Tuesday, 14 June 2016

Blue skies - anxiety, depression and a lot of metaphores


Having received a lot of positive feedback about my trich post, in particular several people have said it has really helped them understand the condition, I have felt inspired to blog about some more tricky mental health issues.

Today I will attempt anxiety and depression. Now I have wanted to blog about depression for a while as it is so difficult to understand. However, I like my blog to be humorous and upbeat. Depression is about as upbeat as Eeyore at a funeral.

How about we start with anxiety.

Anxiety comes in many forms; panic disorder, Generalised anxiety disorder, social anxiety, phobias, and arguably post-traumatic stress disorder. I have only had the privilege of being visited by the first two horse riders of the nervous apocalypse. Whilst I have listed several distinct disorders, there is a great deal of overlap between them so thinking of them as entirely separate conditions is a bit of a misnomer.

I like to think of anxiety as the most popular of the mental health disorders. If anxiety was at a party, it is the one that would be given a warm reception and understanding smiles by the normal folk. It does not scare people as much, as it is an extension of a normal sensation. We have all felt anxious, we can all sympathise with anxiety. It holds the least stigma in a way.

However an anxiety disorder is where this anxious sensation is disproportionate to the situation and wildly out of control. It is a bit like being in a small dingy in the middle of the sea out in a storm. The anxious waves are crashing over you all the time, anxious thoughts scream through your mind like an onslaught of wind and hail. It is incredibly difficult to navigate and see the horizon, all you can think about is surviving the storm.

This to some extent explains why I am such a terrible driver. When anxious I commonly get lost. In fact I get lost all the bloody time. I drive into things, famously I have parked my car into a giant blue skip, a ditch, and a house! How do you not notice a house?! Sometimes I lose the ability to speak normally, coming out with a babble of backwards words, which makes asking for the much needed directions even more of a challenge. And of course I regularly don’t listen/compute when people are talking to me,  meaning you can tell me something and I seem to have forgotten it only seconds later ie by the time I have reached the junction ‘bugger was that left or right they said’! Seriously permanently lost!

Yup the side affects of anxiety basically render me as capable as your 90 year old aunt Sally who lost her marbles a decade ago. I am so caught up and distracted by anxious thoughts that I cannot focus on daily tasks. It is frightening and frustrating and can result in  feeling entirely helpless.

And this is where our friend Depression commonly steps in.

Firstly, unlike anxiety, depression is not simply an extreme form of sad. Don’t get me wrong, it involves a copious amount of sad, but sad is merely a side effect in a way.

Depression is also not well liked, if it arrives at the party people will sigh in disappointment and do their level-best to not get cornered into conversation over the buffet table with it. To onlookers depression is completely frustrating, it seems self-inflicted and selfish. The net result is the people with depression are often are met with hostility.

If anxiety was riding the dingy in the storm, depression is when the boat has sunk. You are trapped at the bottom of a very dark, very heavy ocean and you can no longer see the light.

That sensation of helplessness can lead to despair. Despair is a big part of depression. You are stuck and you cannot find your way out, similar to being subject to a star wars episode 1-3 marathon, extended dvd version, in a hall of mirrors. You desperately want it to stop but there is no exit and Jar-Jar-Bloody-Binks is reflected in everything you see.

Everything seems detached and remote to you. You feel emotions intensely and not at all simultaneously. Perhaps it is the brains why of coping with such intense feelings, a bit like closing your eyes to a bright light. Unfortunately the best emotions are long out of reach, desire, happiness, anticipation. They buggered off with the life-jacket-of-hope when the boat capsized. You forget what it is like to feel these things and cannot even imagine them anymore. All that is left is the heavy stuff that sinks like anger, sadness and emptiness. Most people opt for emptiness, and perhaps dabble in a bit of sad/angry for varieties sake, before shutting their eyes back to emptiness again as sad/angry sucks. Of course a life of emptiness means you don’t really know how to engage with the world anymore. Events lose their meaning. Things that you know you once liked and should make you happy don’t. Things you should look forward to you don’t. Things that you should care about you don’t.

Which leads us onto another fun aspect of depression – guilt. No-one is as frustrated and angry with a depressed person as the person themselves. I would feel immensely guilty that I was not enjoying life. I would feel guilty that people were having to scoff their vol-au-vents in self-defence at my presence. I would feel awful that I could not feel happy about the nice things people did for me. And of course this huge guilt sits onto of your self-worth and squishes it like a fat man on a small donkey. When you feel this bad about yourself you really don’t want to go out and see people anymore. It just makes you and them feel worse.

And finally that leads to the last horrid limb of depression – delusion. Once stripped of functioning emotions, self-worth and hope our minds are effectively standing stark-but-naked in the middle of a paintball field, with absolutely not protection from the horrid paint balls of paranoia. It is hear that we are most vulnerable to delusional thought. I have convinced myself of the most unusual and strange things. I convince myself that everything is somehow my fault. I convince myself that my friends hate me because I have done wrong. I was once so convinced of this that I went out and bought a 'Mog the forgetful cat' book because I left a friends window open by mistake. In my mind she must hate me for being so careless and rude, I was the worst person, she kindly offered me a bed and I repaid her by inviting burglars to her house (she was never burgled). I was so mortified that I could not face her and instead posted the book through her letterbox. Leaving an utterly baffled friend with an open window and a child's book on her doormat. Of course she didn’t hate me, it was all in my mind.

I can feel like everyone is watching me, everyone is talking bad things about me, nobody wants me to be around. I can even think it would be better if I was dead.

…. Yes we appear to have lost upbeat and happy. Cheers Eeyore.

The good news is that anxiety and depression do not have to be a permanent state of mind. You can get better from them, often we need a bit of outside help and support but you can find your way back to happy and functioning.

Sometimes I think it is helpful to think of the mind for what it truly is. Our mind is our brain and it is fundamentally a very complicated, slightly squidgy, organ.

If you hurt a joint, you sometimes need physio to recover and make it work normally again. Muscles and tendons can be manipulated with motion to make them stronger. The brain is not a muscle. The brain is a complicated mess of synaptic connections which work on a competitive basis. The more you use a neural pathway the stronger it will become. Unused connections are re-routed. It is a system to make our brains as efficient as possible. Physiotherapy for the brain involves building stronger positive neural pathways and re-routing the negative ones. The only way to do this is by thinking (and perhaps with a bit of support from medication). To overcome and then manage anxiety and depression you need to continually do thought exercises. The trick is trying to find the right exercise, by no means an easy feat particularly when you can barely find the supermarket. You will then need the will power to continue to keep up the physio for the rest of your life even after you have recovered to prevent re-lapse.

I guess my take home message is that mental health is self-involved not selfish. However frustrating it must be for the onlooker, it is twofold for the sufferer. It takes a huge amount of energy and commitment to recover from a mental health illness, and that is when you know what you need to do to get better. Please be patient and kind to anyone who is suffering and support them to get all the help they need to get better.
Blue skys are on the horizon.

 

 

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