Depression and me: ‘Ireland was where things took a turn for the worse’

Brianna Clark first attended therapy as a child and says it quickly became part and parcel of her life.

“Therapy saw me through an emotionally unstable childhood as my life was always in a state of turmoil or upheaval,” says the American-born 29-year-old. “At some point during my adolescence, I subconsciously developed the notion that I would always attend therapy because it was a regular part of my life and I thought I would always need help – it was only after I started meeting with my current therapist that I realised how dangerous and counterintuitive that idea actually is. The goal I now have is to ‘make therapy redundant’, with the knowledge that I can always go back to it when I need it.

“But I can say confidently that in the US, particularly New York city, where I am from, that therapy is viewed positively and is certainly mainstream. I’ll also admit that in America, therapy is often a lifelong commitment, and when you are depressed for life, that whole chronicle becomes an extension of you.”

The biggest effect depression had on me is unrelenting self-loathing

Clark, who lives in Dublin with her boyfriend, Dave, and their puppy, Choo Choo, says depression takes many forms for her. It often leaves her disliking herself. “A common misconception is that depression is just loneliness or sadness, but for me, it also includes disconnectedness, feeling out of touch and questioning my very existence and place in the world – along with waffling, vacillating, wondering if I made the right choices and comparing myself to others.

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“The biggest effect depression had on me is unrelenting self-loathing. I unabashedly hate myself and wear my self-hate like a badge. Only now, in the self-work I’m doing, am I learning that it isn’t too late to speak to the little girl who endured some awful things, and I can look out for her and tell her it’s going to be okay.

“There’s a myriad of physical symptoms, too, like brain fog, grinding my teeth at night, a tense back, and aches and pains atypical of a 29-year-old woman – which also include fatigue and oversleeping, acne, weight gain, greasy hair and vision loss from staring at my phone – the list is infinite.”

Giving advice

Clark has been seeking help for years and is a "champion" of mental health awareness (this week is Aware Mental Health Week, with World Mental Health Day on October 10th)."I push the advocacy element outward in my darkest days, when I'm not helping myself," she says. "I've gone to therapy. I volunteer for organisations, such as Aware, at the helm of change. I participate in yearly walks for suicide prevention. I've seen acupuncturists and massage therapists and I do mindfulness stuff. Most importantly, I do not hide the part of me that begs to be seen and I remind myself that change takes time. But I also give a lot of advice that I don't take – so I don't eat well or exercise and don't ask for help when I need it.

“I tend to fall victim to my own pattern, which involves taking a sledgehammer to every good thing in my life and smashing it to oblivion. I am not meant to get better, yet I’m constantly fighting to get better, and in my desperate bid to do this – whether it’s to find the medication that works or to find a job that’s my “true calling” – my life weaves itself in and around my poor mental health all the time. Depression and I have been inseparable bedfellows for as long as I can remember. It has been the elephant in the room, the caveat, the ‘but’ of every conversation, large or small.”

She has had suicidal thoughts and has lost a friend to suicide, but after deciding three years ago that she needed to change something in her life, she moved to Ireland to study, but her mental health issues intensified.

“Ireland was where things took a turn for the worse,” she says. “Things happened to me that I thought only happened in films, such as hospitalisation and being let go from a job because I had depression. Covid-19 limited my access to services and, emotionally, I’m in a place I’ve never been before and it scares me.

“I’ve disengaged almost completely from everything and have stopped looking after myself, stopped eating well, and deliberately lost touch with people. I’m intentionally fading away little by little, convinced that there’s not much of me worth saving. I feel like I’m beyond repair.

“Most recently, depression has silenced me in a way I didn’t think was possible. My mother flew over at the height of Covid-19 because she was so worried – but I felt her words bounce off me and ping back to her.”

A&E or a walk

Clark believes that the Irish healthcare system ‘worked against’ her, despite her best efforts to fight it. “When I arrived at university, I sought counselling immediately and although the waiting list was months long, when I articulated feeling suicidal, I was bumped up the list considerably.

“But I was just given two options at my appointment: A&E, or ‘a walk around Merrion Square’. I thought this was a joke. The counsellor asked if I had a ‘plan’ to take my life. I didn’t, but I was sitting there unshowered and barely alive. I didn’t want to take a bed from someone in the emergency room, particularly as my friend said they’d stick an IV in me and send me home. So what did we do? We took a walk around Merrion Square.

“I demanded a therapist and a psychiatrist to sort out my medication, but the wait list was upwards of six months, so I was put on inpatient list for St Patrick’s Mental Health Hospital as I had private healthcare – without it I don’t know where I’d be. In the interim, my mother sent medication to me from the States.

“I don’t think Ireland was prepared for me – a woman who was well accustomed to patient advocacy and wanted to be in charge of her medication regimen and treatment options. I was ignorant of the fact that Ireland is decades behind America in terms of mental health treatment – and if I knew then what I know now about the system, I would have told myself to run while there was still time.”

System in ‘crisis’

Clark has encountered other issues with the care she has received since her time in Ireland and believes that the mental health system in this country is in “crisis”.

“It is a matter of national attention and urgency, and change needs to happen,” she says. “I’ve never felt more galvanised by a single thing than this because there are people dying before they can get help. Mental health funding represents 5.1 per cent of the total health budget. There are thousands of children waiting to see CAMHS [Child and Adolescent Mental Health Services] specialists, and adults can wait years before being seen by a mental health professional. Then, by the time you finally find help, you’re met with overworked and underpaid staff and funnelled through the system as quickly as possible due to the demand.

As it stands, right now, there is no actual help for people with mental health issues

“People are bravely coming forward, now more than ever, and we need to listen to them as it is historically difficult for people to come forward. As it stands, right now, there is no actual help for people with mental health issues. There are resources and systems in place, but they are largely dysfunctional and inadequate, lacking a human touch for a problem that is of the human condition.

“I come from a place where affordable medication is at the forefront, resources abound, and there is no shame in seeking help. It’s a bigger and more diverse place, but that doesn’t mean Ireland can’t follow a similar model philosophically and institutionally. Technology, research and knowledge about mental health has advanced significantly and we are stuck in an antiquated system that is literally killing people.

“This is literally a matter of life or death, and we need to start acting like it.”

Get support:
– Pieta House, 1800 247 247, text HELP to 51444.
– Samaritans, 116 123, jo@samaritans.ie.
– Suicide Or Survive, 1890 577 577, info@suicideorsurvive.ie.
– Aware, 1800 80 48 48, supportmail@aware.ie.
– Childline, 1800 666 666, text 5101.
– HSE Drugs and Alcohol helpline, 1800 459 459, helpline@hse.ie.
– Traveller Counselling Service, (01) 868 5761, 086 308 1476, info@travellercounselling.ie.
– HSE Crisis Text Service, Text 50808.
– St Patrick's Mental Health Services, (01) 249 3333, info@stpatsmail.com.
– Alone, 0818 222 024, hello@alone.ie