You're Not Alone...with Depression...Keep Fighting

In response to the many news articles on the recent tragedy of the Germanwings plane crash I considered writing something today about my views on the way that press coverage of this awful event has set back progress towards developing better understanding of depression.

However, I find that in this New Statesman article, Stephanie Boland (@stephanieboland) says what I want to say, and picks out the same nuanced stigmatising language from (for one) the Daily Mail's coverage of the crash. I would like to recommend that everyone read this article for an analysis of journalistic styles, and how inappropriate these are at times.(In case you're wondering, I was actually incredulous at the massively inappropriate and misleading use of the word 'Incredibly' in the Mail's article, like Boland, and I also took great exception to the word 'heinous' being used to describe what appears to be a completely fictionalised version of a statement of ambition that the co-pilot Andreas Lubitz made to his then girlfriend, a few years ago.

What really stands out for me from reading all the press coverage of how lonely it is to be depressed. I feel this especially when people make assumptions about what you can and cannot do based on your diagnosis of 'depression' without understanding more about how each person's symptoms manifest themselves and how severe they suffer, how often they present with symptoms, how this affects their life etc.

I have felt like this. But there's more to it...

I only started talking openly about having depression last year because of behaviour from others that I - rightly or wrongly - have perceived to be negative perceptions of me. I experienced various occurences where I felt there was a question as to my ability to perform work in a quality way, to be able to continue to function at a normal or above normal level, linked specifically to the fact that I was in therapy or that I had previously suffered with depression or was suffering from a low episode where my depression was worse than normal.

Spiralling negative thought focus is one of my worst symptoms,

worsened when I shame myself again and again for every wrong I've ever committed

I found that when I was ill with depression it was particularly exhausting to function because of my self-imposed rule that I must at all costs conceal it. Trying to live each day and say 'I'm fine' when actually I was anything but greatly aggravated my condition: I was not only unwell, but I had shamed myself and felt shamed by others into hiding what I believe to be a condition that many others suffer from, and that is nothing at all to be ashamed about.

What's more, while having depression over the last twenty years, I made it through school (just), got into Oxford university, managed to achieve a 2:1 degree, then was accepted onto the TeachFirst programme and taught hundreds of pupils aged 11-16 at two outer London comprehensive schools over three years. I then left teaching to become a management consultant at one of the largest and competitive firms in the market. I developed sufficient business acumen to be promoted there - twice - and to be accepted as a transfer candidate with sponsored visa to live and work in New York. I moved back and gained my current job with another large and prestigious consultancy firm.

Me, 2005, punting on the Cherwell in Oxford.

I was suffering from depression when this was taken

The year I got into teaching I was still grieving for a dear friend lost a year before, my father had cancer and I suffered from depression as a result. I had also moved to London only a year before and was in a new relationship. All this was made more challenging by the fact that I was working extremely long hours to become a teacher in a learning curve I can only describe as 0-60 in 10 seconds. The children I taught were at times very hard work: most were keen to succeed but reluctant to learn! I had six weeks of training (combining some practical and some theoretical elements in a crash course) and then started on an almost-full teaching timetable.

Most children were very easily distracted and many had all kinds of special educational needs ranging from dyslexia, non-verbal autism, other levels of autism / aspergers, having ADHD (either diagnosed or non-diagnosed), suffering from trauma, coming from abusive homes, coming from foster care, coming from many different other countries and not speaking English. I could go on and on.

Bristol 2006.

I was on medication to treat depression and sleep problems at the time.

It was wonderful and awful in equal measures on many days but even though the stress of that work helped me develop terrible psoriasis all over my head and brought on worse symptoms of depression I still managed to do the job and qualified with the highest possible grade as a teacher, and was awarded a 1(the highest assessment) during our Ofsted inspection when I was teaching year 8 (the WORST year 8 in the school's history) Romeo and Juliet. I spent weekends planning lessons which would (I hoped) engage the individual needs of every child. I produced many new resources and worked with other amazing teachers to try to grow into a teacher who would give the children the success they wanted. The majority were able to improve their English (I taught English) in spades and for GCSE students achieve the Cs or above they were looking for.

While I was in teaching I took medication for depression but rarely took time off.

Most time off was related to bugs caught from germ-sharing at my schools!

After the first 7 weeks I was burnt out to use the familiar expression used by others to describe Andreas Lubitz. I went to the doctor and received antidepressant medication to help me to improve my mood, cope with work (I missed one week of work due to sickness, including but not limited to depression) and get back on track. Things did improve. I got better and life went on. I didn't miss more work for depression (I did get terrible flu and tonsilitis from schools which remain for all who are parents, students and teachers a breeding ground for all manner of lovely germs!).

2010, after running the London 10K. 

I was suffering from depression at the time.

I finally left teaching for management consulting because I wanted to make more of a difference. My ambition at the time was to lead an education charity one day. Now (8 years on) I still want to run a charity, but currently would prefer it to be one linked to mental health services, though I'm still equally passionate about education / children, so perhaps I'll find a way to do both. It would be a highly appropriate statement for me to say, as Lubitz is reported to have done, ‘One day I will do something that will change the whole system, and then all will know my name and remember it.’

Sydney, 2010, at a wedding. 

I was suffering from depression at the time.

Since joining consulting I've worked in 6 different countries in many industries to learn about how business works. I have worked long hours to produce quality work for my employers and my clients, and I've tried to build a CV that shows my passion for people, for technology and my intellectual curiosity.

2011, just after returning from 3 months working in Ghana and Ethiopia.

I was suffering from depression at the time.

 I've also mentored students through the HEAPs scheme, iMentor (in New York), have coached teachers and other professionals and have supported Mind and Time to Change as an advocate for better understanding of mental health and by being a media volunteer. I was in hospital last year with depression but took only a limited amount of time off from work, because I find work (and activity) supported by others, makes me flourish rather than flounder. I hope that my non-profit activities give value to those whom I work with - I certainly enjoy them because I love people and want to do as much as I can to help people out - it makes me happy to do this. 

Cape Cod, summer 2014.

I had just come out of hospital after suffering a severe episode of trauma-related depression

All the while, I have still had depression. I've taken different varieties of medication, I've attended and still attend CBT with a fantastic therapist who helps me try to get through tough times. I still feel like not being alive on quite a few days. I didn't particularly want to wake up on Thursday morning, just gone, for example, because - and I will not lie - depression can feel unrelenting and it is bloody knackering to keep going with your life when you're worn out from all the negative feelings that you wish would just sod off so that working, exercising, eating, seeing people, and just functioning weren't so drainingly difficult.

Sometimes the simplest activities are as hard as any other task imaginable.

They represent how hard 'living' compared to not living can be.

I am now not alone. I have friends from my support groups to hang out with. I have my beloved husband who supports me even though - I feel - it surely must get quite old when your wife greets you at the end of each day in floods of tears and can't make a decision about what she wants for dinner, despite having polished off a high quality bid and managed multiple projects and written a blog post during the day. I have my other friends who send supportive messages and put up with me being flaky when I can't always make appointments if I'm suddenly unwell. I have my family who are loving and kind. I have a lot. And at work - importantly - I have grown in the confidence to say when I'm not well and expect (and demand) that people to treat me without discrimination because I happen to suffer from depression. I speak out here. I speak out wherever I can. I believe I have the right to a life and the right to work, respect (as long as I show it to others) and fair treatment as an individual.

On days like today, when I feel 'okay' - not great, not terrible, I still hold on to my ambitions and think about the future I want to have. And I say, honestly, and with hope, ‘One day I will do something that will change the whole system, and then all will know my name and remember it.’

Just Breathe...Live.

And I really hope that I do - something positive that allows me to be the change I want to see in the world.‘One day I will do something that will change the whole system, and then all will know my name and remember it.’ And, "incredibly", I will do with depression. 

Me 2015, on medication and seeing a Cognitive Behavioural therapist to help with my depression.

Working, writing, coaching, painting. Living.

Beat It: The Real Deal on Coping with Mental Illnesses

I imagine and hope that tomorrow will feature a fair amount of press coverage of 'Time to Talk' day which +Time to Change Campaign has promoted as a day where they are asking people to take 5 minutes to talk about mental health, with the hope that they will achieve a total of 24 hours of conversations in total.

So what will you be talking about tomorrow?

The three most common types of mental illness (or issues associated with mental illness) are stress, anxiety and depression. The NHS and many other useful websites promote tips on how to counter feelings of stress and anxiety (and depression, though anxiety and depression are somewhat opposite in the way a sufferer experiences them). I'm going to look at the tips, and my response to what this means for someone (me) who has suffered from all three of these conditions at one time or another:

Okay, so pretty much no one looks like this or has a sunsetting beach to run along. And she looks like she's in a female hygiene products commercial.

 Plus I bet the sand is stinging her feet. But getting active can help. 

1.  Be active:

I think physical activity is a wonderful idea. Fresh air helps and getting out and about can lift your spirits by taking you out from where you were and helping you to relax.

“BUT, I don’t think I can get out of bed. I feel terrible today. I just want to stay here and sleep.”

I've felt this often. If you can, take a shower and get dressed. That counts. And there’s a lovely feeling about feeling clean, even if you go straight back to bed afterwards. Even if you don’t have a shower but make it to the kitchen you’re doing really well. Don’t be hard on yourself if you can help it. What you're feeling and experiencing is hard enough without beating yourself up about it.

I do love a shower. Don't listen to my husband saying that northerners are unclean. We do wash. Well, sometimes. 

2.  Take control

The NHS says ‘There’s a solution to any problem’. This is true, for the most part, but you do need to read the tips on managing your time and calming yourself before you can do anything.

“BUT how can I take control when everything is overwhelming. There is no solution to my problem. I don’t know what to do and I can’t stop panicking.”

If you’re massively stressed or anxious your brain cannot think straight to do this, so it’s time for deep breathing and water first, and calming yourself down, before you start to think about taking control or the steps to do so. Again, take care of yourself. You're not well enough to start addressing the things in your life that feel out of control if your anxiety/depression is 8-10 on a scale of 1-10. 

If only this button did what we all really wanted it to do...

3.  Connect with People

Talking can definitely help.  The NHS says: 'A good support network of colleagues, friends and family can ease your work troubles and help you see things in a different way.'

“BUT, I don’t feel like leaving the house to talk to people and I don’t want to talk to anyone right now.”

“BUT, I don’t have anyone I can talk to about this.”

It can be hard to reach out when you feel dreadful. I have been there. It still happens to me now. But talking does really help even if it’s hard to get started. And if you don’t feel like you have anyone to talk to / anyone you can talk to, organisations like the Samaritans are there and someone you don't know, but has been trained to be there for you in hard times can help. The main thing is, do try not to let all the negative feelings build up inside you. Sometimes I just say to my husband: "I'm having a bad day," and nothing more. But it means I have stopped feeling like my feelings are choking me from the inside because I have given them a voice.

Yes, your Facebook page is fascinating. 

Now can you help me? I've got third degree burns from holding my tea cup all this time.

4.  Have some 'me' time. 

Apparently we UK inhabitants work the longest hours in Europe. And it’s true, we do, and it doesn’t help. The NHS recommends doing what you can do to take time out.

“BUT, I’m worried I might lose my job if I want to work shorter hours to take time out for me. I need to check my emails even outside of work to make sure I stay on top of things “

You do need to take time out even if it’s sitting on the loo for 5 minutes. Continuing to be stressed or feeling bad without giving yourself some sort of break (even if a short one) to change your scenery and remove yourself from difficult situations is crucial. You can also get outside at lunchtime. And leave your phone. You wouldn’t be able to answer it if you were in a meeting, would you? So give yourself a break. You may not always be able to relax during ‘me’ time, because learning to relax is another thing you will have to master gradually if you're used to feeling tense all the time. I'm not great at relaxing - and I used to be dreadful at it! Try not to give yourself to hard a time about this.

Even if you're having 'me time' on the loo. 

Which obviously I'm not going to post an image of here.

5. Challenge Yourself

The NHS recommends setting yourself goals and challenges. In some cases I think this is a great idea. Ask yourself, what do I want? Is there something different that I could do to make my life more worthwhile to me?

"BUT, I'm overwhelmed as it is. I cannot deal with adding more challenges. I just cannot take on anything more because I can't cope. Please don't ask me to add more to what I'm going through."

It is tough to face the future, even the next few hours or the next day, when you're very low or anxious. The negative thoughts can be overwhelming and goals and challenges do seem hard. I find this one horrendous sometimes because I already feel overwhelmed. But even if it's only a goal to get across the road to the newsagent to buy yourself a chocolate bar, getting up, or picking up the phone to call a friend, try to do something. That something is a goal. Or maybe a holiday to look forward to. If you can do it - great. And again, just don't give yourself a hard time if you can't. You might need to calm and soothe yourself first. I know that's how it is for me.

Sometimes getting out of bed feels like this. 

But luckily with fewer ice picks and more blankets. Brrr!

6.  Avoid unhealthy habits

The NHS says: "Don't rely on alcohol, smoking and caffeine as your ways of coping."

"BUT, a cigarette / a glass of wine helps me calm down at the end of the day. I like having it. Why can't I do it?"

The NHS is right - these are temporary releases which won't actually help in the end. Caffeine will make you jumpier if you're already anxious. I've given it up because it interferes with my medication and I'm tired of being so jumpy. I don't smoke, but I used to drink nearly every day. Now I've radically cut down on the alcohol because I've realised it is dangerous for me to mix too much alcohol with medication. Unfortunately I like wine and food in equal measures. And for goodness sake we are only human. But take care of your health in these matters - because adding to your existing problems with potential health problems or addiction will not help. 

7.  Help Other People

I really believe in this one. I've found that helping other people in some way, even if it's only holding the door and getting a thank you in return, would make me feel better momentarily. It's for this reason also that I've tried to volunteer for Mind and Time to Change: helping to raise awareness of mental health is important to me, and the thought that I might help other people is something that can lift me in my darkest times.

"BUT, how can I help other people when I'm in this state? I can't even help myself!"

Even the smallest things like putting a duvet over your partner in the middle of the night when it's fallen off and he's cold, feeding your cat, making a cup of tea for someone, is being helpful. Try to remember that and give yourself a break.

We can all help in small ways. Some ways are very cute. Like this.

8.  Work Smarter, Not Harder

Good time management is not something everyone has, but the NHS reminds us that "You have to get a work-life balance that suits you."

"BUT, I've got so many other commitments, I can't possibly work 'smarter' because I just have too much on! You don't know what it's like for me."

It's great to try to be efficient, to consider what really matters. However, when you're ill sometimes you can only do so much. Just try to work out - with help from others around you - what is important for you to get done now, and where you can get help for this, and make a note of other times that you can get done the most pressing things, again with help from others. The most important thing is to try to alleviate some of the pressures that you're feeling. Mind has some great tips on this. It's hard to generalise on this one: if you're a city banker or lawyer you likely feel you can't take any time out at all, but remembering that you got hired for a reason and that you are a smart person is important. Take a breath and reflect on that. And do take a break (even if just for five minutes) to do deep breathing before you try and tackle that mountainous 'To-Do' list.

9. Be Positive

"Are you serious? How can I be positive at a time like this? I feel so dreadful. Everything is awful and I just don't want to be here anymore. It's all too much."

The NHS says 'People don't always accept what they have.' Yep. That would be true. I am not thinking about my house, my husband and my great job when I'm miserable and ill. I doubt even people with a cold aren taking time out to feel grateful for any of these things when their noses are snotty and they're coughing and spluttering with a killer headache. Whatever the illness, we're all in it together feeling like crap and how on earth can we get ourselves out of it? Again, it's important to calm or soothe yourself first before you can try to think positively. This isn't easy at all. I have needed help from a therapist and a good psychiatrist to help me to see myself and my outlook more rationally and more positively. And I can't do it quite a lot of the time. It takes work, so start this kind of thinking, using techniques like mindfulness when you are feeling a bit less ill so that you can actually participate in them.

You can't always get what you want. But if you try sometimes...

10. Accept the things you can't change.

"Changing a situation isn't always possible," the NHS says. Again, Yep. 

"BUT, I can't do anything about my work, I can't change my family situation."
"I'm stuck and I can't get out."

I think the NHS is right here. There are going to be things you can't change and hard as they are to accept, we just have to try. We just need to make it to the next day (or the next hour). And then the next. I think acceptance, particularly self-acceptance is the most important step in dealing with mental health.

Above all, we can all play a part in continuing to talk about mental health de-stigmatising mental illnesses. It's not something to fear, to shun, to avoid, to pretend it doesn't exist. It doesn't mean you can't do a great job, be a great parent, live a good life, make a difference. It doesn't even mean you can't be happy.

Mental health illnesses are complex and difficult. But not talking about them worsens the condition, so please think about that and talk about it tomorrow and the next day and the next. Let's keep talking.