Chipping away at depression

William Styron, the famous Pulitzer-prize winning author, was a sufferer of clinical / major / severe depression, the 'black dog', or whatever you want to call it. He described depression as a 'true wimp of a word for such a major illness', a word that has 'slithered innocuously through our language like a slug, leaving little trace of its intrinsic malevolence, and preventing by its very insipidy, a general awareness of the horrible intensity of the illness when it is out of control.' He described the onset of his melancholy in evocative language. For example: 'I’d feel the horror, like some poisonous fogbank, roll in upon my mind.' He used words like 'monstrous' and 'tempestuous agony' to describe his turmoil. He brilliantly highlighted that clinical / major / severe depression is so far removed from healthy sadness (and even, arguably, mild depression) that you may as well see them as qualitatively and quantitatively quite distinct.  Like in a different ballpark in a different universe.

Styron wrote his memoirs, entitled Darkness Visible, back in the late 1980’s. There is no doubt that in a sense things have moved on since then. More people have a better understanding of mental illness in 2017. There are much improved treatments. This year in particular has seen significantly increased discussion across the media. But there is way more work to do. The illness remains a huge challenge to overcome and we are still not good at talking about depression in general. If we could open up a bit more I am certain that lives could be saved.     

The truth is that, untreated and unchallenged, clinical / major / severe depression (and variants thereof, because we rarely fit into neat psychiatric diagnostic categories) can drive people to kill themselves. It can agitate, distress and torment sufferers to the extent that it feels literally hellish to keep existing. In 2015, approximately the combined population of Greater Glasgow and Edinburgh killed themselves worldwide (around 1 million: World Health Organisation, 2016). In 2014 in the UK alone, over 6,500 people ended their lives prematurely – about 75 per cent of these had symptoms of depression to the fore (Samaritans, 2015). This compares with less than 2,000 deaths on UK roads in the same year (Gov.uk). So as problems go, it’s a biggy for society.  

But with perseverance, patience and support, it can be survived. And it can be managed going forward. Despite life being difficult, and clinical depression more so, there is hope. In my recently published self-help book, Difficult Not Impossible: How to Survive Clinical Depression, there are a range of theories and strategies presented that help to promote understanding and survival of this affliction. 

The book is written from a personal and professional perspective, as I have survived intermittent episodes of the illness over the past 27 years, and also worked in the field of mental health myself for around 20 years. As a Community Mental Health Nurse, then Clinical Associate in Applied Psychology (CAAP), in the NHS, I have helped many people survive and manage the illness throughout the UK, in particular Glasgow, Mid and West Lothian, and the Borders. In terms of my own struggle, as time has gone on I have succeeded in managing the condition more effectively, through the use of all of the strategies discussed.

Furthermore, new ways of coping are constantly appearing and evolving.  For example, since the book’s publication in the summer of 2017 I have discovered and adopted strategies that did not make it into the book.  I have been eating a low gluten diet and I have started taking natural anti-inflammatory ginger and turmeric supplements. Both of these strategies are supported by strong evidence that links lower inflammation levels in the body with better mood. I am definitely noticing a positive effect in terms of relapse prevention. 

The book is written to be user-friendly and accessible to all, covering potentially helpful medication and supplements; diet; coming to terms with, and learning from, our past; noticing and challenging our negative, unhelpful thinking (internal assertiveness); engaging in psychological 'talking' therapies when we are able to; engaging in realistic, achievable, helpful behaviours, like being assertive (external assertiveness); and other treatments like transcranial magnetic stimulation (TMS) and electro-convulsive therapy (ECT).

Getting better from clinical depression, and staying better, is enormously difficult, but not impossible. The sufferer benefits from chipping away at the illness like a super-patient stonemason crafting a sculpture out of a huge granite rock. You will find in this book that there are many angles you can approach your seemingly immovable granite-like depression from. By consistently mustering your limited energies, you can gradually regain control. If you stick in there and do stuff – even just little things – you can have a say in how long the illness lasts for. 

Spike Milligan, the Goon Show and Monty Python comedian and actor, is a helpful example in this respect. He hung on for dear life during many depressive episodes. During one of his worst bouts between late 1990 and late 1991 he was close to calling it a day.  He got so low and treatment-resistant that he was even given ECT, a last-resort treatment for a tiny minority of sufferers. Then about one month before Christmas 1991 his depression suddenly lifted. He was rewarded for sticking in there. He got back to his creative, humorous, outgoing and enthusiastic self again. There is a very funny clip of him on youtube receiving a lifetime achievement award in 1994 (search “Spike Milligan youtube 1994”). He eventually died in 2002 at the age of 83. I’m sure he wasn’t on top form all of that time, but I’m equally sure he died thinking he was glad he persevered.    

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Difficult Not Impossible: How to Survive Clinical Depression, by Craig Barton, is available for £6 in paperback and £2.99 as an e-book on www.amazon.co.uk, and direct as a paperback from the publisher at www.lulu.com.