Saturday, September 19, 2009

Living with the Black Dog

I was going to write a post on Fat Heffalump about depression, but I've decided to broaden the topic a bit and post it here, because I'd like to talk to everyone about depression, not just my fellow fats.

One of the biggest challenges with dealing with depression is that in many cases, it is a taboo subject. Sufferers or the friends and family of sufferers just don't talk about it. It's demonised in the media as well, which makes it even more difficult to talk about. Ironically though, one of the most healing things you can do as a depression sufferer is to talk about it.

Talking about depression (both that I suffer and the experiences of others) has been one of the most healing activities for me, so I'm going to cast that onwards and talk about it some more here.

My name is Kath and I suffer depression. Some of you who know me may think that I am a confident, outgoing, bubbly woman. I am, sometimes. These days I am that woman a lot more than I used to be. However, I do suffer depression and anxiety, always have and always will. I am a lot healthier than I have ever been, but I have suffered severe depression and been suicidal in my past. I used to carry a lot of shame about my depression, but thanks to some really good cognitive behavioural therapy, I am not ashamed any more.

One of the hardest things to deal with when it comes to depression is the "Depression for no reason." That's when life's fine, there are no dramas or serious problems, but you get sucked into a quagmire of depression that is just there for no apparent reason. In my case the reason is usually a flood of whatever brain chemicals it is that cause my depression, but outwardly there is no "reason".

When you have depression, and are in the middle of a bout of it, your thinking is not rational. The judgements you make on yourself and the world around you are not clear and unbiased. Things that would normally not cause you to even think twice suddenly weigh heavy on your mind and your confidence, and affect your thinking more than they normally would. Then this feeds into a spiral, where your depression can get worse and worse, unless you do something to break the cycle. My rule, when I find myself in a bout of depression (which I have now learnt to recognise pretty quickly) is "Cast no judgement." I do my best to not make any decisions other than the bare necessities of living, make no judgement on situations, people around me or myself and to put any critical thinking on hold until the depression has passed. I find that if I just put one foot in front of the other and do what I need to do to maintain my daily life and take care of myself, I prevent myself from getting into a depression spiral.

Sometimes the people around you don't know how to deal when you are depressed. I see this a lot. People are frightened by depression. It's hard to know what to do or how to act when someone is depressed and you don't suffer it yourself. Some even worry that it's catching! In my case, when I am depressed I look like I am physically ill. So people will often ask me if I am unwell. I used to just say I was feeling sick, but now days I tell people that I'm unwell with depression, because I used to get upset at hiding how unwell I was with it. But you need to be careful because sometimes the reaction people have is very hard to deal with. Some people try to "fix" you. Others avoid you. Many say "Cheer up." as if you can actually just do that. Most people do mean well, but it's difficult to live with people's discomfort about your illness.

Depression is not imagined. It is real and it's as physical as any other ailment. Of course it's a little less easy to spot because you don't get a rash or a cough or a sniffly nose. But it is an illness that hits you for whatever reason (there are many different types of depression) and I find the best way to initially approach it is as though you have "come down with depression". When I am depressed, I am unwell, and I take care of myself in the same way I would if I had a flu or a virus or an injury. I take some time off work if I am unable to work, I rest, I eat foods that are good for me and drink lots of water (hydration helps everything, I am sure of it!), I see my doctor and I take care of myself as best I can. Sometimes depression is brought on for me by other illness. If I get a flu, depression is not far away. When I got shingles, depression came to visit too. Same as when I got a tummy bug of some kind. In fact, sometimes when I get depression, the first warning sign is a bout of sinusitis! I think for me, a low immune system brings on both sinus infection and depression.

Another thing I find really helps is to write a "cheat sheet". I have one in the front of all my notebooks (I am a notebook keeper) and now in the notes application of my iPhone. Basically, it tells me what to do to function through a day. It's as basic as:
  • Get up
  • Shower
  • Brush your teeth.
  • Dress (with makeup)
  • Wear sensible shoes.
  • Eat breakfast
  • Go to work, try to do repetitive "automatic" work (oh my databases and record keeping do well when I'm depressed, it's easy, it's formulaic and I can just get into it without having to tax my poor depressed brain.
  • Eat lunch.
  • Go outside at lunchtime.
  • Remember your tea (I keep peppermint and chamomile tea special for when I'm depressed, it does help)
  • Read or watch DVD's that make you feel good.
  • Go to bed by 9.30pm at the latest.
Pretty basic isn't it? But it really does help me focus when I am depressed. I actually do have certain clothes and shoes that I make sure I wear when I am depressed. They are comfortable and I feel nice in them. I can cope with things more if I'm not in shoes that hurt or worried about my outfit.

Most of all, go easy on yourself. Be KIND to yourself. Treat yourself with the same kindness you would treat other people. We are usually far harder on ourselves than we are on people around us.

If you suffer depression, let us know in the comments any tips or tactics you have learned to help you cope.


Kate said...

I think the main thing is understanding and accepting that the day is going to be a tough one but unfortunately you still have to get up and function in the big bad world.

It is so important to try and make it as painless as possible for yourself, given the circumstances. Letting the black dog win and sitting at home alone doing nothing but wallowing in your tumultuous emotions never helped anyone.

I really love your cheat sheet idea. It is such a great idea to help keep you on track and operational and even little things like the comfy shoes/clothes and a feel-good movie can really make a difference.

Girl Clumsy said...

Hi Kath,

This is a very informative and helpful topic, and I congratulate you on your sensible advice and understanding.

Just a quick point though, as a working journalist - I'd really argue against your claim that depression is "demonised" in the media.

There has been a real campaign in recent years to get the word out there about depression, and that 1 in 5 Australians will suffer some form of depression in their lives.

Beyond Blue, the Black Dog Institute and others have really led the way, and in my personal experience, I can tell you stories about depression are treated sensitively.

Just today, coalition MP Andrew Robb stepped down from the frontbench after revealing he's being treated for depression. All the media I've seen has treated him respectfully, outlined details of his condition and mentioned places that can help.

There's even a bit of a change happening to that the old media stand-by "Don't ever report suicide". Organisation like those above say it NEEDS to be discussed - obviously sensitively - with reminders about helplines or other available counselling services.

I think these are all positive signs of a more progressive attitude towards depression in the media.

Cheers, Natalie.

Sleepydumpling said...

I disagree with you Natalie. Just because there is *some* sensitivity shown in the media for *some* cases of depression, doesn't mean that it's no longer demonised by the media.

When a celebrity dies and is found with prescription anti-depressants in their system, it's reported on as some kind of flaw in their personality, or whispered about "Oh you know, he was depressed, it was to be expected."

When television shows and movies portray people with depression and anxiety disorders as serial killers, rapists, drug addicts and other criminals.

When people with depression are depicted as escaping to some form of addiction (alcoholism, gambling, shopping, sex, whatever) as though it's a given that depressives are addictives.

When a famous persons depression is questioned as though they made it up, or they should just get over it, or it's a cry for attention.

When people with depression or anxiety are lampooned by others either in reality (ie talk show hosts etc sending up famous depressed people) or in fiction.

These are all demonisations of depression and anxiety and we sufferers see that every single day.

Depression is still demonised in all forms of media. Yes, there have been some improvements and some cases (and I never understand why some are and some aren't) are treated with respect and dignity, but the demonisation is still there.

beautiful_alone said...

I'm kinda new to this whole depression thing, and reading your various blog posts on the subject have certainly been helpful to me. This is quite timely as I had my first "depression for no reason" the other day - the first time I've not been able to pinpoint even a vague cause for it. It was really difficult trying to explain to my husband what was wrong - when he asked "why are you upset?" I just couldn't tell him.

I certainly agree that chamomile tea and regular meals work to combat it! I finally managed to chase away the blues the other day with a big pile of fried chicken and chips :)

Anyway, I just wanted to say thanks Kath, for the tips and advice.

Sleepydumpling said...

Thank you Ma'am. I have learnt what helps me get one foot in front of the other, and if I write it down enough times, I might actually remember it when I need it.

The "depression for no reason" bouts are the worst. At least when it hits after a shitty time at work, or because you've had some other stress, you know what brought it on. But when it just randomly turns up... ARGH! It's frustrating on top of the depression.

I definitely find that if I take care of myself and sleep, eat, dress and go out, and do all those other normal things, the bouts tend not to be so severe. And the chamomile is excellent to keep the anxiety levels down.

Hugs m'dear!

Girl Clumsy said...

Hi again Kath,

I took your definition of "media" as the world of journalism and reporting, which I guess considering my profession is an easy judgement to make. ;)

I can understand why when looking at some movies and TV shows the odds seem stacked against depression sufferers. However, I would argue that many of the scenarios you described in your response apply more to mental illnesses such as schizophrenia and bipolar disorder than depression.

For example - Heath Ledger. He was found dead after accidentally ingesting too many presciption pills. The speculation was that his "getting into character" to play the Joker may have contributed to ill health. The speculation that playing essentially a psychopath, was what sapped his mental strength. If there's one thing that can be said about The Joker - he certainly doesn't suffer depression! ;)

TV shows like House portray mental illness sufferers a fair bit. Generally though, I've noticed TV shows tend to move to the more "dramatic" end of the mental illness scale - so schizophrenia etc.

I guess what I'm trying to say is that many diseases (both "visible" and "invisible", if I may make such a broad generalisation) are portrayed in TV and movies because they're interesting to people. If people don't know what mental illness behaviours are, they may learn something.

It's an unfortunate reality that people suffer illnesses, and sometimes those illnesses manifest in other ways - so you get the addictive behaviours, etc.

I saw an episode of Law & Order: UK last week, in which a gynacologist turned out to be a serial sexual assaulter & rapist. I don't consider the profession of gynocology to be "demonised" because of that character. It's the job of TV shows and movies t come up with characters that will be interesting to viewers and have traits relatable to us.

I for one would prefer to see more characters struggling with depression in popular culture, not less. It would show that it's normal for people to have these conditions, and that it's just a part of being human.

Flibbertigibbet said...

I've suffered with depression for around 20 years now and I carry a lot less shame about it now than I ever did (thanks to my wonderful therapist).
These days I will tell people I've been ill, I don't make excuses any more or pretend to be happy. If they ask what's been wrong, I'll say I've been depressed. If it makes them uncomfortable that is for them to deal with.

One of my friends told me that she didn't like to hear about me being depressed because it brought her down. So now, I don't talk to her about it. I don't talk to her about anything. It dramatically altered the friendship, you're there for me or you're not and if you choose not, you become one of the friends that falls under the heading of 'acquaintance'.

As for coping with it, I found that the more I fought it, the harder it hit me. I allow myself down time, I allow myself to wallow on the sofa for a day and bloody well feel sorry for myself if I want to. Then the next day I get up and I feel better somehow.
Accepting it's okay not to be happy all the time was a revelation.
I have anxiety too - and being honest with people about it wasn't as bad as I expected. There are things my anxiety won't allow without sending me into an anxiety attack - which, no matter what I do, I can't stop being frightened of. People are really understanding about it when I take the time to explain it.

Sometimes it's just really good to know that you're not alone with it - but isn't that the case with everything?

Sleepydumpling said...

Natalie I'm still sure you're not quite getting it, but I'm not going to argue about it. Number one tip for talking to someone with depression - don't tell them they're imagining the way other people, including ALL types of media, treat them around their depression. And justifying that with "it's portrayed that way because it's interesting" is highly offensive!

I stand by my statement that depression is still demonised by ALL forms of media in some way or other, even if it has improved marginally in some cases.

Flibbertigibbet - one of the most difficult things about depression is that people just don't "get it". They minimise what we feel, they tell us it bothers them (try living with it!), they suggest that we should just get over it, they argue with us when we try to express ourselves (you're imagining it!), or they just avoid us all together. One of the things I'm learning is that I really don't need those people in my life. There are plenty of others who DO take the time to understand or support those of us who suffer depression.

(And I will do some posts on anxiety later)

Girl Clumsy said...

Kath, you've put words in my mouth, here and on Twitter.

I never said "It's OK for people with depression to be portrayed negatively because it's interesting".

I said that ALL types of diseases are given to various characters in various TV shows/movies - because they give depth and layers to characters, that people find interesting.

And I stand by that statement. Perfect people do not make interesting or relatable characters. As someone who stands up for all types of "normality", I assume you back that idea.

Sleepydumpling said...

No sorry, your attitude is offensive. End of story.

Girl Clumsy said...

Interesting. You're encouraging debate and discussion, but labelling me offensive because you don't like my point of view?

Depression is a horrid disease. I don't pretend to have your experiences, but you cannot know mine. My opinions are based on my experiences - personally and professionally.

If they're offending you, perhaps you should examine why you're so quick to judge someone who isn't in 100% agreement with you.

I really enjoy your writing Kath and think you post on very worthy topics. But you surely must understand people are going to have varying views?

Sleepydumpling said...

This is not about agreeing or disagreeing. This is about standing up and saying that the attitude you hold is offensive because it is HARMFUL. This is not negotiable.

You are doing the exact thing I have mentioned on more than one occasion that is harmful and damaging to people with depression. I have told you that it is offensive, yet you continue to do it.

You or anyone else who persists in negating the effect of negative stereotypes of depression and anxiety, or disputes how people with depression feel or think about their depression do more damage than you can possibly understand.

This is the very attitude that keeps other depression sufferers silent, those who have not been able to find the healing and confidence to be able to speak out, as I am lucky to have found.

This stops here. Any further comments of this nature will be deleted.