A Fractured Mind

The last two or three weeks have been my worst of the year so far. I feel like I’m in a never-ending dream from which I want to wake up from, unable to live each day in the present, instead seeing everything as though through a frosted window. As usual there is no specific cause of the downward spiral, or at least none that I can recognise. Sometimes there may be a tiny unrelated thing that happens (something I see, something I think, or something someone says) that may subconsciously act as a catalyst, but often there isn’t even this straw to clutch at as a way of explaining what is going on. If consciously or subconsciously there is a cause of my mental state, then I think of it as a tiny stone that creates a small crack in the windscreen. That crack might start off small and insignificant, but it then highlights a weakness in the rest of the glass, and before you know it the entire windscreen is shattered. The stone is irrelevant, or often unrelated, and it merely precipitates the already weak glass in succumbing to destruction.

Why now has the depression and anxiety got hold of me again? I haven’t been off work sick at all for over 6 months, and therefore why does the inevitable always happen and I find myself getting dragged down again? I think firstly, it’s the time of year. Not the weather or the darkness, as I have always preferred this season over the long summer months. It’s more the Christmas build-up, along with my birthday, that I always seem to struggle with. The weeks leading up to Christmas are full of celebrations, parties, get together and so on. I find these extremely difficult, and they always leave me feeling down, isolated, and empty, as well as inciting heightened anxiety before, during and after. It’s not that I don’t want to enjoy this period (Christmas has always been my favourite time of year), but I think this stretch of time (which coincides with my birthday) provokes in me, again consciously or subconsciously, a reflection on another year passing, another 12 months where my illness hasn’t got any better, and where I haven’t succeeded in the personal life milestones that I want to achieve. This period can act as a trigger to self-rumination and contemplation on how I see myself when compared to others, and in turn how I predict they see me, which is no doubt hampered by the proliferation of social media.

It’s also a time of year where everyone seems to have fun, let loose and enjoy themselves. This only serves to highlight how I am unable to mirror these emotions and reactions, and how any party or celebratory event always leaves me feeling sad and empty afterwards. It’s not merely the anxiety of being in these large gatherings or events, it’s more the fact that I desperately want to be like everyone else and able to have a good time and enjoy myself, whereas in fact I feel like I’m standing outside a window, looking inwards at everybody else, always prevented from feeling part of it due to my mental make up. The alternative, which is often taken, is to lock myself away on my own, but this brings it’s own problems in the form of loneliness, isolation and regret. It’s a lose-lose situation.

Despite all of these possible reasons for this particular ‘episode’, it’s also a fair assumption to say that I’m down now just because I am. In many ways the illness doesn’t conform to particular time periods, or months of the year, it simply comes and goes as and when it feels like it. It’s not as though it only happens at this time every year. Maybe its just the fact that when it does happen the feelings are made all the worse by the knowledge that it’s supposed to be such an enjoyable time of the year, and the sense of missing out inevitably rears its ugly head. It’s the whole chicken and the egg argument. Does the depression cause the difficult time of year, or does the time of year cause the difficult period of depression.

As I sit writing this my heart is racing, as it always seems to be in the height of a depressive episode. It’s partly the anxiety, and partly the 3 coffees I’ve had to try to stay awake. I was close to ringing the Samaritans earlier, but just couldn’t face talking to a stranger, and having to explain to someone things that even I don’t understand, like why I’m feeling like this. It’s the sensation of being on my own (even when surrounded by people) that gets me the most, and the realisation, as another year of my life comes to a close, that the illness has made me unlovable, probably indefinitely. If only my windscreen was stronger, and the small stones were launched less frequently, then maybe the breaking and rebuilding of my mind wouldn’t have to happen so often.

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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.

Trapped In The Mind Prison

I stared at the blank screen of my computer tonight for about 30 minutes, the blinking cursor acting as some sort of hypnotic device sending me into a mindless stupor. I couldn’t think what to write, a combination of the way I’m feeling, mixed with the desire to avoid repeating myself and appearing like a broken record. But at the end of the day, depression is predictable in its repetitiveness, and like the changing of the seasons, it follows the same warning signs, same patterns and same resulting feelings and emotions.

Only a few blog posts ago I was quietly optimistic about exercise potentially proving to be a help, and yet since that blog I haven’t been to the gym once, a result of the time restraints of returning to work, as well as a lack of energy or motivation which is symptomatic of the illness. This epitomises the way that little nuggets of hope tend to be offered, and yet they ultimately fall by the wayside, disregarded and discarded, the fleeting glimmer of positivity a long forgotten memory. Even in a single day there can be a momentary thunderbolt of manic positivity, which can almost instantly be distinguished as the negative thoughts force their way in, and infest the mind at a frightening speed. In some ways these rollercoaster days are worse than a solid day of low mood, as you have no idea where you stand.

The aftereffects of a horrible weekend have followed me into the new week, and the feelings latch on to me as I try and drag myself free. After spending a significant amount of money on going to a friends wedding in Wales, I felt so bad on the Saturday morning when I woke up that I had to get the train straight back home, missing the wedding and the rest of my trip in Wales. At the time the money didn’t seem important, I just had to escape and avoid suffocating in the feelings that were overwhelming me. Added to that was the guilt, self loathing and sense of weakness which followed. How can you explain to someone why you had to leave, how could anyone be expected to understand. Especially when I don’t even truly understand myself. It’s impossible to grasp the necessity for escape unless you have experienced it for yourself.

Another frustrating reality is how an image or experience can provoke different thoughts and emotions depending how you are feeling at the time. For example if chatting with a friend who describes how they are going out with their boyfriend/girlfriend at the weekend, or about a holiday with friends that they have booked, the reaction to this can depend upon your current state of mind.  If you are in a good place then this has little effect upon the mind, and you are able to engage perfectly well in the conversation. However, when already feeling low this simple act can produce only negative thoughts and feelings, such as ‘I will never be happy myself’ or ‘no one will ever love me’. It’s like the chicken or the egg scenario. Does the conversation/experience trigger the low mood, or does the low mood trigger a negative reaction to the conversation/experience? The depressed and anxious mind is busier than Oxford Street on a Saturday afternoon, and you cannot prevent negative thinking or constant mental examination and stimulation.

There’s not a lot than I can do about this, as I can’t shut myself away from all of the causes of depression or anxiety, as even if I found myself in a locked room, my mind would still be my dutiful passenger, never allowing me to switch off or power down my thoughts. I sometimes wish that the mind had a ctrl-alt-del function and I could shut down my thoughts and just be able to exist in blissful ignorance, even if just for a short while. Sleep is the closest thing that comes to that, but the problem with sleep (when it comes) is that it provides only a fleeting leave of absence from the prison cell that is the mind, and once the 7 or 8 hours of oblivion are over, you wake up and are still locked behind bars, and still encased in your mental cell. Whereas in the past I have hoped that it may only be a short sentence that I have been handed, it now truly feels like a life sentence has been afforded me.

Exercising the mind

In the last few weeks I have become an addict. I cannot go one day without my fix, and each day I need more than the previous day as my body has become tolerant and needs a higher dose to produce results. Thankfully this pursuit that I am referring to is simply exercise.

During the last few years I have joined the gym on at least 5 occasions, and whilst initially attending 2 or 3 times a week, within a few months (6 if I’m lucky) I have quit, telling myself that I don’t have time at the moment, and I’ll rejoin at a later date. The positive effects of exercise are universally paraded around to the point that its nauseating, but you can’t get away from the fact that it is good for body, mind and soul.

For me the physical effects of the exercise are incidental, an inevitable side issue that I don’t spend a great deal of time concerning myself with. It’s true to say that for someone like myself who has zero self confidence, extremely low self-esteem and a perception of other people viewing me negatively, the idea of getting into some kind of shape certainly appeals. Whilst mental health is so often out of your hands, you can’t use that excuse for physical health, and if I could look myself in the mirror and with anything other than revulsion or disappointment, then that would certainly be a welcome change. However it’s the mental effects that interest me, rather than the physical benefits.

Engaging in an intense workout has two benefits. Firstly, during the session itself the sheer act of pushing my body to its limit leaves virtually no energy reserves or mental space to focus on other worrys, thoughts or feelings. You simply exist in the moment, concentrating only on putting one foot in front of the other, or pedaling that extra few miles, trying with all your might to not only reach the pain barrier, but to burst through it and come out the other side. I don’t listen to music at the gym because I enjoy the fact that it is the only quiet time of the day within my mind, and I can temporarily put everything else on hold, and just exist in that moment.

The other aspect is the temporary euphoria that shrouds the body after a work out. Exercise produces serotonin, the chemical in the brain that affects mood and of which a person with depression has a diminished supply, and which antidepressants similarly try to increase. This clearly attests to the positive feelings post-exercise, but the problem lies in the reference to it being ‘temporary’. Within an hour at most (in my personal experience) the effects have worn off, and the the thoughts and feelings that have taken a brief rest begin to infest their way back in, burying deep into every pore, and ensuring that any sense of euphoria is all but a distant dream. The exercise induced tiredness, added to the medication and mental maelstrom induced exhaustion, precipitates the depression coming back all the more easily, as the flimsy barriers have little strength to resist.

Exercise, like alcohol or drugs, only provides temporary relief, and can only numb the pain or fill the emotional gap for so long. Whilst exercise is obviously a resoundingly positive pursuit, when compared to alcohol or drugs, as a way of dealing with pain, it still only provides a short term fix. This is obviously not the case for people that engage in physical exertion for fitness or appearance reasons as the results can last long term, but if you are pursuing exercise whilst praying it will help with your mental health (as I have)  then it can be only a diminutive stop gap between two difficult moments, rather than a way of vanquishing those troubling moments altogether. It is generally considered that people who are addicted to alcohol or drugs are trying to fill a void in their life and also attempting to escape their reality. For me the exercise isn’t an answer to my internal pain, but merely a way of coping until an answer does present itself (should that day ever happen). If for an hour every day I can feel slightly free, and distracted enough to be able to briefly put my anxieties and frenzied mind aside, then I will keep doing it as an hour is better than nothing. But I cannot bring myself to the resolution of this being much more than highly constrained positivity when there are still 23 hours in the day to feel lonely, insignificant and bereft of hope. But beggars can’t be choosers.

Brutal Truths

A short post today as I am struggling for inspiration and also the energy (both physical and mental) to conjure up any lucid and meaningful thoughts. I’m very conscious of not wanting to repeat what I’ve said in previous posts, but sadly the repetitiveness of the depression ensure that every day the same thoughts and feelings surface, almost predictably on time, and with no regard for how they will affect the already fragile mind. It feels as though you are stuck in quicksand, and the effort of lifting a leg out is irrefutably exhausting, and also utterly pointless, as your next step results in being pulled back down once again into the mire.

My determination to do the right thing is unwavering, and I fulfill all of the suggested techniques, modes of thinking and action, possible distractions and potentially positive pursuits of my time, but to no avail. Any occasional relief is temporary, and a self imposed (and circumstance imposed) sense of isolation and its subsequent feeling of ‘friendlessness’, precipitates a disconnect from reality and from the fundamental human emotions and ideals. A contradictory factor of depression is that you can often not even feel sadness, frustration, or any feeling at all, as you seem to become a emotionless shadow of your formal self.

Exercise has become an important force for distraction, and also mental clarity. Not only does it provide a temporary euphoric glow as a result of pushing your body to it’s limits, but it also produces the thought that you are doing something positive, albeit for the very briefest of moments. When engaged in this physical activity, you have little time or energy to think of anything else, and this short term relief (matched only by dreamless sleep) is like a drug, the resulting high something that you cling onto, but which sadly fades away once the exercise ends.

I think the most damaging aspect of my mindset is that I spend much of my time thinking how I can gain the approval and affection of other people, or what I can do to ensure that people realise that I’m reaching out or wanting to gain solace in their friendship, rather than thinking of how I can treat myself better. I tend to put my own wellbeing to the back of the queue, and I guess this is also due to my self imposed low opinion of both my worth and also of my value as a person. I begrudgingly concede that the only way to help myself is to take more care of my own health, and to prioritise my own wellbeing above all else, as only then will I be in a suitable position, and have the necessary levels of strength, to finally free myself from the quicksand altogether. But alas, the irony of this supposed truth, is that I cannot do that alone.

Fighting The Fog

It’s been a month since my last blog post, mainly due to the fact I have been having a markedly difficult time and consequently have possessed very little energy or motivation to write anything, and no inspiration to formulate any coherent thoughts. After having been off work for almost 3 weeks it has been an incredibly frustrating period, although sadly something which I am all too familiar with. As my most recent blog posts made apparent, I had been heading down a steep slope for some time, and the inevitably that the ‘Black Dog’s’ clutches would eventually pull me fully down was perhaps obvious for all to see. When it gets particularly bad I have no mental or physical energy left to deal with the day to day, and it’s increasingly challenging to be around people, as I so desperately want to be part of their lives, but am unable to. It probably didn’t help that my weekly counseling sessions that I had been having for the last 10 months had come to an end, and so it felt like there was no outlet or support base for me within London, which probably instigated the implosion (obviously my family were supportive from back home).

One of the most commonly asked questions is ‘what was the trigger’ and most of the time there isn’t a noticeable one. It causes me great frustration that I’m unable to put my finger on what initially sets off an episode, because how can you fix something when you don’t know what is broken? Sadly one of depression’s key features is that often it rears its ugly head without warning, and completely out of the blue. This can be because the thoughts or feelings that precipitate it are so unconscious and so deeply ingrained that without deep psychological analysis it’s very difficult to recognise them. It’s pertinent to note that depression is also caused by a chemical imbalance in the brain (a reduction in serotonin levels) and therefore this ensures that the mood levels are so unpredictable, and prone to fluctuation. Of course there are big life events that people experience (bereavement, loss of job, breakup of relationship) that are very obvious triggers, but for me 95% of the time the black fog comes without warning, and there is very rarely any sunshine to burn out the heavy mist that envelopes me.

I started reading an interesting book on depression and mindfulness (before my motivation even for that deserted me) which posited an interesting theory regarding one aspect of depression, stating: “depression forges a connection in the brain between sad mood and negative thoughts, so that even normal sadness can reawaken major negative thoughts.” (The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness by Mark Williams , John Teasdale, Zindel Segal and Jon Kabat-Zinn)

So for example if the loss of a loved one caused a great sadness, then when we feel a sense of heartache again, even years later, then these original memories are reawakened, causing a further spiral down into depression. Or if we felt a particular sense of sadness caused by loneliness during childhood, then even a passing sadness in later life can trigger those feelings of inadequacy or isolation from the past. We may not even be aware that it is a thinking pattern from the past that is causing the current feelings. This quote from the book efficiently details the theory:

“This is why we can react so negatively to unhappiness: our experience is not one simply of sadness, but is colored powerfully by reawakened feelings of deficiency or inadequacy. What may make these reactivated thinking patterns most damaging is that we often don’t realize they are memories at all. We feel not good enough now without being aware that it is a thinking pattern from the past that is evoking the feeling.”

I’m not sure how these insights can really help me, as being aware they exist doesn’t alter the illness’ effect, just like explaining to someone why they have a headache doesn’t make the headache go away. And similarly, just because I can recognise these connections between memories and emotions doesn’t mean it can help me, as depression doesn’t allow for awareness to be a combatant against the illness. Most of the time I can recognise that I shouldn’t be thinking or feeling certain things, but that doesn’t make them go away, it only leads to further frustration at the fact that I can observe and diagnose them without this ability having any positive effect on my wellbeing. But I suppose that learning more about the illness can only be a good thing, and education can only ever be a positive weapon, as I have tried to petition through this blog.

I feel a very slight improvement upon how I was feeling a few weeks ago as I’ve had time to let the noise in my head settle down and time to reflect and recharge, although it hasn’t alleviated completely, and a medication change has left me feeling listless, bereft of energy and with an increasing foggy mind. My sense of loneliness has continued throughout as I’ve had no communication over the last few weeks (outside of family) which has let me feeling incredibly isolated, despondent and just plain sad, and only serves to confirm the conscious or subconscious ingrained beliefs that exist within. And if Mark Williams in his book is correct, these thoughts and feelings may have subconsciously conjured up thought patterns from earlier in my life. For a long time I have felt ‘why would anyone want to be friends or in a relationship with someone like myself, with the difficulties that the depression presents’? I can recognise that this is a typical negative thought pattern associated with the illness, but as the years go by these thoughts intensify in validity, making me feel that my imprint on other people is at best insignificant, at worst completely absent.

Despite a slight improvement over the last few weeks (although devastatingly slow for my liking) , I’m continually aware that it won’t be the last time I feel like this, and that it’s always lurking just below the surface. This reality is both disheartening and  heartbreaking, and leads to a desperate hope that once the fogs lifts, it does not descend again for a very long time.

Social Media and Mental Health: Part 2

In my blog post from last week I surmised that social media and blogging are exceptionally helpful for those suffering from a mental illness, due to the fact that they can facilitate the ability to open up to friends/colleagues/family etc. They also can act as an information source for suffers and non-sufferers alike, and can help deliver the crucial message that nobody with depression or anxiety is alone, and it is remarkably easy to reach out to others in a similar situation. However, Adrian posted a pertinent comment in reply to my blog:

“This seems like it was a great article. I personally tend to focus on the negative aspects of social media, namely how using it sometimes makes me feel isolated or else compare my life unfavorably to others, but I think it’s mainly Facebook that makes me feel that way. It’s a good point that using social media to express feelings of anxiety and depression outside of your real-life social circle (like Instagram, Twitter, and Yik Yak) can be a positive outlet. Thanks for this post!”

He touched upon a very relevant and significant point, and one which I had intended to focus upon in a future blog post, but it seems sensible to address it now. The benefits and strengths of social media, namely acting as a global platform and communication source,  are also its downfall, and how it can lead to the triggering of depressive episodes, or making existing periods of low mood significantly worse. Certain images or posts can precipitate low mood, such as seeing photos of contemporaries from school who are getting married/having children (leading to thoughts like ‘will that ever happen to me’), or fellow facebookers smiling, having fun, going on holidays with friends etc. These can be triggers in ‘real life’ which proliferate feelings of sadness, desperation, hopelessness and self doubt, and with the rise of social media, shutting yourself away can no longer provide an escape from these factors. One of the features of depression is the necessity to self analyse yourself and make comparisons with other people, and the prevalence of social media (in particular Facebook and Instagram) ensures that this is done on a much larger scale.

Personally, I find social media less of a trigger when I’m feeling stable, however it can have a powerful effect on my mood if I’m already in a bad place. For example, if I’m thinking thoughts such as ‘I don’t have friends/am not in peoples thoughts’, or if I’m frustrated by my anxiety preventing me from going and and doing activities that I want to do, then seeing a photo of a group of friends doing an activity together or on a night out can inevitably lead me to feeling extremely down and demoralised. It provokes feelings of unfounded jealousy, inadequacy and longing. It confirms predetermined falsehoods, and helps foster the incorrect but deeply believed thoughts and feelings about myself, my predictions of how others view me, and also  my prospects (or lack of) for the future.

Another negative impact of social media is an issue I have touched upon in previous posts, and concerns the eruption of nostalgic feelings when viewing images from the past. Seeing a photo of myself as a child is a trigger to negative though processes, including the inevitable questioning of everything that has happened from that point to the present moment, as well as a deep yearning to go back to that time when wide eyed innocence took the place of todays anguish, anxiety, regret and fear. Of course, I look at these memories through rose tinted glasses, as undoubtedly there were worries, concerns and anxieties that existed to me back then, but the power of hindsight and backward reflection, in relation to depression, is that you have no control of what the mind decides to focus upon. For me I see an idealised presentation of what my life was, which evokes a real desire to go back to that moment, and that time in my life, rather than where I find myself now at the end of my twenties.

Social Media therefore is both a positive means for expression, but also a proven trigger for many of the negative aspects of mental illness. It is a both a blessing and a curse, and the key is to learn how to utilise its positive aspects and negate its negative. Social Media essentially is a digital representation of real life, where the words that hurt are written rather than spoken, the stimuli that evoke memories are pictorial rather than anecdotal, and the way to reach out to others is through taps on a keyboard rather than whispers down the phone. Times changes, but sadly the negative and destructive mindset doesn’t. It’s just a case of trying to use social media for its positive enabling abilities, and shielding yourself from its unnerving capacity to break your resolve.

“There are many things of which a wise man might wish to be ignorant”
Ralph Waldo Emerson