“Battling” depression 

I keep seeing things about the fight against depression, battling it, being a warrior, beating it etc… And it’s really annoying me…

As someone who has had depression on and off for many years at different levels, I do not relate to this.

Everyone experiences depression differently and if the battling narrative works for you then that’s fine.  My problem is with it being the only narrative.

For me, firstly, I don’t think I will ever “beat” depression. I think depression is as much a part of me as my faulty joints. Which means fighting depression is not something I will ever win and fighting depression is essentially fighting myself and my DNA. I have spent a lot of years at war with myself, I don’t want to keep fighting.

Secondly, it suggests that if you have depression, you are weak or you aren’t fighting hard enough. Which makes it your fault.

I have spent a lot of my life and a lot of my energy in denial about my depression. My most recent period of depression was foreshadowed by about a year where I was adamantly not admitting to myself that I was depressed again.  And this inevitably made things worse…

By accepting my depression and slowly integrating it into myself, I have found I am much more able to manage it.

When I tell people that I want to put things in place for the next time my depression is severe, I get told not to be so pessimistic, I have to believe that I’m cured etc. But this isn’t realistic. For most of my life I have been depressed, why would this just disappear? And my acceptance of this means I can plan, I can set up helpful routines and check ins when I’m doing better in preparation for when I’m not.  I can work with my depression rather than against it.

Working with my depression means noticing it.  It means saying ok, things aren’t great today, lets engage in some gentle self care, yay you made it out of bed, congrats… let’s pause for today and see if that helps make tomorrow easier.  It means noticing that I am being really irritable and instead of beating myself up about it, I can acknowledge that my depression is playing a role and to ease the irritability, I probably need to look at how I can ease the depression.

As I said, everyone has different experiences with depression and for me, accepting it as a lifelong part of me means I am more likely to spend my time and energy caring for myself rather than fighting myself.

High functioning depressive

I’ve been told before that I can’t have real depression because I was able to get out of bed and work.  It was a horrible thing to hear.  Yes, I did get out of bed and get to work but it took everything I had and it hurt like hell to do.  But equally, there was no way I couldn’t not go to work.

I have the curse of high functioning depression.  My depression does not look like most people think depression should look.  And that means I don’t always get taken as seriously as I need and I get dismissed by friends, acquaintances and medical professionals.

I probably look my most professional and most together when my depression is at its worst.  Only then do I wear makeup, dress smartly etc.  I am not me at those times.  If you ever see my wearing a suit, I am probably a complete and utter mess inside.

I was an A* student throughout school and left university with a masters in mathematics and the entire time I was severely depressed, suicidal, self harming and going through periods of anorexia.  No one ever thought to look past that to see what I was hiding.  No one ever saw my depression.

People have told me time and time again how strong I  am and make it sound like a compliment.  But inside I am screaming that I don’t want to be strong.  I want to collapse in a heap and cry and never get out of bed and never speak to anyone ever again.  But I don’t think I will ever be able to do that.  I function with my depression.  Or at least I do my best to make it look like I am.  I go through the motions whilst desperately wishing I no longer existed.

One of my major triggers is invalidation.  And the stereotypical symptoms or pictures people have of depression have led me time and time again to question my own depression.  Doubting myself made me expect the rest of the world to doubt me.  If I doubted it, would my GP just laugh at me?

Depression comes in many forms and looks like many different things.  If someone has taken the time and effort to tell you they’re struggling, don’t tell them they aren’t.

What are your walls made of?

The eight of swords very much sums up where I am.  I have surrounded myself with walls to block out the pain until the walls themselves have caused me pain.

My unhelpful CPN (community psychiatric nurse) keeps telling me to just let myself feel.  And obviously if it was as easy as that I would do so.  I know numbing myself off from my feelings is bad for me.

Then I came across a more helpful question this week:

What are your walls made of?

For me, I think they are made from the fear of feeling worthless, depressed, emotional pain… I don’t think they are so much about keeping people out as they are about keeping stuff (feelings, memories, thoughts) out.  Keeping people out is a byproduct.

“I have a deep fear of being too much,

That one day I will find my someone, and they will realize that I am a hurricane.

That they will step back and be intimidated by my muchness.”

Michelle K

I think they are made from a fear of my power, my authentic full self. I guess the way in school, I always held back my intelligence because it wasn’t a good idea to show it and a part of me is always moderating myself to stop other people from getting hurt or embarrassed etc.  I make myself small to make other people more comfortable.  And the walls are one way that I do that.

Your playing small does not serve the world.

There is nothing enlightened about shrinking so that other people will not feel insecure around you.

– Marianne Williamson

Time and time again, things return to the idea of reclaiming my personal power, even in unlikely places.

Feeling safe enough to feel

When i was living at my parents, i would hide away under my desk or in the bottom of my wardrobe.  I had a torch, a night light, books, notebooks, saved snacks and a bottle of water.  I would stay in my den for hours and hours and pretend that the outside world wasn’t there.  My mother got annoyed with me because I wouldn’t answer and she couldn’t find me (the door was shut on the wardrobe).

When my latest period of depression was at its most soul wrenching levels of pain I would long to hide under the desk at work.  I would shut myself away in the toilets and curl up as small as I could.

Partly I didn’t want to take up space.  I didn’t feel I should take up space.  And partly because sheltering under a table or behind a door felt safer.

All children make dens and hideaways.  But I suspect most children or teenagers don’t seek refuge in their wardrobes day after day after day.

As a physically disabled adult, I can no longer hide in my wardrobe or under a table.

For a while, my psychologist provided me with a safe place.  A space where my feelings could be felt and would be contained.  She held the space and the room gave me boundaries.  But that is gone.  I am no longer able to access that support.  I have had my alloted hours.  The limited support I get from the mental health team now does no offer me that same sense of safety.  I am not able to use it to access my emotions in the same way.

And I don’t know how I can create, both in time and in space, a similar safe place for myself.

Thinking back, the wardrobe offered comfort and it also offered a space away from holding the mask in front of my depression.  It offered me a small, well defined repository for my emotions.  Closing the door on the way out closed that space.  In the same way that walking out of my therapy building offered a clear transition away from that vulnerable emotional place to the rest of the world.

I have numbed myself off a lot since therapy started drawing to an end. It’s not a conscious thing.  It’s not a reaction to feelings.  I have numbed myself out in preparation for feelings.  I have techniques and tools for helping manage my depression but I don’t have a place I feel safe enough to allow my emotions to come out.  In my check ins I get odd little tiny glimpses, academic insight into how i should be feeling or why i have reacted in particular ways.  But I am not able to really feel the feeling.  It’s like I can almost see it but I am not yet able to feel it.

My mental health support team, what little remains, isn’t turning out to be very helpful with this.  I get told to just let myself feel… If anyone has suggestions, I would be grateful.

Seasonal Affective Disorder

As we head into the colder, darker months, I am trying to come up with a plan of attack for my SAD.

I have a SAD wake up light in my bedroom which makes opening your eyes in the morning a little easier.  I also have a SAD lamp on a timer in my living room.  When I was working I had my lamp next to where I had my morning coffee.

Try and get into the sun; getting as much natural sunlight is an even better option but is often not as easy as it sounds.  As well as logistical issues, there’s the complication that SAD makes you lethargic and makes you feel like you can’t actually be bothered to go out.

Which is where routine and planning comes in.  If you do something every day or every Wednesday or whatever hopefully it will become habit and you’ll be more likely to do it even if you can’t be bothered.  Planning specifics also helps.  If you think you’ll go for a walk one day you might but if you decide you’ll go for a walk to the coffee shop on Monday lunch break you’re more likely to do it.

Exercise is supposed to be good, and you can link it with being outside, but not an option open to all of us.

When you’re feeling low it can be really easy to get into the habit of eating lots of comfort food, fast food or no food.  None of which are going to help your mood.  Eating well sounds easy but I know it’s hard.  Try batch cooking and freezing.  Plan ahead.  Decide what you’re going to eat each day and do what you can to make it easy for yourself.  If prechopped vegetables mean you’re more likely to eat them, go for it.  If shop bought soup is going to mean you’re more likely to eat, do it.  You could also look at vitamin tablets.

If you can, try and get into a healthy sleep routine to ensure you get enough (but try and avoid too much!) sleep.  A disrupted body clock is one of the possible causes of SAD.

Ask for help with tasks you find difficult.  For example maybe a friend could cook an extra portion of a meal and drop it round.  Maybe someone could pick up some things from the supermarket.  Or help you tidy your home.  It can be hard to ask for help but often people don’t know how to help even though they want to.

Medication can also help and if you are experiencing symptoms of SAD please talk to your dr.

Being honest with yourself about your eating disorder

“You have been criticizing yourself for years, and it hasn’t worked. Try approving of yourself and see what happens.”

~Louise L. Hay

These are all questions I’ve been asked during my recovery process, and found helpful at some point (you aren’t always ready for a question and that’s ok). I wanted to pull them together so other people can use them as journal prompts or whatever. They may or may not be helpful and certainly not helpful to everyone all of the time.

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be brave 1

Do you want to recover?

It’s ok if the answer is no, well, ok might not be the right word but unfortunately I really think you have to want to recover. Which is infuriating for the people around you who care and who hate seeing you in pain.

If your answer is no, I’d still urge you to keep reading or at least consider why not.

What purpose does your eating disorder serve?

I don’t think many eating disorders are really about eating or appearances when you get to the heart of them. Mine was about numbing my emotions big style, it was about control, it was about low self worth, it was about shame.

My eating disorder was a way of coping when I was suicidal. In a twisted way, anorexia saved my life. But it also tried to kill me.

Do you know what is you and what is your eating disorder?

Example, a 10k run went past my flat recently. Anorexia responded by saying oh, we could do that, let’s look up couch to 5k online and get out there. I genuinely got as far as opening Google before I kicked back in and reminded myself I can’t walk or use a manual wheelchair. Running is out the question. That’s how powerful an eating disorder can be. And if I hadn’t done a lot of work separating the eating disorder from me, I think it’d have taken longer for the rational part of me to kick back in.

Why does recovery scare you?

No, not because you might gain weight etc. Really, what’s the real reason?  The emotional reason.

Mine was a fear of feeling emotions. A fear of having to face the hellish depression which had preceded the eating disorder. It was also a fear of feeling out of control.

What does recovered look like for you?

I was asked this numerous times.  And the answer changed depending on where in my recovery I was/am.

For me, recovering meant not having to constantly think about food.

It meant reclaiming my brain and my identity.

It meant not being a hypocrite ; I strongly feel people shouldn’t diet and that looks don’t matter, I don’t care what other people look like.

Recovery meant not lying to my friends: are you OK? Yes. Are you hungry?  No. Have you lost weight? No.

And although I’m don’t feel I’m fully recovered, I now have space in my head for thoughts which aren’t about food and I’m being a million times more honest with my friends now than I’ve ever been.

If you want to recover, what are you doing which works against that?

I would think oh, I can recover whilst still doing x, or without doing y.  Somehow I was special, my body was different to everyone else who has an eating disorder.  So what everyone else has to eat regularly as part of recovery, I’m special, my body doesn’t like/need/want to do that… (I’m 99% sure that’ll be the eating disorder talking, trying to keep its claws in you cos recovery terrifies it, if you recover, it dies.)

What is your eating disorder robbing you of?

For me, it was the ability to think, relationships with friends, being able to go out for a drink, enjoyment of food, very nearly my job…

My health – you probably already know all the shit health impacts and are probably thinking somehow they won’t affect you, that’s what everyone thinks…

Who are you with the eating disorder? and Who are you without the eating disorder?

This can be tough to answer even if you’ve not had an eating disorder for very long. The nature of it means you lose touch with who you are and you can’t see who you could be or who you want to be. You forget what interests you.

All of your energy goes into the disorder, how else could you use this?

What did you used to enjoy, be interested in, do with your time?

What makes you come alive?

What might it feel like to love yourself?

I’m not asking you to love yourself, but what might it feel like it you did?

What stories do you tell of yourself? What language do you use to talk of yourself?

It’s so easy to believe our thoughts and take our feelings as fact.  They aren’t always, especially not if you have an eating disorder.  The words we use (internally and externally) to describe ourselves, our experiences etc, those words stick.

“Unloveable, fat, ugly, stupid, idiot, bitch” are words which run through my head.  They run through my head a lot less now because I’ve done some tough work challenging them.  But think about it, if you hear all day that you’re a stupid bitch, you start to believe it.

So, try and do yourself a favour, learn to notice and then learn to challenge your head messages and think about the words you choose when you’re speaking about yourself to others.

what else

I hope there’s something here which you’ve found useful.  I strongly encourage you to go away and journal about these questions or other similar prompts – writing can help you breakthrough things in a way that thinking often doesn’t.

Recovery is hard work, but it’s so much better that the eating disorder and I hope you choose to fight.

Mental health and sexuality

Mental health and sexuality…what a tangled web…

I’m talking here about mental health conditions such as depression, anxiety, personality disorders etc rather than learning disabilities although there will be overlapping issues.

I’m also not going to look at vulnerability to exploitation or abuse here. I think that’s a big topic which deserves its own space and overlaps a lot with physical disability.

This blog post will be partly informed by my own experience of mental ill health; anorexia, depression, anxiety and suicidal feelings as well as reading I have done into the subject.

There’s two key areas I want to look at; sexuality causing mental ill health and the impact mental ill health has on sexuality.

Sexuality causing mental ill health

Sexuality is a complicated, very highly personal identity to navigate. In my case I am a bisexual woman who wasn’t really aware that bisexuality was a real thing and an identity I could own until I was about 18. In my case, a history of mental ill health predates the significant stage of forming of my sexual identity. I’ve had depression for as long as I can remember and definitely dating back to when I was seven and experienced my first suicidal feelings. For other people, unfurling sexuality may be the trigger for mental illness.

We still live in a society which makes it hard to be anything other than heterosexual. LGBTQA teens have higher rates of mental illness. You’re at a stage in your life when your creating your sexual identity, you may feel you don’t fit it, you may be persecuted. And there’s a host of additional factors which come in if you don’t think you’re the gender you’ve been performing for the last ten fifteen years. A confusing time for anyone, adolescence as LGBTQA can be far worse.

This increased risk of mental health issues continues past adolescence. For example, in Australia, it’s estimated that 36.5% of trans people and 24.4% of lesbian, gay and bisexual people will at any time meet the criteria for a major depressive episode. Trans women (male to female) are especially likely to suffer from mental health issues. Gay, lesbian and bisexual Australians are more than twice as likely to experience an anxiety disorder as heterosexual Australians are (31% compared to 14%).

Historically, the World Health Organisation only removed homosexuality as a formal psychiatric diagnosis in 1992. It’s still illegal in over 76 countries. Even if you are lucky enough to live in an accepting community, you’re still exposed to discrimination and hatred and it’s hard for that not to impact you in some ways.

The impact of mental ill health on sexuality

Looking now at the impact of mental ill health on sexuality I’m going to talk about the mental illness first and then move on to any effects that medication plays.

  • You may feel increased or decreased sexual desire
  • You may experience low self esteem or symptoms which make you believe you’re unattractive or unworthy
  • You may experience loss of interest in people, activities etc
  • You may experience loss of motivation
  • Your self care skills may be affected leading to poorer hygiene which in term affects confidence
  • You may find it difficult to meet people, for example if you’re spending long periods of time in hospital or find it difficult to leave your home

Obviously a loss in sexual desire is going to have a huge impact on your sexual expression but the other examples show that there’s lots of factors at play here. With my anorexia at it’s worst, I would have struggled to let someone else see or touch my body. I had a head filled with calorie counting and self loathing and there was no space in there for sex. I was also constantly exhausted and had no interest in anything. With depression, I find myself in a place where I think no one can like me, that I’m worthless and horrible and that’s not conducive to a good sex life! I also self harm and again, I would find it incredibly difficult for someone to see recent injuries.

And if your mental health problems are related to issues such as abuse or rape, then the subject gets even more complicated.

And then there’s the medication… Side effects of medication can cause loss of libido, vaginal dryness, problems getting an erection, problems orgasming, weight gain which can affect confidence etc.

I want to briefly mention substance or alcohol misuse (which can occur because of, or be considered, a mental health issue) because that can have quite a huge impact on sexual behaviour. For example, if you’re under the influence of drugs or alcohol, you may do things you wouldn’t normally do; having sex with someone you wouldn’t normally, having unprotected sex or engaging in sexual acts which you wouldn’t normally (eg sex in public places, being filmed, particular types of sex). Similar behaviour may also arise from a manic state.

As you can see, there’s a lot of interacting issues when it comes to mental ill health and sexuality. I could go on and on, but really, the purpose of my post was to highlight the issue. And try and get people talking about it. Mental health and sexuality on their own aren’t topics people talk about much so mental health and sexuality together doesn’t stand much of a chance.  And yet, communication is a key part of building a healthy sex life.

If you need help with any of the issues raised, please speak to your GP, care team, partner, friends or helplines.

In the UK, the Samaritans are open 24/7 to listen to you.

If you’re struggling with your sexual orientation, have a look at Mind’s useful contacts.