“After all, what are birthdays? Here today and gone tomorrow.”
- Eeyore (from A. A. Milne’s ‘Winnie the Pooh’)
Another year gone. I’ve now officially been on this planet for 19 years and I’m trying to work out where the time has gone. This is the problem I have with birthdays, I can’t help looking back and reflecting on what I’ve done since the last one, and my thoughts aren’t sitting well with me. On one hand you could say that I’ve achieved a fair bit during the last year; I’ve finally come to terms with my depression, I’m getting weekly counselling sessions during term time, I’m slowly getting over my views on anti-depression medication, I’ve successfully completed my first year in university...all things which show that I’m moving on in my life, so why do I feel that the opposite is true?
My counsellor and doctors would probably tell you that my battle with depression has moved on immensely since my last birthday. I don’t disagree with them that accepting that I suffer from the condition is a big step in the right direction, but looking back, I can’t see what has changed. For example, I still can’t bring myself to tell people about my illness, I still have major problems when it comes to talking face-to-face with someone about my feelings; I hide emotions and hide my true self. I feel that the depression itself has gotten worse. Compared to last year, my general happiness is much lower; my depressive episodes are more frequent, last longer and are more severe. I am finding myself feeling vulnerable and considering suicide far more often than the previous year and I have found myself coming far too close to giving into these thoughts.
So here I am, on my birthday, sitting here desperately wanting to cry but my body, so used to hiding such emotion, is refusing to let the tears fall. I feel like a failure. I’m letting this illness take over my life. It’s making me lie to my friends and family, it’s causing me so much conflict in my head that I rarely get over six hours sleep at night, basically it makes me feel shit and I can’t see it changing. It makes me wonder, what will I be thinking in a year’s time? Will I be looking back like I always do and seeing an improvement in my life, or will I be seeing how my depression has taken over more of my life and be in an even bigger state of despair and worthlessness?
One question is even more prominent.
Will I even be here in a year’s time...?
Showing posts with label Counselling. Show all posts
Showing posts with label Counselling. Show all posts
Sunday, 13 July 2008
Wednesday, 9 July 2008
Media Opinions; CBT and Depression
I read an article in the Independent earlier today on the effectiveness of CBT (Cognitive Behavioural Therapy) in treating depression. Here in the UK, the prescription of anti-depressants has been widely criticized, many articles have been written about the potentially harmful side effects, how they are overprescribed, and questions have been raised asking whether they actually work or whether it’s a placebo effect that causes people to feel just that little bit better. After such articles, doctors have been less willing to prescribe medication and now turn to CBT as their first choice of treatment. Now it seems that this shouldn’t be first choice treatment either.
CBT is a type of therapy which concentrates on behaviour and assumptions. It aims to get people to change negative feelings into more positive ones by suggesting new ways of looking at things, replacing the irrational thoughts with more rational and self-helping ones. According to the cognitive theory of depression written by the psychiatrist Aaron Beck, depressed people think the way they do because their thinking is biased towards negative interpretations. These negative thoughts follow a type of pattern and through CBT, a depressed person is helped to break these trends and change their perception on events in their life. According to the facts and numbers, it works. One course of CBT is likely to produce 12 extra months free of depression. So why is it getting criticized?
It was described in the article as a quick fix to the problems depression causes. Unlike other forms of therapy, it doesn’t look deeply into the cause of the depression in the first place. Also its effectiveness at treating major depression is put to question. Personally, I can see where they are coming from. Even though CBT wasn’t suggested to me, looking back, my school counsellor seemed to use those types of techniques. She focused very much on dealing with my feelings there and then rather than why I was feeling them. She would often tell me to try and look on the more positive side of things, try to tell me that I had more reasons to feel happy than sad. Now I’m not saying this is the best example of CBT, I decided long ago that my school counsellor must have gotten her qualification from a Christmas cracker so using her sessions as an example isn’t the most accurate thing in the world, but I’m not sure that CBT would be the best treatment for me. To me it does seem like it just treats the symptoms rather than treating the cause. But I can’t argue with the facts. CBT has been proven to work and I think for mild or moderate depression it should be considered a first choice, if it’s right for the patient that is. For sufferers of major depression and bipolar...in my opinion, no. If someone is having frequent suicidal thoughts for instance, you have to look into why they feel like they do, delve a little deeper than just treating the emotions felt.
Reading the article brought to light another concern for me. Depression is a hard thing to diagnose correctly and an even harder thing to treat. There isn’t a ‘one treatment fixes all’ solution. The media are very quick to point out problems in the treatment and diagnosis. Obviously CBT works, but just not for everyone. Anti-depressants work for some people but not for everyone. The first sign of a treatment not working, the media seem to jump on it. I’m not sure doctors know what the best cause of treatment is anymore and I can’t see how all these articles are going to help. For someone who thinks that they are potentially depressed, aren’t they going to be put off by all this confusion? I have to admit, when it comes to anti-depressants, I have been influenced by the media’s dislike towards them. After reading article upon article highlighting the down points of taking them, I’m currently stubbornly going against my doctors’ opinion and taking a substitute option instead which are anti-anxiety tablets. Anxiety isn’t even a major part of my depression. I know I’m slowly coming around to the idea of taking anti-depressants, after being told by my counsellor, my doctor and Henrik, I’m starting to accept that I may need them. But how many others have also been influenced? How many others are putting off seeing a doctor due to things written and reported by the media? I say they should start telling people how these treatments are helping people rather than concentrating on the negative side of it all. Personally, I think the media need to book themselves in for their own session of CBT.
CBT is a type of therapy which concentrates on behaviour and assumptions. It aims to get people to change negative feelings into more positive ones by suggesting new ways of looking at things, replacing the irrational thoughts with more rational and self-helping ones. According to the cognitive theory of depression written by the psychiatrist Aaron Beck, depressed people think the way they do because their thinking is biased towards negative interpretations. These negative thoughts follow a type of pattern and through CBT, a depressed person is helped to break these trends and change their perception on events in their life. According to the facts and numbers, it works. One course of CBT is likely to produce 12 extra months free of depression. So why is it getting criticized?
It was described in the article as a quick fix to the problems depression causes. Unlike other forms of therapy, it doesn’t look deeply into the cause of the depression in the first place. Also its effectiveness at treating major depression is put to question. Personally, I can see where they are coming from. Even though CBT wasn’t suggested to me, looking back, my school counsellor seemed to use those types of techniques. She focused very much on dealing with my feelings there and then rather than why I was feeling them. She would often tell me to try and look on the more positive side of things, try to tell me that I had more reasons to feel happy than sad. Now I’m not saying this is the best example of CBT, I decided long ago that my school counsellor must have gotten her qualification from a Christmas cracker so using her sessions as an example isn’t the most accurate thing in the world, but I’m not sure that CBT would be the best treatment for me. To me it does seem like it just treats the symptoms rather than treating the cause. But I can’t argue with the facts. CBT has been proven to work and I think for mild or moderate depression it should be considered a first choice, if it’s right for the patient that is. For sufferers of major depression and bipolar...in my opinion, no. If someone is having frequent suicidal thoughts for instance, you have to look into why they feel like they do, delve a little deeper than just treating the emotions felt.
Reading the article brought to light another concern for me. Depression is a hard thing to diagnose correctly and an even harder thing to treat. There isn’t a ‘one treatment fixes all’ solution. The media are very quick to point out problems in the treatment and diagnosis. Obviously CBT works, but just not for everyone. Anti-depressants work for some people but not for everyone. The first sign of a treatment not working, the media seem to jump on it. I’m not sure doctors know what the best cause of treatment is anymore and I can’t see how all these articles are going to help. For someone who thinks that they are potentially depressed, aren’t they going to be put off by all this confusion? I have to admit, when it comes to anti-depressants, I have been influenced by the media’s dislike towards them. After reading article upon article highlighting the down points of taking them, I’m currently stubbornly going against my doctors’ opinion and taking a substitute option instead which are anti-anxiety tablets. Anxiety isn’t even a major part of my depression. I know I’m slowly coming around to the idea of taking anti-depressants, after being told by my counsellor, my doctor and Henrik, I’m starting to accept that I may need them. But how many others have also been influenced? How many others are putting off seeing a doctor due to things written and reported by the media? I say they should start telling people how these treatments are helping people rather than concentrating on the negative side of it all. Personally, I think the media need to book themselves in for their own session of CBT.
Tuesday, 8 July 2008
Have you ever been alone in a crowded room?
“Sometimes when I say ‘Oh I’m fine’ I want someone to look at me in the eyes and say ‘Tell the truth’”
Nights are when I feel worst and these last couple of nights have been no exception. Right now I’m writing this purely to distract myself. It’s hard for me to describe exactly what I’m feeling; an overwhelming feeling of hopelessness, the lack of energy to simply go on, extreme loneliness despite knowing my friends are only a phone call away...
Maybe that’s the problem. I know how the conversation would go. They’d ask me what was wrong and the facade would go up. They’d hang up thinking I was fine, I’d hang up wishing they had probed deeper. This is where the hypocritical nature of my problem appears. I want people to know that I suffer from this, I want them to know that actually I’m not fine, I want them to see what I’m going through but at the same time I don’t want them to know, I want them to carry on believing that I’m a happy stable person. I’ve realised that I’m not going to tell them unless one day they decide to probe a little deeper, question me. Out of the four people who know about my illness, only one has been told willingly.
The first person to know was my mother, I told her that winter night after my early morning adventure. I couldn’t exactly deny that there was something up; I was in a complete state. Even though she suffers from depression herself and I’m very close to her, I find it very hard to talk to her about it. I never go into any detail and I have never mentioned how bad it actually is. I could never tell her that I consider suicide for example, and definitely couldn’t tell her how close I have actually got to it. When I feel like this, I can’t bring myself to go to her, I can’t let her see me because I don’t want to upset her.
Shortly after my Christmas episode I told Henrik, the only person I have told willingly. Now you can probably guess from the name, Henrik is Swedish. Being in different countries, we talk through MSN mostly. At the time, I needed someone to talk to. I had only just accepted that I had depression and he seemed the best person to help. Talking through MSN where you don’t see the person’s face and can’t hear their voice makes talking about my feelings so much easier. The main reason I hold back on telling people is because I don’t want them to judge me or suddenly view me differently. I don’t have that problem with Henrik. I put the fact that I’m still here purely down to him. He has saved me on a number of occasions though he probably doesn’t know it. There are many things I wish I could tell him but there are some things, even over MSN, I still can’t bring myself to say. The issue of course with MSN is I can only talk to him if I’m at a computer and he’s online. Lately he hasn’t been online as much due to work and other issues, meaning when I hit a down spell and he isn’t online, like now, I have to cope without him, something that is getting harder to do. Right now I would give anything to just talk to him; instead I’m left here feeling alone.
The third person to know was Amanda. I knew that when I went back to university after the Christmas break I would need someone up there to know, just so if I did try to do something stupid, someone would be there to look out for me and stop me. I told her because I felt I had to, not because I necessarily wanted to. I chose her out of all my university friends because I thought she would have the best chance of understanding. She suffers from anorexia and had confided in me a number of times. A lot of what she was feeling, I could relate to and so the decision to choose her came pretty easy. Actually telling her was another matter. In the end, she found out through a rather longwinded email (as you can see, I do tend to go on a bit sometimes). I don’t talk to her much about it, I still find it hard to talk to someone face-to-face when I’m in a state, but after Henrik being online less, I’ve had no choice but to rely on her a little more. I’m getting a little better at it, but now, me being back home in Wales and her living in London and currently jetting off to Zanzibar, knowing that she knows offers little comfort.
And then the fourth person is my counsellor. Not really sure he counts, but there we go. I’ve been seeing him for about six months now but as I see him through the university, I’m currently not having any sessions and I won’t start up again until October. Even though I find it hard to talk to him, still not over my face-to-face issues, he is easier to talk to than others. I don’t mind crying in front of him or showing how much everything is affecting me, and not having those weekly let-out sessions are definitely effecting me.
So I’m stuck with feeling alone, in need of a hug and in need of a shoulder to cry on. I often go through all the people I know and I wonder whether I could actually tell any of them. Some definitely wouldn’t understand, most would change how they treated me. Truth is I’m scared of letting people know, despite how badly I need it to happen. I guess all I can wish for is someday someone will see through my facade and that that day comes soon because I’m not sure how long I can take this loneliness.
Nights are when I feel worst and these last couple of nights have been no exception. Right now I’m writing this purely to distract myself. It’s hard for me to describe exactly what I’m feeling; an overwhelming feeling of hopelessness, the lack of energy to simply go on, extreme loneliness despite knowing my friends are only a phone call away...
Maybe that’s the problem. I know how the conversation would go. They’d ask me what was wrong and the facade would go up. They’d hang up thinking I was fine, I’d hang up wishing they had probed deeper. This is where the hypocritical nature of my problem appears. I want people to know that I suffer from this, I want them to know that actually I’m not fine, I want them to see what I’m going through but at the same time I don’t want them to know, I want them to carry on believing that I’m a happy stable person. I’ve realised that I’m not going to tell them unless one day they decide to probe a little deeper, question me. Out of the four people who know about my illness, only one has been told willingly.
The first person to know was my mother, I told her that winter night after my early morning adventure. I couldn’t exactly deny that there was something up; I was in a complete state. Even though she suffers from depression herself and I’m very close to her, I find it very hard to talk to her about it. I never go into any detail and I have never mentioned how bad it actually is. I could never tell her that I consider suicide for example, and definitely couldn’t tell her how close I have actually got to it. When I feel like this, I can’t bring myself to go to her, I can’t let her see me because I don’t want to upset her.
Shortly after my Christmas episode I told Henrik, the only person I have told willingly. Now you can probably guess from the name, Henrik is Swedish. Being in different countries, we talk through MSN mostly. At the time, I needed someone to talk to. I had only just accepted that I had depression and he seemed the best person to help. Talking through MSN where you don’t see the person’s face and can’t hear their voice makes talking about my feelings so much easier. The main reason I hold back on telling people is because I don’t want them to judge me or suddenly view me differently. I don’t have that problem with Henrik. I put the fact that I’m still here purely down to him. He has saved me on a number of occasions though he probably doesn’t know it. There are many things I wish I could tell him but there are some things, even over MSN, I still can’t bring myself to say. The issue of course with MSN is I can only talk to him if I’m at a computer and he’s online. Lately he hasn’t been online as much due to work and other issues, meaning when I hit a down spell and he isn’t online, like now, I have to cope without him, something that is getting harder to do. Right now I would give anything to just talk to him; instead I’m left here feeling alone.
The third person to know was Amanda. I knew that when I went back to university after the Christmas break I would need someone up there to know, just so if I did try to do something stupid, someone would be there to look out for me and stop me. I told her because I felt I had to, not because I necessarily wanted to. I chose her out of all my university friends because I thought she would have the best chance of understanding. She suffers from anorexia and had confided in me a number of times. A lot of what she was feeling, I could relate to and so the decision to choose her came pretty easy. Actually telling her was another matter. In the end, she found out through a rather longwinded email (as you can see, I do tend to go on a bit sometimes). I don’t talk to her much about it, I still find it hard to talk to someone face-to-face when I’m in a state, but after Henrik being online less, I’ve had no choice but to rely on her a little more. I’m getting a little better at it, but now, me being back home in Wales and her living in London and currently jetting off to Zanzibar, knowing that she knows offers little comfort.
And then the fourth person is my counsellor. Not really sure he counts, but there we go. I’ve been seeing him for about six months now but as I see him through the university, I’m currently not having any sessions and I won’t start up again until October. Even though I find it hard to talk to him, still not over my face-to-face issues, he is easier to talk to than others. I don’t mind crying in front of him or showing how much everything is affecting me, and not having those weekly let-out sessions are definitely effecting me.
So I’m stuck with feeling alone, in need of a hug and in need of a shoulder to cry on. I often go through all the people I know and I wonder whether I could actually tell any of them. Some definitely wouldn’t understand, most would change how they treated me. Truth is I’m scared of letting people know, despite how badly I need it to happen. I guess all I can wish for is someday someone will see through my facade and that that day comes soon because I’m not sure how long I can take this loneliness.
Thursday, 3 July 2008
How the Darkness Hit
Looking back, I don’t think I have ever been completely happy. Of course, things have happened which have made me happy for a little while, but on the whole, I don’t remember a period of carefree happiness. I noticed a turning point at the time of my GCSE exams, I was 15 going on 16 and suddenly it wasn’t just sadness anymore, it was a prolonged feeling of hopelessness, it felt like something was eating away at me, taking away all energy and enthusiasm until all that was left was an empty shell. At that time, I had no reason to feel as bad as I did, my exams were going well, my life back home was stable and it wasn’t like I didn’t have any friends. The only thing I could think of that was causing it all was the pressures of growing up and so I hid it away. I was embarrassed that I couldn’t handle such a simple thing as growing older and I learnt to hide these feelings, I managed to put a smile on in public and people believed it.
As time went on, the facade I had created was becoming harder to keep up. I found myself unable to hold back tears and would often have to come up with excuses to explain to friends and teachers. This came easy to me due to the fact that things at home were starting to get a little tense. It offered the perfect get out. My parents were arguing because my dad had been spending money we didn’t have on god knows what. He didn’t work and had slowly become addicted to some online game. He knew more about peoples’ lives on that than he did about me or my brother. Money was tight and I was drifting further away from my dad, but still it seemed like there was something else contributing to my miserable outlook on life.
It’s hard for me to pinpoint when the suicidal thoughts started but I guess it was around this time. Still I would hide away, now even more ashamed for thinking such things just because I couldn’t deal with a little stress in my life. By the time I was in my last year of school, things at home had gotten pretty bad and I was just waiting for my mother to tell me that she was going to ask for a divorce. My chemistry teacher kept me back one lesson and I knew what he was going to say;
“I know something is up. Last year you were smiling away, I haven’t seen you smile once recently, what’s changed?”
It took me a while to answer, in the end I told him all about what was going on at home, my feelings about my dad, everything apart from the thing that deep down I knew was the real issue. I think he knew I was hiding something, to be fair; he had been the only one to notice the slight cracks in my facade. He suggested that I see the school counsellor and after some thought I agreed. My counsellor was a rather plump woman with strong religious beliefs and would often say that all I needed to do was think positively about things. This began to make me feel worse. I still hadn’t accepted that depression was the issue, I still hid away behind the convenient excuses, and she seemed to willingly believe that my stress at home was all that was behind my negative emotions. One session I outwardly said that I just wanted to give up, to which her reply was “I want you to start looking at the positive side of things, thinking positively will help you control your emotions” How could I think positively when all I could see was this bitter darkness that was draining away my energy? I started to skip sessions. I felt like she wasn’t taking me seriously, I felt weak, belittled, and I had this sudden urge to prove her wrong, to show her that she had misunderstood me. I wanted to kill myself so she could see that her get a grip attitude didn’t work. It lasted months. I became obsessed with death, researching into different methods. By this time, my mother had asked for a divorce, and I had started my summer job. I think this new distraction in my life helped me snap out of my recent obsession. I was going to start university in a few months; I would be 300 miles away from home, away from everything. I still felt down, I still knew something was wrong but I had some hope, I thought as soon as I got away from home, I’d get away from this curse, but it didn’t work out that way.
It wasn’t until Christmas time that I finally accepted that I had depression. I was back home and one night I locked myself in my room and began to cry hysterically. I didn’t want to be there any more; I had such a strong urge to kill myself that I had already taken more than the recommended dose of painkillers. But something snapped, I didn’t want to do it, I knew that I needed to get out and so at 2AM I walked out into the cold winter street with no coat, walked for miles not caring where I ended up. Of all the places to go, I ended up at TESCO. The security guard gave me a funny look when I walked in. I didn’t buy anything, I didn’t have any money on me, so I just walked around before deciding to go back home, receiving another funny look as I walked out. I was greeted at home by my very worried mother and all I could do was cry. It was at that point I accepted I had a problem and agreed to see a doctor.
Luckily for me, my university offers a free counselling service. I have weekly sessions with my counsellor during term time who is just a little more competent than my previous one. Medication has been recommended to me a number of times recently and I have only just gotten over my stubborn attitude towards it. My doctor, knowing how much I don’t want to go on anti-depressants, has put me on anti-anxiety medication for now but I know it’s only a matter of time before that’ll change. I guess we’ll see how things go.
As time went on, the facade I had created was becoming harder to keep up. I found myself unable to hold back tears and would often have to come up with excuses to explain to friends and teachers. This came easy to me due to the fact that things at home were starting to get a little tense. It offered the perfect get out. My parents were arguing because my dad had been spending money we didn’t have on god knows what. He didn’t work and had slowly become addicted to some online game. He knew more about peoples’ lives on that than he did about me or my brother. Money was tight and I was drifting further away from my dad, but still it seemed like there was something else contributing to my miserable outlook on life.
It’s hard for me to pinpoint when the suicidal thoughts started but I guess it was around this time. Still I would hide away, now even more ashamed for thinking such things just because I couldn’t deal with a little stress in my life. By the time I was in my last year of school, things at home had gotten pretty bad and I was just waiting for my mother to tell me that she was going to ask for a divorce. My chemistry teacher kept me back one lesson and I knew what he was going to say;
“I know something is up. Last year you were smiling away, I haven’t seen you smile once recently, what’s changed?”
It took me a while to answer, in the end I told him all about what was going on at home, my feelings about my dad, everything apart from the thing that deep down I knew was the real issue. I think he knew I was hiding something, to be fair; he had been the only one to notice the slight cracks in my facade. He suggested that I see the school counsellor and after some thought I agreed. My counsellor was a rather plump woman with strong religious beliefs and would often say that all I needed to do was think positively about things. This began to make me feel worse. I still hadn’t accepted that depression was the issue, I still hid away behind the convenient excuses, and she seemed to willingly believe that my stress at home was all that was behind my negative emotions. One session I outwardly said that I just wanted to give up, to which her reply was “I want you to start looking at the positive side of things, thinking positively will help you control your emotions” How could I think positively when all I could see was this bitter darkness that was draining away my energy? I started to skip sessions. I felt like she wasn’t taking me seriously, I felt weak, belittled, and I had this sudden urge to prove her wrong, to show her that she had misunderstood me. I wanted to kill myself so she could see that her get a grip attitude didn’t work. It lasted months. I became obsessed with death, researching into different methods. By this time, my mother had asked for a divorce, and I had started my summer job. I think this new distraction in my life helped me snap out of my recent obsession. I was going to start university in a few months; I would be 300 miles away from home, away from everything. I still felt down, I still knew something was wrong but I had some hope, I thought as soon as I got away from home, I’d get away from this curse, but it didn’t work out that way.
It wasn’t until Christmas time that I finally accepted that I had depression. I was back home and one night I locked myself in my room and began to cry hysterically. I didn’t want to be there any more; I had such a strong urge to kill myself that I had already taken more than the recommended dose of painkillers. But something snapped, I didn’t want to do it, I knew that I needed to get out and so at 2AM I walked out into the cold winter street with no coat, walked for miles not caring where I ended up. Of all the places to go, I ended up at TESCO. The security guard gave me a funny look when I walked in. I didn’t buy anything, I didn’t have any money on me, so I just walked around before deciding to go back home, receiving another funny look as I walked out. I was greeted at home by my very worried mother and all I could do was cry. It was at that point I accepted I had a problem and agreed to see a doctor.
Luckily for me, my university offers a free counselling service. I have weekly sessions with my counsellor during term time who is just a little more competent than my previous one. Medication has been recommended to me a number of times recently and I have only just gotten over my stubborn attitude towards it. My doctor, knowing how much I don’t want to go on anti-depressants, has put me on anti-anxiety medication for now but I know it’s only a matter of time before that’ll change. I guess we’ll see how things go.
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