So it seems I am suffering with post-traumatic stress disorder with a nice deep filling of depression, topped with a scattering of anxiety sprinkles. If I were a cake, I’d be a fruitcake.
I was thinking this morning, after I left my second Cognitive Behavioural Therapy session, about what mental illness looks like. What does someone suffering with mental illness look like? I guess they look haggard and worn, frayed around the edges. Scruffy, definitely; they wouldn’t have washed in weeks. Tired, with dark purple circles under those sad eyes. Hair scraped back in a ponytail in an attempt to disguise the oil slick it has become from days of neglect. Shoulders drooping, head hanging down, slow lumbering gait where others confidently tread. Yes, I reckon that’s about right. Except it’s rare that you would get a real close look at one, because they’ll be under a duvet, or rocking in a corner; the lesser spotted hermit…
Sometimes, mental illness looks like this…
“Nooo!” I hear you exclaim. “She can’t be depressed! Look at her, she’s smiling. And I know she isn’t depressed, because she lives in that nice house with those three gorgeous kids. Anyhow, I saw her in the Wine Bar last week and she looked like she was having a great time!”
Don’t get me wrong, there are plenty of people suffering with a mental illness who meet the description above. I’ve been there myself, duvet pulled up over my head, praying for it to be bedtime again. But this time, it’s not like that. Mostly I look like the woman in the picture. Sometimes that face has to be painted on, that smile fixed in place with staples invisible to the naked eye. Other times it’s real, and I feel real joy. Sometimes, behind closed doors, when nobody is watching, I lay curled up in the corner of the sofa and cry. I could cry right up to 3pm, then paint that face on and pass pleasantries with you in the school playground at pick up time. Being a great actress comes with the territory.
I don’t want you to think that I am fake. I’m possibly one of the least fake people you will meet. It might be an effort to put on that smile sometimes, but I am generally a very sociable person and if I didn’t feel like smiling before we started talking, it’s very likely that I will be genuinely smiling by the time we part company. I’m like that; people lift me.
And suffering with depression, either long-term or temporary, doesn’t mean that I am miserable all of the time. In some ways, whilst this illness can be debilitating, I think I am one of the lucky ones. I am very tuned in to my thoughts and emotions. When I suffered with post-natal depression after my first daughter was born (nearly 12 years ago now), it was different. I was severely depressed. I believed that my husband’s family wanted to get me sectioned so they could have my daughter all to themselves. I considered leaving, and telling nobody where I was going; figured I’d go live in some little hut by a lake in the Outer Hebrides or somewhere. I thought everyone would be better off without me, and I would be better off without them. On my worst days, I did not recognise myself in photographs. And on worse days than that, I actually contemplated how much easier life would be if my daughter could just be gone…
I’ve always been a sensitive, thoughtful soul. I guess I was predisposed to this kind of malady. In my teens, my old bedroom at home was painted black and I wrote a lot of poetry. I’ve never found it hard to cry. I think I’ve cried an ocean in my years on this Earth. I don’t believe I had ever been depressed before my experience with PND. A bit of low self-esteem maybe, but not depressed. But PND altered me; it’s like a part of me was broken that could never be repaired, and was the catalyst for years of on-and-off suffering with various mental health issues. The last 12 years have been on the whole great, though peppered with periods of counselling, cognitive therapy and anti-depressants. The last time I was prescribed anti-depressants was when I was pregnant with my youngest daughter. The only thing that stopped me taking them was the risk of congenital heart defects for my baby; those of you that follow Freya’s Story will appreciate the irony in that.
Mental illness covers a whole spectrum of serious disorders in a person’s behaviour or thinking, with over 200 different conditions to choose from. Now, that was a bad choice of words; this isn’t something anyone chooses. But you get my drift. And although many people will suffer, with or without a diagnosis, with the same conditions all over the globe, the degree to which they suffer will vary with every individual. What I am going through this time is very different to anything I have suffered with before. Firstly, the post-traumatic element is new; I hadn’t faced any real trauma before my daughter was diagnosed with a life-threatening illness last year, so that’s a first for me. The treatment I am receiving is specifically designed to expel the flashbacks and help my brain to process the memories that have got a little lodged on their way to my long-term memory. The depression isn’t new, however it has been nicely disguised, hiding in the shadows of the PTSD, waiting for the right moment to strike. It felt now was a good time. And then there’s the anxiety, and oh boy ain’t that a treasure!
So, just how much fun is it to live with me these days? I guess you could ask my husband or my kids, but like I said, I’m pretty in tune with my thoughts, emotions and behaviour to give you a pretty honest view of that.
I’ve talked about PTSD before. I’ve shared some of the flashbacks and intrusive memories that I have suffered since my daughter was diagnosed with Kawasaki Disease last June. I’ve told you that sometimes, when I look at Freya for long enough, her face morphs into the sad, scared, sick little baby that pleaded with me with her eyes from a hospital cot. I was embarrassed by the diagnosis. You associate it with war veterans. But, it does happen to people who have suffered a critical illness, or in my case watched a child suffer. There’s a big difference between a flashback and a bad memory. We all have bad memories from time to time; a smell that reminds us of our first love, a song that can recall memories of a lost loved one, events that remind you of the time you were badly beaten up at school by that one girl in your GCSE year (https://bluemama.co.uk/2014/12/01/one-girl-one-day/). Bad memories I can deal with. They are long-term memories, and as such when recalled the emotion doesn’t hit you with the same intensity that it did at the time.
A flashback puts you right back in the original situation, and all the components of that memory – the emotions, the sounds, the smells, the physical surroundings – are replicated with all the intensity of the event itself. Apparently when these happen, I have to tell my inner child, the victim, that it is ok for them to remember, but that I will help them through it. I know, right?! But joking aside, the tips I have been given have worked, and I haven’t had what I would call a ‘real’ flashback for a little while now. Removing the spare cot from our room was a stellar move and my brain no longer keeps me up until the wee hours to avoid going to bed. Cognitive Behavioural Therapy that specifically focusses on trauma, exercises ‘mindfulness’ to overcome that trauma by training your brain to accept the thought, but to prevent it from lingering by focussing your attention on how the thoughts made you feel, rather than the memory itself. I’m sure I’ve just understated the treatment completely, but that’s it in layman’s terms. And it actually seems to be working. We haven’t yet worked through the key reason for my condition (Freya’s illness), instead we are working through three other life events which evoke a particularly poignant memory (good or bad). The idea being that you practice the techniques on some more dormant memories, so that by the time you reach the biggie, you’re ready for a fight. Today we practised the technique on the memory of the death of my grandfather. I’ve been told not to reflect on that outside of the sessions, so I shall leave that there.
The depression is different again, and kind of fills in the spaces between the PTSD symptoms. It’s a general feeling of low mood, varying in intensity depending on the day, the hour, the situation. I can’t describe it any better than it being like a dark cloud permanently looming above my head, casting a shadow over me. The good thing about clouds, is that sometimes they shift a little in the breeze. A strong wind can brush them off completely for a time. And the sun sometimes manages to break through and cast a beacon of light upon my path. In some ways, I have learned to control the weather. In the PND years, I couldn’t have done that. But as I have said, I am more self-aware now. I know that even if all I want to do it bury my head under that duvet, I have to choose another way. Having kids kind of forces my hand. With my firstborn, I didn’t have to be anywhere, so it was far too easy to stay in my pyjamas all day and wallow in sorrow. I know some victims of mental illness find themselves in that place, regardless of their personal circumstances. Luckily, this hasn’t taken all of me, and I do function on a pretty normal level most of the time.
How does depression affect me? Well, I go a bit into myself sometimes. I think a lot. I cry a lot, not always for any reason. I question my capabilities as a mother, as a wife, as a person generally. I lose sight of my self-worth. I retreat from people when I feel hard done to, and the depression makes sure that the further I retreat, the higher the wall becomes. I have automatic negative thoughts (‘Ant’ – you might have met her in previous blogs. She looks a little bit like me, but a lot like that girl that beat me up in my GCSE year. Pretty girl, likes to stick the boot in now and again). My thoughts tend towards the catastrophic. And I get a bit hung up on signs. Numbers, magpies, white feathers, a necklace breaking; all signs of impending doom for me or my relationships. On a good day, it doesn’t affect me at all. No more than a grey cloud hovering above, threatening rain, but not quite managing to defeat the sunshine. I’m stronger than I think I am.
For a more insightful description of how depression feels, I don’t think there is anyone that has done it better than The Black Dog Institute when they put out this video on You Tube (https://www.youtube.com/watch?v=XiCrniLQGY).
And lastly there’s that little treasure, anxiety. That’s a whole new ball game. Aside from the nasty flashbacks, I have found the anxiety the most debilitating and damaging of all. The Mind website provides a pretty comprehensive list of the symptoms of anxiety, so I thought sharing that was as good as any list I could provide (http://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/anxiety-symptoms/#.VsTInsexrjI)
- nausea (feeling sick)
- tense muscles and headaches
- pins and needles
- feeling light headed or dizzy
- faster breathing
- sweating or hot flushes
- a fast, thumping or irregular heart beat
- raised blood pressure
- difficulty sleeping
- needing the toilet more frequently, or less frequently
- churning in the pit of your stomach
- experiencing panic attacks
- feeling tense, nervous and on edge
- having a sense of dread, or fearing the worst
- feeling like the world is speeding up or slowing down
- feeling like other people can see you’re anxious and are looking at you
- feeling your mind is really busy with thoughts
- dwelling on negative experiences, or thinking over a situation again and again (this is called rumination)
- feeling restless and not being able to concentrate
- feeling numb
That’s how I feel a lot of the time. Add to that the fact that I have developed a hypersensitivity to certain sounds, which make me want to explode (want to? You do Jo!) and I’m pretty much a coiled spring of anxious tension from dawn ’til dusk. You can imagine how fun it must be for my husband these days!
But. And it’s a big but. It’s not all bad. I am that girl in the photograph. I do smile, and quite often that smile manages to reach all the way up to my eyes. I want to do things, see people, have fun. I like to escape the confines of my daily life sometimes. I want to be happy. I don’t want to cry, or shout, or feel inadequate. I want my family to love me, not to worry about me or look at me with judgement when I fly off the handle for what seems like no reason at all to them. I have things I want to achieve, places I want to go. For now, I am giving the counselling route a try. If things don’t get any easier anytime soon, I will consider medication.
No journey with mental illness is easy. Some might be easier than others, and I am open to treatment and very self-aware. I know that right now I have feelings that could result in life-altering decisions. I also know that those feelings might not be real, and until the fog lifts I will hold those thoughts. Thoughts are not facts.
To anyone who has ever suffered, or is suffering still, I hope you find your own way to mend. There is help, but it can often be hard to ask for it, sometimes even harder to find. I talk candidly about myself and my experiences now. I haven’t always. When I started this blog I was too afraid to make it public for fear of judgement. But this last year has taught me some lessons about not holding back, so now my heart is firmly on my sleeve for all to see. Judge, don’t judge. It’s not important to me anymore. And if I ever offend with a too glib portrayal of mental illness, please know that a) I only describe what mental illness means to me, how it has affected me, and b) that humour has often been my way of handling the most negative of situations.
One in four people will suffer with a form of mental illness in any given year. Take a look round you, at your family, your friends. If it’s not you, it could be one of them. Be kind, always, because you never know what personal struggles other people may be facing, even when they seem to be wearing a smile.
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