Wednesday, 17 May 2017

Would You Just... Talk About It? Part Four

I've been struggling with depression again recently. It has been creeping back in over the months since restarting the antidepressants, creeping back through any cracks it can find. The medication holds it mostly at bay, but here and there it still trickles back in.

Getting up, getting moving, going to work are all more effort than they should be. I'm more tired at the end of even the easiest days. And days off when I have nothing I am forced to do it is all too easy to simply do nothing. Sticking with the writing is proving especially tough -- I'm finding I just don't care enough about it, or enough about anything.

Depression wears away at your ability to care, at your desires, your hopes, your passions, it blunts your essential life-force, whatever that is, whatever that means. At the milder end of the spectrum this life-force is only dulled round its edges, reigned in, but the more severe the depression, the more your spirit crumbles, right down to the complete collapse of a breakdown, and to the dark places beyond.

I am somewhere nearer the easier end at the moment, for sure, but I still feel it daily, am still plodding rather than skipping through my life. My spirit is still weak.

The antidepressants help, for me, but they are not a cure. As the writer Andrew Solomon puts it in The Noonday Demon, his superlative book on the subject, if depression is a vine entwining and strangling a healthy tree, then medication can push back the vine, but the tree beneath may still be withered and fragile, and pills alone will do little to help fresh shoots to grow.

This is an excellent analogy, but I am not sure if even this is completely true, if there even is a universal truth to depression to ever fully be understood. It is too nebulous a thing, too idiosyncratic, too intimately connected to who each of us is as a complete, living being. Unlike the vine and the tree, in reality there is no obvious dichotomy between what is the depression and what is the person underneath. Depression cannot simply be zapped away, like a patch of infected skin, because it infects everything, is a part of everything -- it is a curling at the edges of existence itself.

Nowhere is this more apparent than when it comes to treatment. Katie Hopkins recently Tweeted that "People with depression do not need a doctor and a bottle of something that rattles. They need a pair of running shoes and fresh air." This comment is clearly intended to be incendiary, to keep the spotlight on desperate, wretched Hopkins, and of course it is stupid and wrong, but I understand why it might have made sense in her head.

There are a million ways to maintain and refresh mental health -- exercise, yes, fresh air, yes, and eating well, getting early nights, getting up early in the mornings, having plenty of hobbies, meeting friends and socialising, discussing rather than bottling up problems, doing maths puzzles, reading, especially fiction and poetry, involving yourself in some kind of creative pursuit, limiting your time on social media, meditating, doing the morning pages, practising gratitude -- all of these things can either prevent or overcome depression.

The problem, however, is that they are all the things that are the hardest to do when you are depressed. Depression, in fact, basically is the inability to do these things.

When you are depressed you withdraw from life, your spirit withdraws, and so of course examples of a life lived to the full, which is what that list is, are the opposite of that. Not the antidote, but simply its opposite. Telling someone who is unable to get up and live their life that they would feel better if they got up and lived their life is tantamount to telling a diabetic that they should just produce more insulin.

Medication can, I think, cut away much of the pain of depression, and the various forms of therapy involve handing over your withdrawn spirit to a trained professional who can teach you routines and habits of thinking that will benefit that spirit -- but truly reigniting a dulled or extinguished life-force is a far more complex and involved undertaking than any health service can be reasonably expected to survive. There are no simple solutions.

Another analogy I like to use, although again, of course, it is only useful up to a point, is one of flower beds. If a depressed mind is like a flower bed where only sad and choking weeds grow, then medication is like the weed-killer that, sprayed every day, will continually push back the tangles, while therapy is like paying an experienced gardener to come down every week to teach you how to pull out the weeds by their roots and cultivate the rough soil and encourage more beautiful plants to grow.

But what I have found from my own experience, and this I believe corresponds to the data, is that once those sessions with the gardener are over, it is all too easy to start slipping back to your old ways, over perhaps years, and for more and more weeds to begin sprouting once again. It takes such an enormous strength of will to prevent this from happening, when the old ways are so ingrained. And strength of will is precisely what depression attacks first. Perhaps someone close to you comments that your garden is starting to look a little ragged again, that maybe you need to spend more time out there with the trowel, and you know this is true, of course you know, but you find you don't care enough to do it, you simply do not by yourself have the drive to work that soil, to grow those plants, to live your life.

And yet. People do recover from depression. They overcome it completely, or, more likely, they find a way to accept it, to structure their lives in a way to get the gardening done despite often not feeling like it, they create a reality that contains the fact of having a weaker spirit without being ruled by that fact.

Yes, an element to their garden will perhaps forever be darker, shrouded, they might always have to work harder to achieve less, and that danger of the weeds one day overcoming them and reclaiming all will never utterly be banished -- but they will have a garden, still, one for which they have battled hard, and the parts of it that blossom will appear to them, in comparison to the decay, more vital and glorious than anything they would ever otherwise have known.

So my depression is still here. I guess I wanted the medication and the work on this blog to have eradicated it, and that has not been the case. I don't think that ever will be the case. But that is all right. I get to be here, on this insane fabulous world, having this sometimes wonderful sometimes terrible adventure. If you are struggling as well, I am there with you, I understand. I'm not sure if it is the stronger, but as well as depression there also exists love. Whether you are in a position to feel it, there is also love. Hold onto that truth.

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