Sunday, 12 October 2014

If I weren't the way I am, I shouldn't write my symphonies. [Gustav Mahler] - PART FIVE

As it's the end of National Depression Week I thought that I'd write a little about how things have been going in the last eighteen months since being diagnosed with clinical depression and starting on my medication. 

At first, I felt a tremendous relief that someone was finally taking me seriously and not simply telling me to pull myself together (I'd told myself that often enough) and that treatment was being offered. The preferred form of treatment is counselling (or talking therapy to use the modern jargon) but, unfortunately, there is a waiting list for this. My employer has been, on the whole, very supportive. I was offered counselling but this takes the form of one half hour session over the phone - if my problems were that easy I'd have sorted myself out long ago! So, the option quickly changed to medication and, being prescribed a Selective Serotonin Re-uptake Inhibitor (SSRI), I became the Sertraline Kid. 

Whether it was the placebo effect, the relief at the diagnosis or the immediate support of friends but I started to feel better and more positive (probably aided by the diagnosis and treatment of my diabetes and sleep apnoea) and it wasn't such an effort to get out of bed in the mornings and to leave the house. I was started on the lowest dose but, within a few months, was gradually moved up to the maximum, where I have stayed.

SSRIs are not happy pills, they still allow one to feel happiness and sadness but they enable the depressed person to function and experience 'normal' emotions. During the past eighteen months, the Sertraline Kid has fallen off his horse several times and there have been very dark times when, if I'm to be frank, I've struggled to keep on going. Fortunately for me, there has either been a good friend around to pick me up or I've been conscious of the fact that I need to battle on as my Dad and the Labrador rely on me.

Although Sertraline allows me to function in everyday situations and to cope with the pressures and stresses of work, it does have a down side in that although it focuses my mind, it removes the emotional drive to compose. It's ironic that when I'm being ruled by the Black Dog I have an irresistible urge to express myself through music but I find it very hard to focus my thoughts to do it and that when on medication I have the focus but loose the urge. I found when writing "Bugles Sang" for the National Youth Orchestra of Wales that I was see-sawing between both states by taking and not taking my medication - abstaining for a few days to get the creative impulse and then restarting in order to focus enough to get everything down on paper. Those few weeks were a real roller coaster of emotions.

Having thought that the Sertraline wasn't working, coming off it was a revelation. It is only when one stops the medication (not to be recommended) that one realises how effective it has been. That said, it can only do so much and one has to accept its limitations. I've been a depressive, with seriously dark periods, for over thirty years and two little pills everyday are not going to change that completely.

I saw a quote the other day "Think you're depressed? What if your pills are really working and your life is just shit?" It's a flippant remark but one that has more than an element of truth in it. We all have our problems, stresses and worries; the depressive person simply can't deal with them nor get them into perspective. We are already predisposed to unhappiness and dark thoughts and sometimes fail to appreciate that we are justified in feeling low because, actually, something shit has happened. I have, after a little thought, identified several things in my life that, if they were to be different, would have a massive effect upon my mood and general outlook on life. All I need to do now is to have the courage to face up to them!

I have spent time in my own personal hell and have faced down some of my demons although others still torment me. We all have the desire to be liked and loved but the depressive person craves it and wants constant reassurance. I'm aware that I have become very narcissistic and want to be  constantly told that my music isn't shite and that it means something to the people that I like, love and respect. There is a persistent and pernicious need for approval and validation, to the point of being pathetic. Normally, if you hate someone or something you just keep away from them, what do you do when you hate oneself? 

Self-loathing is a major problem and very hard to overcome. When people are nice I tend to think it's because they pity me for being a failure and my response can be quite awkward. Everyone has a level of self-doubt, the depressive person develops this into an art-form.

So, the last eighteen months have been both difficult and enlightening as the Sertraline Kid has ridden the Ranges of Depression, frequently falling off his trusty steed and landing on his backside in the dust. I have learnt (and am learning) much about myself and also seeing the world in a different light. I think I'm becoming more tolerant having realised that we can never know what's going on in someone else's mind and what their troubles might be - as the saying goes "Don't judge someone else, you have no idea what their journey might be" - and, deep down, beneath all the bravado, we are all fragile creatures.