I would probably rather forget about it when I’m well, and if you read on you will probably quickly come to understand why. But I think it’s so important for people to recognise what it is like to live in the midst of an episode of depression or anxiety to get an idea of how, frankly, fucking awful it is. It’s the worst thing I can imagine and I would wish it on nobody. Stanford’s Professor Robert Sapolsky describes depression as “basically the worst disease you can get”. So, wrap yourself in a blanket, make sure you have some chocolate or ice cream to hand, brace yourself and read on to find out what it’s been like for me…
Sliding into the abyss
My most recent and significant episode hit in the summer of 2012. Up until that point I had been bouncing along, having been reasonably well for about 5 years and not looking back. I was ‘in my prime’ - the fittest I’d ever been, getting stuck into a fledgling career which had recently taken me on a trip to India. I was enjoying unprecedented success (by my humble standards) on the dating front. I had started to believe I was ‘cured’ (and what a mistake that turned out to be!). But, a particularly intense romance ended a little abruptly and things started to quickly unravel for me.
I can remember being confused about my feelings at first – I seemed unable to grieve for a relationship which I had lost. I felt stupid for feeling so distracted and bummed about a 6-week fling, and I couldn’t imagine ever feeling so attracted to anyone else ever again. I had been so taken by this relationship that I almost didn’t recognise the life I was coming back to. My inability to move on quickly turned into distress. I remember looking myself in the mirror at one point trying to ‘shake it off’ and feeling strangely disconnected from the face that was staring back at me.
BANG, like a shot to the heart, I was disabled. I started panicking that ‘it was all coming back again’ (in fact, I ‘knew’ it was coming back again). I started losing sleep, losing focus at work, losing interest and enjoyment in things. Yet I cared so deeply that I could enjoy things and move on just to show her, myself and the world that I was doing OK and I was in control. After all, I was ‘cured’ wasn’t I? All the while I was trying to grab desperately on to anything that felt like a ‘normal’ frame of reference and I couldn’t get a grip.
Before long I was seeking help from the doctor, calling my parents several times a day. I had given up cycling to work through a fear that I might do something stupid in the traffic on my bike and I was trying to come to terms with what was going on. “It’s OK, you’re going to feel better, you know what to do and it’ll just need a couple of weeks” everyone told me. What they, and I, didn’t realise was that I was already sunk.
Living with co-morbid and severe Anxiety and Depression feels like being in the world’s longest and most awful boxing match. Except when the bell goes to signal the end of a round with Anxiety, you head straight into another round with Depression. They work together in a savage and unrelenting barrage of 1-2 punches and it feels like you’re giving it everything but you don’t stand a chance. And the referee isn’t there to stop the fight when you’re on the floor. Eventually you just curl up in a ball and take it, and you feel fucking pathetic.
For me, the anxiety at this point isn’t like ‘sheer panic’ although I did have a bit of that from time to time. It was more like a relentless sense of worry and alertness that doesn’t have an off-switch. It hits you all the time and at any time. Imagine a situation where your life is genuinely in danger. Imagine what the adrenaline coursing through your veins feels like. Imagine the thoughts and fears going through your mind. Now imagine that it’s like that but for months on end and the thing that controls it is all in your mind. To give you a flavour, here are some of the worries I became fixated on:
“What if this gets worse and I need to quit my job, give up my house, go home and live with my parents? I will have nothing left”
“I’m no good to anyone and no one wants to be around me and I will end up alone”
“What if life is fundamentally meaningless?”
“What if I lose control and throw myself in front of the tube”
“What if I give up and want to kill myself?” (this was the most upsetting for me)
Now: Go back and read that list again. And again. And again.
Unpleasant isn't it? This is what my anxiety was like. I had these thoughts rattling around inside my head, going round, and round, and round. Not some of the time. It was ALL the time. It is so unpleasant. And that unpleasantness is the thing. It feels so uncomfortable and alarming to be thinking these kinds of thoughts that you can’t just ignore or dismiss them. It will seem like your only options are to:
“Solve” the problem*
Give up and die*
*Note neither of these were the right answer. More about this in another blog...
Seems like an easy choice, right? So… you begin to try really very hard to rationalise and convince yourself that really things are OK. This kind of anxiety soon gives way to a fully-fledged obsession as you try to crack the riddle because, in your mind, your life depends on it. It was the only thing I wanted to talk about but no one else wanted to. The only thing is, these are problems that can’t be solved. You can’t know for sure that:
“Things won’t get worse”
“I won’t end up alone”
“Life has a fundamental purpose and meaning”
“I won’t lose control and throw myself in front of the tube”
“I won’t ever give up and want to kill myself”
Soon you find out that these problems can’t be solved rationally. And by this point your poor, frazzled, muddled, desperate and yet surprisingly nit-picking husk of a brain starts to face up to option 2 as a feasible alternative. This paves the way either to more frantic anxiety, or its equally formidable tag-team twin brother.
The depression side of things is much less dramatic albeit equally shit. There is no panic, no sadness, no loss. In fact, there’s very little at all – just a void of emotion, punctuated by gut-wrenching panic and anxiety (see above). It’s quite hard to describe to someone who hasn’t experienced it – but perhaps try to imagine you haven’t slept or eaten for 3 days and you might begin to get a feel for it.
Sure, you can see, hear, smell and taste things, although the senses feel a bit kind of dulled out. But there is absolutely no joy, pleasure, fun or motivation for anything. Just a complete emotional flatline. At first you try to do things that you normally enjoy but you get nothing in return. Things and people start to lose their significance and meaning. You begin to turn inwards, looking to your body for familiar sensations or feelings of ‘joy’ only to find dull aches in your shoulders, sides, neck and legs, and a sort of hollow, crushing feeling in your chest. I remember playing squash with my flatmate in the hope that some exercise would help. But even when I won, I didn’t care – it made no difference.
During every prolonged depression I’ve had, I have started to become convinced that joy and pleasure aren’t real at all. I start to question whether they are imagined constructs – a cruel trick of nature designed to keep you going so that you can reproduce and pass on your genes and nothing else. I have begun to feel like I’m enlightened and seeing life as it really is – a pointless, meaningless and insignificant existence. You can only live for so long with that and it makes me shiver even to think about it.
When you start to think about the world like this, you absolutely lose the will to do anything – to eat, to drink, to go out and see friends. There are points when I’ve wondered what the point of going to the toilet was (don’t worry, I always did!). You fear being on your own for the risk of anxiety setting in, but you don’t see any point in going out since you know fine well you won’t enjoy it. Besides, thoughts like “what if I really struggle getting on the tube” are still ripe in your mind. The only reason I did anything, really, is because I had to and because rationally I knew staying in bed wasn’t going to help things. Emotionally however I couldn’t have given a shit. Mornings were the worst. On so many occasions my parents would have to talk me into getting out of bed and going to work to face another, insipid day. Everything took effort.
The other thing I haven’t really mentioned until now are the physical symptoms. There are the sensations I have mentioned, of course, but there were many others, the King of which was insomnia. It was a constant struggle to get to sleep and stay asleep. Some days I existed on one hour of shuteye and I remember drifting off in work meetings in the day. Between August and December, 2012, I think I watched every episode of QI that ever existed on YouTube from my bed, hoping I'd drift off while watching it. You can imagine how tired and drawn I would be.
There was also sometimes intense nausea. This started when I was around 16 where I would throw up when my anxiety became unbearable. This would give me a temporary reprieve but it wasn’t pleasant and developed into a real problem where I would become terrified of throwing up in public. I will spare the gruesome details for now but weight loss was inevitable. There were also little things. My vision was awful because I couldn’t sleep properly. I often had a very strange, metallic taste in my mouth. My heart would sometimes feel like it would beat out of my chest and I was constantly tense.
I’m not sure but of the four major episodes of anxiety & depression I’ve experienced, I think this one might have edged the others. Before I fell ill, it’d been the longest I’d ever been without taking medication and I’d been doing well, but the hit I took was dramatic and overwhelming. I was a young(ish) and independent adult. I was on my own, save my flatmate/best pal who, to be fair, did his best to keep his patience with this pathetic lump I had become, sitting under a blanket on the couch. I knew what to do when it started but I didn’t react fast enough because I wanted to prove to myself I was OK. Before I knew it, I was in big, big, trouble.
In the end, I did all the right things. I went to the doctor and started to take Citalopram, a Selective Serotonin Reuptake Inhibitor (SSRI for short). Initially I was on a moderate dose but later we raised it to a higher dose when my symptoms carried on. I signed up for Cognitive Behaviour Therapy (CBT) which took waaaay too long to materialise (more about that in another post). I spoke to my parents all the time and they came to visit. We had family friends nearby who did their part. I kept on going to work and told my boss, who showed a good deal of discretion and understanding (miraculously, I even got promoted during that time!). I learned to bake bread from scratch and did a lot of online jigsaws to keep myself distracted. I also had some really, really great friends. The best among them fed me up and allowed me to curl up on their couch under a blanket and fall asleep without judgement. They would help me talk about things or let me just sit there and watch telly with them .
I couldn’t pick any one of these things above the others in terms of what helped me to get better. I think all were contributing factors, one way or another. Time of course, is another important factor. I think I had one good evening in November where I suddenly thought I was getting better but my elation evaporated the day after when I woke up. The first real green shoots of recovery started to become apparent in mid to late December. Not long after I’d upped my dosage I started to go out a little more and almost ‘found my feet’ with depression. I became a little less scared and I remember going to our work Christmas Lunch at the RAC club in London and singing Christmas Carols. I thought ‘fuck it’, had a couple of drinks and I remember smiling and laughing, just a little bit.
Throughout the Christmas holidays I had some ups and downs. Christmas day is always a hard one for me – but it was the first three days of January where I remember a real difference. I had enjoyed New Year’s Eve at a friend’s house until 5am in the morning. I then came home to Mum and Dad’s and gave myself the time and space not to do anything other than potter about the house and make bread. I’d spent enough time with my friends to feel like I had a life again, and I began to look forward to going back to London. I had even, against my better judgement, booked a short ski trip for the end of January and was looking forward to it. Soon after arriving back in London I was online looking at dating again, and soon after that, I met my now Fiancée, Katherine (more about her later).
To be honest, now more than 5 years down the line, I don’t think I’d ever want to say I’ve ‘fully recovered’. Since that time, I’ve worked with 5 more psychologists and I still take the same SSRIs on a slightly reduced dose. The next 6 months was very shaky and for the following year there were still a good few wobbles. Even now I still have significant ups and downs and I experience dips which last a week or two. I have been through a bout of OCD; although none of this is nearly as awful as the major episodes I describe above.
And so, that’s what it’s like. Bloody awful. Awful enough to make your parents and friends cry although I found it exceptionally difficult to cry for myself at the time. I used to think I wouldn’t want my depression to define me. But I think going through an experience like that (four times over) in some way must define you and I’ve come to a point now where, while I’d rather not experience it again, I can express gratitude for what it’s taught me about life. But most of all, it’s my truth and it’s an important basis for understanding everything else I will write about in this blog.
And that’s it. If you have made it this far, thanks for reading. I don’t imagine it was easy. I hope that this gives you a flavour for what it’s like to endure the torturous mental prison that is Depression and Anxiety. But more than that I hope it gives you a sense of why this is such an important topic and why I'm so passionate about it. I also hope that it inspires you to think about how we could change the world - either to make sure people don’t have to endure this kind of struggle; or to make sure the process of enduring it is easier for those that do.