Almost everyone will go through depression at some stage in their lives but even dealing with the worst kind becomes a journey instead of a battle. Here's what I've learnt: (1) The most serious threat to my equilibrium in recent years has come from stress. Everyone's limit is different but frequent feelings of being overwhelmed are a clue that "being down" has gone too far and it's time to get help. Other signs include an inability to feel good things, difficulty concentrating and a failure to think of one thing you would like to do even if you had the energy to do it.
(2) Appearance becomes too much to attend to, a word or thought gets stuck on a loop in your brain, company can feel overwhelming, you feel worthless and ashamed. Some people sleep a lot, some none at all.
(3) Insomnia becomes self-perpetuating and lack of sleep is a fast-track to insanity, so getting your sleep sorted has to be a priority. For myself, a sign that I'm having a problem sleeping is when none of the usual things such as lavender and avoiding caffeine work.
I fear insomnia and it can quickly get out of control, so I break the cycle with sleeping tablets, only ever half, only ever for a few nights. The respite from consciousness is worth the slight hangover. (4) Anti-depressants can provide stability and help with anxiety. But they can also inhibit the libido and cause weight gain as well as becoming a monthly spend that racks up. Many anti-depressants also have quite serious withdrawal symptoms.
I had a really nasty experience coming off a very low dose of SSRI. Although I was careful to reduce the dosage in small amounts, I still suffered from vertigo, tinnitus and, incredibly, given what the medication was for – suicidal thoughts.
I have also spoken to people who find themselves trapped in a cycle. This is a really serious issue and an inadequately documented subject.
Every situation is different – and bipolar issues are different again – but while I believe anti-depressants have their uses, they're over-prescribed and I would be loath to use them again.
(5) Psychotherapy is vital, but unfortunately it's expensive, and, while many health insurance policies will cover hospital bills, which average around €15,000 a month, they won't cover outpatient therapy unless with a psychiatrist.
But it's some of the best money spent when you get the right therapist – and if you don't like the therapist, find a different one.
I learnt that I was a major contributing factor to my depression; I had bad mental habits that I needed to change. While some depression is chemical-based, a lot of it is putrefied emotion.
I had to learn to acknowledge, and stop, my own negativity, fear and tendency to self-sabotage. I'm still working on those, but therapy is when someone guides you towards honesty, not victimhood, and helps you take over the reins. It's good for you and those all around you. (6) Mindfulness is brilliant as a method of moving forward. It's like an anchor and not only helps control negative thoughts but converts them into better ones.
You focus on this moment, cope, enjoy; don't think about it later or before. It makes things manageable but it also reveals fragments of beauty. (7) Exercise really helps and, although it's the last thing a depressed person wants to do, you can start small, preferably in daylight.
(8) Whether chicken or egg, there is a definite link between addiction and depression. It's a double whammy of self-loathing and a chemical rollercoaster that leads to despair. These are not necessarily separate issues.
(9) I never had the option of paid sick leave, and perhaps not having it prolonged my plateau phase, but maybe time off would have prolonged my worst phase. The distraction of work, hobbies, people and volunteering is important after a certain point.
(10) I suggest it's best to tackle depression like any chronic illness and to speak of it as such.
Explain to an employer as if you were explaining arthritis or kidney trouble. I got ill, I got a diagnosis, I'm having treatment and I'm working towards getting well. Some days are going to be bad and for these I ask your understanding. (11) When you're depressed, you worry it will come back. If you have children you worry, a lot, that they too will have it. Worry is a symptom of depression, so as you get better, it fades. And you will get better.