Note: this post has been written as a pledge to share my mental health history, supporting Time to Change’s campaign to end the stigma of mental illness.
Do you know how to kill yourself painlessly?
I do. Five minutes research showed me how to slip from life to unconsciousness to death in minutes.
And last November I seriously considered doing just that.
Why? I was clinically depressed.
If it’s something you’ve ever experienced, you’ll know that the thought of your life draining from your body means escape from the paralysed numbness that has become your daily existence.
It’s often said that depression isn’t about feeling sad. It’s part of it, but to compare the life-sapping melancholy of depression to normal sadness is like comparing a paper cut to an amputation.
Sadness is a healthy part of every life. Depression progressively eats away your whole being from the inside.
It’s with you when you wake up in the morning, telling you there’s nothing or anyone to get up for.
It’s with you when the phone rings and you’re too frightened to answer it.
It’s with you when you look into the eyes of those you love, and your eyes prick with tears as you try, and fail, to remember how to love them – and wonder why they should ever think of loving the grieving shadow you have become.
It’s with you as you search within for those now eroded things that once made you who you were. Your interests. Your creativity. Your inquisitiveness. Your humour. Your warmth. Your sense of joy and absurdity. Your connection with people’s thoughts and hearts and needs.
And it’s with you as you wake terrified from each nightmare and pace the house, thinking frantically of how you can escape your poisoned life; escape the embrace of the demon that is eating away your mind, emotions and sanity like a slow drip of acid.
Churchill referred to his depression his ‘black dog’. I can never externalise it. This illness is an inward looking one, a parasite of the mind that eats away your heart, emotions and vitality. It’s a disease that turns you into a barely functioning automaton, a person numbly going through the actions of life to conceal their illness from judging eyes that would stigmatise their weakness.
But always. Always. The biggest stigma comes from yourself. You blame yourself for the illness that you can only dimly see.
Depression differs from physical illness in one vital respect – you see no road to recovery, so there’s no destination to journey towards (if even you could). You are completely stripped of hope.
Break a leg. Catch a virus. Discover you have a treatable cancer. All are horrible and painful and frightening, but you can fight back, regard them as challenges that you can overcome to regain your wellbeing.
With depression you can’t define your illness, objectify it, separate yourself from it. Often, incredibly, you don’t know that you’re even depressed – your essence is just shed, layer after rotting layer, until you can hope for nothing more than gentle oblivion.
So why was I depressed?
The simple answer is that I don’t know. There was no single factor or trigger that plunged me into this illness.
I’ve turned over many possibilities in my mind.
Maybe it had its roots in my childhood? It wasn’t a particularly happy time, and at various points was overclouded by instability, violence and emotional abuse. But fuck it, many people suffer worse and they don’t get depression. And certainly not after over twenty years.
Maybe I’d overworked myself. Sure, in recent years I’d put huge efforts into my work and business – ironically to see many of the gains evaporate as I became paralysed by the illness.
Maybe I had a genetic flaw? Certainly, in past generations of my mother’s family, there was no shortage of madmen, eccentrics and melancholics. Practically every one of my grandfather’ aunts and uncles was deaf and dumb, insane, eccentric or a combination of all three. But surely that would only give me a predisposition to depression at most, not cause it?
The best I can conclude is that depression can happen to anyone. I thought I was strong enough to resist it, but I was wrong. That attitude probably ensured I suffered such a serious episode – I resisted seeking help until it was nearly too late.
Let me take you back to 1996. I’d just begun my final year at St Andrews and had recently visited my doctor to complain of feeling low.
He immediately put me on a prescription of the antidepressant Seroxat and I got down to the business of getting my degree.
The pills took a few weeks to work, but the effects were remarkable. Too remarkable. About six weeks in I was leaping from my bed each morning with a vigour and enthusiasm I had never experienced, at least not since early childhood. I started churning out first class essays and my mind began to make connections with an ease that it had never done before.
If that had been all, I’d have stuck with the pills and counted myself blessed. After all, I had acquired a relish for life after many years of living what can be best described an intellectually and emotionally muted existence.
The only problem was that the drug did much more. It broke down any fragile sense I had of social appropriateness. I’d frequently say ridiculous and painful things to people I had no right to say them to. (I first realised this in a pub, when I heard myself saying in a very loud voice: “I’m not talking about you. I’m talking about your VAGINA.”)
I also became manic. My sense of the absurd not only rocketed, but it became my default setting. To give one instance, my flatmate wandered into the living room to find me lying ramrod straight across the two arms of an armchair. “What are you doing?” he asked. “I’m doing an impression of an electric bar fire,” I answered. At the time it made perfect sense.
So, after a few months, I decided I had to stop the pills. I ended them abruptly, not realising how foolish that was – and spent a week or two experiencing brain zaps and vertigo.
But it was worth it. I still felt good, my mind was still productive, and I regained my sense of social niceties and appropriate behaviour. For a while.
I had hoped that that would have been my last brush with mental health problems, but it was not to be.
On reflection, I now realise that I have spent over a decade dipping in and out of minor bouts if depression – each one slightly worse than the last.
But about two years ago I realised I needed help. I would go to my office, achieve nothing, be too frightened to take calls or answer emails. I’d take no pleasure in the things I usually enjoyed. I felt emotionally isolated. My income was suffering as it was a monumental task to complete even the simplest piece of work.
So I rang my local surgery to make my first GP appointment in sixteen years.
“Is it urgent?” asked the receptionist.
“Well, if you mean will I live, then no.”
“Then the first appointment I can offer you is in 3 weeks’ time.”
Of course, by the time the three weeks were up I felt much better and was able to cope once more. But I went along to the appointment anyway, telling the doctor what the problem was.
“If it happens again, come back,” he said. “And don’t take up jogging. It’s not a good idea at your age.”
I didn’t take up jogging, but last spring I was in the grip of depression again. I couldn’t work effectively. I couldn’t earn the income I needed. I began coming home at odd hours of the day, retreating to the safety of my bed – using sleep to escape myself and my exhausted and joyless existence.
So I returned to a different doctor and told her about it. It was warm and I was wearing a cardigan.
“Are you cold?” she asked.
“You’re wearing a lot of layers.”
“It was colder at home.”
“I think we should test your thyroid,” she said. “But I think an antidepressant would help in the meantime.
And here I realised, for all my support of not stigmatising mental illness, that I stigmatised it in myself. I found myself hoping my thyroid was bust. Tell someone your thyroid’s not working, and they’ll understand and happily wait for you to recover. Tell them you’re depressed and they’ll just think you’re weak, or lazy, or just making it up.
I really wanted it to be my thyroid.
But of course, when the blood test came back, it wasn’t. I was depressed.
So I kept going and kept taking the antidepressant. This time it was Sertraline, an SSRI that works in a similar way to the Seroxat I took over a decade before.
And it worked. To begin with. A month into the course, the poisonous cloud began to lift and I even felt my creativity and urge to write begin to return for the first time in years. I’d sit in the sunshine, writing pen portraits of the more eccentric and notable schoolmasters who taught me. Not great literature, but fun to write and enjoyed by my circle of friends on social media.
And tellingly my wife, who first met me as I took myself off the Seroxat, said: “You’re becoming more like the person I first met.”
It was a turning point. The drug had given me objectivity about my illness, made me view it for what it was. I could see that for at least a decade I had been slowly dipping in and out of increasingly bad cycles of depression. It was a process of gradual erosion, almost impossible to spot while you were experiencing it.
But the effects of the Sertraline didn’t last. By September I was both deeply depressed and increasingly angry, behaving erratically and feeling endlessly paranoid. My wife threatened to frog march me back to the doctor, so I made an appointment.
It was yet another doctor. He listened to my story and switched me to a low dose of another drug, Venlafaxine. This is an SNRI, which means it works on both serotonin and norepinephrine in the brain.
However, he put me on only a low dose – one at which the drug works on serotonin only.
And two weeks later I was, in earnest, researching painless ways to take my life. The only thing that stopped me was the thought of my wife or children finding my body, collapsed and incontinent with a plastic bag over its head.
So I went back to the doctor and he doubled the dose. Norepinephrine entered the game.
The effects have been miraculous. Nearly two months in I can feel the old me re-emerging. My engagement and interest is flooding back. I’m back at work and I’m producing copy my clients really love – and on time or before deadline. Only eight weeks ago, the very idea I would be sitting at home tapping out a blog post of this length on my phone would have made me grunt derisively.
But that is what happened, and I am truly grateful to all those who love and care for me for pushing me along to this stage.
And now I need to get back to work. Depression may start for no definable reason, but it leaves a growing trail of problems in its wake. For me, the more ill I got, the less work I could do, the more savings I spent and the larger the piles of unpaid bills became.
But now I can start to solve these things. And if you still feel stigma about people with mental illness, please remember two things. One, it could easily happen to you. And two, no-one stigmatises their illness more than the people who suffer from it.
Reach out to them.