Understanding Depression

Regular readers know that I have had and continue to battle depression. I have also found that talking about ti honestly helps leave a breadcrumb trail for others to to follow so that they can seek help for their own battles.

I know that the trail works because I regularly get emails from people thanking me for sharing my stories about depression and sharing about how I came off anti-depressants. Each of us who has spoken publicly, people like John Kirwan and Mike King all help in their own way to assisting people with depression understand and overcome and mitigate the debilitating effects of depression.

I have been thinking over the holiday period about writing some more about the issues but i hadn’t quite worked out the shape of what i would write. As is often the way when I am researching about something a blog post elsewhere pops up and says what i want to say for me.

And so it was that I saw on Andrew Sullivan’s blog his snip from Jenny Lawson’s blog post about her battles:

I wrote this post a month ago, but I couldn’t bring myself to post it then.  I was too weak from fighting to shout, and so instead I whispered this into the night and left it unpublished until I felt like I could speak to it with the battle-cry it deserves.  Years ago, coming out about depression and anxiety disorder was something frightening, but now people are more honest and open and so much of the shame has dissipated.  We may not have pink ribbons or telethons but we know that someone out there understands.  That is, until we’re honest about how it affects us.  I’ve never written about this because I can’t talk about it without it being a trigger but I think it’s important to be honest even when it’s scary.  Especially when it’s scary.

But Jenny said so much more and it resonates with me, and so I will share it too:

When cancer sufferers fight, recover, and go into remission we laud their bravery.  We call them survivors.  Because they are.

When depression sufferers fight, recover and go into remission we seldom even know, simply because so many suffer in the dark…ashamed to admit something they see as a personal weakness…afraid that people will worry, and more afraid that they won’t.  We find ourselves unable to do anything but cling to the couch and force ourselves to breathe.

When you come out of the grips of a depression there is an incredible relief, but not one you feel allowed to celebrate.  Instead, the feeling of victory is replaced with anxiety that it will happen again, and with shame and vulnerability when you see how your illness affected your family, your work, everything left untouched while you struggled to survive.  We come back to life thinner, paler, weaker…but as survivors.  Survivors who don’t get pats on the back from coworkers who congratulate them on making it.  Survivors who wake to more work than before because their friends and family are exhausted from helping them fight a battle they may not even understand.

Regardless, today I feel proud.  I survived.  And I celebrate every one of you reading this.  I celebrate the fact that you’ve fought your battle and continue to win.  I celebrate the fact that you may not understand the battle, but you pick up the baton dropped by someone you love until they can carry it again.  I celebrate the fact that each time we go through this, we get a little stronger.  We learn new tricks on the battlefield.  We learn them in terrible ways, but we use them.  We don’t struggle in vain.

We win.

We are alive.

It is now just over a year since I came through the roughest time of my life. The toughest time wasn’t being depressed, it was coming off the medication and all the side effects both physical and mentally that are associated with that. I have done a lot of rough and tumble things in my life. I have jumped from airplanes, out the back of Hercules, from helicopters, I have tramped, hunted, fallen off cliffs into rivers, white water rafted, kayaked, waveskiid and surfed, i nearly drowned once swimming across an estuary but none of those things were as tough coming off anti-depressants.

But as Jenny says above, I won and I am alive.

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  • Holly

    Thats awesome Cam! I feel I am in the remission stage but don’t want to say it out too loud in case it comes back. I have started to reduce my meds (venlafaxine xr) but the doctor has suggested I do it very slowly as to not interrupt the progress I have made. I can’t wait for the day where I can say I am compleatly off meds and loving life. What a sigh of relief that will be. I really thank people like you, JK, and Mike King for bring this issue out to the public and being so honest about it as this is a very real and very debilitating illness!

    • I was on max dose Venlafaxine….take it very easy…I am not a patient man and I rushed it…perhaps I should have been a bit slower.

      The pay off though is being able to feel again. To feel alive and to care.

      Email me privately if you want some advice.

  • Anonymous

    Good on you, WO.
    I’m sure that having SB there must be a big help too. She comes across as having a wonderful sense of humour (which can often be useful). 

  • Will

    Talking about it is often the first step towards recovery or at least learning to live with whatever you are struggling with. Good on you for being open about depresssion… there are lots of others out there too and your honesty can only help encourage them to get the help they need. Men in particular are often very slow to face up to their demons.

  • cas

    It helps those of us who haven’t got depression to understand from those who have.

    I had a very valued worker in the late 1980s/90s ( who has since died of cancer thus I feel able to write about her) who had it. I’m not sure that I was at all equipped to help her despite being in a quango attached to a large Govt dept. We kept her job open while she went down to ashburn hall and then she had a great living arrangement  at some place in Eastbourne whose name I forget. But I used to come across her in her office asleep or resting on the floor under the desk and don’t know that I ever did much to aid her except trying to be kind and considerate and tried to be as understanding as I could.( we gave her an office to herself for privacy).

    I hope there are better mechanisms in place now to help people in similar employment situations understand.

  • Justme

    Often wondered if depression may be partly caused by hormonal imbalances. Do the Doc’s do hormonal blood tests; for both males and females with depression? Our bodies are all about chemical reactions after all; I’m sure there’s literature and new thinking about depression and the brain/bodies chemical state. There are many causes of depression but it affects all ages. Maybe imbalances either way; too much or too little.

  • Angelbug22

    The past few days I have been a “survivor” I am from the States, and found this blog posted from a friend of mine on FB.  I have suffered from depression for twenty plus years, ( I am 45)  I am currently on Paxil, I was on Lithium but I slowly weaned myself off from it after I lost my job and my insurance as it required trips to the Psychiatrist for refills ( very expensive therapy!)  I also take anti-anxiety meds as needed.  I do not want to be on medication the rest of my life, however I have pretty much come to terms that I will, as each time being weaned I do OK for several months, then BAM it is back with a force and sometimes causes me to resort to “self destructive bahavior”  I have been FREE of that particular behavior for over a year ( I wonder if I really am FREE or if the next go is just around the corner).  It is not an easy issue to live with as all of us with depression know.

  • Anonymous

    I have a life-long mate who is also a survivor. I think it must be terribly important to have someone who will talk to you, in your worst times.

  • Killjoy

    I’m glad you’ve got people around you that care Cam.

    I hope that when someone around me needs it that I can be their shoulder to cry/ rest on 

  • Blam_blam

    Good port, 

    just remember that when you abuse someone because of their physical attributes or their names, or their gender, or their sexual orientation, or their religious views, or their hair colour or whatever abuse they have been subjected to over their years.

    Fell empathy for everyone, and the world will empathise with you

  • Two Hours

    “Two
    hours”

     

    This story was written five days after
    my release from a Mental Health Ward.

     

    My
    Hubris:

    In my attempt to end my life, to “right
    the wrongs” that I13 felt I had been implanted
    in the consciousness of those people who loved me the most; my wife; my
    children; my whānau and friends, I irreparably hurt these people. By engaging
    in dysfunctional, yet enlightening experiences of self discovery, I become an
    “actor” in my own play; a play that embodied a theme of destruction; a play
    culminating in my hubris, my tragedy. Thus, I take full and absolute ownership
    of the experiences that led to my admission. 

     

    In brief, ten days ago, my vision of “self”
    led to a juncture in my thinking which culminated in my unbalanced view of
    “self and “my reality”.  Ten days ago, I felt
    I was excluded from the reality I had perceived “normal” people to be a part of.  Ten days ago, sometime in the mid-afternoon, I
    handed in my PhD thesis for examination.  Twelve hours later, after handing in a body of
    work that took four long years to complete, I was admitted to the high security
    ward in the regional Mental Health Unit. 

     

    Individual exploration followed by
    explanation of the experiences that have occurred for me over my lifespan of
    forty years; experiences which may or may not have helped lead to my admission,
    are at this time, irrelevant for this paper. 
    Although these experiences uncover a tormented and unpredictable journey
    of incredible highs, destructive lows; a journey that left a trail of injured
    hearts in those who love me the most; a journey that resulted in the “darkening”
    of my own heart and my vision of “self” as an uneasy juxtaposition of self
    loathing and self discovery, the retelling of that journey must occur
    elsewhere.  Not here. 

     

    My
    awakening:

    After submitting my thesis, I spent the
    following twelve hours seeking approval to end my life from those people that
    loved me; my whānau, my friends, my children, my wife.  I knew then, as I know now, I should have
    never of sought their approval.  In doing
    so, I was irresponsible; cruel because I had disconnected my view of “self”
    from all of my actions and responsibility. 

     

    In this paper, I share with you – the
    reader, the kinds of experiences and emotions that occur when one is
    institutionalised for a period of time in a mental health ward.  These experiences are retold from the “heart”
    of a forty year old father of two; an academic; a person with a whānau; a
    future.  At the time, my understanding of
    “self” was encapsulated within a thin veneer, in that my view of “self” was a thinly
    veiled penetrable space.  Thus, on
    reflection, understanding “self” for me is like the analogy of and egg and
    broken eggshells.    I viewed “self”, as an ambiguous identity
    location.  The protection I gave my view
    of “self” was weak.  Thus, my view of
    “self” was housed within a reality I had constructed out of an eggshell; an
    eggshell that was shattered through my own actions on one dreadful, self
    loathing night. 

     

    In this paper, I describe my experiences
    of the ward I entered and more specifically, the learned experiences I gained
    from being exposed to and engaging with the “actors” within the Centre.  I describe these experiences as my “third
    space experiences”.  They are third space
    experiences because they are informed by my “third space thinking”.  My third space thinking is informed by the
    “knowledge” I gained from the experiences/stories and actions of “actors” of two
    specific “ways of thinking”; 1) those experiences/stories/actions of the “normal”
    people in society and, 2) those experiences/stories/actions and “ways of
    thinking” employed by the “not so normal”.

     

    Day
    one:

    Waking up in a high security mental health
    ward was not frightening for me. 
    Instead, it was somewhat of a disappointment, and a relief.  I was disappointed that my night of self
    loathing and destruction had not culminated in “its” expected outcome –
    death.  However, I was relieved that I
    had made the choice during the hours directly preceding my admission, to not
    allow myself to reach this outcome.  Thus,
    on the first morning I awoke in the high security ward, although startling, hearing
    the anxious voices of other patients outwardly expressing their desire to
    release demons that clearly possessed their semi-consciousness state of being –
    was ironically calming for me. 

     

    In the high security ward, there are regular
    ten minute “checks”.  These occur at
    measured intervals and involve a nurse asking a few questions of each patient,
    specifically recording and measuring each patient’s “state of being”.  I was never actually told why this process
    occurred, or how behaviour and “state” were being measured.  It was just part of the procedure that
    patients had to follow.  At this time, my
    mediation was Fluoxetine – a derivative of Prozac prescribed for depression.  I had been on Fluoxetine for eighteen months
    prior to my admission.  When it was time
    to medicate the patients in the ward, nurses would distribute each patient’s
    medication according to their requirements. 
    The dosage of which appeared to be based upon the “pre-existing state” of
    each patient; determined on entry into the ward and by the data collected from
    the ten minute checks.

     

    On this first day, I befriended a member
    of the Black Power Gang.  He was a
    pleasant man, aged in his early twenties. 
    Although he was highly medicated, there were remnants of a sparkle in
    his eye that must have existed at sometime in his life.  However, the sparkle had now been
    distinguished.  He and I performed many waiata; him playing the Centre’s guitar,
    me singing.  We sang together and formed
    a connection based in some part on likeness of emotion as well as the
    acceptance that we were geographically close due to the claustrophobic
    confinements of the ward.  His reasons
    for entering into the high security ward were not dissimilar to other patients;
    loss of direction; loss of equilibrium; failed attempt(s) at suicide; failure
    to perform as “normal” in a society where “normal” behaviour was unfamiliar to
    the patient.  I later found these to be common
    themes among most patients’ stories. 

     

    In the high security ward, medication is
    employed by nurses as a means of subduing erratic, abnormal, anxious, or the unacceptable
    behaviour of patients. Although my experiences are limited to the stories that
    were retold to me by the patients during my five days at the Centre, it did
    appear that most patient’s was well aware of their past, present and future
    medication “needs”. 

     

    In general, and collectively, the
    longevity of the patients stay in the high security ward was measured in weeks,
    rather than days.  Most patients had
    been, or were expected to be, “institutionalised” for many weeks, sometimes
    months.  And, most had been admitted multiple
    times during their lives.  One patient –
    a man in his sixties, who self diagnosed as schizophrenic – had been admitted, discharged
    then re-admitted many times over a fifty year period.  At the time, to me, this man appeared
    perfectly sane; lucid and engaging; knowledgeable about various fields of
    academia, history, society and general knowledge.  On reflection, maybe this assessment of him said
    more about me, in that I accept that there are alternative views of reality; I
    accept that people do have different ways of thinking about “self”. 

     

    In the high security ward, most patients
    appeared to have been admitted under the Mental Health Act, in that, an event
    had occurred in their lives that had been deemed by societal practitioners
    (i.e., police, members of the community, doctors) to represent a danger unto
    themselves and/or others.  When asking
    each patient about these initial experiences, I found that each was incredibly forthcoming
    with their stories.  They were open,
    willing and wanted to share their story, to have a “voice”.  In my view, their desire to freely express
    their journey to me was brought on by their inability to have a “voice” in a
    location where ones “voice” is limited by institutionalised procedure.  Thus, for me, the high security ward represented
    a kind of Panoptican, in that it was a place where those in power (doctors,
    psychiatrists, nurses, security guards) surveyed their environment, and thus,
    had power over the “voice” of the less powerful – the patient.  This notion of surveillance was clearly
    evident on my entry into the ward and as I later was to discover, was a clear
    element of all the patients’ stories of their time within mental health
    institutions.   Sadly, what also became a
    clear theme was that for the patients, surveillance was an unhelpful concept. 

     

    Day
    two: 

    On the second day it became apparent to
    me that any deviation from a “normal” level of behaviour by patients was
    immediately met with further medication. 
    Also, if a patient asked to use the phone, to speak with a nurse, to
    inquire about what was going to happen to them, or to inquire about what their daily
    activities might be, these inquiries were quickly met with the nurses’ catch
    cry, “ok, I will let you know”.  I
    observed many patients inquire about these kinds of things.  In some cases, more than ten times in a
    morning; these were simple requests performed in a manner of politeness.  However, were always met with, “ok, I will
    let you know”.  From my perspective, it became
    clear that a patient’s request, however minor, would not be met with the
    appropriate resolution; resulting in the outcome – frustration and
    disappointment for the patient.

     

    On day two I met with a psychiatrist for
    the first time.  This meeting occurred
    thirty six hours after I had been told that the meeting would take place within
    “two hours” of my arrival into the ward. 
    “Two hours”, a timeframe that I now understand as a period of time somewhere
    between four hours and “never”.  When I
    met with the psychiatrist, I was mindful of the way in which I “looked”.  I was well aware that my clothes, my hair and
    face were unkempt.  I was also mindful
    that in spite of this exterior view, I still wanted to present as a person that
    was “together”, not erratic or abnormal in behaviour.  After two hours of being interviewed,
    questioned, critiqued and questioned again by the psychiatrist and the
    accompanying doctor, I survived the process. 
    The outcome being; “no further antidepressant medication was required;
    no further mental health follow up was required”.  Simply put, my “state of being” was not
    psychiatric, but rather, was psychological. 

     

    Day
    three:

    I moved to another ward – a lower
    security ward – after spending “two hours” inquiring about what would happen to
    me after my psychiatric assessment.   This second ward was more open, with had more
    patients.  However, the same panoptical
    experiences occurred.  In general, the
    patients in the second ward were less medicated than they were in the high
    security ward.  However, their stories of
    entry remained the same, i.e., suicide attempts, dysfunctional behaviour in a
    dysfunctional yet “normal” society, loss of perspective, that kind of
    thing.   The rooms were a little bigger
    than the first ward, but the food was the same, the ratio between nurses and
    patients was the same, the questions asked by the patients were the same, and
    the “two hours” and the, “ok, I will let you know” was the same.

     

    Day
    four: 

    As I did in the first ward, I befriended
    most of the patients in the second ward. 
    Again, we shared stories.  Again,
    these patients were forthcoming and open in the retelling of their experiences.  I became quite close and friendly with one
    particular patient who arrived at the ward late on my first evening, and
    subsequently, ended up in the bed next to me. 
    His journey to that point in his life was quite macabre; frightening,
    dysfunctional and to most people irrational. 
    But to me, his story was one of sadness; of miscommunication between
    “actors” in society; of his hope and joy, direction and latitude, opinion and
    view, not being met with the appropriate approval he clearly sought from
    others.  In this second ward, it was
    accepted that whānau – should they choose – freely visit the patients.  I observed many whānau members visit each
    patient.  Clearly, these visits helped
    the patients “state of mind”.  In
    general, they were unmonitored visits, and were never disruptive to other
    patients. 

     

    I played pool and table tennis while I
    was in this ward – often.  Mostly I won;
    an occurrence that didn’t happen with any regularity on the “outside”, in
    “normal” society.  When I lost, the person
    I was playing against was quick to ask for another game.  It seemed to me that they wanted to be “beaten”;
    to keep the games going, because clearly, many of them were capable of beating
    me.  If I were a flash theoretician,
    maybe I could theorise this as their desire to “feel” through loss.  Or, maybe they just wanted to engage more
    with people, in a non-judgemental way. 

     

    My children came to visit me in the
    second ward, as did my sister, father and mother.  My sister found it incredibly difficult to
    deal with, visibly shaking and withdrawn. 
    I suppose she prescribed to the societal view of the mentally ill as unpredictable
    and/or irrational in their thinking and thus, their behaviour.  My children on the other hand – aged 12 and 7
    – were wonderful.  They engaged with the
    patients, playing games of table tennis and pool.  Although to some people, asking ones children
    to enter into a mental health ward and visit their father may appear
    “inappropriate”, I know my children to be well-rounded and caring individuals.  They had seen me in times of despair, in
    times of trouble.  They had also seen me
    in times of great joy and in times where I had great understanding.  I had been their primary care-giver and I
    wasn’t about to stop that.   I hadn’t
    hidden anything from them before, so I wasn’t about to hide anything from them
    this time.

     

    Day
    five:

    My final day; I was discharged after
    “two hours”.  Walking outside of the ward
    into the sunshine with my sister at my side, should have been more empowering
    for me.  However, on reflection, it
    wasn’t.  Primarily, this was because I
    felt that I had survived a five day experience that informed me, more than it
    affected me; I had survived a five day period that made me become more informed
    about my own reality, my place in the world, my view of “self”.

     

    Today:

    Where to from here? I don’t know.  Do I struggle daily? Yes.  Do I fight with trying to explain the ongoing
    questions I ask myself about reality, about “self” and my external
    relationships with other people in society? Yes.  Am I insane? No.  Am I sane? I am unsure.  What I am sure of is that I am a third space
    individual who has third space experiences and third space knowledge.  It is this knowledge that I grapple with
    everyday; knowledge that both extends my understanding of reality and impairs
    it.  I do not wish to be “normal”; I wish
    to be functional and third space in my thinking, because to be “normal” for me
    is to be unwilling to accept my view of “self”. 
    Thus, for me, being “normal” is a concept counterintuitive to my view of
    “self”.  My third space choice in
    thinking is difficult to navigate because it is a way of thinking that is riddled
    with contestations and contradictions.  I
    function as a third space individual in a “normal” society, where the “normal/not
    so normal” binary is recognised as unbridgeable; where borders between the
    “normal” and “not so normal” are patrolled through surveillance of the “not so
    normal” by those actors in society deemed by a majority as the “normal”.  In a Panoptican, the less powerful “actors” have
    no “voice”.  Thus, my “voice” here is
    simply a reflection of my experiences within the panoptical landscape of the
    mental health system.  Therefore, my
    “voice” represents the collective “voice” of mental health centre patients.  

     

    Although I infer that the mental health
    system and “its” methods to institutionalise and medicate the “not so normal” do
    not appear to be working for the patient, I offer no alternative method.  What I do suggest is that the imprint left on
    patients who are discharged from these kinds of institutions, AND their
    whānau and friends, is irreversible.  I
    cannot measure or quantify how much so, nor do I wish to.  But I am sure that academics have already
    either successfully, or unsuccessfully, attempted to do this.  Here, in this forum, my “voice” is an expression
    of the patients “voice”; a simple retelling of an experience that informed me,
    and shaped me; an experience that may not be understood by people in “normal”
    society because it is an experience that may be viewed with some suspicion,
    some concern, or some lack of understanding. 
    Nevertheless, I hope that my experiences might help other patients, AND
    practitioners of mental health, engage in a “better” manner, with “better”
    outcomes for patients.  However, it is my
    fear that any resolution to the current system will take the obligatory “two
    hours” to manifest into any successful and/or productive strategy that is
    driven by and for positive outcomes for patients.

  • Gazzaw

    Onyer Cam. My longstanding business partner suffered from it for years and I hadn’t a clue what it was all about initially. We worked together very closely as  partners and his battle in a sense became our battle. Like you the toughest time was breaking loose from the medications but he did it and thank God he’s been doing real well for several years now. All praise to John Kirwan for his public awareness campaign.  

  • Wearsblack

    thankyou

  • Balanced View

    Nice one Whale – I don’t think I’ll ever get it, but happy that you’re dealing with it proactively and are using your experiences to help other.

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