How depression has affected me
Depression there long before diagnosis
I was first diagnosed with depression in the January of my final year of my undergraduate degree, after some heavy persuasion from my then girlfriend. Depression was really something that I had probably struggled with for some time before that, dating back to as young as being 12 or 13.
Anxiety and lowness at school
I remember one period of being worried about going into school because I wasn’t sure if I was doing well enough, and was anxious about my work, probably when I was in Year 8. I had a good group of friends at school, even though I was a long way from being one of the popular people, although I often felt quite low, and isolated, even when I really had people around me all the time.
Experimenting with self harm
It was also during this period that I first experimented with self-harm, where I had ‘cut’ myself with implements of varying degrees of bluntness, more of a symbolic gesture than a real desire to harm myself.
The pressure of exams was also something I felt very keenly, especially my AS and A2 exams, after shocking myself with how well my GCSEs went. Home life was generally fine, although I have had quite a frictious relationship with my mother during most of my home life.
Isolation and lack of interest
Arriving at university gave me room to be more myself, although once again I found myself feeling isolated from others, and persistently feeling drained, uninspired, and generally indifferent. There were often times when I genuinely felt completely disengaged from everyone and everything else, and this has continued at times when I have been feeling particularly low.
Perfectionism about results
My depression became pretty strongly intertwined with how I perceived I was doing, often having panics about my perceived inability to get a First in exams, which left me pitying myself and distracting myself from work. By the January of my final year, I could just not shake the persistent flat emptiness that I was feeling, and the troubling thoughts and behaviours.
Still struggling, but getting help
I am still affected on a regular basis by periods of low-mood, anxiety, and general depression, but some of the things that I have tried and some of the methods I am still using are helping me to get on top. I have still had lots of days in the past few months where I have been unable to motivate myself to open my eyes in the morning, and have spent the whole day hiding away, looking for any excuse to avoid seeing people, but some of the help I am receiving now is helping limit the effect this is having on my every day life, and allowing me to carry on with my degree.
Hard to pin down
I find it quite difficult to really pin down where my depression might have come from, but I suppose there are some general trends from throughout my life that may have had some effect on this.
Difficult relationship with mother
As mentioned above, I had a rather difficult relationship with my mother from quite a young age. My mother is someone who will happily have an argument to make sure she gets her own way, and it is something people in my family are generally used to, so the general strategy is to agree with her. Unfortunately, I was rather a ‘moody’ teenager, and so found it difficult to accept this, and was more than willing to question her, and this resulted in some quite difficult arguments over the years.
Self image and weight issues
I also feel that I had self-image issues associated with my weight from a very young age, as young as 10 or 11 at primary school, where I remember being concerned about being called fat. Quite a long history of binge-eating and pinching food when ‘nobody was looking’ led to my weight increasing rapidly until I was 16, when I had decided I had enough. Over the following 3 months I lost 4 stone, massively limiting my food intake and exercising at least twice every day. My weight is once again a concern to me as it has crept back up to a level way beyond that which I am comfortable at.
Bullying and pressure to excel
Bullying, sometimes to do with my weight and sometimes not, continued at secondary school, only really stopping totally around year 9. Another school-related pressure was the desire and encouragement to do well. My family put no pressure on me, as I was already achieving way above where my parents had been at school, but the environment of the grammar school, and the pressure to be getting As and A*s in exams has been an anxiety that carried on throughout my university degree, with constant fear about not being judged good enough.
View of myself
In general, a lot of my depression and negative thinking seems to be related to how I view myself, and how I think others view me, whether that is physically, academically, or my performance in the lab.
Finding what works for me
I have made use of a wide-range of treatment options over the past 30 months, and am beginning to get an idea of what particular strategies have been useful to me.
Antidepressant medication is something that I started taking from the same day as I first went to my GP, and is something that I am finally beginning to appreciate. Whilst I have been through a few different iterations of particular antidepressants, with a variety of different effects and side effects, I do not consider this to be a negative experience.
Pros and cons of different medications
I initially took citalopram, but due to finding it very difficult to sleep more than a couple of hours a night, along with very little positive benefit, I switched to mirtazapine. This had the opposite effect compared to the citalopram, with finding myself sleeping way too much, as well as a massive drop in sex-drive, which went almost unnoticed to me, but caused some relationship issues. Switching to venlafaxine made quite a marked difference, with the side-effect of losing a considerable amount of weight very welcome to me. I have since experimented with adding mirtazapine alongside venlafaxine (which I have now discontinued due to the effect it had on making me incredibly sleepy), and will soon start taking a small amount of aripiprazole alongside the venlafaxine.
Worth continuing to find the right medication
Whilst this has clearly been quite a complex journey through different antidepressants (SSRI, SNRI, tetracyclic… etc.), I do not feel that this is time that has been wasted, as I have definitely begun to notice the positive effect that the medication has on the stability on my mood. I understand that medication is not a cure-all, but is there to provide additional support to help me to help myself.
Cognitive behavioural therapy (CBT)
Another approach which I have had considerable experience of, to a rather mixed personal review, is cognitive behavioural therapy. I have attended numerous 1-on-1 counselling sessions where our main focus has been CBT, along with a course run by the university counselling service. I found that even though I struggled to apply it in everyday situations, the process of filling in forms and tables helped me to realise some of the connections between thoughts, feelings and actions, and also helped me to uncover some self-beliefs that I have about myself.
Recent developments using the mentoring scheme through the university Disability Advisory Service has allowed me to get to grips with the CBT technique better, and I am now considerably better at identifying negative automatic thoughts, and therefore at tackling these problems head on. Importantly, going to the mentoring service has enabled me to keep myself motivated so that I can get into university every day and do the work required, which in itself has eased the pressure.
Whereas before I would wake up and just not want to go in to work, now I am largely capable of getting up, getting myself ready and at least getting some way to achieving what I have planned for the day. To say that this has helped my mood would be an understatement!
Similarly, I briefly attended a university-run mindfulness course. Whilst I found it difficult to apply what I learned as much as I would like, it does sometimes still help me if I find myself thinking about too much too far ahead etc, and can help me bring myself back to the present and to worry less about what may or may not be.
I have also attended a graduate group counselling session run by the university. I have found this to be rather helpful, as even if it does not necessarily bring answers, it allows me to bring any thoughts or concerns I may have to the group, as well as offering my thoughts to those things that others bring. It has encouraged me to be more vocal with discussing my thoughts and feelings, which I have often found difficult, but opening up has helped me, and I often feel much better after a group session.
What I’ve learnt
Getting help was the best thing I ever did
Going to the GP was one of the best decisions I have made, and has helped me learn to tackle my depression, with varying degrees of success, but always getting a better idea of where I am heading. I do not think I would have coped so well with the death of a close friend followed closely by a spell of serious illness if I had not sought help that I needed, and still in some ways continue to need.
There are things that can help
One of the main things that I would like to pass on to others from my experience is that it is entirely possible to get help, even when things seem so bleak that nothing will improve them. I think the treatment process can be highly frustrating, but I have learned that there is a wealth of different treatment options available, you just need to know who to go to, and where that help can come from.
I am stronger than I thought
I have learnt that I am actually a lot stronger than I thought I was, that I am able to confront my thoughts and fears, and that I am able to take positive steps towards making myself better. I am amazed by actually how much better I feel, although this is not always something that is easy to appreciate.
I’d like to pass onto people that mental illness is nothing that people should be embarrassed or ashamed of. These are things that nobody asks for, just like any other illness, so we just have to do our best to avoid any negative stigma that people attach to mental health problems. I have also learned that the people that really matter will not judge you for being depressed, whether they be family, friends, loved ones.
Reach out to others even if you don’t feel like it
Just as with any illness, in my experience, those that area really close to you only want to see your continued recovery, and I feel that having people there for you, and making time to see people rather than locking oneself away (because that is how you feel) can actually be a very beneficial way to help improve mood, whether just by socialising or by taking part in some other activity.
Keep trying until you find what helps
The path might not be short, and you have to be determined to experiment with what works best for you (especially if taking the medication route, due to the large variety of different modes of actions of antidepressants), but it is worth it.