What happens after you’ve been diagnosed with depression? Let me tell you about my year…

Eight months ago, in April, I wrote about my long-time battle with depression, which included the declaration that “the rest of my life starts now”. That column generated a very warm response from friends, colleagues and peers in the journalist community and beyond. It was gratifying and humbling.

My “coming out” was cathartic and the response comforting beyond measure. Writing about my experience, many readers told me, was of great benefit to them, which made it a doubly rewarding experience.

I have wondered whether it would be appropriate to end 2014 with an account of how the “rest of my life” is progressing. Would it be an extravagance? An imposition on your goodwill? I hope not.

I’ve decided to provide some insight into my year not because I derive some perverse pleasure from laying bare my life, but because I believe it’s important to shine a light on what’s involved in overcoming, or at least getting a grip on, depression.

My intention is not to provide a treatise on depression and its treatment; this is my experience alone. And it’s only the first leg of a long journey.

My depression began when I was a schoolboy, just 13 or 14. At that tender age I experienced the physical sensation of depression sitting on me like a thick, heavy “black fog”. (Churchill called it the “black dog” – the description doesn’t matter; its salient character is that it comes unbidden and stays for as long as it pleases.) These occasions were crippling, not linked to any particular cause or event. The sadness was overwhelming, and to my parents’ consternation I would burst into tears for no evident reason.

A maelstrom of emotions combined fear, guilt, introversion, self-loathing and desolation. Without realising it, at school I learnt to disguise it; I developed coping mechanisms. My time at university was much the same. Like many undergraduates my period of adjustment was difficult, but for me “difficult” meant periods of the blackest anguish.

Soon after graduating with my BA in history and political science I landed a job as a reporter for a country newspaper, a happy time and the first step in what would unfold to be a mostly satisfying career. Journalism was my solace.

The depression and its manifold symptoms continued, worsened, and were left untreated. I convinced myself that I was coping. The death of two brothers, my youngest, at 15, by his own hand, the other in a car crash at 22, within the space of four years, were largely suppressed as I buried myself in my work.

Learning to juggle career and depression seemed to be working, but I know now that I was simply delaying the inevitable crash.

Marriage and the birth of our three boys over 10 years provided me with a time of unconfined joy. But it was only a stay. As my beloved boys grew into their teens, the depression dug in, by now equally persistent at home and at work. That’s when my depression entered its most destructive phase: when work no longer provided a release for all that pent-up anguish.

And it all came crashing down

Despite doing what I regarded as my best work as a columnist for BRW and the Australian Financial Review, every word was a mountain. I found it hard to concentrate, my temper was getting shorter, and motivation was hard to find. At home, I had all but closed down. By the end of 2013, I couldn’t go on and took a voluntary redundancy from Fairfax. Just a few days into the new year, on the eve of our 25th anniversary, it was my wife who couldn’t go on. Our marriage collapsed and for the next six months I lived with my parents.

The grief and devastation was unbearable. In February, I asked my parents to drive me to my GP. I told them I had some test results to collect. In fact, I was there to seek help for my depression. In the waiting room I was unable to stem the silent flow of tears – not helped by the fact that there were young mothers with their toddlers in the room, bringing to mind sweet memories I could not handle. The receptionist noticed and kindly allowed me to wait in a private room.

The GP was visibly moved to see me in such a state. He referred me to a psychoanalyst, who I was able to see almost immediately.

The psychoanalyst was straight out of Central Casting: sandals, round-rim glasses, jeans, Viennese. He even had the archetypal couch in the corner of the room, although over the next half-dozen visits I never once used it. We talked, I cried, he asked questions that took me to faraway times and events, I cried some more.

Even in a daze I found myself admiring his forensic skill as an interviewer. It was like being in a dream. “Am I really seeing a psychiatrist?” At other times it was all too real, and raw, as he expertly but without fuss linked pieces of my seemingly scattered narrative into cohesive threads.

“I think I can make a diagnosis, but let’s talk again next week,” he said. (Let’s call him Max.) Max prescribed some sleeping pills – for the uninitiated, psychiatrists are medical doctors – and wrote out a referral for several pathology tests.

Those tests resulted in prescriptions for compound medicines, in addition to anti-depressants, as well as recommendations for various vitamins and supplements and the beginning, for the first time in my life, of an exercise regimen. I was so determined to get myself on top of things that I unconditionally accepted whatever was recommended.

By the end of the second visit, the diagnosis of clinical depression came as a great relief. Partly because it provided the basis for treatment, but also because it provided some validation or context for the way I had felt for so long. “You’ve never seen anyone about this?” Max asked more than once, shaking his head in disbelief. “I don’t know how you’ve gone this far without treatment.”

“This is very serious”

“Becoming unemployed can lead to depression, the breakdown of a marriage can lead to depression, but on top of that you have depression that goes back to your childhood which has gone untreated. This is very serious. You – must – have – treatment.”

This was not just a declaration. He wanted me to acknowledge the challenge ahead and to make a commitment to stay the course. I willingly made it.

“Getting stronger” – physically and mentally – was something Max spoke about often. I still longed for reconciliation with my wife. He’d seen enough marriage breakdowns to know what the odds were on that front, but he humoured me.

“There will be no reconciliation unless you are strong … You are no good to your wife or to your children unless you are a strong … They can’t be confident about the future if they see you like this.”

My challenge was to rebuild. An important part of my recovery was achieving a state of emotional equilibrium. Taking anti-depressants for the first time was a revelation. I had assumed that anti-depressants meant being in a perpetual torpor. Not so. I simply became me without the constant crying or sudden descent into melancholy. The medication kept a lid on all the cues that would normally set me off.

My diary entry for 21 February: “First day on anti-depressants. First day no tears.”

Max’s role was to see me in a fit state to progress to long-term clinical treatment. He recommended that I see both a psychotherapist (who can be a psychiatrist, but whose primary focus is helping patients gain an insight into their behaviour as the key to dealing with depression) and a psychiatrist, who would manage my long-term medication.

This was tricky, he explained, as psychotherapists often don’t like working in tandem with “psychopharmacologists” – psychiatrists who only provide prescriptions and manage medications. Max made his recommendations, undertook to write to them, urged me to make contact, and in the event that they agreed to work together, I would need to obtain referrals from my GP.

The psychotherapist (“Laurence”), a psychiatrist of some eminence, didn’t so much agree to collaborate with the workaday psychiatrist (“Harold”) as tolerate the fact that I was seeing him. In the eight months that I have seen Laurence he has never mentioned him or shown the slightest interest in what medication I am on.

Since April I have seen Laurence weekly. He has a couch, and it’s not a prop. Each week, I lie on the couch and he sits behind. In the early weeks he would simply say “Let’s begin” to start me off. I soon got the gist of proceedings, which was that once we were in position I would start talking. Sometimes Laurence would barely speak. Perhaps a “Mmm” here and an “interesting” there. Other times something would prick his curiosity and he would quiz me on something.

Bursting forth like a toxic torrent

There have been times when I think “What on earth am I going to talk about?”, but the moment I hit the leather the hurts, slights, torments and agonies from the past burst forth like a toxic torrent. All the while I hear heavy scribbling behind me. (I also soon discovered that while the Freudian Max loved picking my dreams apart, Laurence had no time for dreams.)

In addition to our weekly sessions, Laurence “recommends” that his patients also attend weekly group therapy sessions, which he oversees. These sessions can be like weekly soap operas and strangely compelling. The group comprises a core handful of Laurence’s patients. Occasionally a newcomer will show up, stay a few weeks and disappear. In the time that I have attended the group its membership has included lawyers, a university lecturer, an Anglican priest, a nurse … and a journalist. Some occupations go undiscovered. We only use first names, which provides sufficient anonymity for people to disclose the most horrific details of their lives.

Somehow, the stories in group therapy thread and intersect, with Laurence’s gentle (and sometimes not so gentle) guidance cajoling, stimulating and challenging; providing insight into our own lives even while we think we are discussing the choices, decisions and anxieties of others.

Harold, meanwhile, whom I see every month or so, is agnostic about therapy, and kindly dismissive of some of Max’s “holistic” approaches to care. Harold regulates my medication, trying to find that happy medium. It seems to be as much art as science.

But is it working? It’s early days yet. When I compare the mess I was at the beginning of the year with where I am today, the answer would have to be ‘yes’. But there’s nothing linear about this process. I have ups and downs, wins and losses, moods that still peak and trough.

Depression is not a tap that can be turned off and on. The flow of water is constant; it’s about managing (dare I say channelling) the stream.

A couple of months after I commenced my treatment I found myself feeling invincible. Marriage over? Fine, life goes on! Career to rebuild? No worries, the work’s pouring in and I might even write a couple of books while I’m at it. People kept telling me how good I looked. The first few times I took it as something that people say, but on one occasion I asked a former workmate, after she’d made the comment, what she meant. “The last couple of years at BRW you were walking around with a little black storm cloud above your head. We could all see it. The cloud’s not there anymore.”

This period of invincibility was perhaps a way of soaring above realities that still had to be dealt with. The high didn’t last. That would have been too neat and easy. There are more knocks to come; that’s just the way it is. But that light at the end of the tunnel is the best incentive I’ve got. My boys.

It’s all about my boys

I still miss my boys and try as I might I cannot come to terms with having to make times to see them. It’s not pleasant to have to make appointments to see your kids. And the one certainty is that no matter how enjoyable the time together may be, I always have to say goodbye to them as they return home – what until quite recently was “our home”.

My heart aches that I missed out on their school speech nights; that this year I wasn’t there to put up the Christmas tree as the boys gather to decorate it; that I won’t be part of the annual “family” holiday. I can’t help thinking of the milestones, parties, celebrations and gatherings that I will not be part of.

It’s fair to say that the boys – aged 19, 16 and 16 – seem to have made the adjustment to the new status quo much more easily than I. But the effort that goes into maintaining a relationship with my teen-aged sons today – as difficult as it may seem now – is about ensuring that we enjoy a more meaningful relationship for the long term. I get that.

In the meantime my grief and loss are still playing themselves out. Sometimes I’m above it, sometimes I’m not. Sometimes I cry, sometimes I’m clear eyed. (It might be time for Harold to rejig the medication again.) But for all that, what I am is resilient.

At the beginning of 2014 I was reclusive and inconsolable with grief; now I enjoy meeting up with friends, contacts and former work mates. I’m living in my own apartment and I relish those moments when I walk through the front door and feel that I’m “home”. I’m grateful and humbled that there are so many people who care about me, worry for me and respect me.

And without a hint of embarrassment I will say that I don’t know where I’d be without Twitter. Whatever my mood and disposition I can engage with some of the brightest and most interesting people in Australia and the world. And while we’re handing out accolades, my home away from home, the Saint & Rogue, is up there as well.

Professionally, what pleases me is not that there is so much work flowing in, but that what I am producing is finding its mark with readers, editors and in many cases, me. I hope that 2015 will be even more fruitful. And, yes, that includes plans for at least one book.

Last year, having given my reasons for writing about my depression, I concluded: “But most of all there is a very personal reason for this column. I am drawing a line in the sand: I am going to beat this thing.” How’s that going? The battle’s not won, but I am winning.

And a final word: if you’re suffering from depression: get help. Now.

The original piece: My life-long battle with depression: the rest of my life starts now, 4 April 2014.

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8 thoughts on “What happens after you’ve been diagnosed with depression? Let me tell you about my year…

  1. I love this post Leo. I think I noticed that the cloud had shifted a bit too when we met for lunch. Keep up with the therapy and anti-deps! Sounds like they’re working.
    Of course the work is flowing! You’re great.
    Jx

  2. You can be proud of the progress you’re making as well as your insights. May you have a good deal of laughter and live this Christmas.

  3. After letting us peek at your soul in such an erudite and engaging fashion, all I can say is may you finally experience some of the joy you have been missing out on all these years this Christmas and in your 2015. Be well, my friend.

  4. Leo What a superb piece this is and admirable for its frankness and depth. I think it will certainly help others suffering in similar ways to confront their challenge and get some help. Congratulations.

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