And all the drugs in the world can’t save us from ourselves…

Usually I don’t start a piece of writing with a title, in most cases that comes at the very end after I’ve finished the words and have a clearer picture about what I was going to say. But listening to a song by the Manic Street Preachers earlier, the above words just stuck in my head since they resonated a lot with what I’ve been contemplating for quite some time now, a long time in fact.

The issue of mental health has long been of interest to me. I was first diagnosed with depressive disorder at the age of 11 or 12 and have been battling with what has grown into chronic depression ever since.

Speaking about an illness that isn’t too obvious on the outside is a difficult one, since nobody except people who have experienced some kind of mental illness themselves would fully understand what it really means. Speaking from my perspective, depression has nothing to do with outer influences that affect the mood, like the loss of a loved person or the breakup of a relationship. It feels more like a numbing filter that distorts every aspect of life to a more or less severe extent. It is something that is always there and can’t just be turned off, no matter how hard you try.

Depression isn’t about feeling sad all the time — it’s rather about feeling nothing at all. It sucks all positive energy out of body and mind and deprives it of feeling anything between happiness or sadness. It kills all motivation to do anything. Even simple and mundane tasks like getting out of bed in the morning or simply structuring the day become almost impossible. The result of this very often is complete withdrawal and isolation — a vicious circle that is very hard to break. A sense of complete worthlessness that comes along with massive self-hate and anxiety.

As much as depression can turn grown men into lost children again, more often than not people in their immediate surroundings start retreating as a result of feeling helpless and rejected. Attempts to motivate the depressed person to do something useful or to generally cheer them up will not work, since in a clinically depressed state they won’t be able to get the message. They don’t even enjoy pursuing things that otherwise would be considered a joyful pastime. For me personally music has always been a powerful resource. But during severe bouts of depression even playing my favourite records doesn’t interest me the slightest bit. It all seems like a worthless waste of time through the reality distortion filter of mental illness.

It is hard to comprehend that clinical depression is something that can’t be toned down by outer influences, a fact that seems even harder to accept by people who don’t suffer from it. ‘Don’t make such a fuss’, ‘don’t wallow in self-pity’, or ‘get your act together’ are just a few of the ill-advised hints aimed at depressives. However comments like these only make things worse, as all they do is reinforce feelings of inferiority and ineptitude. The last thing a depressive person wants is to feel worse or even more useless. In most cases it’s out of their hands though to deal with their situation alone as the mental illness cripples the senses and distorts perspective.

As much as I would like to say society’s acceptance and understanding of that invisible disease has changed and advanced over the years, sadly I have come to think that it hasn’t. People tend to either romanticise or stigmatise depression, depending on what they’re looking at. On the one hand there is the stereotype of the troubled genius, the tortured artist that expresses himself through his suffering and more often than not ends in tragedy: Ian Curtis, Nick Drake, Kurt Cobain, to name but a few… on the other hand mental illness is frequently taken as a lame excuse for irrational and destructive behaviour. Look at the media coverage of all the tragic and despicable incidents happening around the world at the moment: Mental health problems are all too quickly attributed to anyone committing a crime or injuring people, which leads to stigmatization of illnesses like depression and branding it as dangerous and a threat to society.

Therefore it is no wonder that the primary treatment approach for mental illness always seems to be to make a depressive person function normally again in order to avoid worse things not only for him, but for the environment around him as well. The patient’s individual needs and demands very rarely are taken into consideration at this stage, as it is mostly deemed too time consuming for the practitioner to dig deep enough to get to the core of the underlying problems. In most cases the prescription of some antidepressant drugs turns out to be the first method of treatment on offer.

It has to be said that even though the use of antidepressants can be entirely justifiable particularly when it comes to relieving acute symptoms like insomnia or heavy sadness verging on suicidal tendencies, they are hardly the miracle weapon the pharmaceutical industry wants us to believe.

In all the years I’ve been affected by depression and anxiety I have seen many doctors that have prescribed me a number of antidepressants. Over the course of almost 30 years I have tried many of the common drugs designed to brighten the mood or to get better sleep. In the end none of them really had any noticeable effects, apart from making me feel even more numb and apathetic at times. Some of them helped me to get better sleep, which was some kind of relief, as sleeplessness is one of the main symptoms of my depressive disorder. Nevertheless I still continued to feel low, bleak, lethargic and devoid of joy.

I would go as far as to say that taking drugs that don’t have the desired effect can significantly worsen the mental condition. When I realised after some time that none of the medication that was supposed to cure me did anything for me, I went into a state of limbo between trying to ignore my constant state of melancholy or combating it with excessive intake of alcohol. Of course, none had any positive effect on me either, so at one point the idea to undergo some kind of psychotherapy was brought to the table. We are still talking early to mid Nineties, so suggesting therapy was neither as common as it is now, nor was it particularly well accepted. In those days people undergoing psychotherapy were even more easliy stigmatised or considered insane.

That I am currently in the midst of my fifth long-term therapy shouldn’t put anyone off. On the contrary, it only shows that persistance and the will to work on oneself will most likely pay off at one point. It is a slow and sometimes very painful process though.

I did have my first three periods of long-term behavioural therapy during the Nineties, all with different therapists. Back then the primary focus of my therapy sessions seemed to mirror the approach of antidepressant drugs: it was designed to make me function ‚normally’ again, to keep my demons at bay instead of getting to the bottom of my constant unhappiness. The emphasis was put on altering my behaviour and changing key elements of my personality in order to adjust better to my environment and, consequently, to reduce the levels of stress and anxiety. It all felt a bit too much like cosmetics on the surface, like an attempt to further disguise the illness rather than grasp the opportunity to seriously identify it and work out ways to cope with it. As a result I might have felt better for a moment or might have gone through some stressful situations more successfully, but it hardly had any long-lasting effect. My melancholy, sad and sometimes very down nature still dominated my days and sleepless nights.

After a halfhearted fourth attempt at psychotherapy came to nothing and still not having found any working medication to pull me out of the slump I kind of settled into a life of trying to accept my fragile mental state as an integral part of me, as something that is woven quite fundamentally into my character and my way of being. Still I have never stopped thinking about what it is that keeps paralysing me for days or weeks on end, time and again.

To my surprise I have found time to be a great helper. For me, growing older, gaining new experiences, watching my environment and finally being able to take a step back and look at life and myself from a wider perspective has enabled me to discover things about myself that have pointed me towards new starting points for another attempt at psychotherapy. I do believe now that the key to solution lies in ourselves, yet it’s a long, hard road to find it. It takes a lot of time and guts to go in confronting yourself with your inner demons, yet there is no way around it.

My current fifth attempt at cognitive behavioural therapy finally seems to be moving in the right direction. Not only do I think that in my third decade I now know a lot more about myself and about the things that trouble me. I do believe as well that the approach of psychotherapy has gradually changed over the years. For the first time I feel that the main goal of this new therapy is not to cover up the things that don’t work or to try and push things to work in a certain way, but to find out more about myself and about what keeps dragging me down. It’s about finding out how to make the best of life as it is, about finding resources to draw strength from and about gaining some self-confidence. It’s about accepting the things that are here to stay, to better cope with them yet not be defeated by them. When previously I have learned to disguise my problems and pretend to be someone else in order to function in my environment, now I am learning how to stand up as an individual, to be myself and not to hide away. I will still be a very private person that likes to keep his thoughts to himself, but hopefully I will be a happier and altogether more stable one.

Having someone to talk through personal problems, to dig deep enough to unearth the true reasons of the paralysing sadness and to try and find some strategy to deal with them definitely has to be considered one of the core starting points when it comes to treating mental illness.

It has to be absolutely clear that depression, no matter how severe, is a serious illness like any other physical illness. Just because you don’t see it, doesn’t mean it’s not there. Stigmatising or romanticising depression just makes the whole thing worse for anyone involved. It’s got nothing to do with lack of willpower or laziness or whatever, it’s a disease that is hard to control.

Psychotherapy can be a very effective method to support patients on their way to recovery, yet again it might take a lot of patience and maybe a few tries until a therapist that is willing to do the right things will be found.

Prescription drugs can be a reasonable method to alleviate the worst symptoms, as in my case a moderate dose of Mirtazapine now helps me to calm down and get enough sleep at night.

But in the end it’s down to us and the people around us, as well as time and patience… in no way can drugs replace what communication with a knowing and understanding person can achieve. Covering up the cracks and ironing out the rough spots with some medical aid might bring temporary relief and an illusion of recovery, however it is no effective long-term way to deal with mental illness. Face the facts and face yourself… all the drugs in the world can’t save us from ourselves, indeed.