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22 Days of Musing: 21

21. It’s okay to not be okay.

Hoookay, folks; tonight’s reflection is going to be a relatively short one, I fear, as I’ve come down with a rather nasty case of cellulitis on and around my left elbow and resting it on the arm of the chair to type is causing it to ache rather unpleasantly. I’ve already been prescribed a good heavy dose of erythromycin, though, so don’t worry about me (at least, not until my arm turns black and falls off entirely – let’s try and avoid that, shall we?). Nonetheless, I’ve just found out that this week, from the 9th to the 15th of October, is National Mental Health Week, and focused upon the now-passed World Mental Health Day on the 10th. This is a week in which to reflect on mental health as a phenomenon, as an experience, as a burden, and try to ask ourselves what we can do or improve on to help both ourselves and others to move closer to a state of mental wellness, and I think it’s apposite, then, that I reflect on that. This kind of awareness campaign is incalculably valuable, I believe, because such a powerful stigma still exists even now against talking honestly about one’s less-than-ideal state of mental health in a public arena. People are in varying degrees content to ask a friend how their treatment for cancer is going, how their broken arm is mending, whether their cold has cleared off; but when it comes to mental illnesses like depression and schizophrenia and PTSD, we really lack the cultural ability and social framework within which to engage with those kinds of conversations. There’s a feeling pervading almost every niche of society, even now in 2016, that feeling mentally ill is still something that it’s proper manners to keep the fuck to yourself, as tightly wrapped as a pharaonic mummy – to the point where I even found myself apologising to my psychiatrist when I burst into tears during my last session with her. Prima facie, this should be completely ridiculous, the idea of apologising to the very person I should be opening my feelings to for the very act of opening my feelings to her in what felt to a part of my brain like it was an excessive, if not outright shameful, manner. I fight this feeling every day, battling hard to maintain a matter-of-fact attitude towards my own mental illness (while not being cavalier, of course) when I discuss my health issues with others. Awareness campaigns of the sort we’re seeing in the National Mental Health Week give me great heart for this reason. It’s one thing for me to model the kind of approaches I’d like to see when it comes to engaging with mental illness more generally (and even here I’ve been told at times that I share too much, that it’ll hurt my future career prospects, that it’ll scare people away from me, et cetera – ironically, mostly by an ex-partner who herself was at the time suffering from rather serious mental health issues that were at the time going undiagnosed and untreated), but having the backup of organisational-level efforts like National Mental Health Week, the It’s Okay To Say (If You Don’t Feel Okay), and the R U OK? campaigns to normalise the discussion of mental illness in public is truly cheering for me. It’s a big public display of support for the mentally ill in general, and for me in particular it helps to reinforce the small, serene voice in my head that tries so very hard to convince me that I’m allowed to speak up while being constantly drowned out by the other voice in my head, the shouty Don Rickles-impersonating motherfucker on the megaphone. So if I can make a request of you, dear reader, I’d ask that you please do something this National Mental Health Week to show your support for those with mental illness, even if all that is is to ask a suffering friend if they’re okay, and listen without prejudice. And if it’s you that’s suffering, please look to those around you to try and start building a support network. There’s a wonderful quote I like from, of all places, Tumblr; some time ago, a user going by the alias tahtahtahtia posted this to their Tumblr blog, which I reproduce here verbatim.

today my anthro professor said something kindof really beautiful:
“you all have a little bit of ‘I want to save the world’ in you,

that’s why you’re here, in college.
I want you to know that it’s okay if you only save one person,
and it’s okay if that person is you”
– tahtahtahtia

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22 Days of Musing: 15

15. Grokking my fullness.

I’d like to talk tonight about how desperately important it is, when you suffer from any kind of mental illness whatsoever – depression, anxiety, schizophrenia, PTSD, bipolar disorder, anorexia nervosa, obsessive-compulsive disorder – to maintain a network of supportive and trusted people around you who can assist you to maintain at least a certain handle on the illness, and can act as a soft place to fall if the disorder should get difficult enough to require that. For a plethora of reasons individually too small to consider problematic but joining together to form a larger and more formidable challenge of my psychological strength, it tends to be my friends in whom I place the most trust when it comes to being open and frank about my battle with mental illness. I don’t know what it is that makes me trust them moreso than anyone else. Perhaps it’s the discomfort I feel with the fact that there’s a societal obligation upon family to care – that blood is thicker than water, to the point where in many cultures the word for “family” or “clan” even comes from terms for body parts, as in Māori iwi “clan” (literally, “bone”) and the Ubykh equivalent lhepq (literally “blood [and] bone”) – an obligation that anxiety makes me sometimes question, even as I tell myself not to be so bloody bone-headed. I ask myself, are they being supportive because they truly want to be? Or rather because blest be the tie that binds and the omnipresent ᴛʜᴇʏ would look poorly upon kinship coming not before all? Having anxiety sometimes makes me ask such terrible questions even as I loathe myself for doing so. And so the hands of my friends, bound by no such ties of kin that might conceivably oblige them to catch me as I fall, tend to be those I trust with my psychological well-being (or lack thereof), because I’m more comfortable, on the whole, with the idea that they’re supportive because it pleases them to be so.

Nkiéjuale mğiéjuale waléwmıt.
(Old friends and old roads will not deceive you.)
– Ubykh proverb

This very evening, in fact, I spent a solid two hours (we can’t seem to help talking longer, always, than what either of us plan!) on the phone nattering with my best friend, ranging over a whole slew of topics and running along glorious tangents at every other turn. The peculiar thing is that it need not be a conversation about anything in particular that helps me to feel better or more positive; I don’t necessarily need to drop my bundle or vent my spleen to get a sensation of improvement. It can simply be the mere fact of having contact with another human being who cares about me for just exactly what and who I am, warts and all, that gives salve for the wounds that respond to no physical cure. When you’re mentally ill, the value of having somebody understand you is incalculable. And I’m not talking here simply about passive understanding, the sage nod of the “oh, I see” from someone who intellectually comprehends the words you’ve said, the scenario you’ve described, and might perhaps even feel sympathy, expressed (or not) in a platitude of some sort. Merely being understood is sometimes not what you need, or at least, is often not what I need. Rather, what I mean is having someone actively understanding you, or (with apologies to the late Robert Heinlein) grokking your fullness: not the mere statement of someone’s understanding, but an activity that communicates that understanding. Actions speaking louder, et cetera. The kind of understanding I most value is that shown not by attempting to “understand” as such at all, but by simply interacting, talking, laughing, commiserating, joking, raging together, in a way that demonstrates – that perhaps even performs – one’s understanding of me. Not of my illness, or of my circumstances, but simply of me. This is exceedingly difficult to describe, and the English language really lacks the lexical and grammatical tools to express the idea as cleanly as I perceive it, but equally impossible to describe is the value I place on spending time with people who’re willing to perform this kind of understanding. And sometimes all that’s necessary is to simply exist in the right place at the right time. On two occasions in 2011 after the “girl from the conference” débâcle, I lost my composure and fell apart in public towards the end of two nights out with a group of friends. In both instances, I realised what was happening and separated myself before I dropped my bundle completely. But one friend noticed my unexplained absence and came out to simply sit with me as I sobbed in the gutter and rest his hand on my shoulder. Both times it was the same friend, and he said nothing as I wept. But he knew, somehow instinctively, that I didn’t need someone to comfort me with words; I just needed someone to be with me and perform an understanding of the fact I just needed to feel like I was not alone. To turn a phrase, he understood the shit out of me on those nights, just as my best friend did earlier this evening. Loneliness is one of the curses of depression, and knowing who your truly understanding allies are can help to fend off that loneliness when it becomes too much to bear; I imagine this could be true for any mental illness, that the establishing of a small group of intimately trusted people who can grok your fullness can save you in those circumstances when your mind is seeking rather to betray you.

22 Days of Musing: 14

14. Zero drive.

Tonight I’m not feeling any particular drive to write a reflection. I suppose that, in itself, bears talking about. Much as the antidepressants do help me avoid the deep troughs of psychological anguish that used to haunt me, they’re not a panacea by any stretch of the imagination; their function seems to be more to stabilise my mood at a tolerable level, rather than to restore a “normal” pattern of mood – whatever the fuck that might be, as every person has their own unique patterns of mood and all are stimulated by a unique set of experiences – and although the stabilisation certainly does ferry me across the rough seas when they occur, it’s difficult still to find ways in which to bring myself genuinely positive states of mind. To an extent, the recognition during my bleak fortnight in 2011 that the things I used to do when I had the blues no longer worked was one of the factors that pushed me to seek help in the first place – the realisation that my spells of coming forth into daylight had lost their power, and that I needed to find new and more powerful ones. Music was for many years a means through which I could express my emotions in a raw, untrammelled manner; I played saxophone, guitar, clarinet, and harmonica at various stages in my childhood through to early adulthood, and even when I wasn’t actively playing music, I might’ve been singing along to a richly emotional ballad, or even just losing myself in the depths of a song whose harmonic lines seemed sometimes to bypass my ears completely and speak straight to my soul.

Regrets collect like old friends
Here to relive your darkest moments
I can see no way, I can see no way
And all of the ghouls come out to play
And every demon wants his pound of flesh
But I like to keep some things to myself
– Florence + The Machine, Shake It Out

Reading was long a means of escape I cherished, too. My tastes have always run in the direction of fantasy and science fiction themes – both the kind of pulpy smeg that, as fantasy author Jessica Amanda Salmonson puts it, is to literature as potato chips are to gourmet cooking (she herself offers the unarguable caveat that “potato chips are spiffy too”), as well as more grandiose or peculiar explorations of the human condition – but sometimes I fell for much different fare, as with Tim Willocks’s grimmer modern-day fiction, simultaneously more philosophical and yet more violent than much of what I read out of the SFF realm. But depression has largely robbed me of this as well, although there are exceptions: when I first read George R. R. Martin, I hadn’t read a new fiction book in over two years. I own over two thousand books, you see, and there was a time when I would visit the university market day and buy two or three second-hand books every week, read them, and then come back for more the next week. So to go for so long without feeling any interest in fiction (and I did try, numerous times) was itself a dark sign. Reading A Game of Thrones was a kind of revelation to me for that reason; I bought the first book new (normally an unthinkable luxury on my paltry student’s wage at the time), and I was so enthralled by his writing style, as well as by the fact that I had all of a sudden discovered fiction that moved me again, that I went out thereafter and purchased – also new – every single one of the subsequent books in the series. It was as though I’d learned to read all over again, and although it wasn’t able to bring me back to the reading obsession I used to foster, it did offer me back a little of the pure joy that I had long forgotten I could obtain from a book. Depression still largely keeps me from feeling excitement about doing things, and even when I do feel a thrill of excitement, a frisson of actually feeling something (a good example would be last week, a week during which I got notifications that one of my academic articles had been published and another two had been accepted for publication), it tends not to last; in the days where I’m not as positive as others – for even on the antidepressant medication, the stability of my mood is not complete – I tend to fall into a torpor of sorts, an inertia from which it becomes difficult to extract myself. The things that can draw me out of this inertia are rather less predictable now than they used to be, but they do still occur, every once in a while.

22 Days of Musing: 12

12. The candies of fun.

The treatment options available for mental illness are rich and varied, and include not only counselling – the first place I looked to for assistance, primarily because I was not in stable employment and the counselling service they offered through the university support services was free – but also psychological and psychiatric intervention that may or may not include medication. After some time spent working with the university counsellor, I experienced a general reduction in the severity of my symptoms, but not a complete dispersal by any means, and I had a relapse after a couple of months. But as I mentioned in yesterday’s reflection, in this little while I’d come to realise that there were additional options I could seek out through the public health system, and once I did my general practitioner was my next port of call; through him I was referred to a psychologist, and subsequently started on a combination of cognitive behavioural therapy and medication, with which we were able to get my depression more or less adequately managed.

When we anticipate, we’re the happiest. Unless you’re on antidepressants. The reason you take antidepressants is because you can’t anticipate. You think everything’s going to be horrible, so it usually is.
– Lewis Black

Previously I’d never thought about the idea that in my depression and anxiety a chronic illness might be affecting me, but after sitting down with the doctor and psychologist and developing a list of the episodes I’d experienced – not only since January, but since the first phase of depression I’d recognised in myself back in 2008 – it gradually dawned upon me that I was staring down the barrel of exactly that: chronic mixed depression and a social anxiety disorder (this is the precise nature of my illness as it was eventually diagnosed). Over the five years and a bit since my first diagnosis, I’ve been moved onto and off a range of medications: sertraline, desvenlafaxine, escitalopram, diazepam in a couple of instances where my anxiety has come to the fore unusually strongly, and most recently, paroxetine. Psychotropic medications of this sort can be of great assistance once the right one is found, but here also there are many challenges to confront. Starting on an antidepressant medication can disorient you, or even appear to worsen your symptoms for a short while. Missing a day of medication can unsettle you, either psychologically or physically (or both). Being on a medication too long can cause it to lose effectiveness – one of the reasons I’ve been on several different antidepressants; I was on sertraline for about three years before it lost its potency, desvenlafaxine for another year or so after that, escitalopram for just a few months (long enough to realise that it didn’t really work well for me), and paroxetine for the last few months. And changing from one medication to another, which necessitates spending a few days withdrawing slowly from the previous one to the upcoming one, can be even more disorienting than starting on antidepressants for the first time. That only happened to me once, fortunately, while coming down off desvenlafaxine; I’ve heard from other depression sufferers that this is one of the tougher therapeutic drugs to withdraw from, and the otherwise basically indescribable phenomenon some refer to as “brain zaps” were entirely alien to my experience. But they didn’t last long, thank goodness, and upon moving to the escitalopram they subsided within less than a day. I know people who are fundamentally opposed to much of psychiatric practice because of the use of psychoactive medications, but in my experience they’re a tool just like any other, to be respected but not feared; though times do occur when I feel as though the medications veil the positive and pleasant and desirable emotions nearly as much as it does the negative and painful and torturous ones, certainly I don’t think I would have made it through the last five years without their assistance.

22 Days of Musing: 10

10. The Big Bad Tale.

Two days ago I noted that often, those who need help most desperately are those least able to see any way out of their own private hell. Sometimes, though, the crash to the bottom of the pit can be so rapid, so deep and severe, that it becomes easier to see the necessity for assistance. So following on from yesterday’s scene-setting, tonight I’d like to – well, not like to, but I will – reflect upon the darkest single time in my entire life: the time when I first realised that I needed psychological help. (I speak this way only in the interest of candour; I apologise in advance for parts of this that will no doubt come across as melodramatic.) Yesterday I talked about first recognising depression in myself in 2008, and that many (though by no means all) of my subsequent experiences with depression would, like this first one, have at least something to do with the emotions surrounding romantic attraction. Let me explain: when I fall for someone romantically, I have a habit of letting those feelings grow more deeply than I should, meaning that when those feelings are removed they don’t slide out neatly like a cork from a bottle; it’s rather more like the uprooting of a tree, tearing away not only the feelings’ roots, but also taking little pieces of my heart with them and leaving raw and gaping wounds behind. It’s happened more times than I care to count, and isn’t helped by the fact that I find it difficult to perceive the subtle cues that most people use to signal romantic interest, so often I think someone might be interested romantically when they’re in fact just very friendly, or have particularly extroverted personalities, or whatever else. Because my dysfunctional romantic sense has sought out those connections and been disappointed so many times, I suppose it’s logical that eventually my subconscious would come to use depression as a means to seal off those psychic wounds: perhaps helping to prevent me from feeling the pain associated with sorrow, loss, grief, rejection.

And so it goes, and so it went also in late 2010, at a conference where I met a fellow archaeologist (I swore an oath to commit her name to damnatio memoriae both for my mental health and for her privacy, an oath I’ve broken only on specific request from previous partners), just finishing her honours. We’d spent the last night of the conference lying on the grass under the stars, talking and holding hands. When we had to leave the next morning, we exchanged contact details, and within a week she was already talking about flying to Brisbane to see me. Over the course of six weeks leading into early January, we exchanged hundreds of messages, chatted or spoke on the phone every single day, and she spoke of her intentions and hopes for us in a manner loud and clear that even my incompetent romantic antennae received. But the day she arrived here, she and I and some mutual friends had a barbeque and an overnight stay at a friend’s place, and after I left the following morning, it was as though extraterrestrials had abducted her, leaving behind a doppelgänger. She stopped responding to messages, she claimed she was feeling ill, she put off us spending one-on-one time, she reneged on coming to stay at my house, she wouldn’t engage with me while we were on a group trip to Dreamworld with our friends, and within a week she finally sent a message with the tired, sickening old saws that turn up on Internet listicles of breakup clichés (and all at once, into the bargain): saying how much I reminded her of her brother (excuse number 3 – bing!), that it was her and not me (excuse number 2 – bing!), that we both needed to focus on uni (excuse number 1 – bing!), and she just wasn’t ready for a relationship at all at that point (excuse number 9 – bing!); she also assured me she’d answer any questions I had about the breakup. Because she subsequently didn’t respond to any of my questions, though, I soon sought advice from a mutual friend to determine whether I’d done something wrong. And suddenly, I did get a response: a page of enraged text lashing out at me about how I’d betrayed her trust and how I’d mistreated her by going behind her back. It was through this period of about a week that I fell headlong into a pit the likes of which I’d never experienced. Cast downwards at first by her sudden cooling towards me and the anxiety, confusion, sadness and disappointment they caused – just before she arrived I had decided to summon the strength to tell her about my feelings of gender variance (at least such as I understood them at the time), something that at that point I had shared with no-one – her angry message ignited a rocket rushing me swiftly down through a blackness into which light shone not at all, the very pit of Apollyon. I had just enough emotional strength left to send a single email to her to respond to her anger, speak in my own defence, and tell her I thought it would be best if we didn’t speak for a while. And for two weeks I lay on a futon, picking myself up only to use the toilet; while awake I stared at the television, not really watching it at all, as all 256 episodes of M*A*S*H (120-odd hours of television) played back-to-back from my hard drive. The only emotion that touched me was utter despair. Except when a family dinner had been prepared, I drank only water and ate nothing. I lost five kilos over those two weeks and by the end of the second week I could clearly see – intellectually, at least – that this was in practice coming close to a depressive catatonia and that I wouldn’t be able to climb out of this pit on my own. That was when I realised I needed help, and I’ll tell you more tomorrow about how I began to act in seeking it.

“Sometimes I lie awake at night, and I ask, ‘Where have I gone wrong?’ Then a voice says to me, ‘This is going to take more than one night.'”
– Charles M. Schulz

22 Days of Musing: 9

9. The scene is set.

In tonight’s reflection I was finally going to tell the story of coming to realise I needed psychological treatment, the one I alluded to previously. But after having attempted to write out a retelling of the story in the fullness it requires, I realise that I’ll need to put that off just one more day and use this post to set the scene first, by talking about my first experience of recognising depression in myself at all. This is necessary to a comprehensive telling mainly because the first experience helped me to understand what depression even was; as I described in the very first of this series of reflections, I’ve felt anxiety to a greater or lesser extent ever since I was very young (at least since I was about eight), but even though depression runs strongly in my family and has had substantive impacts upon it for at least thirty years that I know of, I had no understanding at all of the concept of depression while I was growing up. Indeed, nobody ever really taught me what mental illness was in a more general sense; these were things I had to discover for myself as I grew up. Consequently, I always thought of myself as little more than cowardly or even afraid, rather than having an anxiety disorder, and though I do remember times through all my years of school when I felt isolated and alone and incapable – and cried many tears of pain in those times – I don’t know that I’d have referred to those episodes as depression, not as such. Once older, though, I had a better grasp of what depression truly is, and it was after catching up with an old primary school friend in March of 2008 that I wrote this in my first blog:

I can’t remember the last time I felt something I could truly class as “depression”; whenever it was, it was a long time ago. But I began to feel it yesterday, and can’t yet shake it… Not sad, not angry, not upset; just drained and empty, like there was a black hole inside my head sucking all of the positivity out of me. Perhaps someone who’s had clinically diagnosed depression can say whether this is it, but it sure as hell felt like it. It was a horrific feeling, and I’m still trying to work through it.

For a few years after this I continued to experience phases of this sort; often (though not always by any means) it would happen as a result of a romantic failure. Always the potential of actively approaching someone in the hopes of kindling a romantic relationship has brought on deep and terrible anxiety in me, moreso maybe than all other challenges, though these reflections are not the place for me to go into that issue in great detail (it plays a role in tomorrow’s reflection, though). In any case, this event in 2008 was the first time when I felt the utter emotional deadness and sense of futility that more recently have become almost normalised for me. A most frightening and unsettling aspect of that first phase of depression was not just that it was so foreign to me at that point, but also that it occurred almost as a kind of neurotransmitter crash after an occasion that really was not negative in any identifiable aspect whatsoever. I’d spent a wonderful, pleasant, fun, deep, charming, exciting night catching up with a woman who I’d not seen in twelve years and yet seemed to have a great deal in common with me, from musical tastes to book preferences to hopes for the future to favourite foods and drinks; we were almost the same height (I stand 185 cm, 6’1″ in the old money, and she was shorter than me by less than an inch), and we’d even both undergone exactly the same type of spinal surgery  at almost the same time in late 2007. I felt an extraordinary kinship with her, in addition to all the rich promise that romantic attraction conveys, and to have such an ecstatic emotional state collapse in on itself so devastatingly afterwards – and indeed, so rapidly – felt very strange and unwelcome. But it was only a relatively temporary phase, prolonged though it was by her ungraciously toying with my further attempts to get to know her better, and it passed soon enough without professional assistance. In 2011, however, I was not so fortunate. And this segues neatly into the Big Bad Tale.

22 Days of Musing: 8

Day 8. Shadows and daylight.

Tonight’s reflection is going to draw on some poncy philosophy, which I hope you don’t mind: as I said to a good friend today, many people have said many things at many points in history, and many of those words are far better than mine. I spoke in yesterday’s reflection about the way in which depression’s intractability is owed partly to the fact that it disables and attenuates exactly that part of the psyche that would otherwise help the sufferer seek treatment for it. For some people, this disabling of their drive to act is so entrenched that it prevents them from seeking that help at all (and I know someone just like this, someone who suffers from chronic untreated depression and a fundamental lack of self-esteem, but who’s rationalised not seeking further help by cultivating in themselves a mistrust of the entire field of mental health professionals based on a prior bad experience). Such is the paradox: those who need the help most desperately are often those who have fallen so far down into their own private abyss that they can no longer see light anywhere. And like the cavern dwellers in the seventh book of Plato’s Republic, who’ve similarly become so accustomed to seeing only dim shadows cast by fires on the wall as their only and therefore apparently “true” perception of reality, they may often lash out at one who’s ascended up out of the darkness to see the world we know illuminated and enriched by sunlight:

Would he not provoke laughter, and would it not be said of him that he had returned from his journey aloft with his eyes ruined and that it was not worthwhile even to attempt the ascent? And if it were possible to lay hands on and to kill the man who tried to release them and lead them up, would they not kill him?
– Plato, The Republic: VII.517a

Plato sought to speak primarily about education – or perhaps enlightenment is better – and its lack, but this is absolutely relevant to understanding depression as well. One who spends long enough in the pit becomes accustomed to the absence of light, and comes to accept an almost perfect dark as the norm, but such a one may also resist all attempts by others to raise them out, either through sheer inertia or active contrariness. My own experiences with depression have shown me that you have to realise it yourself: that if you need help, you must seek it out yourself, and all the help others can give you is of use only if you can first find a shred of will that still survives on the floor of your oubliette, even if it be hidden at first beneath inches of dust. There’s another metaphor involving illumination that I find useful in this aspect, though this one from Egyptian thought rather than the Greek. The funerary texts we call the Book of the Dead were used by Egyptian people to ensure that a part of the soul – the ; roughly, the sum of attributes that go to make an individual unique – was able to continue living after the death of the corporeal body. In Egyptian, these texts were referred to as rw nw prt m hrw “Spells of Coming Forth into Daylight”. I like this phrase and its cultural context as a metaphor for moving forth out of depression as well: emerging from the darkness of an emotional death of sorts, and entering into the daylight of renewed emotion, of being if not fully able, at least better able to feel pleasure; joy; humour; wonder; love. To do so, you have to write your own personal rw nw prt m hrw, in a sense. If you want to come forth into daylight, others can offer “spells” – techniques with great potential or exercises or materials for thought – that have worked for many people before you, and they may well work for you too, but you need to try them in order to discover which ones will succeed for you, and then you can add them to your own spellbook so you can reuse them when necessary. It’s a powerful thought and reassuring, that a written list of thought exercises from the psychologist, loving texts from friends that can be reread later, a folder of silly image macros that always call up involuntarily chortles, a hand-painted canvas with a strong fortifying quotation on it, can together act as a small (or sometimes large) push forward in helping me come forth into daylight – or, at least, come forth out of the darkness.

22 Days of Musing: 7

Day 7. Depression’s evolutionary self-interest.

I’d like to continue on a little from my mention yesterday of the listlessness and lethargy that depression brings, and draw an analogy: one that I think helps to explain why depression can be so intractable, and why it’s so difficult to just “snap out of it” or “get on with things” or “keep a stiff upper lip” or any of a thousand other pseudomotivational bullshit speechlets that one gets from well-meaning but largely deluded people who have never experienced or understood the havoc that depression truly wreaks on the psyche. I’ve said to a few friends that I’ve often thought of depression in some ways as the psychological equivalent of the human immunodeficiency virus. The analogy with HIV isn’t a complete one, mind; it’s largely predicated on one unusual property that both diseases share. Let me explain this thought a little further. Many viruses cause horrific illnesses that kill painfully and rapidly. Crimean-Congo haemorrhagic fever often causes death in less than two weeks after the initial infection, Ebola in as little as eight days. But from an evolutionary perspective, such viruses in humans are actually rather inefficient, because the disease progresses so rapidly and causes such substantial damage that the victim dies before they can effectively pass the virus on to others. (And despite how devastating the Ebola virus disease is in humans – the Zaïre outbreak in 1976 had an 88.1% fatality rate, higher than untreated typhoid, tuberculosis, and bubonic plague combined – it’s actually incredibly hard to catch, requiring direct contact with blood, faeces, or urine from an infected person.) HIV, on the other hand, is evolutionarily a close to perfect virus: though it also spreads via relatively narrow means, upon entering the body it wreaks its broad devastation by integrating itself directly into the host’s genome, such that it can become recognised as belonging to the body. Thenceforth, it begins to attack the immune system, that very system of the body that might otherwise be able to engage with and destroy the infection. As a consequence, HIV may persist and continue to reproduce for several years even without treatment (and in fact rarely even kills directly; death usually arises from other opportunistic infections or cancers that the ravaged immune system can no longer fight off). Again, I want to emphasise that there’s much that I don’t intend this analogy to include. But I think this targeting of the immune system in HIV is a good analogy for why depression, once it sets in in earnest, is a hard mental illness to treat effectively. Because of the way depression so effectively saps your motivation, your will, your drive to seek out things that bring you pleasure, and your ability to even feel that pleasure even when you do those things (a psychological state the professionals call anhedonia, from the same Greek root as the word hedonism, the devotion to the pursuit of pleasure), depression – like HIV attacking the immune system that would otherwise allow the body to successfully fight it off – affects and disables exactly that part of your mind that would allow you to go forth to seek help. It can just seem too problematic, or too daunting, or too much effort to seek assistance from those who specialise in mental health issues. Making appointments, meeting new doctors, visiting Medicare offices, negotiating the complexities of the healthcare system, all serve as hurdles to the one whose fundamental medical problem is a loss of drive to act in the first place. And as one with just that problem, that’s more than a little frustrating.

22 Days of Musing: 6

Day 6. One among many.

I’d originally had thoughts of writing this reflection on another topic entirely, but a comment on Facebook in which I was tagged by a friend was speaking on a topic that, upon reading it, took me like a mallet striking a gong in the dark: resonating unexpectedly, powerfully, and suddenly. Consequently, I found myself needing to write about this, and I’ll leave the other topic for another day (which I’m not unhappy about, in fairness, as it was going to be a topic which still distresses and confuses me when I talk about it; but that’ll come tomorrow, so enough). The topic I’ve decided to reflect on tonight is that of connectedness, both within the community of those who suffer from mental illness, and between sufferers and well people. You see, this comment on Facebook was that of a new friend I met through my best friend’s birthday party on the weekend, and part of the wonderfully emotive, complimentary, deep post she wrote was a brief defence of the value of Facebook as a means for interpersonal connectivity. This was a very small part of the post, truth be told, but it was the mallet-strike out of the darkness that set my thoughts resonating. And this is what I said in response:

Without Facebook, I would have long since mentally disintegrated by now. For those who suffer with depression and anxiety, as I do, Facebook allow us to continue to see how our friends’ lives are progressing when we don’t have the energy to interact, to interact by comments and sharing posts when we do have small amounts of energy to spend, to exchange messages and conversations and plan get-togethers when we have a greater energy reserve. And while I don’t really use Facebook to meet new people so much as I do to keep in contact (or to try, at least) with people I know already, it’s almost a lifeline of sorts for maintaining that contact.

The listlessness and lethargy that come along with depression do make keeping in touch with loved ones difficult indeed, and I’ve spoken to both my psychologist and my psychiatrist about the challenge posed by the constant tension between my conscious mind on the one hand – my intellectual desire to be in contact with people, to let them know how I am, to ask them how they are, to find out all that life is delivering to them and celebrate or enquire or empathise or offer assistance in those ways I can – and my emotional subcurrent on the other, the part that’s affected by and stunted by the depression, that steals away my motivation the moment I sit down to write a message or email to a friend. But I agree absolutely with this friend in the extraordinary utility of Facebook as a tool for the mentally ill person to maintain a lifeline to the outside world: to friends and family who may be widely dispersed even while incredibly dear, and also to those experiencing very similar challenges with their illnesses. It allows me to remain in contact with people as much as I’m able, to seek advice when I need it, to find a digital shoulder to cry on if it should become necessary. And if all I’m capable of on a given day is a sentence or two in a personal message, or a brief comment to a lolcat someone’s posted, so be it. (Whatever deities may exist, may they all bless the lolcat. There are days when funny image macros and memes can winch me out of the quicksand, and it can buoy me no end to know that someone I love wishes to bring cheer to their own friends by passing forward something they found pleasing. Even if it’s nothing more than a kitten in a beer glass, or a selfie with a quokka.) In any case, being part of a network of digitally active people on Facebook is a wonderful way of remembering – or being reminded, on those days when you struggle to keep hold of the thought yourself – that others are around you, that you are not alone, that people care for you, that people miss you, that people want you in their lives, that you bathe in the love of others. And to have all of that is to possess and be enriched by an immeasurable and infinitely beautiful gift; it’s just that sometimes, you need a bit of a poke to be reminded of it.

22 Days of Musing: 4 and 5

Day 4. Quick as lightning in its tracks.

As much as depression and the anxiety that accompanies it are a part of me, the way in which I perceive my mental illness is often as a sort of entity apart, almost (though not quite) a spiritual companion – albeit an entirely less than pleasant one. It helps me, sometimes, to conceptualise my illness this way in order to obtain a degree of psychological distance from it, which in its turn allows me to view it through a lens of greater objectivity while seeking to find ways to treat and ameliorate it effectively. It also seems as though it does actually have a kind of mind of its own on occasion; certainly it’s often the case that its ebb and flow seem to have not much in the way of pattern, and while there are events that can trigger a phase of depression, or an attack of anxiety, there are also many instances where I have no idea why I feel more poorly than I do at other times. It seems almost like the wendigo of Algonquin and other folklore, and latterly Algernon Blackwood’s classic supernatural story: a strange malevolent being of great “height and fiery speed”, and always at my back no matter how rapidly I turn around to face it. Sometimes it can be little more than a particular thought that spirits it into existence for its eldritch fingers to begin enlacing themselves into the convolutions of my brain. Then at other times, it’s as though its whispered chant – a silent siren call to a dangerous, isolating state in which the normal ability to emote disintegrates – has lowered a veil of tiredness and desolation over me, a magical mist out of which excitement, optimism and determination can’t filter.

“…for the Wendigo is simply the Call of the Wild personified, which some natures hear to their own destruction.”
– Algernon Blackwood, The Wendigo (1910): IV

There are times that this helps, the metaphorical construction of my illness as an intangible but distinct being – not really an evil as such, but more an omnipresent irritation I’m constantly trying to learn how to deal with. There are times also when this conception is considerably less helpful, but it at least brings me a means by which I can maintain a clean separation between the depression and myself; it helps me to avoid being overtaken by it completely.


Day 5. In a mirror, lightly.

The reason why no separate reflection appeared on this blog yesterday was that I was out of range of wireless Interwebs, attending the 40th birthday party of my best friend in Armidale, some six hours’ drive from my home city of Brisbane. And upon my return, I feel that this is an excellent opportunity for me to turn these reflections on their head in a sense, and speak on one of those times during which the coin I spoke about in an earlier reflection has been successfully flipped in the air, overturning the void-swallowed obverse of the coin and revealing the reverse face, rich with the spectrum of emotion. With the exception of a hard lightning-strike of anxiety associated with a sudden change in plans today that I took very badly for a short while, the past 48 hours have been wonderful. Filled with excitement, joy, intrigue, awe, gladness, fascination, intellectual debate, and perhaps a little hilarity under the influence of a little cider and sangría, it was a night and a day of gorgeous emotional positivity that I’ve not experienced much of in the last little while. Few of the people at my friend’s birthday shindig were people I knew personally, but I knew several from either direct or indirect interactions on Facebook, some I’d met previously although briefly, and some were complete strangers. But after some initial uncertainty and anxiety on my part, the night progressed with all the celebration a good party requires, and much more besides. An exceedingly intelligent, well-informed group of partygoers interested in a wide variety of topics of conversation – gender politics, potty humour, quantum physics, gothic country music, natural and constructed linguistics – brought me pleasure of a rare magnitude, and every conversation I engaged in was a genuine treat. The reason I speak of all this in such glowing terms is that this, too, is depression. Or at least, it’s part of the broader phenomenon of depression, which need not be continuous and inexorable; if depressed people have good days, or feel happy or pleased or excited temporarily, that is not to say that they are suddenly “no longer depressed”. Depression is a descriptor for a condition moreso than a specific disease, and can be symptomatic of a wide array of underlying disorders. What this means is that a person may experience depression in a manner that might be constant, or periodic, or seasonal, or largely aperiodic. Some types of depression may even show temporary improvement in the presence of positive stimuli. In my previous reflection I spoke about the aperiodicity of my own depression, and the fact that even if I’m not suffering from a phase of that depression, a specific event (whether it be by words or by actions) can sometimes shove me into the zone in which my emotions shut down for the sake of self-preservation. The opposite is rarely true – it’s hard to move out of that zone once I’m there – but certainly I’m still capable of feeling, of emoting, and of enjoying, while I’m psychologically not in that zone. Depression may be a crippling disability, but sufferers still may have occasional bouts of relief; for my part, I usually try to take advantage of my rare such periods whenever I’m gifted with them, as I managed this weekend (although having to push through much anxiety to make myself go in the first place). And for the fact that such relief does come to me at all, I’m infinitely grateful.