Sunday, 24 October 2021

Waiting for the upswing...

I meant to publish this post to coincide with Mental Health Awareness Day which was earlier this month but then I dithered, edited, and then delayed, dithered some more, made further edits and delayed again. Why the reticence? Well, despite having relatively few readers, to publish a deeply personal post about mental health still feels very much like an exposure - it's putting yourself out there, allowing yourself to show your vulnerability and, potentially, invites judgement, accusations of attention-seeking, or worst of all... disbelief.  

Though there is much helpful information about mental health, and a barrage of hashtags on social media, there is still a stigma attached to it and many misconceptions. I have struggled with bouts of recurring depression for over 20 years and yet if I ever admit this to people they are often surprised and some do not understand at all, diminishing the condition entirely with lines like, 'I get a bit down sometimes too'. Feeling a bit low is not the same as experiencing the overwhelming, persistent and  oppressive, despairing sadness of clinical depression. Recognising this, and talking openly about mental health, not only raises awareness but helps to give a voice to those struggling to express what they are feeling and that's the reason I finally published this post - not for attention or pity but just in case it helps someone else.  

Each person's experience of depression is, of course, different but there are three main ways that depression affects me, and many others. I have summarised these under the headings  - distortion, disengagement and dissociation - all appropriately enough beginning with the negative prefix 'dis':

Firstly, depression affects cognitive processes - it hijacks your ability to reason objectively and distorts your reality. Almost everyone experiences these types of thinking errors at one time or another but with a depressive disorder the thoughts are constant and, for me, include: 

Emotional Reasoning - an entirely subjective viewpoint where you think that if you feel something then it must be true. For example, you might feel that you made a bad job of something - a task at work maybe - and so because you think this, it must be true.  You can't apply any logical reasoning but rely on emotional judgement instead.

Mental Filter - the feeling of gloom and hopelessness dulls everything around you so you can no longer see any light or pick out any colour. Everything darkens and the only details of any situation or event that you can focus on is the negative and you will dwell on this exclusively. Like Alice, you fall down the rabbit hole but instead of seeing Wonderland you just see the hole.

Mind-Reading -  where you make negative assumptions and conclusions about other people's actions without any real evidence to support them. For example, if a friend is busy and can't make a get together then you might wrongly conclude that they don't want to see you at all; someone delays answering your text, or gives an unusually brief response - they must be angry or upset with you. You don't question your mind reading ability or bother to check out your assumptions.

Depression creates disengagement from friends and family and from any previous source of joy and inspiration. You cannot fully engage socially with people you would normally enjoy spending time with. You feel too emotionally distant and numb to initiate a conversation and too physically exhausted by the mental process of appearing 'normal' to engage in any activities or hobbies.  A close friend observed that she knew I was depressed when I said that I hadn't been able to read; this is coming from a voracious reader who generally has at least two books on the go at a time. If I picked up a book then I would feel like a machine reading - I read fluently but the words meant nothing. There's a disengagement from day-to-day living too - you cannot find the motivation to meet needs with action. You need to get up, you need to take a shower, you need to work, but you stay buried alive under the duvet, reach for the dry shampoo and don't bother with the makeup, then sit almost catatonically at your desk unable to engage your 'work persona', feeling instead like an useless imposter.

Dissociation is a term that encompasses a number of conditions. For me, dissociation is the most distressing part of depression. It is the unsettling experience of depersonalisation and derealisation. You become so disconnected that you feel that you are literally not yourself. Trying to manage depression for any length of time means having to do things on autopilot and this creates a sense that you are looking at yourself from a distance - an observer in your own life. Not feeling connected to your internal dialogue makes your thoughts seem as though they come out of nowhere and sometimes they become bizarre, random and intrusive. Everything around you feels artificial. Bad dreams seep into waking life and flood your perception, meaning that you have to actively question what is real and what is not. 

I think, ironically, that I've managed to write a thoroughly depressing post when that wasn't my intention! One thing that I have learned about these bouts of depression is that there is an upswing - you just have to be patient. But it's not something you can manage alone. Your instinct is to shut down and retreat into yourself but you need to be brave enough to reach out to those around you for help and support to give you that necessary push.