Tuesday, 19 April 2011

Snap out of it!

A year ago I wrote “The Silent Victims” about victims of people with narcissistic and/or anti-social personality disorders. I wrote it partly for my own benefit, working through some events in my life and partly because I was sick (literally, more about that in a while) of the taboo surrounding victims of emotional and verbal abuse. Much to my surprise, that blog entry has shown up in many internet searches and is being quoted on several other pages. Now I’m facing another taboo, so I thought I’d try the same therapy and I’m afraid it’s another long post…….please bear with me while I slowly get to the point ;)

Many of you know that I suffer from migraine attacks. Nobody knows why, we just know that certain things are likely to trigger attacks. There’s probably a chemical imbalance in me, but scientists aren’t sure. Yet, nobody who’s seen me during an attack has any doubt that I am in severe pain. To my knowledge, nobody challenges the diagnosis or has any objections to my use of painkillers during attacks. It’s socially acceptable to suffer from migraine and to try to ease the pain with medication.

It is also fairly known – especially by people who’ve seen me in a bikini ;) – that I have undergone surgery for scoliosis. Again, it was a serious disease or malfunction and nobody questions the diagnosis or the need for treatment. Get the point I’m trying to make? When people see that we’re ill they are understanding and support us in our quest for treatment and healing.

Nine years ago my husband, Martin, died. My sadness was disabling and so severe it was almost tangible. It was easy for people to see that I was grieving and for several months I was allowed to be selfish in my mourning. After that, the first voices started “you really should get another man”, “you have to snap out of your grief”, “you have to think positive”. When I still wasn’t “over him” two years later, I only had a minimum of support left – only my closest friends and family accepted my state of mind (or emotions).

During my grieving period I was offered both psychological and psychiatric treatment. I declined, because I believed that psychiatric treatment would mean that I didn’t process my emotions and that I would turn into an emotionless zombie. I wasn’t alone with that belief. There is no doubt that I was suffering from a depression, which had been triggered by the death of the man I loved. At that point in my life I’m pretty sure that nobody would have frowned if I’d undergone psychiatric treatment. What I’d gone through during Martin’s illness and death was too tough to comprehend and ending in a depression was a natural consequence.

What very few people know is that I had suffered from depression several times before. I definitely had episodes of depression as a child and young teenager, but the first severe case was when I was 17/18 and something strange happened in my life. I was very good in school, I had many friends and I was known for being constantly happy, helpful, friendly, joking and smiling. I had every reason to feel happy, but I didn’t. Unknown to me and not triggered by anything, I was in a depression. It was a very scary experience which lasted several months. I had no idea what was happening and I made up crazy stories about my illness and absence because I had absolutely no clue how to explain to anyone what was going on. I almost got kicked out of business school and I knew I was extremely sad, felt lonely, helpless, hopeless and suicidal – but I didn’t know why.

So how does it look, this depression thing? What is the reality of a depressed person? First of all, being in a depression is not the same as being sad. Somewhere I read the description “malignant sadness”, which is quite accurate, I think. Secondly, depressed persons will invariably have different perceptions just like migraine sufferers have different perceptions, but essentially we go through the same thing. And just like a person who has never had a migraine attack can’t relate to that pain, a person who hasn’t been in a depression can’t relate to that pain. One of the best descriptions I’ve read is by Mary Rowe in an article published in The Telegraph March 2010:

“They say clinical depression is crippling. I say it’s like being buried alive. Crushed under the weight of your own sadness, you scrabble at the walls, gasping for air, for light, for someone to help you escape. It feels like every part of you – mind, body and soul – is dying, and eventually you lose the strength to struggle, become calm and sleepy ... and just wait.”

Being in a depression means sleeping for days or sitting for hours (literally) and stare at the wall, unable to move. Simple tasks like getting out of bed, taking a shower or eating become insurmountable hurdles. It means getting scared when the phone rings, not wanting to talk to anyone ever again and it takes hours of mental preparation to call in sick. I once sat on my bed with my toothbrush in the hand for nearly two hours – I’d finally managed to get it from the bathroom, but I didn’t have the strength to stand up while I cleaned my teeth and once I sat down I couldn’t find the strength to get up and walk the 5 meters to the bathroom. It means carrying an inhumane burden on your shoulders, having suicidal thoughts, feeling utterly hopeless and helpless. Sounds horrible, doesn’t it? Believe me, it truly is horrible. But it gets even worse….

Apart from the obvious physical and psychological problems of being in a depression, there is the social aspect of it. Being in a depression isn’t really accepted unless there is a valid reason (for instance the death of a loved one). A gifted, smart and attractive young woman has no right to be depressed, she should be grateful. Right? So, apart from being depressed, we also feel guilty and worth less because we can’t “just snap out of it”. We are reprimanded for not contacting our friends whereas just the thought of having to talk to someone makes us panic. And of course we’re very likely to be confronted with the standard patronizing remarks from people who have absolutely no concept of what it feels like:

“You don’t like feeling that way? So change it! You’re responsible for your own happiness”
“Life isn’t meant to be easy.”
“This is what life is like. Get used to it.”
“Pull yourself together.”
“You just have to get on with things.”
“Stop feeling sorry for yourself, other people are far worse off and they manage”
“You have so many things. What do you have to feel down about? Count your blessings”
“You just need to cheer up.”
“I know how you feel. I get really sad at times too”

“How about I cook you a good meal. That will make things better.”

“You’re not depressed; you’re just feeling a bit down. That’s normal”

Once we manage to get out of that super-deep, super-dark hole yet again – after weeks or months - we feel battered, bruised and tired, but also very relieved that we survived. That would be the perfect time to go out and tell “the world” what we’ve been through, but unfortunately most of us have learned from our earliest childhood to hide our true emotions. Especially when they are embarrassing to watch. So while we recover from our depression “attack” and build up strength inside, most of us continue spending whatever energy we have to maintain the image of happy, successful people. Even during the early stages of depression we manage to find the strength to keep up the public image, so that most people who meet us have absolutely no idea what’s going on. We work, we socialize, we smile – and inside we know and we feel that we’re on the verge of falling into that deep, dark hole. It is a feeling of complete and utter loneliness to be surrounded by people and know that the world is about to collapse on us. By pretending towards the world that we’re fine we are of course shooting ourselves in the foot. Rather than focusing on getting better, we focus on appearing to be fine. And while people could surely help us during our recovery stage, we automatically waiver our rights to receive help or empathy by making them believe we’re doing just fine. Our closest friends, colleagues and family members often recognize the symptoms and are very often frustrated because they can’t help us.

About a year ago events in my personal life triggered another depression. Everybody could see that I was ill: I was underweight, tired, grumpy, and sad, I didn’t care about anything or anyone, there was no spark in my eyes and I had dozens of open wounds due to an auto-immune disease. It was obvious that I was ill, but most people just didn’t know what was wrong with me. Thanks to my family, I came back on my feet and finally sought professional help. I was diagnosed with periodic depression and acute depression and now receive medication against both. Now, imagine depression would be recognized for what it is: a disease caused by a malfunction. Just like migraine, depression is a disorder which can be diagnosed and treated. In my case, a chemical imbalance plays a big role. It’s like a diabetic needing insulin to function.

I was so relieved to discover that my everyday life is easier to handle. I have more energy and at the same time feel calmer. Once I found good migraine medication, the frequency of attacks went down, because I wasn’t afraid of getting them anymore. I imagine there is a certain portion of that in the case of my depression medication. Also, to my surprise I realized that I have absolutely not turned into a zombie; I still laugh, cry, get scared, have fun – the whole spectrum of emotions is intact. I’ll probably still fall into deep, dark holes; but I trust that they won’t be quite as deep and dark, not as disabling – and it’ll be easier for me to come out of them again.

It was a big step for me to seek professional help and it was definitely triggered by desperation. I simply couldn’t go on anymore so it was a matter of suicide or getting help. It was a relief to find out that I am “just” suffering from periodic depressions. I’m not insane, there’s nothing wrong with me, I’m not a weak person – I suffer from an illness. And still, when I have told people about it, some of them have reacted the “old” way. “That’s wrong, you’re not depressed” (said in a grave tone of voice as if depression is an embarrassing STD) or “that’s a load of BS, you just need to make the decision to be happy”. These remarks hurt. A lot. Which is why I find it important to spread awareness and understanding of emotional disorders (sounds nicer than mental diseases, don’t you think?). And in some ways, “going public” with it now is an even bigger step. With this, I am opening up to criticism and ridicule – but of course also to understanding and empathy. Approx. 10% of the population suffer from depression disorders. How many people do you know? You never thought I suffer from depression, did you? Don't I look happy in this picture?

When I went to hospital here in Thailand a couple of months ago and spoke to a psychiatrist, he asked about my history. He was shocked and his jaw dropped when I told him that my first definite case of depression was in my late teens and he said with moist eyes “you have lived with this for twenty years? That is so sad”. He was right, it is indeed very sad. If emotional disorders and their treatment were less of a taboo I would probably have sought and received help many years and several depressions earlier. I would have been spared so much pain.

I am still me. I am a happy, friendly and smiling person. I am reasonably intelligent and attractive. I am strong, self-confident and independent. I am also a person who suffers from migraine and periodically gets “depression attacks”.

Thank you for listening and to everyone who’s helped me: I am deeply grateful for your patience and tolerance


Karin xxx


Dan.P said...

I understand exactly how you feel
Your description of how it feels existing with depression put all that i feel into words.

Ill defenetly be checking back

Pete Dako said...

Thanks for sharing this Karin, and be well :)

Anonymous said...

I am so glad that I have come across your blog today - it's been a real eye opener to have a condition confirmed that I have suffered from for more years than I care to think - I'm 65 and have been in these dark holes on several occasions culminating in suicide attempts. No one understands and all the doctors do is put me on anti-depressants which make me zombiefied. I no longer take medication and plod on with the artificial happiness persona but deep down loneliness and I dread the rest of my life going through the dark periods. They are less frequent since I retired, work & the stress of it didn't help my condition. I wish you well for the future.