Wednesday, 13 August 2014

Quarantining depression

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Depression and suicidal feelings are more common than many of us realise. And they are never easy issues to deal with; fear of getting it wrong, making things worse or just not understanding what's involved prevents many of us offering help where it is needed. Which is why it  is so important to bring depression and suicide out of the shadows. 

One of my earlier memories was sitting on my mother’s lap and being asked to smile for the camera by an uncle. Though the picture today merely shows a pixie-headed pouter, what I remember most is the feeling when the photo was taken - that there was a hole inside my chest slowly absorbing all joy, or indeed, any emotion I could feel. I was around three years old at the time.

That hole has grown in pace with me. When I was fourteen, I had a big family fight and my mother and sister sat with me and placated my emotions until that familiar hole came and found me to suck me clean of feeling. Hours later when they were all asleep, I turned off the tv and blandly declared it was “time to kill myself”. It was a perfunctory statement, like I was going to put the bins out. Suicide, as part of a mundane evening ritual, viewed with no emotion from the safety of the hole in my chest.

The next morning I was found unconscious and choking from a massive drug overdose and spent the next few days comatose in intensive care, followed by another month in hospital. It was my fourth or fifth attempt to kill myself.

My capacity for suicidal thoughts and depression continue to this day. That urgent whisper to lurch forward when I stand at the train station or busy intersections. The practiced imagination of feelings, how my body would collide and pirouette in the air before breaking. How a bullet might feel exploding into the shell of my skull. That occasional kneel at a pew to ask a god I rarely believe in if I can die. And then there’s the ultimate motivator, a constant thrum whispering that death is a solution, an ever-present and ever-offered option, just waiting for me.

Depression can also be exacerbated by other stresses or injuries. For the past two years I have tried to recover from post traumatic stress disorder. Not a mental illness, but an injury, acquired from a psychologically abusive relationship where my fragility was stretched so thin I doubt I will ever shrink back to my original size - that dependable form who trusted others and didn’t fear intimacy. That injury compounds my depression and adds a geyser of adrenalin to going out in public, even if it’s just to check my mailbox.

Meet me and you wouldn’t know I battle suicidal thoughts, depression, an injury or that I’m trying to not listen to that urging voice. In person, I’m confident and warm and, through the haze of cigarette smoke I carry with me, possibly even charming. I probably wouldn’t tell you about my mental illness because I’m not interested in sympathy and I’m too wary of how often people respond to depression with ignorance.

Despite the constant call, I haven’t attempted suicide in many years. Having struggled with therapy and pills for years, instead I had to hack out my own path, using hope to pull me through. For me, the path is the hope that I can finish the books I’m writing. I hope to be the sort of person who can break her addiction to Febreeze and actually do laundry on a regular basis. I hope to visit Japan again and swim in that overwhelming relief that comes with surrendering your language, because even wankers need hobbies. I hope to pay the fucking cat registration fee. I hope to never unleash the sadness of death onto my daughter. I hope to see her grow up, I am fascinated by her potential, whimsy and will.

I’m sharing this now because we don’t talk about the personal experience of depression enough, or dismiss it as a 14 year old’s muddled Tumblr rants. Using my story is important, not only to combat the shame associated with mental illness, but also to demonstrate that no depression is alike. It is an illness that afflicts and contaminates each brain differently.

So many people talk about depression with singularity, as a fog that either persists or lifts in exultant victory. It is more like a fog than we realise - not just in how it feels but also how it is made. Trade molecules of water and ice for chemistry and genetics, swap temperature and wind for personal events and you create the fog but the factors collide and collude to create something different every time.

Yet, we seem to give depressed people the same reactions and advice before listening. As valid as the advice is to reach out and seek help, it is just as crucial we help people understand how to listen or respond. No amount of #RUOK? will help if we don’t answer to the response.

People with depression have heard it all before. “But was it a serious attempt?” they ask, “or was it was just a cry for help?”, as though we have the luxury of extra tears. “If only….” they daydream, unaware of our reality, before concluding “suicide is the ultimate act of selfishness, a way out for the weak”.

Still you try to tell people. You meet with the GP who won’t listen to your medical history and prescribes antidepressants that make you avoid looking at the mirror lest you see the feral creature you feel you’ve become, one that could let out an endless scream if you trusted your body enough to open your mouth. But you don’t trust your mouth, body or your mind, and now you don’t trust the medical profession either.

Or perhaps you reach out at work and have to deal with a HR department that wants an invasive level of information to put in your personnel file before allowing you to visit a counsellor. The stain of having your mental health catalogued on file along with your work performance is enough to make you go back to your desk defeated.

Then there are the people closest to you who will either lose interest after any more than three conversations on the topic or offer their own quick fix solutions - because apparently one good experience is all you need to turn your life around. I have been told to lose weight (because it will find the ultimate antidepressant: a boyfriend), wear more dresses, just cheer up, go for a walk, an eyebrow wax, go out more, go out less, be all about baths, just stop focusing on sadness, listen to upbeat music, take vitamins and - in one spectacular experience - had a spiritualist perform an impromptu exorcism on me to rid me of alien spirits.

Talk to someone? Sometimes there’s no point talking if these are the only people to talk to.

Despite the excellent progress made by committed organisations, there is still a disconnection between depressed people and the communities imprisoning them. People report feeling isolated when battling depression and yet so often many of us are responsible for isolating them, whether it is by rejecting their request for help or rejecting them socially, professionally and medically.

Perhaps the isolation can be traced to how we care for people with depression. Our model of care when it comes to depression is one of complete social, therapeutic and professional quarantine. We tell them to reach out, only the draw the curtains around them to hide them from view.

We must come to the point when we realise we cannot quarantine depression or suicide.

Over the next few days, if not weeks, people will share their stories of depression or suicide. These are not cynical grabs at a news cycle or attempt to hitch their wagon to a falling, broken star. They are accounts that have broken free from the enclosing screen of privacy.

End the quarantine. We need to talk about the global rise of suicide rates. We need to examine if our culture of isolating the ill is really the best way to provide care.

But most of all we need to listen.

If you are in trouble and need some help, there are many places you can find it.

Your GP can help you find a therapist experienced in dealing with your particular issues and help you with a mental health care plan so medicare will cover 10 sessions for you with the registered therapist of your choice. If you can, it might help to ask around online or people you know who have found a good therapist. Not all of them are good and not all of them will be a good fit for everyone, it''s ok to walk away from one who is not helpful and try again to find one who is.

Some links that might be of use: 

Some reddit depression posts are very good for people who aren't able  to speak out loud about what they're feeling.

Beyond Blue is a useful starting place for facts and symptoms. 

Dnet is an online support site with information, research, links and an online chat room. 

Amy Gray

Amy Gray is a writer and broadcaster from Melbourne, Australia.

Follow her on Twitter @_AmyGray_