Beating the blues: why depression must be fought and pursuit of happiness is a false objective

In my last post, I gave an overview of my symptomatic experiences of clinical depression. Following on from feedback given by readers, I would like to stress that this series of articles relates to my personal experiences of the illness: readers who suffer from depression may find that it manifests quite differently in them. As such, these articles are not intended as ‘gospel’, but are merely a reflection of how the malady has manifested itself in my own psyche. Any constructive criticism or other feedback is always welcome; all I seek to do is to raise awareness and heighten understanding of mental illness by contributing my own perspective.

As I said in my previous post, I do not yet know if severe clinical depression can be comprehensively beaten, or merely contained and attenuated (that is to say, made less potent and malignant). What I do know is that certain things work and certain things don’t; moreover, that some things work only if applied in conjunction with other activities.

One of the things that depressives are often told to do is to keep busy: to distract the mind so as not to allow negative feelings of depression to overwhelm us. This is a core example of something that doesn’t work if applied on its own. Yes, by all means, those suffering from depression should get out and do things as often as possible, and not succumb to the paralysis of despair. However, the fact remains that if like me you suffer from chronic depression, that persistent negative inner voice will not be silenced until it is confronted and challenged head on. Whilst keeping busy with external and social activities is an essential part of the recovering depressive’s daily routine, applied exclusively it amounts to a kind of running away; you simply can’t stay busy all the time, that would be to court burnout and further mental stress, and at some point you will need to rest. And that is precisely when depression is most likely to rear its ugly head and strike.

Another common suggestion given to depressives, based around the cognitive behavioural therapy (CBT) method of treating depression, anxiety and obsessive thinking, is to ‘accept the intrusive or unpleasant thoughts’. Now, this piece of advice is very tricky, because whilst it does carry considerable merit it can also be misapplied and wind up doing more harm than good. To draw on my own experiences, I spent several months trying to follow this advice, and the result? I allowed the negative, depressed side of my thinking free rein, and my psyche took an almighty battering as a result. This mistake, along with a relapse into alcohol dependency, cost me my last relationship, a loss I am still mourning.

So let’s clarify what is really meant by ‘accepting’ the negative thoughts. Accepting negative thinking does NOT mean allowing your inner demons to run rough-shod over your conscious mind without putting up a struggle; accepting negative thoughts means accepting they are there in the first place and then acting to oppose them. You cannot block out a negative thought, however painful it may be; once it has manifested, it is there. But you can bloody well challenge it. What I have found so useful in recent months – and full credit must go to a good friend of mine who also suffers from depression for suggesting it in the first place – was to write down all the positive, rational thoughts produced by my conscious mind at times when I wasn’t under depression and therefore thinking clearly.

And now the hard work begins – because if, like me, you have suffered from unchecked depressive thinking for a number of years, the chances are your negative subconscious has been firing intrusive, negative and untrue thoughts at the naturally happy conscious you for years. That’s a lot of territory to reclaim, and the only way to do that is to wage war – and I will return to this combative metaphor time and again – on the negative part of your mind that has turned on you so virulently. As such, once you have written down whatever coping statements you’ve come up with when thinking more clearly – repeat, repeat, repeat. Read them back to yourself several times a day, every day, for months or even years if necessary. Sounds too much like hard work? Sounds like auto-brainwashing? Believe me, depression has been working very hard every day for years to brainwash you into thinking you are worthless, that your life’s achievements are nil, that your life itself and everyone and everything in it is null and void. If your demons can work so hard to poison your thought processes, why can’t the conscious, rational you do just the same to reverse the damage?

Because I repeat folks, you are at war here, whether you like it or not. You are in a dogfight for your mind, and be assured that severe clinical depression will fight you for its possession down to the last stray synapse. Accepting the need to go to war is not the same as accepting the presence of an enemy and passively turning the other cheek. If peace of mind is worth having then it is absolutely worth fighting for – every day, for the rest of your life if need be.

If this combative approach still seems a little contrived to you – and yes, I initially thought so too – try looking at it from this perspective: an anorexic looks in the mirror and is convinced that she is overweight. Any healthy person around her can quickly see how deluded she is, but the anorexic does not. Accepting your negative inner voice without countering its statements is like accepting the notion that you need to lose weight; in both cases you are in fact suffering from a delusional form of mental illness that has distorted your thinking and perception and resulting emotional responses. Just as anorexics must have their self-destructive ideas about not eating challenged, so depressives (and those suffering from anxiety and OCD-type disorders) must have their self-destructive ideas about themselves, their surroundings and their very lives challenged.

To fight this war you need more than one kind of soldier, just as in a real-life war different types of fighting unit – sappers, air strikes, infantry, what have you – serve different functions but cooperate towards a single ultimate goal of victory. I’ve already touched on challenging the demonic inner voice with statements of rationality, strength and positivity (I won’t suggest specifics, as each of us suffers from our own personal demons – you’ll need to figure out your own coping statements, which will be an essential part of your arsenal against clinical depression). Now let’s look at some of your support activities, your auxiliaries if you will.

These are in themselves based around simple common sense and are things that would be recommended to healthy minded people as well, namely: good diet, regular sleep, proper exercise (as a recovering alcoholic and former slob I cannot recommend this highly enough) and meditation (yes, meditation – as well as working for Buddhists for thousands of years, it is now scientifically proven to help against depression/anxiety and is part of NHS core recommendations for treating mental illness). To torture the cliche – healthy body, healthy mind. But REMEMBER, this is only one part of your treatment – eating and sleeping well and getting regular exercise might be enough in themselves to beat mild depression, but severe and moderate depression will require that you do more. In other words, eating and sleeping well plus regular exercise and meditation is simply your base: the foundation on which you will construct your fortress.

Now the real fun begins: we already have the coping statements, what I  like to call my ‘mantras’, which you will repeat to yourself every day, several times a day if necessary. That’s one key building block for your fortress. Another is prescription medication accompanied by a total (yes total) abstinence from alcohol and other recreational drugs. Oh, I’m sorry, does the latter part offend you? Fair enough: play it the way I did for three years, and drink on your medication. I ended up having a psychotic episode during which I repeatedly lacerated myself with a kitchen knife and lost about a pint of blood. I drove my partner away, and nearly drove my poor mother into a nervous breakdown of her own, and I now know what the insides of both a psychiatric ward and a police cell look like. That’s what happens when severe depressives mix booze and medication – and believe me it wasn’t much fun.

Severe clinical depression is no joke – you wouldn’t expect soldiers to fight a war under the influence would you? No. So… Put. The. Bottle. Down. For those of you who also have alcohol dependency issues, I’ll talk at greater length about addressing these in another post.

Even without alcohol and other drugs interfering, prescription medication will not work by itself: severe clinical depressives cannot expect a pill a day to chase their blues away, and meds must be applied in conjunction with other treatment methods. One study I read says that only a third of depressives can expect medication alone to ‘cure’ them, while another third experience no improvement in their mood at all. I personally believe I belong to the middle third: medication helps but other methods of tackling depression must also be applied. One of those most often touted is therapy. Again this is tricky as different kinds of therapy work for different types of people and depressives. I personally found CBT to be a useful front-line soldier – think of it as a kind of shock trooper – but not enough on its own to beat severe long-term depression. If, like me, you are the sort of person who needs an answer to things, to understand why you are thinking the way you do when depressed or in a state of anxiety or obsessiveness, you will need to combine it with psychotherapy or psychodynamic therapy, methods that tend to explore your personal history and do not focus exclusively on the here and now as CBT does.

As a personal aside, if you are in the least bit suicidal or prone to obsessive, negative and harmful ruminative thinking, I would avoid psychoanalysis like the plague. This assertion is of course based on my personal experiences, but I found it did more harm than good – psychoanalysis fails to take into account that many of our inner thoughts are irrational and untrue, and tends to follow the erroneous line of thinking that what you think must always be valid. This is patently absurd and, in a severe depressive, a very dangerous and toxic idea. As observed above in our example of the anorexic’s thoughts about her weight, clearly much of what you think when under depression is not true; and an essential tool to beating depression lies in realising this and learning to discern the untrue depressed thinker from the more rational, balanced thinker; the naturally happy you that existed before life events and chemical imbalance conspired to give rise to the depression now assaulting your psyche.

Choosing a therapist and type of therapy is a potential minefield, and I’m afraid constitutes a whole battle all of itself. My recommendation is to try several different types until you find a practitioner you absolutely trust (by this I mean you should feel able to tell them anything, your darkest secret, worst fears, etc, without fear of being judged or misunderstood). I have personally seen at least half a dozen different therapists in my life, and I’m sure there are other clinical depressives out there who’ve seen more. Above all, take your time and be patient – your illness may require more than one approach to tackle it, as mine has done, so the sooner you accept that you are engaged in a time-consuming business and in for the long haul, the sooner you will find some peace of mind.

To recap then, atop our foundation of exercise, diet, sleep and meditation, we have our fortress, so far constructed of therapy, medication and personalised coping statements or mantras. Another building block we can add to that is staying active – hopefully you should now begin to see how keeping busy works, but only in the context of a wider patchwork of different treatments. So yes by all means, get off the bed and get out of the house. Find things to do that you like. I’m fortunate in one respect in that I am an accomplished musician – so out comes the guitar and off we go to play on the streets or at an open mic night or any old place that will have me. But you don’t need to have talent to find things you like doing – go to the cinema, walk in the park, visit a market, wander the fucking streets looking at people if that’s what it takes. Just try and engage with the wider world as much as you can. Easily said, less easily done, I know – but trust me, if a formerly suicidal depressive like me can manage to do this, anyone can. And if you can repeat your mantras to yourself while out and about, so much the better. That will prove a doubly good use of your time.

Next building block: friends. Be very careful here. Some of my good friends I have had to avoid of late simply because they drink too much and while sympathetic to  my condition have no understanding of what it means to be clinically depressed (lucky them). This has led to unfortunate situations where close friends have ended up inadvertantly saying things that made me feel ten times worse when in their cups (‘How can you think stuff like that?’ and ‘If you don’t stop thinking that way, you will never get over it’ are two of my personal favourites). I’m sorry to have to report that clinical depression can be a very lonely illness; drinking buddies and close friends from the good old days may be people you now need to start avoiding. Sorry, I never said it would be easy. Fighting depression is a tough business, and a key part of it is learning to stand alone when necessary.

So choose your friends carefully – people who have suffered from some form of depression themselves are ideal as they will have a much better idea of what you are going through. Failing that they will need to be very understanding and analytical enough to at least grasp in theory what you are dealing with – sympathy alone is not enough. And obviously, pity is out, out, OUT. Anyone who pities you is no friend; both pity and self-pity are toxic to the depressive. Compassion is subtly but crucially different; friends exercising compassion, understanding and tolerance are gold dust and should be treasured accordingly. Also, remember: seeing friends can be helpful, but don’t overdo it! As I said already, learning to stand alone is of paramount importance. At some point you need to be able to be alone with your thoughts, and that’s why I am placing so much emphasis on the mantras – you will find yourself in single combat with the darker side of your mind periodically, and that is a fight you will need to get used to fighting.

But what happens when the depression is so overwhelming, so potent, that none of the above works and your carefully constructed fortress crumbles? As a severe clinical depressive you will inevitably have those days. This is when it is crucial to remember the war metaphor – you may lose a battle, but that DOES NOT mean you have lost the war. A good general doesn’t waste time mourning the loss of his troops in battle; a good general thinks about the next battle in the campaign and prepares accordingly; a good general does not give in to despair as a result of one setback. And so it is with the war on depression.

Yes, sometimes you will find yourself, as I have, lying on your bed or curled up on the sofa, your mind churning with anxious and troubled thoughts, or simply overwhelmed by a feeling of hopelessness and despair. It is at these times that the doctrine of acceptance must be, well, accepted: you are at a low ebb but this will pass. Just as soldiers in a real-life war must be sacrificed, so those minutes and hours must be given up as lost; sometimes it is stronger to accept times of weakness and weather them than fight yourself to no avail. Because remember, fighting your demons is one thing; beating yourself up over losing a battle you cannot win is quite another. The key to attaining eventual victory is to not give up hope altogether – feelings of hopelessness must be ridden out and regarded as fundamentally impermanent. Believe me, you will emerge from these rough patches, and through learning to accept the pain of a lost battle you will gradually grow stronger.

For it is strength you need to pursue – not happiness. Focus on the pursuit of happiness and you will come unstuck, as I did. For years I chased happiness in all its gilded forms: career, money, success, recognition, travel, sex, relationships, drink, drugs, socialising, the list goes on. And I ended up miserable, despite having all of the above at various different times in my life. The lesson I have learned has been a costly and painful one, but it is salutary nonetheless. Chase happiness and you are chasing a chimera, the proverbial pot of gold at the end of the rainbow.

Pursue strength on the other hand, and you have something much less fleeting and far more dependable within your grasp. To court strength is to secure the ability to stand alone, friendless and single if need be, on your own two feet, and not be destroyed by the world or your perception of it. The strength to look your weaknesses in the eye, without recourse to alcohol or other mind-altering substances, and change them wherever possible or accept them where not; the strength to feel completely overwhelmed by despair one day and yet come back fighting again the next; the strength to have nothing and still feel you are worth something; the strength to realise that inner peace means far more than mere happiness; the strength to embrace all your emotional pain, your neuroses and your heartache and your frustration and disappointment unflinchingly and without complaint.

Because, my fellow depressives, you may not ever be happy, but each and every one of you has it in you to realise this inner strength, and in so doing lead a life that promises little joy but is also free of fear. Let go of the desire to be happy, and you will see how quickly your fears vanish. I do not believe we fear death for its own sake; we fear it for the absence of happiness-pursuit it inevitably must bring. This is why depressives so often turn suicidal – they simply give up believing that life can offer them any joy, so why not embrace death? But put happiness aside as your primary goal, and court strength instead, and you will find the need to destroy yourself suddenly becomes much less acute. This, I believe, is the state of mind that sustained our ancestors in less pampered, privileged times, and it is one am working towards, every day.

I am a long way from winning my war, but just over three weeks after giving up drinking and taking up regular physical exercise – the final missing pieces in my own fortress construction – and four months on from being a suicidal emotional wreck, I can safely say this: I have never felt stronger, or more real, than I do now. I may be less happy than I was in former times, but I am undoubtedly also less weak. My bouts of depression have lessened in frequency over the past fortnight, and are less long-lasting and intense when they do occur; my obsessive thoughts seem far less potent and real than they did last year; and my feelings of anxiety, once so crippling, are now virtually non-existent.

I am, in short, becoming a new person, someone I have never been before.

I trade on results, and these are results. I will continue to build my fortress of medication, therapy, friends, activity and mantras on its foundation of exercise, meditation, diet and sleep. I will build and build and build, as many times as this disease can knock over the things I make, I will build and rebuild. And hopefully one day, when my demons have grown tired of smashing themselves to pieces against the defences I have so diligently and meticulously maintained, I will take back possession of my mind.

And if and when that day comes, I will know inner peace.

Take whatever you will from this article. Feel free to disagree with any of it if you wish. All I seek to do is give others the benefit of my experience as well as inform loved ones as to where I am at in my struggle with clinical depression. If you are reading this and know anyone who suffers from an anxiety/depressive disorder, please feel free to share this with them. My biggest mistake in hindsight was a failure of recognition; I failed to realise that my mind had grown diseased, that alcohol dependency and unchecked neurotic thinking had poisoned it. This eventual recognition, that my mind has been overrun by depression and that a prolonged fight is now necessary to take it back, has brought me from the brink. But I had to fall very low first; I paid a high price for self-knowledge – I lost two great partners, several friends, and very nearly my life. Though at liberty I now have a criminal record, and had I continued in the same vein said liberty would almost certainly have been lost, to the prison system or a psychiatric ward.

Learn from my mistakes: the sooner you accept that your mind is ill and that you are at war with whatever demonic thoughts afflict you, the sooner you put pursuit of happiness aside as a luxury and start to pursue strength instead, the sooner you will know some measure of inner peace. And who knows, it may just turn out that, paradoxically, happiness will come to you as a result of having that strength and inner peace. But the key point here is, it won’t matter even if it doesn’t.

Because you will have become strong enough to live without happiness.

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Depression – it’s not what you may think it is

I have suffered from depression on and off throughout my adult life with varying degrees of intensity, the past four years representing the high-water mark. In this two-part article, I will attempt first of all to delineate as comprehensive a definition of this illness as I can, based on my personal experiences of it, and secondly to make suggestions as to how it may be contained and beaten, once again drawing on my own experiences and work done with various therapists. In so doing I hope to help others who are going through the same or similar pain, and express what I have been obliged by circumstance to cope with. In the latter case I hope this article will benefit loved ones who are sympathetic to my condition, but not fully aware of what it means to suffer from severe depression. I should add that I am only too glad that many of them aren’t – this is not a condition I would wish on my worst enemy, let alone people I care about.

I would like to stress at this point that I am not in any way trying to solicit pity from anyone in writing this. My troubles are my own to contend with; all I seek is to further understanding of this debilitating and destructive illness. If I succeed in doing this and reaching out to others who suffer from depression, I shall consider my time well spent. As such, I would urge anyone reading this article to forward it on to anyone they know who might possibly benefit. My name is of no importance whatsoever; all that counts is the message I seek to impart to anyone wishing to hear it.

Depression is, I believe, commonly viewed as an intense and lasting form of sadness, often not justified by the sufferer’s external circumstances. While this is a handy enough definition by way of a starting point, I feel it falls somewhat short of the mark.

Depression is not merely a feeling; it is a distortion of reality.

Severe clinical depression won’t warp your perception in quite the same way as a full-blown psychotic disorder such as schizophrenia; it works on a far more subtle and insidious level, making it much harder to spot than the more grievous forms of mental illness classified under psychosis. If schizophrenia represents a complete hijacking of cognitive awareness by rogue elements of the mind, depression is more attritional: it creeps up on you gradually over time, infiltrating and corrupting your thought processes. When you are in the throes of depression, when  it has had enough time to penetrate your psyche unchecked, you will start to believe things that the healthier you of former times, and loved ones around you, would recognise as patently absurd. But the depressed you will not: the depressed you will implicitly believe your inner demons as they whisper one ‘fact’ to you after the next. These inner voices can vary strikingly in content and subject matter, taking the first, second and sometimes even third person, but they will all share one common theme: they are pronouncing statements hell-bent on making you feel as bad about yourself and your life as possible.

For the chronic depressive, the worst possible interpretation of external events and internal thoughts and feelings will always be sought out, with unerring and unnerving mental dexterity, and believed without question.

You remember that girl you used to work with, the one you had the big crush on but never said anything to because you didn’t want to betray your girlfriend? Well, that was the love of your life – you failed to approach her because you are a rank coward. As a result you will never be happy in love and don’t deserve to be, ever. No one else you ever date will come close – of course you never dated her, but she would have been the best partner you could possibly have had. You have definitively screwed up your love life, for good. You remember that concert you played the other night? The one where everyone applauded and told you how well you played? Of course they didn’t spot the mistakes you made – but you did. In that moment, you exposed yourself for just what you are – a talentless phony with no business being near a stage, pathetically hankering after acclaim you don’t deserve and never will. People who tell you otherwise are either just being nice or are themselves worthless and incapable of judging you correctly. Only somebody who thinks ill of you is worth having their opinion solicited; no one else’s counts. You remember when you fell out with that friend, a few years back? Well, he’s out there now, having a better time than you are – no matter where you go or what you do, you’ll never live life to the full. But he will. You’ll only ever be a pale imitation of him, at best.

Does all of the above sound absurd? Ridiculous? Of course it does. And at various points in my life, when under severe depression, I have thought all of the above things, in some cases repeatedly and obsessively, believing every word without question.

That is what severe clinical depression does to your mind; severe clinical depression is not about seeing things in ‘shades of grey’, severe clinical depression is about seeing things that aren’t there at all. A missed opportunity becomes a monumental failure with lifelong negative ramifications; a bad event turns into a life-shattering trauma from which you will never recover; anything and everything good in your life – friends, partners, talents, achievements, successes – becomes an irrelevant sideshow to the main act you have unconsciously embraced: the tragedy that is now your life, with you in the starring role.

One of the most hurtful and sad things about depression is that it will spur you to make bad life decisions: friends and partners who genuinely care about you will be rejected as either ‘not good enough’ or ‘too good for you’; decent jobs will be thrown aside for much the same ‘reasons’. When you are severely depressed, either nothing is ever good enough, or good enough but more than you deserve; because you are never good enough – your negative feelings about yourself inevitably colour your perception of everything around you. And as you pile one bad decision on top of the other, and the actual quality of your life diminishes and deteriorates, the vicious circle is completed and your self-fulfilling prophecy of doom and gloom realised. Your life actually turns to shit, because you were incapable of seeing it any other way in the first place.

Now you are down, at rock bottom: and yet you feel strangely comfortable. For this is where you belong; a chronic depressive has no business being happy in any case. Careers, partners, friendships, fulfillment of any kind is a chimera, a pathetic illusion not worth pursuing. The depressive always knows better; he or she carries absolute conviction in his or her own opinions, which inevitably amount to this: you are not a happy person, and the truth must always hurt. The world is a bleak and alienating place; your time on it short and futile. Better to drink or drug yourself into an early grave than play along with self-deception like all those contented fools you are forced to rub shoulders with. The depressive is infinitely superior in his or her misery; happiness is for idiots, fuck happiness, you know far better! And the price to be paid for your penetrating ‘insight’ is pain, unrelenting and ceaseless – for are you not the star of your own personal tragedy?

Chronic depression represents the ego unbridled, left to run amok through your mind without restraint. You know best; no one can help you, and anyone who tries to is being obtuse and moronic. The latter-day savant Eckhart Tolle has correctly identified the ego as being the source of such self-inflicted misery, although to my mind his writing is not specific or thorough enough to really help somebody far gone in a state of severe depression. It is not sufficient in such cases, in my considered opinion, merely to ‘watch the thinker’. In severe depressives, the egoic thinker must be challenged, sometimes head on; his usurpation of your mind contested, without respite, without cessation, until that ego is driven far back beyond the borders which it has so brazenly encroached upon.

In my next post, the second part of this article, I will explore this concept in more detail as I attempt to outline some of the techniques and methods I have found useful in my own lifelong struggle against depression.

I don’t know yet if severe depression can be truly definitively beaten; what I do know is that some things work and some things don’t, and that applying a combination of different approaches is, in my opinion, essential to making headway against the illness. Another thing I have learned, which I shall also explore, is that those struggling with depression must also be prepared to accept losses and live to fight another day – not all the battles can be won, but that does not mean the war is necessarily lost.

Because, my fellow depressives and those who care about them, make no mistake: you are at war here, whether you like it or not, against a part of your mind that has turned rogue and is up in arms against the conscious, happy you. As someone who has had his fair share of lost battles, I can testify that the struggle against depression is not for the faint-hearted; but I can also state categorically that escapism – be it into drink, drugs or whatever – will only ever get you so far for so long. At some point we all have to confront our personal demons, and for the clinical depressive these may well be of Satanic proportions. But the fight is worthwhile, and anyone facing down a mental health problem deserves as much praise and patience for their courage and perseverance as any real-life war hero.

I will go into all of the above at greater length in my next post. Until then, stay strong and remember: it’s OK to fall down, as long as you pick yourself up and carry on. Even when every step is painful, there’s always a chance that the next one won’t be, or the next one after that: but you’ll never know unless you keep walking. Sound simplistic and reductionist? Perhaps – however, the logic is irrefutable.