The Complex Reality Of Living With Long-Term Depression
The Debrief: 'Here’s what living through a decade of depression has taught me'
‘Are you on any medication?’
‘Um, yes. Citolopram, 40mg.’
‘Oh, right. What’s that for?’
* silence *
So it goes. Anyone would think I’d just announced that I’m actually an alien wearing a human skin suit, given the sudden frosty atmosphere that this answer inevitably invokes in doctors, dentists, employers, university tutors, and so on. I can see the funny side now – it’s ten years since I was diagnosed with depression, and almost eight since I started taking anti-depressants. Without a sense of humour I would probably have confined myself to the safety of my bedroom surrounded by my cats a long time ago.
As I came to terms with my illness, I also began to realise how ill-equipped society is to deal with mental health problems. It had been a struggle to even get to the point where I could see a psychiatrist due to funding cutbacks for adolescent mental health services – but the worst was yet to come. My high school and even my university were hardly set up to deal with students who were on long-term sick leave due to mental illness. Some of my teachers/lecturers actively seemed to think I was making the whole thing up to bunk off, which couldn’t have been further from the truth. Quite the opposite in fact, I’d have loved to be there.
So how do you manage to become a (sort of) functioning adult whilst you’re suffering from long-term mental health problems? Here’s what living through a decade of depression has taught me.
Know when depression is depression
Most people will, at some point in their lives, experience depression. That’s natural. Sometimes life is bloody awful, and even when it isn’t, it’s more than okay to feel that it is. Brain chemistry is one of those things we have very little control over, like British rain on a summer’s day. It. Just. Happens. There can be triggers such as stress or bereavement, but for me depression didn’t seem to be caused by anything.
Depression is a spectrum of experience, ranging from low level to major or clinical – my depression graduated from moderate to clinical when I was about fifteen. After two years of trying on various forms of therapy on for size it was a relief, in a way, to know my teenage angst wasn’t just teenage angst, and that there were ways to treat it.
There is help available – make sure you get it
Admitting that you’re struggling with your mental health is difficult and often humiliating. I’ve met some incredible doctors and had some wonderful employers who have been infinitely understanding but I’ve also gone toe-to-toe with those who are less than sympathetic. Mental health services are woefully underfunded. It’s sadly often a case of ‘If you don’t ask, you don’t get’. I had to be brutally, uncomfortably honest to get the support I needed. I had to sit in a GP’s office in tears and tell him that I wanted to kill myself and show him where I’d self-harmed before anyone would listen to me.
The irony is, I find it a lot easier to talk about my depression now than I did back then – when I really needed help. If it’s easier, you can write down how you’re feeling and take the notes to show your doctor – I did this too, when I was really struggling to talk.
‘Fit notes’ are a pain in the arse, but also invaluable
I’m incredibly fortunate in that I had the same GP for twenty-two years before I moved to London. He’d known me since before I was born and watched me grow up – to this day, he still asks my mum how I’m doing. He was instrumental in finding the help I needed when I first became ill, and whenever I needed a fit note (formerly known as sick note) to prove to my university that I wasn’t just bunking because I had a hangover or not writing essays because I couldn’t be bothered, he was there to help.
Many universities and pretty much all employers will require a fit note for absences of more than seven consecutive days or multiple illnesses less than seven days. It’s a pain in the arse, especially if you haven’t disclosed your depression (and you don’t have to), especially since you can be charged for them if the fit note is for less than seven days. Be honest with your doctor about your situation, and explain how your mental health is impacting on your ability to work or study.
To be frank, my university were fairly crap about my depression – the departmental secretary hated me with a passion and would send me emails threatening me with a disciplinary tribunal ‘due to unexplained non-attendance’, which is the last thing you want when you can’t even get out of bed in the morning. I did, however, have a brilliant mental health advisor, who fought my corner and was able to help me communicate with lecturers and university staff – who more often than not seemed to think depression was a fancy word for ‘can’t be bothered’. If you’re at university, speak to your union or student services about the support available for students with mental health conditions.
It’s shit that you have to justify yourself and your illness, especially when the likelihood is you don’t want to talk about it at all but, like any illness, there’s procedure and the best we can hope for is that depression is treated as seriously as possible by society.
Don’t do what I did, which is pretend it’s not happening and tell yourself that you can do it all, and then have a breakdown because you’re not a bloody superhero, you’re a human being.
Some employers will be dicks but this is never okay
I’ve been asked if my depression will impact upon my ability to work before – not cool. I’m fairly sure it was just benign concern, but it was an incredibly ignorant question than had me stunned into silence. A real ‘You wot mate?’ moment.
Depression is still one of those mystical-sounding illnesses that many people don’t quite understand. Aside from in a few specific jobs, you are not legally obliged to tell your employer about your depression. That said, there are definite advantages to doing so.
I’ve also had some top notch employers who are very sympathetic. They went out of their way to ensure I was happy at work and at home. If you feel that you are being discriminated against at work because of a mental health condition, don’t let it slide. And you know what? Your most important responsibility is to yourself and your mental wellbeing – not your employer.
Know what treatment is available, and try different things
I could sing the praises of my antidepressants until the cows come home. I bloody love them. However, medication doesn’t work for everyone – some people prefer various forms of therapy, and some favour alternative forms of treatment. There’s no right or wrong way to treat depression, and don’t let anyone tell you there is. Just because something worked for your next door neighbour’s cousin’s Aunt Sheila, doesn’t mean it will work for you.
It sounds trite, but living with depression requires a great amount of bravery and strength as well as a willingness to work at finding treatment that works for you. Don’t be afraid to tell your doctor if something isn’t working, and ask to try alternatives.
Surround yourself with people that care about you
They do exist – I promise you that. Depression is a total bastard for making you think you’re unlovable and that everyone would be better off if you just ended it for good, but that is never, ever the case. I was lucky to have a supportive family and tight-knit group of friends who didn’t see me any differently once I told them about my depression, but also found a lot of support online.
I always felt more comfortable talking about my depression with the friends I’d made online through forums – you should never share more of yourself than you’re comfortable with, and always be aware of stranger danger (yes, even when you’re a sensible adult), but it was a place where I found support and comfort at a time when I wasn’t able to vocalise my feelings. It also allowed for a degree of escapism in the way films, television and books do.
Don’t worry about the long term. Survive the day-to-day
I am a world-class worrier – if it was an Olympic sport, I’d be Michael Phelps. Living with depression for a decade means I’ve had to come to terms with that, and start to focus my worrying on things I have more control over, separating the important and rational anxieties from the things I have absolutely no control over. It’s a cliché, but you really do have to take each day as it comes and get through it. It gets easier with practice – if you’d asked me at thirteen where I’d be at twenty-three, I wouldn’t have been able to comprehend the question.
Not a day goes by when I don’t think about my illness, even if it’s just when I’m taking my antidepressants every night, but I’ve accepted it as part of who I am – and that acceptance of yourself is a large part of the battle.
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