Depression and communication

Depression can make communication very difficult. This is why encouraging depressed people to ask for help isn’t actually that productive – if you can’t communicate, you can’t flag up distress to other people. Putting the onus on depressed people to actively seek help doesn’t solve much, adds to the pressure and it reinforces the idea that solving depression is a problem for the individual sufferer.

People who are deep in depression don’t always know that’s what is happening – especially if they haven’t experienced it before. Around communication, depression can manifest as having nothing to say, no ability to put what’s happening into words, feeling overwhelmed by the idea of trying to have a conversation with anyone. Not being able to do the things you normally do to express yourself. For me, one of the first things to go is singing. I can’t always speak – my throat literally closes up. I don’t write about depression when it is drowning me – I tend to blog when I’m surfacing, or when things are less bad. On the worst days, I can’t talk about what’s happening. The worse it is, the less able I am to ask for help.

Not knowing that the loss of communication skills and the feelings of being overwhelmed even are depression symptoms means that someone suffering won’t know that they might need help. It also means that if you see someone go quiet, you won’t necessarily get much insight by asking if they are ok – they may well not be able to tell you whether they are ok. It’s worth asking anyway, but don’t assume that an ‘I’m fine’ means the person is actually fine. They may be in trouble and largely inarticulate.

Talking about distress when you aren’t ready to doesn’t reliably help. It can feel like having to perform your pain for someone else. It can feel like you have to explain what’s going on – and you may not have the resources to do so. Pushing people to talk about their feelings won’t necessarily help them.

In these kinds of situations, small gestures can be really powerful. Text your silent person. Send them photos of cute things. Bring them chocolate. Offer opportunities to go out, to talk, to do something you would normally do together, but don’t take it personally if they decline. Make a path for them to come back when they are ready. Make it clear that your care for them is not dependent on their being able to perform for you. Keep talking. If someone who matters to you falls silent, don’t wait for them to ask for help. They may not be able to do that. Get in there in whatever way you can, and be as patient as you can be.

Environment and health

‘What is wrong with her?’ They asked.

Not ‘what is wrong with her environment?’

It’s a vitally important question and one that we too often overlook. When it comes to mental health and physical health alike we’re too quick to focus on the individual who is suffering and far too unwilling to consider the context.

Poverty, work stress and insecurity make people ill. We know this. The evidence exists. Poverty equates to poor diets, lack of access to green spaces and other insufficiencies that undermine the health of the body and the mind. We know that it is lack of control over your situation that causes the most stress and the most damage. We know this is why people in insecure jobs, zero hour contracts, short term contracts and at high risk of debt suffer from stress and all the illness stress causes. We know, but when people break, we make it personal, individual, specific.

We also know that people are happier and healthier when they have access to green spaces. We’ve seen this around lockdowns. The evidence was there before 2020 from studies from all over the world. Without access to green spaces, our health suffers. And yet, if we get ill for lack of time outdoors, this won’t be part of the discussion we have with our doctors, or the welfare system.

When children can’t cope with sitting for long periods at school, we ask what is wrong with the child, not what is wrong with how we approach education. When people aren’t especially productive in the workplace, we ascribe it to things that are wrong with them, and not to the workplace. When people don’t engage with each other socially, we blame them, and their relationship with screens. We don’t ask what’s creating the pressure to behave that way in the first place.

The environments in which we exist, work and attempt to live are not inevitable. They are co-created. They are often dictated by those with the most power and forced upon those with the least. But even so, they can be changed. We need change. In the meantime, resist the temptation to blame individuals for things that are done to them. Look for the collective in both the problems and the solutions. Support other people where you can, share resources. Resist the culture that says any of this can be fixed through hard work – this is a lie. Resist the culture that says suffering is good, or necessary – this is a lie designed to keep the many placid as we work for the benefit of the few.

Health – for the body and the mind, are very basic needs and essential for human flourishing. We need to live in environments that support human health, not spaces that undermine it.

Breakdown and breakthrough

CW trauma recovery

Healing can be a messy process. When it comes to matters of mental health, there are points in the journey that can only be messy. Most of us do not get into difficulty on our own. There are reasons that we suffer from depression and anxiety, and those reasons tend to involve extreme stress and traumatic experiences. To recover from that, you need to be in a safer place, and you will have to square up to what happened.

The most common environment for wounding to occur is the domestic one. People are most at risk from violence, abuse, sexual assault and rape from people they know, not from strangers. This is more traumatic to begin with because of the layers of betrayal and broken trust when the people you should have been able to most trust are the ones who harm you. Part of the healing process for many people will involve squaring up to what someone they loved did to them. That is a vicious, painful process to be in.

Abusers encourage their victims to feel responsible for what is happening. This protects the abuser and keeps the victim pliable and cooperative. The mental health damage is massive. It’s further complicated when the victim wants to think the best of their abuser and is easily persuaded to feel that they are to blame so that they can keep believing that their partner, or parent or other person they care about, is actually a good person. To heal from that experience requires re-visiting it and re-framing it and that is a hard process.

While you’re in there, the difference between breakdown and breakthrough can be almost impossible to spot. Some healing is impossible without some breaking down of the old self and the old worldview first. Again, this is a desperately hard thing to go through, and while in the thick of it, there may be no sense that this is a breakthrough process moving you towards healing. Not everyone hits this in the context of having professional support to get through it.

Breaking down always creates the possibility for a breakthrough of some sort. But, that’s not an obligation to heal. Without support, resources, time and care, a breakdown can be just another hellish period of misery. Having the space to transform breakdown into breakthrough is a privilege issue. For the person who is still in the harmful situation, healing isn’t an option.

But, it can be some comfort to know that when you hit a period of breakdown, it might lead to breakthrough. There is every chance its happening because you are able to step away from the past and start re-building. It is not an easy choice to go with this process rather than fighting it, but sometimes, surrendering really pays off.

I will likely be coming back to this in the not too dim and distant future to talk in more detail about how recent breakdown has allowed me to make some specific breakthroughs.

Checking in

Depression will tell you that no one cares. It will tell you that you don’t matter. It may go further and suggest to you that everyone you know would be happier and better off if you disappeared. This kind of thinking can kill people.

It is one of the most crippling things about being depressed – that the very nature of it can make it impossible to seek help. You don’t believe you deserve help. You feel like no one would care, or take you seriously. You may have voices in your head (which probably started as things other people said) about how you make a fuss, over-react, are attention seeking and like to wallow in misery. This stuff is the enemy of speaking up and seeking any kind of care or support.

Check in.  Ask people to send kittens, or otters, or whatever lifts you a bit – it’s an easy way to get some gestures of support without having to be too explicit about how you are feeling. Talk to someone. It doesn’t have to be much, you don’t have to go into detail about what’s going on. Just show up where you can.

Check in, because the odds are good someone does care and would notice. There may even be people who would be hurt and frightened if you suddenly went quiet. And those people might not be ok either, and sometimes the threads holding any of us together are thin and fragile.

I’m not ok right now, but I’m checking in. I thought about not posting, but the previous blog came from a dark place and I do not want anyone to see my absence and worry about what it means. I’m still here. I’m going through some really difficult things. I will get through them.

I think part of what yesterday’s post means is that I’ve broken through into some of the narratives that go on in my head. I’ve recently encountered the idea that we might gaslight ourselves, and I’m going to spend some time considering my own thought patterns in light of that. I’ll be back when I know something.

Talking about mental health

In a recent blog post, Cat Treadwell flagged up some of the things that reliably happen if you try to talk about mental health problems.  It is unfortunately quite normal to hear that you are attention seeking, making a fuss, being a drama queen, over-reacting and things of that ilk. It is also equally normal, when people turn out to have self harmed, attempted suicide, or managed it, to find a lot of people wondering why they never said anything and never asked for help. As though these two things are totally unrelated.

Talking saves lives. Emotional support, witnessing, expressions of care and help with the problems that are causing the depression in the first place all increase a person’s chances of survival. Our culture tends to frame mental health problems as personal, but usually it isn’t – poverty, lack of opportunity, poor physical health, insecurity and a lack of dignity all pushes people towards the edges. These are social, systemic things and we could fix them. Western culture makes people lonely.  The solutions to this lie in community and relationship, but if you can’t speak of it, you can’t access that support.

How something is experienced depends a lot on resources. The less resourced you are, the harder a setback can be to bear. So, if you are doing ok, and your friend appears to be in a similar situation and struggling, is this because they make more of a fuss than you do? What’s the bigger picture? Throw in a large debt, a health problem,  an abuse history and the thing you think shouldn’t be a big deal becomes much harder to manage.  When people ask for help we can’t always see the scale of their issues, so it is as well not to dismiss or diminish whatever is mentioned.

Some people are more sensitive than others, but society tends to view sensitivity as weakness. To care, to feel empathy, to be afraid for the world, to grieve over the loss of species, or the homeless on the streets, or the hungry children depending on food banks – there is so much to break your heart over. Increasingly to be viable is to be heartless. To care about anything is to live with a broken heart. If we prized that sensitivity we’d be a lot closer to fixing the entirely fixable woes we create. If we treat sensitivity as a failing, we can only push on to make life worse for each other.

You may think that if someone was suicidal, you’d be able to do and say the right things to keep them alive. What many non-depressed people don’t realise, is that your suicidal friend isn’t likely to pick up the phone and tell you they are going to kill themselves. It’s not what we do. It’s not when the windows of opportunity occur most reliably to save lives. Your very depressed friend might however speak up about some aspect of how they are suffering before it fully overwhelms them.  It may not make any sense to you. It may not seem like a big deal. Often, the life and death stuff is much smaller looking than is really the case.  Respond well to those smaller expressions and the person you are supporting may never end up trying to kill themselves.

Tell someone they are making a fuss, and when they no longer know how to keep breathing, they may remember that, and not reach out for help.

The impacts of gaslighting

I’m writing this post in the aftermath of the UK Prime Minister and other leading figures telling us that when their man broke the rules he wasn’t breaking the rules. Also if we loved our families we’d have broken the rules. Weeks of difficulty seem meaningless in face of this. People who have suffered greatly while trying to do the right thing are reeling, disorientated and in distress. This is what gaslighting does to people.

I know what’s going on and I can see the process. It will have a much harder impact on people who did not think they were being lied to and who trusted this leadership. Gaslighting drives people mad, and I wait to see with a heavy heart how all this will play out. For some people, it will be a quiet fall into despair and dysfunction. Some people will freeze up and become unable to act or make decisions. Some will lose the plot entirely and what they do will be hard to predict. How many in which category? How much mental health damage done? How much more pain inflicted?

My body is heavy and sluggish this morning. I feel exhausted and it is hard to push back and persuade myself to get busy. There are things I need to do, but in face of all this, there are voices in my head suggesting there’s no point even trying. There is no win available. I’ve been a victim of gaslighting before and one of the major impacts of what’s happening on the national scale, is that it is bringing up for me a lot of unwanted memory about how that felt when it happened on a personal scale.

It is so hard to resist – something people who haven’t experienced it tend to under-estimate. Disorientated, second guessing yourself, no longer knowing what to believe or who to trust and feeling like you are losing the plot – it makes a person so easy to manipulate, or just unable to defend themselves.

When everything is this confusing, anything that sounds plausibly like a calm and sensible suggestion becomes incredibly attractive. I worry about what’s going to seem persuasive.

Mental health is a delicate thing. Humans are more inherently fragile than most of us want to believe. Not recognising that is of itself a vulnerability, because when we get into shit like this we can be slow to realise we are being broken and are in danger. But, looking at the distress, despair and confusion in the UK right now, we are being broken and we are in danger and we need to do as much as we can to assert a functioning reality, look after each other and build sanity and mutual support.

Druidry and rescue

This is a tested approach for dealing with someone in emotional crises. In an ideal situation it would just be a case of grabbing some professional help, but mostly there isn’t any of that to be had, so if someone close to you is in crisis, you may be all they have.

This approach needs handling with the calm authority you would bring to leading a meditation or a ritual. That means you may well use your emotional range to get things done, but you have to do so from a place of love, strength and confidence.

1. Make non-threatening physical contact. It helps focus attention. If someone has disappeared into themselves, and isn’t functioning, touch is a good way of getting their attention. Put a hand on their shoulder, hold their hand, that kind of thing.
2. If you don’t know what’s happening, ask, and listen without judgement. Say nothing that will undermine them, or invalidate their feelings. You may not agree with what they are feeling and why, but if you bring that up now you will only make things worse. Don’t criticise, avoid anything that could be taken as you saying these feelings are not reasonable or valid – you have to start from where the person is right now. No one is ever rescued by being made to feel that their emotions are somehow wrong. Your understanding is essential.
3. Validate their feelings. Tell them you understand why they feel as they do. Recognise the context in which this is happening to them. Empathise with them. If they don’t talk or you don’t need to ask, verbally empathise. Tell them as much as you can about what you understand of what’s happening and why it’s a reasonable response.
4. Using your empathy, you need to persuade the person that you are inside this situation with them. Not that you feel exactly the same, but you are in there, feeling what is happening. You may need to cry for them, but be careful not to make it about you.
5. Refuse to leave them in this place. Tell them you are with them, and that you can get them out. Believe that you can walk them out of this place. One breath at a time. One step at a time. This is where your pathworking/ritual skills really come in. You have to walk them out. Keep it in the present tense, don’t talk about the future too much. Take a ‘this is what we’re going to do right now,’ tone. Keep it simple. Reassure them that they can get through this. The rest you will have to make specific to what’s happening, but it is your empathy and your being in there with them that will enable you to pull them out a little way. You do not need to fix everything right now, you just need to get your person to engage with you and consider that things could be better. Your love, determination and compassion are key here. Don’t use emotional blackmail. It is ok to say ‘I need you’ or ‘I don’t want to live without you’ but don’t say ‘stop doing this to me I can’t bear it’ because that kind of thing will push them deeper in. Make it about them and what they need. They probably do need to feel needed, but not wholly responsible for you.
6. As soon as you have them engaged with you, make some physical interventions. Do things that will be grounding and physically supportive – hot drinks, food, a blanket, getting them to bed, or under a shower, or into a bath and fresh clothes. Brush their hair, massage their feet, make them a hot water bottle, get them outside for some fresh air, or to a window. From this point onwards, focus on physical care – it supports mental health, is a good expression of love and support and creates space in which they can keep talking. Encourage them to keep talking, but don’t push hard, talking is often exhausting when in crisis. It may take a few rounds to deal with what is happening.
7. When things are stable, consider the underlying issues and what can be done to tackle them. Do not try and do this when the person is in crisis, they won’t have the resources and may be overwhelmed and intimidated.

Lockdown and mental health

It has worried me from the start that politicians aren’t factoring mental health impacts into their choices. I thought today I’d talk about some of what I can see happening, in the hopes that if any of you are experiencing this, there will be some comfort in identifying the mechanics. This is UK based but may apply other places.

We’re social creatures, so being asked to isolate is really hard. Doing it heroically to save lives is feasible, most of us can get behind that and sustain it. Doing it when economically based contact is allowed, but love is not, is brutal. We can go back to work, but we cannot go to family, friends and lovers who do not live in the same house as us. We are allowed our economic relationships, but not the ones that matter.

None of this ever made any sense. The biggest source of spreading is households. If one person gets it, everyone gets it because most of us don’t have room to isolate from our families. We should never have been asked to do this. Ill people should have been isolated in medical facilities, keeping their nearest and dearest safe. If you have vulnerable people in your household the advice has been to go to work and isolate from them at home. Technically difficult, and emotionally harrowing. We should be able to cling tight to the people we love, and be confident we can keep them safe.

Big events with hefty financial aspects were allowed to go ahead when they should have been cancelled. Plane loads of people from virus-afflicted areas were allowed in unchecked. We were put at risk, all of us, for the sake of money. This kind of treatment will impact on your mental health. We’ve been lied to and blamed, over and over. This is gaslighting, and it makes people mentally ill.

The whole thing has been organised the wrong way round from the beginning. We should have been protecting close relationships and getting people away from numbers of strangers. We’re safer when we can assess our risks together. The friend I can talk to about how we handle this is far less hazard to me than the stranger who coughs on me in a supermarket. Not being allowed to keep the people we live with safe has massive mental health implications for many people, as well as the hideous virus implications.

Usual mental health advice is all about staying connected with people who can support you. We know what people need to be well, but that knowledge has been ignored throughout this crisis. If we put mental health first, we give people resilience. If we had protected intimate relationships and sacrificed economic ones, we’d be better off. If we had done this the other way, people would have felt less need to push back against the rules.

Usual mental health advice also tells us to get fresh air and exercise. The mental health of people with no gardens, and people living in cramped conditions is not being talked about. It should always have been ok to sunbathe at a distance from others. It should never have been ok to force non-essential, usually low paid workers to keep working and commuting. One of these things runs the real risk of spreading disease and the other, simply does not.

Faced with political choices where you and your loved ones are at risk, and you can’t do the things that might sustain your mental health – little wonder if many of us are suffering. We should always have been putting life ahead of money, and mental health is a key part of life, not some kind of luxury extra for the better off.

In need of wildness

I was struggling long before lockdown with the need for wildness. I live in a beautiful part of the world, but the car noise, the careless walkers who leave bags of poo in their wake, the cyclists who treat ancient monuments as obstacles and things of that ilk had been getting to me for some time. I craved a landscape with fewer people in it, and more wild things.

Then we hit lockdown and everything got worse. The main walking and cycling routes close to my home are busier than ever in the day. Not wanting to add to that and finding it stressful, I moved to twilight walking, but as it has got warmer, ever more people are about at the end of the day. I used to spend hours walking, and the loss of time in the landscape has left me depressed and disconnected. On top of that, poor circulation and/or low blood pressure have caused me sleeping problems.

This week I decided to make some radical changes. So, rather than getting online when I wake up in the early hours, I got my walking boots on. Tom and I went out. The first time, we saw no humans. The second time we ran into a couple of people, but compared to how many folk there are out in the day, it was nothing. Narrow paths I would not have risked in the daylight became totally socially distanced. The world that I had lost opened up to me again.

I came home with the dawn chorus, euphoric. I came home able to sleep, both times, which means my sleeping has radically improved, so my head feels clearer. A tension is easing out of my body, that had come from feeling disconnected from the land. With more time outside and better access to the wild, I am more myself again and lockdown is a good deal more bearable.

There is also more wildness at night – foxes and hedgehogs, owls and others. The dawn is full of birds, and there are lots of wildflowers to appreciate as the sun comes up. With almost no other people out there, the landscape seems wilder. In darkness, familiar places become less so – there’s a lot I can work with here.

We don’t have a garden, so an hour of exercise might be considered the proper amount of outside time we can have in a day. Although guidance around how long a person can be out for varies. An hour is not enough for my mental health. I can’t walk as far as I need to in that time and it has really taken a toll on me. But if we set out in the night and see no one, I can’t see it matters how long we walk for.

I’ll keep doing this long after lockdown – walking to meet the dawn has changed my relationship with the place I live. I feel re-enchanted. Being liberated from the presence of people I have no interest in seeing is a great relief to me. In the silence, with the wild things and a most excellent walking companion, I no longer feel so lost.

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.