Maybe you, the reader, already know me. Maybe you’ve seen me around in pole dance groups on Facebook, my posts on Instagram, or you’ve seen me around elsewhere. Maybe you regularly read our blog, maybe you don’t.
Maybe we’re friends in real life, or maybe you’re family. Maybe you work with me. Maybe I’ve directly talked to you about my mental health, or maybe you have no idea what’s going on with me.
Or, maybe you don’t know me at all.
However you’ve found your way onto this post, welcome. This post is for you.
Even though there’s a better culture around talking about your mental health these days, it’s still tricky. There’s still a lot of stigma around the subject, particularly as our experiences can be entirely subjective. Mental illnesses affect no two people the same, and it often can be difficult to describe what we’re feeling in a way that people who have never experienced mental illness can fully understand.
But here you are, hopefully to understand. At the very least, you’re curious. That’s a good thing, and I’m glad you’re reading.
In early 2018, after spending many years battling my own mind and eventually having a mental breakdown, I was diagnosed with Mixed Anxiety Depressive Disorder (which I lovingly refer to as MADD).
Going to get help for the second time from my GP was perhaps the hardest thing I’ve ever done. After the first time I went four years ago, which was when I was referred for therapy on the NHS, I ended up doing therapy sessions that made me feel way worse than I already did. So I didn’t particularly trust my GP surgery to actually care about my problem, and only care about getting me out the door.
However this time, I was met with a calm and understanding GP, who talked through all of my symptoms with me and gave me a proper diagnosis. I was started on a course of antidepressant medication to deal with the symptoms, and a promise to get me referred again for therapy. This promise was never fulfilled but given my last experience with therapy…that was probably a good thing.
What is Mixed Anxiety Depressive Disorder?
Mixed Anxiety Depressive Disorder is a relatively new classification within the DSM (the Diagnostic and Statistic Manual of Mental Disorders), which is the handbook medical professionals use as the authoritative manual on mental health disorders. The DSM is revised and updated regularly, to take into account new classifications such as these.
My diagnosis means that I experience both anxiety and depression at limited but equal intensities. Effectively, I don’t experience them both at the intensity that would make a diagnosis of depression and anxiety appropriate, but they still have a marked effect on my life.
Depression and anxiety have a high comorbidity rate – meaning, it’s common for people who are diagnosed with one to either be diagnosed with or develop the other. As it’s only been added to the DSM-5 there’s no statistics available for how common MADD actually is, but as depression and anxiety are quite sadly common themselves, it wouldn’t surprise me that this has a similarly high rate.
What Caused It?
Short answer: I don’t know.
Long answer is that it could have been caused by any number of factors. Mental health can be influenced by environmental, biological or psychological factors in any combination. There doesn’t have to be one definite cause — although there can be — as most of the time, having the influence of one of the things above only predisposes you towards developing a mental health problem. For instance, having a family history of depression can predispose you towards developing it, but psychologists aren’t sure whether that predisposition is fully genetic, or comes down to the environment in which you were raised.
The fact that there’s a lot of different causes means mental health issues like MADD are difficult to treat and require a combination of treatments.
Can’t You Just Take Antidepressants For It?
I actually really lucked out with the first lot of antidepressants I tried. I’m on a drug called Fluoxetine, or Prozac, which is an SSRI (Selective Serotonin Reuptake Inhibitor) and effectively stops my brain from munching up all the Serotonin in my system. While I did get some weird side effects for the first six weeks, things balanced out once my system got used to them and now I don’t really get any side effects at all. Well, none that I’ve noticed.
Antidepressants help take the edge off the physical side effects 95% of the time. I can concentrate and focus far easier, and I have a lot more energy than I used to. I don’t have days where my heart is racing and I feel nauseous for no discernible reason. The insomnia I used to get has gone, and I can get to sleep way easier these days.
However, this doesn’t mean I’m free from bad days. My depression and anxiety can, and does, creep back for a day or so before it buggers off again, but this is a vast improvement on my symptoms lasting for weeks or months at a time.
Like I was saying earlier about the causes of mental health disorders, antidepressants deal with the biological side of things; they don’t tackle the environmental or psychological side. For me, though, I started taking antidepressants as I didn’t have the motivation to stick with therapy (as I didn’t feel like I deserved to get better), or the focus to sit down and actually do the work needed to get the most out of it. Tackling the biological side means I’m not able to deal with the other things and focus on working through my therapy sessions.
Surely You Can’t Be On Them Forever Though?
Antidepressants are obviously intended to be taken short term – medically, meaning for a minimum of six months – but for some people, that is not the reality. It can be more of a risk for some people to come off their medication as the withdrawal symptoms can be far worse than the side effects of staying on the medication, and withdrawal can last for months. Even if you can make it through the withdrawal, there’s no guarantee that your symptoms won’t resurface again. So some people do have to stay on medication long term to keep them healthy.
That is perfectly fine, and there is no shame in that. There is never any shame in taking medication for your mental health, whether short term or long.
[Update 24/07/19 – As of 3 weeks ago, I’m starting to taper down my dose of Fluoxetine with the guidance of my doctor. The discontinuation effects are…weird. Overall I’ve got no signs of my original symptoms coming back in full force, thankfully, but I am getting some fun little things like headaches, random flu-like symptoms and fluctuations between having absolutely zero energy and wanting to exercise for 3 hours a day. It’s a laugh]
Depression isn’t Real, You’re Just Sad
Depression is way, way worse, and a hell of a lot more than just ‘being sad’.
My focus and concentration completely flies out of the window. I can’t even focus on things I normally enjoy doing. Typically, I end up doing something I don’t have to think about doing because I can’t focus on a single thought long enough to get myself to do something.
I feel completely numb. Nothing goes through my head. I don’t have the energy to care about anything, and nothing provokes an emotional reaction. Rarely, the only thing going through my head will be a line from a song I heard that day, over and over. For hours. This means my motivation dies, and I’ll probably end up staring into space. I won’t even care about things I normally love doing (like watching my favourite TV show or playing video games) because it all feels pointless.
I have no energy to do anything. Getting up becomes ten times harder and deciding what to do is impossible. Walking anywhere takes me a lot longer. I stop looking after myself because I don’t have the energy to go get myself a drink or make myself some food. If I don’t have anyone with me, I just won’t eat or drink.
Primarily, I feel worthless when I’m depressed. I feel like I don’t matter, and anyone who pretends otherwise is just doing so to humour me. I feel like my achievements don’t count for anything, that I’ll never amount to anything, and that the rest of my life is going to be 60+ years of me doing nothing worthwhile. Obviously, none of this is true, but depression has a wonderful way of making you believe those things.
Perhaps You’re Just Too Sensitive, Everyone Gets Anxious!
Everyone does get anxious, that’s true. Anxiety is a normal fear response. However, the difference between a healthy level of anxiety and one that isn’t so healthy is how much it gets in the way of you going about day to day life.
For instance, with my anxiety, my mind races to the point where I can’t finish a thought before the next one begins, or I become fixated on all the minor details around a very minor thing. I can’t sleep, because my mind won’t stop thinking about something, no matter what I try to do to calm it down. Then, I get worried that I’m not sleeping, so I obsess over that for a while.
I can’t talk to people without having to run a conversation in my head a million times, convinced no matter what I say they’re going to be annoyed I’m bothering them, or that I’m stupid, or that they’re going to get angry. When I pluck up the courage to speak I trip over my words as I rush over a pre-rehearsed sentence or say some kind of stock phrase that I know is safe. I want to get out the conversation, but the other person might think I’m rude.
I can’t make decisions, because whatever decision I make might be the wrong one. I might annoy someone, or break some rule I didn’t know about, or simply cause something bad to happen that I didn’t foresee happening, even though I’ve run the outcome through my head another million times.
What Can I Do To Help?
Please listen to me.
If I tell you I’m not okay, it means I trust you. It’s a very difficult thing for me to want to seek help, as my depression convinces me no-one will care, and my anxiety tells me they’ll just be annoyed at how needy I am. Most of the time, I just need someone to listen to me, and to be there to support me. We don’t have to talk about what’s bothering me (if it’s anything specific) if that makes you uncomfortable, but I appreciate distraction if things aren’t crazy bad.
Please don’t try and guess why I am the way I am, unless you’re my therapist. I know you mean well, but it’s not helping. Sometimes it just makes me feel more broken.
I appreciate the “have you tried…?”, because I know you mean well, but chances are I’ve tried it. I know what works for me, and what doesn’t. I struggle to meditate. Only certain kinds of exercise help, and I hate running. Walking without a purpose sucks. Yoga is great for my flexibility but I don’t get the meditative effect from it.
Respect that I’m on medication. Don’t make me feel ashamed for taking medication to deal with my mental health, or tell me that antidepressants will make me violent or a zombie. Antidepressants help me through my daily life and I’m not ashamed about that. Just like any other illness, I need medication to deal with it — it’s just that with it having a psychological component, I need more than one treatment to deal with it. Yes, I know it’s easier for doctors to prescribe antidepressants than to help them fully with a combination of medication and therapy — my doctor didn’t offer me therapy when I had my medication checked a month ago, and I’ve ended up taking CBT through my work’s occupational health provider. It doesn’t mean antidepressants aren’t effective. I don’t want to hear your quack theories on antidepressants, or that the rise in antidepressant use is down to a ‘snowflake’ generation. You can get out of here with that bull.
Don’t tell me “it’s all in my head” — of course it is, my brain is sick. That’s what I’m trying to treat. Just like any other organ in your body, your brain can get ill — it’s just that mental illnesses aren’t fully understood, and because they’re not understood, they’re ‘scary’ or ‘weird’.
Don’t tell me to “smile”, “look on the bright side”, “stop worrying”, or “calm down”. If I could do any of those things to deal with my mental health issues I wouldn’t be on antidepressants. I wouldn’t be getting CBT.
If I don’t want to talk about it, I don’t want to talk about it. Please respect my need for space. I might not feel comfortable opening up to you about what’s bothering me. This doesn’t mean I don’t appreciate your support, because I do — it just means that there’s some things I don’t want to divulge to other people.
Most importantly, educate yourself on mental health disorders and the stigma surrounding them. The NHS, Mind and the Blurt Foundation have been amazing sources of information for me around what I’ve been going through. With 1 out of 4 adults having some kind of mental health condition, someone you know could be struggling too.
If you think someone’s struggling, reach out. Depression can convince us that people don’t care, and anxiety can tell us that we’re just annoying people anyway, so we stop contacting people. I wouldn’t be where I am today without a support system of people who genuinely care about me and my mental health, and I can’t describe just how much having people like that in my life has helped me.
Don’t blame us, just listen.
Today is Time to Talk Day, supported by the Time to Change campaign, which aims to end the stigma about mental health issues and get the conversation around mental health started.
The Time to Change campaign has plenty of helpful resources to help anyone struggling with their mental health, as well as advice on how to support someone who is struggling. Reaching out to someone can make all the difference to their mental health, as often our illnesses convince us we are alone.
We are stronger together, and together we can end the stigma of mental illness.
For further support, check out Mind, as their database of knowledge has been invaluable in my recovery.
If you are in desperate need of help, please click here to find a helpline or advice centre.