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.

Yea, but WHY? aka part two

**For the purposes of the next few paragraphs whilst talking about 'physical illnesses' what u really mean is communicable diseases. Obviously there are other illnesses, for the sake of simplicity in narrowing it down. Anyway....**

I said I'd come back to this. But I lost my train of thought a little.
Anyway this photo popped up on my fb a while ago and I figured it was as good a starting point as any.
There are several similar images around...The combating of stigma through comparison of physical and mental illnesses and how they're treated/perceived.
And it's a pretty powerful tool. I mean physical illness is something everyone can relate to and can understand to a greater or lesser degree. I guess it comes back to the whole causality thing, there are certain things we accept as basic facts when it comes to physical ailments. But it's not always been that way, and there are times in the past where people with simple physical illnesses WERE treated with the same fear that many mentally unwell people experience nowadays. Without doing any real research (sorry!) The ostricisation of lepers or the crosses on the doors of plague victims spring to mind. These two reactions also sprung from fear, the fear of contamination from diseases that at the time weren't understood. In a time before the development of germ theory, which we all largely accept now, theories such as that of miasma prevailed. And with no clear knowledge or understanding of how to avoid or cure such diseases fear for personal safety was a natural reaction.
Since then the works of scientists such a pasteur, lister, koch amongst others have led to huge improvements in medical knowledge and public understanding. None of us enjoy being ill but the most common everyday illnesses tend to cause irritation more than fear. We can isolate, view, name and in many cases kill avoid or eliminate the pathogens responsible.
With mental illnesses however we're stuck at s point much earlier in the journey. Our knowledge base is increasing and there is a lot of research bring carried out and several different theories from experts. But a) this is not so much in the public domain and b) nobody really KNOWS. And don't you just hate that? Is terrifying right? Easier to just lable mental illnesses as 'individual choice' and move on. The problem is its pretty terrifying from the inside as well. It's certainly not unusual for sufferers to entertain similar ideas, to blame themselves, or even to embrace their illness as a lifestyle choice (think pro-ana/-mia).
Unfortunately the nobody knowing bit is not something I have the power to influence, I can however help to share what we DO know on this little part of the Internet. For a start over the next few weeks I'll be dropping in 'fact box' type posts, focusing on specific conditions. Obviously my own knowledge is also limited and whilst I'll try hard to be accurate I will also be pointing the way to more in depth specialised resources.
For now I'll leave you with a couple if general Links to time to change and mind. :).

A change is as good as a rest

So, yes i changed my nails AGAIN lol. Though i did only paint them once today which is an improvement from yesterday's 3 times haha.

However, that's not really the change im thinking about. Next weekend is the time-to-change village comes to Christ's Piece, Cambridge. This is an event centred around raising awareness of mental health problems and tackling the stigma that often surrounds them. It may be apparent by now that this is a cause i wholeheartedly support.....and since Cambridge isn't so far away from dear old Norfolk i signed up to volunteer at the event, rather on impulse i must confess. Anyway, yesterday i received details of my role at the event, as well as a prior training session. Eep. So i thought id share this event here :).

Basically my job is to wander round and engage people in conversation for the whole afternoon. Now ill admit to being slightly anxious about this (read: absolutely terrified haha), a few years ago i wouldn't have dared even think about doing something involving so much interaction with the public. i still remember the girl at uni who hid away in her room at every opportunity, checking the peep hole before leaving so i didn't run into anyone as i crept out to do laps of Parker's Piece in the middle of the night or clean the communal kitchen while everyone was asleep......yea i wasn't exactly at my best at uni! lol. But anyway, that was then and this is now. im certainly not 100% well these days, not by a long shot, but ive come a long way.

Counselling and therapy and all that aside there are two things i thank for that. One is my job...which throws me into close proximity with a whole range of people all the time. And when you're helping people wash and dress and other such intimate tasks it pays to be able to get chatting with them quickly! The second thing is bell ringing. There's a reason the professionals are always banging on about getting hobbies :p. Having an activity to do helps neutralise some of that awkwardness when you can't think of a thing to say....plus you know there's always at least one interest you have in common to discuss haha. Asides from that the bellringers ive met have been some of the most welcoming and accepting people ive known. An eclectic bunch of all ages and walks of life.....ive never felt judged there.

Oh dear shall i return swiftly to my original point before i start gushing? lol. The time to change village will be open from 10-5 and entry is free. There will be all sorts of things going on including live entertainment, information on local resources and the depressed cake shop. Volunteers will be around to discuss time-to-change, mental health in general and personal experiences (both yours and theirs).....including me :p. 

i could ramble about this for hours but i think ive probably gone on long enough tbh. Plus i have to start work at 6 so its probably bedtime. 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