Depression, anxiety, Covid and the whole damn thing

Last year began with the advice of my psychiatrist of six years that I should undergo electroconvulsive therapy, or ECT.

He was concerned that after a period of equilibrium, minor fluctuations aside, I was experiencing bouts of depression and anxiety that were more frequent, more intense and of a longer duration than had been the case for some time.

ECT is a procedure, performed under general anaesthesia, which involves passing small electric currents through the brain, causing changes in brain chemistry to relieve severe depressive and psychotic symptoms. Drastic as it was, ECT could be the circuit breaker, literally and figuratively, that I needed.

I was open to the idea of ECT, to the possibility of relief from the re-emergent maelstrom of despair, grief, guilt and remorse, feelings of helplessness and worthlessness, of unforgiving self-loathing and self-reproach, debilitating low self-esteem, the tears, the nightmares, the thoughts of suicide, the sensation that one is drowning in life, not for a moment or two, but for weeks at a time. The intensity waxes and wanes but even in moments of relative calm the dread remains. It’s utterly exhausting.

Anxiety came hand in hand with my depression. Anxiety is a natural part of life; a normal and momentary response to stress, worry or pressure. For some, their anxiety is so chronic, so utterly disproportionate and excessive, that it creates a searing nervousness, fear and apprehension of the unknown.

For me, anxiety has been something to endure and crash through. Not that I understood it as a clinical disorder; it was just part of my maddening introverted “personality”. Without even realising it I planned around it so that I could function with apparent self-assurance and, one hopes, aplomb.

Imagine if every time you enter an unfamiliar doorway you do so with a feeling of dread at what you will find on the other side.

I have always avoided arranging to meet someone in an unfamiliar pub or café. The idea of standing in a foreign place and looking around, craning my neck to survey unfamiliar surrounds, was terrifying, as if every eye was on me at this vulnerable time. Meeting someone in a restaurant was preferable. It provided the safety valve of spying my companions at their table, or failing that checking in at the host station, which was especially useful if I was meeting people I did not know, which was a regular occurrence in my business. In the latter instance, once seated at the table, I flicked the switch, and I was “on”.

Rickety house of sticks

This is the paradox of depression: the ability to function, even to reach the highest levels of attainment, to give every appearance of being confident and in control, while being neither. It’s this delusion of “coping”, grinding as it can be, that creates the pretext for not seeking help.

Some will take their undiagnosed or untreated depression to the grave, but for others, and certainly for me, the rickety house of sticks that is coping with depression eventually comes tumbling down.

After decades of living with undiagnosed depression it became clear that I was losing the battle. At the end of 2013, I took a voluntary redundancy package from Fairfax Media, a decision made necessary because I could no longer endure a sustained period of change and instability in the workplace as a feckless management struggled to set a course for the company in the new media landscape. Concurrently, in the background, was my failing marriage, dying the death of a thousand cuts as I progressively shut down, aware but emotionally incapable of responding to the crisis before me. My marriage ended in January 2014.

Some weeks after the breakup I finally reached out for help. My GP referred me to a psychoanalyst and I was diagnosed with clinical – or severe – depression, which I wrote about at the time. He referred me to others and so began a new and intense world of psychiatrists and psychotherapists, which I also chronicled. I underwent treatment, a regimen of anti-depressant medication and therapy, treating a combination of biological and psychological factors.

With that treatment I got to experience the unfamiliar liberation of inner peace. I felt equipped to face the challenge of overcoming the end of my marriage of 25 years and the separation from my three boys. I had the resolve, and the confidence, to rebuild, reboot and refresh. And I was kinder to myself.

One welcome outcome was the apparent reduction in my anxiety. I was much more at ease with the unfamiliar, whether navigating the public transport system or venturing into strange pubs to meet people. I was socialising again after years of being quite reclusive. Although a loner by disposition I was also more comfortable with my own company outside the pub or home, happy to go to the cinema, theatre and concerts on my own, and even to dine alone.

Depression can be managed

As part of the renewal I moved to the Macedon Ranges in regional Victoria, a one-hour train trip from Melbourne. Surrounded by towering gums, delighting in the abundant bird life, it was an idyllic sanctuary for a freelance journalist; when not meeting deadlines I was plugging away at the Great Australian Novel. It seemed to be working.

The journey out of depression is not linear. Depression doesn’t entirely go away with treatment. It lurks and occasionally makes its presence felt in momentary bursts, but it can be managed. The brain can shrug off triggers that might normally descend one into debilitating melancholia. The important thing is that one is not monstered by it; it is not the tail that wags the dog.

After a couple of years of relative peace things turned. The occasional momentary bursts of darkness were becoming more frequent and lasting longer. The nightmares were back, vivid and pointed. Because my sleep was fitful each cycle would bring on a fresh dream. I would wake up feeling sad, distraught and occasionally tearful. Even when I could not recall details of the dreams I would feel burdened by the night’s unforgiving narratives. Although perpetually exhausted I dreaded going to bed and it became my custom to busy myself until the early hours.

The waking hours were no less fraught. Triggers that had been kept at bay were reasserting themselves with a vengeance. How many tears can one person shed? Almost anything could set me off. Television became a minefield of catalysts – somebody declaring “I love you”, depictions of parents with young children, birth scenes (Call the Midwife was best avoided), a journalist or writer at their keyboard (amazing how many times that comes up), even Metricon commercials. The reference points were unambiguous. Not that it necessarily took a particular event to suddenly find myself mired in a thick tar of torpor. It was not uncommon for me to sleep through entire weekends – a sleep to be distinguished from my fruitless attempts at nightly repose – to remerge on the Monday to tend to the week’s deadlines. The work was tedious – mostly “sponsored editorial” for the AFR – and offered little professional satisfaction but it provided a measure of structure to my week.

My psychiatrist was naturally concerned by this slide; I seemed to be back where I was when he started seeing me. He adjusted the regimen of anti-depressants. The combination that had worked for so long was clearly proving ineffective. But nothing helped and that’s when he finally recommended ECT.

Another layer of angst

I went home to think about this course of treatment for further discussion at our next appointment but I was ready to proceed. I wanted the pain to stop and I was desperate for some clear air. And then Covid-19 struck and everything was put on hold.

The lockdowns and restrictions in response to Covid initially had little direct impact – I was already living an isolated existence – but as 2020 progressed it became apparent that the pandemic was adding another layer of angst to my fragile state of being. There was an overwhelming sense that the world was changing around me and that it was leaving me behind. What if I no longer knew how to function in this new world of QR codes and density limits? Would I walk into a pub or café and set off alarms because I wasn’t doing it right? There is nothing rational about anxiety; I understood the facts of the Covid restrictions but it was the menacing shadow of change and uncertainty that rattled me, magnified by the relentless media coverage of the unstoppable coronavirus. The wearing of masks was a manifestation of this new world; I wore them when necessary, but I hated doing so and had an almost pathological aversion to being surrounded by people wearing masks. (This was not a Karen thing; I had no quarrel with the state’s authority to mandate masks.) There were times when I could not bear to step out of the house; not even my idyllic surrounds could tempt me. Because these moods would lift and wane, I would find myself jumping at the chance to do some gardening; it’s difficult to convey what a magical experience mowing the lawn can be.

Quite apart from the devastating disease itself, Covid must be causing untold mental anguish in the community; for some, it will be a mental torment being experienced uniquely and for the first time as a direct result of Covid; for others, it will be exacerbating existing mental illhealth.

A couple of months ago I decided to give up my solitary regional idyll. I can’t precisely pinpoint Covid as the primary reason for that decision, but it probably was. I moved in with my elderly parents in Melbourne. It’s not going to be easy. They are good people, but as they say in the classics, we have issues. The move is not without personal and material sacrifices. Most notably I’ve had to give up my library – my pride and joy – a wrench beyond words.

On the plus side I hope to wring every advantage from living rent-free and without the burden of having to maintain a household. I’ve given up the advertorial work, which was both soul-destroying and an affront to every tenet of journalism I hold dear. I’m lending my hand to a start-up news site for Australian Defence Force veterans and I will be taking a last stab at finishing that damned novel.

As for the ECT, I can’t be certain that I would have proceeded with it had Covid not intervened. I can only say that I was open to it at the time. Today, not so much. There’s no firm reasoning behind that change of heart. I have chosen to trust in myself to do my best and let the cards fall where they may.

Leo D’Angelo Fisher is a Melbourne journalist, writer and commentator. Connect with him on Twitter: @DAngeloFisher

COVID-19 provides Scott Morrison with a clean slate and an opportunity to reboot Australia

It has been said many times in recent weeks that things won’t be the same when we get to the other side of the COVID-19 pandemic. That’s probably right. What hasn’t been said is that the eventual defeat of COVID-19 will present Australia, and the world, with a clean slate, which is infinitely more exciting.

The society we live in today is not the result of a master plan, nor the fruits of a grand vision or epic struggle. It is a haphazard melange of outcomes good and bad.

A clean slate presents a rare opportunity to start over: an opportunity to right past wrongs, to repair the unintended consequences of globalisation, to create a fairer and kinder society.

Simply shrugging that things are going to change, more as a function of dumb circumstance than deliberate agency, is the kind of apathy that gave us the bloated, selfish and unsustainable way of life that has brought our planet to the brink.

Beginning with the corrosive Howard government Australia has continued its lurch to the right. Paul Keating, sensing defeat in the 1996 federal election, was on the money when he warned: “When the government changes, the country changes.”

The Howard years changed Australia into a country that was less tolerant and more self-centred, a country whose overt racism was reawakened and given license by a government that knew no shame – Tampa, Children overboard, “We will decide who comes to this country…” – a country whose people still parroted jingoistic ideals of the fair go and mateship but who had become self-absorbed and heartless, a country whose economy had, like the US, baked in a permanent and growing underclass that was vilified for bludging off the rest of the nation. Howard embraced a scorched-earth brand of globalisation in which the drive for “global competitiveness” and a quasi-religious faith in “the market” would supposedly ensure the commonweal. What poverty could not be alleviated by globalisation was deemed the fault off the poor. Howard super-charged traditional Liberal antipathies by demonising the unemployed and trade unions.

After 11 years voters grew weary of the “mean and tricky” Howard government and in 2007 booted the government from office and Howard from parliament. But while voters were attracted to the optimism and vibrancy of Kevin Rudd’s Labor, we remained Howard’s Australia.

Voters went off Howard – the cranky old coot in the tracksuit – but they weren’t prepared to hand in their white picket fences. Howard orthodoxies still coursed through the electorate and continue to do so. Labor’s dilemma became how to be progressive without alienating Howard’s conservative battlers.

John Howard hasn’t quite left the building

In the post-Howard years poverty and homelessness became more entrenched, the unemployed and disadvantaged remained marginalised, the mantra that “work is the best welfare” continued to inform government policy, the harsh treatment of asylum seekers continued and – Rudd’s historic Sorry notwithstanding – the grievances of indigenous Australians went unanswered. It says everything about Australia’s political climate that in the 2019 federal election Labor could not bring itself to promise an increase to the Newstart allowance, committing itself only to a review.

The Liberal party has remained Howard’s Liberal party, and then some. The Abbott-Turnbull-Morrison governments venerated Howard and practised his hard-C brand of conservatism – even if Malcolm Turnbull was an unwilling acolyte.

The returned Morrison government, full of Pentecostal vigour and conviction, was intent not only on preserving white-picket fences in the suburbs, it was going to build a white-picket fence around Australia.

Morrison shared Howard’s conservatism but, unlike Howard, he was inarticulate and tin-eared, was a weak policy thinker, tended to shoot from the hip, was almost comically sensitive to criticism and enquiry, and, to put it bluntly, often seemed out of his depth. Morrison surrounded himself with ministers who shared similar attributes and he frequently overlooked and defended blatant ministerial incompetence and malfeasance. The national bushfire emergency marked the beginning of 2020 and never had an Australian prime minister been found so wanting in a moment of crisis.

We can only speculate on the course and fortunes of the frazzled Morrison government had the coronavirus not intervened. For a time, as the global health emergency unfolded, it seemed that Morrison was again out of his depth, proudly declaring that he was off to the footy even as he foreshadowed a ban on large gatherings. His early public statements on the virus were rushed and confused and verged on incoherent.

And then something changed, not least the prime minister himself. He overcame his distaste for Rudd-style economic stimulus, casting aside firmly held ideological verities about big government. What changed? Morrison was not known for changing his mind or accepting unpalatable advice. We can only assume that once he accepted the enormity of the threat posed by the pandemic the policy options recommended themselves. Morrison is not known for nuanced policy formulation, so again we must assume that this time he followed advice from inside and outside government.

An opportunity to reimagine Australia

Unlike the Rudd government’s response to the GFC the Morrison government’s response to COVID-19 is not designed to stave off recession. That there will be a recession is a given. But at least the blow to Australia, both economic and social, will be cushioned. The government’s $320 billion (16.4% of GDP) in economic support for the Australian financial system, businesses, households and individuals affected by the coronavirus will ensure that come the other side of the pandemic Australia will not have been reduced to rubble.

Morrison’s thinking is very likely that once the coronavirus is defeated Australia (that is, the Coalition government) will resume “responsible” economic policy.

But the “defeat” of the coronavirus is unlikely to be total and in any case it’s unrealistic to assume that Australia can bounce back as if 2020 was a self-contained event. The economic impact of COVID-19 is likely to linger for years, which will necessitate extraordinary policy settings and “new normals”.

In many respects, the Morrison government has let the big-government genie out of the bottle; it’s going to take some doing to get that genie back in there. (Scott Morrison will become the new Major Anthony Nelson.)

So why not use COVID-19 as an opportunity to reimagine Australian society?

The Liberal ideal of small government is just that, an ideal, an ideal wrapped in mythology. Australia has never had small government. Small government ended with colonisation. Since 1788, government has loomed large in the lives of Australians, and especially in the lives of the original inhabitants.

Instead of an unattainable – and ultimately dishonest – quest for small government, Australians should be clamouring for better government. Australians already want that; they have simply stopped believing that it is possible. This may be our chance.

We have the opportunity to reset Australia, to be true to the values we claim to hold dear, to strive for a fairer society rather than accept that progress cannot co-exist with equity. As Barack Obama recently observed, the pandemic has underlined the importance of government and, more to the point, the importance of good government.

Hopefully the coronavirus emergency will make people more vocal in insisting on honest and accountable government in future. Australians might realise that their tacit acceptance of mediocrity in government has been at their expense.

The Morrison government has an opportunity to anticipate the demand for better, more enlightened and more relevant government by making some fundamental changes.

It should use its clean slate to reconsider its ambivalence to climate change; it can overcome its ideological myopia to consider whether some of its “wartime” measures should become permanent features, free childcare being a case in point.

It can reconsider its kneejerk opposition to wage rises for our lowest paid and give meaning to its rhetoric about the importance of shelf-stackers, service workers and the many and varied invisible workers that make society tick, particularly casual workers. (State governments can put taxpayers’ money where their mouths are and properly reward healthcare workers, teachers and first responders.)

It can use some of the empathy gained during the pandemic to devise an asylum seeker policy that restores human dignity to the world’s most vulnerable people and it can get serious about making a meaningful peace with our own most vulnerable, Australia’s dispossessed First Peoples. It can also call off its ideological vendetta against Australians on welfare.

The Morrison government has a once-in-a-century window to reset Australia, to banish the corrosive ideologies that have been permitted to fuse themselves into Australian society, to channel New Zealand’s Jacinda Ardern and place kindness at the centre of its deliberations, to act with its new-found compassion in the interests of all Australians. And it can use the reset to clean up its own back yard.

If Scott Morrison thinks his job is to restore Australia to business as usual post-coronavirus then he hasn’t learned a thing.

Leo D’Angelo Fisher is a Melbourne journalist, writer and commentator. He is on Twitter: @DAngeloFisher

 

 

The scramble for toilet paper was just the first surprise of the COVID-19 outbreak…why weren’t we better prepared?

If the coronavirus were to be considered a test for humankind we would all be feeling pretty nervous about the result right now. An F-minus seems in order. And one imagines we haven’t even got to the hard part of the test yet.

The coronavirus disease (COVID-19) pandemic has revealed much more than our predilection for toilet paper. But even that deserves a moment’s reflection.

The scramble for toilet paper in the nation’s supermarkets reveals a hitherto little seen aspect of the Australian fundament, and more is the pity that it did not stay out of sight. And if you are wondering, either definition of fundament will suffice.

Here are the three stages of the Great Australian Toilet-paper Stampede: initially a quaint unexpected consequence of the developing coronavirus contagion, then mildly disturbing as supermarkets took to assigning security guards in the toilet-paper aisle, and finally a sense of despair that neither calls for calm nor public shaming could arrest the irrational mania for paper products.

Oh, for the days when the paper wars referred to circulation battles between The Age, the Herald Sun and The Australian. (Readers in other cities insert your own mastheads.)

The good news for Australia’s daily newspapers is that for critics who have long maintained that newspapers were only good for toilet paper, the rush for actual toilet paper suggests otherwise.

It’s difficult to attribute this behaviour to the “great unwashed”, for clearly these are people of impeccable hygiene.

Why then this collective conclusion that stockpiling toilet paper somehow outsmarts the coronavirus? Especially as the virus, little troubled by borders, perforated or otherwise, is now criss-crossing the globe with contemptuous abandon. For now, there is little clue as to when and how the warehoused toilet paper will make its mark.

The impact of the coronavirus has way outstripped the initial mealy-mouthed assurances of calm and calls for perspective from politicians and grandees such as Alexander Downer.

Downer tweeted a few days ago: “So far this year 4,000 people have died from covid19, 92,000 from flu, 320,000 from HIV/AIDS, 256,000 from road accidents. Perspective!”

As of this morning federal finance minister Mathias Cormann was inclined to agree with Downer. Cormann told breakfast radio that he was still contemplating a visit to the Melbourne Grand Prix even as the Victorian government and Formula 1 organisers were preparing to shut down the event. Perhaps Cormann was sanguine about the effect of the coronavirus because he has adequate provisions of toilet paper.

Much more than a nasty cold

By the end of the day, even the ponderous Morrison government finally understood that the coronavirus is much more than a nasty cold and that it is spreading more rapidly than was initially held.

The historic cancellation of the Melbourne Grand Prix has cast doubts about the start of the AFL season next week – with the prospect of matches taking place without spectators under consideration – and the NRL season, which commenced this week, is a week by week proposition. In the meantime, Cricket Australia has banned crowds from the Sydney Cricket Ground for tonight’s Australia-New Zealand game.

These are conversations that would have been considered unthinkable a year ago. However, with the Morrison government today accepting the advice of national, state and territory chief medical officers to ban gatherings of more than 500 people, many more of these unthinkable conversations will be taking place around Australia.

While we’re at it, another conversation worth having is why it has taken more than two months since the first report of the outbreak on 31 December 2019 for such crowd bans to be considered. Instead, even as the number of coronavirus cases increased around the world, authorities and organisers of large cultural events in Australia insisted their events were safe, with plenty of free hand-wash to be made available. It is only a matter of good luck that Australia has not had serious breakouts of the virus.

Similarly, the Morrison government took its time before announcing its $17.6 billion economic stimulus package. This is supposed to assure Australians that the government was being methodical, considered and proportionate – blah, blah, blah. This was a government that placed cosmetics ahead of what was important for Australia. It was more concerned with not appearing to “rush” its response, as the Rudd government allegedly did in response to the global financial crisis, and with being more “targeted”, again, unlike the Rudd government’s supposed haphazard approach to stimulating the economy. (Scott Morrison’s visceral, not to say un-Christian, hatred of Kevin Rudd and former Treasurer Wayne Swan has been something to behold.)

$750 handout is laughable

If we think the cultural impacts of the coronavirus are going to be significant – and they will be – they will be dwarfed by the economic hits. The Morrison government has at last publicly given up on its spurious budget surplus, but is not yet moved to prepare the community for a recession. (A technical recession, that is; many Australians have been living in recessionary conditions for some time.)

It seems absurd that it’s even a matter of debate whether Australia will go into recession. It almost certainly was going to anyway; the coronavirus pandemic simply seals it.

Government one-off-payments of $750 to six million Australians from 31 March might soften the blow of a weak economy belted by the coronavirus, but even that’s a best-case scenario. The coronavirus is going to expose all those households that have been teetering on the edge for the past decade. The idea that $750 is going to make a difference to anyone is laughable; it won’t even touch the sides of most household debt, which is where most of it will go.

COVID-19 has been revealing in so many ways.

Here we are, humankind in the 21st century – enlightened, beneficiaries of scientific breakthroughs, holders of unprecedented knowledge, enjoying record good health, wealth and peace – and we’re fumbling around in the dark, unprepared, displaying wholesale panic, fear, greed and stupidity.

A noticeable feature of the coronavirus pandemic has been the lack of international co-operation between governments. So much for that top-secret World Government that was supposed to be pulling the strings behind the scenes. Instead, it’s every government for itself, every government, with a few notable exceptions, apparently run by Laurel & Hardy. (With apologies to Laurel & Hardy.)

Of our response to COVID-19 it can be concluded that we have learned nothing from the past and the future is a place for which we are ill-prepared.

Leo D’Angelo Fisher is a Melbourne journalist, writer and commentator. He is just as pessimistic on Twitter: @DAngeloFisher