It's the No.1 killer of young men, and it can sneak up on you, too. Andrew Dickens squares up to the sly creature that is depression.
Sometimes it takes people a while to come to terms with reality. Things like the Earth going round the sun and witches not being made of wood never sink in quickly. Some people still believe that dinosaurs were wiped out because they couldn’t fit on Noah’s ark.
This happened with depression. For centuries it was diagnosed as anything from imagination to demonic possession to being a big girl’s blouse. Thankfully, it’s now seen by anyone with a grasp of reality as an illness as dangerous as any other.
However, despite this enlightenment, depression still has its insidious little claws heavily embedded in society. It indiscriminately affects one in five people at some point in their life (and that’s just the diagnosed cases). That means, if you’re reading this in a populated area such as a café, train carriage or pottery class, several people around you have it.
It’s a particular problem for men. Nationally, according to the Campaign Against Living Miserably, suicide (depression’s most extreme symptom) is the biggest killer of men aged 15-34 and, despite depression affecting both sexes equally, we’re three times more likely to end our own lives than women. The good news is that it can be effectively managed.
Spotting depression is tough because it affects people in different ways. The wide spectrum of symptoms is like a mental health Dulux paint chart, with less appealing names. However, there are some primary colours to look out for.
The first, perhaps obviously, is your mood. If you experience a regular Sunday slump, you should calm down your Saturday nights or find a job you don’t hate. But if melancholy follows you like a bad smell for days and weeks, there might be more to it.
“The length of time is important,” says Emer O’Neill, chief executive of Depression Alliance. “Depression sticks. You’ll have a low mood or feeling of flatness. Things will add to it and you’ll get to a point where you feel hopeless. Your confidence and self-esteem goes.”
“You’ll have less interest in things you normally enjoy,” adds clinical psychologist Dr Roger Kingerlee. “Your sex drive can drop, as can energy and motivation levels, and you can find it hard to think, concentrate or make judgements. Often you’ll have recurrent thoughts of death or suicide, feelings of worthlessness or inappropriate feelings of guilt.”
There are physical symptoms, too. You can get aches and pains, your speech slow or quiet, your movement ponderous, bringing you within a tree branch of becoming a human sloth.
Your behaviour will also change. Sleeping and eating patterns can alter. You can become irritable, socially withdrawn, craving isolation. Alternatively, you might work too hard. And if you’re a man, you could well indulge in something psychologists call ‘deflection’ — a symptom easily confused with having a good time.
“You might increase substance use to try to self-medicate,” says Dr Kingerlee, “or other addictive behaviours — drugs, alcohol, gambling, sexual behaviours. If someone’s stressed, rather than talk about it, they’ll have a few pints. There’s a school of thought that men will become withdrawn and try to deal with it autonomously rather than seeking help.”
Depression seldom gives warnings. It likes to creep up silently and pounce, like a vampire intent on sucking all the fun out of you. And it can hit anyone. Two and half years ago, Joe Nickel was 29 and working in wealth management for a major bank in London. Then he was bitten.
“With the credit crunch and a new house to pay for, I was feeling stressed, but I thought I was coping,” he says. “Then, one morning, I started crying. I couldn’t make it to work. I tried going back to work two days later, but got half way there and started crying again. It was a shock. I was a senior manager at a bank, I was robust and sporty, I had great friends. Suddenly everything became tricky. I couldn’t get out of the house and I had no self- confidence. I couldn’t even decide on things such as socks and sandwiches.
“I was signed off work for six months and started medication and cognitive behavioural therapy (CBT). After three months, I was worse. I became suicidal. I decided to set an end point. Either I started to get better in the next month or I would take my own life. At least that way I could see an end to the pain.”
(Churchill was dogged by depression)
HOW TO COPE
It’s a good definition of rock bottom, yet we’re talking about Nickel in the present. That’s because he’s now thriving with a new career in the charity sector. He’s living proof that depression can be managed. As are other depressives who have done all right for themselves, such as Simon Cowell, Stephen Fry and Alastair Campbell. You just have to do the right things.
The first of these is to fight every ounce of your masculine pride and seek help from your GP, as Nickel did, so they can look into things such as medication or therapy and work out what’s best for you.
However, once you know you have the illness, there are some DIY measures that, if you stick with them, can help manage the situation. “Get information about it,” says Dr Kingerlee. “For many men it can be confusing — knowledge can be empowering. Talking about your feelings is good, too. Isolation is not good. Psychologically and intellectually, when new information comes into our system we update our view of the world, and that’s a hard thing to do by yourself.”
“That’s what we do at Depression Alliance,” agrees O’Neill. “We connect people with depression. The value of that is they’re all people who have been there. Compile a list of numbers that you can call if you need to, and who you know will take your call.”
“It helps to have structure and routine in your day,” Dr Kingerlee adds. “Positive event scheduling is a good one. Make plans to do things you enjoy and stick to them. Keeping a ‘what went well’ diary has also been shown to work. Every day for a few weeks, briefly note three things that went well, for instance, ‘Walked the dog, dog had a good time.’ It lights up different brain areas that remind us of our strengths.”
This order is also important in the office. As O’Neill explains: “People with depression often push themselves too hard at work. The depression’s triggered by setting standards that they can’t always meet. It’s important they find that balance, have breaks, go out for a run, get away from the computer. For employers, instilling that culture in the workforce is very important.”
Getting yourself moving is also thought to be vital. But when getting out of bed feels like an achievement, bashing out a quick triathlon has all the appeal of wet toast. However, exercise is nature’s endorphin- releasing pick-me-up, so do everything you can to get your heart pumping. “Still being able to do sport made a big difference,” says Nickel. “I honestly think that sport saved my life.”
Winston Churchill famously referred to his depression as the Black Dog and, while the beast still isn’t fully understood, there’s enough knowledge and support out there to ensure that, even if you can’t put Fido down, you can at least keep him on a very tight leash.
Images: REX FEATURES