National Bipolar Day

Once upon a time I would have reflected on past weeks as being the ‘well’ me. This judgement would stem from the incredible levels of productivity; my self worth being measured by the things I achieve each day. This ‘busy’ version of me has whispered a deadline to complete all our homemaking projects before the baby arrives in early October. It’s a deadline I’ve responded to well and the enormous list of unfinished projects is steadily toppling as I press on. Our home, inside and out, was a renovation project from the outset because this was all our pockets would allow. The episodes of depression year upon year have always stunted progress; that and the financial struggles that come with being unwell.

Since mid April I’ve advertised and sold 81 items on eBay, including some of our furniture and family car, raising the money needed to complete the projects. Seeing the progress has been truly rewarding. Working on these projects at home helped to give me back some of the confidence I lost to depression. Alongside our homemaking projects I have been working to revive the business. Again, with each episode of depression I lost projects and opportunities. The momentum is building again as bookings come in. I am relieved.

I suggested this was the ‘well’ me in action but an awareness of the mania phase of bipolar disorder suggests otherwise. I have more projects and commitments on the go than I can truly handle. I’m unable to sit and rest without feeling restless and driven to do something. My mind is busy all the time scanning for things that need my attention. I am never in the moment. When my body tires from all the doing I switch to planning and plotting future projects – unable to accept it is time to stop and rest. I get irritable with those around me especially when they are unable to keep up with my pace and see the need to hurry. And as rude as it may sound, when friends are talking to me I’m finding it really difficult to concentrate on what they are saying and hold my attention still.

During this period I have been a bad blogger, not publishing for more than 50 days. A few days ago the blog notched its first year, and I didn’t give it a thought. My busy mind has kept me from blogging – unable to tether myself to such an activity for any length of time. Even showering, shaving and cooking are filed under time wasting activities when so much more could be achieved in the same time. It is warped thinking, I know, but I feel a little out of control.

So why is it I have turned to the blog today? Well, just recently things have started to get a bit more difficult again. I put it down to tiredness at first, given that I’ve been pushing through when the body wants to quit. But there are a few things that together form something of a warning flag. I’ve had to talk myself into seeing other people, feeling an internal resistance to it, be they friends or customers. I’ve been getting really anxious, worrying about all sorts of things and feeling uneasy in myself. To manage this at work I’ve been rehearsing projects carefully and planning schedules and kit. It helps but I can still feel the internal, self made, stress. I’m eating a lot more chocolate and other sweet things and drinking coffee – using these types of foods when I feel the mental and physical inertia and need a boost. It’s a bad idea but the cravings are really overwhelming. I’m starting to feel the need to nap although I haven’t given into it yet. The fatigue is becoming heavier and it frightens me. Morning starts on Quetiapine have always been slow but increasingly I am unable to pick up my energy levels as the day goes on.

The dose of Quetiapine was clearly not sufficient to manage the manic phase – although I didn’t complain because I enjoyed the feeling of getting so much done. It may be that the dose isn’t quite right to manage the depressive episodes too. That said, I have a lot still to learn about this condition so that I can manage it in the future through other changes aside from medication.

Today is national bipolar day. Sounds like a good day to start learning.     

I Am Not Depressed

As we sat down to dinner this evening I noticed Xavier was wearing an apron. “Why are you wearing that?” I asked. He mumbled something which I didn’t catch and then replied, quite unlike a four year old, with a heavy heart and a flat tone “I don’t want to wear this bloody apron.” My first thought and in fact my reply was, that is the correct use of the adjective, and I held onto my laughter, although I’m sure some escaped through my eyes. Since dinner we’ve consulted a thesaurus to find some other words that can be substituted in, with all the feeling and minus the offence. He’s particularly tickled by ‘blasted’ and ‘darn’ and we’ve agreed to mutually remind each other of the alternatives should we ever forget.

I’ve been reflecting a little on whether things are working out between me and Quetiapine (Seroquel, Ketipinor). It’s a tranquilising psychiatric medication used to manage psychosis by blocking the receptors in the brain that dopamine acts on. My tablets are designed to be slow release, giving me relatively steady blood levels of the medicine throughout the day. This is why it’s important I take them on an empty stomach; food would speed up its absorption into my bloodstream.

So first I’m just going to take the symptoms I’ve been experiencing through depression and examine each one in turn – noting how things are now, compared with how they have been in the recent past.

Anhedonia, an inability to experience pleasure from activities usually found to be pleasurable, is what characterises depression the most. The numbness severs through everything, even my relationship with my wife and son, the two greatest joys in my life. The magical morning sunlight, my eager dogs, the sound of music on the radio; everything disappears into a blind spot. Now things are different, I can project the love and affection I have for my family, colours have come back into the world and everything around me is buzzing with life. I have a grasp on happiness again, although it is different to before – sort of a tethered happiness, not the vivid winged happiness I’ve known in the past. It is practical.

Feelings of grief and guilt, my two close companions during depression, keep me ruminating irrationally on past failures, conflicts and inadequacies leading me to a place of hopelessness and intense stress. This is when, combined with the anhedonia, life stops making sense and becomes something I stop fighting for – something I’m actually desperate to be relieved of. I’m grateful that these dark feelings have lifted and it has become easier to rationalise my thoughts and memories, and manage the internal stresses. Horrid thoughts still pop into my head and I get quite anxious, but they don’t imprison me as they did before; I am not the scratched record.

Psychomotor retardation is a slowing of thought and movement so that both can feel desperately heavy and cumbersome. Making simple decisions became difficult, as did other tasks that required a degree of concentration. I shuffled about, sloth like in darkened rooms, or more often than not – remained in my bed pinned down by my heavy limbs and the stress of my own debilitating thoughts. I slowed to the point of sleep – if fortune was kind enough to afford me the peace of sleep. I have to distinguish now between that feeling, which I’m glad to say has passed, and the sluggish feeling I experience because of the Quetiapine. Sure, I feel sleepy and physically tired a lot of the time and have brief bursts of activity and energy – but it isn’t the same as the depression.

So on balance my relationship with Quetiapine seems to be working out, except for the way it makes me feel physically. Now that my mind has returned to me I find it is keen to make plans and push on with work, but my body feels like it’s holding me back. This is a deep furrow for negative thinking to prosper and therefore something I continually need to keep in perspective. I must not let this physical slowness dishearten me – and I do have a knack for seeing the negatives. It has been interesting for me to get this all down on paper – things are more positive than I had realised. If Quetiapine is prepared to give me something of my energy back, then this relationship could well work out.

'Dad' Fit

A typical game of ‘Guess the Animal’ with Xavier goes a little something like this:

Me:                  Does it have four legs?

Xavier:             Yes.

Me:                  Is it a mammal?

Xavier:             (in a hushed voice) Are tigers mammals?

Me:                  (in a hushed voice)Yes.

Xavier:             Yes, it’s a mammal.

Me:                  Is it a predator?

Xavier:             (in a hushed voice) Are predators the ones that get eaten by carnivores?

Me:                  (in a hushed voice) No. Predators eat other animals.

Xavier:             Yes, it’s a predator.

It is endlessly fascinating understanding the world through the eyes of a four year old. For instance, Xavier thinks that when we get older we’ll need to move into a bigger house, and by bigger, he means taller. From his perspective he gets taller ever year and he doesn’t see that ever stopping, so at some point well need a really tall house.

Only recently he appreciated for the first time that he wouldn’t actually catch up with his older cousin in age. He was looking forward to the day that they would both be six together, but hadn’t considered that with each year his cousin would grow older too. Time, generally, is a bit of a strange concept when you are four. The other day he was really caught out when I was talking to him about a time before I knew Alicia. This was a real surprise to him; the idea that Alicia and I met, and before then we were not together, or more to the point, didn’t live in the same house.

Xavier loves winning and takes losing quite badly (much as I did when I was a child - but I’ve found it’s something you can get used to). He has just started to cheat at snakes and ladders, which is brilliant. I give him plenty of opportunity by looking away and getting distracted when he’s rolling or moving his counter. Alicia says when children start cheating at a game, that’s when you know they really get it and you can start to raise the bar a bit. He cheated at table football yesterday too, and then looked at me squarely to see if I’d noticed. I hadn’t of course.

He doesn’t play with toys that much. At first we both thought this was a bit strange. He doesn’t want for new toys; he has a stash in baskets and cupboards all over the house in almost every room, but it’s as though it rarely crosses his mind to take them out and play with them. But I think the truth is, he is really a social creature and what he prefers is to play with others. So he will play with anything, even if it is just a cardboard box, if we are playing together. Toys, by themselves, do not occupy Xavier for very long.

He totally adores his magic drawers. I have this small old chest with about twelve tiny little drawers in it. They are magic because whenever Xavier does something wonderful, he can open any drawer and he will find something inside. On all other occasions the drawers are magically empty. He chooses the drawer to open and he is always excited to discover what’s inside. He has found sparklers, popping candy, tiny wind-up toys, finger puppets, magnets, a parachute and lots of other fascinating objects that take him off on a curious tangent. The magic drawers came about when I was tidying and found that smaller things, no matter how wonderful, could just get overlooked and lost as they jostled with large, colourful toys, just like plants, competing for space, light and attention.

The world is so different for Xavier to the place I grew up in. His curiosity can drive every moment of his day. You Tube means that all his questions about the baby growing inside Alicia can be answered vividly and on demand. He dives into the ocean to see blue whales giving birth, then travels through time to see dinosaurs fighting over carcasses, then up into the sky to be with astronauts moving about in a weightless space station. There are so many wonderful events to witness from across all of time and space.

He is an active boy too. Only the other day he had been penned in somewhat by the rain and as I tried to talk to him I could see every limb in his body twitch and his eyes darting about - and I stopped myself and realised he is bursting with energy and that now was not the time for talking. When I am in better shape we walk the dogs together and chat along the way. There is always something he's trying to figure out, like what happened to all the even numbered houses on the street or what made that hole in the gound.

With Xavier devouring the world at an incredible pace and finding his place in it, and with another member of our pack on the way, I really want my energy and ‘me-ness’ restored so that I can be everything I want to be to my wonderful family. So that I can be that 'giant' that Xavier thinks I am, still growing skyward. But even when I'm not my best, he understands like a best friend would.

Tiny Little Goals

I’ve been taking Quetiapine for 26 days. For 14 days I have been on a dose of 100mg. I passed through a dark place where suicide held my hand for a little while and I achieved little outside my own thoughts. I’ve got two good reasons why it would never come to that so there is no call for alarm – it was just that my mind wondered onto suicidal thoughts in much the same way as anybody’s can become fixated and preoccupied.

The pace of mornings continued to be dictated by the medication’s side effects until very recently, when I became disciplined about not eating for two hours before taking the tablets, and for one hour afterwards. This places my evening meal at around 5.30pm and I take the Quetiapine spot on 8pm. Not the most sociable of habits but necessary, if I am to wake the next day alongside everybody else.

A month ago I was walking my dogs regularly and trying to be mindful, and then I found myself trapped inside a cumbersome, sedated and tired body again. I was tired too of having to start again, I had started again so many times. Each time it was hope that helped me make the first move - but now I was starting to feel a little cheated by hope. There seemed to be more snakes than ladders on my board.

About a week ago a flurry of articles about exercise and mental health were widely publicised by campaigns like Time to Change, which coincided with my own wishes to be more active. I accept that being active sometimes helps me fight the depression, but I recognise too (as more articles ought too) that sports men and women are not immune to depression. With the encouragement of others I took the first steps again, walking with the dogs around the block that encompasses the red brick church with its high walls. A short walk by any measure, and exhausting too – but it was a walk all the same. The tiniest of goals achieved. Yes, a month ago I could walk much further but this is where I am now. This is what I have to deal with – there is no good that can come from drawing that comparison.

As my mornings were returned to me and those short walks became once again a part of some kind of routine, I became useful again. My body was responding better to what I wanted to do, and my mind more able to focus. I was still astonished at the frequency with which needed to stop and rest, but I accepted it and tried to think of it all as exercise on the way to somewhere healthier.

My mood has been improving and the facial expressions that Alicia recognises as me are, at times, evident again. There is a component missing though – emotion feels muted somehow. Alicia has noticed it too. But I have been busy and can look back across a day and claim to have done something worthwhile.

Today has been a difficult so far but that means nothing at all. It says nothing of yesterday and of course can say nothing about tomorrow. It does bother me though, because I do want to be reliable. I want to have up and down days like other people who don’t find themselves completely derailed by the downs. I want an employer or client to look at me and be confident that my downs won’t keep me off work or critically alter my functioning – but they do. This is something I’d like to consider more another day in another post, when my energy and mood permits it. But for today I’ll just accept that this is what I can manage for now, just like my little walks.

Bipolar Disorder Versus Depression

At my meeting with Dr A, Consultant Psychiatrist, nineteen days ago, I was asked why I thought I had bipolar disorder. Well, the truth is, at the time of being asked - I didn’t. All I knew was that despite various courses of well reputed antidepressants, therapy and a great deal of effort and learning on the part of me and my family, I was still experiencing a roller coaster ride of depressive episodes. It wasn’t that I thought I had bipolar disorder, but given that the treatment regime I was under was not working, in the sense that I could not maintain good mental health for more than a few months at a time, it felt like somebody needed to questions either the treatment or the diagnosis of straight depression. That somebody turned out to be me.

This blog post may well lack continuity. It’s nearly 8pm and every few minutes Xavier brings me the Lego plane he is playing with - in three or four pieces, for me to put it all back together again. Bless him. I know 8pm might seem a little late for a four year old but that is another story. We abandoned bed times after a five day trial period. Before that bedtimes were a bit of a battle ground and the only way Xavier could win was to do his utmost to keep himself awake in bed long after his story had ended and the lights had gone out. This just made him grumpy in the mornings. Now he gets ready for bed around 8pm, including a bedtime story, but after that he does what he likes, so long as it isn’t watching a DVD or playing on my phone (far too stimulating). He falls asleep really peacefully in our company and gets carried up to bed whilst he sleeps, with an ego the size of a five year old!

During the conversation with Dr A it emerged that a diagnosis of bipolar disorder would not be clear cut. Other factors, like my perfectionist tendencies and low self esteem could also account for some of the symptoms making it difficult to give a definitive diagnosis. It was a frustrating discussion for me because the whole conversation was based on my appalling ability to recall facts from my life. I’ve met people who can reel off their life as though reading from a CV and I am not one of them.

After the meeting, away from the stress of it, I was asked to complete The Mood Disorder Questionnaire. I had never seen it before; it claims to accurately identify 7 out of 10 people who have bipolar disorder and screen out 9 out of 10 people that do not. In the quiet of the waiting room and without the social interaction, these questions were now much easier to focus on. I want to reflect on those questions again here because, as I found in my first meeting with Dr A, so much depends on the ability of the patient to communicate key information.

There are most certainly times in my life when I feel very, very good; sort of invincible. During these times I’ll be more prone to do things such as strike up conversation with strangers; be a bit reckless for fun like stealing something from a shop or an exhibition; and be a bit loud even without the alcohol – talking over others. I feel like I become very in tune with the world, as though I can see how it is operating beneath the surface. Experiences become vivid: painted marks on a canvass, a musical movement, light penetrating a tree canopy, a plastic bag caught on the wind; they all become intensely beautiful and moving. My creativity at these times explodes and I get an inexhaustible thirst for new information, usually fed by days of research on the Internet. If I talk it through, conversation jumps around unpredictably as thoughts quickly fire in and out of my mind and the exciting connections form. I become driven – working on projects harder and longer. Our very own modest Victorian terrace house is a good example of that: The completely renewed wiring and plumbing; the newly installed central heating system; the bathroom and kitchen remodel: the new loft insulation and boarding, the solid wood flooring installation; and so much more in this house was done with these two hands whilst I worked a full time job in a secondary school. And as for whether I’ve done things considered excessive or foolish, remember I have seriously attempted gambling as an occupation in the past, out run the police when pursued and live now with unserviceable debts, not related to the gambling I might add.

Something that is perhaps a bit more 'out there' is a feeling that I have some sort of power over the world, like an ability the think consequences into being. Totally awkward admission right there. I feel somewhat superior to others, as though I understand truths in a way they can't. Other people can irritate me with little aggravation because their thinking can seem so clumsy and their methods backwards.

I’m not proud of any of this. Actually I am quite embarrassed about some of it, and even a little ashamed, but I’ve always said I’ll be honest here - even if that means I have to admit I can be a thoroughly detestable person at times. This is a picture of life, as me, that I’ve never discussed before because nobody has every really asked about it. It is, in a quite perverse kind of way, now that I read these paragraphs back, something that has been absorbed into the image I have of myself when I am well. It doesn't sound at all well though, does it.

When I am asked, as I was, if I have ever been in trouble with the police then the answer is indeed ‘no’. I have never been in trouble like that but for a speeding infringement. When asked if any of my blood relatives have been diagnosed with bipolar disorder the answer is again ‘no’. But that isn’t to say they don’t exhibit all these traits too. My parents are first generation emigrants who keep themselves to themselves. What you and I might consider symptomatic of a mental health issue would never be spoken about in these terms.

So I am a little frustrated at both the questions I was asked by Dr A and the way I answered them, because I think we could have had a much more productive hour together. I have another follow up appointment at the start of May. The evening’s dose of Quetiapine has started to make me feel very drowsy again, so its time to go to bed.

Work Capability Assessment

People ask how we are coping financially while I’m unwell. The answer is that I’m on Employment Support Allowance (ESA). ESA is a benefit that provides financial help to people who are unable to work because of illness or disability, worth around £50 per week. I wrote about the complex application process back in this post. After claiming ESA we completed a questionnaire (limited capability for work questionnaire ESA50) asking about how my illness is affecting daily life and I regularly supply up to date medical certificates from my doctor, confirming that I am still unwell. In most cases the Department for Work and Pensions (DWP) request that claimants attend a face to face medical assessment, regardless of your GP’s or specialists’ judgement about your health. The report arising from this assessment, known as a Work Capability Assessment (WCA) is passed to a decision maker at the DWP who uses its findings to continue or stop your ESA benefit.

The prospect of having my health scrutinised by a Work Capability Assessment is a great source of anxiety, fear and stress for me as a depression sufferer. It is an experience I expect to find deeply uncomfortable, an event that I do not trust holds my best interests, and one I do not expect to be sensitive and understanding of mental health conditions and their impact on daily life. The prospect of this assessment is exactly the sort of thing my depression feeds on to hamper my recovery.

Atos Healthcare (a division of the Atos S. A., a private French technology corporation) conducts disability assessments for people claiming a range of disability benefits including Employment Support Allowance, Incapacity Benefit, and Disability Living Allowance. It’s a strange feather in the cap of this international giant with 2011 annual revenue of EUR6,812 million. Interestingly, Atos Healthcare came into being in London in 2007, months before the introduction of WCA and quickly dominated the provision of occupational health services to government departments and local authorities, as well as winning the contract to carry out disability assessments. In November 2010 Atos Healthcare was awarded a three year contract extension worth over £300 million by the Department for Work and Pensions (DWP).

Atos Healthcare recruits doctors, nurses and physiotherapists to disability assessment jobs, where they are known as disability analysts. They carry out over 800,000 face-to-face medical assessments for the DWP each year. Up to 40 per cent of all ESA claimants are claiming primarily because of mental health problems. Since the introduction of WCA in late 2008, these assessments have been a source of much controversy, much of which relates to the computerised script used by disability analysts and devised by Atos Healthcare.

Atos say: “The programme, called LiMA (Logic-integrated Medical Assessment), was developed by Atos Healthcare to improve and ensure consistency and quality of the reports.” However Baroness Sheila Hollins, past president of the Royal College of Psychiatrists, said in her 2011 address to the House of Lords: “There are real concerns about Jobcentre Plus and Atos assessing staff's knowledge and understanding of mental health conditions.” The Citizens Advice Bureau, an advocate for benefit claimants, expressed “grave concern at the number of people unexpectedly being found fit for work”. They said: “We still hear repeated reports of rushed assessments, assumptions being made without exploration, inaccurate recording and poor recognition of mental health problems.” The personal stories and campaigns are easily discovered by searching on Google, campaigning and personal blogs, and You Tube. I could link to them here but websites reporting on this have been taken down for a lot less.

Five days ago The Guardian reported the chief executive of mental health charity Mind, who also acts as a member of the panel responsible for monitoring the functioning of the work capability assessment, faced a moral dilemma.  This was: “should he continue to sit on a government advisory panel, charged with scrutinising a policy that his charity believes to be inhumane? Or should he resign, publicising his anger at the coalition government's refusal to listen to the charity's concerns, and remove himself from the room where improvements are being discussed?” He chose to resign, saying: “The DWP seems absolutely committed to pushing 11,000 people a week through a flawed system”.

In the DWP’s own July 2011 report it is confirmed that at least 390,000 people have gone to appeal since 2009; tribunal courts have been forced to open on Saturdays and to increase staff by 30% since January 2010, to deal with the backlog. Appeals are costing the government around £50m a year, in addition to the £100m it is paying Atos, to carry out the largely computer-led assessment.

Atos Healthcare was in the news again recently after The Guardian reported that medical staff assessing benefit claimants were told to sign the Official Secrets Act. Two doctors who work for Atos raised their concerns with the Guardian and online political blog Liberal Conspiracy after the company asked them to sign a document pointing out their obligations under the OSA. “Both doctors believed that signing the document would hinder people in the organisation from blowing the whistle on patient safety and issues around whether medical assessments were being carried out appropriately.”

Accessing information relating to the Work Capability Assessment continues to be a stumbling block. Wikipedia reads: “Attempts by advocacy groups, and even MPs, to secure access to LiMA in order to demonstrate its weaknesses have been refused on the grounds of commercial confidentiality”. In April 2011 Atos Healthcare sought to officially accredit disability analysts by teaming up with the University of Derby Corporate. The British Medical Journal reports that the University of Derby would not disclose its fees for hosting the course, and Atos would not disclose the course materials.

The difficulties surrounding Work Capability Assessments continue to be a concern to people like me, faced with attending one. From the collection of stories others have posted about their WCA experience, I expect to be asked how I travelled to the assessment, if I can make a hot drink, if I have pets, if I watch Coronation Street, all of which can be used to make extrapolated judgements about my mental and physical health. I have little choice but to put my faith in a system that others have found fault with, and that disregards the judgement of my own mental health team. It’s just me against the point scoring machine, LiMA – and everybody else that has been a part of helping me get better thus far can only watch from the sidelines.

Should you be unfortunate enough to be in the same strange position, I’ll leave you with a link to Rethink Mental Illness who provide advice in advance to attending a WCA.

Quetiapine Days

I’ve been on Quetiapine for 12 days. Quetiapine, pronounced kwe-TYE-a-peen, boy have I struggled with saying that. Swallow whole, do not chew, take one at night (8pm) an hour before food or on an empty stomach, may cause drowsiness, avoid alcohol. That’s what the ugly printed message on the squashed white box says.  Well, on the 50mg starter dose I think I’ve eaten my way to the next trouser size up - the lack of mirrors in our home is a blessing. The raised appetite thing might be undesirable, but it is expected. I’ve been struggling a little with taking the pasty pink tablet according to the instructions because of the raised appetite – I don’t think I have an empty stomach any more but for those few minutes before breakfast. Sorry, I think talking about my appetite like this all sounds a bit grotesque… but you know what… it is – a little.

Morning starts on Quetiapine can be slow. The first seven days I slept a lot, a couple of times joining the rest of the family on days out in Dorset, very much at my own slowed pace. The feeling of fatigue was offset at times by a lightness to my mood – I think connected to being away from anxieties and the rest that the medication imposed on me.

Every day, as the Fluoxetine wears off and before it is time to take the Quetiapine, my mood sinks and I become irritable, impatient and aggressive. It is a time when, regardless of the day’s progress, I am likely to become overwhelmed by events and recoil into myself. Having picked up on this, I try and keep myself from others in the late afternoon - because the ensuing arguments are inevitably my fault.

On Saturday, I shone through quite unexpectedly. I bolted from the bedroom, showered and walked the dogs with Xavier before breakfast. In that single day a lot was achieved. I picked up ingredients and made delicious Mediterranean meals for lunch and dinner. During the day Xavier and I went out to the playground where we both clambered up the rope nets, rode the zip wire and swept back and forth on the tyre swing. We made a visit to the sheds at the top of the garden and collected a small haul of objects that had been in storage since we moved here four years ago. When the weather held out we returned, after lunch, to play basketball and eat a 99 from the ice cream van on the West Hill whilst we looked out over the fishing fleet. After that we still mustered the energy and enthusiasm for a game of football on the artificial pitch next to the playground. I felt driven by a curious restlessness, and big plans were forming inside me that spread out into the imaginary days and weeks ahead.

The next day I was propelled along in much the same way by a taut, uneasy spring, But my mood was starting to buckle. I photographed some of our furniture and put it on ebay to bring in some much needed cash. This is time consuming but given that it will hopefully raise several hundred pounds – it’s worth getting right. People don’t easily part with that kind of money over a photograph. Xavier and I played with the pair of whistling spinning tops we had found in the shed the previous day, followed by games of dominoes and snakes and ladders – two of his current favourites. We have yet to try out the wooden balloon powered boat we found. Late into the evening the frantic activity continued as I fought off the sedative effect of the medication to post here just before midnight.

After that the bottom fell out of my world again and I went back to being the heavy, slow moving, bedroom dwelling creature that sits and stares at the nothingness. I collected refills for my medication today at the surgery and the Quetiapine goes up to 100mg tonight. I’m glad I had those two days where I could be more myself without employing strategies to get through each moment. Everything is uncertain. I just make it to the next day. This is not a time to be drawing conclusions, because day to day things can be so very different. Just go with it, keep writing it down, keep communicating with the team of different professionals. Revel in the times when I surface and sit tight when things are hard. This is mid process and nobody knows what’s going to happen next, sounds kind of exciting put like that doesn’t it. 

Socks See Off Depression

With the Easter break in full swing, thousands of holiday makers anticipating an enjoyable long weekend will instead be met with the misery that accompanies traffic delays and time with family. In doing so they will get a taste for what is becoming a growing epidemic, the malaise of depression. According to the Health Organisation of the World depression is set to afflict one in four of us, or put another way, a quarter of each of us.

From Top: Ben, desperate depression sufferer;
John from S4S; Prof Kirk's Sock Applicator;
New Swedish Sock Suspenders

Professor Kirk from the Institute of Depression said “depression is no joke, it is much worse than a bad back, in a way.” He added: “Without the work of our institute, depression would see the economy grind to a halt as shoppers close curtains and take phones off the hook”. He explains: “The secret rests in elevating the Sock Line (SL) relative to the ankle so that the sock is itself at its maximum tension” or put simply, that pulling up our socks can indeed pull us out of depression.

Father of two and depression suffer, Ben (pictured anonymously) said: “Other people don’t realise how hard it is. I often can’t even find my socks, and when I do I’m having to pull them up every five minutes. They don’t always go with what I’m wearing either” (Ben gestures desperately towards his sandals, pictured).

It’s difficult not to be touched by Ben’s story and the stories of many others like him. Thankfully, the work of Professor Kirk brings renewed hope. “We recognise the difficulties that arise when applying socks and found our patients responded favourably to Sock Applicator Therapy (SAT)”. SAT is helping hundreds in a pilot programme across the UK to return to therapeutic levels of sock wearing. The simple device slips over the open sock and allows toes to easily be aligned with the sock neck (pictured).

Local footballer and general team player, John (25, single) said “I’ve been using SAT for my depression for a few months now. It’s helped me enormously and the lads have really got behind it.” The club now champion charity Socks for Solidarity (S4S) which sees players pull their socks up together before each match in unity against depression (pictured).

As for the problem of socks falling from the requisite therapeutic height, a Swedish company has stepped in with a unique solution, the Sock Suspender (pictured). When used in conjunction with a shirt, Uric Jenova, inventor and mental health entrepreneur, guarantees elevated moods correlating with sock height. The Sock Suspender is awaiting a decision on its UK licence from the Board of Supplementary Therapies following revelations that trials were conducted on mice wearing tiny little socks.

Peter Fellows, holiday maker and depression sufferer remarks: “Personally I don’t see the problem with socks and sandals.”

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Brad Pitt reveals he sat next to somebody with depression on a train once.

Alicia's Post

As I have been with Mehdi through his depression, I have seen and learnt many things. My own experience of the illness some years ago has gone some way to helping my understanding but, nonetheless, depression being such a different thing for each person, it has been an experience for us full of twists and turns, a road through steep hills where sometimes we can go along miles of blind bends. You learn to expect the unexpected though, and what that really means in the context of being a couple and having a (gorgeous) little boy. What I can never learn not to be surprised by, though, what always knocks me for six, is the people who ask me, quite unabashed, 'yes but how long are you going to put up with this for?'
Well. Where do I begin?

The 'this' in that question obviously refers to Mehdi's mental illness. I always am silent for a moment after I hear that awful question ; I think there is a moment of shock that Mehdi's brave battle with such a nasty illness, for which I admire him very much, has been casually described by someone who clearly doesn't understand as 'this'.
Once I've taken a moment to inwardly address that initial shock, then the second one sets in. This is the idea that this person expects there to come a time when I will no longer be with my soulmate, the love of my life, because he has depression. When phrased as above, as I find it so often is, the question gets me as well because it isn't an 'if ': it's clearly a 'when ', as if my love is sand in an hourglass that will eventually run out. My answer is always in the vein of 'I will never leave or give up, I love Mehdi, our happiness is bound up in each other and I don't see why our overall life long happiness should be another tragic casualty of his illness.' The person who most frequently asks this question of me being Mehdi's mum, that's usually where I leave it to avoid rocking the boat too much. I've had long conversations with her, just the two of us, trying to help her understand. That sounds a bit patronising, but I don't mean it like that; I just think that if Xavier needed help and I didn't understand why I'd be grateful if someone helped me understand. But these conversations seem to have an effect that quickly wears off.

But I do want to volley a few questions back to her, as I do to anyone else who might pose the 'how long' question (weirdly enough though, my experience is that this is rarely asked by those outside the family) .

First I want to ask what other illness someone could possibly have for it to be acceptable to ask of their spouse how long they will stay; then I want to ask why it's OK to ask this about mental illness. I don't need to ask though, not really. I'm pretty sure I know. I think it's because some people just can't shake the idea deep down, whatever they might say outwardly, that the afflicted person can somehow help it. I think that's been the worst blind bend to come across in the last few years: the one where I realized that when Mehdi, and also we two as a couple and we three as a family most need compassion and a kind smile, we are in fact under scrutiny by some (a minority I must add - we know lots of amazing people)  to see when it will all fall apart completely. But it won't. It's not always easy, some days it's rarely easy, but it won't fall apart. It's hard to explain because I know it may be incredible to some given our situation but we are happy. And when I think of Mehdi, in all honesty the first word that springs to mind is happy. You see, for me it's not related, who he really is and his depression. He is and will always be that joyful person, so in love with life, whom I first met and fell in love with. It's just the depression means you can't always see that person. One day I hope I'll see that person more. But just because I can't see oxygen doesn't make me afraid I won't be able to breathe.

Leaving the Nest

Yesterday I sat quietly amongst the Mute Swans of Abbotsbury. I watched a pen arrange her angular nest neatly about herself, studying the movements of her chalk white neck as she reached for disobedient reeds and lifted them into their architectural place. She stretched out in defensive attack of passers by that drew too close. Too close to her nest, and when she rose up and flexed her arched wings in celebration of natures structural perfection, I caught sight of her prize... a single grey blue egg.

She looked at me a moment and appeared to study me back in silent contemplation. A moment later she left her nest to join the colony in their hundreds feeding on the generous servings of wheat in the lagoon. I felt responsible, as though she had asked me to keep vigil over that single precious egg. And I did watch over it with such mindfulness that I didn't notice the crowds disperse and the buckets of wheat being barrowed away, and the colony thinning once again into their inseparable pairs.

The vivid experience of life as I see it is still present and yesterday it reached out to me. Yesterday it entered my body through its sights and sounds and softened me from within, sculpting away the anxiety from my once petrified face.

With my own wings outstretched in anticipation of flight I visited a grocery store to collect some ingredients for a family dinner. The grocery store, a hornets nest of human existence where too many of us share the same space in mutual competition. It's been many months since I set foot in a place like this. I came out some time later, fragile, upset, beaten and without a single purchase. This is a helpful indicator of how, for the moment, day to day activity can trigger a stress response in me akin to what you would experience if your life were in danger. And the evolutionary glitch that is memory permitted the self analysis of my failure to reign through the afternoon until its energy dissipated into sleep.

I awoke later feeling restored, but such glitches are important in measuring out the size of my strides on the road to recovery. My mood feels more even, although fragile and susceptible to derailment by life's teacup tempests. The sedation is easing away and my waking hours are stretching out into the day.

Another day beckons.

Excess Baggage

I've been sleeping during the daytime and thinking about food when I wake.

The chemical pathways that are acted upon by antidepressants to alter our moods are somewhat crudely tweaked. So sleep, appetite, aggression, and sex drive are all tweaked too, inadvertently, by antidepressants. I remember how my appetite crept up when taking mirtazapine until one day I couldn't walk past food without tucking in. I looked and felt awful. The hunger drive is a powerful one and I satisfied it, whether I needed the calories or not. The weight gain was rapid and, because the behaviour didn't show any signs of subsiding, it continued rising indefinitely.

Quetiapine has a similar action on appetite and, given my dose is expected to increase steadily from 50mg to perhaps 300mg, this battle with my weight is set to be a long one. Sadly, some patients refuse to take Quetiapine because they fear the weight gain. It might seem strange that someone with a mood disorder would leave it untreated to preserve their appearance. However, low self esteem is a common foundation stone in cases of recurrent depression, as it is with me. Low self esteem ... that's looking in the mirror metaphorically and literally, and finding all sorts of reasons to dislike what you see. It isn't a good context for binge eating and weight gain. The mystery is why pharmaceutical companies consider antidepressants that cause weight gain a success.

One blogger taking Quetiapine recounted how he awoke each morning to find food on his mouth and open wrappers beside the bed. He had been sleep eating! Another told of how she now set five different alarms to wake her - but still found she couldn't make it to work on time! In her sedated state she had turned each alarm off in turn and smothered her iPhone under her sleeping chest.

I can appreciate the feelings in each of these stories. My brain's focus on food is akin to what you would experience had you fasted for 24 hours, only I am eating and I've yet to feel full. My sleep has been a dreamless void into which I disappear indefinitely without means to reach me.

I want to avoid the weight gain and the excessive sleep. I'm well past the vanity of attending to my appearance ... I just want to be fit enough to do the things that fathers do. So even now, as the Quetiapine makes its first claims on my appetite, I'm fighting back... albeit with apples and water! There, I've said it now, so you can hold me to it.

Quetiapine-lets

I woke up a great deal earlier today. I've had my little green and yellow capsule this morning and my chunky red one last night. My mind and body feel out of sync.

Since I started taking the chunky red tablet I've been thinking about food a lot. The search for a bowl of cereal is what raised my sedated limbs from the bed this morning. Last night I fell asleep to dreams of chocolate biscuits. Sweet foods dominate my thoughts in a way that I find strange and unfamiliar. I can only imagine this is a consequence of the Quetiapine. This is a bit of a worry, but it is early days on this new medication. Every drug has affected my appetite, citalopram and cymbalta gave me a diminished appetite whilst mirtazapine and fluoxetine raised it. Appetite, like so many other drives, is controlled by chemical switches. Chemical switches which antidepressants tamper with.

I have as much control over my appetite as you have over your bowels. Just consider the way your thinking can be dominated by a need to toilet.

Whilst my body feels knocked out by the sedative effects of Quetiapine, my mind does feel a little calmer. Admittedly I haven't been conscious for much of the time over the last 36 hours, but my waking hours are an improvement. This tranquil white cottage and the spring light is making this a comfortable time for me. This is what it must feel like to be a peg doll living in the opulent paper surroundings of a miniature dolls house, away from the stresses, great and small, of real life.

I'm hoping the lethargy will subside today long enough that I can investigate the landscape around this little cottage and meet some of the horses, whose hooves I've heard echoing through the thick Jurassic walls of this old stone cottage.

Today marks the end of the first trimester, yes, Alicia is now three months into her pregnancy with our second child. Somehow that gives us permission to ratchet up the excitement a notch more. To enjoy the hope that passing time brings as little limbs and organs form against the odds in nature's finest of magic tricks.

Dorset Cream & Quetiapine

It's a little difficult to recall the events of yesterday's meeting with Dr A, a psychiatrist. As I write now I'm distracted by two things: an unabated hunger and the sedative effects of my new medication. Oh, and the lady on the television is cooking in a sweet little domestic Parisian kitchen, breaking eggs onto a blue rimmed enamelware bowl.

Alicia came into the meeting with me and we sat in a glass office high above the coastline on comfy, fat, green chairs. On another day, under different circumstances, I imagine we would all have stood silently at the glass, noses pressed into the windows, hypnotized by the tides muted motion.

It was difficult talking through the story again as though it was the first time. I could feel the pressing need to cover a lot of ground in our allotted hour. I found it frustrating spending any of that time answering detailed questions about my employment history, and the occupation of parents and siblings. Perhaps it is relevant in ways I don't yet appreciate. The time line was important too, and I am hopeless at recalling the years in which various events took place. Alicia, helped me greatly with these questions.

I came away with a supplementary medication to be taken alongside the fluoxetine I already take. Quetiapine, a medication used as a mood stabaliser in lower doses. I am to take it daily at 8pm on an empty stomach, which has left us wondering when we should sit for dinner. One could consider eating a late supper after downing the medication, but for the fact that it makes me drowsy soon after. Slumped over my soup is hardly an attractive look is it.

Sorry, you lost me a couple of times there. I keep falling asleep you see. I started writing this post around six hours ago. The birds are singing in the tree tops outside my window. The family have been transplanted to a farm house in Dorset for the week. We travelled along the coast yesterday afternoon and arrived at dusk. The cottage is peaceful. A good place to be unconscious. These days away are a very generous gift from Alicia's grandmother, who overcame cancer last year. Xavier is a human space hopper in these new surroundings.

So the question of diagnosis is, for the moment, unanaswered. But, for the first time somebody spent time asking me about what life is like between the depressive episodes. Making sense of the last three years, however, seems impossible. The experiences are overlaid with the shifting reactions to different medications, the challenges of enormous life changes and extensive periods of poor mental health. From this muddy memory it is not possible to extract a simple story of manic and depressive episodes. It is as though the ink bottle was upturned onto the page and now the underlying story is obscured. Now with this further change to my medication I find it difficult to understand how this won't complicate the picture further. This seems to be the inherent difficulty of diagnosing mental health conditions mid treatment.

Anyhow, I embark on another phase of acclimatization to a new medication. Each time the experiment is unique, the first time this drug has inhabited this body and affected this brain. The notion is that the dose on this medication will be steadily increased as I find my feet with it. Under its influence my mood should become more even, which is something which sits uneasily with me. I have become rather attatched to my own particular vivid experience of this world's beauty and wonder if that is one of the mental creases to be ironed out by Quetiapine. I shall have to wait and see.

Waiting Room Thoughts

In three hours I'll be sat with a psychiatrist for the first time. I'm filled with anxiety. I will have one hour. Perhaps in that one hour I'll be asked the right questions. Perhaps I'll be fit enough to respond meaningfully. Perhaps he will have the expertise and experience to fill in the gaps that one can't cover in an hour. Perhaps he will understand how important that one hour will be to me. Perhaps.

Depression takes several forms and correct diagnosis is key to medicating appropriately. Three years ago I swallowed my first antidepressant. I've been on four different antidepressants since then: Citalopram made me anxious and suicidal; mirtazapine tranquillized me, took away my mental agility and made me fat; cymbalta was a love affair but it's affects were short lived and eventually we grew apart; fluoxetine made me aggressive in high doses, in lower doses it helped me bounce along the bottom of the mental health sea.

My working life these past 3 years has been a train crash. The hold this illness has over me makes me unreliable, anxious, fearful, socially awkward and completely without resilience to everyday stresses. I've gone from a £45k salary to living on benefits. I'd like to be well enough that I can work a year without another major depression tripping me up.

A year of uninterupted work growing my business. A year without my weight ballooning or shrinking under the influence of medication. A year without suicidal daydreams. A year of being a father and husband. A year without conspicuously missing seasons ... without a major depression.

It's been a while since I allowed myself to dream ahead a whole year. That is what this hour with a psychiatrist means to me.

White Rabbit

My mother just returned from Hajj, a religious pilgrimage, a sort of Glastonbury for Muslims. Since returning she has told me that I need to stop this, by which I think she means stop being mentally unwell. She tells me I need to go back to work, because I need to be a good example to my son, Xavier. If I read between the lines I think the suggestion is that I’m not a good example to him right now.

She visited too. I couldn’t explain why, but whenever my parents visit they typically insist from the outset that they cannot stay. My father will often sit in the car, outside the house; perhaps he’ll smoke a cigarette. Or, on occasion, he will stand on the door step. With only the most persistent of encouragement, will they both come in, and even then they both always refuse to remove their coats. Actually the whole thing becomes quite exhausting, because every step from leaving the vehicle, to entering the house, to taking a seat, to accepting a cup of tea, requires such reserves of energy and encouragement on our part. It is a scene fit for the stage, couched in comedy. Every attempt to make them feel welcome and comfortable is met with some retort about how brief this visit will be. This is made all the more comic if one takes a moment to survey the sedentary lives my parents lead. They have lived in this region for nearly thirty years, but still know little about its scenic beauty. A walk for them is what one does travelling from the dairy isle of the supermarket to the bakery section. And between walks they watch extraordinary amounts of television.

Anyhow, her visit to us was brief as always. On this occasion my father didn’t come in. My mother sat down but kept her coat on. She didn’t make much by way of conversation. She did prod my stomach and tell me I am fat, something she said I needed to sort out. She gave Xavier a few inappropriate presents, the sort that uniquely combines plastic, noise and violence.

Both Alicia and I couldn’t help but notice how well my father seemed whilst my mother was away. He came across as carefree, energetic, spirited and joyful. Now there is a marriage I might never understand.

It’s been a positive week and I continue to recover, with the expected ups and downs. To myself I say, surround yourself with passionate people, everybody else can wait for now.



6 Years of Alicia

Educating Otherwise

Xavier, our son, will be five years old this November. His experience of formal education thus far has been attendance at a local playgroup for three mornings a week. In England, the next step for a five year old is school, but not in Xavier’s case. The Education Act 1996 defines the parents duty as "... to cause (the child) to receive efficient full-time education suitable to his (or her) age, ability and aptitude and to any special educational needs he (or she) may have either by regular attendance at school or 'otherwise.” So in Xavier’s case, I guess the operative word there is ‘otherwise’, because we are not planning to send him to school, at least not right now.

Our decision to educate our son out of school is something of a conversational minefield. We have many wonderfully understanding and supportive friends, but outside this circle I become rather uncomfortable talking about it. There are all sorts of reasons for this social discomfort: For one I don’t want our decision to be taken as a criticism of parents who choose to send their children to school; secondly, I really haven’t taken to the look that passes over some people’s faces when you tell them; and thirdly this invites the question of ‘why’ and I haven’t figured out the simple way to answer that with integrity.

It is not the radical decision some may think and there is a growing trend towards educating children away from school in this country. With some things we have a habit of thinking that they are the same the world over; it’s difficult to imagine them being any different to what we know. For example, if I asked you all to show me your wedding ring, you might think all married men and women pointed to the same digit on the left hand, the magical ring finger once believed to connect directly to the heart by the vena amoris and thus be a symbol of one's love. However, in a few European countries a Greek Orthodox bride will wear her wedding ring on the left hand before the marriage ceremony and transfer it to the right hand after the wedding. Likewise, children the world over do not all start compulsory schooling at the same age.

Whilst the journey through a fixed curriculum starts as young as four in England, children in sixteen other European countries (including France, Germany and Italy) are still at play, where the school age is six onwards. Perhaps more surprisingly - in Finland, a country regarded as having the highest educational standards in Europe, children start their compulsory education aged seven, and spend much fewer hours in the classroom than their English counterparts over their educational lives. So at this point in Xavier’s life, one could hardly justify raising an eyebrow at educating him out of school.

But this is England, and the shape of our modern day education system has risen up from the antiquated politics of the industrial revolution. Only two hundred years ago England argued virulently against the education of the poor for fear it would teach them to despise their lot in life and make them idle. One hundred and fifty years ago privileged girls who were lucky enough to be receiving an education had to make do with a curriculum aimed at preparing them for social display and companionship. Mean while, the Protestant work ethic of industrialized England set its poorer children to work under the strict regimes of the factory system, and to uncertain futures in the bowels of our coal mines. English children were a cheap source of labour for the industrialists and factory owners.

The demand for a more capable, ‘useful’ child worker; the demonization of the poor; warped religious attitudes to work and pleasure; an established upper class education reluctant to modernise its curriculum and purpose; an educational curriculum for the masses tempered by a fear of educating the poor; a narrow view of intellect conceived by our university system of educating; an era in which all that was to be learnt existed between the covers of books, in the head of a teacher, in a building called a school house; all of this is the mould from which today’s English education has been cast… and all this is what is wrong with education in England today.

All these tensions are evident in the way we organise our schools like factories and our children into batches of products grouped by age. Evident in the way our politicians still battle between an education for the masses or the preserve of an elite. Evident in the hierarchical way schools value and compartmentalise their subjects. Evident in the way each institution sees its purpose to be a stepping stone to the next institution. Evident in the way young people are directed towards futures that are perceived to be useful for our economy. Evident in the way the childhood joy we have for creativity, drawing, singing, dancing and music is quickly extinguished by a pressing timetable of more ‘important’ pursuits. Evident in the balance of power between educational institutions and children. Evident in the way the process of academic inflation has made a masters necessary where once a degree would do. Evident in the way we medicate our children to be like other children.

I’ve met many talented teachers in my life, but this is what they are up against and this is no criticism of them. Education, as an institution in this country, is dancing out of tune to the music. Anyone who is really interested in learning, would not choose to start with a model of schooling as we know it. And thankfully, English law permits that we don’t have to.



Tick Tock

I am on the climb upwards. These depressive episodes are like descending into a deep cleft in the Earth, being swallowed up by the dirt, followed by a climb up a slippery, brittle, shale elevation – the steps forward interrupted by frequent backslides of smooth, broken rock. I am enjoying the advances and despite the instability of the ground beneath my feet, I am able to look down, and see that I am making good progress. I am functioning now, even though that might be within the confines of my own home in the main. Functioning is to leave the bed and the bedroom, shower and dress, prepare meals and communicate. Actually I’m more than functioning. I have been taking the dogs for walks each day, and I have taken on chores around the house, starting to get things tidy again. I’ve spent time with my Xavier and Alicia, cooked for them and cared for them both - as they did for me.

I am still taken away each day by my own thoughts, the rumination of depression, starts are stalled, progress is halted, activity suspended, energy evaporated, but each time I am now able to get going again, eventually. I am able to ‘talk myself away from the edge’ in a way that seemed completely impossible these past months. Months! Has it been that long? The suspended life of the depressive… so deep inside thought that not even the clock can be heard ticking, counting second after identical second of cocooned existence.

All those months ago my GP made a referral after I found myself in his office again, head in hands. I think you’ll know from reading here that I have been willing throughout the fight with each depressive episode. Each time practising what I have learnt, and learning more along the way. Each time making realisations and changes to protect us, my family and I, from depression’s destructive influence. I have been a good student, so it was in frustration that back then I approached my GP to discuss another slide downwards. Reading across these posts it is astonishing to see how I have changed since that first big crash, and how much we have changed the way we live our lives as a family. Depression and our fight with it has destroyed a career and created a business, brought us closer together as a family, brought understanding friends into that family, left unsympathetic relatives out in the cold, threatened us with financial ruin but opened our eyes to different, more fulfilling ways of living, slowed the pace of life. Where we once strove for happiness that came in the form of successful shopping trips, now we strive for good health and moments where we can be ourselves, together as a family. Hang onto your good health if you have it; you will miss it if it abandons you and it is worth more than you realise.

On Wednesday somebody called from the Health In Mind team to do an initial assessment over the telephone. This service provided my cognitive behaviour therapy in the past. They’ll consider what we discussed and come back to me in a week. It’s a little frustrating to be telling them the story all over again, from the start. It's a long story. I’m not looking for more CBT and I hope that isn’t where they are going. As I say, I was a good student and I use the CBT learning where I can. But, given the cycling nature of these depressive episodes and how hard we have worked to stay well, I want to know if my diagnosis is correct. Depression comes in many forms. If it is bipolar disorder for example (what used to be called manic depression characterised by highs and lows) it will be medicated differently.

All I know is that I have to press quite hard right now to get help. Health professionals, understandably, don’t always appreciate the landscape of things beyond one's health. Emotions aside, this most recent episode of depression has taken us close to the edge financially, missed mortgage payments, suspended utility bills, bank charges. Our tiny reserves were used up fighting the difficult times before that. We have communicated and renegotiated payment plans for what we now owe…and the pressure is on to be well and working hard to claw our way back. Tick… Tock… If and when depression strikes again, our financial position will become even more challenging - how challenging will just depend on its timing. That is the backdrop to our story and it gives us a sense of urgency... to be proactive, diagnosed and treated correctly and on a path towards health, or if not, at least to have a better understanding of my ill health so we can plan our lives accordingly. I have frequently swung between health and major depression for several years now, and it's taken its cumulative toll on us. We are flexible, we are a family of fighters, and we have fought unpredictable event after event. We're just being smart, there isn't much left in the tank now and another fight would really hurt us bad. Its time to look to the corner for some help. Let's hope they appreciate what sort of shape we are in.

Sublime Happiness

The pursuit of happiness is one in which I am gaining ground. Mindfulness is for Jon Kabat-Zinn to explain, and I couldn’t convey it as he does. I can only share what I understand for myself.

Do you ever look at others with depression and see that they have a home, a job, a loving family, possibly children, and wonder what it is they are depressed about? I’m sure you accept that depression is an illness and not to be confused with an emotion - but doesn’t part of you wonder why they can’t see they have every reason to be happy, joyful and thankful? I think that too… for people like me, with depression, it is a deep well of guilt. We look at our own lives and cannot justify the way we feel, the sadness and despair and hopelessness. I can explain it away with science, but, what I would rather understand better is how to reach out to all that is around me, all that you can see, all that would bring me joy if only I could see it.

To see what is around me, and take a step towards personal happiness, I needed to step away from my own thoughts. I think of the wiring inside me a little like this: Thoughts are really powerful. Just with a thought I can close my eyes and be anywhere and with anyone. We know this best when we dream. With my thoughts plugged in, I am lit up inside with pictures and sounds, and whatever I see and hear stirs my emotions. I go from thinking, to feeling too. Feeling all sorts of powerful emotions like grief, loss, sorrow and fear, just because of the thoughts inside my head. Depression has this connection between my thoughts and feelings firmly screwed home; it isn’t a feed that is easily broken. But alongside this strong connection there is another, slightly wobbly cable labelled senses. If I could tweak this cable into action I might be able to give my emotions something else to stimulate them; to divert their attention from my thoughts.

In essence, my practicing mindfulness is just that, tweaking the cable that connects me to my senses so that I can appreciate what is around me and be absorbed by it. Like the loose power cable plugged into the back of my laptop, some days I make the connection in a matter of minutes, other days it can frustrate me for some time as it drops in and out of place. It can be exhausting, but it is definitely worth persevering with.

A week ago I awoke and, as has become habit, spent a little while in the quiet company of my own breath, just feeling the air pass through my nostrils and expand my chest. This exercise is helping me to strengthen the connection between senses and feelings. I am, in that moment, not striving for the next or dwelling on the last. I am simply the sensation of breathing, experienced though the senses. The thoughts come but they go again, like the sounds of children in a distant playground. Occasionally they do interrupt and I don’t always notice straight away. But when I do notice, I bring my attention back to my breathing and let the thoughts be, without berating myself for having let my attention wander. On that day a week ago, after this exercise, when I open my eyes, I felt an immovable smile on my face, a peace across my forehead, a compassion in my eyes. It stayed with me all day, a feeling I could only sum up as a sublime happiness brought on by a deep inner peace.

That day, Xavier and I had many interesting conversations, and we played as though nobody else was there to see or judge. We enjoyed everything that we did and gave ourselves to each moment. I realise now that Xavier does this all the time, instinctively. It is why hunger catches him by surprise, why he never wants to go to sleep, why he spends so much time under the shower with his head raised up and his eyes peacefully closed. I suppose we all knew nothing but the moments once, before we started learning to name things, and then learning to judge them… we have all perhaps been mindful children.

Not everyday is like that one, but every moment I have the opportunity to return myself to a state of inner peace and be awake in the moment. That is surely the most uplifting, optimistic, hopeful forecast that anyone with depression, or anyone for that matter, could hope for.



Puppy Training

It has been a while since I saw 8.30am, showered and dressed and ready for the next thing. But here I am, and I’m very satisfied about that. Yesterday was a good day for me too.

My ‘one thing’ yesterday was to walk the dogs, and again this is something I haven’t been able to do for a while – I haven’t really been leaving the house much. Walking the dogs is one of those things that makes me smile; seeing that the dogs are happy. Its funny how dogs are so immersed in their senses; there we are on our walk and the world is so full of interesting sights, smells and sounds that they can barely walk in a straight line. On the other hand, when my own thoughts have tied off the flow of sensations from my senses, I can travel the same walk without any knowledge of where I have really been. They are so in the moment, whilst depression can make me so the opposite. As Ami said so well, my mind is like a recalcitrant puppy that needs frequent tugs on the lead to stop it from wandering. So yesterday I took the lead, so to speak, from my dogs, and each time my mind turned inwards I snapped it back out again. Another act of mindfulness that I am finding is serving me well and helping me heal (there I go again with the puns).

I noticed the lichens growing on the north facing brickwork, the beautiful eggshell cracks in the old signs that mark the street names, the well proportions front doors of Victorian and Edwardian terrace houses. I quite agree dogs, it’s jolly difficult walking in a straight line.