Monday, 25 June 2012

Must Try Harder

I can't remember when I first learned of depression; it was certainly before I ever considered I might be suffering from it, and before I had internet access to find answers easily.   I imagine the early filtering through of information came from posters and leaflets read out of boredom whilst waiting for doctor's appointments.  From this, I knew it was unhelpful to tell the person to “pull yourself together”, and that someone suffering from depression already felt useless and guilty so you needed to be nice to them. 
These two things seem pretty obvious to me.  If someone is depressed, they clearly can't “snap out of it”, or they presumably would have done so already.  Depression is, by it's very nature, no fun whatsoever.  And anyone suffering in any way is surely deserving of sympathy and support.
Apparently it's not so obvious to most people (including mental health professionals).  The same tired and unhelpful old assumptions just go on and on; people don't even realise they're doing it.  For example, people are always suggesting to me that I do things to help me feel better.  This irritates me beyond belief, because:

  1. I already do that and their suggestion subtly sweeps aside my efforts as worthless.  I know when just getting out of bed is a huge achievement; they don't. 
  2. They always suggest activities that are basically living everyday life – things like getting a job, socialising more, or taking up running/swimming/anything else that feels like climbing Everest when you're low. 

If I could do these things, I'd be fine!  The reason I don't do them is not because I am unimaginative, lazy or stupid.  It's because I feel exhausted, physically lifeless, struggle to concentrate, find things more effort than fun, and can't keep a fake smile plastered to my face at all the required times.  I'm not sat around twiddling my thumbs, bored and depressed, for want of a hobby.  Actually, I'm not bored at all, and certainly don't lack hobbies.  I'm just putting in a lot of effort for what seems like little return, trying to feel moderately ok whilst taking hours to keep on top of things like laundry, eating healthily, and not ending up being dragged to A&E by police.  I think I'm actually doing quite well, in my own small way, and suggestions for further action, however well-intended, just leave me feeling like I've got a to-do list the length of the Amazon, which is totally overwhelming and means I actually end up doing even less. 

I am constantly frustrated that otherwise kind and understanding people fail to grasp this.  It's the whole point (for want of a better word) of depression.  What gets to me especially - and I have been pondering this lately – is that other people seem to do the most silly things, whilst bumbling along quite happily and dealing with the eventual fallout with ease.  For me, the stakes are too high. I have to carefully consider every decision I make – and have learnt over time what is a good idea and what is not.  (A friend actually commented the other day that I am “quite sensible”, whilst incredulous at various unfortunate, unlucky situations I've been in.)  So, in terms of what people do with their life and the decisions they make that affect their happiness, I'm actually doing pretty well, and am in relative terms, it seems, quite wise (and oh-so-modest!)   Yet these same people who make silly mistakes in their own lives view me as someone who's just not trying very hard, or possibly is not clever enough to figure out what to do.  Even some mental health workers I've had the bad luck to encounter seem to be displaying signs of personality disorders that should render them ineligible to work with vulnerable people, let alone make judgements of them. 

I sometimes wonder if everyone actually has the same amount of 'depression potential' or whatever it'd be called, and it just manifests differently.  Some of these things are recognised as being linked to mental health – substance abuse and obesity, for example.  But what about things like having a messy house, eating erratically (though sensible weight), being racist/sexist, or generally a bit of a tosser?  These things aren't considered 'essential' by society in the same way as, say, holding down a job or managing to go to the shops without having a panic attack.  So theoretically, if I gave up bothering about certain things or caring about other people, would I have more resilience in dealing with other things?  Do I use up all my self-discipline and energy on things considered less important by society?

I've heard people being described as so depressed they “can't hold down a job”.  Yet for me, a job is the first thing that goes.  Having to be somewhere at a certain time, able to concentrate, not allowed to break down in tears, etc etc, is hard!  Yet I can keep my flat and myself relatively clean, and try to eat healthily, and don't turn to alcohol...
Do I have my priorities wrong?   Does society?

What really bugs me is that I'm the one asking for help from mental health services, I'm the 'broken' one, whilst others might be making all sorts of mistakes or living in a selfish way, yet perfectly 'fine'!  I want to yell at psych-types: “Give me some credit!” and point out all the sensible decisions I've made, not to mention the bad luck I've had too.  I suppose it's to do with the stigma of mental ill-health, and the blaming attitude towards certain diagnoses from mental health professionals.  If they decide you are not 'mad' (floridly psychotic), they automatically see you as 'bad' (attention-seeker, not trying hard enough etc).

I'm not really sure what conclusions to draw from all this, except that the mental health services are as messed up as those they treat, and their job is basically to make these individuals function in a messed up world.
On the plus side, I suddenly feel a lot saner!


Tuesday, 12 June 2012

First Post...

Have been dithering over my first blog post for some time.  This is partly because technical hitches setting up the blog and fiddling round with fonts etc has provided hours of procrastination and taken the edge of the 'new project' enthusiasm.  Of course, this isn't a 'project' but an outlet for thoughts, frustrations and reflections, but I have to constantly suppress the creative perfectionist tendencies that can take over.   Note to self: repeat ten times - “Blog is an outlet, not a masterpiece...”

The second and main reason for the delay in posting anything is that my rant-o-meter is swinging wildly all over the place, as the mental health services differ in their attitude towards me.  I set up this blog when it seemed all hope of treatment/therapy was lost, but as soon as I began expelling my wrath and disappointment in the form of a post, they suddenly became very helpful.  Rallying the forces after this unforeseen development, I started writing about my general thoughts and issues with psychiatry and mental health service provision, only to find myself becoming increasingly annoyed at and disillusioned with them and their previous attitude towards me.   I say 'previous', but this attitude seems to be indelibly, eternally etched into my notes; misunderstanding (wilful?) laid upon misunderstanding.  It causes mental health types to ask me some odd questions as they try to reconcile the person on file with the person in front of them, as well as a marked change in tone of voice over the phone whenever they get my notes up in front of them.   I sometimes worry that in future I might suffer from a rare disease, and instead of investigating it, I'll just get fobbed off as a mental attention-seeker. 
(Incidentally, whenever I imagine my psychiatric notes, I picture a huge bundle of yellowing, torn pages held together with chains, insulting words carved into them with a scalpel, sat forlornly on a trolley between dusty shelves of rustling paper.  They probably have dart-holes in too.)

Anyway, I digress; the point is that I am now wondering whether I'm actually better off out of the system. I've been reading “Users and Abusers of Psychiatry” by Lucy Johnstone which is very enlightening, although guaranteed to get the blood pressure up.  As well as being very skeptical of the mental health system, I'm also very aware that they may drop me due to a life situation (more in a moment) that would probably be labelled as non-compliance.  So I'm in a sort of non-committal, inbetween world whereby I don't want to hope for therapy I will never get, but also don't want to burn my bridges in case they may actually be helpful or I need them in future.
It really seems like it has to be one or the other though – I can't slink off, let down and hopeless; I need to be able to stick two fingers up at them, finding my own way on, knowing I tried the other way and it wasn't the answer.  I suppose what I mean is that it need to feel like a positive choice.  Obviously if they do help me, there is plenty of room for healthy skepticism, but I would need to embrace therapy to get the most use from it.
I guess I'm secretly hoping I'll just somehow get better during the next year without needing therapy, that somehow my reflections and insights will eventually all join up and complete the parts that make me struggle to function.  However, I'm not sure how likely this is, and I'm also going to be putting myself in a situation somewhat removed from everyday life so will likely appear to be fine when that may not be the case.  This is because I am going travelling (yey!) at some point over the winter.  It seems like a very good idea for my mental health to be off with the backpack again - all that soul-searching under the stars and whatnot.  Only now, of course, the mental health services are finally responding to my pleas for help (approx. 20 months after the initial GP appointment) and it will look like I am:

a) Completely irresponsible, immature, and unwilling to commit to a treatment plan, or anything for that matter (they would probably use the phrase 'not engaging with services')  
b) Trying to 'run away' from my problems (as if you can run away from problems in your mind!)
c) Obviously not really struggling, an attention-seeking waste of time as they previously thought.

With regards to the last one, I can see it seems odd that I can trot off to foreign lands when basic things here day-to-day seem so hard, and I have spent many hours musing on why this might be.  As it is, even planning the trip is making me happier although only marginally improving what I manage to do each day - probably because of the crippling tiredness I feel.   Still, when I am away I can still sleep when I want, socialise when I want, etc, etc – but with the added bonus of sunshine, exciting/entertaining experiences, and new and interesting people.  I don't know really, but if I could crack the puzzle and apply it to my everyday life, I'd be sorted.  I think it'll require further thought and a follow-up post...

Anyway, I am hoping the mental health services will understand my reasons for going away for a bit, and I will be able to get therapy when I return.  Even better, that I magically get better (or at least slowly get better via insights as mentioned) while I am away and hereafter lead a worthwhile, productive and fulfilling life.
Or something like that...