Approval Junky

Having the approval of others is something I have chased; it’s all part of who I was, and the mould I came from. When you have a feeling of worthlessness at your core, you need to find a way to get by… to live with it. For me, it was to have my worth confirmed by others.

I won’t pretend that it is easy to be this honest with myself. The truth is that what started as a child chasing approval and praise turned into an entire career. People climb the career ladder for different reasons; what I heard was people saying… ‘You could do that’, ‘you might be good at that’… and whilst that is lovely to hear and encouraging… it was more than that to me. I would only have to hear those words to start chasing the next thing. A career built on vanity.

I wasn’t really in control. Like any junky, it was all about the fix and when you got one you’d start thinking about the next. Trying to please other people made me hard working and determined… but it also must have been a source of anxiety as the wants of different people don’t add up, and pleasing people becomes complex.

I’d like to think that I’m reformed now. In truth, I wake up in the morning and look at this face in the mirror and tell myself, today I’m not going to measure my worth by what others think of me. The approval dealers are everywhere… Facebook, Twitter, Blogger… it is so easy to click a friend, pick up a follower, and in doing so inhale a little more approval; that comforting, self-affirming admission into the pack and recognition over invisibility.

Even writing this blog, I have to remind myself that I have gained so much strength and clarity from taking a moment each day to empty my head and make something from the mess. It isn’t about who is following and reading. In therapy there was a tendency on my part to try and be a ‘good’ patient. Opportunities are everywhere to give this part of my character the oxygen it craves, so I keep reminding myself, talk myself down, catch myself. It’s a nanny state in my head until I can trust myself to act in the interests of good mental health.

Sedated

Getting medication right can be tricky. I’m waking up each morning feeling sedated. I’ve been on Fluoxetine (Prozac) for a little while now, and had different experiences on different doses.

Medication can be varied in so many ways, and each variation can affect you in a different way. For starters, there are different types of anti-depressants that work in very different ways. Then, there are the multitude of similar anti-depressants, working in a similar way and interchangeable, but each with its own set of side effects. Then of course the side effects will affect some but not others; there is no telling until you try them. Not only that: the side effects at the start of treatment can be more pronounced, and subside as treatment goes on. I remember my first few days on Mirtazapine; I slept for about four days continuously under its sedative influence. Finally, the size of the dose and when they are taken can be varied. On 40mg of Fluoxetine I was waking up at 5am, but also feeling aggressive and picking fights with complete strangers. On 20mg I am sedated in the morning… but on a more even keel.

If you are someone who has just started on anti-depressants…. I would say go with it… please keep communicating your side affects to the person who prescribed them (sleep, anxiety levels, aggression, etc)… and if one particular combination doesn’t work for you… don’t give up on medication all together.

I don’t like waking up feeling like this. I am out of it, and when I’m asked simple questions I can see the answer forming in slow motion in my head and feel my inability to react in ‘normal’ time. I preferred how I felt on 40mg. But as Alicia will tell you, when the so called red mist descended and I flew at some stranger, there seemed to be no stopping me. It is early days on this dose… so I’ll keep going and be careful not to draw any conclusions too early. The early side effects may subside as my body gets used to this drug.

It’s interesting to me how aggression can be simply a bit of chemistry. How a drug can be administered to a normally placid person and turn them into an aggressive adrenaline junky. Believe me, feeling adrenaline flowing through your angry body makes you feel really alive. It makes me think a couple of things in response: Firstly that it is hard to pin down a person’s character from just watching their behaviour… because behaviour is so easily varied by chemical meddling. Secondly, that out there in the big bad, beautiful world we should be careful about getting into conflicts with strangers because we aren’t all being governed by the same restrictive chemical codes of conduct. And there is no way of telling if you are dealing with a crazy, like me, until you poke us with a stick!

And now, for coffee.

Beautifully Broken

When I first started talking to people about perfectionism, having identified perfectionist tendencies as a contributor to a break down, I was of the opinion that I needed to rid myself of this characteristic. Anyone reading previous posts will be able to join up the dots and see how important it was for me try and do things better than other people, how this was a rule I had for myself that helped to hide away what I really knew, which was that I  wasn’t good enough.

Perfectionism was a force greater than me. It would make demands of me; drive me to work harder and longer and with more and more focus… like a madness. I didn’t realise it at the time, but it was pushing me to breaking point. I was exercising excessive care and attention to even the most mundane tasks. It was a mechanism within me tightly wound that demanded everything or nothing. It was a ruthless task master. When I found myself breaking I tried to take my foot off the pedal, but I couldn’t, then I knew I had a problem. It was the realisation one tired day that I didn’t know how to do things any other way.

I wondered, is perfectionism a plague to be extinguished? We all have diverse talents and a place in our complex and old societies. I would have to learn to enjoy perfectionism and exercise it at will, rather than have it control me. I took comfort from the intricate works of Islamic art in the V&A museum. I felt somehow connected to these works and their creators, as though we somehow shared the same madness. The pursuit of perfection was, for these artists, a form of worship.

It made me turn to my depression and look too at this, and its usefulness. Every cloud as they say… I know my writing stemmed from this depression and my relationship with it. I knew too that it had strengthened my friendships and relationships. I had come to know myself and others more intimately. I had made choices that take courage.

Did I want to be better, cured, to be fixed? I think….. no… I’d rather learn to be beautifully broken.

Memory Box

In these recent posts I’ve been talking a lot about my childhood. It is as though I have taken the shoe box from beneath my bed and emptied the contents onto the floor, picking through it and revisiting the stories it holds. To keep picking through everything would be unhealthy. We all have shoeboxes under the bed. There was after all a reason for keeping memories in a shoe box in the first place. But maybe it is better that they are in the box because we put them there… rather than being there by default. Maybe it is better to put things back in the box when we are ready.

I am, slowly, putting my memory box away again. Whether I took it out in the first place, or whether it accidentally just got kicked open is debatable. I think that other people will always rather that the box was firmly closed and stowed away. Like I say, we all have a box like this. There’s nothing wrong in that and if you do ever root through yours - don’t worry that others might hurry you.

Yesterday I told my dad about this blog. And today I met with him to talk a little while. My dad is a good man. He came to this country with nothing and carved out a life for him and his little family. It was hard work and the world was a different place then. I’ve always wanted to be closer to him but never quite knew how to bring that about. It was good to sit in his garden and talk.

I remember years ago, when depression emerged and people named it, they would ask… ‘and do you know where it came from?’ And at first I would say ‘no’, ‘it came from nowhere’.  Then I would come to learn that it always seems to come from somewhere and now I know that in all likelihood it came from my early childhood. When I was a teenage I remember tearing a page out of a magazine. It was a woman’s face, photographed in black and white and so close that really the picture captured little more than her eyes. There was a quote from her on the page… in tiny white letters… which read ‘there is a deep sadness in me… I don’t know where it comes from’. I had that picture pinned to the wall behind my door for years. I was really attached to that picture and it meant something to me… but I also always felt there was a reason for pinning it up behind my door… where people were unlikely to know it was ever there. It’s funny to join up the dots so many years later.

Now with my attention on putting things away, I need to remind myself of the strategies I learnt in therapy that helped me change my life and liberate me from my own, inherent, faulty wiring.

11.27

It’s been a slow morning. Finally, at 11.27, I am conscious enough to react to the news that it is now Monday. 11.36 and I haven’t written anything more. I wasn’t kidding when I said slow morning.

When my eyes opened this morning I was in a place I hadn’t been in for some time. I wrote the other day about inside depression but I had forgotten about this place. It was a place where I felt numb, remote… as though I was there in the room able to hear what was going on around me but nothing more than that. Not able to in interact with the sounds. There is no tension, or sadness, or anything… just numb. It is somewhere between sleeping and waking… somewhere you can sit a while and be something other than yourself.

It’s tempting to stay there… but I won’t getter better if I do stay; best not to get too comfortable. Several long hours and a shower later, I am writing again. I’m guessing it my dose that has brought me to this place. It’s probably too low and I’ll discuss it with my GP later, just to get the go ahead to up it. Bloods. Better go get those bloods tested too so that we can see what’s happening to that thyroid of mine.

So, this is what it feels like to exist, but not live.

It is a small plan for today. But if I manage to achieve it I’ll know it was an accomplishment.  

Sundays

It was Alicia that first noticed that Sundays were my worst days. I always found Sunday the toughest day, but I thought that was because in teaching I would always have to give up a large part of the day to planning, or when I was studying it would be the day I’d have to travel back… it never seemed to be the day of rest it was intended to be.

Delving back into childhood, Sundays held a special significance then too. It was the day my mother chose to give us religious instruction, which largely involved learning prayers by heart. This, I never found easy. By contrast my sister would learn them and then play. I would try, and try and try… until my mother, believing I was just not trying, would give up on me.

It was years later, through my training and experience as a teacher, that I would discover dyslexia and find that I displayed both the signs and had developed the coping strategies. How it went undiagnosed at school I don’t know. I remember hearing an audible sigh in the room from the rest of the class each time I was asked to read aloud. And each time I would stumble, slowly through the text in a way that was painful to both me and the listener. My spelling was the subject of humour for my English teacher. In later life I envied people who could tear through novels… I chose my reading list carefully, knowing that it would take me many, many months to read a book.

Learning prayers by rote involved reading Arabic words, written with the English alphabet. I didn’t know the meaning of these words. This is what an educator would refer to as nonsense word reading and it’s a standard test for dyslexia, as dyslexics typically perform poorly compared with non dyslexics.

So there was a pattern to my lows, which might be connected with childhood. Judy helped me identify other patterns. She got me to note my thoughts and feelings, and where I was. I started to realise that some of my worst depressive thoughts were experienced when I was in bed. The very place that I retreated to when I felt vulnerable and unable to cope was the place where I felt worse. It helped me to break with patterns like this, so that at difficult times I might instead search out Molly, my lovely bichon.

Well, I have another Sunday ahead of me… so wish me luck.

Inside Depression

I know how hard it is to reach someone with depression, and if it’s someone you love it is desperately frustrating. It isn’t always obvious at first that what you are dealing with is depression… and that in itself can be confusing for everyone involved as behaviours and attitudes change for the worse.

I want to take you inside depression, just for a moment, so that you can get past all the clinical descriptions out there and feel my symptoms… and so that you can love someone through their depression and resist their attempts to push everyone and everything away.

I try and talk about the chemistry behind depression in my page Everything I Know (Almost). Here I want to touch on the everyday reality for me in those dark days… it isn’t easy reading but understanding can be difficult to achieve without putting you in the shadows for a moment. Through it all, this is a story of survival and determination and with it hope for anyone suffering from depression.

Before I had therapy, I didn’t know how to deal with all the negative thoughts. They came thick and fast… pounding away at my confidence, self esteem and hope. It was my own voice in these thoughts, but it was a cruel and relentless message it delivered. About what a failure I was, how worthless I was, what a burden I had become. I wanted to run away from it… but how do you run away from yourself?

At first I found peace in sleep. It was no easy task getting to sleep. At night with the darkness to stare in to, my thoughts lit up like movies… playing memories of past failures and disappointed colleagues. When I thought about the future my thoughts persuaded me that it was to be feared, that only terrible things awaited me. The reaction of friends and colleagues… seeing me as some kind of freak… broken… wasted… undeserving… responsible.

Fear would change me… I stopped answering the phone, stopped answering the door, and stopped taking the little risks we take every day that make life colourful. I stopped making decisions. I stopped leaving the house. Eventually I’d stop leaving my bed. Fear would keep me from friends and family and places I loved.

The hamster wheel of thoughts eventually tires those little legs and then sleep becomes inevitable. And that moment, when my heavy, lifeless limbs sunk into the bed deeper than ever before, and my mind felt the first aesthetic effects of sleep… that was peace. Welcome, heavenly, peace.

In search of peace, I would turn to my bed… more and more often. My body would be tightly rolled into a ball or my head buried under a pillow, as though the thoughts were physical blows and I was protecting myself. But sleep never came easily in my bed, and my thoughts would keep me awake until there was nothing left of me to torture anymore.

My body was weak, my limbs heavier than usual, my muscles wasted… in my mind at least. I moved slowly… sloth like. My eyes were dark… and like windows on to my fear I kept anyone from looking into them. I retreated to my bed, in a darkened room, alone, as though preparing for death.

I would become more isolated, cutting myself off from the world and the people around me. It did no good to talk about how I was feeling, so I kept quiet, leaving only my eyes to do the talking. And those loveless dead eyes put distance between me and those who loved me. Sleep was never enough, and the torment was always too much. Eventually I would seek out another more powerful aesthetic. Suicide. Thinking about it, living it over and over again as a movie in my head… became the only sinew of hope in this decaying body. There was peace in sight, an everlasting peace. Somewhere where my thoughts couldn’t hurt me anymore, somewhere where fear couldn’t reach me. But suicide wouldn’t claim me… and I would learn to talk about it… so that I could defeat it with the help of others.

I was lucky, Alicia never left my side, never gave up on me, and she made sure through everything that I knew her love for me was unwavering. Some people battle depression alone, and it’s a mystery to me how they do it.

Psychology Part 2

I was an outsider at school. For those who don’t know, my parents are Asian Mauritian. Back then I was the only brown boy at my primary school; the south coast was a great deal less multi-cultural. That doesn’t necessitate being an outsider… but I think that the different culture my parents brought with them may have put distance between me and other people. I can remember times when we’d be studying another country or religion and out of the blue the teacher might stop the class and ask for my contribution, because I was different. They may have felt they were ticking some sort of ‘sensitive to other cultures’ box… whereas I was just a kid… wanting to be like any other kid…

I think children do generally pick on the differences between each other and they can be cruel about them. I worked as a teacher for many years and know only too well how mean we can be to each other. One particular childhood memory of my own stems from primary school, on a summer’s day at lunch break, on the school field. I don’t know how it came about but a few of the other children started taunting me. My father was a staunch pacifist and I respected him, so I never fought back unless I lost it. I walked away and the other children followed, the numbers swelled to a large crowd, growing in size as we travelled the field. Boys and girls following me like a swarm of wasps, all taunting me about the colour of my skin. The sheer number of people involved shocked me… I couldn’t have felt any more rejected. People behave differently in crowds don’t they? I would have gone home that day and not mentioned it. In fact I’ve never told anyone that story.

So my core beliefs, I’m not good enough, were firmly established in me from an early age… and although they are unhelpful and outdated now, they were understandable and they made perfect sense… given what was going on for me then.

Judy taught me that thoughts were different to feelings. She taught me that, whilst I couldn’t help my feelings, I could do something about my thoughts. Thoughts popped into my head all the time… negative thoughts. Thoughts that judged me… told me what other people were thinking… told me what terrible things would happen next. The experiences of childhood were carried through to adulthood by these unkind, critical and pessimistic voices. It was exhausting… relentless… even overwhelming.

Before I began focusing on controlling these thoughts I knew them only as my own voice and as such, embraced them. I would tell my self ‘that isn’t good enough’ … ‘you have to get this right’… ‘you don’t deserve to be doing this’. I thought this was me, driving myself to be better. I even told myself what other people were thinking, reading expression and reactions in body language. Judy quite rightly pointed out that I am not a mind reader and I often tell myself that now. I didn’t realise that I couldn’t trust my own voice, that it was working against me, that it stemmed from and supported the belief that I wasn’t good enough.

These thoughts gave rise to my anxiety… they kept me awake at night… distracted me from eating and fed on my energy. These thoughts changed how I behaved… I worked on things for too long and took on too much, what I couldn’t perfect I procrastinated over. Without realising it, I was doing everything I needed to break myself and finally prove once and for all that in fact ‘I wasn’t good enough’. After all, other people could manage couldn’t they?

And so I gave way to my own creation… the capital upon my core beliefs… my depression. I would have to learn how to manage my thoughts. Learn to recognise them when they popped into being and disown them… treat them objectively, challenge them… look for alternatives. I would start to wonder if there is anything I could do to shift this hard stone inside me, if my unhealthy beliefs about myself could ever give way to something else.

Psychology Part 1

Somewhere along the line I developed some pretty negative beliefs about myself. The word ‘beliefs’ is a bit misleading because as far as I was concerned these were facts about me. The strongest of these facts was that I am not good enough. This manifests itself as me thinking I’m not good company, not as clever as people think I am and not as interesting as other people… I’m somehow a fake.

It took years of shaping and moulding to establish these facts about me. It must have been confusing as a child… why could I never choose a present my mother liked… how could my teachers think I was doing so well when I would get such a telling off after every report and parents evening, why couldn’t I read as well as my sister and why is it when I got things wrong I felt like I wasn’t loved anymore? As a child I would never have thought of my mother as impossible to please, a hard parent that switched love on and off… instead a child would persevere… blame themselves for getting it wrong and try harder. The moulding would come through my continuous and systematic failure.

It was my birthday yesterday, but I can only remember one childhood birthday. I was due to have a brace fitted… I guess I must have been pretty excited that day because mum told me we’d go to find a present after the appointment. My brace wasn’t fitted that day… the orthodontist called my mother in and must have laid into her a bit when he found that my teeth weren’t clean enough. I remember him scraping them and showing my mum - she would have been deeply embarrassed. I never understood why I couldn’t have just cleaned them there.  After all, in the excitement I just hadn’t done a good enough job first time round. We left the orthodontist, I got a telling off, we went home and I don’t remember leaving my room for the rest of the day. I wish I could remember some of my other birthdays.

None of what happened when I was a child seems all that bad, and that I find kind of scary. It shows just how easy it is to mess things up. As a child I was regularly punished for failing to meet a parent’s standards, short on praise and the odd one out at school. Next thing you know, I develop into an adult that has perfectionist standards, overvalues praise from others and places too much emphasis on other people’s opinion of me.

As I grew up, believing those unhelpful facts about me, I would develop rules for living that would ‘protect’ me. If I was not good enough… I would need to conceal it… to try harder and work harder to be better than everyone else. My perfectionism was a way to guard against failure and criticism. I planned meticulously as another way of averting failure… I didn’t do anything without researching it endlessly. I kept myself under tight control, concealing the real me for fear I would become the odd one out again. I believed the only achievements that were worthwhile were those that were recognised by others. These rules for living would make me a driven person, running from fear of failure rather than towards success. In some ways these rules served me well… from the outside others saw a young man who quickly progressed through the ranks. On the inside though there was the voice of a hard parent driving me and I could never be good enough.

Being driven can make you do some unhealthy things… but I wasn’t in control to stop it… and I drove myself into a breakdown. Being overstretched and not being able to live up to ‘rules’ left the way open for those unhelpful beliefs I had about myself to surface. And from that point on everything I did and everything that happened to me would only confirm in my mind that I wasn’t good enough. I couldn’t fail without attacking myself.

At this point I draw breath, take a break and remind myself that the ideas I have about me are an understandable reaction to my experiences.

Parenthood

Whilst in therapy we explored a bit of stuff to do with my childhood. Judy thought it was useful to have some insight into where some unhelpful core beliefs came from … but nothing more than that. The focus was always on ‘what are we going to do about it’. My mother and my relationship with her was at the centre of those core beliefs and what astonished me then and now is how the boy shaped the man.

At the time Xavier was one and I couldn’t help relating what I was learning to him and my relationship with him. So many people say ‘I don’t want to become my mother… I won’t make the same mistakes’. It isn’t as easy as it sounds… certainly when I am stretched I seem more vulnerable to becoming my parents and I watch myself in astonishment when I behave as they would.

I can’t really remember a great deal of my early childhood. I posted some old photographs on Facebook yesterday and I don’t remember any of the days they capture. I wonder if there are happy memories in there that I just can’t get at…. that I’ve forgotten. I certainly look really happy in a few of the photos.

I must have been a pit of a pickle when I was little. When I was naughty my mother would take her shoe off and beat me with it. I think that made me rebellious. When I was older, knowing that I had done something that warranted a smack, I would then goad her from across the room until she had thrown both shoes and thus run out of ammunition. I couldn’t have been an easy child.

My aunts had a cruel sense of humour; I don’t think they knew any better. My mother is one of seven sisters. For a long time I thought there was something wrong with me… that I was somehow destined to be a bad person. Aunt Y was convinced that I had the devil in me, or at least that’s what she told me. When you’re a kid I guess that’s kind of terrifying.

I don’t really remember seeing my dad much… As a first generation immigrant making a new life for himself and his family, he worked two or three jobs at a time. It seems like a noble thing to do but I swore that Xavier would see more of me than I saw of my dad. I didn’t always get that right though. Like I say… it seems the default position is to be like your parents in times of stress.

The single most important thing I realised about parenting was that if you do anything with your children, make sure they feel that the world is a safe place and that you love them unconditionally. I underplayed the significance of that in my own upbringing but as Judy explained to me: when you are a child you are completely dependent on your parents for your survival in an animal way, and so if a parent withdraws love from you as a child it will feel life threatening.  

My mother did the best she could, given the person she was. She didn’t have a host of super nanny strategies to keep me in line; instead she switched love on and off to check my behaviour. I remember feelings of utter helplessness as a little boy, banging on the door trying to win her love back and being shunned.

I could have been angry at her and blamed her, but I also realised that she was once a child and that this person had been shaped by her own parenting. It made me curious about her childhood and for the first time I started to see her as a person with her own emotional baggage, rather than just my mother. It made us closer for a long time, but when the depression surfaces it’s best to keep her at arm’s length.

Now, as Xavier’s father, I must tell him a hundred times a day that I love him, that I’ll always love him whatever happens, and that I am so proud of him. He’s a smart three year old, loving, gentle, confident, kind and very funny. There are those occasional times when we need to have words but through it all I can’t tell him enough how much I love him. Alicia knows how important this is to me and sometimes when she has to tell him off she sees me wincing in the corner saying ‘but tell him you love him too’…. And she does. She’s a good mother.

Medication

Medicating depression is all about getting a foothold on the ladder to recovery. No one out there is going to tell you that medication is the answer. But depression is an all consuming illness and it leaves you feeling incapacitated both mentally and physically. Sometimes medication provides the leg up needed to start dealing with the other issues that gave rise to depression, after all… there aren’t many problems you can solve whilst curled up in a ball under the duvet.

On my page, Everything I Know (Almost) I talk about the chemical origins of depression and how commonly prescribed antidepressants (SRI’s) work.

I went undiagnosed for a long, long time. Even when I suspected that I was suffering from depression I resisted going to the doctors because I didn’t want the label… and I didn’t want people to look at me differently. So my earlier episodes of depression were hidden from others… I was just someone who didn’t have a great attendance record and seemed susceptible to bugs. In fact, the flu like physical symptoms and the fact that many of us will feel down if we are not on top physical form, means that it can be easy to delude yourself at first.

When I did present with depression it was to my then GP who lacked the expertise in mental health to be of much use to me. Not her fault I guess. When you are desperate, and you are hanging onto the small part of you that wants to stay alive… and that part of you summons the energy to go and see somebody for help… you really don’t need to be met with a hard arsed apathetic GP. She reached for the prescription form before you could say a word… and the drug everybody seemed to be on back then was citalopram, also known as Cipramil.

Citalopram (Cipramil)
I’m guessing this antidepressant was cheap because everybody seemed to be on it. When I was interviewed by various different health professionals over time they would always raise an eyebrow and give a knowing nod when I mentioned this drug. It didn’t work out for me. All medications have side effects and you don’t know until you take them how you’ll be affected. My anxiety levels hit the roof and the next thing you know, I was presenting to the Crisis Team. A single red sock belonging to my then 1 year old son, Xavier, was stuffed in my pocket and it rarely left my hand. It was what I used to remind me there was a reason to stay alive and that part of me wanted to fight.

Mirtazapine (Remeron, Soltab)
Seeing the gaunt, lifeless man in front of them, staring down into his lap, avoiding eye contact and struggling to stay concentrated on the conversation before him, the Crisis Team had me meet with one of their doctors. Mirtazapine was prescribed to stimulate my eating again and get that serotonin working for me. At the time it was what I needed to kick the anxiety into touch, but it came at a cost. It had a tranquilizing effect on me, so I became a sort of disconnected from things. My concentration was affected too…and focusing for any length of time at my white collar job in teaching became really hard. I hated people seeing me like this. It made me feel stupid in front of them… I couldn’t keep up. I lost my mental agility… so I seemed to lose my usefulness to the team. I relapsed.

Cymbalta (Duloxetine)
When I started on this drug I was delighted with the side effects. I’d put on a lot of weight on Mirtazapine; the stimulating effect it had on my appetite meant I was now eating for two. Cymbalta had the opposite effect on my diet and I lost all the weight I had put on with other medications. I was on a big dose, but it seemed to be working out for me. Whilst on this drug my family saw me return to being the person they knew and loved… the person I loved. It was great being me again. Whist on this medication I: changed my GP; had therapy; took the decision to leave my job in teaching; took steps to sort out our financial difficulties; rekindled friendships; started a business; and got married to my amazing wife, Alicia. Over time though I started to feel like the effects were wearing off. Mornings were becoming more difficult again… I was missing appointments… sleeping too much, beating myself up mentally, putting on weight again.

Fluoxetine (Prozac, Sarafem)
Things were complicated now by a dodgy thyroid, which was slowing me up physically and making it harder to push through the physical demands of each day. My confidence took a knock and I started to fear the return of depression. Depression feeds on itself, so anything you can do early on to head it off is time well spent. I sought help early. I’ve done a lot of work in therapy, and now know the early signs that things are not well. I could apply the tools I’d picked up from therapy, but I still felt myself sinking. I lost faith in meetings with my GP… he didn’t seem to understand that I couldn’t wait around, that I was self employed and each day I struggled I had to also watch my business go to the wall. I sought a second opinion at the surgery and that’s when we agreed to switch anti-depressants again. I took the prescribe dose for a bit, it wasn’t working out so I doubled it up (not a good example to follow). The early and welcome signs of progress were that I seemed to wake up at 5 am like clockwork. I had gotten my mornings back. I started this blog in those early mornings and it helps. Things are improving, but having doubled my dose I ran out of pills and had to switch back to the Cymbalta to keep me going between appointments. I’ve been taking the Cymbalta again for a couple of days and almost instantly I’ve become ‘punch drunk’ in the mornings again. Sleep on Cymbalta is amazing, transcendental… but trying to shake the sleep off in the mornings is a real challenge. Feeling the best I can feel in the mornings is really important to me… I can usually take it from there. So I’ll be going back to my GP tomorrow and asking for more Fluoxetine. I’ll keep you posted on how I get on with it.

Suicide, Never!

There was a time when suicide presented a very real option for me. At that time I needed the intervention of the Crisis Team to keep me alive. Life had disappeared from my eyes and my thoughts revolved around plans to end my life. Dark days.

But it wasn’t until my second episode of depression, whilst receiving therapy, that I started to address the issue of suicide. My therapist, Judy, wanted me to talk about it but it wasn’t up for discussion. I needed to keep my plans secret so that nobody could interfere with them … I didn’t want anyone trying to save me, or do anything that would take the option of suicide away.

In fact, if someone is really very determined over a long period of time to commit suicide there is very little we can do to stop them. I spent months in my darkest days researching suicide and honing my knowledge. It was amazing then and still is now to think about how dangerous the world around us is… just about everywhere you look there is the means… if there is a determined enough will.

If you personally have never considered committing suicide, reading this might all seem a bit alien. So to put some flesh on it… let me say that for me at least my plans took into consideration my courage, phobias, the likelihood of success, and considerations about who I wanted to protect from finding me. I also didn’t want to taint our family home with my death or anywhere else that meant something to us. I didn’t want to cause inconvenience, require much cleaning up, wreck the car for Alicia... Once all the considerations come into play you start to realise that this really is something that demands very careful planning.

Reading that last paragraph back now… I can see that the focused mind of someone intent on suicide is always going to be difficult to get to grips with.

With plans fully formed I started to become quite flippant about suicide and was using it as way to get through the days. I would head off to do something and say to myself… ‘well, if it doesn’t work out I can always end it’…. Or be worried about something in the morning but comfort myself with the thought that I could be dead by the afternoon. It sounds like a joke but I was deadly serious… and it got me through the day. It gave me the attitude I needed at the time to take the day on. In the same way that if you were punched in the stomach you might place your hand on that hurt to ease it in some way…. When a tormenting, anxiety filled thought charged through my head threatening to shut down my day… I would apply a suicidal thought like a sticking plaster and in anesthetised me.

I knew from my dabbling in psychology that suicide was a coping strategy, a kind of security blanket, and I also knew that of all coping strategies… it wasn’t considered a particularly good one.

My therapist did a very simple exercise with me and from that moment onwards I would never seriously contemplate suicide ever again. Maybe it appealed to the analytical side of me… but for whatever reason I just couldn’t square suicide with what I learnt that day. Some people say suicide is the coward’s choice… but judging people with that kind of ‘name calling’ never changed my attitude. What did reach me was when I thought about the specifics.

Take one instance when you have considered suicide… really had the will to take your life. What brought about that thought … what problem is causing the distress? How big is this problem… give it a number on a scale of 0 to 100? What about your reaction to the problem, suicide… how big a reaction is this on a scale of 0 to 100…the effect of suicide on you and everyone who loves you…. Finally, ask yourself this simple question… is the reaction proportionate to the problem? … And the answer is almost always… no.

What happens next was even more incredible for me. You see whilst suicide stays in play as a viable option it affects how you live each day… what you cope with using suicide as your security. Take that away, like taking away a child’s blankie, and something is going to have to give. For me it meant I was going to seriously consider for the first time changing the direction my life was going in… You see if you stop thinking about dying, and start thinking about living… you’ve got to start planning all over again.

I’m so sorry that I terrified my Alicia with the prospect of losing me. I’ll always be there for you.

We've Come A Long Way

I’ve come so far I tell myself. And I have. Back when I was doing my post grad in Architecture the depression paralysed me, although back then I didn’t know it by name. I would curl up in a tight ball on my bed and breathe into the sheets, eyes shut tight trying to block the thoughts firing across my head.

It was years later that I had what people call a breakdown. It was as though the wheels of life just became jammed, seized up. I withdrew from everything, eating…my relationship…my job… my family. I became fixated on suicide and started to plan how and when and where. Concentrating on suicide was in a funny kind of way what was keeping me alive… because thinking about the anguish ending and knowing that I could end it, gave me some kind of hope and power over it.

Back then I got help from the Crisis Team. They saved my life. Much later they admitted that I came very close to being hospitalised, which in this day is not the preferred route of treatment unless you are a danger to yourself. I came back from that episode of depression with an anti-depressant that made me eat like nothing you’ve ever seen before! The crisis team had worked through the ‘signature’ of the depression; the subtle signs that would indicate to me or Alicia that the depression might be returning.

When the depression hit the next time I realized it was coming a lot earlier. The Crisis team had taught me to recognise it, but I didn’t know what to do about it! It was like depression was a train and the first time it ran me over… the next time I could see it coming down the tracks from a long way off but I could get out of the way. It was a really frustrating experience. I crashed again and life imploded. Once again I became isolated, cut off from everyone and everything. People were talking to me about my two episodes of depression like they were linked, but back then I argued fiercely that they were two completely separate things… I hadn’t a clue what had triggered the second episode.

One day I realised that there was something about me that I didn’t know how to fix… I had started to join the dots up and for the first time I realised that getting better would mean changing who I had been for the past 35 years. I didn’t know where to begin, and that made me see that I would need help. Judy was an amazing therapist.

By the end of therapy I had come to realise I needed to break with the old me… I left my career in teaching, I left behind my old habits… the old me… and I renewed my relationship with the people around me, almost starting again. In particular I started again with my mother… I started to see her too as a child who had been shaped by her experiences and as someone who harboured some unhelpful ideas about herself.

Now I was equipped with the insight I needed to understand where this depression in me stemed from… what triggers it, what happens when it’s triggered, how I can tell I’m not doing so well and what I need to do to keep myself healthy. I thought I was invincible. I was so deeply in touch with what was going on in me that I could see it in others everywhere I looked. I could see their insecurities surface momentarily, the way they undermined themselves, the part of them that betrayed them and shaped them into something they didn’t want to be.

I became then a new person, seeing the world an entirely different way… understanding better what it was that I cared about… Alicia and Xavier, family. It took a while for Alicia to get to know this person, she wasn’t used to me being so easy going. I could see how the old me had shaped her and I didn’t like it. I guess it’s what we do to survive in each others company.

This third time I’m so much stronger. The days when I retreat are much less frequent. I understand this animal so much more than before and although sometime I tire of the fight, I know I’ll win and I will certainly never take my own life. They say what doesn’t kill you makes you stronger and in the long term that is true… in the short term it just wears you out. This time round though I’m bigger and better, because like never before I know how to call on the support of friends and family, I know who to push away and who to bring in close. I’m never in this alone… and for that I’m grateful and lucky. Here’s to us.

Mornings

I feel like life is falling apart slowly. Unravelling itself. Every day a thousand thoughts pop into my head. Some unhappy memories, some thoughts about my situation and the hole I’m in… and sometimes a thought about the future. I’m drowning in these thoughts… and keeping them under control is a full time occupation. At times when it gets too much I just hit out… with words… with fists. I long for peace.

I think about Rye… the horrible conversations I had with Ann… makes me feel awful just writing her name. I think about my business… how I’m struggling to meet the schedule and the needs of my customers. I should be so happy with the sheer quantity of work coming my way but instead I’m overwhelmed and constantly robbing Peter to pay Paul in excuses for why this or that isn’t done yet. My relationships with family are broken… I can’t have a conversation without it descending into an argument… I’m at the edge of argument like a fuse ready to blow. I don’t mean Alicia or Xavier… they are my real family and my saviours. My very own heroes.

I have customers waiting on me to do jobs, provide estimates… invoices… its all falling apart. It’s like I’m self destructing… ripping apart all forms of support and everything I’ve created. I’m terrified of seeing people I really care about and love for fear that I’ll argue with them too and push them away. I’m a ticking bomb.

The bills keep coming, but it’s been a while since the money has come in.

The sun is shining and work is waiting. I wear and immovable furrowed brow… the outward sign of the inner turmoil. My eyes are dark, the lights are off.

When the phone rings or there is a knock at the door I freeze and wait for it to stop.

There has to be a better way to start the day. There has to be a way to raise momentum and sustain it. But like the hamster on the wheel I am busy spinning thoughts and fighting them off… and slowly it wears me down… and it feels like I need the strength of two men to both keep up the fight and make some dent in the day before me.