Depression diaries: The thing that is eating me

"Mental illness is not a brand that you wear. It doesn’t scar you (unless you self-harm, of course, in which case you, like I, have carefully hidden the evidence). It isn’t visible, it isn’t something you can easily spot. Partly because when I’m really, really ill, I won’t be there for you to see.” – Joely Black

Photo | Pixabay.com

When I came across this piece by Joely Black on Medium, that articulates what it’s like to have depression so well, I remembered my own account, which I had put down in an outburst one morning when I was starting to feel better, and a trigger jolted me to put down the multitude of thoughts about suffering from depression, that I now suddenly had energy to articulate. I wrote and wrote a note on my phone, until my mind was empty, then I saved it and made a note to return to it later when I got another burst of inspiration, enough to divide it into sections and put it up on my blog in a series of posts.

That was never to be: A thief stole my phone and with it my story. I never did get another urge to articulate what it’s like to be depressed until yesterday. I have the momentum now, but the story will come much later, when it is ready.

The first thing you learn when you get depressed is that nobody understands what you are going through and because of their ignorance, and in a bid to help, they make recommendations about what you should do to be "un-depressed." The most common is: It’s all in your mind. Just think positive thoughts and you’ll be okay.” I’ll tell you for free that when you are depressed, no amount of positive thinking will make you feel better. You can spend a full 24 hours trying to think positive thoughts and proclaiming positive affirmations, but they’ll do nothing for you.

 Here are some other things that people tell you when you have depression that won’t help:

Things not to tell a person with depression or other mental illnesses (with the help of Joely's article):
 

Photo | pixabay.com

1. “Have you tried meditation? You totally should! It works like magic!”

2. “You need to take [insert vitamin] and [insert supplement]. They’re great for depression.”

3. “Exercise is great for mental health. I run every day and I feel fantastic. You should try it”

4. “When I feel a bit down, I do yoga. Do yoga and you'll be fine.”

5. "It's all in your mind. Just snap out of it. Just think positive thoughts and you'll be okay."

6. "What you need is to read the Bible and pray and maybe go for exorcism and you'll be fine. These things are spiritual ..."

Again I’ll tell you for free that I pumped my body with vitamins; in the early days I tried to exercise, before chronic fatigue got the better of me. I tried to meditate, I went to church, went for counselling and prayers ... I tried positive thoughts, I tried everything I could to feel better, that is everything except yoga, but I didn’t.

 I was in constant despair. I was continually exhausted. I couldn’t eat. I couldn’t think. I couldn’t talk. I didn’t even want to. Not even to listen to someone talking -- it was all very exhausting. I just wanted to sleep it all away, to have a blackout that would take away the pain that I felt inside. I was numb. Keeping my head above the water every day was a constant struggle. I was drowning. And I only started out on the right path when I had a breakdown one morning that saw me admitted to hospital for a few days. There, I finally got introduced to the one thing that would work, the one thing that would drive the depression away: treatment.

A lot of people don’t understand that depression is an illness. I didn’t understand that too, or rather, I fought that thought. Surely, doing all those things that people recommended would make me better, not so? I was just feeling down, so if I did all the right things, the clouds would be lifted and I would feel better, right? How wrong I (and every other well-meaning person) was!

Depression is an illness just like malaria and it cannot be wished away. You can’t wave a magic wand on depression and boom, it goes away. If someone told you they had malaria, you wouldn’t say to them, “just take a multivitamin, think positive and exercise and you’ll be healed.” Instead, you’d tell them to go to hospital and adhere to the treatment and the doctor’s direction. Then and only then, would you prescribe prayers and Bible verses, after all, faith/prayer that is not accompanied by action is dead, right?

So why is it different for depression? Why do we assume we can fix depression, an illness, without proper treatment? Treatment in itself is another process, and I only started to get better after more than two years of treatment (that’s another story altogether). And the minute I started to feel better after following a treatment regimen for what felt like ages, that was when it dawned on me that depression is truly an illness and treatment works.

Treatment for depression is multi-pronged, combining medication, lifestyle habits and cognitive therapy among many other approaches. And when it comes to treating depression, one size doesn’t fit all, you have to keep at it, keep fighting it even without energy, keep trying something until it works.

Before then, like Joely says, I wore a mask when going out. I sucked it in and tried to act like everything was fine when it was not. I didn’t want to be outside the confines of my bedroom. Every time I stepped out of my house, all I could think about is how many more hours until I retreat to my cave again? I didn’t want to go out and did not go out unless it was absolutely necessary, like if I had to go to work.

 If anybody asked why I wasn’t showing up, I’d tell them I wasn’t feeling well and that would usually suffice and if they insisted, I’d tell them it was my head – I had a severe headache, if they pressed, – and that would be it. I didn’t want people to know I was depressed because first, a lot of people don’t understand depression, and second, while trying to be useful, they end up being very unhelpful and third, they wouldn’t know how to handle you. But now that I am better, I can speak about it, and I will resume re-writing my depression story. It is quite long, but I’ll do it in bite-size pieces.

Why pharmacists are not good people

The other day I went to buy a prescription-only drug at one of the "cheapest" or rather, most affordable/cost-effective pharmacies in the city. I happened to have been in town early enough, and I decided to pop in, while mentally bracing myself for the long queues filled with bargain-hunters like myself, that are a permanent feature of this particular drug store and its sister stores.

With pleasure I noted that there was just a handful of clients, looking bored and impatient as they idled on the rather insufficient seat at the waiting bay of the cramped chemist. I made my way to the counter where I ordered a prescription-only anti-depressant, while simultaneously fumbling through my handbag for the prescription. Before I could fish it out, the attendant on the other side of the meshed counter had completed my order complete with a discount, without ever asking to see my prescription. He directed me to join the other clients/patients who were waiting impatiently on the bench, as a different pharmacist worked on filling my prescription and completing my order. A few minutes later, I was out and about with my prescription-only anti-depressant without having to show any prescription chit from a doctor.

In my years as a person suffering from depression, I have been to many pharmacies, but only a few ever insisted on a prescription before dispensing the prescription-only drugs I asked for. Musing about this later, a thought crossed my mind that pharmacists are not "good" people.

A pharmacist will never tell you, "You look/sound awfully sick or you've been coming here to get pills to relieve these symptoms for too long, don't you think you should see a doctor to get to the root of your symptoms?"

Instead, a pharmacist will ask  for your symptoms and give you something to relieve them. I guess the first rule of pharmacy is to take the money, always; never turn away a customer ( patient). Yet sometimes those seemingly little but niggling problems belie a serious underlying illness, that needs urgent attention, but a pharmacist will be happy to take your money and prescribe something to relieve the symptoms, even as the illness simmers and festers beneath the surface.

Banned drugs

I've seen pharmacists push anti-malarials on people who've not had their blood passed through a Malaria Rapid Diagnostic Test. A pharmacist will sell you the absolute prescription-only abortion pill without a prescription. A pharmacist will sell you morning after pills without throwing in a cautionary “you should consider ‘regular’ contraceptives or even the possibility of HIV.” A pharmacist will sell you the one-tenth dose of antibiotics that you asked for as long as you slip the money across the counter, never mind that the world is grappling with the effects of misuse of anti-biotics in the form of drug-resistant bugs.

I once had a person standing behind the pharmacy counter prescribe Metakelfin (long after it had been banned alongside other sulfa-based anti-malarials such as Fansidar) as a way to prevent malaria just before I traveled to a malaria-prone region. It made me feel so sick, I had to go to a doctor, who informed me that that taking anti-malarials as a preventive measure before traveling to a malaria hot-spot was no longer recommended, not forgetting that I had ingested a banned drug and one I was allergic to too (I'm allergic to sulfa drugs).

Maybe I require too much from pharmacists, much more than they are cut out to be. Maybe they didn't take the Hippocratic Oath or any oath on patient safety and public health interest being paramount. Maybe those attendants who man pharmacy counters are not even real pharmacists, not even pharm-techs. Maybe they're just salespersons, placed there complete with sales targets. Maybe pharmacists are taught that the interests of the bottom line come above everything else.

Lastly, the self-medicating customer is also a fool who is easily parted with her/his money at the pharmacy and later in the hospital which s/he thought s/he'd dodged by bypassing the doctor and going straight to the pharmacy, after consulting Dr Google and/or a couple of strangers and friends.

Still, pharmacists are part of our health problems.