The Closet Depressive

One day you’re at work, dashing around, organising, going to meetings, talking to clients, the usual 15-hour day. The next you’re in the GP’s surgery.  You chat, you fill in a questionnaire, she taps into her computer and says: “With a score this high, you should really be on antidepressants. And you should take time out.” You know it makes sense – after all, that’s why you’ve been sent here – but you resist.

“Think about it and give me a ring,” she says. And off you go, back to work.

In the office you can hear yourself shrieking at colleagues, you're on the shortest fuse. At home you’re so irritable that a drop of tea in the sink can send you into a rage. Your husband and children hide in the garage or their bedrooms and you slink off to the computer, even though you’ve spent the whole day in front of a screen.  You go to bed late, wake often, and feel like death in the morning, regardless of whether you had a drink the night before or not. Is this life?

And so, for the sake of those around you as much as yourself, you return to the GP and take her advice and her pills. Congratulations, you have become one of the millions of people in this country to be prescribed antidepressants.

You have a diagnosis, a course of treatment and a sick note. You should feel better. But no, you feel worse. Yesterday you were at work, today you are officially ‘sick’. How can that be? You feel guilty, pathetic, wimpish, a waste of space. We are in a recession, everyone is under pressure. Everyone is being asked to work harder and longer as big businesses slash staff to try to keep profits up and the shareholders happy.

You have a job, you should be grateful; think of all those who have been sent down the road. John in sales and Freya in marketing are now doing virtually everything by themselves. How can you take time off and leave them another man down? And what about bare-headed Marcus, who comes in between courses of chemo for leukaemia? That’s a real illness. You’re supposed to be strong, resilient, a leader, you don’t want to be seen to buckle while others soldier on. And so the shame is piled on to the guilt that is already making the symptoms worse.

And what are you going to tell the family? You obviously have to fess up to the husband, who shows surprising understanding, but you’re going to have to think up a story for the kids. You can’t have them worrying about their loony mum when they should be revising for GCSEs and A levels. ‘I’m working from home on a special project,’ you say – a story that proves convenient for other relatives and friends.

But as you embark on what is to turn into an endless round of doctors, counsellors, psychiatrists and therapists, it becomes more and more apparent that you are really quite ill and that you won’t be back at work in a couple of weeks. The children and neighbours start to ask how long your project is going to take, when will you be returning to the office? And worst of all - but with the best of intentions - 'Are you enjoying your break?'

The pills knock the stuffing out of you. You used to be able to run a department, now you can’t run a bath. Walking to the end of the garden is a supreme effort. You can hardly keep your eyes open. Your mouth is dry, you are constipated and gaining weight, even though your appetite is disappearing. Your sex life is going to pot and when you do get to sleep you have the most extraordinary dreams: vivid, disturbing; not nightmares more magic realism.
You don’t want to kill yourself – suicide is selfish, think of the kids, of whoever finds you – but to be dead would be nice. Just to disappear, for everything simply to stop being.

Eventually you start to confide in a select few, although you don’t go into detail. At least half of them say they know what you mean, they’ve been through it, or know someone who has. Can this be right?
You should be grateful for the solidarity and empathy, but instead you think you're just one of a crowd, nothing remotely special, belatedly jumping on to the bandwagon of the latest fashionable ailment.

We are told that a quarter of the population can expect to suffer mental health problems – does one in four people really feel as ropey as you do? A quarter of the population isn’t off sick month after month after month. You feel more guilty, more inadequate. If they can cope and carry on working, why couldn’t you? Time to man up.

The GP asks when did you last feel 'normal'. What's normal? Isn't everyone fed up nowadays? What have those smiling people in the street to be so pleased about?
The psychiatrist tells you to do things that you enjoy. But it's so long since you did anything but work and sleep that you can't remember what you once enjoyed doing. Joy is a word that has long since slipped out of your vocabulary.

You have a library of self-help and misery memoir that the specialists have ordered you to read: I Had a Black Dog, Taming the Black Dog, Shoot the Damn Dog, Managing your Mood, Overcoming Perfectionism, Overcoming Low Self-Esteem....It’s like the reading lists you had for A levels. And all they do is make you feel yet more miserable, because you can’t tame or shoot the bloody dog – you’re too damn zonked even to take it for a walk.

But you must. Because as well as the pills that make you feel rotten, your treatment involves a seemingly impossible list of tasks, and at the top is ‘take exercise’. It will lift your mood. Fine - but first it would be nice to be able to lift one foot far enough off the ground to put it in front of the other. You must also eat well, even though you have no appetite, socialise even though you have no friends, go out at least twice a week even though going out to hang out the washing is an ordeal that requires hours of preparation.
Then there is the homework, recording every thought, every reaction, trying to view every situation in a different light, confessing the error of your ways in taking such a negative view of yourself (even though in you still believe it to be accurate). And the icing on the cake: lay off the booze. 
Having given you this daunting list of dos and don'ts, the doctors, shrinks and counsellors all exhort you to 'be kind to yourself' and reward yourself for little achievements. Stop beating yourself up. Easier said than done.

Then we get a report saying that 43 million SSRI antidepressants are being prescribed in Britain every year, and the newspapers come up with helpful headings such as ‘Pill-popping nation’ and ‘Drugged Britain – are we hooked on happy pills?’

Happy pills? These things don’t make you happy. The best you can hope for is that they will help to stop you feeling abject.

The columnists weigh in with their ‘buck up and shape up and stop being so wet’ advice. ‘Look at me, I got through the baby blues without taking anything. You’re all hypochondriacs.’

People with real understanding of what you're going through also add to the pressure, even though they don’t mean to. Health experts and charities say we need to raise awareness of the mental health ‘epidemic’ and get proper treatment for sufferers. A laudable objective; of course we do. Few employers will carry on paying full wages to someone who is sick for months on end. Availability of talking therapies on the NHS is haphazard. It’s hardly surprising that people get back to the grind before they are ready, risking relapse or even worse bouts.

Earlier this summer Parliament held a debate on mental health provision and four MPs spoke of their experiences. They were applauded for doing so by many, including Alastair Campbell, who has been frank about his breakdown and given a lecture entitled the Happy Depressive.  And so now, in the interests of improving health provision, you are expected to be open and come clean about your condition which, for some reason, is constantly likened to pneumonia or a broken leg. Who knows why these are always the examples cited, as in ‘If you had a broken leg, you wouldn’t go to work...’

Well for some folk, being a depressive is a bit like being gay. You know there’s nothing to be ashamed of; that it’s just the way you’re made. The world shouldn’t treat you differently from anyone else and there are laws to protect you in society and in the workplace. If you are well-known it's almost obligatory to stand up and be counted pour encourager les autres (in the nicest possible way).

But coming out is scary. Those dearest to you know. Those around you have almost certainly guessed, so they're likely to shrug their shoulders, which will make you feel foolish for making a big deal of it.  But what about everyone else?  Would they still treat you the same? What will be the impact on your career? Won’t your employers see you as ‘broken’?

Some people don’t want to feel obliged to become a poster boy or girl for the problems in their heads any more than most gay people want to be defined by their sexuality.

Besides, the desire for secrecy may be more to protect others than yourself: the children who don’t want to be questioned at school, the elderly parents who will spend long hours stewing and fretting over whether you’re going to be all right.

If you are suffering from severe depression, you don’t want to go and tell the world. You want to hide in a corner until you get better.
So please understand why some of us prefer to remain in the closet.