I've got to know Clive recently as both of us write blogs for Haddon Musings' Senior Salon on WordPress. Clive kindly agreed to share his experience of depression by answering 20 of my questions, and hopefully his answers might help readers in a similar situation. You can find out more about Clive by following his blog https://cliveblogs.wordpress.com/about/ or checking out Haddon Musings' Senior Salon http://haddonmusings.com/2016/02/10/senior-salon10/
1. Did you have a happy childhood?
Yes. My parents weren’t rich, but both worked hard to give my sister and me as much as they could. I used to enjoy reading and playing games, outdoor sports and indoor board games. With much less than today in the way of distractions – only 2, then 3 TV channels, no computer games – we made our own entertainment and were encouraged to talk and discuss things. Above all, we felt loved.
2. Did you enjoy your schooldays?
Yes, again. I went to a small village primary school, which was a lot of fun. I guess I was lucky in that the academic side came easily to me which always meant that I enjoyed lessons. And we had the use of the local playing field beside the school too, so lunchtimes and sports were great! Moving on to grammar school was good for me, although I admit to being nervous about the change: I was born two weeks after the cut-off date for secondary admission and was allowed to start just before my 11th birthday, rather than wait a whole year. I felt that the other boys would look down on me at first, as some kind of oddity, but I quickly got over that and really enjoyed it. Good friends, some – but not all! – good teachers, and an environment which suited me. But as it was a single sex school I did feel at a disadvantage in chatting up girls when the time came! Fortunately, I got over that quickly too!
3. Do you tend to suffer from low self-esteem?
This is a really difficult one. It’s complicated, as they say! I don’t lack for self-confidence, and believe in my abilities. But I do feel that I haven’t left much of a mark on the world in my 62 years to date. I don’t feel worthless or undeserving of people’s friendship, but I do think of myself as somehow being less ‘valuable’ than some others.
4. Are you an extrovert or an introvert?
Definitely an introvert. I’m very comfortable with my own company, and can be quite shy meeting new people, particularly in a group setting where I’m the new one. I’ve always felt happier being part of a team and, although at one time in my career I was managing a team of 15 staff covering 6 different roles I think I make a good second in command! That’s not to say that I shy away from putting myself forward if I have to, but if I’m honest with myself I probably try not to get into that situation in the first place. However, having said all that, I have become very used to going out on my own since I was divorced 8 years ago: I really enjoy concerts and live sport and always chat quite happily with the new people I meet there.
5. Do you have a network of close friends that you can call on for support?
I’ve never been that good at holding on to friendships beyond the context in which they were made. I have one close friend from schooldays, plus a couple of others that I still exchange Christmas cards and news with. But I’m no longer in contact with anyone from my university days – either university! I made a conscious decision not to make that mistake again when I retired, and we have kept together the ‘gang of four’ who used to lunch together, even though none of us still works for that employer. We now meet roughly monthly for lunch and an activity, like a museum, an exhibition or an art gallery, and there is regular telephone contact too. I feel that I can and do rely on this group for support nowadays and, if the depression returned I know I could depend on them. They know me well and look out for me.
But if the question had been asked about my long spell off work with depression, that answer would have been ‘no.’ I took a long time to admit to myself that I was ill, and then shut myself away from people I knew. In fact, I had more contact about it with people on Twitter than I did with people I knew: I guess it was easier to relate to others that way than to try to explain it to people face to face. Mental health issues are stigmatised and I did that to myself.
6. Was work-related stress a major factor in your depression?
I don’t think it was, but I have difficulty explaining what the triggers might have been. I had a 3-month spell off work with ‘stress’ in 2006/7, but my marriage was falling apart at the time and this seemed the obvious reason for that. But the second, much longer and more severe spell, 9+ months in 2011/2, started at a time when I was under less stress at work than I can ever remember being at any time. My stressful job had been restructured out of existence in 2009 and I’d had 2 years working on projects, being used as a troubleshooting resource on work that needed to be done but which no one had the time to take on. I was happy in this, I was on my third such project and it was going well, so I really can’t see how that could have brought on my depression. But I can’t think of anything else that would have caused it, either. I think I could more realistically have expected it to happen in 2008 after the divorce and my mother’s death, but three years later seems like a very long-delayed reaction!
7. What do you think caused your panic attacks on your return to work after a long absence of sick leave?
I had several minor feelings of panic after I returned to work in July 2012, but there was no obvious cause for these: I think it was just an underlying nervousness about ‘being out in the world’ again. The major panic attack came one morning about three weeks after I went back, in early August. I live at the end of the Central Line on the London Underground which, at that time, was ‘enjoying’ heavier than normal traffic as it was the main line for the Olympic Stadium. That morning, a system failure meant that we had no trains and were not even allowed into the station. I spent about an hour waiting in what became a fairly large, impatient throng, comprised both of commuters like me trying to get to work and people eager to get to the Olympics. Gradually, as space was limited, people starting pressing forward and I suddenly felt totally incapable of coping with the crowd. I managed to extricate myself and made the short walk home faster than I usually do. I had an appointment with my counsellor booked for the next day and told him about this, and my nervousness at being in a crowd. He encouraged me to develop a coping strategy based on recognising my own space and protecting it from ‘invasion,’ a form of avoidance, really. Sometimes this could be easier said than done but it served me well: I managed to attend the Olympics Football Final in a capacity crowd at Wembley Stadium about 10 days later without any problem, until I reached the huge crowd waiting to get into the station after the game. I spoke to a policeman and on his advice made my way to a different station, which had none of the same crowds. I think I may not have managed the larger crowd though! I’m lucky, but I’ve never had a feeling like that since, even on a crowded train – and if you’ve ever travelled on the Central Line in rush hour you’ll know what that can be like!
8. Did you think you would ever be cured during the ‘black dog’ days of your worst depressive episode?
No. At those times there seemed no end to it. There were no positive thoughts anywhere in my brain, and all I could do was to try to wait for the darkness to lift and hope that I didn’t cause anyone any hurt or upset by my behaviour. I had a couple of fallouts and learned that the best way to cope was to shut myself away until I was capable of interacting with people again. But these only felt like a brief respite: being ‘cured’ just didn’t seem like a possibility.
I don’t think you can ever be ‘cured’ of depression anyway. If it is in one’s make up to suffer from it, or any other mental illness, it could recur at any time. I don’t think of myself as cured nowadays, rather that I am in some kind of remission which will hopefully be permanent.
9. Do you remember your worst ever day, or in general does the brain tend to try and forget?
To be honest the only day I can really remember is the one on which I finally admitted to myself that something was wrong, and made the call to my GP to seek help. I had a number of really bad days – including a few after I went back to work – but never had any suicidal thoughts. I’m probably too much of a coward to have tried that anyway, even if I had had them. Otherwise, the days just seemed to merge into a long period of horribleness, during which I felt incapable of doing anything. I had no ability to concentrate, e.g. to read or watch a TV programme. Somehow, I just existed.
10. What advice did you receive from your counsellor, and did you find it helpful?
Initially, this is where the system failed me. I was referred for the local counselling service almost as soon as I was diagnosed with depression but, despite several reminders from my GP and, later, from me, I was never accepted into a programme. The service was provided by a voluntary organisation and from what I could gather they weren’t able to provide enough capacity to meet demand.
I got lucky later though. I worked for the NHS – perhaps ironically for an organisation providing mental health services – and one of the conditions of my return to work was to agree a programme with the Occupational Health Service. This included a referral to the in-house counselling service, and I was allocated a six session course of Cognitive Behavioural Therapy (CBT), which actually became seven sessions. The focus of this was geared towards helping me understand how I thought about myself, how I could see what had happened to me and to develop a way of coping with everyday life and with any times when I might feel low again. It started with him getting me to put some notes together for our sessions, answering some questions he had set to give me a focus. These took the form of a ‘homework,’ which I had to start before our first session. I have managed to find the template he gave me, which was this:
Thoughts about SELF, EX-WIFE, FUTURE, RELATIOSNHIPS
What are your UNACKNOWLEDGED NEEDS?”
Clearly, he was getting me to look into myself in ways that I had never done before, as a way of drawing out anything which I needed to work on to improve my outlook and approach on life. I don’t know if I still have the originals, but initially these were just handwritten notes, and then he got me to turn these into longer narratives. I imagine that I do have these somewhere, as I’m an habitual hoarder, but the fact that I haven’t felt the need to find them and refer to them for so long is, to me, a good sign. One of the longer pieces that I have never shared with anyone other than him was a ‘letter to my ex-wife’ which I remember was blisteringly honest and which I would never actually say to her! Underlying all of this was his helping me to build confidence in my ability to cope, and to be able to self-assess as I had never done before. Above all, his advice was to try to take a step outside myself and to take as objective a view as possible of what I was feeling and doing, to be able to think my way through any problems or issues. He also encouraged me to be honest with myself about my feelings, and moods, and to relate back to what I had written as a means of recognising any subsequent recurrence of my illness.
He described my writing as ‘inspirational’ and suggested I used it to start a blog, which I did. My first post was just over a year after my depression had been diagnosed. At that time, I was quite active on Twitter and that helped me to build a potential audience for my first attempts at blogging, but I still got a much greater and more positive reaction than I could either have hoped for or expected. Above all, I felt valued in that sharing my experience was helping others, and was amazed how many people shared similar experiences as a result. This is what my counsellor had been telling me, and this was his way of showing me that he was right! It helped me not just to get this response but also in that committing my thoughts into blog posts was a form of catharsis, it somehow took me out of myself and helped me better to understand what I had gone through. This was, I think, the most valuable benefit from the counselling process.
11. Were you encouraged to join a support group?
One of the possible reasons for my not receiving any counselling from the initial referral was that I had agreed with my GP that a group situation wouldn’t work for me – I would probably withdraw into my shell and not contribute. Group treatment was more readily available but we felt that this just wouldn’t be right for me. This must have been on my record somewhere, as Occupational Health told me that they would seek to provide me with individual, one on one support.
Nowadays I’m much more comfortable talking about mental health, both in general and from my own experience. If I was ever in that situation again I feel that a support group might be helpful for me now.
12. Do you have to continue on a low maintenance dose of anti-depressants for the rest of your life?
No. I continued with medication for just over four years, with a gradual reduction of the dosage to the point where it was planned that I would run out of tablets and have two weeks free of them before my next GP appointment. As I was coping well we agreed that I should come off them. That was just over two months ago and I haven’t felt any need of them since then. But I am being trusted to recognise any return of the signs that led to my original diagnosis and to seek help if I do.
13. Did you find exercise beneficial on your ‘black dog’ days?
On the worst black dog days nothing could have been further from my mind than exercise! I just wanted to retreat into myself and hope that the world would leave me to myself. I have some exercise equipment at home but prefer to get my exercise from walking and taking in fresh air – at these times that wasn’t a possibility and I don’t ever recall thinking that step or weight exercises would help me feel better. I am well aware of the importance of good physical health towards good mental health, but my brain wasn’t capable of making that connection on those days.
14. Are you able to daydream and to take your mind off to a better place?
Maybe it’s because I’ve always thought that I don’t have much of an imagination but I don’t really daydream, either now or when my illness was at its worst. I have thoughts about what I want to do with the rest of my life which I guess some would describe as daydreams: to me, though, they are hopes and outline plans!
15. Do you still suffer from panic attacks today?
Not in crowds any more (see above). I do sometimes get a bit more worried than I should about being somewhere on time, but these aren’t really panics as such, more an extension of my tendencies to worry and to not wanting to let people down.
16. What advice would you give to anyone suffering from depression?
Try to be honest with yourself and seek help. The hardest part is to make that initial judgement on yourself and to do something about it, but if you don’t things may never improve.
Talk to friends and/or family, it can make such a difference if you know that others are aware of how you feel and can be there for you. If friends give up on you question how valuable they are as friends, maybe you don’t really need them in your life. Consider if you would be there for them if things were reversed: if you would, but they aren’t prepared to support you, drop them. It will make things worse for you if you waste time and energy worrying about why they are treating you the way they do.
Don’t make the same mistake that I did and shut yourself away from other people, or shut them out. People can help, and you need them.
Don’t be afraid of it but try not to fight it: try to work round it and through it. If you treat it like a battle you’ll exhaust yourself.
Try to do something – anything – to occupy your mind. If you can rebuild your ability to concentrate on activities, however trivial, it will help you take your mind off yourself.
If you are prescribed medicine, take it! I know that it doesn’t work for everyone and you will hear people say disparaging things about dependence on anti-depressants. But depression is a form of chemical imbalance in the brain and the meds help to adjust that. If you feel uncomfortable about taking them, or if you think they are giving you side effects, talk this through with your doctor. Don’t decide on your own just to stop taking them, as this can do more harm than good.
Never, ever give up hope.
17. Are you enjoying your retirement?
Yes, very much. I don’t think we can ever underestimate the value of being able to decide how to use our own time, to choose what to do and when, and more importantly what not to do. The big advantage for me is that I now lead a lifestyle almost entirely devoid of stress, which for me is the ultimate benefit that retirement can offer. It gives me hope for my future.
18. What’s your proudest achievement?
As I’ve said earlier, I’m not sure that I have really achieved all that much in my life so far. I think the things that make me proudest are actually people: my two wonderful daughters, for whose development into well rounded, intelligent, caring adults I must take at least a share of the credit. And for one specific achievement, managing to stand up in front of 150 people and give the father’s speech at my older daughter’s wedding, just three months after I went back to work, is right up there! And in full penguin suit too!
19. What is your favourite hobby?
I have several, and can’t really choose a favourite. I like going to watch live sport, especially football (I’m a season ticket holder at Leyton Orient) but also tennis, and I’m getting my first taste of live athletics later this year. I also like live music, particularly what would be termed folk or Americana. I listen to a lot of music at home, too. I’m fond of my gadgets, and have a collection of computers and tablets, as well as an Xbox. I also enjoy writing, and am trying, unsuccessfully so far, to widen my scope beyond just my blog. I don’t read as much as I’d like to, either. And I’m taking the first faltering steps towards learning to play a musical instrument, something I’ve always wanted to do since the chance at school passed me by. I was hopeless at the recorder and was written off as a result, so I’d like to prove them wrong!
20. Nowadays, is your glass half empty or half full?
The glass is always full: what isn’t occupied by liquid is air. Sorry, that’s the pedantic Virgo in me! I’m definitely an optimist, both in terms of how I see life and how I always want to believe the best of people, even if the evidence suggests otherwise. Having come through a long period of depression, and having felt worse than I can ever have imagined possible, I tend to see the best in everything now. However, destroy that viewpoint or let me down and I can be very unforgiving!
Thanks Clive for your very candid answers. If there are any readers who have undergone a significant life event, would like to be interviewed and contribute to the book 'Understanding...' that I will eventually publish, please feel free to contact me here on my website.