Trigger Warning: Depression

I roll over onto my face so that it is buried face down in the pillow, bring my hands to the back of my head, elbows nearly closing around my forehead and I wait. I wait for it to stop but it doesn’t. I brace myself for it to get worse. It won’t stop. It feels like a screaming and a silence. It feels like it will never end and I will never be ok again. I close my eyes, screw up my face, fists and hands, and hope that this coiling and clenching will help release it. Whatever it is. It won’t stop.

This is how I feel near my worst, when my depression has fully taken hold of me. Today is World Mental Health Day and I feel I have to say something. This year has been rough to say the least, for everyone. For me, the pandemic coincided with a long-brewing bout of depression and anxiety that overflowed and left me really very sick. I eventually had to take four months off work and at points couldn’t be on my own as I was a danger to myself. It was really not good.

I was lucky enough to have people around me who helped me find the help I needed and who intervened when the depression had gone too far and I was not in control anymore. Without hyperbole or metaphor, I can say that they saved my life. I found a GP who understood mental health difficulties and was able to understand my long history of depressive episodes and helped me find the right medication. I did everything I could to make myself better. At the time my only motivation was to protect my family and friends from me doing something drastic - now, I’m well enough that I want to be and stay well for my own sake.

I did all the things: exercising, yoga, meditation, drinking water, cutting out alcohol and cigarettes, sleep hygiene, therapy, medication, hypnosis, acupuncture. You name it, I did it. I had to throw everything at it because I had ignored the signs for so long that I had ended up at Rock Bottom. I mean, Rock Bottom. Rock Bottom and I, we have history: we go way back and I really don’t like it there. The only benefit of Rock Bottom is that it can’t get much worse.

I guess one of the reasons I’m writing this is to say that you don’t actually have to do it the way I did. Funnily enough, you are allowed to get help before you reach Rock Bottom. I pushed and pushed and pushed and ignored, ignored, ignored. Mental health is thought of by so many, as an ON/OFF binary, as if you’re either ok or you’re taking 4 months off work and having a crisis. Or, worse, the ON/OFF binary is: you’re either ok or you’re being sectioned. This binary is so damaging. It means that we can only ‘be ok’ and we can only reach out when we’ve reached Rock Bottom and it’s the only remaining option. Mental health isn’t an ON/OFF though. I’m not suddenly better after being really sick; you don’t just suddenly recover back to your old self. Similarly, I didn’t get to Rock Bottom overnight - it was insidious and ignorable. I didn’t want to face it so I didn’t. I didn’t want to be depressed again so I forced myself not to be.

I have always found the ON/OFF binary to be illogical. We don’t think of physical health in this way. When someone breaks their leg, we don’t think of them as being wholly ill, we think of them as having a broken leg. Further, we are able to distinguish between life-threatening illness and a common cold and understand grades of illness in-between. My point here is that you can reach out for help before it gets bad enough to need help; you can implement changes to improve your mental health without there being a crisis; you can have periods of not being ok and needing support without it being your Rock Bottom.

My journey didn’t start with a bang, it started slowly and built over a long period of time, arguably years. My recovery will be slow, too. It really sucks to say this but there is not a quick fix and it takes time. Another reason I wanted to write today was to share my experience of slow recovery. It worries me that so much of the discourse on mental health aims to find a quick solution rather than advocating for habitual and boring life adjustments. Slow and boring are anathema to our modern world but for me they were an unwelcome godsend. I am too quick for my own good and hate slow change. I think it, I do it: that’s me. So my approach to recover was: I would like to get better NOW, why is it taking SO LONG?! Once I reluctantly yielded to slow and steady recovery (hate that the Tories have stolen this phrase), I actually started to get better. It was also a composite of measures, rather than a single intervention that has kept me on the up and even plateauing at being ‘ok, actually.’

Boring is good. I feel the concept of ‘self-care’ has been mixed up with ‘treat yourself.’ I don’t want to sound like a puritan but I have to remind myself that I might not always need a treat, I may just need a shower… This sounds weird but so many markers of poor or diminishing mental health are the standard, boring things you do every day: showering, having stable eating patterns, regular and good quality sleep. Supporting yourself through and self-care should be about the boring everyday. IKEA yourself don’t treat yourself. Focus on your space, your self and your relationships - supercharge the boring parts of your life and make sure you’re looking after yourself. I treat myself all the time. Honestly, I have a coffee and pastry problem that will eventually bankrupt me and, to be honest, I’m ok about it. If you don’t treat yourself to things every now and again, then of course you should embrace the ‘treat yourself’ hype and take yourself out for dinner/buy that gorgeous thing you want. I’m not saying don’t treat yourself, I’m just saying that a lot of my ‘treats’ are not that good for me [e.g. alcohol, high sugar foods, bingeing TV, smoking] so treating myself eventually became antithetical to ‘self-care’. For me, I have to remind myself to look after myself first and treat myself second.

Finally, it’s likely that there is a bias effect in who reads this, with those with experience of mental health issues more likely to read about it. For those who haven’t had personal experience or don’t “get” mental health - that’s ok. Just as I’m asking you to be open to the idea that I have a different experience of the world to you, I owe you the reciprocal respect of understanding that you have a different experience of the world. But please do respect my experience and note that not everything happens to you so maybe you just got away scot free when they were handing out the mental health struggles before we all came down to this earthly realm. Honestly, I could not be more jealous. Some of the most supportive people don’t “get” it: the main thing you need to be is there and try to avoid fixing it.

The element of ‘fixing it’ imagines mental health as this on/off binary rather than a continuum that needs to be proactively managed rather than reactively responded to. In my experience, the most important thing to have around you is someone you can tell if you feel at risk to yourself. I can tell you from experience that once you have got to a certain point (e.g. Rock Bottom), there are very few people you feel comfortable telling you’re at risk. It feels awful and it feels like a failure - it’s not, to be clear. It is a huge show of strength to admit you are not ok. And if someone you know is at risk, does it really matter if you “get it”? My conclusion to my declining mental health was unthinkable. Unthinkable to most, but crucially not unthinkable to me. It was truly awful and I’m so glad I had people around me who never judged me, accepted how I felt without question, and whom I could trust with the information that I was seriously not ok. As I said, they saved my life and I hope that you never have to support someone through that. The support, however, starts when your loved one is well not when they’re not well or at Rock Bottom. It starts with being open to the idea that poor mental health isn’t a choice or a reflection of someone’s character. Mental health a whole spectrum of experiences, manifestations and outcomes. Unfortunately, you can’t fix the roller coaster, you just have to wait with the bags until your loved one gets off safe at the end - reassuring and waving and encouraging from the sidelines.

To be clear, I am not a mental health professional and my advice would always be to seek professional help if you are worried about yourself or someone around you. Better safe than sorry.

If you are experiencing difficulties or supporting someone through difficulties, I feel you, I hope you’re ok, and it will get better. I have been to the place where it seems nothing will change and you will never get better, hopefully you will believe me that it can and you will.