Helen was diagnosed with, and treated for, depression in her late 40s, after many years of 'weird and bizarre' experiences. Throughout her life, she has coped with a range of symptoms from anxiety to deep depression.
Tell me about your life and when you first felt something wasn't quite right.
I think almost ever since I can remember, I felt something of an outsider in my family and at school. I was aware that I got tummy aches all the time, that I wet the bed and bit my fingernails, and that, generally, I was an anxious child. My parents were very kind about that. The school wasn't, but my parents were.
That was just the way I was, feeling anxious, as if I had a layer of skin too few. I tended to retreat into myself and read books, because sometimes relating to people was just too hard.
When I was in my 20s, at home with two small boys, I began to ritualise things. The kids got exactly the same thing for breakfast, lunch and tea. And I did exactly the same thing every day, in the same order. Looking back, I think it was a way of creating a reality, when I felt very isolated and lonely.
I wasn't diagnosed with depression until I was almost 50. And, at that point, I'd had all kinds of experiences that were weird and bizarre.
Why didn't you get a diagnosis for such a long time?
I really don't know. I think I probably present as a pretty positive person. I started doing these really odd things and I was ashamed of them. I didn't feel they had anything to do with illness. I always thought that it was a form of moral failure on my part.
I guess I have done good things to try to counter the difficult but I think, with depression, it's a constant battle to stay on top of it. It's a constant battle to get up in the morning, not to think negative thoughts and to try to redirect your thinking if it's becoming negative, and it's very easy to turn for comfort to things that are themselves destructive: alcohol, cigarettes, inappropriate relationships.
There's a whole range of comfort things that our society allows and condones, but which can turn on the person who uses them. A drink in the evening after a difficult day can become more than one drink, and there's always the possibility that something will turn into a dragon that you can't keep in the cave.
Can you tell me about your depression and how it manifests now?
My depression has worn so many different faces and continues to. I think, when I was younger, it came more in the form of anxiety, and the anxiety would become more and more intense until it became compulsive behaviour.
In recent years, I've had some really severe depressive episodes; it's as if you turn into a person who is observing her own life and you think, 'It's okay, because all of that awful stuff is happening over there, and I'm not really in that'. For me, it has felt like I'm standing on an island, detached from the mainland, and that island is starting to float out to sea. That becomes a very seductive kind of image, that your last vestige of control is that you could end it. You don't have to put up with it any more; as though you could choose a painless way in which the island could continue to float out.
You never realise what a seductive idea suicide is until you are severely depressed, because, I suppose, ordinary people think of suicide as being impossible, because it means leaving all the good things in life, but that's not the way it is. Suicide is about leaving all the bad things behind.
And yet there is something in yourself that says, 'No. No that's not an option. No, you must resist that because, even though awful things are happening over there, there are still these people and you love these people, and there is still a life and you are alive and you're part of life'.
Is having suicidal thoughts something you feel goes hand in hand with depression?
It certainly does. I remember seeing an advertisement recently where someone said that ballet is like an Olympic sport but it has to be made to look effortless, whereas, with sport, it doesn't matter if you grunt. So, in my life, I try to keep the grunt and sweat of keeping the seductive bad things out of the way invisible, and I try to build up a bank account of positive things, so I can draw on them when I need to.
One of the things that severe depression has taught me is that you don't have to be 100 per cent 100% of the time. I have put a burden on myself much more than other people have put on me and, hopefully, I'm learning how to modify that and say, 'No, I need time out too. I need “fritter time”, the same way that I need fritter money! I need time that I don't have to account for and I don't have to be 100 per cent there for other people all the time'.
I think people really don't understand what depression is. If I had diabetes or heart disease or breast cancer, there would be immediate recognition that I had a legitimate illness. Depression is something that I have trouble feeling is legitimate.
Do you take medication?
I do and it's terrific. I've tried a number of medications, and some of them have had side effects, so I've changed medications to minimise the side effects. I regard them the same way I regard hormone replacement therapy. If I can take something that is going to change the chemistry in my brain to work at its maximum, then I am happy to do that.
I see a psychiatrist regularly, where I talk about how I'm managing it, how I'm coping with it and how things are going in my life; I find that hugely supportive and helpful, because I find that it's one place where I can put my needs first.
What would you say to someone recently diagnosed with depression?
I would say, it's an illness. There's very good treatment, but you have to be very proactive in going out and getting the best mix for you. Give things a good go, but don't be content until you've got the best mix for you.
If you're depressed and you have to be proactive, how difficult is that?
It's incredibly difficult, and I think that's where education for the community comes in. If you have someone in your family who's been diagnosed as depressed, you can't expect that they're going to get up and do a whole lot of things on their own behalf. A good idea might be to take steps on their behalf (with their consent) and, when they're very well, say 'What would you like me to do on your behalf if you should suddenly become very ill?' So that, if they get to a point that they can't act productively on their own behalf, you've made a deal as to what can be done.
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