Editors note: This is the fifth in a monthly series of guest posts on the subject of mental health. Rin Simpson is a Bristol-based writer of fact and fiction. As a journalist she specializes in crafts, home interiors and lifestyle subjects; she has had a short story published in Honno’s anthology Cut on the Bias, and is currently writing her first novel. She has experienced depression on a number of levels: her father committed suicide when she was a child, her sister is currently on medication for depression, and Rin herself – whilst loath to adopt a label and preferring to take action rather than anti-depressants – acknowledges that she needs to guard against those dark times that can so easily overwhelm. You can read her blog at www.nowiamthirty.journoblog.net.
Have you ever had a day where you feel so angry or sad or otherwise negative that you feel like your head might explode, but you just can’t quite figure out why?
As the hours go by the anger or the sadness are joined by other feelings – guilt at having snapped at your children, shame at having burst into tears on your boss, fear that you’re going crazy.
And then you have a light bulb moment: of course, you’re due on in a couple of days, you’ve just got PMT!
The relief is immediate. Sure you might still be snappy and weepy and all sorts of other things, but at least now you know what you’re dealing with, even if it is still meddling with your emotional wellbeing.
Nothing is ever quite as frightening when you turn on the light and face it out in the open rather than listen to it scurrying around in the darkest corners of your mind.
The same is true of depression, and that’s why one of the things I most despise about the disease is the way it sneaks up on you without announcing its true nature, so that for a few days or weeks or even months you live in fear.
Fear that you’re going crazy, that you’re a bad person, that you’re simply not good enough because suddenly things that you were managing to hold together just fine – a job, a relationship, a normal routine involving doing the dishes and taking off your makeup – seem beyond your grasp.
Depression makes you feel like you can’t cope with anything. Your judgment goes completely out of the window, particularly your perceptions about yourself, your worth as a human being and your ability to change.
Or maybe it’s just me. That’s another problem – the lack of dialogue about the disease, which leaves sufferers isolated and guilt-ridden, feeling that they really ought to just pull themselves together, that there are people with far worse problems and that they are just being weak and lazy and self-obsessed.
All of this goes on, for me, under the surface for an indefinite period of time. After all, you can’t let your crazy show, can you? You’ve got a job to hold down, kids to take care of, stuff to do for goodness sake. You can’t afford to have a meltdown and anyway, what would people think?
So you cope (and I use the word loosely) for as long as possible. But in time cracks start to show and eventually you come to the end of yourself, to the point where you simply can’t anymore.
And it’s often around then that you have that light bulb moment I was talking about: of course, I’m not going crazy, I’m experiencing a bout of depression!
That’s when you can stop blaming yourself for how you’re feeling, or for not dealing with things better, recognise that you have a disease and get on with the healing process.
Blame makes you feel trapped, not least because if you feel like something is your fault then you’ll probably be too ashamed to ask for help. If you can identify the problem, you can start to shake of the blame.
I am a firm believer that those who suffer from depression have to play a part in our own healing. Just as we can’t blame ourselves, we equally cannot simply blame the disease for all our problems and wallow in the unfairness of it all.
But it’s vital to recognise that depression is a disease, and identify it as quickly and accurately as possible – not just the first time it strikes, but every time. Only then can healing begin. Only then can we start to hope again for the future.
No more wriggling out of writing ...... 
As a long time sufferer, I have begun to move away from a clinical approach to the problem. The more I read about brain chemicals and imbalances, the less convinced I become about them being the cause of depression. I am questioning all the associated pathology of depression on a grand scale (at least for personal stance) and asking whether in fact there are far more subtle things at work. If it were merely a matter of serotonin reuptake etc, then it would be a matter of jigging meds around till you find something that deals with it; likewise a matter of other brain chems.
Have you come across the concept of the Highly sensitive person, or Low Laten inhibition? A quick google search and a trawl round even dear old Wiki brought me a fair few lightbulb moments. Can it be that the measurable changes in brain chemistry are the result rather than the cause of depression?
Worth thinking about.
thanks for the article; anything that raises awareness is a winner in my mind. And also to destimagtise something that may be a result of deepening of humanity hits the spot for me.
Viv, I agree that the chemical imbalance could be either the cause or the effect of depression – this is certainly one of the most central debates on the subject in the field of Psychology. And because of this I believe, as I think Rin has tried to demonstrate in her article, that medication alone will not solve the problem. It is vital that we, as sufferers of depression, take direct action ourselves. That may initially come in the form of therapy or counselling, but also needs to come from within; from our own conscious efforts. Understanding that a chemical imbalance underlines the disorder makes it more tangible for those affected, and the medication available can be very effective as a first step to getting out of the hole.
But as you say Viv, regardless of the cause and effect debate, I am all for raising awareness on the subject and shedding the stigma attached to depression. Only through understanding and recognition of the symptoms in ourselves and in others can we take the necessary steps to help those affected, and learn ways to prevent the disorder from raising it’s ugly head again.
Hi Ingrid,
I take in what you say, but there comes a point where after a lifetime of fighting with this illness/disorder/whatever it is that a person becomes both sick of the disease and of the medical profession who constantly change their minds.
For some medication can work, for others a more talk based therapy or a combination of the two.
Provision for mental health help varies in the UK quite wildly. When I was originally treated, I was given medication on the understanding that it was a precursor to “proper” psychotherapy; the pills were to stablisie the condition enough to make therapy possible. At the point this became a possibility, and I was deemed ready, we moved areas, several hundred miles in fact to a new health authority and ended up at the bottom of the list there(having reached the top of the queue). Three years on and the same thing happened again. And after that, another three years down the line, having been geographically stable, I get told that I am no longer considered sick enough to get any therapy beyond pills. In this time, I worked on my own coping strategies and on dealing with the monster. When we moved to our current location four years ago the stress of the move triggered acute symptoms and I sought help again. My GP referred me to a local authority centre where I was assessed. Again, I was told that because I was still functioning, I was not eligible for help other than medication.
I’m a high functioning depressive. I hide my bad days. I fight. And in doing so, I have apparently managed to shut doors to any effective help that might come from beyond myself. I’m the kind of person who keeps going: I once crawled almost a mile along a frozen river bank with acute appendicitis so I could get mobile signal and get somewhere the helicopter could land. In being strong, I have simply made things worse. People who make no effort are given the resources. People like me are told just take the pills. And the pills do not work and they create other problems. SSRIs frequently cause sexual dysfunction; there are probably plenty of relationships that have been destroyed as much by the meds as the depression. No one knows what the longterm effects of any of these meds can be.
OK, sorry for ranting. I would fight to the death for depression to be treated seriously and with compassion, and for there to be greater understanding that it is not about weakness but rather about strength.
I really enjoyed and approved of Rin’s article, and am all for taking the fight on. But I don’t believe that there is any measure of hope left for people like me, in terms of medication or of therapy.
Insightful article!
I especially liked the balance in these lines:
“I am a firm believer that those who suffer from depression have to play a part in our own healing. Just as we can’t blame ourselves, we equally cannot simply blame the disease for all our problems and wallow in the unfairness of it all.”
This is so true:
“Nothing is ever quite as frightening when you turn on the light and face it out in the open rather than listen to it scurrying around in the darkest corners of your mind.
The same is true of depression, and that’s why one of the things I most despise about the disease is the way it sneaks up on you without announcing its true nature, so that for a few days or weeks or even months you live in fear.”
And if you ever figure out how to spot the symptoms before they really take hold, please let me know! I have been affected by depression for most of my life and have been on and off medication for 10 years. Having also studied Psychology as a BSc, specialising in mental health for my final year, I thought I would be fairly adept at spotting the little cretin as soon as it poked it’s head around the corner of my life. But this most recent bout that I am dealing with (perfectly under control with medication for now) had been “scurrying around in the darkest corners of my mind” for at least a year and wreaking havoc on my life (job, boyfriend, friends, family etc) before I recognised it and got myself down to the doctor.
This is another reason that it is so important to talk about this matter and raise awareness not only for those who are suffering with the disorder, but also for those around them. Recognising depression in yourself is never easy, even if you know exactly what you are looking for, so it is crucial that friends and families can spot the symptoms in their loved ones and try to help them manage the problem.
Thank you all so much for your comments. Thanks also to Rin for sparking such a lively debate. Having been affected by depression on and off for many years now I know only too well how difficult it is to explain why it happens. This discussion just proves how important it is to make mental health a real priority for the NHS and health services around the world.