit, and I like Craig a lot. Reviewing a book about depression and anxiety written by someone who suffers, and being someone who suffers, I have some idea what a brain can do in these scenarios… Craig is lovely, and his book is thoughtful and insightful and some people are going to find it incredibly helpful. (But I can almost hear the voice in Craig’s head trying to explain why I probably hated it, and him…)

If you suffer from depression and anxiety and feel alone in this, reading Down Days might just help ease that a bit. It’s not just you. There’s much to be said for a friendly, understanding voice, and Craig is that.

It is, I have noticed repeatedly, a lot easier to think about other people’s problems. We’re likely to be kinder to other people. I rate your chances of reading about Craig’s experiences and feeling clear that the things that live in his head are horrible, unfair things that need treating kindly. Even when you’re telling yourself that the near-identical things living in your own head are perfectly sensible and justified. Sometimes, what we can feel for other people opens a door to being able to see ourselves differently.

Perhaps the most useful aspect of this book is the scope for giving it to someone else. Talking about mental illness is really hard. Explaining what it’s like is very difficult. I’m a words person, and on a good day I can have a crack at describing it. On a bad day I can barely string sentences together and I don’t talk about what’s happening. Not everyone has good days. Even on the good days, you might not have any words. What Craig has written is a very readable, unthreatening sort of book about depression and anxiety from the inside. So, if there’s a person whose understanding would make a lot of odds to you, but to whom you cannot explain things, this book could be the perfect answer. It would be a way of starting a conversation without having to do the talking, and a way of helping someone else understand without having to dig into the things you least want to have to think about.

One of the things I think reliably breaks people down is not knowing how to treat ourselves kindly. Many of us did not get here alone, and may be kept here by what’s happening in our lives. After a while, you can start to feel like you don’t deserve kindness – that’s very much part of the condition. It persuades you that this is all you are worth, that no one could care, that if they do, you don’t deserve it and that you are at best, a waste of space. This book is kind. This book will be kind to you, and it will show you things that might help you be a bit kinder to yourself, and not have that be a frightening thing.

You can buy this book other places online, but buying direct from the publisher’s blog is also a thing, so here’s the link – https://www.inspired-quill.com/product/down-days/


Learning to like myself

For most of my life, I’ve not much liked myself. I mistrust my judgement and my motives. I feel I have to justify my choices. I never feel like I’m doing enough, giving enough and that alongside this I am a mostly inconvenient nuisance. Worrying about what I cost financially goes back a long way. Aged eleven I started keeping a diary because it helped me ascertain whether I could justify my existence on a day to day basis. I worry about being fake and fraudulent and making too much fuss and not being stoical enough and not working hard enough. I don’t like my face or my body shape either and there are lots of ways in which my body is a difficult place to be.

(And I wonder, when I share things like this if anyone is going to have a go at me for being attention seeking, or feeling sorry for myself, or not trying harder to be positive… because that all happens.)

Just in this last year or so, I’ve started having small windows of something entirely different. Usually it’s prompted by something I’ve done that has demonstrably gone well. I get bursts of time when I think I’m a decent person and that it is possible to enjoy being me. It is surprising, and the impact in terms of my feelings of wellbeing is dramatic. It also gives me some sense of what it might be like to go round feeling like a good person who is entitled to exist and be happy.

Depression has been with me for a long time. It may be with me for the rest of my life. But, these windows of getting to feel ok are dramatic and remarkable things. I really had no idea that was available. Prior to experiencing it, I did not imagine it existed, and I did not know that I was not even seeing that could be a thing. If I can do it for a few hours here and there, perhaps I can do more of it. Perhaps I can get to a place of not mostly feeling bad about who and how I am. Perhaps I can do enough things I can feel that good about that the impact continues for longer. I don’t know, but it feels worth trying.


Suicide and selfishness

Trigger warnings, in case the title of the post wasn’t entirely clear on that subject.

This week has seen World Suicide Prevention Day, and a lot of conversations around why suicide happens and how to stop it. The idea that suicide is an immensely selfish thing to do has been challenged a fair bit, but, I wanted to pick over the mechanics. I feel this one keenly.

I’ve had a lot of rounds of wanting to die – not necessarily wanting to take my own life, but just wanting it to be taken from me so that I might stop hurting. I have also had rounds of wanting to take my own life and moving towards acting on that. Those rounds had one thing in common – the growing belief that it was the best thing I could do for everyone else.

When depression gets its teeth into me, I feel awful, useless and worthless. I feel like I’m a burden to everyone else, a nuisance, a problem. If my being depressed has a negative impact on other people, if my not coping causes someone else a problem, that suspicion creeps in that the best thing I could do would be to offer my absence. Usually I just step back, go silent, disappear, but death is the ultimate absence, and sometimes it starts to look like the single best thing I could do.

There are so many things around how people often respond to suicidal feelings that really, really don’t help with this. Here’s a non-exhaustive list. Calling it selfish. Focusing on how suicide would harm other people. Demanding that you get meds so as to not make the other person uncomfortable. Shutting you down when you try and talk about what you’re feeling because it makes them uncomfortable to hear it. What all of this does, is to make the suicidal person the least important person in what’s happening.

If you’re staying alive so as not to inconvenience someone else or to avoid upsetting someone, this is not a strong position to be in. Whether it’s ok to keep living or not becomes an equation in which you weigh their comfort against what you do. The worse you feel, the more depressed and stuck you are, the harder it gets to persuade yourself that the upset you’d cause by leaving is not in fact greater than the harm you cause by staying. When you’re feeling awful about yourself, it is hard to see your existence as anything other than innately toxic.

If you want to feel comfortable dealing with someone who wants to die, you are not the best person to be talking to them. That might feel uncomfortable, but I think we need to ask people who are largely ok to think carefully about how they prioritise themselves when dealing with people who are desperately ill and in massive distress.

If you want to keep someone alive, you may have to engage with what’s going on for them, and that may hurt. Consider whether it hurts more than the prospect of losing them. Consider what you can say or do to boost their sense of self-worth so they might want to live for their own sake. If you make it about you, then you may well be piling on the pressure and adding to their stories about how little their own life is worth.


Keep Rolling

Music has a singular power to get through to a person, to impact on our feelings and to keep us going. You can carry a song silently within you, and it can be a powerful talisman, a motivator, a comfort.

It’s been a tough week – with a vast amount of bodily pain and significant amounts of anxiety, and now the cold, wet blanket that is depression. There have been two songs I’ve been holding on to.

This is one of them – a traditional style song from Show of Hands.

 

The other song was one Professor Elemental performed live in Stroud, and the lyrics about acceptability are a powerful antidote to the things happening inside my head when I’m not well.