Fragility of the Balance

The fragility of mental health is so finely balanced that it can take only a small thing to shift the balance and cause the scales to tilt one way or the other. It can take a feather to tip the scales downwards, but a 100 tonne weight is needed to pull them back up level again.

I’ve always tried to live my life as kind person, not just because that’s how I think we are supposed to act, but because that’s how I want to live my life. For me the greatest feeling is making someone laugh, or smile or just be happy. For all of the uncontrollable issues I have in my mind, I am able to control how I interact with others. I just wish I had control over my mind. I had a panic attack this afternoon, and am still going through it, and thought I would describe the feelings I’m experiencing, as it’s a lot harder to remember after the event.

  • A sudden feeling that my heart is going to beat out of my chest.
  • Feeling sick, nauseous and like my whole body is vibrating.
  • A sense of doom and thinking that I have messed things up permanently, and that there is no hope on the horizon.
  • A feeling of complete exhaustion and yet at the same time being completely on edge and alert.
  • Tightness of breath and a feeling as though someone is clamped around my chest, suffocating me like a boa constrictor.
  • Stomach cramps and a stabbing pain in the tummy.
  • A complete sense of loneliness, but also a need to isolate myself totally. This can happen in a heartbeat: one minute feeling ok, and the next like my guts are being wrenched out.
  • Social isolation and letting down others. I missed a gig tonight that I had been looking forward to for a while.
  • A wish to go back in time and undo past wrongs.

It’s impossible to fully decribe what it’s like in a few bullet points. When in the midst of an attack of anxiety or depression you honestly feel like you are never going to get out of it or be ok again. Being rationale you know that isn’t the case, but when in the moment rationality is not a skill you possess.

I’ve had a complex relationship with people through my life. On the one hand I have always been shy, lacking in confidence, and tending to lead a fairly solitary life. On the other hand people are everything, and those that I care about are what help me get through the difficult times. I’ve always found it challenging to make and maintain lasting bonds and friendships (even at nursery school I apparently stuck to myself, and didn’t want to interact). Therefore, those people that I do befriend, especially later in life, become so important to me. And I recognise the precariousness of those friendships because I realise how important they are. I have always been someone who shies away from conflict or argument, as I hate the thought of upsetting people. While it’s not pleasant if someone upsets me, at least the only person affected is myself. But the thought of upsetting someone else is crushing. I think my illness may sometimes make me blind to how I act or behave, and while it doesn’t even cross my mind that I may have done something wrong, or crossed a boundary or been insensitive, that doesn’t mean it hasn’t happened. If I have ever done that unwittingly to someone, it was not intentional, and would have caused me prolonged guilt and sadness when I thought this was the case. All I can say is sorry from the bottom of my heart. I’m not making an excuse, but it’s the part of my brain that I’m trying to fight that was responsible, not the part I am trying to save.

I find wisdom and meaning in music, and these words from Frank Turner pretty much sum up the difficulties of realities versus aspirations.

“But I don’t want to spend the whole of my life indoors
Laying low, waiting on the next storm
I don’t want to spend the whole of my life inside
I wanna step out, and face the sunshine”

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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.

The Cycle of Thoughts and Feelings

Thoughts and feelings are at the very heart of Depression. The simple fact is that the thoughts we have can influence the feelings we experience, and vice versa. It’s a viscous cycle, and the cyclical nature of the illness ensures that once you are in the cycle, it is very difficult to break free. Thoughts can often pop into your head from seemingly out of nowhere, and of their own volition. Frequently however, these introspections are provoked by associations arising from what we see or hear around us. Photos, friends, people in the street, a piece of music, or a particular building can all conjure up thoughts, and consequently feelings, which are both unwanted and damaging. This can happen to all of us, although I would suggest that those with a depressive disorder will experience them in a far greater frequency.

Memories can be very significant stimuli in depression, and can be triggered by a wide variety of occurrences. For example, the other day I walked past a previous flat I had lived in, for the first time in about 3 years. This induced painful memories of the difficulties I was going through when I resided there, and the dark place that I found myself in. For the brief time the building was in my eye line it reignited the anxiety I had all those years ago, and the effect this had upon me took some time to wear off. Just as they say a smell of cooking can take you back to your family kitchen when you were a kid, this visual reminder conjured up all kinds on unwanted sensations and anxieties. On another occasion, I walked past someone in the street who looked remarkably like a person from a few years ago who I had a bad experience with, and this generated the same feelings of anger, sadness and frustration that I had felt at the time. It acted as a kind of portal, which transported me back to 3 years ago and bestowed upon me the exact emotions I had experienced during that period.

It can work the other way too. A certain image or stimulus may conjure up memories of a happy event, and illicit a smile and feeling of warmth, as though you are living through that event once again. The problem stems from the fact that the effects of positive memories wear off extremely quickly, whereas the effects of negative ones can linger for many hours or even days.

When a particular issue or source of anxiety is at it’s height, I often focus upon those things that will justify and confirm my beliefs about it, rather than seeking out those truths that may offer a counter argument. For example, if I get self conscious or low about my appearance I will ‘notice’ people who in my mind are ‘more attractive’, ‘normal looking’, and consequently to my prejudiced perception ‘happy’. This will then feed my exiting beliefs and anxieties, and prolong the cycle of mental unrest. It becomes impossible to see the things that would offer a counter to these beliefs, as you cannot help becoming blind to them. Depression could be described as like a special pair of glasses that allow you to see the negative things, but blinds you to all of the positives.

It seems to me that a need for support from other people is inevitable, and paramount as a facilitation to help you try and overcome this. Not so much for reassurance, as that can have detrimental consequences and potentially lead to a heavy reliance on reassurance before you can even function at all (another cyclical process). But just having other people who are not wearing the ‘depression glasses’ can encourage you to open your eyes and see things for what they really are. My illness (among other factors) has prevented me from ever having a girlfriend, and that has always been a huge roadblock to getting to where I want to be, and consequently has promoted deep levels sadness and frustration, as well as an inevitable elevation of that part of my ‘desired life’ to a near mythic unobtainable feat. This is not merely because ‘you want what you don’t have’, but because of the knowledge that whilst it wouldn’t necessarily solve everything, it would mean that I would no longer have to do things alone, and would enable me to express my emotions in a positive way towards another person (love, happiness) rather than a negative one (anxiety, fear, stress, resentment). Plus it’s its just too damn appealing to be with someone who loves you for who you are, and for which you can reciprocate.

Obviously thoughts and feelings aren’t going to go away, and nor should they, as they are what makes us who we are. The goal however, is to be in a position where you are in control of your thoughts and feelings, rather than them being in control of you. It feels as though mine do not only control me, but in fact own me, and dictate every step of my life. If there is a way to take back this ownership, then that must be what I, and indeed everyone, should aspire to.

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.

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.