Silly little things take two

So, following on from my negative post the other day I figured I'd do a more positive post on the flip side.
Yes silly little things can kick start a downward spiral.... But the smallest comment or gesture can just as easily add a tiny happy spark to a bad day.
So often when I'm struggling visibly the people around me am what they can do. Which is a thoroughly reasonable question, it is painful to watch someone in pain and not know what you can do to help. Unfortunately the answer that trots off my tongue more often than not is 'nothing' (there's no point nothing will help I don't deserve anything....Yawn the depressed mind is terribly dull).
It's the wrong answer though. A better answer would be 'nothing special'. I don't expect people to wave a magic wand, and I don't want to turn my friends into therapists (I can't afford to pay them enough :p). The things that make all the difference are those 'silly little things'. The reminders that I'm loved, I matter, I'm real. A simple 'I hope you're okay' message, or a how are you from someone who actually wants to hear the answer. If you know someone with mental health issues the simplest and most powerful thing you can do is just check in.
That's not to day half the time I don't answer with a highly irritating 'im fine'... But that doesn't mean it haven't registered, just that talking is too much just then. Our maybe in just fine Haha. Don't be discouraged if you seem to be hitting brick walls all the time, every little helps (Oh dear lol).

I need to blog earlier in the day my brain turns to mush after dark. But my point, essentially, is that all the little things do matter and are appreciated....More than you probably realise. The best way you can help a friend is to... Be a friend basically, simple as that.

(Nails- I played with striping tape, colour club unnamed Blue topped with a blue textured 17 polish.... um I think? I'm bad at this Haha)

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.

"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.