An Unwinnable Tug Of War

Continuing on from my last post, I’m really struggling to climb back out of the pit I currently find myself in. My mind is full of unending doubts and negative assertions, and my body is in a constant state of anxiety. Time seems to drag, and my goal each day is to reach nighttime where I can sleep and find temporary respite. I’ve been dreaming a lot more than usual recently, and have found that these nightly imaginings are formed of idealised life events or pursuits: developing a relationship and ultimately having a family, being with friends and feeling like I belong, and being a child again with all the potential ahead and none of the burdens. Whilst these are pleasurable to engage with, the disappointment upon waking and realising they are not real brings with it a great sense of sadness.

The thing I’m finding most challenging is the persistent tug of war of that is occurring… on the one hand I want to be on my own and shut myself away from the world, whilst on the other hand I feel desperately alone with a unwavering worry that I am alienating my friends. It’s the biggest challenge of the illness, as there are so many contradictions, and conflicting emotions. Balancing a desperate need to reach out to people, with a heartfelt desire not to alienate those same people by being too full on, is a constant source of mental disharmony. When I’m at my most down I sometimes message people with perhaps a little too much honesty about how I’m feeling, and if I subsequently read into this that I may have upset someone or made them feel uncomfortable, then it only leads to more worry and anxiety. Unfortunately I can’t prevent this need to reach out.

It doesn’t help that the NHS ended my therapy last June before I felt I was ready to finish, and after consequently being re-referred by my GP, I haven’t heard anything from them for over 8 months. To say that I’m frustrated by this is the understatement of the year. I went back to the doctor today, to chase the re-referral for a fourth time, and his response was ‘oh, you should have heard something by now’. Thanks, that’s really helpful. With hope already funneling it’s way out of my body like sand through a sieve, this lack of purposeful help from the doctor does nothing to help curb the flow, and in fact just makes the holes in the sieve bigger, and the rush of sand quicker. If the very people who are supposed to help you cannot or will not, then how are you expected to carry on?

I’m going away for a few days now, which may present a chance to reflect. My worry is that it will only act as a temporary respite, and that the knowledge that I will be returning to the darkness very soon will be a burden. That’s assuming it doesn’t follow me away, which it has a devilish tendency to do. Whether it follows, or merely waits, I find myself running out of ways to deal with it, and lacking the  energy to go on fighting the good fight.

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Swamped

All around me are familiar faces
Worn out places, worn out faces
Bright and early for their daily races
Going nowhere, going nowhere
Their tears are filling up their glasses
No expression, no expression
Hide my head I want to drown my sorrow
No tomorrow, no tomorrow

Mad World – Michael Andrews & Gary Jules

—————-

How do you feel?

Lie: A little down to be honest, but I’ll be ok. Probably just the time of year.

Truth: I feel like my insides are tearing themselves to pieces. I feel like I’m standing on a stage facing a thousand people and my heart is going to burst right out of my chest. I feel like things aren’t, have never been, or never will be OK. I feel like I want to bawl my eyes out until there are no more tears left to shed. I feel like no one understands, none more so than myself. I feel like I am destined to die alone. I feel like I want to get into bed under the covers and never have to get out again. I feel like I want to throw the towel in. I feel like the light from the centre of the sun could not vanquish the darkness I feel inside.

It goes without saying that I’m not in a great place right now. I’ve been down this road enough times to know that eventually it will subside. But I’ve also been down this road enough times to know that it will happen again…and again. The resolve breaks with this knowledge. How can you expect to drag yourself out of a swamp, when you know that you will be back down in it’s muddy depths within a matter of weeks or months. It becomes too easy to give in and stop trying to pull yourself free.

Time has become a large focus. It’s a thought process of contradictions, on the one hand wanting the day to rush by and be over with, whilst on the other hand being scared witless at how fast the years are rolling by. Being 30 terrifies me, not because of the age itself, but because the milestone reminds me of how much of my life I have wasted, or rather my illness has wasted. I want to go back, and have another shot at things. I find myself not having experienced, or having dealt with certain things that I should have in my teens. I can’t help feeling out of place, and not belonging, and terrified of the past, present and future. On the one hand I want to run away and hide from the world, and on the other hand I want to shout from the rooftops ‘please like me’. I simply don’t know what to do. All I can do is get back up again in the morning and carry on. The Garden of Eden must be out there somewhere. I’m just too tangled up in the undergrowth to see it.

Art Imitating Life

Cinema is a big passion of mine, as it is one of the few pursuits that allows a total escape from reality, and a departure from everyday worries and emotional pain. Books and TV also provide this path to escapism, but cinema is the master of this craft as it is a full sensory experience, where you can forget within moments of the opening credits that you are sat in an air conditioned building in Tottenham Court Road. You can leave your worries and baggage at the door, and inhabit a new world for the next precious few hours.

There are two types of movies for me, the ones that engage me, and the ones that affect me. A good proportion of films that are released act as a way to pass the time, and can excite, shock, scare and allow the eyes to widen with wonder. However, there are also those releases that deeply affect the way I feel, whether because they reflect an aspect of my life, or mimic the way I am feeling at that particular moment in time. In the last few weeks I have seen three films that have had this effect on me; La La Land, Manchester By The Sea and T2 Trainspotting, all to varying degrees. The three films couldn’t be further apart in their stories, settings and characters; however they very perceptibly share some common human themes: regret, nostalgia, loss of hope, ageing and relationships. At various points throughout these three movies I felt deep wells of sadness, poignancy and sorrow, not just at the predicaments the characters faced, but also because I could relate to the thoughts and feelings that the characters were experiencing. Particularly the ideas of nostalgia and regret, as looking back and imagining how things could have turned out differently is a constant source of discomfort for myself. In La La Land there is actually a montage where a character pictures how a particular moment in time, if tackled in a different way, could have led to a completely different life, and it felt like the director had plucked  these series of thoughts straight out of my head.

Movies can act as powerful emotional triggers, and have a unique ability to affect you to the very core. Why do people watch sad films, especially people like myself who suffer from depression and emotional struggles? To the outside it may seem a tad perverse intentionally putting yourself through the emotional ringer, and surely it would be preferable to watch a happy and uplifting movie? It’s very difficult to answer this, but I can posit a few theories. Firstly, there is a fascination with seeing how characters navigate through dark episodes and experiences, which can in turn make you feel like your own story is being represented upon the big screen. They can help us analyse our own foibles and emotional frustrations, without having the pain of actually going through them ourselves. Perhaps it makes us feel like we are not alone in our struggles, and can engender a sense of reflection that we all need to engage with at one time or another.

It’s also true that any strong emotion makes us feel more alive. It’s not just exercise that produces endorphins, but also strong surges in emotion, whether positive or negative. It’s perhaps inevitable that we are drawn to stories that reflect our own emotions; and a feeling of fiction induced sadness, whilst uncomfortable at the time, can lead to assurances that we have an ability to feel, and an ability accept our emotions. For instance, I am not going to be able to adequately relate to an action film, or a sci-fi adventure, as I have no experience of these topics, but a film involving a character struggling with their emotions, that’s something I can get on board with.

Maybe there is credence to the notion that by seeing characters experience, deal with, and possibly overcome certain life events and mental strife can give us hope that we are potentially able to do the same. It might make us feel less alone knowing that other people are thinking the same thoughts, and experiencing the same lows, albeit in a fictional setting. This may not lead directly to an improvement in mental health, but at least it could foster a sense of satisfaction that our story is shared by others. It is perhaps inescapable that when you are in a period of depression, you are drawn to media that reflects your own personal mental state, rather than ‘uplifting’ music or films which counter-intuitively would not help improve your mood, but rather emphasise how far away you are from the faux happiness exuded by these pieces of work.

These are just theories though, and I can’t categorically state why emotionally challenging art causes such a draw. All I know is that these 3 films in particular deeply affected me, and left me with a sense of melancholia that persisted for some time after leaving the cinema. Not necessarily in an unpleasant way, but rather as a way of inducing a strong sense of reflective contemplation. My only hope is that one day I will have no desire to watch these type of films, because they will no longer be able to act as a mirror to my own life, and will instead merely act as a reminder of a previous dark time. That is the hope anyway.

 

 

Katelyn

At the weekend a news story went viral about a 12 year old American girl taking her own life and live streaming the whole event on social media. Katelyn Nicole Davis from Georgia recorded a 42 minute video in her backyard on 30th December, featuring a heartbreaking explanation to camera as to why she was deciding to end her life, followed by her apparently hanging herself from a tree in the fading daylight. The news story focused upon the fact that the tragic event unfolded live on the internet, with the potential ramifications of this, and the inevitable difficulties in attempting to take the video down, as there is no legal obligation to do so (although the moral obligation is undisputed). Whilst the manner of her suicide being carried out for the world to see is clearly a significant concern, it was not what stuck with me when reading the multitude of articles that sprang up on Saturday. Clearly issues of social media and the ways that people live out their lives on the web is a big feature of society in the 21st century, and one that cannot go unanalysed. However, what concerned me more was that a 12 year old girl felt that her only option was to cut short her life, with all of it’s undeniable potential, because she believed she had nowhere else to turn to. In an age where we can put a man on the moon, travel to the other side of the world in less than 24 hours, and discover cures for natures most deadly of diseases, how can we find ourselves reading about a little girl in so much pain and anguish that her only option was to cease living?

I haven’t watched the video myself (why anyone would want to I can’t imagine), but some of the articles showed pictures and featured transcripts of her final words. Apparently she was abused mentally and physically by her step father, as well as having suffered with depression and a tendency to self harm for many years. And all that by the age of 12. It’s impossible to know exactly what was going on within her mind, and what support (if any) she was receiving from her family and friends. But what is clear is that her final words are both chilling and devastating:

“I’m sorry – I’m sorry that I’m not pretty enough…I’m sorry I came into your lives just to get out of it this quickly. I’m sorry for everything. I’m really and truly sorry for everything. But I can’t do this. I’m sorry…I’m sorry everyone. I’m sorry I let this depression get to me.”

See how many times she apologises. She has been the victim of abuse, and of a terrible illness, and yet she is the one saying sorry. Society should be apologising to Katelyn for letting her down. Depression really is such an irrational illness, which causes you to despise and blame yourself for everything. She has allowed the dark thoughts and feelings of hopelessness to infest and take over her mind, and this is something I can relate to as it is a daily challenge that is faced by many people. But what is impossible to grasp is how for a 12 year old girl these thoughts and feelings prevented her from seeing any other way out.

We live in an incredibly connected world, in which communication with people in the far reaches of the planet is possible at the touch of a button. However, this network of connectivity can further highlight the feelings of loneliness or isolation that the mentally vulnerable feel, rather than providing an outlet for compassionate consideration. The loneliest of moments are often not during times of being on ones own, but rather when one is surrounded by others, both physically or virtually, as you are privy to the kinds of human relationships or successes that you fiercely yearn for. Rather than a casual sense of longing that you may feel when alone, this becomes a source of desperate painful longing when you see these relationships existing in the real world, but just out reach.

Depression is without doubt this centuries biggest health crisis. It’s not good enough that someone may have to wait 12 or 18 months before getting therapy that may save their life. It’s not good enough that systematic child abuse goes unchallenged and unpunished. And it’s not good enough that depression plays a part in at least 50% of all suicides, and that the statistics are going in the wrong direction. I know that every time I feel that the darkness is enveloping me, or that I am not strong enough to go on coping, I will think of Katelyn. We cannot let this illness keep on killing, and we have to ask ourselves some very stark questions. Is enough being done? No. Is there a quick and obvious fix. Not really. Do we need to do something at all costs? Without question. The tragedy is that for Katelyn it is already too late.

Walking The Tightrope

Have you ever played one of those 2p coin pusher arcade games? All it takes is one little coin being pushed through a slot to cause everything else to fall apart. That sums up how I feel. Now more than ever it seems as though every day I’m walking a tightrope, and I’m one little nudge away from falling. The constantly changing mood is in many ways worse than a persistent period of feeling down, as the ability to predict what my state of mind will be from one day to the next becomes impossible.

It’s amazing how tiny things can cause the already unstable equilibrium to become seriously unbalanced: a throwaway remark from a friend, an image on facebook, a memory or thought coming to mind. It’s not these things themselves that cause the spiral downwards, as often they are meaningless, insubstantial or wrongly interpreted, but rather they act as the final little push needed to facilitate the nose dive into turmoil. When a particularly strong sea wave causes a rock face to crumble and fall into the sea, it’s not that single wave that did the damage, but rather it was the years of constant battering that caused the rock face to weaken. The last 7 days have featured the highs of laughing with friends at Christmas parties or in the office, to the lows of shutting myself in the toilets and failing to hold back the tears.

A significant cause of anxiety is a perception or concern with how others view you, and generally these preconceptions are either false, or hugely exaggerated. However, there is one person I know that truly despises me, and that is myself. I find that the loathing I have for myself is only matched by the desire I have to make others happy. It may be a cliche, but how can you expect anyone else to love you when you don’t even like yourself? More than the contempt I have for myself is the constant fear I have of it alienating friends, and all I want to do is constantly apologise for how I am to be around at times. It’s too important that I don’t lose these people…the consequences could be devastating.

As previously mentioned in other blogs this time of year is a particularly difficult one, and whilst I got through my birthday without the immediate difficulties I had anticipated (due in part to the kindness of certain friends in making the day feel special), I certainly feel the affects as a delayed reaction. As 2016 comes to a close it should present everyone with a sense of optimism for what 2017 will bring. For me if merely fills me with dread of another year of my life ticking by, and being nowhere nearer to feeling any semblance of happiness or peace. Is it really worth another year of pain? On 1st January I will have been writing this blog for 1 year, comprising almost 50 posts. The fact that from blog 1 to blog 50 I am still writing the same sorts of things is a testament to how frustrating this illness is, and epitomises how difficult it is to remain hopeful. Whilst it’s true that “to be alive is to have hope”, the longer time goes on the less alive you feel and therefore it’s not just the hope that you crave, but the feeling of being alive.

 

Trigger (Un)Happy

When finding myself in the midst of particular difficult period I often get asked ‘what triggered it this time?’ This is a perfectly legitimate question, and one that a non-sufferer would be completely justified in asking. Of course there are some obvious triggers, such as big life events like bereavements or breakups, that are bound to cause a whirlwind of emotions and a downward spiral into depression. However, for the majority of the time there are no rational or tangible triggers that precipitate the relapse; instead it appears out of the blue, like a bullet train rocketing out of a tunnel. In some instances it builds up gradually before it reaching its painful crescendo, but on other occasions it hits you full pelt in the stomach, with no warning or let up.

According to this the article Top Relapse Triggers for Depression & How to Prevent Them “the risk of recurrence — ‘relapse after full remission’ — for a person who’s had one episode of depression is 50 percent. For a person with two episodes, the risk is about 70 percent. For someone with three episodes or more, the risk rises to around 90 percent”. That statistic doesn’t provide much comfort, as clearly the chances of relapse increase with each depressive episode that occurs. Putting it bluntly, things will only get worse.

The article proceeds to suggest 3 potential trigger categories, and how they can manifest into a period of depression:

Not Following Treatment

The article proposes that “The biggest issue regarding relapse has to do with children and adults not following through on their treatment plan… this includes anything from skipping therapy sessions to missing doses of your medication to ending therapy too soon”. I can certainly relate to the negative effects of ending therapy too soon, although through no fault of my own, but rather the underfunded and oversubscribed NHS. If these support structures are not strong enough, or are fragmented and disturbed, then it undeniably ensures that a relapse is increasingly likely. The article also suggests that “while your life may involve psychotherapy, medication and the need for a protective structure that keeps your illness at bay, also realize that you have passions, desires, gifts and talents that require just as much attention.” It is all to easy for these facets of life to fall by the wayside, which consequently prolongs the negative cycle.

Ruminations

“Negative self-referential ruminations play a key role in recurrence… for example, individuals with depression tend to dwell on their (supposed) flaws and failures. They also may view neutral events with a negative lens.” Ruminations are a big deal for me, allowing my mind to dwell on my insecurities, and conjure up thoughts of sadness, hopelessness and a misguided longing for a perceived better life. This trigger is particularly problematic to tackle, as the thoughts come out of the blue, and linger sometimes for days or weeks. Unfortunately the mind cannot be switched off, and the more time you spend alone, the more the thoughts penetrate deep into the brain, eating away at you, with little or no regards to the consequences. Despite being a cliché, it’s like being trapped inside a prison, with only your thoughts as the ruthless prison guards for company.

Knowing Your Personal Vulnerabilities

“Triggers may be very specific to each individual’s situation, since all of our emotional responses are unique to some extent…learn how to recognize the who, what, whys and whens of your emotional and physical life.” For example particular dates or times of the year can prove to be difficult and act as triggers for a depressive state of mind. For me personally my birthday and Christmas are particularly troublesome as they can provoke the ruminations mentioned previously, and cause them to take hold, whilst also proliferating ideas of another year having passed by and another year when I still feel trapped in a deep well of unhappiness. Regret, frustration and sadness are emotions that become second nature. The article also notes that “If you find yourself excessively fatigued, irritable, having trouble eating or sleeping, you might be in the midst of a trigger event.”

Identifying certain triggers doesn’t really provide much assistance or solace. I sometimes have anticipated an event 8 months in advance as a potential cause of anxiety or depression, and despite this warning, it plays out exactly as I had envisioned. Plus the fact that there are so many invisible and intangible triggers at play ensures that any attempt to fight the process becomes virtually impossible. The article concludes that you “don’t measure your success living with depression on whether relapse happens or not. Instead, realize that if relapse occurs, true success comes from rising after the fall…Fall down seven times, get up eight.” The difficulty comes in the fact that falling down is so easy, but getting back up again requires reserves of energy and determination that are in very short supply.

A Silent Killer

We are currently in the midst of some important dates: yesterday was International Men’s Day, and the whole month of November is the flagship period of the Movember Foundation. What both of these events have in common is their dedication to raising awareness of men’s health, and in particular focusing upon mental health and suicide prevention. The theme for this years International Men’s Day was Stop Male Suicide, and whilst the moustache growing month of November is what is most closely associated with the Movember Foundation, it is in fact an organistion working all year round to tackle men’s health issues, including suicide prevention. The statistics on the subject are frightening. Around the world on average we lose a man to suicide every minute of every day, and three out of four suicides are men.

It’s hard to reconcile why there are such a high proportion of suicides among males. Perhaps it’s simply that men are a lot less comfortable with opening up about their feelings and emotions, and about mental health in general. There is a lot pressure within the media for men to act tough and manly, and to not show any emotion. Men may consequently feel self conscious about admitting their vulnerabilities and frailties, misguidedly believing that it depletes their levels of masculinity, and therefore makes them appear unattractive, weak and somehow inferior. It’s often been the case than men just ‘brave things out’, ‘get on with it’, and keep their emotions to themselves, because they are ‘men’, and that’s what ‘men’ do. However, the bravery comes from opening up and talking about mental health, rather than by burying it deep down under a facade of pretend happiness; a pretense which in my own personal experience results in the volcano inside consistently being at the point of eruption.

In every country in the world (bar China where its equal) the male rate of suicide is higher than that of women, and in Russia the rate of male suicides is 6 times that of women. The statistics are staggering, and its not an exaggeration to say that mental health is truly a global and silent killer. For the first 22 odd years of my life (before I first went to the doctor) I would rather have cut off my own arm than talk about what I thought was ‘my big weakness’, and the idea of recounting my experiences in a blog or to camera would have been bordering on the ridiculous. However it soon becomes apparent that the more you talk about it, the easier it does become, and with the support of those around you it can be a vital step towards changing those terrifying statistic above. I’m not saying that merely talking about mental health will solve everything, as this is far from the truth, and medication and therapy will play an important part, and there will be many bumps in the road along the way. But at least you are on the road, and haven’t felt that you have needed to leave the path as so many men and women tragically have. As a society we need put the treatment of mental health up there with cancer, and provide as much funding and study as we possibly can to make people sit up and take the illness seriously. If not, then I fear it will get a lot worse before it gets better.

Pouring money into the NHS, supporting children and young adults with mental health treatments, and funding charities like The Samaritans, Calm and Movember are undoubtedly crucial actions that need to take place. However, a simple act of asking someone how they are, or listening to them talk about how they are having a bad day, can be all that is needed to push someone into opening up, and make them realise that they are not alone. It is infinitely more difficult for someone to admit to their mental health issues when they feel that they have nobody that cares or who will listen to them. If we can make this world a place where opening up is not a challenge but merely part of life, and where the idea of depression being a stigma is a thing of the past, then we will be on the way to cultivating an environment where we can really begin to tackle this silent killer in the decades ahead. This may seem like a monumental task, and a impossible feat, but after all, a journey of a thousand miles begins with a single step.