MENTAL HEALTH FEATURE: Depression

A first-hand account by Dr Duncan Stewart and Mike Wall.

Do not confuse ‘being depressed’ with the medical syndrome of the same name, this would be like misunderstanding the difference between sleep and a coma. No one who has suffered from depression harbours any doubt that they were seriously ill as this account of his illness by my friend Mike Wall will demonstrate.

“When it eventually happened it felt like a sudden explosion going off in my head. I had known something wasn’t quite right for some weeks, perhaps about a month. Looking back now I think that there were probably signs of my mental deterioration for longer but it was gradual process until the last few days. 

“While writing this I’m still experiencing some slowness in my thought processes, which isn’t surprising as this was the symptom that eventually forced me to accept that I wasn’t feeling right. 

“For me the first signs were probably about 12 months before the ‘big bang’. It was around that time that a friend commented to Roger, my husband, that he felt I seemed unhappy. When Roger said this to me I was a little shocked because I thought that I was hiding it very well. I admitted to Roger that I did feel sad but that I couldn’t explain why. 

“At the time I put it down to anxiety, which I had been experiencing regularly since homophobic activity at work led to my having to take time off with symptoms of severe stress a couple of years previously. At that time I was also starting to become aware of a reawakening of demons that I’d been struggling with since living through some traumatic events in my childhood. I had successfully suppressed these memories and emotions for so long, that I felt that I’d be fine this time too and just get on with things.

“Six months passed by and I was still feeling unexplained sadness on occasion. My sleep pattern was also a mess. I found it difficult to fall asleep and when I did I would wake in the early hours and find it almost impossible to go back to sleep. This too had been going on for some time. 

“When I think it through I can, with the benefit of hindsight, see that at around that time there were other signs. I lacked any motivation to do things that I previously got a lot of pleasure from and I was feeling tired all the time. For example, I used to love spending time at my allotment but now I lacked the desire to go there at all. I thought that this was mainly down to tiredness. 

“Then, about three months before my breakdown, I was finding it very difficult to focus on things. At work I would find myself reading sentences over and over again, I needed to spend a lot more time preparing for meetings as I was losing confidence in my ability to offer input and I began to doubt my own judgement about the simplest things. 

“Most days I would wake up feeling uneasy about everything but I have never been a morning person so I just put it down to that. However, looking back I realise that I felt the same most evenings too. My mornings and evenings were plagued by sadness and I’d find myself feeling quite tearful for no apparent reason. It was affecting me so much that I could be sitting watching TV for an hour and have little or no idea of what I’d just seen. 

“Now that I understand depression better I realise that there were physical symptoms that could also have been linked. I never would have associated regular headaches, feelings of nausea and tummy ache as being connected to something going on in my brain.

“The final month was the most difficult. Whilst I’d been drinking more and more over the last 12 months, during the last few weeks I was increasingly drinking to get drunk rather than drinking for pleasure. I guess it was an attempt to self-medicate – to turn my brain off so that I didn’t worry so much about my lethargy, lack of motivation and dread of being in social situations. Usually a sociable person I truly didn’t want to be around people, not because I was afraid, but because I just didn’t care to be around other people and couldn’t muster any enthusiasm for conversation. 

“I also feared that I would lose my patience or even worse my temper, as I was starting to find that I was getting more and more irritable and my mood swings were quite unpredictable.

“In the end the crash was quick, over about 48 hours it felt like my brain gave up. I couldn’t think clearly, I started speaking gibberish and I truly felt that I just didn’t want to go on. Luckily for me Roger was there and he took me straight to my doctor. He immediately diagnosed me with depression, prescribed some medication and gave me and Roger some excellent advice. Thankfully, Roger was there as I wasn’t really taking much in. My doctor also referred me to see a counsellor, which was very useful.”

Some people have the misfortune to be genetically predisposed to developing depression but Mike’s illness, coming on after a period of stress or as a reaction to a personal disaster, is more typical. He developed all, or most, of the expected symptoms caused by a gradual depletion in the natural brain chemicals that enable nerves to interact, enabling our thought processes, controlling our body clock and physical activities.

What often makes the diagnosis, or our own realisation, difficult is that not everyone develops these symptoms in the same order or to the same extent. One of our aims in writing this article is to encourage anyone who recognises this pattern of symptoms in themselves, or people close to them, to seek advice.

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