This is a post about some of my own experiences with depression. I am not writing this to give others advice about their own mental health, and I do not suggest that the content is in any way definitive. My motivation for writing this post is to give myself a reminder about how to recognize and minimize ‘dips’ in my own health: a written memo may help me with self-diagnosis and treatment in the future. I’ve decided to publish it here so that friends who want support me can better understand my experience and, on a more public-spirited level, to contribute to reducing stereotypes and stigma around mental health.
There is a useful metaphor about the role of medication in treating mental health conditions. When someone is bleeding profusely, you do not send them on a chainsaw safety course: you stop the bleeding. I think that is a very valuable rule of thumb, both for focusing on prevention and early intervention with mental health and for understanding the need for medication in some circumstances. I extend the metaphor here, but I do want to state that this is not a post about my experiences with or thoughts about medication, and I hope that any ensuing dialogue will respect that.
I’m just getting over a dip now. I’ve cancelled quite a few commitments over the last few days, and realized that, although I’ve got better at prioritizing my health during times like this, I’m not very good at saying “I can’t come because my depression is bad” – which is slightly odd, given that most of the time I’m very open about my mental health and how it impacts on my life. The chainsaw metaphor applies here too. If I’m covered in blood, I don’t want to get drawn into a conversation about how I feel about being covered in blood, or how I got to be covered in blood, or how it makes you feel that you can see me covered in blood, or whether my blood is more bleed-y than your blood, and how the bleeding might be ruining the fluffy white carpet that we’re obviously standing on during this whole metaphor … I JUST WANT TO STOP THE BLEEDING. So please, help me to feel that it’s safe to verbalize that “my depression is bad right now” by agreeing that you will not push me to talk about it there and then. Let’s have a conversation another time, when I have the energy to engage properly and when I won’t distort everything that I hear you say.
Here’s what you can do. Check in. Just say hi, and that you thought of me today and that you are available if I need you. In rational times, I know that I have a wonderfully supportive network of friends and family. But when depression is encroaching, my unhealthy habit is to tally up how many times it was me, rather than you, who suggested a meeting or call, or began a text conversation – and then to interpret this as meaning that you do not care about me, or notice how much I need you: that I am an intrusion on your real, more important life. So please, just say hi. No gushing or facebook platitudes needed. And if you do want to help by doing more, offer to do something practical (during the last few days tasks like cooking, filling the car with petrol and moving files from one device to another have all felt like major undertakings) or, if you’re not nearby, tell me to do something practical and specific: make me agree to make a cup of tea/get into bed and sleep/put on warm clothes and watch an episode of a British period drama, then check in a bit later to see if I’ve done it. Your practical caring, and showing that you will keep caring, makes all the difference and will help me find the strength to talk about these things at a time that’s healthy for us both.
Now to the writing that is more for my own benefit, to help me identify when such a ‘dip’ is approaching and hopefully reduce its impact (although if you can read it too, and remind me about the content in the future, that would be very helpful). The emergency warning really should set in when there’s a dramatic change in the weather, combined with an unforeseen or stressful work event. I’ve also only just realized that having clung on through the dark days of January and February, March is always going to be a month of feeling depleted – and that I need to stop kidding myself each March that “It’s getting easier because Spring Is Nearly Here.” Anyhow, if I fail to notice that initial trigger, it can quickly develop into a state of anxiety, sensory overload, overthinking things … and, not surprisingly given all of that, physical exhaustion. The problem is that these symptoms can easily be attributed to other triggers (PMT, ‘fighting a bug’, a bad hangover, work pressure) and it’s only when consciously linking them to depression that I see them collectively, and take them seriously enough to stop further escalation. Annoyingly, it is often not until I get horribly constipated (which I assume is linked to physical anxiety symptoms) that I piece everything together and acknowledge that both my body and my brain need a break in order to get back in sync. And it’d be really really great to figure that out without having to deal with constipation. So please, if the weather’s gone a bit bonkers and you see me getting anxious, or struggling to keep going with daily routines, or claiming that my friends all hate me: tell me to tell you that I am struggling with depression. And also tell me to eat lots of prunes.