This is the third in my series of articles on depression — my depression. They are written from a very personal perspective; they are my views of how I see things working and what it feels like on the inside. Your views and experiences may be vastly different. My views and experiences are not necessarily backed by scientific evidence or current medical opinion. These articles are not medical advice or treatment pathways. If you think you have a problem then you should talk to your primary care physician.

The medical profession generally characterise different types of depression by their causes and effects, and they may range from mild, through moderate to severe. (See, for instance, www.mentalhealth.org.uk/help-information/mental-health-a-z/D/depression/.)
However pragmatically, over the years, I’ve come to realise that there seem to be two types of depression, which I have never heard voiced by a clinician. I’ll call them Dynamic Depression and Static Depression on the basis of what appears to help alleviate them. I’m not in a position to work out if the symptoms and/or causes are different although I suspect Dynamic Depression is at the milder end of the spectrum.
Dynamic Depression
This is the type of depression which everyone thinks you have, and which is the subject of every self-help book (and a lot of counselling) that I’ve encountered. The “cure” (which is how I characterise these two types) goes along the lines of “put on some brass band music, have a cold shower, think how blessed you are with everything you have going for you, and just get on with life”. Yeah, right. That may work for some people; probably those with low-grade depression who have a short-term problem. This is out of the book of “tell it like I want it to be and it’ll be that way” management. It is a fallacy which does nothing but con the brain — though that may of itself be valuable for some. It doesn’t work for me; it never has; and it may be why I’ve never succeeded with talking therapies.
Static Depression
Many years ago I read an article by a couple of medics who had looked at a small number of patients hospitalised with depression. Unfortunately I didn’t keep the article and I cannot now trace it, but this was the gist … They found that if these patients were given the standard treatment of drugs and compulsory occupational therapy they didn’t get better and sometimes got worse. Further they observed that all the patients wanted to do was to sit in the corner. So the medics allowed them to sit in the corner. And they found that as long as the occupational therapy was there, and visible to the patients, then allowing the patients to sit and vegetate meant they eventually started to get better; they eventually came out and joined in the occupational therapy and started to recover. The medics’ hypothesis was that this was because these patients were suffering from too much stress and change in their lives and they needed a prolonged period of stability, on their own terms, to recover.
This is what my depression is like. It is (at least in part) triggered by stress, lots of expectation and a high level of change. Which, I suspect, is why the “dynamic” approach doesn’t work on me.
Fortunately it is now recognised that change, especially, is a major contributor to depression. And change is why our society has increasing rates of depression — society is always chasing after “faster, better, cheaper”; there is no stability and no respite. It is becoming a major mental health problem, and the solution is not to keep popping happy pills.

To be continued …

This is the second in my series of articles on depression — my depression. They are written from a very personal perspective; they are my views of how I see things working and what it feels like on the inside. Your views and experiences may be vastly different. My views and experiences are not necessarily backed by scientific evidence or current medical opinion. These articles are not medical advice or treatment pathways. If you think you have a problem then you should talk to your primary care physician.

I was first diagnosed with depression back around 1980 — certainly some time in the two years after Noreen and I married. I have been on and off antidepressants ever since. And over the years I’ve tried just about every possible approach to managing the depression: drugs; psychiatry; counselling; CBT; giving in and curling up under the duvet.
Talking therapies don’t work on me and they never have; I know (and have likely tried) everything they try to suggest and I know already it doesn’t work. Such is the curse of being intelligent, questioning and experimental. The last thing I need is for some therapist to give me something more to do.
For the last couple of years I’ve been having monthly-ish hypnotherapy sessions and even this has not yet been very productive, although I remain hopeful; it feels closer to a solution than many previous attempts.
Looking back I have probably been depressed at least since my teenage years, maybe earlier, although no-one, including me, realised. It may all be tied up with being shy; a loner; and not having many friends.
The first real trigger I can remember was at the start of my second year at university (so over 40 years ago) when my girlfriend of over 2 years and I broke up (at her instigation).** This, piled on top of other circumstances, left me paralysed with depression for several months; I’m very lucky I didn’t totally screw my chances of getting a degree. Of course being male, and young, and not really knowing what was happening, I never got medical help but just tried to struggle on.
Since then, although I have had bouts of more serious depression, above the background level, I am not conscious of any particular thing which has been a trigger. I’m lucky in that I have never been seriously suicidal or into self-harm; that’s something I’ve not had to cope with. Nor do I have bipolar disorder: I never have the highs.
But one general trigger does seem to be a high level of change and overload. Too much to do and/or too much change. This happened when I was at work; everything occasionally got on top of me and I had to take a duvet day. This did my career and reputation no favours, and I was well aware of it. This is also why I never pushed to get higher up the ladder than I did; I knew I didn’t want the aggravation that went with it, much as I would have liked the recognition. It is also why I ended up retiring early, because I could not have done another year of the “project from hell” I was working on.
And this overload/change effect still happens, because I still keep doing things. I cannot not be involved. If I didn’t get involved I fear I would quickly vegetate. As someone expressed it to me the other day: “if I sat at home all day I’d go senile”.
But sometimes everything gets too much. I try not to let it get in the way of things I have committed to do for other people – just as I tried to avoid it affecting my professional life. But that means all too often the fallout descends on my personal life. Hobbies get neglected; and far too often I end up ducking out of something we’ve booked to do. However much I need to find that space, I always feel bad about it because it always affects at least Noreen as well. I’ve got to the stage where the only real way to mitigate this is to book as little in advance as I can. And that in itself is demoralising and depressing.
I’m very lucky in that Noreen does her best to understand this and ride with it, even if she cannot really understand from the outside what the depression is actually like on the inside. Understandably she feels helpless to do anything to alleviate my suffering. I’m continually surprised, and hugely grateful, that Noreen is as understanding and patient as she is. She does a lot to help: doing bits and pieces for me; mopping up after me; quietly, behind the scenes, helping me achieve a lot of the things I get involved in. And she stops me getting involved in too much! I don’t think she realises just how much difference she makes and just how grateful I am. In this I am truly lucky; it is probably the one thing which really keeps me going.

To be continued …

** I’m not going to write in detail about this because although 95%+ of it would be about me there would be things about other people from whom I cannot get consent and who, should they happen to read this, may not wish to be reminded of what happened.

This is the first of a series of articles on depression — my depression. They are written from a very personal perspective; they are my views of how I see things working and what it feels like on the inside. Your views and experiences may be vastly different. My views and experiences are not necessarily backed by scientific evidence or current medical opinion. These articles are not medical advice or treatment pathways. If you think you have a problem then you should talk to your primary care physician.

My name is Keith. I have depression.
I have been in a serious bout of depression for most of the last 6 months — yes all summer and autumn — and I have no clue why.
I’ve decided to write a occasional things about depression; my depression. Just because.
Unless you are one of the half a handful of people closest to me you would probably not know I have depression, because most of the time when I’m out and about I can put on a mask to hide it and function more or less normally.
I want to get rid of the depression but I don’t have the first fucking clue how to.
No that isn’t an invitation to tell me how to do it – so please don’t! — because over the years I have tried almost everything and it hasn’t worked (as you’ll see by reading on).
I’ve been on antidepressants for many years; this time around I know it is well in excess of 12 years because I was on them when I changed doctors shortly after the millennium. I’ve been on the tablets for so many years I no longer have a clue whether they are doing any good, but currently it feels as if they’re useless.
Unfortunately the antidepressant I’m on is one of the worst for withdrawal symptoms when you try to get off them. I’ve had several attempts over the years but failed every time. After talking with my GP recently I’m currently having another attempt to switch to a different antidepressant. I’m hopeful this time I will succeed; but I’m fearful that I won’t.
What makes this worse is that I don’t really know why I have depression. I know that it is multifactorial and I know what some of those factors may be. For instance I know that I am worse during the winter and that I do technically have mild SAD (I was tested for that about 25 years ago). I know change and overload are also big factors. And there may be a genetic predisposition as my father and his father were also both depressives. Worrying about all the things I know I should do (exercise, lose weight, blah, blah, blah) makes the depression worse too. So it isn’t as if there is one cause which I can change to fix the problem. I wish there were.
Along with the depression, for me, go anxiety and panic attacks. Fortunately the panic attacks are now relatively rare; much rarer than they were back in the 1990s. But only because I have found strategies to avoid putting myself in the position where they are likely to happen; so I can to a large-ish extent control this.
For instance, I dislike the London Underground: the motion; the lack of fresh air; being packed in like sardines; the claustrophobia. So ask me to travel on a packed tube train and you’re asking me to have a panic attack. So I don’t travel on the underground if I can avoid it, although short distances and the over-ground parts are doable, sometimes. I feel similarly about buses, although there the problem is more to do with motion sickness — something I’ve always suffered from. Compensating for this gets expensive as it means using taxis. And luckily I am OK with normal trains; I’ve always loved proper trains.
Here’s a useful graphic which will tell you a lot more about depression. (Click the image for a larger, readable, version.)

To be continued …