Unwanted Change

A few months ago we were told that The London Studios, where I have worked since 2013, will be closing down next April, resulting in redundancy of the whole department. This wasn’t an immense shock and it had been on the cards for some time, but it was still a surprise that it was happening so soon. I’ve kept reassuring myself that I’m “not too worried”, and that “change might be a good thing”. It certainly has been one the few things that hasn’t affected my mood in a negative way. Or so I thought. On reflection, I’ve probably underestimated how the next 12 months are going to affect me, and it’s only in the last few days that this realisation has hit me.

A person like myself relies on stability, and the concept of change combined with the breakdown of routine, can be an irrefutable source of anguish and despondent ruminations. Depression thrives amongst the unknowns, the what-ifs and the disruption of the equilibrium. I will have been in my job for 5 years, which is a significant period of time for anyone, and whatever else has been going on in my life, it has provided a security and comfort the like of which is only fully appreciated once you realise that it is ending.

The job itself is not the thing that concerns me the most, as it will hopefully provide me with a necessary push towards a different challenge, and an understanding of what it is that I want to do with my life. I can become too comfortable, thriving on the stability and lack of change, which consequently prevents me from progressing. In addition to this, I’d like to believe that I have enough experience to enable me to find another job in the future, and there will be opportunities out there waiting to be found. No, the thing that bothers me the most, and that has been swirling round my mind like smoke around a bonfire, is that my job has essentially been my life for the last 5 years. For someone who lives alone, and does not find socialising all that easy, work essentially becomes my existence, and the people I work with my family. I have made some very good friends through my job, who I get to work with every day, and the knowledge that this will all end has made me feel extremely dejected, as I recognise that it will leave a great hole in my life.

Nostalgia and melancholia, in my experience, play a significant role in depression. The realisation that things will not always be as they are, and that people will move on, is an unwanted facilitator of sadness. People get married, move away, get new jobs, have children, and thus things are always changing, and constantly in flux. In years to come I will look back at the last 5 years, and this snapshot in time will merely be a memory. It will no longer be the present or the future, but will be deeply entrenched in the past. The idea that ‘all good things must come to an end’ is true, but this recognition makes it no easier to handle. When something is happening you never imagine that one day it will be over, and that it will only exist as a distant recollection.

I guess this notion of change also causes me to focus on my own place within the world. In 12 months time people will move on and still have lives they live, jobs they work and families they bring up. But I see myself as being stuck, treading water, and that whilst everyone will move on, I will remain standing still in the same spot. This sense of nostalgia for the past coupled with a disappointment of the prospects for the future, is not simply evident within this particular scenario. It is ever-present throughout the entirety of my life. Thoughts, memories and dreams all become entangled, and it’s impossible to discern how to turn them into a source of positivity, rather than as a reminder of times gone by or perceived failings of oneself. I’m so often stuck in the past, that I forget about the present that is passing me by, and the future that has yet to be written.

 

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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.

Living To Die Or Dying To Live

I have never considered suicide. I want to put that out there straight away. Yes I have often thought ‘is this really worth it?’, or ‘why can’t I have a different life?’ when feeling particularly low, but I’ve never thought about ending things all together. There are probably a number of reasons for this outlook, such as the fact that my illness is not as severe or debilitating as other sufferers of depression, and its probably accurate to suggest that those who feel that suicide is the only option are severely ill, and suffering deep emotional turmoil. Another possible reason is that my idealised desire to get better, have a happier mind set and sense of fulfillment, is my overwhelming priority, and consequently I have no thoughts of ending my life, but rather changing the one I have for the better. Whilst this may seem like a pipe dream for the majority of the time, it is enough of a glimmer to keep on going. It may seem obvious, but taking ones life means giving in to the idea that there is no hope of getting better, and I can never envisage getting to that point where all other options have expired.

This 2015 article from the Guardian offers a stark reality of suicide rates in the UK, and in particular those amongst men. The shocking statistics show that suicide is the UK’s biggest cause of death in men under 45, and that in 2014 there were on average 12 suicides per day. 75% of people who take their own life are men, which I was rather surprised to read, but perhaps less shocked that 90% of suicide victims suffer from a mental illness or psychological difficulties. The article suggests that men’s reservations about discussing thoughts and feelings, combined with a sense of embarrassment and inadequacy, plays a significant role in the high rate of suicide. Jane Powell from CALM (Campaign Against Living Miserably ) gives credence to this, stating that “we see from the research that men feel they shouldn’t need such support, that they are failing as a man when feeling suicidal.” I recognise the credibility in this argument based upon my own experience, as it was extremely difficult to open up initially about my thoughts and feelings,  and the illness in general, and I find that the written form is the only method that allows me to be 100% honest and open. I find it significantly more challenging to talk about the issue in person, and I often clam up, and claim everything is ok in order to avoid the embarrassment or awkward questioning.

Another pertinent consideration, that I can relate to personally, is that its verging on the impossible for men to open up to other male friends. I find it inordinately more attainable and reassuring to open up to female friends/colleagues, rather than  to males. As the father of a suicide victim states in the article “as a bloke, if you go out with your mates, you drink a few pints, you talk sport, you might moan about the missus, but you won’t talk about your feelings, about how you can’t cope. Your mates would run a mile. They don’t know how to talk themselves. Men don’t, it is not seemly”. Whist I believe he is being slightly flippant, and overgeneralising and stereotyping the issue, I do support the perception that the predicted reaction of other people is a significant cause in the bottling up of thoughts, and precipitates an inability to open up about the internal struggles that may be being suffered. Despite the fact that perceptions have significantly improved, even the last 15 years or so, and stigmas are slowly starting to be challenged, the brutal truth is that men don’t talk to other men about these types of issues. I certainly never have, with the exception of close family, and would feel deeply uncomfortable and disconcerted, which is why its fortunate that most of my friends and colleagues are girls!

The 64 million dollar question is what more can done? I truly believe that the most beneficial and potentially life changing way forward is to raise awareness, break down the stigma attached to mental health, and encourage role models to inspire those who may feel they they are alone, and encourage them to start talking about their illness. Organisations like CALM are crucial, and we need to give them as much support and funding as we can. Similarly, if more celebrities, or people in the public eye, come forward and describe their experiences with mental health, then I am convinced it would lead to sufferers gaining the confidence and incentive to talk about their experiences, without fear of embarrassment, isolation, or ridicule. These figures of inspiration can also be on a more local level, such as ambassadors within schools, workplaces, clubs etc. They can act as a beacon of hope for those who are unable, or unwilling, to open up about their experiences.  A significant reason for starting this blog was to try and create awareness, and also as a way of talking through and examining my thoughts and feelings, which I wouldn’t have the confidence to do in a verbal or one on one setting . It’s undeniable that the rates of suicide won’t fall if nobody is talking about the difficult issues, and meaningful honest conversations are crucial and severely lacking  in schools, workplaces and society in general. The ultimate goal is to get people to a place where rather than living to die, they are dying to live.