Saturday, 30 July 2016

My Battle Cry

I wrote this in January.  Note: contains swears, anger and stuff like that.


Depression is a hot topic these days. Everyone seems to have it. It’s almost weird if you
don’t have it. And I’m sure you are all sick to death of reading about it by now. I know I am.
But a recent meltdown and subsequent recovery prompted me to confront my depression
head on. I did this by writing to it. Yep. I wrote to my depression.

Why? Because writing is what I do. I write children’s books - many of them bright and funny
and silly. Perhaps they are my therapy. Who knows. Because inside me lurks a darkness
that constantly threatens to rise up and choke me. A cloying black tar that erupts from my
intestines, that seeps out through my pores without pattern, without reason or warning. This
is what depression is like for me.

I have been dealing with what is called depression for over thirteen years now. I’ve been
lucky. I’ve had professional support and my family have been amazing. But it’s been hard.
So very hard. For all of us.

Pretty much every day begins with lurching anxiety. “How do I feel today? Will I be able to
function? Will I be able to work? Can I keep myself out of bed? Can I stop myself behaving
in a way that is harmful to myself or my family?” I lie in bed and check myself mentally, all
over. Like checking for wounds only the cuts and grazes are not physical. Discovering I am
feeling okay is a delight. But it seems totally random whether I’ll get a good day or not.

Mornings for me are particularly difficult. I usually try not to think too much. If I can just
propel myself out of the house with the dog, I’m usually ok for the day. Usually. But deciding
where to walk often overwhelms me and I become paralysed with indecision. Then I’ll stand
or sit with my head in my hands, sometimes for half an hour. Or an hour. At this point I will
often give up and go back to bed.

It sounds ridiculous, I know. It IS ridiculous. But apparently depression can affect the
decision-making parts of your brain. I read that too. So there you go. It’s a thing.
Apparently.

Anyway, the point is, I had a massive meltdown the other day. I won’t bore you with the
details, but once I’d recovered I found myself feeling very very angry. Furious in fact. So I
took myself off to a cafe I don’t usually go to. I needed to hide. And I wrote something very
dark and very black and very raw. And afterwards I felt exhausted. But I also felt more
empowered that I have in a long time.

And it prompted me to issue this battle cry. A battle cry against the condition that is trying to
destroy me.

Before you read it, you should know, it is full of vitriol, swears and capital letters.
So yeah. Here it is.


Depression! Is that you?

Are you listening?

Good

Because I. AM. RAGING!

I am FURIOUS!

I am ready to fight

And YOU are going to FUCK RIGHT OFF!

You are a pain in my arse

A thorn in my side

You are a malicious cancer growing in my throat, trying to strangle me

You are a black beetle crawling around inside my head, interfering with my thoughts, eating

away at my self respect, my confidence, my vitality.

You are an oppressor

You are a manipulative spiteful liar

You try to make me do things that will hurt me

You try to make me do things that will hurt the people I love

You delight in telling me how useless I am, what a failure I am.

You are not my friend

I did not choose you

I do not want you

I do not need you.

If I could cut you out I would

I would would slice and slash and wrench you out of me

I would reach down inside of myself, and pull with all my strength

And if that brought out all my intestines too, it would be worth it

I would throw you on the ground and stamp and stamp and stamp on you

I would vomit you into the sewers.

If I could I would.

But I can’t do that

You are not a tumor

You have no physical presence

You are intangible

Often I don’t even believe you are real.

But I know you are.

But guess what?

You are not as strong as you think you are

You need me

You are nothing without me

You prey on vulnerable sensitive people and that makes you weak

You need my attention to grow

The more I nurture you, the bigger and uglier you get.

So I have decided not to give you the attention you crave

When you call to me, I will close my ears

When you pester me I will look the other way

When you cry for me, I will laugh in your face.

Because you are nothing

You have no substance

You exist, but you have no power without me to feed you.

Hear this, depression.

You will not win

I will not let you control me

I will take out my club and batter you until you fall to your knees and beg for mercy

I will fight you every minute of every day if I have to

If you beat me down, I will get up again

And again.

And again.

You will not have my life

You will not have my freedom

You will not hurt me any more.

So listen to me you manipulative, spiteful, joy-sucking, pathetic, whining, piece of nothing.

FUCK OFF and LEAVE ME ALONE!

This is my battle cry.

Every time I feel that I’m tipping, I’m going to read it out. I’m going to shout it out loud and it’s

going to make me stronger.

At least, that’s the plan.


Wish me luck.

Tuesday, 26 July 2016

How I Manage - and I DO Manage. Mostly.

First of all, I want to say thank you to everyone who has sent me messages as a result of my first three posts.  So many people identify with what’s going on for me, and have thanked me for putting it into words.  So here’s to you all - you’ve done it now - I’m going to have to keep writing!

So, I’ve been dealing with depression and anxiety issues for at least 14 years.  That’s consciously.  I think, actually, I’ve had bouts of depression throughout my adult life, but just didn’t know what they were.  So I’ve had a long time to learn how to deal with my condition and how it presents itself.  

It’s still hard.  At times, it’s excruciating, but I do know now that it comes in waves and that I WILL feel better again, even if I don’t believe it at the time.  Here are some of the things that have helped and continue to help me live the best life I can.

Medication
It took me around five years to agree to taking medication.  I had a terrible bout of post natal depression which I couldn’t admit to for a very long time. I felt inadequate, a failure. I was ashamed at my inability to cope.  But after lots and lots of counselling, I finally agreed to start on medication.  

Let’s be honest, medication has not fixed things totally. But it does give me enough to at least think rationally about how to manage my moods.  Without it, I’m totally out of control and can’t function at all.  

It took three attempts to get the right medication for me.  Everyone reacts differently, which makes treating depression even harder.  I started on prozac, but it just slowed me down so much I ended up driving at 10 mpg and went to bed thinking I was shipwrecked. The second one I tried was Trazodone, but that was awful. It sent me to sleep within minutes, but gave me very manic, very loud dreams. I would wake feeling exhausted and wrung out. So Trazodone had to go.

Then the consultant psychiatrist (I know, sounds scary right?) prescribed me Sertraline and I’ve been on it ever since  It’s not perfect - I get the jitters and weird creeping sensations in my legs sometimes, but on the whole it does help.  

If you have been suffering for a long time, and feel like things will never change, I would urge you to consider trying medication. It might not work, in which case you can stop.  But if it does work then you might just start to get your life back a bit.


Therapy
As I said before, I’ve had lots of counselling.  Mostly it’s been helpful, though it can take a while to find the right person.  The wonderful thing about the NHS is that you can ask to see someone different if the person assigned to you is not really helping.  I was lucky enough to be referred to a local charity, the Derwent Rural Counselling Service which allowed clients to pay as much as they felt they could afford.  At more than £40 a throw, private counselling can be expensive, so this was a real life-line.  I was out of work at the time, trying to become self-employed so money was an issue but now I’m doing well, I’ve made several donations to try and pay back some of what I owe.  The charity has now been taken over by the NHS but still provides invaluable support.

I’m also registered with my local Community Mental Health service.  This is where the consultant psychiatrists reside.  The man I saw was young and up to date, though I suspect that not all are as good as him.  They also provide talking therapy and have been a great support.  I’m sure it’s not the same in all local authorities though.  And it did take me a long time to find the services I needed. Largely, I think, because I found it incredibly difficult to admit I even needed help, let alone ask for it.  

Those first five years were the hardest, and I would have really benefitted from a “buddy” to help get me the support I needed.  I now try to be that person for others I know who are suffering as it can be really daunting and very lonely and scary trying to get support initially.

One counsellor I saw suggested that a lot of my “symptoms” fitted with a particular diagnosis, and recommended me for a course of DBT.  Dialectical Behaviour Therapy to be precise. You can find out more about it on the Mind Website.

This was very much a taught “course” rather than therapy itself, which was great as it was not an emotional arena, but a mainly practical one.  For me, this was a massive turning-point as it gave me insight into why my brain is the way it is, and left me feeling empowered rather than a victim

Exercise
I have realised recently that I'm happiest when I'm walking, cycling, doing zumba or kayaking. Particularly when I'm doing these things with people I relate to. But sometimes it can be hard to get out of the door, let alone do any exercise.

I have a dog who needs a long walk every day, and I usually feel good once I'm moving, even if I've felt drained or overwhelmed in the house. But I'm not too keen on walking on my own. Sometimes I walk with friends, which feels like a real treat, but more often than not, I plug myself into my phone and listen to an audio book. Audio books have been a real hit for me because when I'm listening to a good one, it makes me want to get walking so I can find out what happens next. It also squashes any other thoughts from my mind. Often they don't come back as the walk itself will have given me enough momentum to cruise through the rest of the day and even be productive.

For me, it all starts with a walk. Everything else follows.

Sleep
If exercise doesn't work, I sleep. And, as I’ve already said, I sleep a lot. Sometimes I get stuck in a spiral of emotions that is very hard to break out of.  Sleep resets those emotions so that I can wake up and function again.

Medics say that people with depression do sleep a lot.  I think it’s because trying to constantly modify your feelings and behaviour is knackering!  The adrenaline produced during bouts of anxiety put your body into hyper mode, and coming down from this is when you feel exhausted.  So for me, sleep is hugely important.  

Pacing
My GP once talked to me about pacing. It's something I've never been very good at. I'm either on or off and there's not much in between. But over time, I've learned to pace myself better. It's tempting to go mad and do too much when you're feeling okay, which can lead to a crash, as I've discovered many, many times to my cost! Living in the extreme can be exhilarating and rewarding during the highs. It's when I'm at my most productive. Feverish almost. I just have to remember to leave space for recovery once the bout of activity is over.

I would say that this is one of the most practical things I do to manage my condition. I accept that I will have flurries of intense activity, and that afterwards I need quiet time to recover. I do this by blocking out time in my diary and usually staying in bed, or meeting a friend for a walk or lunch. Which leads me on to my next point. Acceptance.


Acceptance
If you lose a limb, or have cancer, or chicken pox or break your arm, you know you are ill, or have something medically “wrong” with you.  You feel physical pain. There might be blood, or spots or the absence of something that was once part of your body.  There is a concrete diagnosis and course of action that you have to take, be it physiotherapy, chemotherapy or cool baths and chamomile tea. Your doctor recommends treatment and you manage your activities accordingly.

But when you have depression, it’s really difficult to believe that you are actually ill.  This is partly driven by society and its expectations that you are just sad, or that you should “get over it”.  And partly because it is a condition of the brain, which interferes with your rationality.  

It took me years to admit that I was ill, and not just useless.  I still find it difficult to believe, but I know better than to rely on how I feel.  When I’m low, I try to rely on my rational beliefs.  I pay attention to what I KNOW, rather than what I FEEL.  I know I am ill, even though I feel that I’m just a time-waster and generally useless person.

The DBT counselling I mentioned focuses quite strongly on questioning your perception and asking whether your thinking is based on what you know or what you feel.  It’s a good way of testing whether you are dealing with things in the most helpful way.

Accepting that you have depression and that it is an illness might seem simple. But it’s not.  It helps me to separate my emotional (chimp) brain from my rational (human) brain. I force myself to believe what the doctors tell me, even though believing it feels like admitting defeat.  I have found that the only effective way to manage is to tackle my depression head on.  So I have depersonalised it.  I see it as a separate entity that messes with my mind and I deal with it accordingly.  It’s not easy, but it helps me.

Some people even give their depression a name.  I think mine would like to be called something like Weasel, or Gargantua, or Colossus.  But I think I’m going to call it Beetle, just to annoy it.


Next Time: A letter to my Depression

Friday, 22 July 2016

What Depression Feels Like to Me

Depression manifests itself in different people in different ways. But I think many of us do have symptoms and behaviours in common.  In this blog, I’m going to tell you what it’s like for me, and in the next blog I’ll tell you more about how I have learned to deal with it. But like all good suspense stories, you’ll have to wait for that part.

Grey.
Grey is how I feel.  I’m told that this is depression.  Like all the colour has been sapped out of me and lies in a puddle on the floor at my feet.  There is no joy. Not even the appearance of a new book, or lovely comments from fans can touch it.  Mornings are often grey, but by 11.00 I’m usually ok.  But if life is stressful, the grey can last for days.  

Overwhelming Exhaustion
I sleep. A lot. Many people with depression find it hard to sleep.  I am the opposite.  I think my brain just decides to shut down when things get too difficult for it to manage.  I speak of my brain as a separate entity to myself.  That is because I am in control of myself, but my brain has a mind of it’s own. So maybe two or three days a month, I will just sleep.  Sometimes for as much as five hours in the day, and then all night as well.  As a minimum I will sleep for two hours in an afternoon on off days.

“They” say that too much sleep is bad for you, and that’s true, by definition.   “Too much” of anything is bad for you, otherwise it wouldn’t be too much!  But this is not a lazy slumber. It is not an indulgent lie-in.  It’s an overwhelming drowsiness that takes over and knocks me out.  For me, the key to deciding whether I needed the sleep or not, is whether I feel better afterwards.  Sleeping when you don’t need it invariably makes you feel groggy and fuggy.  The type of sleep I’m talking about is restorative. It usually enables me to reset my mood and helps me get things into perspective.  Also, if I sleep soundly the following night, I know I was right to have a nap.

The trouble is, at the time I’m feeling drowsy, exhausted or fuggled, I find it very difficult to decide whether I really need the sleep.  Sometimes a walk or going shopping will be enough to shake the fuzz and get me going.  So when I’m feeling particularly tired in the morning, I try to propel myself out. If after an hour walking I still feel exhausted, I go to bed.

I have spent a lot of time over the years feeling hugely frustrated that I am wasting my life sleeping. But these days I just let it happen and decide after the event whether it was helpful or not.  Usually it was.

Paralysis
I am told that decision-making can be difficult when depression strikes.  And for me this is definitely true.  I often find myself standing in the kitchen, head in my hands for minutes on end, because I can’t decide where to take the dog for a walk.  I know rationally that it doesn’t matter at all where I go, as long as I go.  But my brain has other ideas.  It starts to argue:

You must go for a walk
But I’m tired
I’m bored of the same old route
Well go on a different one then
But where? What if it rains?

I mentally travel round the countryside within 15 minutes’ drive and try to visualise myself on each walk.  Then reject all of them because they are too far away, or that I’ll have to then bring the dog back home which is double the driving and a waste of precious time and petrol.

My mind moves from one possible course of action to another, and all the while thinking
about all the jobs I have to do in the day, or all the jobs I should do, and which is the most efficient order to do them in and I berate myself for wasting time and get frustrated with myself for being so stupid.  I stand in the kitchen. Head in my hands.  Anxiety building over what I know is really a simple decision and if I’d just gone out without thinking, I’d be halfway home by now.  And then it starts all over again.  

So just GO
But… And round and round and round I go. Stuck in a mental loop, my feet glued to the kitchen floor

Sometimes I give up and go to bed, knowing this is counter-productive and that it’s wasting even more time.  But on the better days, I grab myself by the scruff of the neck and throw myself out of the door.  Once I’m out, and 10 yards down the road, I’m usually fine.  It’s just getting out that’s the problem.

I think this tendency is a mixture of depression and anxiety.  The depression part is the inability to decide/ commit/ concentrate. The anxiety part involves worrying about my inability to decide / commit / concentrate and the possible consequences of this, such as wasting time, making things worse, giving in, feeling weak or stupid, not getting things done.  When they work together, depression and anxiety can really make a mess.

Shouting, screaming and slamming doors.
Before I was on medication, I used to get unbelievably and irrationally angry about the tiniest things.  A comment from a child or husband would send me into a door-slamming, head- banging rage, followed by frustrated tears and feelings of self-loathing.  Why couldn’t I control myself? Why did I fly off the handle? I was making the situation ten times worse and making everyone feel horrible.  When I take my medication, my anger is much more under control.  That is, when I take it.  And I usually do.  But not always.

Crying
If I don’t take my medication for a couple of days, I start to cry.  I weep over the tiniest things and find it almost impossible to stop.  I WANT to feel wretched. I DESERVE it.  That’s what my brain tells me.  When the tears start, that’s when I get strict with myself and tell myself to take the pills.  They help enormously. But if life is emotionally stressful, sometimes I get onto crying even when I do take my tablets.  

The desire to run and hide
I think this is more to do with anxiety than depression.  After all, that’s kind of what anxiety is for. It’s there to keep us safe from potential dangers around us.  If we see a Tyrannosaurus Rex running towards us, we’ll feel a lurch our stomachs and our breathing will get faster, our hearts will beat and our legs will be running before we’ve even had time to think about it. We are filled with a surge of adrenaline, which at times could be life-saving. Even the thought of being chased by a T-Rex or a picture of one can bring on this response if we have had a previous near-death prehistoric encounter.

Luckily, life these days is pretty devoid of T-Rexs. Or any other major predator for that matter, for those of us lucky enough to live in the gentile and sedate English countryside.  People living in any of the war-ravaged parts of our world are not so lucky. Their anxieties probably save their lives every day, but a huge cost to their future mental health.

Even so, my anxiety is still alive and kicking and if I feel I’m under threat in any shape or form, for example from a heated discussion or a misplaced word, my brain and my body tell me to run.  Or hide. Or both. Controlling these urges can be very difficult at times and can result in internalising the stress, which can lead to self destructive behaviour.  So why not just run, until I feel better? Well, because I have children that I don’t want to upset. I have a husband I don’t want to upset.  I have a rationality and societal expectations that tell me running is not an acceptable behaviour.  But sometimes I do run.  Sometimes I hide too, when it all gets to much.

Self-destructive thoughts and behaviour
I get very, very frustrated with myself.  Frustrated when I can’t just get on with things. Frustrated when I’m wasting time. Frustrated when I over-react.  Frustrated when I hurt the people I love.

And I take that frustration out on myself.  After all, I’m the cause if it.  

I won’t go into details here on the nature of those thoughts and behaviours, partly because they may be triggering to others, and partly because I actually don’t want you to know.  These days it is mostly only thoughts.  I’ve had a lot of therapy.  Remind me to talk to you sometime about a model of “distress tolerance” I learned about on a course.  It’s helped me enormously.

Self medication and impulsive behaviour
Alcohol.  Hmm. It’s a difficult one.  On the one hand, it does help me to chill out.  But on the other hand it can make me angry and impulsive.  If I could just stop at one glass I think it would be fine.  But after one, I inevitably reach for another.  It’s a self-destructive thing actually, if I’m honest.  

Luckily after three glasses, I usually fall asleep so I think my liver will survive another year or two.


So yeah. That’s what depression is like for me.  Mostly you don’t see it and that’s the way I want it. Because I don’t want to have to deal with other people’s reactions to it. Like many people with depression, I hide it well.

Tuesday, 19 July 2016

Truth, Fear and the Quagmire

The trouble with the truth, is the truth.  The truth as we each see it is different of course.
But how do we tell our own truths without irreversibly hurting and alienating the people we love and work with?  

How people behave towards us is so much a product of their own experiences.  I get that.  And therein lies the problem.  

I have had lots of therapy.  Loads.  Gallons of it. So much that I’m now so hyper-aware of the nature of emotions, mine and other people’s, that I can not just react any more.  Because I know my thoughts and feelings are “only” thoughts and feelings.  That I can choose how I react and that I don’t have to act on my impulses.  I am in control.  I am not a chimp, I am a human.  I am a rational being who understands that emotions are transient.  They can lie. They are inconsistent.  They feed on ingrained experiences that are hard-wired into our brains from an early age.  They are not always helpful.  

I know all that.  But being in control of your emotions is hard.  It’s hard bloody work to stay on top, to keep a lid on it, every day. Especially when emotions change so rapidly, and half of what you think is not real, or based on fact.  But I am so practised now in questioning my emotions and my reactions that I don’t trust any of my feelings any more.  I am so aware of the impact of my actions on other people, that I struggle to act at all.  I am scared to express myself for fear of upsetting someone else.  

Am I perverse in my envy of people who just say what they think with no regard to others? The Jeremy Kyle show types who shout and scream and spit and blame? I do envy their freedom of emotion, but to live with the aftermath of these outbursts? No.  

Have you read The Chimp Paradox by Professor Steve Peters? It’s a bestseller and a really enlightening read. I managed about a third before it lost me but that third had a huge impact on the way I see myself and think of myself as a human being.  If you haven’t read it, do get hold of a copy.  Well, the first 100 or so page at least.

Anyway, Steve Peters says that we have two brains. Actually he says we have several, but let’s start with two: the Chimp brain and the Human brain.  So the chimp brain is our “old” brain.  It’s reactive, emotional, survivalist.  It’s the part of our brain that deals with flight, flight, sex, addiction, desire, hunger, love.  It’s essential for our survival but if we’re honest, a bit of a pain too.  It’s the whining child. It’s the philanderous partner, the angry, grabbing, jealous, greedy, exuberant, joyful side of us all.  

And then there’s the Human brain.  This is the boring bit of us that is rational, analytical, socially responsible, the “Best not have that third glass of wine,” the “Go to bed at ten O’Clock you have an early start,” part of our brain.  And these two brains are in conflict.  And the Chimp brain is something like eight times stronger (eight? Not seven or nine?? Search me?). Eight times stronger and faster than our human brain.  So our initial reactions are always Chimp.  But as social, rational, sensible humans we must learn to control our inner chimp. To not react emotionally to everything but to take a breath and think about our actions and their likely consequences before we do something inappropriate and fuck things up for ever.

To be able to operate in full Chimp mode is tantalising. Tempting.  It would allow us to express our feelings in the raw. To get them all out regardless. But it would also leads us into a quagmire of other people’s reactions that might be impossible to crawl out of.  It is not taking responsibility for our own thoughts and feelings,  but rather shoving them onto others. Blaming others for our misery.  Transferring our misery to them.  

Yet to have empathy and understanding for others is difficult too.  It is what prevents many of us from expressing how we feel.  It leads us to bottle things up and lock them in, which we all know is unhealthy.  I guess that’s why talking therapy is so good.  Because it allows us to get all that stuff out in a safe place, to a person who couldn’t care less whether we drank that third glass of wine or shagged that idiot at the proverbial office party.

And I think this is the fundamental reason why talking about mental health outside the therapy room is difficult.  It’s scary.  Because how do you talk about the stuff that’s going on in your brain, without revealing the details of difficult things that have gone on in your life?  And how do you reveal what is difficult in your life without hurting or upsetting the people involved in those difficulties?

I am how I am because A, B and C have happened to me.  Because I hate having to deal with D, E and F, because G said something that upset me. Because I did H, I and J.

I believe that depression is intimately linked with an inability to express emotion and feelings. Being creative - writing, doing art, inventing things - is a way to express our feelings.  For me, writing is joy.  It is escape and distraction from what is going on in my head. Yet the thing I really need to write about, is the thing that I actually can’t write about. Because I can’t take the risk that anyone I care about might read it. I don’t want to hurt or blame or expose others.  I don’t want to throw myself into a quagmire so deep and tangled that I am unable to ever claw my way out.

Monday, 18 July 2016

There are no Prosthetic Brains

Have you seen the Channel 4 trailer  We're the Superhumans ? It's totally inspirational.  Seeing all those athletes who have to work twice as hard - wait, probably six times as hard - to achieve what able-bodied athletes can do in swaps.  They are true heroes.  Superhumans for sure.  We see their prosthetic limbs, blindness, dwarfism and we can make immediate assumptions about what they have had to go through to achieve what they have.  We imagine their courage, their bravery, the challenges they have faced and overturned.

But what of mental disability or illness?  There are no prosthetics for people who suffer depression, or crippling anxiety.  We do not applaud their bravery or courage for their achievements.  And it's because their afflictions and battles are invisible.  And what we don't see does not exist for many of us.

I am a children's author.  I have had over 20 books published in the last 7 years.  And I'm well-respected as a newcomer with things to say and ways to say them.  But what most people don't know is that I'm battling every day with a depression that is often crippling.  It pulls me back to bed to sleep away whole days. It continually attacks my self-confidence and self-esteem.  It threatens my marriage, my role as a mother, my relationships, everything.   

But does anyone see me, and people like me, as brave? As courageous?  Of course not. Because I hide my affliction from most people.  I am ashamed and embarrassed and self-conscious about it.  Mentioning it is easy.  Talking about it is okay, but telling the truth, the whole truth about my condition and what it does to me - impossible.

So I've started this blog because I need to talk.  I don't even care if nobody listens to what I have to say, or reads what I have written. I do not want to be an advocate for people with depression. Or a spokesperson, or a font of all knowledge.  I just want to talk about what it does to me, to tell the real truth about my struggles and challenges. Perhaps in the hope that I can be a kind of hero too.

If only they made a prosthetic brain.