Living with the waking nightmare of depression
Instead of talking about recovery from depression, it is important to talk about acceptance and understanding
Fiona Kennedy: ‘Medications help, therapies help but there’s no magic bullet. It takes time, a lot of support and a lot of effort.’ Photograph: Joe O’Shaughnessy
Language is a powerful tool, and how we talk about a particular subject frames and reinforces what we think about it. Mental health is no exception. I’ve long had issues with phrases such as “suffering from” mental illness and, to a lesser extent, words such as “recovery”. While “suffering from” is more of a bugbear for me personally, I think “recovery” is a far more loaded word in the broader sense.
Back when depression first became a serious problem for me, and then when it subsequently passed, I assumed I had “recovered”.
I thought that was the last I would see of depression, that it would be an unpleasant memory but something that could be consigned to the past.
The reality could not have been further from this, because over the years I’ve come to recognise that depression is, and quite likely always will be to one extent or another, simply part of my life, part of who I am. It’s not all of who I am, not by a long shot, but there are times when it takes over to such an extent that it overshadows everything.
It has led to two severe bouts of postnatal depression, as well as several other episodes since then; two periods of extended sick leave from work; one prolonged stay in a psychiatric unit; self-harm; suicidal ideation; and complete withdrawal from family and friends.
It has left me at times angry beyond words and incapable of rational thought, or else numb to the point of sitting and staring at nothing for hours on end.
It has led me to being unable to look after myself or my kids, and to unimaginable strain on my marriage. It has left me sitting on the kitchen floor, sobbing without knowing why, screaming with a rage that I couldn’t hold back, or kicking doors and walls in pure frustration.
It has affected my ability to work, to be a friend, a wife and a parent. There isn’t a single aspect of my life that has been untouched by this.
Borderline personality disorder
All of this has been compounded by another, only recently diagnosed disorder – borderline personality disorder (BPD).
This is a really tricky one. It takes years to diagnose and is incredibly complex to treat. It involves medication, talk therapy and almost constant awareness of my thought processes, responses and reactions to whatever situation I find myself in.
Management of it is challenging at the best of times but when depression comes into play as well it becomes all but impossible.
Even the simple act of waking up is unbearable, like trying to pull myself out of the deepest hole, while all the while being pulled back down and, not only that, fighting against the urge to give in and allow myself to be pulled down. Giving in would at times have felt like such a relief.
Everything becomes the most monumental chore. Actually, no, chore isn’t nearly a strong enough word.
Using a vacuum cleaner is a chore. Unloading the dishwasher is a really tedious chore. But waking up, surfacing from the relative peace of sleep into yet another day with a depressed mind tainting every thought, and every action? That’s so much more than a chore. It’s a waking nightmare.
As a result of all of this, I am very wary of the term “recovery” when it comes to talking about mental illness, because although I have recovered, I have also relapsed, time and time again.
I realise that this is not what a lot of people want to hear, and I don’t want to discourage anyone who may be struggling, but I think it’s important to be realistic about the possibility of full recovery from severe mental illness: that is, to the point where it will never return.
In talking about my current and ongoing state of mental health, recovery does not feel like the most appropriate word to use. I’ve been warned to expect further bouts of depression – apparently each episode leaves it more likely that another one will occur. I am still only at the very early stages of trying to understand BPD and all that it entails.
I don’t think I have recovered so much as I have learned (and I hasten to add I’m very much still learning) how to manage these conditions.
Every episode has taught me something about my triggers, about the helpful and at times profoundly unhelpful coping mechanisms I’ve developed, and ways that I can help get myself back on track again.
Acceptance and understanding
So instead of talking about recovery, I think it is equally important to talk about acceptance
and understanding. People are often wary of being assigned labels, and I have two big ones. I fought against them, repeatedly. I’ve had countless arguments with both my psychiatrist and my therapist as to whether or not depression is a real illness or whether I genuinely have BPD.
I don’t want these labels and I’d gladly not have them, but ignoring them won’t change the situation or make it any easier to handle.
What helps – and I know this from bitter experience – is trying to accept where I’m at at any given time, whether that is good or bad.
What also helps is understanding, or at least trying to understand, why I have reacted to a particular situation in the way I have, or why sometimes my mood is erratic.
It has taken a long time and a lot of therapy to be able to recognise my triggers.
I could recite the main contenders in my sleep but that still doesn’t mean I can always avoid them. Sometimes I don’t want to avoid them.
If I’m feeling in a more destructive mood, I will actively avoid doing what I know will help.
I realise how ridiculous and self-defeating this sounds but it’s all part of what I’ve got. It’s almost as if every now and then I need to put myself to the test, to see just how far I can push it before I’ll snap. It’s never a smart move.
Thankfully it’s something I have done much less of lately, but it still happens.
So, recovery? For some people maybe complete recovery is possible. It could be argued that recovery is possible for everyone, in that depressive episodes pass, and the more difficult aspects of BPD can be managed.
But I also think there’s the danger of false hope and, consequently, a minimising of the responsibility that anyone experiencing mental health problems has to take for their wellbeing.
Medications help, therapies help but there’s no magic bullet. It takes time, a lot of support and a lot of effort to get through these episodes.
But there is a flip side to all this. All the time and effort that goes into understanding and managing these conditions brings huge learning. It has given my marriage a strength I never knew it could have, because we had to fight for the longest time to stay together.
It has helped me to have far greater compassion for and understanding of what other people may be experiencing.
It has made me far more aware of my children’s mental health and how important it is to teach them to be able to manage their emotions; and, even more importantly, to teach them it’s okay to allow themselves experience both positive and negative emotions.
I would rather all the crises of the past few years had not happened, but at the same time I’m very grateful for where they have brought me to. Given the choice, would I do it again? Would I change anything?
Ideally I’d have got to where I am now without any of the heartache that got me this far. But without that heartache, I don’t think I’d be the person I am today. Right now I’m well.
Have I recovered? Who knows. Today, at least, I can accept that.
Contact Fiona Kennedy