Fact box: depression

So, since anxiety and depression is the most commonly occurring mental health issue I figured I'd start my fact box series there. Depression today, anxiety to follow (sounds like the weather forecast to my life Haha).

Names depression, major depression, major depressive disorder, MDD, unipolar depression, clinical depression.
Symptoms include
Low mood, pessimism, Tearfulness
Apathy, lack of motivation, low energy
Poor memory and concentration
Irritability and anger
Lack of interest in enjoyable activities and reduced sex drive
Low self esteem and self worth
Feelings of hopelessness and worthlessness, pessimism
Changes in sleeping and eating patterns
Lack of self care and personal grooming
Poor coping strategies- drugs, alcohol, self harm
Thoughts of suicide or harming oneself
Social isolation and reduced interaction, withdrawal

Amongst others. There are certain common recurring features but everyone's experience is different.

Diagnosis
The first port of call for symptoms of depression is usually your gp (or equivalent).
A decent gp should listen to you and probably ask you to fill in a couple if quick diagnostic tests (and no not ALL of them are, they're human too....But that's another post and I'd never discourage someone from seeking help simply because of the possibility of a bad reaction).
The most common of these are the patient health questionnaire-9 and the Beck depression inventory, though there are many similar ones used. They will simply ask you to rate how often you've noticed certain characteristic symptoms over the last two weeks, and how much this has affected your life. The over two weeks but is part of the diagnostic criteria (as per DSM-IV) though some people may be suffering for a lot longer before seeking help.
These tests are a basic way of screening for depression and giving a rough gauge of the severity of the condition, along the way your present to the Dr and the things to share with them.
Treatment
Depending on factors such as severity, risk (to self or dependents) and social/family support your gp may treat you themselves without initially referring you.
This could be through online self help or self help workbooks, exercise, or medications (more below).
Alternatively you may be referred on for more specialist assessment and treatment by qualified mental health professionals. This can include:
Cognitive behavioural therapy (cbt) which aims to identify and change unhelpful patterns of thinking and behaviour.
Counselling which encourages patients to talk through worries with an impartial professional
Community psychiatric teams such as home treatment teams who can support those who are struggling to carry out tasks for every day living
Psychiatrists who are specialised mental health doctors and able to prescribe medications that a gp may be less familiar with.

Ah, yes, medications.
Antidepressants the most common antidepressants used these days come from a group called selective serotonin reuptake inhibitors, SSRIs (fluoxetine, citalopram etc). As the name suggests they treat depression by increasing levels of serotonin in the brain, which seems to alleviate the symptoms of depression. They generally have fewer side effects than older tricyclic antidepressants, though headaches, nausea, anxiety and changes in sleep, appetite and sex drive are reasonably common but tend to decrease after the first few weeks.
Medications can be effective but are only recommended for moderate to severe cases, and may take several weeks to take effect.
Less commonly other forms of psychotropic drug such as antipsychotic drugs (risperidone olanzapine),  or mood stabilisers (lithium, lamotrigine) may be used in conjunction with antidepressants. This is more common in enduring cases where the usual treatments have had little effect.

Even less commonly more drastic treatments such as hospitalisation, electroconvulsive therapy or deep brain stimulation made be used. There is plenty of info around on these but such complex therapies are not something that should really be discussed with professionals not by me on a blog (I'm all for speaking out about mh but some times one can do more harm than good by sharing incomplete information).

Statistics
2.6 per cent of people in England will experience depression, this rises to nearly 10 per cent for mixed anxiety and depression
1 in 20 will suffer diagnosable depression at any given time (both taken from mind.org)
A WHO study found that depression has a greater impact on personal wellbeing than conditions such as angina or diabetes.

Related conditions
Mixed anxiety and depression (MAD)
bipolar disorder
Seasonal affective disorder (SAD)
Post natal depression
Dysthemia

Links
The depression alliance
Depression UK
Moodjuice (online self help)
NHS choices depression page

Phew that's longer than intended, I'll try to get more succinct I promise. It's getting late so if any of the links don't work let me know and I'll try fix. Also if there are any sites you've tried that you would like to share let me know and I'll add them.... same for anxiety which as mentioned is coming next.

When to admit defeat....

So yes. Today i called in sick. Because i couldn't cope, basically. i woke up hyperventilating and the day didn't improve much from there. i detest calling in, particularly for mh reasons....it makes me feel weak, like ive failed, and of course guilty for making other people's jobs more difficult.

But, moving on from self-castigation and onto the real point of my post, it got me thinking about the difference between knowing your limitations and using mh issues as an excuse, allowing it them to rule you. It's a fine line, and one i fear i often fall on the wrong side of...in both directions. In the past particularly ive certainly struggled to know when its a good idea to give myself a break. Its easy to slip into denial and 'im fine mode' and just keep going despite all obvious indications that its time to stop. And stepping out of denial can be pretty damn scary so once i will go along way to maintain it. i become a veritable little yes-man (or woman) and agree to anything and everything, fill every hour of every day with work, friends, activity. Its very easy at this point to kid yourself that you *have* to do these things, that its all for other people, that they're relying on you. To hide behind a façade of selflessness in other words. Its all complete bs of course. Of course i care about other people, of course i like to help out with friends, work, whatever when possible. But its still bs. Its all just one gargantuan effort to keep busy, keep moving, do anything to avoid thinking too much about anything. And the problem is when people express concern and i turn around with a padded out version of that stroppy teenager cliché 'its my life' that's bs too. Sure it's my life, and sure im often hurting myself when i get like that.....but im not ONLY hurting myself. The quality of my work suffers, i treat my friends badly, snap at my family, double and triple book myself and let people down, i worry people and frustrate people and inevitably i crash and it all falls apart anyway. Sounds like the opposite of selfless tbh doesn't it?

So it's something ive tried hard, with limited success, to work on. The problem is im proud and im a stubborn cow and i constantly fear falling on the other side of that line. The side where i refuse to test the limits at all. The side that's dominated by i can't. i can't go to that club it'll be too crowded. i can't ring at that tower the room is too small. i can't go to work today...i can't get dressed right now....no, really i can't get out of bed. i couldn't possibly. It's not my fault, im ill. (im not in any way judging or criticising people who really are so ill with mental health issues that they really DO feel unable to get out of bed, leave the house etc. It's just that im not in that place personally right now.) Cos that's a very slippery slope. Depression sneaks up on you and convinces you that its faaaar too much effort to do all those things....you know the ones that get you out and active and help fight the depression. It can spiral, basically is what im trying to say. And every time i call in sick or don't make the effort to contact a friend, or miss something im committed to (all of which i am ashamed to say ive done too much recently) i worry that im simply allowing the head-shit to win....and all my good intentions about knowing my limits go out the window.

Definitely a work in progress. And im pretty sure none of that made any more sense on 'paper' than it did in my head lol. Oh well ill leave you with the obligatory pic of today's nails to lighten the mood :p :

Polish is cheaper than therapy!

Today's colourful, if a little scruffy, effort :). i got very over-excited when i came home to find a parcel on my doorstep...i only placed the order with Tara's Talons on monday so i was very impressed. Aaaanyway couple more pics, since im feeling lazy and wordless:

im a sucker for anything wrapped up in pretty paper....and since i had no idea what polishes to expect (i went for the lucky dip option) it was like getting a present from myself hehe. i haven't tried the other two yet but i used the orange and the yellow as part of my little rainbow...i never would have chosen a yellow polish but im a little bit in love i must confess. Here's a (very slightly!) better pic of the two polishes in question:

Sorry for the photo and nail overload today, my brain is a little mushy. Though in case anyone is curious about the polish obsession (im clearly not a nail artist :p) the facetious title pretty much sums it up. The nail painting thing is really very new, in fact until recently it was rare for me to paint my nails more than once a year. i bought a random bottle of purple polish on a whim in the accessorize sale (i struggle to resist purple...and bargains haha). To my surprise i found nail painting strangely relaxing....i say surprise since most of my forays into the world of makeup and beauty result more in frustration than anything. i also found it killed a nice little block of time when i otherwise would have been left with my own silly thoughts and headnoise. i started playing and experimenting and researching and whilst few of my efforts turn out as i intend im having great fun. When i made the decision about 6 weeks ago to really start fighting the sh urges again (i confess i had become a little resigned to myself as a self-harmer for a whole) it became my go to distraction technique. The thing is i struggle with distraction techniques, i guess maybe i differ to some self-harmers in that i don't get intense waves of wanting to do it, more just a constant nagging itch. So, while yes i can write out my feelings or go for a walk or any of the great suggestions that can be very helpful, i always find the urges still there after, and eventually i cave in. The thing with the nails is, it can pretty much fill up as much time as i need it to......but without making me feel like im constantly busy, moving, running. Plus i can do other things while i wait for coats to dry....but not sh.

Does that make any sense?

My collection of different polishes is disgustingly large considering how young it is, and tkmaxx and boots are getting exorbitant amounts of my money....but then a bottle of polish is a few quid, when i was in private therapy i paid £134 an hour, so as the title says............x

"But why?"

Aka the most frustrating and often asked question in my life. For their part, others are generally left frustrated by my responses too.

Us human being seem always to want to understand everything. To string together the causality and figure how things came about. Maybe it makes us feel safer, more in control? Maybe we believe if we can figure out why good or bad things happen then we can alter whether they reoccur? It would be pretty scary to believe its all just entirely random afterall wouldn't it?

This is me being me.
And that's who i always intend to be on this blog, so far as the constraints of the internet allow.
Who else can i be afterall?

Though in real life im not always me. Or rather, often i only allow certain aspects of me out in public.
There's nothing particularly unique about that, we all do it to a greater or lesser extent.
The part of me that gets held back more often than not is the part which is mentally ill. The depressed part, the anxious part, the part that looks to razor blades for comfort. That part isn't very socially acceptable, and isn't very fun to be around. Its my choice to hide and im happy to do so i don't like that side much either.
My close friends know most things, everyone else knows....bits and pieces. Sometimes i chose to tell, and sometimes i slip up: the panic attack at work, the scars that accidently show as my leggings roll up, slips of the tongue, trips to the hospital. Whatever.
i don't mind people knowing so much nowadays....ive had some bad reactions but ive also had some amazing ones. More people understand than you'd think. Whats the current statistic? According to www.time-to-change.org.uk its that one in four of us will be affected by mental illness in any year. That's a lot. So why not talk about it?
i guess the short answer is fear of judgement and backlash.
The long answer brings me (finally!) back to the title of this post.
"But why?"
Why do you freak out in crowds when i don't?
Why do you feel 'down' when there's nothing really wrong?
Why does adding another ugly scar help?
Why did you take all those pills?

i still remember an a and e doctor asking me whether i thought it was reasonable to overdose and not know why. i didn't particularly thinking it was a reasonable action at all but i didn't think that was a sensible answer so i just shrugged. No it wasn't reasonable. But it was true.

But oh dear, im not here to share war stories and broadcast all the self-destructive things i do...bear with me im not quite with it today lol.

i don't always, or often, know why i do the things i do or feel the things i feel. 'that's just the way i am' as the song says. But that is a terribly frustrating answer to anyone outside trying to offer support. How can they help if they don't know what's wrong? And its my brain, my thoughts, my feelings, so i must know, surely? So they think im holding out and continue to ask, and i continue to repeat the same aggravating i don't knows.......and they get frustrated at me for the lack of response and i get frustrated at them to continuing to push and everyone ends up feeling pretty damn crap.

So thats why i sometimes chose not to share, why its sometimes safer to hide.
And that's part of why this blog is here....to try to piece together some clothes to put onto the naked from of 'i don't know'. i truly believe in ending stigma, and that people have the right not to be judged for illnesses that they can't control. However, with rights come responsibility so maybe we have a responsibility to try to HELP people understand.
This could be interesting....its not like i understand it myself......tbc.

Oops i seem to have started a blog...

...and i have no idea where im going with it!

i suspect it will probably end up being the dumping ground for all sorts of brain mush. 

i will confess this blog is pretty much designed to be the dumping ground for all sorts of brain mush.

i guess there will be a predominant theme of mental health awareness since this is an issue very close to my heart (or, more pertinently, my brain haha). However i don't want to label it as such, im not on a crusade. This is more about me blurting out all the random things that occur to me throughout the day. My thoughts, my opinions, my experiences Me, basically. im certainly not always right, im open to debate, to being proven wrong.

Bah, heavy. 

No, im not on a crusade. i would just like to try and show people a little bit of my world. How i cope, how i fail to cope even. What its like to be mentally ill (and i could write a whole blog on what it took to accept that label was applicable to me). But also the bits of me that aren't the illness. i HAVE a mental illness, that doesn't mean i AM one. 

i really don't want to preach and i will try my best to restrain myself, but i will include posts on things ive found helpful, self-help stuff, therapy stuff, distraction techniques ya know the drill.

Oh speaking of distraction techniques: Nails! :D. ive discovered the joys of painting my nails, so expect to see lots of photos of my hands. However, this is definitely NOT a nail art blog, since, whilst i found a lot of enthusiasm, i seem to have failed to find any talent. There will probably be frequent links to some of the many nail bloggers i find myself in awe of though, and posts when i can't resist sharing a new polish ive fallen in love with, like Revlon scandalous:

Purple glitter :D 

...yea im not a photographer either :p lol.

Other recurring themes and pet causes including (but not limited to): girl guides, bellringing, care of the elderly (i work as a carer in the community, i love the job but frequently hate the system), music, my confused forays into the world of beauty and make-up, science, psychology and.....purple? There's not much to post about purple i just love it hehe.

Clear as mud right? Oh well we'll see what happens. x