Note: This is in continuation of the first article in the series published last month which depicted how it feels to be clinically depressed. This part describes the process of recovery from the perspective of the person who experienced depression.
They say that when it comes to mental health, insight is half the recovery and that was what exactly happened in my case as well. For as long as I was blind to my condition, I did not do anything about it and continued to suffer. For a long part, I struggled not knowing what was happening to me, and was despising myself. I didn’t recognize the symptoms when it was happening to me, though I have known them for so long. I thought I was being lazy and lacked discipline, which worsened my condition because it made me feel ashamed of myself and caused me to feel a deep sense of guilt for not being able to do a lot of things that others were able to breeze through. Waking up on time was one simple example. I couldn’t sleep whole night and went to sleep at about 4 in the morning. Waking up at six became a very challenging task that I had to struggle with. I was also losing the will to live. I wasn’t able to care for people at home, show any affection to anyone or carry out my responsibilities, which resulted in a lot of criticism from my family members. It made me feel so guilty that I would think of dying. This preoccupation with death became so intense that for a long time all I could think about was death, and would make plans of when and how to die.
My biggest problem at that point was that I did not know that I was suffering from depression. As I had distanced myself from a lot of my friends and colleagues, there was no one who could have given me the feedback that I looked sad or depressed, and my family members had refused to acknowledge that I could possibly suffering from any mental ailment.
I am not sure how exactly the insight began to dawn on me, but I slowly began to understand that I wasn’t being myself. This wasn’t who I was. I was this strong cheerful woman, who had at one point of time had never known what a bad mood was even if I had the worst day ever. There never was a day when I hadn’t wanted to care for myself or others. As I realized that I wasn’t being myself, I began to wonder why. Why was I being like this? What was wrong with me? What was the cause? Nothing drastic had happened in my life – there was no death, loss of job or any sudden traumatic event that could have resulted in me becoming so disorganized, stressed and sad. Yes, there were some chronic stressors, but I hadn’t given in to them so far, why was I giving in now? That’s when I realized that I might possibly be suffering from depression. I thank all the circumstances that led me to the realization that I had depression, because if I hadn’t realized, it would have made my recovery more challenging. Once I realized what my condition was, I felt as if a huge burden was taken off my shoulders. I now knew what was happening to me, I was depressed, and it was a medical condition. I wasn’t lazy or irresponsible; I was a patient, I needed care and treatment. This realization removed a lot of guilt, and helped me to normalize my feelings, and kick started my healing.
The road to recovery was long, very long indeed, but because I knew what was indeed happening to me, I knew what I had to do. I was very hesitant at first, but when I knew I had no choice, I approached a colleague of mine whom I trusted, and confided in him. Although I knew how severe my condition was, I let him administer a few rating scales to determine the severity of my depression and it was found that I was in the moderate level of depression, which needed medication as well. He prescribed anti depressants to me, which I took regularly. However, I knew that medicines take a long time to act and it is not a magic potion to happiness, and I had a lot to work on myself. Overcoming clinical depression takes more than medication. While medicines help with balancing the neurotransmitters, a lot of problems are psychological in nature and have to be handled at psychological level. Although I knew all about psychotherapy, applying it to myself was becoming increasingly difficult, because my depression was interfering with my motivation and action, and applying it to myself was a very challenging task.
In a way, my mother’s presence at home helped, though she was not as sympathetic as I would have liked her to be- but, she would ensure that I was following her schedule, which was to wake up early, bathe, perform pooja, walk in the park, have breakfast, dress up and then go to work. When I returned from work, she would want me to take her shopping, or visit temples. She was relentless in her pursuit of making me follow these routines, and though I tried to resist, I found it easier to give in to her stubbornness than to fight with her. Initially, I was very irritable, at times angry and I wasn’t enjoying being forced to do things against my will, but I had no choice, as it was next to impossible to argue with my mother. Maybe it acted as a type of behavioral activation for me, because had she not forced me to keep up to my schedule, I would have succumbed further into my depression, lost my job, cut off all friends and that would have worsened my condition in a never ending cycle. Slowly, I began to follow the schedule with less resistance, until it became a natural tendency, more like a habit or a routine that I was able to follow naturally. But I must emphasize that it was a very gradual change, and it took me several days’ time to let a daily structure fall into place.
Early morning walks helped me feel fresh and better in the morning, and it sort of set the day off for me. They say that exercise releases certain feel- good hormones called endorphins that elevate the mood. Because exercise kick starts the metabolism and burns calories, I also began to feel a lot more energetic. It wasn’t a sudden process, but it definitely helped me.
Another factor that greatly helped me recover was social support I received from my colleagues and friends. I had drifted very far from my friends, and I was hardly meeting or interacting with anyone, and most of our conversations were very reserved and related to work. I began to notice that while all other friends and colleagues still continued to be good friends, there was an air of formality surrounding my interaction with them. One day in the elevator, I met an old friend and when I asked her how she was doing, she started to complain about her workload and the difficulties she was facing. I knew I had to break the barrier I had built around my friends, and I remarked something like, ‘have you noticed that we just talk about work when we meet?’ She was surprised at my comment, but she agreed that we had indeed drifted apart, and we decided to go to canteen for coffee. One thing led to another and I was soon telling her about what I was going through and my struggles. She was very empathetic and supportive, and it was a very comforting for me because I needed someone to talk about my feelings without being criticized or judged. Of course, I was tearful, but crying only made me feel light. After that we began meeting regularly, discussing personal matters rather than the formal work related issues. She helped me identify the cognitive errors I was making in how I was conceptualizing my life, helping me view my life, stress and problems in an objective manner and identify the areas that I needed to work upon. As we spent more time with each other, others began to take notice and gradually we had more people join us and they were soon making plans to go out, and were including me in their plans as well. Although I didn’t want to go to any restaurant or movies, I said to myself that I must go even if I didn’t enjoy it at all. So, I began going out with friends for dinner, movies and even travelling during the weekends. Initially it was very uncomfortable, I could think of every excuse to get out of it, and had to drag myself to go. I would sit quietly at the table, sometimes listening, sometimes lost in thought, not contributing much to the conversation, praying for it to be over, so that I could go home. But, slowly, over a period of time, I began to get more involved in the conversation, sometimes agreeing readily for their plans before I began to enjoy these outings. I thank my friends and colleagues, who helped me sail through this difficult phase just by being patient with me. They may not have realized it, but their persistence in trying to get me out and have fun helped a lot. These relationships were also very important, because I was able to confide in a few friends about my problems and workout solutions with their help. Talking to them not only acted as a means to ventilate my feelings but I also felt understood and validated; and I felt that my problems though might have seemed silly to my family, were indeed genuine, and my suffering was real and needed to be addressed. It felt so relaxing to know that I was understood and my feelings were valid, and that my suffering was not trivial, and I wasn’t over reacting.
As the days passed, I began to feel more interested in my activities, my energy levels were going up and my confidence too began to increase. I knew that I wasn’t worthless or that I was inferior to anyone. I also realized that a lot of problems I was having at my workplace were not attributable to me alone, but rather to other factors such as shortage of man power, which I was internalizing as my own faults. This helped me structure my work better and do a better job at work.
In recovering from depression, there is no definite point of cure, where one can say that he or she is cured of depression. It is a continuous ongoing process which involves not only medical adherence, but also recognizing our biases and missteps, correcting the way we perceive the situations, and handling the negative automatic thoughts which are part of clinical depression. In addition to it, it helps when we are able to mobilize the support of others who can help validate our feelings as well as aid our coping and problem solving efforts in different ways. Furthermore, recovery involves taking responsibility for one’s physical, mental and social well being, and taking necessary actions. I was finally able to reach a point where I was able to slowly taper and stop medicines as recommended by my doctor. I continue to utilize support from my friends; while I am also able to support them, more like my typical self.
I have learnt that stress is part of our everyday life and there is no escape from stress, and hence learning to manage stress is the only way. I have understood that balance is the only way to manage stress, and no matter how much work load is there in the office, I must learn to plan so that my life is not just work, but it should also involve leisure and pleasurable activity. I have understood that I cannot please people, and that I should let go of my need to make people happy, because it can only cause disappointment and hurt. Most importantly, I have learnt that I am the most important person in my life and that no one can care for me as much as I can care for myself, and hence I am the most responsible person for myself. This has helped me to ensure that I follow my activity schedules and routines by myself, without any external coercion. Currently, I have reached a point where I am able to function relatively well in social and occupational areas. I am quite satisfied with my progress. However, this is not the end and I understand that I cannot take my mental health for granted, and I need to continue to take care and work on myself, to enhance and maintain my well being.
By: Anjali S.
Indentifying pieces of information have been changed to protect confidentiality.