Bi-Polar, Depression

Depressive Illness – The curse of the strong

IMG_5311Depressive Illness (The curse of the strong)   Dr Tim Cantopher   Sheldon Press 2003

I picked this book up at our local support group and from the very first page I knew that this was the best book on Depression that I have read over the years.

 

His introduction starts with typical Monday morning blues after a restful weekend as he explores all the feelings this brings. The point he makes is that those who feel down on Monday mornings or dip into low mood occasionally, for example when they are tired or getting over a virus, are not what the medical profession would call ‘depressed’ although many people do use this expression to describe their moods. He cites those who say ‘oh I get like that and I just pull myself together and get over it’. They don’t ‘get it’ and he comes down heavily against people who make such comments to those with depressive illness. It is not helpful.

 

This book is not as heavy as some I have ploughed through. It is accessible and an easy read. Cantopher has an engaging tone and he certainly knows what he is talking about. He describes what happens to the brain when people fall into the depths of. In depression, the levels of the chemicals in the synapses of the limbic system plummet and the nerves get less sensitive to the chemicals too. This is usually brought on by stress or other triggers. Basically if the limbic system is taken beyond its design limits it will malfunction and a gap will appear between the end of one nerve and the other (the synapse)

 

His list of symptoms is the most comprehensive I have seen. Most symptoms involve ‘loss’.

Loss of sleep, appetite, energy, enthusiasm, concentration, memory, self-esteem, sex drive, drive, enjoyment, patience, feelings, hope and love. However, loss of memory, according to the author is caused by the loss of concentration and does not mean the memory is impaired.

 

Chapter 5 is What to do when you get ill and he devotes three pages to ‘rest’, likening it to a thermostat which has got too hot and has to be switched off. While he accepts that sufferers initially spend long periods in bed, he advocates a preference for plonking yourself on the settee and watching mindless day time tv or romantic films ie nothing too taxing.

 

His chapter on Staying Well is excellent. If nothing changes and the same choices continue to be made in your life then the depression will come back to hit you again and again. He equates ‘crisis’ with a ‘time of opportunity’ as it allows you to switch off, cancel your busyness and all those activities which led you to ignore your self-care. This is the opportunity to make changes. If nothing changes, everything remains the same.

 

Once recovery has begun the author describes a stage when he visits a patient and finds the hoover in the middle of the room. We feel better and the mess is at last irritating us and making us want to ‘clear up’. However, we get the hoover out and start hoovering only to find that within 5-10 minutes we are exhausted and abandon it. We can’t even put it away.

 

When I recounted this stage to my partner he immediately recognised it. The spirit is willing but the body has not recovered enough. The lack of exercise over even two or three weeks will take its toll. Also lethargy is one of the symptoms. Rather than hoovering the whole house and leaving ourselves exhausted and back ‘down the hole’, he advocates increasing such activity slowly. For example, rather than push yourself to go to the supermarket and feel drained, make your first outing a trip to the shop on the corner. Oh yes, I have found myself there a few times since Christmas.

 

There is much more in the book to explore. As the author says, if you are reading it when you are first unwell just read the first five pages in two or three efforts. Even the most avid reader cannot concentrate on a complicated novel when they are depressed.

 

I have to return the book in ten days time so I intend getting my own copy.

 

Do try it and see if it makes a difference to you. I did it for me!

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READING AND WRITING AS MEDITATION

Occasionally in life an activity not of our choosing is found to be enjoyable. This, of course, is part of the learning undertaken in school. If we chose to play all day, we would not learn to read and write, skills which enable us to disappear into another world either of our own or another author’s making.

Reading and Writing are a form of meditation but were sadly not encouraged in my mental health wards. To be read to is a wonderful gift and this could be done easily by a staff member, visitor or volunteer. To brainstorm ideas about depression and recovery and write a four line verse is creative and empowering.

I have never found the art activities on hospital wards helpful as I am not a person who paints or models with clay. I do decorate my own home and find that a calming and satisfying activity but to represent my feelings on a piece of paper is just not my way. My way is with words. Sadly the thinking seems to be that art is healing for the mind, so volunteers and even paid art tutors come to mental health units to conduct sessions. I can see how it can help some but, for me, I need the written word.

I have sometimes tinkered with the idea of volunteering to do some creative writing in our local hospital, particularly poetry which is a shorter, more easily composed form and with which I have had success. But always at the back of my mind is the thought that perhaps I do not want to return to the place that could remind me of my dark days one spring only two years ago.
Perhaps this year, which is a special year for me as I reach a birthday with a 0 on the end, I can add this activity to my list of firsts.

If I could open up someone’s mind to free or rhyming verse and start them on the road to reading and scribbling ideas, it will have been worth it.

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THE LEARNING JOURNEY OUT OF DEPRESSION

HOW FAR HAVE I TRAVELLED?

I have journeyed far since my diagnosis in 1991, following a second breakdown. It was called manic depression in those days and I thought it would go away. It never occurred to me it was here to stay and would shadow me through life tripping me up when I was off guard. No-one told me anything about the nature of the condition, its causes, symptoms, signs and treatments. After both spells off work I ploughed my way back into normality through a black cloud, feet wading through treacle and my stomach tied up in knots.

There was no help outside of hospital in 1989 or 1991 – well not where I was living. Both times I was discharged home to an empty house where I sat in the same chair in the kitchen for 12 hours a day. It was what is now fashionably called ‘a dark place’. My only outings were to buy a few items of food to cook at night and to walk our dog in a nearby large park. My colleagues at my college were busy and some shied away from contact with me. It was a desperately lonely time – a drab existence with a failing relationship and the belief that any good life was over forever, that I was unworthy and deserved little. My weekly GP visits brightened my life not because of the doctor but the lovely Receptionist who greeted me warmly, the first time saying how nice it was to see me out and about. She could not have known how I treasured that statement. Few said the same preferring to treat me as an odd ball.

When out of the house, I avoided people, frightened they might ask why I was not at work or might sense I was a mentally ill misfit. I was scared most of the time. Scared of losing my marriage, my job or my home or all three. After all I had met patients in hospital who had fared much worse than me in all three areas.

Luckily I returned after both breakdowns to resume teaching. Perhaps mistakenly but I knew no other way to earn my living. No-one suggested the stress could make me ill again. There were no CPNs (Community Psychiatric Nurses) visiting me at home, no day centres to offer occupational activities, no home visits from the GP. There was just one follow up Out Patient appointment six weeks after discharge. Five minutes to say if I was feeling better. No advice, my only medication a mixture of anti-depressants and Lithium.

I look back in horror at a NHS mental health system that was so lacking in care and information. No-one sat me down and explained what manic depression was so I continued a rather frenetic lifestyle, working late at night marking assignments, planning lessons and writing. I failed abysmally to nurture my inner self, take care of myself properly or do my relaxation exercises – these were the only technique used at my hospital. Once home I had no tape to use although after the second breakdown I was given one but using it was impossible as my husband objected to me shutting myself away in solitude and quiet. I still smoked 20 cigarettes a day and drank more than I should. I had not conquered the essence of a healthy diet and when I did take longer shopping one week when I decided to read all the labels and consult a healthy eating magazine my longer than usual absence was criticised.

In the end my proactive nature saved me. I scoured bookshops for books on depression – the internet was in its infancy – and spent hours walking my dog trying to work out what had gone wrong in my life. It was hard work but I learnt a good deal. I read much and used exercises in the books such as making a list of five things to do each day that I would enjoy. I did crosswords, took up knitting and began writing a diary.

I was, in effect, my own therapist and in the end that is what we all have to be. Recovery has to come from us. No-one can do it for us. But when everything in your head and body is broken and your world is in a state of upheaval, it is practically impossible to take action. Only those who have suffered clinical depression understand how hard it is to drag yourself out of the mire.

I did emerge from the dark place and the mire gradually became a clear calm lake on which I could sail my boat of life. I hope to write about those dark days and how I brought myself back to the land of the living. It won’t do me much good but it may help others.

A card from a true friend contained the following phrase which I try to remember when the clouds darken my mind from time to time. She wrote ‘you will soon be back in the swing of things’.

And I was.

 

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