Hello and welcome to Depression Awareness Week: a week of campaigning, chatting and, apparently, wearing hats, all aimed at, you guessed it, raising awareness of depression. Back in pre-austerity 2010, halcyon days I think you'll all agree, I wrote the following article in an attempt to do just that. My personal circumstances have changed, as has my waistline, but I'd like to think that the message hasn't. If it makes you feel anything; familiarity, sadness, hunger; then I implore you to do something. Seek out more information, talk to a friend, wear a hat - it doesn't matter. You can also email/tweet me. My details are at the end of the article. Thanks for reading.
Depression may be common in men, but it’s also highly taboo. ShortList’s special projects editor Andrew Dickens reveals his own battle with the black dog.
As the middle-aged Asian lady came to the door, she gave me a funny look. Pubs are used to people waiting outside for them to open; this, however, was a newsagent and it was 6am. I walked in wearing tracksuit bottoms, a coat and slippers – which may have contributed to the funny look – and bought 20 Marlboro Lights. I went the 30 yards back to my home.
If you met me, you would think I was fairly normal. That’s because I am. However, on this day, at this time, things were not so normal. I sat on my sofa, alone, stinking because I hadn’t slept, showered or, until that excursion, left the house for two days. Perhaps the newsagent lady could smell me, too. I poured a whiskey, chopped out a line of cocaine on my coffee table and stared through glazed eyes at BBC Breakfast. Then I cried.
I picked up the newspaper the other day (normal, see?). An article in it quoted recent research by mental-health charity Together. It was staggering. It claimed 55 per cent of Britons have suffered depression and 59 per cent its evil twin – anxiety. These are truly epidemic proportions; if they were pig-related, there’d be mass panic.
The opening paragraphs are a snapshot of dark days when depression had a nasty grip on me, battering me physically and mentally like an invisible school bully. It’s something I’ve never talked about before, because I always assumed I was a ‘freak’ that people wouldn’t want to touch for fear of catching my ‘mentalness’. Reading the report, though, I realised I wasn’t; I was in the majority. I also got to thinking and realised I’d never really understood my condition and how much it had affected my life. I now wanted to.
WHERE IT ALL BEGAN
I’ll give you a quick sketch of those bad old days; like an X Factor back-story (cue moving R Kelly track). For a period of about two years in my late-20s (I’m now 35), my life spiralled downwards. Crippled by a lack of self esteem, I thought the whole world was a success apart from me. I had no ambition, couldn’t hold down a job, lived off loans and cards and treated my then-relationship with as much fidelity as a Chelsea footballer. Add to all this a serious cocaine habit, the financial impact of which rapidly escalated the debts and eroded the job prospects.
Sleepless, solitary, powdery nights were spent becoming au fait with through-the-night television schedules, chain-smoking and drinking whiskey by the bottle. I stuffed tissues up my nostrils to absorb the nosebleeds, but would still whip them out for another line. When I eventually went to bed, I’d lie there, heart pounding, weeping at my inadequacies before contemplating taking my own life. Sometimes I wouldn’t get up again for a day. If that isn’t good enough for four yeses from the judges, I don’t know what is.
Now, before you conjure up an image somewhere between Trainspotting and Leaving Las Vegas, I’m illustrating the dark side here. It wasn’t all self-destruction and duvet days – a lot of the time I was fine; I had friends, I went out, I could be witty and charming (in my head, at least) and loved life. Sometimes.
The truth is, people can function, even thrive, with depression; if every person included within that 55 per cent statistic started wearing foil hats and shouting at lampposts, then the economy would collapse. But it hasn’t (well, not quite). Countless icons of the art and politics worlds have coped with depression, from Winston Churchill to Alastair Campbell and Stephen Fry. Coping, importantly, is the operative word here. As with any illness, you get good days and bad days, but you are ill. While people can cope, consciously or not, they still need to seek help. This, it seems, is a particular problem for us men.
The numbers say it all: twice as many women as men are diagnosed with depression, yet most countries have a male-to-female suicide rate of at least four to one. It can’t all be down to football results, so why the contradiction? I spoke to clinical psychologist Dr Roger Kingerlee who explained: “Guys often deflect the symptoms of depression and that can manifest itself in things like substance abuse, sexual behaviours or work addiction. This means they perhaps don’t get picked up as much.” That rang some extremely familiar bells.
“Men are also less likely to seek help for fear of being seen as incompetent or emasculated, while there is evidence to suggest the way men are raised makes us less inclined than women to deal with emotions,” he continued. “According to many, the two-to-one diagnosis ratio is simply because we won’t ask for a help.”
FIRST STEPS TO RECOVERY
I sought help – eventually. I plucked up the courage to see my GP. I didn’t know I was depressed, but it was very apparent that life’s box of chocolates was 95 per cent raw liver flavour and I wanted an explanation. He barely raised his eyes from his desk as I explained my lethargy and sadness. He made me feel like a truant schoolboy trying to make a fake illness sound plausible, which made me keep all that other bad stuff back. He suggested I buy a tub of St John’s Wort, a herbal remedy that ‘perks you up’. His attitude stank and, more importantly, he was wrong.
If we could make flashing neon signs appear on the page (I’ve asked – we can’t), I’d put one right here saying ‘read this paragraph’. That’s because I don’t want my experience to put people off seeing their GP. I’ve found out since that, thankfully, he was in the minority. Most GPs understand the condition and, if they can’t help, will refer you to someone who can. If you’re not happy with their diagnosis – and I know asserting yourself is the hardest thing to do when you’re depressed – insist there is a problem. And if that fails, get yourself a new doctor.
Months later I went back, insisting things were serious. He referred me to an NHS mental-health unit who diagnosed me with depression and prescribed Seroxat, an antidepressant. Ironically, fearing dependence on the drug, I took it for a week before throwing the pills away, but at least I now had a reason for the way I felt.
After two years of decline, the next 18 months saw a gradual climb towards life’s sunnier meadows. I began writing short, but reasonably lucrative, magazine articles – my first foray into journalism – which initially funded my habit, but eventually helped drag me out of the pit. For some reason, I never took drugs when I worked, so the more I worked, the less I took drugs. And the less I took drugs, the better I felt. It eventually got to the point where I’d be at magazines for weeks at a time and these periods of clarity gave me the chance to take stock. I ended the faithless relationship and, very soon after, knocked the coke on the head. My energy and enthusiasm began to increase, and I didn’t contemplate topping myself. Everything was hunky-dory. Or was it?
Until that point I had thought that the lethargy and suicidal thoughts were my only symptoms back then, but Dr Kingerlee’s far-too-familiar explanation of ‘deflection’ and a quick Google search for ‘depression symptoms’ showed they weren’t. Aside from the substance abuse and ‘sexual behaviours’ I had been exhibiting, I discovered that the self-esteem issues, distorted sense of achievement and sleeping problems are all classic signs of depression. The grip, I now understood, had been a lot tighter.
I also had food for thought; a huge bowl of Alphabetti Spaghetti spelling out the question: “Did I really rid myself of depression simply by ignoring it?” I wasn’t convinced. Despite having a great job and loving girlfriend, my self-esteem is still very low, enough to keep me from making the most of any ability I have, while my fervent atheism means I’m obsessed with mortality, and I definitely think that you earn more than me. I still ‘deflect’, too, just differently; the cocaine and sex replaced by food, booze and video games (I know that sounds like trading Keith Richards’ life for that of Keith from The Office, but I swear it’s an improvement). Self-analysis said I was still depressed, but I wanted to make sure, so I made an appointment with Dr George Fieldman, a London-based psychotherapist.
Entering his warm office, in the front room of a terrace house in leafy Barnes, I peeled off the multiple layers that had been protecting me against the new ice age. I sat slightly awkwardly in a comfy chair, while he sat cross-legged in a less comfortable one, asking me about my past and my present. I had been nervous, but now I confessed to everything, more than ever before. I could tell him anything without repercussion. It was actually easy. Perhaps this is where the phrase ‘the comfort of strangers’ comes from.
He carried on, asking me to score my relationships with parents, partner, ex-partners and siblings on a scale of one to five; a challenge for someone cursed with chronic indecision, especially as you could use percentage points. He asked me what aims I would have from therapy. “To get better” was the best I could come up with.
Finally, he gave me tests for anxiety and depression, questionnaires full of harmless boxes to tick. Dr Fieldman totted up the scores and told me that I fell into the ‘moderate’ range for both. (Well, they do say everything in moderation.) He flagged the low self-esteem up as a major indicator and raising this became one of my aims. He also surmised from the hour we had spent together that I had no personality disorders (as opposed to simply no personality). Good, I thought.
MANAGING THE SITUATION
He decided that I should try Cognitive Behavioural Therapy (CBT), a drug-free psychotherapeutic approach to treating mental illness that helps people change the way they think about a situation and how they react to it. All I had to do was use a form to rationalise my thoughts and, hopefully, provide a positive reaction. He also said that I needed to do more exercise and cut down on the whiskey and real ale, which sounded harder than filling in the form. This was all to be interspersed with hour-long therapy sessions every month or two. Painless and, if it wasn’t for the fact that it’s now in a magazine, something I could have done without a soul knowing.
So, was it all worth it? Absolutely. It gave me the confidence to be open about things, both on these pages and with the people I had most wanted to tell: my parents. I’d always feared stigma; as with any ‘new’ condition, humans are sceptical, lumbering towards understanding it like a gorilla who’s just been introduced to flat-pack furniture. But with my parents I was more worried about hurting them, disappointing them, that they would (incorrectly) blame themselves. I couldn’t have been more wrong. There were tears, of course, when I told them, but all I received was unconditional love and support and some of the kindest words I’d ever heard. I don’t know why I’d expected anything else.
It wasn’t easy to accept that I’m depressed, but by knowing I can recognise the signs, deal with it and, through a simple process, hopefully make more of life and myself. I had worried that, by examining my past and present states, I may end up with floor-to-ceiling soft furnishings and lots of white clothing. That didn’t happen. I don’t think it would happen to you.
For help with depression, contact your GP or visit NHS.uk/depression. To contact Andrew directly with any questions, email email@example.com or find him on Twitter @andrewdickens
This article was originally published in Shortlist Magazine in April, 2010.