Thursday, 30 April 2020

Guilt Trip

One of the symptoms of depression is guilt or, to be more accurate, inappropriate guilt. Guilt is a natural emotion and most of us feel guilty from time to time about something we've done or not done. The big difference with depression-related guilt is that it can be magnified ten-fold.



Whether this is due to feelings of worthlessness or the inability of the brain to work rationally when depressed is not known for sure - but this elephant-sized guilt can literally beat you up. It can pummel you. It can have you crawling on all fours. To all those around you, it is chronically out of proportion - yet the depression makes it seem perfectly reasonable. If unchecked, guilt can actually become life threatening.

When I was first ill, I remember being overwhelmed by a sea of guilt. Here is a list of the things I felt guilty about:
  • being a poor father
  • being a poor partner
  • being ill
  • not having earned enough money in my life
  • not having a large enough pension to retire on
  • of working part time
  • of not being more mechanical with cars
  • of not being happier on holidays
  • of not looking after my partner better when she had ME
  • of failing to love my children
  • of not contacting my sister more
  • of not appreciating my friends
  • of being a failure at writing
  • falling out with an old friend
The level of my guilt was simply astronomical. I remember my partner asking my children to write lists of the things that they liked about me. These were lovely lists - but at the time I couldn't accept any of the nice things they were saying; I was just this terrible person and an appalling father. End of. Looking back now I can see that depression had completely skewed my view.  The level of guilt I was experiencing might have been appropriate if I had just gambled away the family home on the horses - or had a string of mistresses or had been physically abusive. I was none of these things - just a quiet guy who had always worked and earned money - who maybe spent a bit too much time writing poetry - but who now had become ill.

This ramping up of guilt is another trick of depression. It can make you feel utterly worthless which, I suppose, is exactly what depression wants you to feel. It reinforces all the other negative messages that are flooding your brain. It is confirmation of your badness - your worthlessness - and that you deserve to suffer.  


Wednesday, 29 April 2020

Invisible Illness

If you Google the word 'depression' and search for images you will typically find black and white photographs of people with their head in their hands - possibly squatting in the corner of a bare room.



These are the stereotypical photographs of depression - but the reality of depression can be very different. In the real world, depression is often invisible and can wear many different faces. Even today when there is far more acknowledgement of mental illness - many people with depression do their best to hide their illness. There is undoubtedly still a stigma surrounding depression which causes many of us to pretend that we don't have it. Some people go to great lengths to hide it. Some people become very adept at hiding it. Some depressives even develop a jokey exterior to conceal what they are feeling inside. (Its probably no surprise that many comedians are actually depression sufferers.)

So, once again depression is tricking the world. Because of the shame of the illness - it manages to conceal itself from the world. Somebody may be experiencing unspeakable anguish - but may still be managing to hold a normal conversation with you about the weather. If people were truly sitting with their head in their hands we would all be better placed to help. This means that you need to be vigilant. Your friends or family could be suffering from depression and you may not  know. The person sitting next to you at work could be a sufferer or the lady who walks her dog with you over the park.  

One of the other big problems with depression being invisible - is that it leads people to be skeptical about the condition. How can something which is so devastating be invisible? As a result people tend to underestimate it or dismiss it altogether. This, again, plays right into the hands of depression. That's why it's so important that depression is recognised as a real illness and why we need to keep a dialogue about it going constantly.

Tuesday, 28 April 2020

Physical Symptoms of Depression

In my post about leaden paralysis - I mentioned that depression can also cause physical symptoms.


When you're in the midst of depression it's often hard to disentangle physical symptoms from the mental/emotional ones. But it's very important to be aware of them because, once again, depression can play tricks on you. Here is a list of possible physical symptoms that can be caused by depression:

  • head aches
  • constipation
  • shaking hands
  • motor retardation (slowing down)
  • fatigue/tiredness
  • leaden paralysis
  • temperature fluctuations
  • muscle pain/back ache
  • increased sensitivity to pain
  • vision problems/reduced contrast perception
  • impaired hearing
  • numbness
  • dizziness
  • stomach pain
  • digestive problems
  • difficulty swallowing
  • joint pain
  • sleeping problems (can't sleep or over sleep)
  • night sweats
  • weight loss or gain
  • lower sex drive/impotency
  • brain fog
As you can see, it's quite a list. When you're in the throws of depression it's easy to think that you're imagining things. These things can also lock you tighter into the depression - making you feel even more desperate.

When I was first ill, I experienced a range of physical symptoms including: dizziness, numbness in my left foot, stiffness in my hands, constipation, deteriorating eyesight and hearing, weight loss (over a stone) and brain fog. The worst thing was the dizziness which seriously affected my balance and spatial awareness. 


Monday, 27 April 2020

Mystery Malady

Depression has been around for thousands of years - probably since the first cave man lost motivation for the hunt and retired to the back of his cave. It's longevity as an illness may be due, in part, to its mysterious character. Although it has dogged mankind for millennium - it has always been hard to explain or to pin down. Even people who have struggled with it all their lives have trouble identifying exactly what it is. If you ask someone with depression to describe how it feels - they are often at a bit of a loss. They may describe it as painful or unbearable but this doesn't actually explain how it feels to be depressed. People with depression also disagree about where depression is experienced. Some will say it's in their head - others say it's in their chest - while others say it's in their limbs.



In Darkness Visible, William Styron said: 'Depression is a disorder of mood, so mysteriously painful and elusive in the way it becomes known to the self - to the mediating intellect - as to verge close to being beyond description. Thus it remains nearly incomprehensible to those who have not experienced it in its extreme  mode.'

So why is depression so hard to describe? Well, for one thing it is experienced differently by different people. They often say that no two depressions are the same - even though they may share common symptoms. It's also hard to know whether depression is a thought or a feeling. (In reality it's probably a toxic mixture of the two.) The brain-fog that it often induces also makes the job of getting a handle on it even harder. Even the word depression itself seems completely inadequate. It's a hollow in the ground or a low pressure area in meteorology; it gets nowhere near to describing the hideous reality of the illness.

In some ways its elusiveness seems like another clever trick on the part of depression. If you can't identify it then you can't cure it. It's like a survival strategy. What can't be described can't be dealt with - allowing it to run riot in the minds of so many people. In some ways it reminds me of the Chinese concept of the Tao - of which Lao Tzu famously said: 'The Tao that can be named is not the constant Tao.'

As a result, we tend to speak of depression in metaphors: it is the Black Dog, the inky cloak, the tsunami. We often resort to the weather to give an approximation: the dark cloud, the rising fog, the storm.

It's because of its elusive quality that we need more memoirs about it, more self-help guides and, dare I say it, more blogs like this one - for anything that helps to pin it down (or bring it into the light) - helps to lessen its grip.




Sunday, 26 April 2020

Brain-Fog

Brain-fog is a common symptom of depression. It's the sensation that your thinking has become foggy or clouded. Some people describe it as like having a head full of cotton wool. It can vary in intensity from mild to extreme. It can impact upon memory, concentration, the ability to process information and to carry out tasks. It can be a temporary or a permanent feature.



In some ways, it can be seen as another trick up depression's sleeve. Just when you are under the cosh with negative thoughts - brain-fog can make things feel worse. Just when you need to be sharp and alert to deal with the black-cloaked intruder - your brain fogs up. Just when you need to be resourceful and energetic - you become a woolly headed dope. This feeling of incompetence also fuels feelings of inadequacy and hopelessness which can feed back into your depression.

In her book Out of the Blue  Jan Wong describes how she became very forgetful when she was depressed and also how she kept getting lost in her car - even in the streets round her home. I had similar problems with my sense of direction - which had hitherto been good. I also found that I could no longer deal with practical jobs around the house. Mending a puncture became a logistical nightmare. I also remember putting a lock on the wrong side of a chicken house door. But the worst one of all was when I once went to the local cash point machine - tapped in my pin number and requested £100 - but then walked away forgetting to take my money.

If you think you have brain-fog (or cognitive impairment) then you need to give yourself more time to complete tasks. Also, it's worth writing yourself lists or putting notes on your phone. Try not to be too critical of yourself because this can deepen your sense of depression. Like leaden paralysis, brain-fog can seriously impair your ability to carry out tasks. (If you have the two together, like I did, you face a double struggle.) So you need to congratulate yourself on what you achieve. The good news is that brain-fog is reversible. 

The Great Confidence Trickster

In some ways depression is a trickster: it makes you believe things about yourself that aren't true. How does it do this? Well, it does it by subtly working on your mind. It taps into negative thoughts that you have and then uses them against you. It takes these feelings of failure and worthlessness and then amplifies them.  It makes your believe that these new intense thoughts are all your own and that you deserve to suffer because essentially you are a bad person. For those who are susceptible to this game - usually those with a low sense of self-esteem and a pessimistic outlook - it can have a devastating effect on their well-being. These black thoughts can weld themselves to your mind. They are sticky and very difficult to disentangle.


How can you distance yourself from these thoughts? One of the best ways is to try and be more aware of your thoughts. Try and detach yourself a little and observe these thoughts as they arise. You may start to notice thoughts that keep repeating themselves. It might be worthwhile writing these down. For me, it might be: 'this pain will never end; I will lose my mind.' By observing the thoughts you can then create a bit of distance on them by saying things like: 'I'm having that thought again, the one about the pain never ending.' This then shifts the emphasis slightly - so the thought is not necessarily a fact. Bringing yourself into the present can also help with this as this means that you don't fight with the thoughts but simply change your emphasis.

The important thing to remember is that the depression is not you. It is something inside you that is making you feel like this. It is an illness. It may be subtly invasive and Machiavellian - but it is still an illness.  Matt Haig famously says in Reasons To Stay Alive: 'Always it is smaller than you, even when it feels vast. It operates within you, you do not operate within it. It may be a dark cloud passing across the sky, but -  if that is the metaphor - you are the sky.'

Saturday, 25 April 2020

The Power of Now

The term mindfulness is slightly misleading - it should really be called mindlessness but that has other connotations too.
Photo by Cameron

Escaping from the mind into the present moment is extremely important for depression sufferers. The depression head-space can often be a toxic realm of negativity and endless rumination. At it's worst it can actually be a killer. As Eckhart Tolle says, there is no pain in the present. As usual, depression will do its utmost to undermine any of your plans. It will torment you will worries about the future and recriminations about the past. But there is peace to be had if you can only focus on the now. Try to use all of your five senses to ground yourself. And remember to breathe.

Leaden Paralysis

Many people assume that depression is just something that messes with your head. Wrong. It is also something which messes with your body. One physical symptom that often occurs with depression is called leaden paralysis. This is the sensation that your arms and legs are very heavy or leaden. This makes all movement a struggle. When leaden paralysis is present, simply ascending the stairs or going to the local shop can feel like scaling Mount Everest. It also provides a serious disincentive to exercise - which is something that can alleviate depression. I have climbed Great Gable and Blencathra with leaden paralysis and it was hellish - like I had a rucksack full of bricks.



Leaden paralysis also makes the depression sufferer feel clumsy and uncoordinated which can exacerbate existing feelings of worthlessness. LP feels like another trick which  depression plays to tighten its grip on the sufferer. But, it's important to be aware of it and to realise that it isn't just you being lazy; it's the illness making you feel tired. You need to seriously congratulate yourself when you do any physical activity because any activity requires a Herculean effort. 

Welcome

Welcome to my blog.

Not everyone who commits suicide is depressed - but the vast majority are. This means that depression is one of the biggest killers out there. In fact it is the biggest killer of men under 50. Bigger than cancer, bigger than heart disease. Men are also more than three times more likely to kill themselves than women.

Despite being around for thousands of years, depression is still a complicated and mysterious illness. And despite improvements in mental health awareness there is still a big stigma associated with it - a stigma that prevents many people from seeking help for it or, perhaps, even acknowledging it in the first place. As a result, it is often an invisible illness.

Added to this is the fact that depression undoubtedly plays tricks with your mind and body. It is devious and manipulative. This blog is an attempt to expose some of depression's tricks in the hope that the illness can be brought out into the light.

I've lived with clinical depression for five years now and it has been the hardest thing I've ever been through. However, it has made me acutely aware of the importance of sharing our experiences. When you're down in the depths, it's vital to know that other people have been there too and come out the other side. That knowledge can literally save your life.





Spoiler alert: some of my posts are very bleak.

Hang in there!

Even the thickest,
Most pernicious fog must lift
Eventually.

Cameron