Mental health and me
Fair warning: at about 4,000 words, this is by far and away the longest blog post I have ever written (and probably will ever write). It’s poor form, artistically speaking, but it is not something that I wanted to break into separate posts. This is a ‘rip the bandaid’ off kind of thing. Please forgive the lack of brevity – if you make it to the end, I hope you’ll understand.
I was never going to write this.
So why, then, is it here? Why are you reading this?
Well, first I guess it makes sense to explain what ‘this’ is. I have a mental health problem. I suffer from a condition called ‘Persistent Depressive Disorder’, sometimes known as ‘Chronic Major Depressive Disorder’. I was ‘officially’ diagnosed about 3 years ago, though I had been having feelings that you would associate with MDD since my late teens.
For the most part, you probably wouldn’t notice it. I tend to drop off the radar now and again, and sometimes I drink a little too much at social events. But these are usually attributed to constantly being on the move, and having a generically poor but not necessarily sinister relationship with alcohol, respectively. One of the things having a mental health disorder makes you very good at – at least in my case – is perfecting the art of the veneer.
Why hide it in the first place?
The main reason, simply, is the fear of backlash, ridicule, and general defamation of character that such a revelation might illicit. I’m talking about reactions like this:
“To be diagnosed as depressed is the holy grail of illnesses for many. The ultimate passport to self obsession. Get a grip people.”
— Katie Hopkins
Now, obviously, I couldn’t give a tiny rat’s ass about the bile that spews from that vile woman’s mouth. The problem though, is that her view is not an isolated one. As long as people with this mindset (regardless of how far down the scale they are) still have the scope to give this sort of viewpoint air time, there is still a danger that revealing yourself will cause you problems. As someone working in the start up world, you bet your ass I’ve been sat on this post for nearly a month, worried that the knowledge that a co-founder of a company is anything less than perfect might scare people away from business with us.
This isn’t just a hypothetical concern. Up until now, only a handful of people know about my mental health problems. For the most part, everyone has been 100% awesome about it. But there has been more than one instance where telling someone has ended badly, in some cases for reasons that would never have occurred to me. As human beings, we seem to be hard-wired to remember only the bad things, and being shaken as badly as that sticks with you.
There is a third reason; I’m not entirely sure that disclosing my mental health problems is even fair. I could write an entire separate blog post on my thoughts around this. The abridged version, though, is that I hate the idea that I would be a burden on people – that people might have to go out of their way to change the way they act towards me, because I’m more fragile than I let on.
Why am I talking now?
So, the question again. If I promised myself to never talk about this, why have I decided to put it on the Internet – a medium that is infamously permanent in nature.
The honest answer is, I’m not 100% sure. I wrote this as a form of catharsis during a particularly low point. Usually that works – I write it out, file it away, and get some form of solace. Sometimes, if I need more, I’ll stick it on an obscure blog in some far corner of the internet. Lately though, this hasn’t been working – I sensed that I needed it to be ‘out there’ for me to feel better for it.
That’s not to say it was an easy decision to make – when you’ve been hiding something like this for almost the entirety of your adult life, none of this feels right.
I read a lot of blogs by people suffering with mental health problems though, a lot of them I thoroughly recommend. This one is particularly good – and there are others at the end of this post. Anyway, I realised the other day that while the majority of them do help, none of them 100% nail what I’m going through. It took me a while to realise why this was: no one is going through exactly what I’m going through – because no two people can experience the same things in the exact same ways. By that logic, there’s no such thing as the perfect blog post for this, but the more content there is out there, the more people in general might benefit. If my account of my issues helps one other person better articulate a small part of what they are going through, that has to be a good thing. Right…?
Another reason why I’ve decided to break my silence is that it frustrates me how poor the level of dialogue is in general for mental health – and specifically for men’s mental health. This isn’t to say that I have ever helped with this. My attitude to talking about mental health is a little like the NIMBY attitude to nuclear power or to wind-farms – sure, they seem like a good idea in general, so long as it is Not In My Back Yard. Wider discourse in the media and online and whatever PSHE lessons in schools are called these days, sure. But I’ve always been nervous about talking about it from a personal point of view.
Source: xkcd – Pastime
In short, I’m a hypocrite. Actually it’s worse than that – I’m a coward. I think all of these things, yet I still don’t want to be the one to do them. I refuse to talk properly to my doctor, seek a therapist, or approach any of my friends about how I feel. I know all the steps I need to take — all the steps I would tell anyone else in my position to take — to get me to a better place. I just refuse to do them. I hide behind a social media presence that flits between conferences, geeky tweets, and rants to companies that piss me off, rather than using it as a platform to speak about something important that – actually – is a subject on which I have a lot of things to say.
Which leads me to the final reason (or at least the final reason in this list). Opening up about my mental health may well give me more scope to write about my experiences in this blog. How mental health is looked upon in the startup world is something that fascinates me. I’m not saying that I’ll suddenly be spewing out thought pieces that Harvard students will use as case studies in important essays. But a guy can dream, right?
“I am a writer perhaps because I am not a talker.”
— Gwendolyn Brooks
So, what does the black dog look like for me?
I mentioned at the top that I read a lot of blogs on this subject. One of the things that I sometimes find quite encouraging is when people describe how their depression manifests itself in them. It gives me something to connect with. Given that, I thought it might make sense to try that myself.
The first thing to understand about depression – and indeed this is true of any ailment – is that it presents itself in different ways in different people. Often, it will even present itself in different ways in the same person.
There are a number of ways to describe how I react, and I wasn’t sure how best to frame it. I’ve decided to just talk through some of the most common and/or severe reactions to what I call my ‘down phases’ – periods of time where I feel particularly low. Some of these you might notice in a person, and others you might not.
In my case, perhaps my most common reaction to low points is to withdraw into myself. There are currently only two people who can get me to talk when I feel like that – and that’s only because I work with them, and it’s very poor form to go radio silent from one’s business partners when you’re running a three-man start up. But if you’ve ever added me to a group chat and I don’t pipe up, chances are it’s because I’m going through one of my ‘phases’ and I’m having one of several reactions. For instance, I might be feeling intimidated by the group and convinced that I have little of value to add. Sometimes, responding to a social call is too much effort, and simply pretending I don’t exist is the easiest (if not the most mature) way of dealing with that. Sometimes, and I swear I’m not making this up, I genuinely think that you’ve added me to the group by mistake (perhaps we’re all in the same social circle, and Facebook suggested you add me to the group and you clicked yes without really putting much though into to it but, has you thought about it, you actually would have unchecked my name).
I’m fully aware that ignoring a group chat might make me come across as arrogant, uncaring, or a mix of the two. That’s never my intention. It’s just that it is – somewhat paradoxically – easier for me to deal with that stigma than it is to go through the draining process that is social interaction during a phase of major depression.
It goes without saying that, not every time I respond to a message late, I’ve just climbed out of the dark pit. Sometimes, I am just really bad at replying to things.
My most common ‘non-public’ reaction is long periods of sleeplessness. The cause of this can range from simply not feeling tired, to restlessness caused by anxiety, right the way through to full-blown nightmares keeping me awake.
I’ll talk about how I cope with down-phases in a minute, but when it comes to my insomnia, there’s very little that works. I’ve tried meditation, strict sleep schedules, I even keep a potted lavender plant on my bedside table. Some remedies work better than others, but when it gets really bad I just have to sit it out. I imagine prescription sleeping pills would work, but my condition prohibits my GP from prescribing them – lest I wind up as another statistic.
Even in good phases, my sleep is pretty screwed. The bright side is that I’ve managed to start a business that means being awake at 3am is beneficial to the events I run. The downside is literally all of the other things associated with insomnia.
Guilt, feelings of inadequacy, low self-esteem – for me, they all pretty much merge into one. Really, with this ‘symptom’ there’s not any way I can win. It could be that I’ve not had a particularly productive week, or maybe I’ve offended someone, or perhaps my actions have caused a series of events that have ended badly.
The thing about these is that it’s more or less irrelevant whether or not any of these things actually happen. I can’t count the number of times I’ve felt bad about a situation and spent hours worrying about it, only to be met with surprise that I’d even thought anything was wrong if I bring it up. The flipside, of course, is that there have been just as many situations where this hasn’t been the case. One tends, as we know, to focus on the bad.
Things don’t even have to have happened to bring this on. Often, it’s the thought or imagined outcome of a situation that can leave me with sometimes crippling anxiety. As I mentioned earlier, this post, for instance, has caused me to worry a lot about the affect it will have on people who read it, vis-à-vis their interactions with me. This is entirely separate from my worry about how people will view me as a person. The best way I can explain it is by giving the scenario where someone has issue with something I’ve done. I wouldn’t want that person to hold back on their criticism of me because of the perceived (or actual) fragility my condition causes.
The thing is, I’m fully aware of how ridiculous that sounds. Yet the amount of decisions I’ve taken, based on nothing beyond the desire to mitigate the harm I cause to others, is frankly concerning. Guilt – whether caused by past actions, or by potential future actions – is a powerful thing.
Thoughts that are… darker…
I’m not going to talk here about me, not yet, and maybe not ever. But as this is a post about depression written by a man, I feel compelled to add the reminder that such thoughts can lead to the most common cause of death for men aged between 20 and 49 in England and Wales.
I also wanted to make the point that, for some, this is a constant state of mind. No matter what therapies they are going through, or medication they are taking, or actions they are engaging in, sometimes just waking up in the morning is the most challenging thing that they will ever do.
I mention this to counteract the fact that I’ve cited the disgusting harpy that is Katie Hopkins in this post, and her inexcusable fuckwittery on the subject.
How do I cope with it?
I wasn’t sure whether to write this section, mostly because 80% of the time the simple answer is “not well”. There’s also a large part of me that really resents reading articles with title such as “11 of the best ways to beat the blues”, or “Feeling depressed? These 6 foolproof methods will perk you right up. You won’t believe number 4!“. Whatever well-meaning place they come from, they almost always over-simplify the condition, and are universally naïve about the supposed healing powers of camomile tea.
That said, there are a handful of things that I do fall back on, so it seemed fair to share them.
Build something new
One that I stumbled on almost by accident a long time ago was the act of creating something. I guess the idea is that I feed off of the notion that something exists in the world because I exist. I used to bake, but my down phases usually occur alongside bouts of vicious insomnia (see above), and clattering round the kitchen at 3am isn’t particular considerate towards people I live with. Coding, on the other hand, one can do in ones own time without bothering anyone. The vast majority of my coding prowess (yea, I said it) comes from trying to salvage some kind of productivity from many a sleepless night.
Otherwise add value
One doesn’t have to build something new to make one’s dent in the universe. For instance, I have mentored for a lot of the same reasons. Someone said to me once that it was amusing that they could rely on my God-complex (their words, not mine. Honest.) to ensure that they could call me in for a training session at short notice. I laughed (because it was funny), but actually that’s only half the story. It’s not a God-complex that means I’m at the end of the phone at 2am, it’s a desperate need to prove my worth to a cause I care about.
Some studies have posited a link between anxiety and depression, and use of creams containing SPF (eg. sun creams, some moisturisers). The theory goes that, as well as blocking the harmful UV radiation, it also inhibits the body’s ability to absorb all the lovely Vitamin D that the sun is so generously throwing at us. Vitamin D, in turn, is a key ingredient in making monoamines, such as serotonin, which are the body’s natural anti-depressants.
The science is somewhat disputed, but I can vouch for a lack of sunshine correlating with poor moods. My point is that being outside is something that I find helpful. The caveat to this is that actually there are a lot of things required to get a depressed individual outside – especially if they wake up and decide that bed is their domain for the day. With that in mind, I have a list of things under the ‘be active’ umbrella that also help (and yes, I am aware that this is inadvertently turning into one of the articles that I – not moments ago – lambasted).
- Shower and change into clean clothes
- Do some housework – tidy your room (which, if you’ve spent days holed up in, will be a mess. Not sure how it’s possible to make a room messy when you haven’t really left the confines of your duvet, maybe it’s a superpower we depressed folk have acquired), clean the dishes, take the vacuum cleaner for a spin, whatever.
- Stick on Spotify’s ‘#ThrowbackThursday‘ playlist
- Have a banana. Seriously. In fact, if you’re up to it and you have the ingredients, make a smoothie. Two reasons: blitzing loads of things is oddly satisfying, and bananas have all the brain-friendly chemicals.
If you can make it outside, the next step that many self-help sites will tell you is to do some exercise. Sure, endorphins are great, but my struggling to get out of bed doesn’t morph into me wanting to become Mo Farah just because I changed clothes and ate some fruit. Good news is that even a walk helps.
Source: Depression Comix – Trapped
I have something of a checkered past with anti-depressants, but it seemed remiss of me not to include them here. I’ve been on half a dozen prescriptions over the last few years, from SSRIs such as Prozac to NaSSAs such as Mirtazapine. By and large, I’ve hated them all. That said, I have recently come off medication, and that has coincided with a somewhat-severe decrease in my mood. I wouldn’t like to say that one caused the other – but it is interesting to me that maybe the medication was doing more than I gave it credit for.
In either case, regardless of my personal journey with meds, I don’t have time for people who dismiss them as a valid form of treatment. VICE ran this article a while ago that articulates this better than I ever could.
Yea, I know what I said. Shut up…
So… now what?
People are a mix of things – a kaleidoscope of hobbies and quirks and opinions and skills. No one person is seen the same way by two other people, and no one sees themselves as the same person in front of different people. That said, I do think that most people have a ‘default’ way of looking at themselves – kind of like the real-life version of your headline on LinkedIn.
For me, that headline is my diagnosis. It’s what I immediately return to whenever I self-reflect, and it is the lens through which the majority of my actions are taken. My condition causes my ‘default’ view of myself to be a negative one: I detract from social situations, I leech off of other people, I don’t add any value to scenarios – and in fact in most cases, I detract from it.
For the majority of the time I interact with people, I try to keep a lid on it. I do so for any number of reasons ranging on a scale from ‘actually I’m not too bad today’ through to ‘no one should have to deal with this level of crazy’. In the process of trying to write this post though, I’ve had to really think about my condition, and articulate it in a way that is coherent within the medium. The problem is that people are far more complex than that. I’ve not begun to scratch the surface of how my condition has shaped me as a person, I’ve skimmed over things that deserve more attention, and I’ve probably given certain things a narrative importance that they don’t necessarily deserve.
I have no idea how I’m going to react to this being in the public domain. Firstly, because it presupposes that people will actually read this. But also because I’ve spent nearly a decade deliberately trying to make sure that ‘real-world Will’ and ‘depressed Will’ are entirely separate entities, never the twain to meet.
I’m not sure it can go on though. Not because I have a burning desire to talk to everyone about my mental health – I really, really don’t. But the subject is far more important than one person’s view on it. We’re retrospectively told – all the time – that whatever social issues we face are always solved given enough time. But time isn’t the solution. It takes action to make change, whether that’s a change in discourse about mental health, or in something else entirely.
I’m not arrogant enough to suggest that my ramblings here – only some of which were entirely coherent – will play any significant part in that change. But if just a few of those words make someone think differently about their situation – just as countless other people have made me reconsider mine – then that has to be better.
Source: xkcd – Positive Attitude
Postscript: Some things I’ve read
In no particular order, here are some of articles and blog posts that have particularly resonated with me in some way or another. For anyone looking for other things to read, as you’ll probably notice, I highly recommend Medium as a good way to get in front of content.
- The Masks We Wear, The Lies We Tell, The Secrets We Keep – Felicia C Sullivan, Medium: The Coffeelicious
- Why I’ll Never Stop Taking Prozac – Simon Hattenstone, VICE
- When You Can’t Be the Person The Internet Wants You to Be – Felicia C Sullivan, Medium: Life Learning
- Mental health in Startups – James, Medium: Mental Health in Startups
- My Anxiety Disorder Doesn’t Mean I’m Crazy – Hanna Carter, Medium
- Dealing with Bipolar Disorder – Unseen Perfidy, Medium
- Read This If You’ve Only Been Pretending To Be Okay – Ari Eastman, Thought Catalog
- What it really feels like to have depression – Alba Lanuza, LifeHack.org
- Depression is NOT a Mental Illness – Jamie Flexman, Huffington Post
- What You Call Depression I Call The Truth – So Sad Today, VICE
- Men do cry: one man’s experience of depression – Matt Haig, The Guardian