How to discipline that wilful, big, black dog
Depression is a highly debilitating condition. Michelle McGrane lifts the grey veil on her experienceNovember 28, 2004 Edition 1
Michelle McGrane
What do Sheryl Crow, Jim Carrey, Monica Seles, Anthony Hopkins, and Teddy Pendergrass have in common? Depression. Winston Churchill labelled it "the black dog".
It has been called "the noonday demon", "the savage god", and "the dark night of the soul". For me, it was a grey veil shrouding the experience of life. No light was let in. There was one shade of dark, an unhappiness that infiltrated my universe and obscured my perceptions of the world. It was a mental hell. There is no lonelier place.
At 22 I was diagnosed with clinical depression, that is, a chemical imbalance in the brain. When my first major depressive episode was diagnosed I had been suffering with the classic symptoms of depression for months. I was continuously morose and melancholy. I had lost all interest in life. I slept excessively, trying to escape the sense that my life was meaningless and insignificant, yet no amount of sleep reduced my fatigue and lack of energy.
Having to make the tiniest daily decisions filled me with dread. My self-esteem plummeted. I was overwhelmed by a sense of worthlessness. If you asked me how I got to the stage where life was so unbearable, I would have to say I'm not sure. It seemed to sneak up insidiously upon me until one day I realised that life no longer seemed to have any purpose.
Depression often exaggerates a person's character traits and living with someone suffering from the disorder is often puzzling and frustrating. I was self-centred, self-indulgent, irritable, difficult, demanding, and unsatisfied. During that time my bewildered family and friends alternated between being irritated and extremely worried by my sudden, unexplained outbursts of crying.
Being called a "drama queen" was something I became used to. Everything made me cry. The smallest upset would start me off. Tears lasted for hours. When I look back to that time all I can remember is either crying or being on the verge of tears. I could no longer connect with anyone around me. I was on the inside, they were on the outside. I felt alienated, cast adrift from human contact, an island. Depression is a narcissistic and isolating condition.
I hit rock bottom. I reached crisis point. Sitting in my parents' living room sobbing, I was irrational, distraught, and exhausted. I couldn't think straight. Everything was out of focus. All I wanted was to be taken out of my environment and away from all responsibility. I couldn't cope. I wanted to be taken care of.
I had had enough.
I did not want to carry on living this way because life was not worth living. I believed I had come to the end of the road. I wanted to lie down and sleep forever. Luckily for me my parents took me seriously.
I was hospitalised in Pietermaritzburg and a diagnosis was made during my week-long stay in hospital. I can recollect very little of that time although I remember receiving a florist's delivery, a beautiful spray of pale green orchids from my father and a basket of fruit from my work colleagues.
There was a distinct sensation of relief accompanying my admittance to hospital and again in speaking to the psychiatrist who came to visit me in the ward the next morning. I remember thinking that now I had help I was going to be all right. I would not have to shoulder the burden of survival on my own anymore. The psychiatrist assured me that I was not going crazy and that many other people in the world felt the way that I did.
I began to understand that what I was feeling was not my fault. It was not a punishment. There was something wrong with me. It was a disease called depression.
In hospital I underwent sleep therapy. Sleep disturbances and depression are anything but strange bedfellows. Nearly all depressed individuals experience sleep problems either in the form of insomnia or hypersomnia, which is excessive sleep. I was put under sedation daily in order to give my body and mind the opportunity to catch up on my sleep deficit.
Under the psychiatrist's supervision I began treatment on Aropax, an anti-depressant known as an SSRI. Anti-depressants do not act quickly, but with the assistance of tranquillisers and sleeping tablets, I slept through the days and nights of that week. Extreme exhaustion had taken over my body and mind.
I was not forced to use up my energy on any activity and the only decisions required of me were choices of meals from the hospital menu and whether I preferred coffee or tea in the mornings and at tea times.
Upon discharge from hospital I continued with the treatment of anti-depressants in conjunction with regular therapy sessions with a compassionate and nurturing psychologist I had been referred to.
When I was initially prescribed the anti-depressant I was relieved and eager to try anything that might jump-start me out of the despondency.
My views of anti-depressant medication have altered somewhat and become tempered with the personal knowledge of their possible side effects. During the last seven years of my life I have had a colourful, at times alarming, relationship with these tablets.
I have had two frightening experiences. One experience occurred as a result of a medication dosage that was too high.
The over-medication of Aropax made me exhibit symptoms of hypomania much like those experienced by a manic depressive or bipolar sufferer. The second experience involved a transition to different, more affordable medication for financial reasons.
Despite similar characteristics to Aropax, fluoxetine, a generic of Prozac, provoked an extremely bad depressed response in me within the space of a month.
I also discovered that the anti-depressant, Cipramol, did not agree with me. We are all unique and what works for one person may not work for another. I am not saying that anti-depressants are the solution, but they may be part of the solution. At least they have been for me.
It is cause for concern, however, that increasingly well documented studies in First World countries such as the United States indicate the common over-prescription of anti-depressants such as Prozac to anyone who is having "a bad hair day".
My encounters lead me to suggest giving careful thought to the fact that taking an anti-depressant, should you not require it, may not be beneficial in the long run. There are times when I wonder what long-term side effects I am yet to experience from the happy pills am I popping every day.
Studies are still being done. Unfortunately, I believe that there is still a stigma attached to people suffering from depression within our working and social environments.
Depression is a very real problem. Many men and women suffer in silence and paralysing despair because they cannot admit to themselves or anyone else that they are feeling depressed. They are ashamed and embarrassed of what they are experiencing.
Books that deal with depression urge people to see a doctor should the symptoms of a depressed response go on for longer than a week. Depression can ruin lives if it is allowed to run on unchecked. It can end lives too.
If you are dealing with a depressed family member or friend, no amount of exhortation or cajoling them to "pull themselves together" or "snap out of it" will move them to action if they are afflicted with major depression.
It is unrealistic to expect a depressed person to have the motivation, direction, and energy to improve their state of mind, most of the time they are too mired in despair to care. In my case, it took both therapy and medication to put me on the road to recovery so I am less than tolerant when I hear people using phrases like "I wish she would pull up her socks".
There is nothing remotely elegant, interesting, or romantic about suffering from depression - it is utterly boring. It feels like a momentous feat to get out of bed in the morning. It is an effort to talk. It is a battle to brush your hair and to change into different clothes.
Quite frankly, you don't give a damn what you look like and you don't care what anyone thinks of you. You feel pathetic. You don't want to try anymore. You want to curl up and die. It is impossible to approach your life with anything akin to optimism and joie de vivre. All you want to do is lie in bed, sleep and cry, then sleep and cry some more.
As I said, it's boring.
Happy and healthy, I now feel distanced from that time in my life. After a while, something changed in me. The fog lifted and the sunshine returned. I began to feel alive again. When I woke up in the morning I began to look forward to the day ahead.
Resources on depression are varied and detailed. The internet is a good source of information, there are books you can read, and qualified people you can talk to who have been trained to help depressives and their loved ones. Today I know that there are definite measures I can take to improve my sense of well being when I am feeling low.
I am fortunate to have a loving and understanding family I can turn to whenever I need support. Trying to keep busy and spending time with people who care about you and accept you unconditionally is important. Being with people when you feel hopeless is usually better than being alone.
Regular exercise is a natural anti-depressant. Exercise is the quickest and most reliable mood elevator. Nurture yourself with good nutrition, a balanced diet, and a good multivitamin and mineral supplement.
The correct amount of sleep is essential for soundness of body and mind. Relief can be sought in forms of meditation and creative visualisation, and expressing your emotions imaginatively through writing and painting.
I began to write poetry, using writing as a healing device and cathartic tool. Later, after I had recovered from my depression and was no longer in therapy, poetry developed into an all-absorbing passion. It has remained one of the greatest discoveries of my life.
There are things I have learnt to avoid, for example, letting negative thoughts and feelings take over, putting myself in unnecessarily stressful situations, or being in a relationship where I don't have the emotional safety or space to grow.
Alcohol and drug abuse compound the spectre of depression and are not a solution. Getting high may deaden the pain for a while but when you wake up you find that the ache has grown worse. Like most things in life, my experience with depression has not been wholly negative. The time I spent in therapy learning to examine my actions and emotions was particularly valuable.
It precipitated a deep-seated period of transformation that renewed and enabled me to reorganise my life, distinguish my priorities, and cut through the clutter of people and personal habits that were weighing me down.
I believe this mental illness can impart a certain wisdom, understanding, and compassion to those who are prepared to turn the experience around. Albert Camus wrote:
"In the depths of winter I finally learned there was in me an invincible summer."
Ultimately, I believe this has been true for me.
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