Sunday, 26 February 2012

My thoughts: Latest depressive episode.

Meh, it was only a matter of time before I go through another depressive episode, I expect it I accept it for the most part. The worst of it for me is not exactly knowing the trigger of them, yesterday morning and this morning, low energy, no motivation to get off the sofa, the empty feeling (that has nothing to do with food), the dread of facing a new day and the overwhelming sadness have all returned to earmark the new episode.

Why am I depressed? I've asked this twice as I woke up and lay on the sofa for a bit and i haven't got a definite trigger i can identify and say "ah this is why".  Best i can say for the moment is i don't believe it is due to a single factor, i reckon it is a small number of things that have combined into a trigger and took me unaware.

My beloved football club is going through a bad run of form and lately I've not looked forward to listening and watching the matches. I've gotten no where in my quest for full employment my last interview for a vacancy being last September and just now I'm struggling with my latest Open University course assignment.

Also with those three i don't see anything changing for the moment, the negative train of thought "my club won't be successful anytime soon, i won't get a job anytime soon and I'm not as intelligent as i thought i was" is turning into a vicious cycle, which i have to stop.

Well can't do anything about the club, can only apply for jobs and hope for the best so for the immediate future I'll be grimly determined to complete and submit my latest assignment (6th March is the deadline for submission) and get a good (or at the very least, passable) score for it.

As all of the above is entirely subjective it is probable I've missed something, times like this i do actually miss the guidance of a mental health professional, someone who would see things I am blinded to.

Still I'll carry on regardless, the journey continues.

Thursday, 16 February 2012

Would you like a label? Or should we just stick to the symptoms at hand?

Currently there are 297 disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) this book is the bible of guidance for the diagnosis of mental illnesses for those who work in the fields of psychology and psychiatry, the next DSM (due to be published May 2013) is likely to have a higher number of classifiable disorders.

On the surface categorising and labelling of mental illnesses seems like a logical thing to do, after all there are different sub types of the very general term 'mental illness' and just as like other illnesses are labelled e.g. common cold, flu, ear infection, tonsillitis etc. we know what causes such illnesses,how to treat them and sometimes avoid them.

However mental illness is much more complicated when you start exploring the underlying issues of why an individual suffers from such a illness.

We all experience the world in our own way and there are limitless incidents and experiences, which are unique to each individual, that can contribute to the development of mental illness.

So is there a benefit in having a label for a mental illness? Possibly. For starters the label can help you to understand that you are not weak, stupid, immature or just a miserable git, as a matter of fact you are suffering from an illness and you did not realise it until a medical professional says to you that you have been behaving/thinking/feeling this way because of this particular thing.

Okay, we have a diagnosis of an illness, now that we know what it is, how do we treat it and for how long? When can I get back to work/college? When can I get back to 'normal'?
Having the illness diagnosed may offer some answers to the above and some have said it is a relief to finally know what is wrong, no longer do they have to keep asking themselves 'what the hell is wrong with me', you have a answer.

Some of the disorders (like depression) are very common throughout the world and so it might offer some reassurance that you are not in fact alone with what you have to deal with. Also it helps the medical professionals to categorise your illness to simplify the recommended course of treatment.

There is a flip side. Probably one of the biggest issues of being labelled is being defined by the illness;

Person A: Hey how is C doing these days?
Person B: Oh you didn't hear? C is a schizophrenic.

Whether it is schizophrenia, clinical depression, bi-polar disorder, a personality disorder or whatever disorder someone may have, often the individuality of a person gets stripped away and is replaced by the disorder.

This can lead to the person in question being discriminated by employers (in fact recently a friend of mine lost his job after having time off due to depression), friends, family, partners etc. and once a diagnosis is made it will stick with you for the rest of your life regardless of whether you become ill again or not.

Usually having treatment takes a fair amount of time in which you may not be able to do anything and so if you look to get back into employment you may well have to disclose your illness and subsequent treatment to a potential employer to explain why you have had an unemployment gap of x time.

Being given a label of a disorder could induce a sense of hopelessness especially if the illness is severe, there are times I feel my life will never get better because I have depression and sleep terror disorder both of which cannot be cured and will continue to undermine me. Others may feel as I do, that it will never better and its all about containing the illness as best you can but it won't go away.

The label is for life, the illness is for life...your life.

Not to mention that some disorders share a crossover of symptoms, like schizophrenia and bi-polar disorder which share psychosis, depression (an illness with its own category but is a major feature of bi-polar disorder and often affects those who suffer from schizophrenia) cognitive impairments and so on.

The diagnostic criteria gives a general outline of a disorder, however it does not help with subtle differences and variations between people who might be classed as having a certain disorder.

Therefore confusion and misdiagnosis can happen, even worse it is possible in some instances for some to move from one disorder to another (schizophrenia alone has a number of sub types, paranoid, disorganised, catatonic, undifferentiated, residual), thus incorrect treatment can be given, causing more harm than good.

So what is the alternative?

There is a debate going on about the ethics of labelling within the psychology and psychiatry fields and some call for it to be abandoned altogether, after all the one size fits all approach is fraught with difficulty if you consider that you are dealing with people who all have unique experiences and reasons for their illness.

For me when I sought help for my issues I was never diagnosed with a particular disorder, instead my symptoms were the focus for treatment. It is clear I get depressed, anxious and angry a lot of the time, so I was referred to a group psychotherapy sessions and here they explored my past and how that past affects the way I think and behave now.

So here the reasons for my depression, anxiety and anger were looked at, basically they noticed that whenever people tried getting close to me emotionally in the group I become hostile and pushed them away by getting angry, making them afraid to approach and challenge me.

The reason for that is I had been badly treated in the past, enough so that I became depressed as my self-esteem, self-worth was low and often attempts at increasing it was rejected by others and so I pushed people away before they had the chance to reject me.

Once it had been established how I think, feel and behave and why I do so, the therapists seek to address what they believe is unhelpful way of thinking and behaving on my part that can actually be part of a vicious cycle with my depression, for instance when I pushed people away to stop them having the chance to reject me in some way I was also pushing away the chance of something good, like making a friend.
In my case it was easier to focus on what symptoms I displayed and the underlying reasons for their existence and what I could do to help alleviate what issues I faced.

By addressing the symptoms themselves it will help in avoiding to a certain extent at least the stigma that may follow from being labelled with a disorder, some people won't get help due to the fear of stigma and discrimination associated with mental illness.

Also dealing with the symptoms alone means the individual's circumstances are more likely to be taken into consideration as it will not be as necessary to look up the DSM as often for the guidance of a diagnostic criteria.

I hope one day the labelling will be scaled back enough that it is nothing more than a very broad term which does not stick with a person for life.

Thursday 16th February, the journey continues. 

Hyperbole and a Half: Adventures in Depression

Hyperbole and a Half: Adventures in Depression

A vivid description of depression and the spiraling vortex of misery it can wreck upon you.

Tuesday, 7 February 2012

My thoughts: Kelly

Even typing the name fills me with dread. It is no exaggeration to say she has had an immeasurable impact on my life.

Throughout the ten odd years I knew her she was at times and probably will be in the future, a nasty piece of work. I wasn't perfect though, as she would tell you I can be a difficult bastard to know and try to get along with, moody, negative, cynical and self loathing at times (not mention being depressed), she put up with those ugly sides to me longer than anyone else with the exception of one.

There were (and will be) times when she is actually sweet, funny, intelligent and charming, things that contributed to me falling in love with her and keeping her in my life in the hope we would be together in a committed relationship raising her daughter for far too long, causing such emotional and psychological harm to all three of us.

One factor in her having such an impact on me is she is the only woman I have had a sexual relationship with and I won't disturb you with the details but this aspect between us was a complete disaster and after she lost patience with it she had little qualms in belittling me, including giving me all the responsibility for getting things on track.

It isn't me at all its you, I’ve never had such a problem with anyone else”

One of the comments she made to me about it, which wasn't helpful nor reassuring seeing as I had anxieties about taking a chance at a relationship with her and that while she is experienced sexually, I am not.

The first time I wanted your virginity, the second time was a favour as your first time wasn't very good”

Part of that was a text message she sent me and that part I am not likely to forget for as long as I live. That part by itself is bad enough; add in the fact I was already in the process of a psychological breakdown due to dropping out of university and being evicted from my flat where I ended up moving into my grandfather's house (I've had a difficult relationship with him since the age of 11). All of this happened within a year.

That wasn't enough though, she later on tells me that during those two encounters she was making her mind up on whether she wanted a relationship with me or go back to her ex (she didn't tell me at the time but she ended getting back with him). I was completely devastated, I didn't feel it could get any worse.

I was wrong.

Kelly expected us to go back to being friends and act as though nothing had happened, I was bewildered by how heartless she was being and by her adamant statements of she had done nothing wrong, I should simply get over it and it was just sex.

I refused to go back to how things were, how could I? It may have been nothing to her what happened, me, I was heartbroken and I told her that she broke my heart. She was enraged by this, shouting at me for being immature, to grow up, oh you love me do you? That's bullshit and what seemed like an almost endless wave of verbal abuse over the months as although we kept in touch over the phone (why? I honestly don't know, I’ve asked myself a million times) I refused to go and see her, frankly I felt ashamed, humiliated, degraded, cheap, useless, name every negative word or emotion its probable I felt it all then and the thought of actually being near her made me sick.

Thankfully I had been referred to a psychotherapy group for treatment and I started a few months into the whole thing which gave me some much needed support and strength, I remember I sent her a text when she started having a go at me again, now she accused me of using her for sex and then walking away from her (of course she maintained she had done nothing wrong), I said to her that I was in therapy and I had more important things to worry about than what she thought of me, this deflated her as all she managed in reply was why are you being like this what's your problem.

I simply ignored her. She still took a few shots at me but they lessened considerably, she tried changing tactics at one point (she had broken up with her ex again) now she was all nice, how sorry she was for putting pressure on me and she promised she wouldn't say or do anything that interfered with my therapy, she actually did, she tried telling me what I wanted to hear but by now I didn't trust her at all and this was the final straw, I told I had enough of her and I was finished with it all.

Before all of that there were times she treated me like shit, such as turning against me after I supported her during a relationship breakup and setting me up to be attacked by a guy who disliked me for being her friend (she never explained why she did it however she ended up sleeping with this guy, I concede this is the jealously talking but I say she wanted to sleep with this guy so much she co-operated with him over trying to put me in my place).

No doubt people will think well if all of this is true and you continued to pursue having a committed relationship with her then your an idiot and they are right, well just wait for the next bit;

After a year or so out of therapy, I got in touch with her. That's right, I let her back into my life, what the hell was I thinking?

It will be different this time.

Its priceless it really is when I think about it, now it'll be of no surprise when I tell you that at first went well then it reverted to how it was before, this time;

  • She accused me of taking advantage of her the first time we had sex.
  • She said I took advantage of the vulnerable
  • (She apologised for those two, “I’m such a evil cow, your lovely, you don't deserve this” etc.).
  • She humiliated me on national radio.
  • Finally, the most unforgivable of the lot, she used her own daughter to hurt me.
Basically after a row between us which ended up with her coming around to my place to throw the spare keys I gave her and a shirt I left at hers at me and stormed off. It was her daughter's birthday a few days previously and I was ill with the flu, I talked to her daughter on the phone to wish her a happy birthday and I promised her I would get her a present when I felt better.

After Kelly stormed off from my flat (I didn't go after her, I went back to bed as I wasn't going after her) she text and called me, I tried to reason with her, that we both said and did things we shouldn't have and it is not one sided, she simply ranted at me, I know its not all you and the final thing I got from her; LEAVE ME ALONE.

I bought her daughter a book and sent it through the post with a card, Kelly called me but didn't say anything, as soon I said hello she handed the phone to her daughter so she could thank for the present. I'm certain Kelly forced her daughter to talk to me on the phone, as she would have likely to have wanted to thank me the next she saw me (unless she was told she wouldn't be seeing or speaking to me again after the call which I don't believe happened as she would have asked me why this was the case).

She sounded so nervous which was uncharacteristic, Kelly's daughter is a happy confident girl which is a result of how good a mother Kelly is and she didn't have much to say besides thanking me for the book I got her, usually she is very chatty, she likes telling you everything she has been upto in school, what books she is reading, what music she is listening to and so on, during the call there were awkward silences in between the questions I asked her, I should have ended the call much sooner, at one point she asked me if I wanted her to pass the phone to her mother, Kelly snapped at her “NO! Just put the phone down!”

I said to her “No no its okay sweetheart I've got to go, I love you, I’ll see you soon” she said I love you too bye bye. The last time I talked to her.

This was a little over a year ago, I’m still moving on from it and I don't know just how long it will take before I can say I have moved on. I still miss them both, I sometimes think it was all my fault, I wasn't the man she wanted, I let down her daughter with how it all turned out and I’ll never forgive myself (you see there's the self loathing I mentioned at the beginning).

I did lose something good, when we were okay we were very close, we talked about a lot of things, serious deep meaning conversations to having a laugh to giving each other support when we were depressed. The good times with them both made me truly happy.

While with Kelly being out of my life means I no longer feel like a emotional punching bag every so often I miss the good things we shared and I often torment myself by thinking about it and thinking things could be different if we tried again.

It will not be different this time

Even if Kelly got in touch to say how sorry she is for how she treated me and how much she misses me I know I’ll have to ignore her. Despite everything I will always love her and I wouldn't change a thing about her, as I once told her, I accepted who she is, the good and the bad. I still feel the sorrow and emptiness from it all.

Tuesday 7th February the journey continues without them.