Sunday, 26 May 2013

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Be back soon with more important things...

Wednesday, 1 May 2013

Musings on my mental illness

Okay, so the current bout of depression has me facing some facts I would rather not face.

1. I will probably struggle with depression my whole life.
I don't want this to be true and I know that there is always a chance that the perfect pill, learning to live with myself better and a miracle are all possible and that a future without depression could happen. But the present situation provides a great deal of evidence to the contrary. And I hate that this could be true. It sucks for me and my family, especially my husband. It is knowing you will live with a person who has a chronic illness which impacts on their ability to be themselves and function and be the partner that are supposed to be. I can't speak for him. But I hate that our future could be punctuated with me disappearing under a black cloud and him having to cope with it.

2. My meds aren't working anymore.
I have increased the dose and the anxiety is gone, mostly. But the dispair has really moved in to stay, as it were. This means I will probably have to change meds. This is terrifying as the process can make you feel even worse, before you feel better, and there is no guarantee that I will only have to switch once.

3. There is no magic fix for this.
I have been through this enough times now to know that no one thing will make enough difference.

Here are the basic models of treatment and recovery from my very amateur observations and reading:
  • The JK way (John Kirwan) - he credits his recovery and wellness with active relaxation and exercise. 
  • The "Live More Awesome" way - this is the guy who set a goal to float down the Waikato river on a lilo to raise money for the Mental Health Foundation. He also recently created the longest water slide ever. He doesn't believe in therapy so much as setting big goals, the achievement of which make life exciting and worth living for.
  • The talk therapy way - there is a lot of evidence for the efficacy of various forms of therapy to help work through issues or experiences which may contribute to mental illness. However, it is quite dependent on the relationship with the therapist. I personally have found psychotherapy really helpful. The principles behind it is that the actual relationship you have with the therapist can be used to face things in a safe and empathetic way and also learn how healthy relationships can function.
  • Cognitive behavioural therapy - this focusses on how the thoughts we have can help or hinder our mental health. What stories do we tell ourselves about the world around us, the people we interact with and daily events? What assumptions do we make? Is their really evidence for that? It encourages changes in thinking patterns to move away from thinking that isn't useful or helpful. 
  • Natural therapies - this may include supplements, diet changes, acupuncture etc. There is a lot of evidence to support some approaches and diddly squat for others. You also have to be very careful because often medications for mental illness have contraindications with natural medicines and herbs. There are also people making bucket loads of money off vulnerable and desperate people.
  • Healthy lifestyle - good diet and exercise all help to increase the good feelings in the body. Eating like crap and living on the couch would make anyone feel a bit gloomy. That said, if you in the throws of depression the energy required to do anything seems to require superhuman effort. I am not a great example of using this approach ;)
  • The skills approach - this aims to increase a person's resilience to the ups and downs of life by introducing skills which give a person greater control and mastery over their mental state. Psychologists often focus on this and CBT is part of this approach. This may include mindfulness techniques, meditation, strategies to use in a crisis or when a mood or action is triggered. 
  • A spiritual approach - this has overlaps with other approaches and can be as vague or as structured as the spiritual beliefs which the approach is based on. There is the very unhelpful "mental illness is demonic possession" approach. Now I am a Christian and I do believe in evil as an actual thing in the world, but it is not wise to tell someone with a mental illness that they have a demon in them. The people I know who are wise and discerning in the church understand that one prayer session may not bring the instant healing which we all would love to occur. But I do believe that a Christian faith built on the knowledge of being unconditionally loved by God, that we are all messed in some way, that we can be forgiven and healed and live a purposeful and significant life, can be a truth that helps to heal and provide the comfort in despair that  makes a difference. I personally have had times when my anxiety was crippling and prayer, with no words, just my spirit groaning, was all that brought relief. But depression is not a sign of a person's spiritual failings or lack of faith. We live in a broken world with broken people who hurt each other. And all of us suffer in some way for that. For other people Buddhism, and other spiritual practises create meaning and peace in a way that can make a significant impact on their mental well being. We are all spiritual and it is an aspect of our existence which is often the part most in pain and most seeking of hope and significance.
Probably a mixture of all of the above will work or help most people. I have done the therapy, some cbt, some mindfulness. I am definitely not an "active relaxer" like John Kirwan but it is really good for me to get engrossed in an activity such as gardening or scrapbooking( I feel no shame). Exercise and diet definitely make a difference too. But my perfectionist tendencies mean I have to be very careful about how to approach it. I am also not one for 'out there' goals. Worship in church and the singing that is part of it really can help me. But sometimes it seems that God has hit the mute button and all I have is doubt and confusion.

This time around I am not going to use therapy - as I read recently on the Live More Awesome facebook page "shit in a food processor still comes out as shit". For me I think I need to let go of all the stuff I could use to explain my depression. I just don't want to be depressed anymore. I have talked a lot. Now I just want to get on with life.
Meds will continue to be part of my life and actually I really need this to work so that I can do anything else that could help.
Healthy living is definitely a priority - sleep being the major one and some regular exercise. I reserve the right to eat junk cause at 3pm in the afternoon with two preschoolers it can be the life raft.
I think I want to focus more on how my faith could counteract some of the intrusive and negative thinking that plagues me. Maybe I will find someone who I can talk to who has expertise in that.

If you get a chance to listen you should check out the interview with Mike King on Radio NZ. He runs the Nutters Club on ZB which encourages people to phone in a talk about their struggles with mental illness. He is making it not taboo and speaking to groups about how we can all support those with mental illness. He is honest about his own journey and I found what he said really refreshing.

The thing I guess that I wish people realised is that depression is deadly. It kills so many people each year in NZ. It makes people feel there is no hope, no escape and that taking your own life is a reasonable choice to make. A lot of people express anger if someone chooses to end their life. Their actions appear selfish and self indulgent, leaving so much pain and grief, questions and guilt. But if you can just imagine how awful someone would have to feel to make that choice, then hopefully you can remember that when someone says they are stuggling with depression. Because no matter how much they tell you about how hard life is for them, they will never tell you how truly torturous it is.

So tomorrow I will have my appointment with the adult mental health team. I will become an official mental health "consumer" again. And I really hope that somehow, someone whose mind is working well for them, can help me through this time. I am fresh out of brilliant ideas.