The news in brief 16th August 2014

It’s important that we talk about these things, so today The news in brief is handing the microphone over to a poet with something to say. Reproduced with kind permission from:  http://projectshandy.co.uk/?p=846  

Depression: It Takes More Than One Conversation

I’ve seen a lot of posts around on Facebook, Tumblr, Twitter, etc relating to the death of Robin Williams, encouraging those who suffer from depression to speak up, speak out and reach for help.
They are admirable and worthy sentiments, but there’s something missing from them which I’d like to talk about here.
Depression isn’t fixed within a single conversation or admission. You need to keep talking and keep talking and keep talking. And those who are offering so valiantly to listen need to keep listening and keep listening and keep listening. Even when the things that you’re hearing might already have been said a hundred times.
I’d like to compare two different types of sickness at my workplace which I’ve witnessed in the last 12 months. Names have been changed to protect the innocent.
Trudy damaged her knee ligaments in an accident. She was in a lot of pain, struggling to walk around physically even with a brace and crutches, and even after one or two attempts at returning to work, she needed to take some extra time off to recover when she outpaced herself. She worked from home as much as she could, but the pain medication sometimes zonked her out and it would take her a couple of days to get back to people who had tried to contact her.
Nowhere was she met with anything less than absolute sympathy and compassion. When people saw her or talked on the phone, the first thing they asked was ‘How are you feeling, how’s the leg?’ and they listened with sympathy and patience as Trudy described her struggles with the medicine, the frustration of not being able to walk and the wish to return to work full time. People described her as brave and spoke of her with admiration when she did return only to need more recovery time.
Then there’s Rachel. Rachel’s father had a stroke and ended up in intensive care in hospital. Her mother and extended family rallied around him, but Rachel took it very hard. She was based far away from her family and wasn’t able to be there in person very often. Once her father’s condition improved to the point where he could breathe without a ventilator, she returned to work after two days compassionate leave.
But then depression hit her, and it hit her severely. She was in and out of work for some time, often working from home and making phonecalls instead of attending face to face meetings. She was pretty upfront about her struggles with her immediate team, including her manager and me, one of her closer colleagues. Most people knew about her depression, even if they didn’t know the details of how or why.
Rachel and I were due to attend a nationwide conference a few months after her father’s illness. The rest of our department attended too. Rachel managed one day, and then had to call me to say she was too ill to drive, because her depression medication had knocked her out.
When Rachel didn’t turn up, a few staff asked what had happened to her. I explained that her medication had made her unsafe to drive and I was going to fill in for her. One of them, in relative innocence, asked whether it was medication for her depression. Another said, in reply, ‘Oh yeah, she mentioned that a while ago, I thought she’d be better by now. Surely she doesn’t still need those drugs, does she?’
No she wasn’t better at all. She was terrified every time someone from her family called her. She worried about her father incessantly. She was isolated from her family by distance, trying her best to work and keep up with the demands of her job and struggling to keep her everyday life going.
At this point, Trudy walked up. Literally walked, but with a cane for support. The two members of staff fell upon her with coos and oohs and ahhs. The same person who had commented on Rachel’s continuing issues said:
“Oh you poor thing, you’ve struggled on for ages since coming out of that brace, you must be longing to get better.”
In that moment I realised the difference between how people react to a long term physical illness and a recurrent mental illness.
Rachel had done what all the advice about depression suggests. She had talked about it, been open about it, never hid why she was struggling. However, she was still battling against the perception that after discussing it and being open about it and taking some tablets, she should be ‘better’. It was understandable to these people that Trudy would take a long time to recover from an injury, that she would need several attempts to get stronger and return to work and that it would require persistence on her part. It was harder for them to accept that in Rachel’s case.
Rachel ended up taking some more time off, but she called me before coming back to work a few months later. We spoke for a while about how she was feeling, and she said that she had called me as one of the first because she knew I wouldn’t ask if she was ‘feeling better’. Rachel knew about my own struggles with mental health issues and anyone who’s been through it themselves will know that ‘better’ is not really something that you attain on a permanent basis. There’s no bench mark for feeling ‘better’, like there would be for someone like Trudy, who will be ‘better’ when she can walk again with no assistance and no pain. When you struggle against your own brain chemistry, you learn to be grateful for the good days and accept that bad days can come with no warning.
Admitting that you have depression is a really brave first step. But it takes a different sort of persistence to keep people aware that your struggles are an ongoing issue, and the fact is that people who don’t understand how the illness works will think that you are ‘milking it’ if you talk about it more than once. There are no constant physical reminders that people suffer with depression. The only way to keep people aware of your struggles is to keep talking about it. And that gets both boring to do, and frankly boring to listen to, especially if you can’t see any evidence of the sickness that the person is talking about.
The first time you tell someone that you are depressed you will get sympathy. Because people are now aware that this is how they should respond. The public awareness campaigns have done their jobs.
After a time you may begin to feel better, but if it re-surges and you begin to feel bad again, you have to explain yourself all over again. The second time you tell people, there will be some resignation. Because this is old news now. You’ve been through this. People think it’s like chicken pox, that once you’ve survived it you can have some form of immunity and tool kit to deal with it. They wait for you to remember your training, for you to return to ‘normal’, because you proved you could do it once.
A second recovery will be greeted with relief. Perhaps now things will be back to normal. Woe betide you should you suffer a third attack. Telling people once again that you are feeling depressed, which to you might feel like being trapped behind a thick glass of numbness and struggling to breathe through chest pains while you mental list reasons to carry on living, you might get a raise of the eyebrows and a ‘hmmmm’. Skepticism. How can this human keep malfunctioning? Are they actually sick, or are they just wanting special treatment. They don’t look any different to anyone else, after all. There is a pattern to this behaviour now, and some people will begin to ascribe it to your character rather than your medical well being.
The fourth time you bring it up, you might start to get pointed looks and stares along with comments about how they ‘thought you would be feeling better by now’. People will start asking things like ‘Is this really the job for you if you can’t cope?’ Or ‘have you tried approaching life through a more positive mindset? Or taking up a new hobby to distract you?’
Patience wears thin for struggles which are invisible yet repetitive. Admitting that you have depression once does not make the problem go away, even if you experience a period of recovery. It’s a roller coaster which lasts throughout life, along with all the peaks and troughs and sharp corners.
Every bout of depression leaves the sufferer feeling weaker than the last. Because it’s like being punched in an old bruise. And yet as time goes on, public patience and support lessen, wane, fade and disappear exactly when they need it most. People have described Robin Williams as ‘battling’ with depression, they don’t know how apt a statement that is. It’s an ongoing war, a crisis inside your own head. There might be periods of peace, or at least a truce or ceasefire, but you live in fear of the next onslaught. After a while, public sympathy becomes exhausted. You are seen as the creator of your own circumstances, because they begin in your head, and people believe that you should be in control of your own head. The very point behind Mental Illness is that you’re not. You have to fight for the controls of your own existence and even when you have them, there’s no guarantee you’ll hang onto them or have a smooth ride.
Encouraging people to come forward is one thing. And it’s a good thing. Nobody should have to suffer in silence. But if you are encouraging a depressive person to speak, you may need to be aware that they will need to speak more than once. A lot more than once. And to them the horror of their own mental landscape is just as real each time, even though the story might sound the same to you.