Depression & Bipolar Disorder
Snapping the Black Dog: A Photographic Competition about Hope and Resilience in the Fight against Depression – Highly Commended: Alecia Rudge, NSW
A mind is like a limb. It can be broken and, even after it mends, it must be cared for with tenderness and compassion. If you have never suffered from depression, you may not know this. In all likelihood, you may have given little thought to the workings of your mind. But serenity is a gift on which too great a value cannot be placed.
Today I do all the things I should to keep my mind strong. I have also learned to relish small joys, the things that are on the surface for us all to see and celebrate. The smile of a stranger, warm sand between my toes, the first tightly-wound buds on my fruit trees, a quiet moment to listen to music or delve into a book.
I avoid noisy or argumentative people, I take the route least likely to be populated by angry drivers, I never do anything just for the money.
I consider depression not a curse, but a wake-up call. It tells you to be true to yourself, to have compassion for yourself as well as others. It leaves a scar that is a reminder of what can be lost and what is worth protecting.
Depression brought my race with myself to a stop. I was forced to look into the darker caves of my conscious. I was scared. I wanted to be like everyone else. I wanted to be normal. But what is normal?
Today I realize that I am like everyone else in one way – I am not impermeable to stress or emotion. But I am grateful that I am different to many in that I have suffered an illness that has made me more accepting of myself and more aware of what I want to strive for. I want a rich life. I want to be wondrously alive and I know that means being wondrously vulnerable.
You could give up, but you won’t because as well as having a bio-chemical imbalance in your brain, you also have a remarkable resilience in your soul….and four magic words that keep you going – This too will pass. It might not be this afternoon, or tomorrow, or next week, but this depression WILL pass and you WILL survive it.
At first there’s the shock, fear, tears, recriminations and guilt around by brother’s acute episode of mental illness. And then, after a very brief period of mourning for our ‘old’ lives, we are ready to mobilise. My parents arrange for my brother to see a psychiatrist, who diagnoses him and prescribes antidepressants. The medication helps with the many physical symptoms of his depression. Mum then arranges for him to see a therapist, who finds ways for him to visualize and manage his stress, helping him regain control of his runaway thoughts and feelings. We all read as much as we can. Recognising that knowledge is power, we endeavour to familiarize ourselves with every warning sign and symptom, learning about the role of diet, sleep routines and exercise in keeping this menacing black dog at bay. Most of all we do this together, as a family.
In some ways the experience evolves from something stressful into something strangely positive and cathartic as we are all forced to stop and take stock of our busy lives. We come to appreciate the importance of taking time to be available – really available – to each other; to talk, to give hugs, to praise, to sit down to dinner together, to go on long walks in nature, to laugh, to cry and to take nothing for granted. My brother finds relief in that he is no longer hiding the darker part of himself from his family and has their unswerving support and acceptance. He works hard to coach himself to challenge his circular, negative thinking and comes to recognize that his thoughts are his own best protection rather than his worst enemy. Everything in our lives, from the grassroots upwards, begins a lengthy process of being overhauled, remodelled and reborn, and as a family we are all the better for it.
Two years later and Mum says she feels very proud to have such an emotionally attuned and deeply feeling young man as her son, and privileged to have been given an opportunity to come to really know him. He describes us as having ‘caught him’ when he was falling, and has since emerged as a gifted and talented educator of children. In this environment his sensitive soul and natural empathy is put to great use and he has flourished.
Our family has travelled a dark and winding road, but together we have now arrived at a much happier and more hopeful place, where the sun shines most days and the grass is green and lush. The seasons may of course change and the grass develop occasional sere patches, but together we are no longer afraid of what tomorrow may hold; the roots that keep this family strong are deep and constant.
The D Club*
I’m the perfect party guest. Put me anywhere and I’ll energise. Sit me next to the nerd and we’ll be digitizing computers and code, saddle me up to an artist and it’ll be all art house and film noir, introduce me to a mum and we’ll be gushing over the new-born. Well, until baby needs a nappy change.
Yep, I’m an energetic kind of guy. I’m into things. All things. Passion is my mantra. Be passionate, be proud. ‘Tis cool. ‘Tis sexy.
What’s more, people respond. I ask questions. They give me answers. It’s like I have a truth serum aura or something. My intuition is strong, it is real, it is instinct. It is David Beckham.
Well now that you have my RSVP profile and we’re on intimate terms, I can tell you a little secret. A kind of friend-for-life, confidante, I-trust-you-a-whole-lot secret. I’m not always the bundle of kilowatts you see before you. I’m not always the interested, interesting persona who invigorates, and who epitomizes the successful young professional – the man about town who’s hip, happening, sporty and fashionable.
Yep, while I sit here typing this on my new ultra-portable, carbon-coated, wireless notebook, because looks are important, I am reminded of my darkest hours. ‘My achey breaky heart’ hours. And I hated that song from Billy Ray Cyrus and his mullet.
Only a few months ago I finished Series 5 of ‘Desperate Individuals’. It’s my own spin-off of Desperate Housewives, except with a limited budget there were no major co-stars or Wisteria Lane – just a cast of two, with my sofa taking the supporting role.
Truth be known, my sofa deserves an Oscar. An Oscar for the best supporting furniture in a clinically depressed episode.
My sofa does what it always does when I’m alone in my depressive mindlessness. Cradles me, protects me and warms me. We’ve become quite acquainted over the years since my late teens. We hide from the phone together, cry together and starve together. Ain’t that a shit. I have a relationship with a couple of cushions. At least they cushion me from a world I can no longer face, expectations I can no longer live up to, productivity that has left me behind.
It makes for good television. Because my life as a depressive is today’s TV. It’s 100 percent reality. It’s repetitive. It’s boring. It’s cheap. It’s a mockumentary to everyone but the participant.
My sofa doesn’t eat; you can tell that form the crumbs under the cushions, and with clinical depression, I’m not hungry either, so we’re a perfect match. Food? My tongue is numb and I can’t taste anything so why bother.
Looking back, it’s hard to see when each period of depression started. That’s because most depressive episodes end up being a blur; a juvenile alcoholic stupor forgetting the hours between midnight and 4 a.m., except in my mental state it’s a whopping six months that are hazy and foreign.
Seconds don’t exist in my world of depressive dryness. Seconds have become hours. Hours are now days. Months are lost in a timeless void of nothingness. No sleep, no interest, no energy. And it is here that life becomes its most challenging.
Don’t get me wrong, I’m all for the comfortable cinema vicarious experience with stadium seating and popcorn. I just wish depression was a two-hour affair on a cold Sunday afternoon instead of the rigor-mortic torture that makes it too painful to stay in bed, but even more painful to get up.
Depression is incoherence – the death of wellbeing, direction and life. Everything aches. Everything! Your head. Your eyes. Your heart. Your soul. Your skin aches. Can you smell it? Oh yeah, ache smells and I’ve reeked of it. My grandmother ached. She told me just before she died of cancer. From then on I saw the ache in her eyes. Sometimes in the middle of a depressive episode, I see it in mine. To look in the mirror and see your own total despair is ….horrendous.
Now all of this is sounding downright pessimistic and I mustn’t dwell on the pain of the past. After all, I’m here to tell my story when many others are not. For I write this not to recapitulate history but to shed a little light on an illness that affects 20 percent of adults at some time in their life.
For those of you who have been or are currently clinically depressed, welcome to the club – the members-only ‘D club’. Here’s your card and welcome letter, and don’t forget that we have a loyalty program. You get points for seeking help, points for talking to friends and family, and points for looking after yourself.
Now news headlines would count the economic cost of depression, which is in the billions, but from a human perspective, it’s simply a hell of a lot of agony.
The good news is that public perceptions, which not long ago relegated mental illness to that of social taboo, are slowly being broken. Courage, dignity and honesty can be used to describe Western Australia’s former Premier, Dr Geoff Gallop, who detailed his depression at the start of 2006. Here’s a small excerpt:
It is my difficult duty to inform you today that I am currently being treated for depression. Living with depression is a very debilitating experience, which affects different people in different ways. It has certainly affected many aspects of my life. So much so, that I sought expert help last week. My doctors advised me that with treatment, time and rest, this illness is very curable. However, I cannot be certain how long I will need. So, in the interests of my health and my family I have decided to rethink my career. I now need that time to restore my health and wellbeing. Therefore I am announcing today my intention to resign as Premier of Western Australia.
Stories like Dr Gallop’s allow more of us to talk about how depression can affect our health, jobs, families, partners and friends. It’s not a sign of weakness to express our inability to function mentally. It is in fact a sign of courage, openness, sincerity and trust.
It is not unusual for those of us who are suffering from depression to feel guilty, as if we have somehow brought this illness on ourselves, that we are weak, it’s all in our head, or that we’re somehow protecting those around us by hiding our mental paralysis.
Truth be known, so many of us are lost in today’s frenetic lifestyle that we don’t see the signs of unhappiness and helplessness in our loved ones. Sometimes it takes a meltdown to even see it in ourselves. But it is only through acknowledging mental illness that we can get treatment and start to finally feel better. Who would’ve thought that asking for help would be so hard?
For someone suffering from clinical depression, just to talk can be exhausting. During my last episode, I had repeating visions of falling asleep on my grandmother’s lap because there I could forget the worries of my world. Memories of her gentle hand caressing the back of my neck are safe and warm. A simple gesture can mean so much.
Today, instead of my grandmother, I have dear friends who offer to cook, clean, wash and care for me. They fight my fierce independence and depression-induced silence with frequent visits and constant dialogue. Their lives haven’t stopped, they don’t feel burdened and they haven’t moved in. They are now simply aware that I have a mental illness, and we are closer because of it.
I, too, have taken responsibility to seek assistance from qualified medical practitioners. Don’t get me wrong – taking the first, second and third steps to get help from a doctor can be traumatic. It’s not easy admitting that you’re not coping with life. And finding a physician who you feel comfortable with, and antidepressants that work, can take time. But I am testimony that you’ve got to stick with it.
And so, as I sit here and start to daydream as I look out of the window, I am reminded of a recent time when I lost my ability to sing, to share in laughter, to swim, to eat, to talk, to enjoy, when waking up was just as difficult as going to bed. It’s a frightful place that sends shivers up my spine.
However it’s a fleeting memory, because Mr Passion, that energetic kind of guy, is back, and he doesn’t have time to dwell on the past. This D Club member is in remission and it’s time to party.
A tumultuous childhood of divorced parents, blended with my sensitive, pensive and analytical personality, mixed with a highly delicate biochemistry, and a pinch of destiny to taste, left a young woman like myself susceptible to an emotional and mental breakdown. However, in hindsight and with the knowledge of what can be gained by experiencing such hardships, I would call these times a breakthrough.
When I’m 64*
The Beatles’ song ‘When I’m 64’ seems to connect age with decline rather than Wisdom! Well, I am sixty-four and I have therefore been living with depression for a very long time. I have made many mistakes but I now believe that I have learned how to live with my black dog, for at last I have her trained, but it has been a long, slow shift in power from her to me.
I imagine there is a gene with ‘Depression’ written in some fancy script on one of my chromosomes. My grandfather and my mother had that gene and now in my extended family others share this gene or ‘short straw’.
My early childhood may also have contributed to my depression. My mother was often depressed and, as she had no treatment, there were long periods when she was removed emotionally as I was growing up. I tried constantly to please her, but telling her I loved her, or giving her presents, or doing well at school, never seemed to cheer her up. Once I came second in my class and was praised by my teachers so I ran home to tell my mother, but she was only interested in who had come first and why I had not managed to get a higher place in class.
I slowly learned how to live with depression.
My most important lesson was when, after forty-six years, I was given a diagnosis for years of suicidal thoughts, sleepless nights, difficulties in my relationships and an unexplained lack of energy. It was a huge relief to know that my problem was depression – not failure, weakness of character, or a flawed personality. I had an illness shared by many others including some famous people like Abraham Lincoln, Virginia Woolf and Samuel Johnson.
Once I had the diagnosis I was able for the first time to seek appropriate treatment. In my case it was medication that was most helpful, though I had the usual frustrations of finding the right medication and of waiting for it to take effect. I also made the common mistake of going off the medication too early, of relapsing and of not seeking help quickly enough when the black dog was nudging me. To paraphrase Peter Cook, I have learned from my mistakes and can now repeat them almost exactly.
I found a good psychiatrist who listened to me and was very helpful, and later I got myself an understanding general practitioner. When the black dog wags her hateful tail, I now seek help immediately. The warning signs are suicidal thoughts, poor sleep patterns and, particularly, dwelling on negative ideas in the early hours of the morning.
Once, after being hospitalised, I was concerned about going back to work as a teacher. I said, ‘I don’t know what I will tell the students when I return to school’. One of the other patients replied, ‘Tell them the truth’.
When I returned to school I went into my class and one of the boys asked, ‘What’s been wrong with you?’ and I answered, ‘I have been hospitalised for depression’. It was one of the rare lessons I gave when I had absolute silence and interest from the whole class. After the lesson, many of the students came and talked to me about their own problems and, although they were young, I felt my relationship with them had changed to a much deeper level. Recently, Geoff Gallop won respect for being open about his depression—perhaps he was even more respected for this honesty than for his successful years as Premier of Western Australia.
For many years I had used a variety of escapes as my ways of dealing with depression. When I was a child I used to daydream when I was unhappy. In these dreams I would rescue people from burning buildings or from shark attacks. I would compete in Olympic Games, out-swimming Olympian Dawn Fraser, or create great works of art.
As I grew older my escapes were more physical – I would travel or ‘run away’ overseas. Later, I drank alcohol or worked far too hard, and twice attempted suicide. But the ‘dog’ always chased me ferociously. Now I have turned to face her and she has taken a step back.
A psychologist once told me that depression is a distortion of perception, so that you see yourself and the world in a very negative way. He then added rather cynically, ‘Depressed people may have the right perspective and the rest of us may be wrong’. It is true there is much sadness in the world – poverty, social injustice, war, corruption and such things can weigh you down. I remember though, after six weeks in hospital, waling in the grounds one spring day, and seeing flowers and birds and realizing I had stopped looking at beautiful things for a long, long time. I have only to think of my travels to wonderful places or of the good people I know to realize that the world is a magnificent place.
I am also luckier than many others with depression as I have lived for twenty-six years with my partner, who has a good understanding and tolerance of depression. My friends know that I suffer from depression periodically and are tolerant if I withdraw from them at such times. Some are very comforting to be with even when I do feel down.
I try also to find things that give me solace. I love music and while I may choose a maudlin adagio rather than an energetic allegro when the black dog is at my side, music does help. Walking in the country or by the sea has helped me as it is difficult not to see beauty when two huge sea eagles fly above you or when a school of frenetic dolphins swims past. I have used medication to help me relax. I try to take care of myself in all aspects of my day-to-day life.
I have also constantly sought education about depression and have tried, without being too boring, to educate others. It is a physical illness like any other and it should be treated as seriously and as without discrimination as any other illness. There are constant medical advances. Even over my lifetime, antidepressant medication has become more effective and there are new forms of treatment, such as cognitive behavioural therapy, and even experiments with the effect of light on mood. One size (or treatment) does not fit all but you learn what suits you.
I know I am fortunate and may people with depression are lonely and are quite isolated, but there are groups to join or there is individual counselling, and members of 24-hour help lines who will listen in the early hours of the morning. I try always to put something (however small) ahead of me to look forward to, a walk, a film, a day out.
So now at sixty-four I am a happy person, and when the black dog sneaks up behind me I turn and face her quickly. Suicidal thoughts, disturbed sleep patterns and excessive stress are early warning signs and I do not delay seeing my general practitioner. I know which medication helps me. I rest. I do not drink alcohol at such times and I listen to my partner and friends as they are keener observers of my moods than I am. I am not ashamed of depression and recognize it is an illness and it is treatable. There are worse things to live with than the black dog, especially now she obeys my orders. I just wish I had learned more quickly how to live with her. Now I am older, I think of Voltaire’s encouraging words:
It is true I am rather deaf, rather blind, and rather cripples; And that this is capped by three or four atrocious infirmities, But nothing deprives me of hope. (de Beauvoir, 1972, p.337)
Finding a way to live with depression has been a long journey but an interesting one, and I am probably a better person now than I was when I was young. Anyhow, as I am sixty-four, I will hope for a valentine, a bottle of wine and a few years more to enjoy my life!
About two weeks after I had got over the shock of my diagnosis (Bipolar I) I thought, ‘Well, what am I going to do?’ I have to actually work out what this is, what this illness is. If I had some other illness, if I had diabetes or cancer or whatever, I would want to know everything about it so that I could manage it as best as I could, so that I could have control over me and the illness and so that I had the most chance of controlling it instead of it controlling me.
So, we sought a lot of information and it started to make a big difference in my attitude, because that was when we learnt that it’s a chemical imbalance in the brain and that’s what mental illnesses are. They are physical illnesses, they’re a chemical imbalance in the brain and that’s a physical illness just like, if you have diabetes you don’t produce enough insulin, that’s a chemical imbalance and I have bipolar and I have a chemical imbalance in my brain and I shouldn’t feel stigmatised. I shouldn’t stigmatise myself, and I shouldn’t feel stigmatised by other people because I have a chemical imbalance.
So, we started to have acceptance of that, of it being a physical illness that manifests itself psychologically and that took away a lot of the pain and grief that I was feeling and it gave me acceptance, gradual acceptance of it. At that stage, I knew that perhaps the malicious mind monologue of self-pity and self-hatred wasn’t normal, but what exactly was wrong with me?
I broke down crying during a doctor’s consultation, when she figured out that the reason why I wasn’t eating was because I hated myself, and hated myself because I had a mood disorder called ‘social phobia’. This is a variant of depression that explained the years of why I curled up in a dark corner with a book whenever my parents dragged me along to dinner parties. Why I dreaded school assemblies in case I won an award and had to go up on the stage. Why I had panic attacks whenever I thought of the future and what was expected of me in a world that answered phones and knocked on doors. As the doctor handed me a pamphlet about social phobia, the bullet points on the glossy paper read like a script from my life. But I had to be in that room, salted eyes and frail with exhaustion, to hear those words and have them mean something to me. And to know what to do.
A doctor’s scribbling in a manila folder makes the situation real, but then what? I went home with my pamphlet and a video to show Mum. We watched it together and cried. She was relieved that I finally accepted that something was ‘wrong’ with me. Now it was time for action. I went on antidepressants and saw a counsellor twice a week. I was given therapy tasks to get me out into the world; small steps, like saying hello to my uni classmates, instead of blushing or muttering my way through tutorials.
After two years of medication, a regular exercise routine and counselling, I had my first job, was invited to parties and even had the courage to ask someone on a date. Thus, I managed to reach some semblance of normality. But I am an actor in the farce that is the ‘normal’ world. I find I lapse into negative self-talk if I go even a day without physical exercise, or am not challenged mentally at work.
One minute he was my hero and someone who I wanted to embrace, the next he was someone terrifying who I wanted to hide from and avoid altogether. I remember being confused by his symptoms. I realized that unmanaged depression has a devastating impact on people’s lives. Without treatment, it destroys friendships, turns marriages upside-down, and tears families apart. There is hope. Beating the illness takes time and is often a process of four steps forward and two back. Support is crucial. We all need help, someone to believe in us. It’s important that we stand united and help deal with life’s adversity.
I have experienced at least six episodes of depression, each one becoming more severe. The thought of having another episode still fills me with fear. And yet my life is good – I have an understanding partner and two great children, a good job, reasonable health, good friends, enough money and, significantly, plans for the future.
Recognising depression, and most importantly accepting it, has been crucial for me to be able to live successfully with it. This sounds so obvious, but, for me and others, this is hard to do because of the social stigma involved and a great sense of personal failure. Recognizing the condition in the early stages can be hard because of the usually insidious nature of the illness.
What I have found most useful in early detection is being aware and knowing my first signs, which are mostly physical. My body feels trapped in a slow-motion movie sequence and I begin to wake in the early hours of the morning. The longer this goes on, the more severe the depression gets and the more pervasive. Each time it happens, I go through the same difficult process of trying to fight it and not wanting to accept that it is back again.
I have found that being able to say ‘I suffer from depression’, even to myself, has a better effect on the way I view myself than saying ‘I am depressed’. By naming depression it takes on an identity outside of me and allows me to separate myself from the illness. Doing this allows me to acknowledge the symptoms of depression, knowing they are symptoms of an illness not my whole self. After all, I don’t say I am a broken arm, or I am a tumour, or I am the flu, or am glandular fever, or I am a toothache. I know that these conditions affect part of myself, not my whole self.
Unfortunately, with depression, there is a tendency to identify oneself with the illness because it affects one’s thought processes and one’s perspective, one’s way of looking at oneself and the world. Once I am able to name the depression, it is easier (but still not easy) to accept a task-oriented approach to addressing the symptoms.
Getting to this stage is difficult for me and talking with an understanding, non-judgemental person who is empathic and supportive and directive when I need direction is important for me. My partner and my GP have been wise and caring, allowing me the space to recognize what is happening without taking control. Having someone who understands this process and is patient enough to allow you to talk it through is invaluable.
When the depression finally lifted, I felt a new sense of self. It was a different me that emerged from the cocoon of darkness. It took time to get there, and it wasn’t easy. But I was ultimately enriched form the experience. I learnt a new lifestyle that is a great foundation for the rest of my life – good times and bad. I learnt about my inner strength and resilience, and about how simple things in life can sometimes be the most powerful.
Be gentle with yourself, and trust that this process will leave you with some positive outcomes such as greater insight and self-knowledge. Have courage and faith in your ability to steadily get through it – and one day you will look back, and see that the black dog was just a shadow in your life. Like a shadow, you have to look back to see it – so instead keep looking forward!
Names have been changed to protect privacy. The above personal accounts have been extracted from Navigating Teenage Depression and Journey’s with the Black Dog. The autobiographical stories in Journey’s with the Black Dog are written by sufferers of depression. The stories open the lid on this insidious and often silent disease and chart the journey from first onset to successful management. Inspiring and insightful reading from people who know exactly what it means to bring the black dog to heel.