So, you take your pills, have your therapy, learn some lessons, write a few blog posts, and your mental health problems go away and leave you in peace, right?
Well, maybe they do and maybe they don’t. Perhaps they go away for a while, then pay a return visit at a later date. But it’s also entirely possible that your enemies will become like the horror movie franchise villains who stubbornly refuse to die, and come back for seemingly endless sequels.
The latest dip in my rollercoaster recovery began towards the end of last summer. These late-summer plunges have happened before in the last few years, but to avoid the pattern becoming too predictable, depression and anxiety – being two sides of the same coin, and being partners in crime – like to mix things up and take it in turns to lead. One weighs in first, usually triggered by some kind of prolonged stress or worry, then the other puts the boot in.
They seem to lie in wait for a time when I’m winding down and starting to relax, so holidays can be a prime opportunity. That’s when all the pent-up mental poison starts to ooze out and build up, like that nasty pink slime in Ghostbusters 2.
What does it feel like?
My thoughts turn dark and destructive, the despondency and lethargy set in, and other symptoms start to show:
- irritability and anger – finding people insufferably annoying, especially those who dare exhibit any energy or enthusiasm when I have none
- illnesses – I’ve had a different illness every month since last October, ranging from a standard cold to lingering laryngitis, suggesting a run-down immune system
- despair and fear – seeing the worst in everything, and finding it hard to see things getting better
- paranoia and over-sensitivity – I get wound up by any little comment aimed at me, even if meant in jest, to the point that I get embroiled in a series of long-running imaginary arguments
- over-thinking, indecision and forgetfulness – the din in my weary brain makes any kind of thinking difficult, and impossible at times
- mornings are hideous – I haven’t had problems sleeping with my latest episode, but getting myself up and out in the morning still feels like I’m having to physically drag my leaden body to wherever it needs to go.
“I’m fine, thanks.”
I wonder how many times a day we get asked how we are, or we ask how other people are. It’s how we greet each other; part of everyday conversation.
I’m generally a very honest person, but I have lied to people. I have lied a lot. Because many times when I don’t feel fine in the slightest, I don’t want to say so. It’s not that I mind being asked, I just want to pretend I’m fine until the reality catches up, and I don’t want sympathy, or to drag other people down.
The confusing thing about depression and anxiety is that we can also feel perfectly fine for much of the time. Once I’ve got through the first half of the morning and got suitably distracted, I might well have a perfectly decent day, unless something triggers a negative thought. Then I’m at the mercy of spiralling, toxic thoughts and feelings.
I am fine right now, and have been fine for the past few days, and that is good enough for me. If I wasn’t feeling fine, I wouldn’t be writing this and I certainly wouldn’t be sharing it.
So what am I doing about it?
As I always do with these episodes of mental ill-health, I try to face up to my problems and get help in various ways.
I went to see an excellent doctor, and – with some hesitation – decided to team up again with my old pal Citalopram, an antidepressant that I’ve just about managed without since autumn 2013. I always thought I wouldn’t want to go back on the meds, but it was a better option than struggling on without them.
I’ve been on a course, learning tips from cognitive behavioural therapy (CBT) and am on a waiting list for some further CBT to try and crack some persistent and recurring issues.
I’m trying to get out and enjoy nature as much as possible, so am grateful for the weather improving in the past week. The continuous rain and snow was, I think, getting me down more than I realised.
And I’ve finally found another kind of exercise that I’m enthusiastic about and committed to, having drifted terminally from running. I’ve joined a martial arts class after seeing how much my son loved it. The intense workouts leave me thinking I am either going to vomit or keel over, but it’s a good way to release tension and focus on something positive.
Perhaps my biggest lesson in these last few years has been that life does not have to be about doing, exceeding or producing stuff. There is great value in doing very little, or passing time in a not-obviously-productive kind of way – things like jigsaws, favourite TV programmes, games… and trying to rediscover hobbies like drawing birds.
I’ve also made a conscious decision not to set myself unnecessary challenges this year. Why add to the pressures of daily life?
To end on a positive note…
There is one consistently positive thing that recurrent depression and anxiety do for me. Each time they gang up on me, and I go through this gruelling experience, it makes me rethink and evaluate my life. What can I do differently? What’s harming me? What’s good for me? What have I tried that worked but I’ve forgotten or neglected? What haven’t I tried yet? Is there something I should give up? Something I want to find time for?
So I keep learning and arming myself against these attacks. I’m lucky in many ways – my depression and anxiety are fairly mild compared to what many people endure, and I have the support of great family and friends.
I’m sharing this not to alarm anyone, not to attract attention, or to elicit sympathy or pity, or to be considered brave, but just to be honest about my experiences in a society that still stigmatises people with mental health problems.
One year ago, I sat down to write my first Dippyman blog post – a whimsical piece about the timeless delights of a seaside holiday in Filey. The year, and the theme of my blog, came to be dominated by something far less jolly.
I’d set up the blog about a month before but wasn’t quite sure what I wanted to write about. I just knew I wanted to write. I toyed with the idea of writing about what it was like to turn 35, but realised that if I didn’t care what it was like to turn 35 nobody else would either. I thought maybe I would write about birds, and indeed I did, although just the once so far.
Once I got started, I thoroughly enjoyed writing, and went on to describe things that amused or interested me, but it was something that was completely devoid of amusement that launched my blog in a new direction – depression.
When I started writing Dippyman, I had been living with depression for nearly two years. I’d been on antidepressants for more than a year and had finished my first round of counselling. As the summer went on, I felt well enough to lower the dose of my medication and that went well for a while, but in my haste to leave the tablets – and (I thought) my depression – behind, I went further than my moods would allow, and had to increase the dose again before the summer had ended. My stress levels were building up.
In September, I wrote about depression for the first time, likening stress and depression to Darth Vader and the Emperor from the Star Wars films. It was a big step to take. I’d only told a handful of people how I’d been feeling, and friends and colleagues reading about it were surprised. I’d obviously hidden it well, although that did me a fat lot of good. Being open about my illness made it easier – less like a dirty secret.
I returned to chirpier subjects for a while, but depression had a sting in its tail. Well, I say a ‘sting in its tail’ – it was more like a whopping great boxing glove smashing me in the face. Bash, bash, bash. It hit me with a knockout blow on 13th October, when I found myself dazed and confused, asking ‘Can brains explode?‘
I staggered zombie-like through a day at work on the 14th, but it was a case of the lights being on (perhaps with a dimmer switch) and nobody being home. My self-esteem plummeted. My moods turned black. The insomnia started. A star was born – my twisted, shadowy alter-ego, Paul Brookes, who made frequent appearances in my blog posts during the bleakest months of my life.
When I was feeling most dreadful, when I was off work and had increased the dose of my antidepressants, something unexpected happened. My blog took off. I’d read on Twitter that some people were using the phrase ‘mental health day’ as a euphemism for throwing a sickie, or skiving off work. I was enraged – perhaps not surprisingly, given my circumstances at the time – so I wrote about it. A friend at work tweeted the link to Alastair Campbell, who read it, described it as ‘excellent’, and shared it with his thousands of followers. It didn’t stop there. Next I spotted a tweet from Jeremy Vine, who also shared the link, saying:
“Man writes brilliant blog about his depression”
The response was way beyond anything I could have expected. Nearly 1,500 people read what I’d written in one day alone. I was overwhelmed and humbled, and in my depressed state didn’t really know what to make of it all, so I just kept writing about how I was feeling. It was quite therapeutic, and the supportive and encouraging comments I was getting – and have carried on getting since (thanks everyone!) – helped me to keep going, at a time when I would be sitting in my car praying for enough strength to cope with the day ahead, lying wide-awake at night silently pleading for sleep, or staring into the distance with an unseen enemy feasting on the destructive thoughts in my head.
Since then, I’ve been privileged to write about depression for a number of great organisations, websites and magazines, have written 40 blog posts (41 now), and my site stats tell me that the pages of Dippyman have received more than 33,600 visits at the time of writing. On one crazy day in January, more than 2,500 people visited in one day, after more kind tweets from those top gents Vine and Campbell and a one-off retweet from Twitter colossus Stephen Fry.
Reading this objectively, it could sound like I’m blowing my own trumpet. Apologies if it comes across that way. Really, it’s just my way of proving to myself – reminding myself – that from the abject misery of depression, something to be proud of has risen. I felt like nobody and this blog, and more importantly the support, encouragement and goodwill that so many people – friends, relatives and strangers alike – have given me, has helped me to feel like somebody.
The blogging year ends with Brookes as the nobody – a fate he deserved all along.
I’ll end this anniversary post the way I started Dippyman last July, with a happy memory of the seaside. I was in Filey again last week, and took this photo of a lifeboat, which – with its bright colours and the promise of help for people lost at sea – seems a fitting way to sign off.
This article was first published in One in Four magazine, summer 2012, as part of a feature headed ‘Can celebrities contribute to the battle against mental health stigma?’ Yes, they certainly can, I argue.
It’s hard to talk about depression and other mental illnesses, especially when you’re living with them.
You might feel ashamed – like you’ve failed in some way, like you are weak. Or you might be afraid of the reaction you’ll get if you do talk about it. Will you be called a nutter? Will people treat you differently? Will you get told to pull yourself together?
In an ideal world, anyone, anywhere, at any time, would be able to talk openly about their experience of mental illness without worrying about discrimination, ignorance or stigma. Until we arrive in that world, there is a lot of awareness to raise.
Everyone who feels able to can play a part in improving understanding and awareness of mental illness, but celebrities are able to do more than most. They have fans, admirers, connections – people who listen when they have something – or nothing, as is often the case – to say.
This might make it seem that celebrities have it easy, with this huge, ready-made audience hanging on their every word, but might the opposite be true? Any person – let’s not forget that celebrities are people, not just tabloid fodder – who is suffering from depression (for example) is likely to be low on self-esteem and feeling vulnerable. I think it takes enormous courage to bare your soul to potentially millions of people if you’re feeling like that, or can remember vividly what it feels like.
OK, so there are too many so-called celebrities getting too much coverage in too many places, and perhaps some might use their mental illness to boost their profile, which might trivialise what other people are going through. That shouldn’t detract from the great work some famous people have done to explain the reality of depression, bipolar and other illnesses.
I’m recovering from depression. One thing that has helped me in the last few months is finding so many other people, particularly through social media, who have gone through the same thing or are still going through it. It’s been very encouraging to read, watch or hear some famous people in sport, entertainment and politics talking openly and honestly about their experiences of mental illness.
By sharing this part of their lives, they’re showing it’s OK to bring it out in the open. It’s not something you have to keep quiet, as I did for a year. It’s not something to be ashamed of. It isn’t a dirty secret. Depression doesn’t discriminate. It is an illness and it can affect anybody, rich or poor, famous or unknown. If one in four people experience mental illness, that same statistic must apply to famous people. Why shouldn’t they talk about it?
I’m grateful to celebrities who talk about mental illness. If they can describe something I relate to in a way that can reach thousands or millions of people, that’s a powerful force for good. I raise my hat to Stephen Fry for his documentary about bipolar; to Andrew Flintoff for his programme on depression in sport; to Ruby Wax and Rolf Harris for talking about depression on TV chat shows; to Alastair Campbell and Bill Oddie for writing about their experiences; and to pop star Frankie Sandford for telling the press about how she had felt worthless – that if she disappeared it wouldn’t matter at all.
People look up to celebrities – idolise them, even. The growing number who are talking openly, genuinely and informatively about mental illness are using their fame to help others in the same boat. To me, that’s what being a role model is really all about.
It’s had a go at my moods, my self-esteem and my energy, but one thing depression hasn’t been able to defeat is my sense of humour. Although I haven’t felt like laughing a lot of the time, there is still part of my brain that’s hot-wired to automatically generate puns at every opportunity.
Even in my darkest moments, I don’t know if I’d have been able to resist the obvious ‘tooth hurty’ gag if someone had said to me that they had an appointment with the dentist that afternoon. If you wanted a blog about double entendres I could definitely give you one. If you wanted pencil puns I could quickly get to the point. If you wanted puns about baking bread I could rise to the challenge. As for dairy puns I could milk that subject until the cows come home.
While I try to see the humour in most aspects of life, there are some things that just aren’t funny. Depression is one of those things. Confusingly, despite its extreme unfunniness, there is a link between this miserable illness and comedy. People experiencing terrible depression can still be very funny. Take Kenneth Williams, for example – a man who made millions laugh, but who suffered from depression throughout his life. He is one of many high-profile comedians or comic actors to have grappled with mental illness while making a name for themselves as someone who tickles ribs and splits sides.
Making other people laugh is a good – but often unintentional – diversion from what is going on in your head. On the outside, you appear bright and bubbly, like a glass of champagne. On the inside, you might feel more like flat cola or sour milk, but nobody would know, because you’re still cracking jokes. When there’s nobody else around to amuse or entertain, that’s when the forces of darkness are at their most powerful and dangerous. With just depression for company, there’s little chance for a chuckle or a chortle.
Humour, it would seem, comes in spite of depression, not because of it. For all those depressed people who carry on making others laugh, it’s not depression itself that’s funny. How many jokes do you know about it? I’ve just done a quick Google search for ‘jokes about depression’. It turns out there are some, but unless I’ve missed any hidden gems, most don’t actually seem to be about the depression I know and none made me laugh. This doesn’t surprise me. I’d already experimented with my own jokes about depression, substituting parts of some very old and well-known jokes with depression-related symptoms or scenarios, and found them about as funny as a cabbage. For instance:
Patient: Doctor, doctor, I have constant headaches, I’m frazzled, I hate myself and don’t look forward to anything any more.
Doctor: Maybe you have depression.
OK, let’s move on.
Why did the depressed person cross the road?
Because they hoped the other side would be better than this one.
Oh – again, not funny in the slightest.
Someone with depression.
Someone with depression who?
Let’s stop right there. That one doesn’t even make sense.
How many depressed people does it take to change a lightbulb?
Who cares about the lightbulb?
Enough! You get my point. If this blog was a stand-up routine I’d have been booed off.
Much as I love a pun challenge, I have to admit defeat. I just can’t think of anything funny – or even worth a small smirk – about depression. Can you?
Whoever said nice guys never win was wrong. At least, that’s what I’m telling myself as I prepare to enter a battle that I really need to win.
But am I too nice to fight? After all, the only fight I’ve ever had was in 1987 and resulted in me getting my ears boxed. I am, by and large, a fairly gentle soul. I try to be kind and thoughtful. I try to put myself in other people’s shoes, however ill-fitting they may feel. I’m generally quite affable, pleasant and jolly. Chirpy even. I enjoy making people laugh. I am, of course, only human. I’m also impatient, stubborn and sometimes grumpy. I say things and do things that I later wish I hadn’t. But I think ‘nice’ is a word quite a few people would use to describe me. So that takes us back to the question about whether I’m too nice.
Well, too nice would suggest that there is something wrong with niceness. It would imply that niceness is something undesirable – a chink in the armour, a flaw in my personality. Maybe I’m some kind of nice doormat for people to step on. Perhaps I’m a wispy bit of wishy-washy niceness that gets pushed aside as the stronger personalities barge past.
I’ve decided in the last couple of days to stop thinking of my niceness as a weakness – something I need to change if I am to become respected and successful. I will recognise that being nice is part of being me, and I’m giving myself permission to accept it, not to fight it.
Niceness is, after all, a good thing. Surely it’s better than being nasty. A nice friend of mine unwittingly confirmed this today when she said:
“My mum always said when I was a little girl that being nice is the most important thing as it makes the world go round.”
Niceness is a strength. If you can still be nice to people every day – even when you feel like you can’t cope, that life has trodden you down and it would be easier if you didn’t have to be you – then that is a sure sign that you are made of strong stuff. You’re a tough nut to crack.
There can, however, be a hidden downside to niceness, and to being a tough nut. A ‘nice’ person is often one who is diligent, reliable, sensitive, has a strong conscience and sense of responsibility – all admirable qualities, but all things that can bring extra stress. Dr Tim Cantopher, in his book Depressive Illness: The Curse of the Strong, says:
“Give a set of stresses to someone who is weak, cynical or lazy and he will quickly give up, so he will never get stressed enough to become ill. A strong person on the other hand, will react to these pressures by trying to overcome them. After all, she has overcome every challenge she has faced in the past through diligence and effort. So she keeps going, absorbing more and more, until, inevitably, symptoms emerge.”
And that’s pretty much a summary of how I ended up with depression. I carried on coping at work, wherever I was working and whatever the demands. I carried on coping at home, in spite of a total of three years of disrupted nights while I adjusted to the challenging world of fatherhood. I was strong. I kept going. But something had to give – and it did.
The fight I mentioned earlier is not a physical fight. I’m not going to enter a boxing ring and pummel someone senseless. I’m not going to get into a street brawl. I am, though, going to be handing out a severe beating to a special someone: Paul Brookes.
“Who is this unfortunate character?” I hear you ask. “What did this chap do to you?”
He’s my twisted alter-ego. My nemesis. The vicious, low-life, power-crazed villain who skulks in my subconscious. And I’ll tell you what he did to me. He brought me down. It wasn’t even a fair fight. There was no ‘Paul Brook in the blue corner, Paul Brookes in the red corner – ding ding, round one’. No, he crept up behind me, pulled a sack over my head and suffocated me. He is my depression – and he deserves what is coming to him.
So what form will this fight take? I’ve thrown pills at Brookes, and he’s been weakened but hasn’t retreated. He was knocked down by my first round of counselling, but had a rest and made an unexpected comeback when he was ready.
A very wise gentleman who lived next door to me when I was a boy once gave me a pen and told me:
“The pen is mightier than the sword.”
Although I mostly write using a computer these days rather than a pen, the message is the same. Words are powerful. I’ve been blogging about depression for a few months now, and each post has, in some small way, punched a small hole in the force field surrounding Brookes.
It’s time to take the fight to the next level. Armed with my own resilient brand of niceness, I will kick Brookes’s backside with the boots of merriment; stab him with the sword of silliness; knock his lights out with the fist of fun; and render him powerless with the shield of pleasantry.
To help me win this duel once and for all, I am going back to my counsellor. And that is what this blog post is really all about, under all the dramatic metaphor. A normal, fairly nice bloke, struggling with an illness, getting some help – and mustering up some extra courage and fire in his belly to try and shut that illness down for good. Begun this war has.
I have a little friend called Citalopram. We have a strange friendship. We have had our ups and downs, and on occasions I’ve doubted whether I need him in my life. Not only that, I hope we’re not going to be friends forever. I’d rather we remain friends for the next few months and then, when spring arrives, we might be able to go our separate ways and bid each other an amicable farewell.
The problem is, it’s hard to say goodbye to Citalopram. After a couple of attempts, I’ve had to concede that actually I do need him. He’s just a tiny, white, oval-shaped tablet – considerably smaller than Paracetamol – but he is a powerful little chap.
Now that he and I are friends, I find it hard to admit to him that once I had quite a prejudice against him, and others like him. Antidepressants. Ugh.
In early 2010, I had to face up to what was happening to me. I’d been getting headaches every day for two or three months and was getting struck down by minor ailments on a regular basis. I was clearly stressed out and had lost my perspective. I wasn’t looking forward to anything and was experiencing some horribly dark moods. The only thing was, I was afraid of going to see the doctor about it, because he might ‘put me on tablets‘.
I don’t know why I didn’t trust these ‘tablets’. I didn’t even know what they were, but presumably they were going to alter my mind, and that just didn’t sound right to me. The irony was that I was having to take Paracetamol at least once – often twice – a day for my headaches. I had no problem taking on a headache with medication, but this was different.
It’s obvious now that my mind needed altering, because my nemesis and shadowy alter-ego, Paul Brookes, had crept into my brain, staged a hostile takeover and needed sorting out. When I did go to see the doctor, he confirmed what I’d suspected but hadn’t really wanted to accept. I had depression.
One of the standard ways of treating depression is with antidepressants, like Citalopram, which is what I was prescribed. You can take it in various doses. I started off on 20mg, a fairly low dose.
“What’s happening to me?”
The first night I took Citalopram, something scary happened. I got up to go to the toilet in the middle of the night. The next thing I knew I was lying face down on the bathroom floor, feeling very strange and extremely queasy. I hadn’t a clue what was going on. I managed to crawl to the bedroom, where my wife found me. She realised I had fainted and luckily for me she was very calm and knew what to do.
I still felt unwell the next day, and had to make two phone calls:
- to my doctor: he said the fainting episode might not be related to the antidepressants. It’s apparently not uncommon for men to get up during the night to go to the toilet and then faint, because their blood pressure suddenly drops. That’s how I remember the explanation, anyway. The drop in blood pressure might have been a result of taking antidepressants, but might have been nothing to do with it. Whatever the case, it has not happened since, which is quite a relief.
- to my manager at work: this was more than the average “I’m ill and not coming to work” phone call – it was a revelation that I was mentally ill, and one of the first times I’d had to discuss it with anyone outside my family. Fortunately for me, she was very understanding and supportive. I had to take two days off, but was back doing my job just as well as usual the following week.
Since then, I’ve had a rollercoaster relationship with Citalopram. The 20mg dose didn’t seem to work, so my doctor upped it to 30mg – one 10mg tablet and one 20mg. There was an improvement and the headaches gradually disappeared, but although we were treating the symptoms, only counselling could get to the heart of the causes and help me to deal with them.
Early in 2011, I was feeling good. By the time I’d finished my course of counselling, I was feeling ready to reduce my dose of Citalopram. You can’t just stop taking it by going ‘cold turkey’, I’ve been told. The consequences do not sound attractive. So I dropped it to 20mg after talking to my doctor.
It was at this point I learned how big a difference antidepressants can actually make, because I soon found my mood darkening again, just by dropping 10mg of Citalopram. Within a week, I’d gone back up to 30mg. Once things had settled down again, and I’d been feeling great for a few weeks, I tried 20mg again.
This time, there was no backlash from Paul Brookes. I was fine on 20mg – yippee! I could sing Jimmy Cliff’s ‘I can see clearly now’ loudly and confidently in the car, knowing I was at last on the way to getting myself off my medication. I started dreaming of cold beer, a cheeky whisky, or maybe a glass of wine one evening. Citalopram and alcohol don’t mix well, I understand, so I have been teetotal since the day I took my first pill.
As summer 2011 neared its end, I dropped my dose again, down to 10mg. Was the end of my Citalopram odyssey in sight?
Alas no. I’d dropped my dose as a particularly busy and stressful season kicked off at work, and I needed my little friend to help me fight the re-emergence of Brookes. My doctor said I should stay on 20mg as my stable dose through the winter, which I was happy to agree with.
This time, though, my little sidekick was no match for the sinister powers of Brookes, who rose from the shadows and gave me a good beating, this time resulting in three weeks off work and a return to 30mg of Citalopram.
I’ve learned a few things from this unfortunate adventure:
- Depression is an illness, which you can treat with drugs, just as you would with any other illness. And, like other illnesses, people recover and no longer need those drugs. The same will happen for me – just not quite yet.
- Citalopram is a powerful drug. You might think it’s not doing anything, but it is. I only really recognised this when I tried to come off it. It needs careful management and close consultation with your GP.
- I need Citalopram at the moment, and don’t see this as failure or weakness. It is a necessity, and the alternative is much more damaging.
- Antidepressants are my allies. Citalopram has complemented my counselling, curbed my anxiety, banished my headaches and cured my insomnia.
So I have accepted Citalopram as my friend. I’ll be glad when he’s gone, but only because that will be a clear sign to me that I am better. In the meantime, he’s my companion on the road to that promised land.