You Matter. World Suicide Prevention Day #WSPD15, #RUOK

I think few would disagree that suicidal thoughts are in themselves very frightening. However hard we may find it to live in this complicated world of wars, births, deaths, marriages, losses gains, progress, recession and so on, suicide is not something that we often discuss, at least not among my friends. Imagine, though, a person whose world has become so unbearable that it seems a release to consider letting go of all of the things that are making life seem impossible for a different choice – a choice where none of these struggles exist anymore, and where that person will be freed from expectations and constraints of life placed on him / her by others, or, most importantly, by him/herself.

I recently spoke to a group of senior leaders at work about resilience in my definition of the term. More to come on that in another post. During my talk, I mentioned how bad things had been last year and how things still were, quite often, very very bad for me with depression and anxiety invading and dictating various aspects of my life – what was possible and impossible. I told the group that at my lowest ebb I had not been suicidal, meaning I had not made plans to kill myself or set about putting those plans into practice. What had happened to me, though, was something very damaging: I had stopped wanting to live. I awoke each day with a heavy head as I looked out of the window at a world I no longer wanted to be part of. I felt a total failure, despite the promotions, the new job, the happy marriage, the friends I had. I felt awful. I felt I was awful, and that feeling this terrible way each day was my life sentence, a sentence I wanted to give up.

Nothing if not practical, I eventually realised that the tears every day before work and the panicked feeling that I couldn’t shake no matter how much exercise I did, sleep I got, reading or other distraction techniques I employed, the feelings of absolute hopelessness, were not going away, and that I had to do something about it. I chose to see my psychiatrist and explain how I felt. He made me fill out a questionnaire to assess the severity of my depression, and as I circled ‘very frequently’ against ‘feeling of not wanting to be alive’ I started to cry and cry, realising when I saw my self-assessment on paper just how bad things really were. I was dreadfully ill. I was living not even a half-life, even though from the outside every aspect of it was going well.

And this is how to interpret...

Mind puts it like this:

Mixed feelings
You may be very clear that you want to die – or you may simply not care if you live or die. However, for most people, suicidal thoughts are confusing. As much as you want to die, you may also want a solution to your difficulties. You may want others to understand how you feel and hope that they can help. Yet, you may not feel able to talk to anyone who offers to help. Having such mixed feelings and being unsure about what to do can cause great anxiety.

The latter description is more relevant to me – I just did not care whether I lived or died. But I did want a solution and I did want others to understand.

In hospital I met many other patients who were stuck and wading through the treacly mess of depressive thoughts. Looking into the treacle to try to find meaning, but seeing only blackness. Trying to get out of the treacle, but being sucked back into its sticky, strong mass that we had not the means to counterattack.

One patient who became my friend was very silent almost the entire time that I was there. Many more were like him. I was pretty well versed in the language of therapy and (no surprises here) had always been something of a talker, but others, particularly men but not exclusively, were so immersed in the terrible depths of their illnesses, so entrapped, that their mouths and gestures were glued shut and slowed by the treacle. And even if they opened their mouths to speak, many times they had no language to say what was going on.

You may be aware that more men commit suicide than women, by which I mean that more men succeed in the attempt. It is always dangerous to make generalisations, but the rates of suicide among men are rising over the past few years, whereas for women they have stayed broadly the same.  Wikipedia says: “The rate of nonlethal suicidal behavior is 40 to 60 percent higher in women than it is in men. This is due to the fact that more women are diagnosed as depressed than men, and also that depression is correlated with suicide attempts.”

The Guardian says: “The Adult Psychiatric Morbidity in England 2007 survey found that 19% of women had considered taking their own life. For men the figure was 14%. And women aren’t simply more likely to think about suicide – they are also more likely to act on the idea. The survey found that 7% of women and 4% of men had attempted suicide at some point in their lives. But of the 5,981 deaths by suicide in the UK in 2012, more than three quarters (4,590) were males“

As I have said before, I am not a doctor and have no qualifications in this field other than the benefit of my own lived experience.

I personally believe that we need to do more to support each other – whether we are struggling or not – to prevent ourselves and others potentially struggling to the extent that life ceases to be enjoyable. Even for me, while I may (may, no proof) be genetically predisposed to depression and therefore have life’s experiences + genes to thank for my seemingly effortless propensity to become depressed through various times in my life, life can be enjoyable and often is. I am so lucky that I have people who ask me ‘Are you okay?’ and really mean it.

The hardest thing for me about feeling so dreadful was the loneliness of it. And I talked about it as it was happening to my husband and my doctor, and still I felt alone. What must it be like to be someone who is experiencing these terrifying thoughts that a world without them in it would be a better reality than one with them?

We cannot move mountains to end all suicides today. But we can do little things to connect ourselves to one another and seek to invite connection from others, so that people feel that they are not alone, and that someone – a lot of someones, in fact – cares for them. We can ask each other how we are, not as a throw away ‘hello’ platitude, but as a real question expecting (and accepting) a real answer.

We can ask about each other’s lives and share something of our own, so that we make connections with each other. We can smile at the person we meet out running and wish them a good morning. That might be the only time that person sees a smile or hears that all day. Simple steps like these can be very powerful. And at the end of the day, we can say thank you to our work colleagues for what they have done for us. We can ask them what their evening or weekend plans are, and listen and share our own. We can thank our friends or partners for helping with dinner (whether ordering Domino’s or cooking a three course meal, whatever!).

By connecting ourselves with others and by sharing things about ourselves, especially if we are not having a good day and we feel we can say it aloud, we are inviting others to do the same. So when I next ask you how you are, or how things are, or if I ask, “Are you okay?” I promise: I really want to know the answer.

We Need to Talk About Mental Illness: Time to Talk Day - 5th February 2015

February 5th is Time To Change (@timetochange 's #TimeToTalk day), encouraging people to take 5 minutes out of their day to have a conversation about mental health.

It's something that people find hard to talk about, myself included, despite this blog and my media appearances over the last year. There are still large numbers of people to whom mental illness is something to be feared or looked down upon. I've met people who have avoided me after learning that I have depression; I've met people who appeared to think that suffering in this way affected my ability to do my job at all, and who saw it as a red flag, requiring decision making to be taken completely out of my hands. And I've met friends and acquaintances who have not understood and have kindly suggested that I 'pull myself together'. And so on.

When I suffer acute depression episodes one of the things that I find hardest is that I often suffer from feelings of acute defectiveness and failure:

"I'm depressed, there's something intrinsically wrong with me."
"I'm depressed, I will never get better, I have failed as a human being."
"Why can't I just feel better? I'm always lurching back into doom."
"I'm so anxious that I feel physically sick and can't focus on anything; I'm no good and I'll never be able to do anything properly."

In the summer of last year, when I was so ill that I agreed with my psychiatrist that the best course of action was to go into hospital to have more intensive treatment and rest from all the external forces worsening my depression, most particularly the bullying I was experiencing, I had to decide whether to talk about what was happening to me or not. I thought carefully about the people in my life who were my friends, and what would change if they knew that I was depressed. The negative thoughts that I've listed above are completely false in many ways, but I was so depressed and anxious that I needed help to get rid of them. They made me sick with fear that I would lose the friends I so cherish and love, and constantly tearful at the state that I was in,

On the other hand, I didn't want to keep my illness a secret because it was contributing to my illness. I didn't want to accept that it was something to be ashamed of, and something that I should be hiding from other people. Those very perceptions were only exacerbating my illness, because the effort to conceal my true state required something close to the superhuman. The smiles, the jokes, the well turned out woman with styled hair, made up face, with the pretty work dresses and the fabulous shoes (I will never not be wearing fabulous shoes. I'm addicted.) These were my friends and if I had a hope of being better part of that was to be more open about my own illness and how I was feeling. I was afraid of rejection. I was terrified of being seen as a failure and as someone who was damaged. But I wanted to be honest. So I 'came out' from my hiding place and told them.

"Dear friends,

As some of you know I have been having a hard time at work recently with some bullying and difficult people, which has made me very upset. Unfortunately because I also suffer from depression I've now come to the point where I can't cope anymore with working.

I've decided with the help of my superb doctors and counsellor to go into hospital to recover from some of the impacts of this situation. I will probably be in hospital for 1-2 weeks, we think.

I would love to receive text messages or messages of support during this time - and of course, despite its very inconvenient location - you are most welcome (and encouraged by my doctor) to visit. However I won't expect this as I know many of you might find it difficult. 

I hope you understand why I wanted to be honest with this with you and I hope that you can support me.

Sending much love xxx Jessica"

At the time of writing this email, I cried. I cried when my mobile rang a minute or two later with a call from one of my friends ringing in response. I couldn't answer the phone because I was crying, and I cried when I heard the answerphone message sending love and reassurance that my condition didn't affect our friendship at all. And still I cried.

Why did I cry so much? I think it was because I did not believe that my friends would stick by me, someone who was defective and a failure. Who wants to spend time with someone who's so down in the dumps that they have to go into hospital? Who wants to be friends with someone who's been bullied? Doesn't that mean that there's something wrong with me?

No.

Had I not sent the email above I don't think I would have made as much progress in hospital learning that the negative thoughts above were symptoms of my depression and not fact. Had I not told the truth I would have been holding back on my recovery. And when I did tell the truth I realised that I could be myself - illness and all - and I would still have support from those who cared enough about me to understand, or to learn more about what it really means to have a mental illness, and those at work ready and willing to listen - many more people than I expected.

More than this, though, was the aftermath. I have gradually become braver about talking about my condition. I have made myself speak to the press about my experiences as a way of training me to talk to others about my condition and how I need adjustments to help me to deal with it. And I hope that I will continue to get better at talking about mental health, because I am an example of how there is no one-size-fits-all mental illness sufferer. We come in all states, shapes and sizes. 

So, along with other supporters of #timetotalk, on 5th February I will be spending a good part of the day having 'honest conversations' at work about my mental health and about mental health in general. I will be inviting my husband to dinner and talking to him about mental health, something which he has had to learn about through nearly 10 years with me suffering the ups and downs of depression, anxiety, medications of different kinds and their varying side effects. I will be speaking to my family about it through email, phone calls and posts on Facebook, and I will be tweeting @volette to record my thoughts throughout the day.

I feel I must keep talking about mental health to try to help myself accept myself as I am, styled or dishevelled, weeping and weary or well. And I want to try to help others understand the complexities of these illnesses and the impacts that they may have on sufferers, from the personal perspective I can offer. I would love you to join in with this conversation and spare 5 minutes on 5th February have a conversation about mental health. Whether you're a sufferer, know someone who is, or know nothing about it at all, it's so important that we keep the conversation going. Taking the time to talk will make a difference. Perhaps more than you know.