It's invisible illness awareness week and I'd normally prepare a post about my ME/CFS or NMH or chronic pain/illnesses etc, but I've discussed all that before, plus I don't really feel that these conditions are particularly invisible for me anymore- for example: I use a mobility scooter, I'm a bit wobbly, I live in an adapted room, I wear (really sexy) compression tights and am often grimacing in pain. There's one recent aspect of my health challenges that is normally completely invisible though..
This really, really, really isn't easy for me to admit, but in the interests of honesty, openness, and not bowing to stigma, I want to mention my recent battle with symptoms of depression and anxiety. About 3 months ago my mental health absolutely nosedived- scarily quickly.. Mental health difficulties are such a huge problem in our communities nowadays, and yet too often they are not talked about openly. In fact I haven't really been open with many friends about this at all- until now.. Before you read on, can I just reassure you that I'm describing how things were at my worst- I've come a long way since then. But I am sharing to raise awareness, help others going through similar feel less alone, and to make the invisible visible.
For those of you who have never experienced either depression or anxiety, please let me try to give you some insight into what it's like to be depressed and anxious, or at least what it was like for me: Every minute of every day is a huge, overwhelming battle. Even when you are not thinking about anything in particular, there's a pervading sadness- it's not really like a feeling, it's a state of being. I felt continuously uptight to the extent that I felt like I couldn't breathe; the anxiety was suffocating. There was one evening when I must've breathed into a paper bag on over 20 occasions in an attempt to try to get my breathing under control- I was in a constant state of complete panic. I was much, much more irritable, and it felt like everyone was saying the most infuriating things possible. I often saw(/see) things out of proportion- relatively small problems/challenges seem completely insurmountable. I wasn't always nice to be around, partly because I felt like people had no idea and weren't grasping what I was going through. I was quite uncommunicative at times though, so understanding what I was going through was a challenge. I was tearful and ended up crying a lot, including in public on multiple occasions. I sobbed my eyes out to one doctor, and welled up in front of multiple others. I was stressed and felt unable to cope with anything and everything. I really seriously wanted to quit uni, despite having worked for years and years to get where I am, to try to reduce the stress and anxiety I was feeling. The only thing that sometimes helped was being around people as this distracted me, but the idea of being around people was truly terrifying, and getting myself up and dressed to leave my flat was horrifically difficult. Some days it felt like I was experiencing 1,000,001 emotions all at once, other days I felt completely numb and distant from everyone and everything. Some of the time I cared too much about absolutely everything, the rest of the time I simply couldn't care less about anything. The effort involved in putting on a brave face was utterly exhausting and not sustainable. I just wanted to curl up in bed and not move; just the idea of needing to get out of bed brought me to tears on multiple mornings (this was particularly frightening having had to fight my physical health difficulties to prevent becoming bed-bound). Motivation was (is..) lacking to a really serious extent. And when I did find the motivation to do things, my anxiety would sometimes prevent me being able to, and I would have to abandon trying to do it to relieve the anxiety because I'd get tearful and the anxiety was paralysingly overwhelming. Even doing important things for my physical health was, and sometimes still is, completely beyond me.
Some of this probably doesn't sound particularly 'invisible', but most of this happened in the privacy of my own home, and few people were actually aware of what I was battling. It was only when I admitted to a select few people, to varying extents, how I was feeling that anyone got some sort of an insight. A vast majority of the time the pain and turmoil was hidden by a smile, or at least a blank face if that's all I could manage, and nobody would've ever guessed how broken I really was.
The impact of mental health on physical health is huge, particularly when you have conditions that you need to actively manage. Managing health problems when you are struggling with low mood and lack of motivation is practically impossible. Mental health challenges also cause, or worsen, some physical symptoms.
The impact of physical health on mental health can also be absolutely massive. Most of my emotions were centered around things to do with my physical health problems (although there were other very significant things going on in life separate- to varying extents- from this too). I still struggle to accept my disabling chronic illnesses, and that has an affect on my mental health. Living with constant pain and so many other symptoms and limitations is indescribably difficult. It's also hard when your illnesses cause you to fall behind your peers, and you feel increasingly 'different'.
Although I have distinguished here, I really don't like the separation between physical illnesses and mental illnesses. They're all just illnesses, and they're all incredibly challenging to deal with. Illnesses are often deemed 'unquestionably physical' when a level of something is found to be wrong, but if my 'mental' health problems can be treated with something that alters chemicals- is that not physical too? It's just a strange distinction in my opinion. Mental illness does not get the respect it deserves, and you'd think there'd be greater understanding given the numbers of people affected. There's stigma associated with mental illness, and you feel as though you should hide it. You feel like you can't open up and tell people that your head is a real mess at the moment. You feel like people expect you to be able to make yourself better because it's mental rather than physical, but it's really really not that easy. You can't just snap out of it and choose not to be depressed/anxious. You would if you could, because it's an awful place to be.
It's strange because there's sometimes discussion about how difficult it is to distinguish between ME/CFS and depression, and I can understand how that could be the case as a doctor who is an onlooker, but the experience is entirely different- or certainly has been for me. With my ME/CFS I've been desperate to do things and fighting to get upright and back involved in things, but was unable to due to symptoms, whereas when I was depressed I just wanted to be left to curl up in a ball under my duvet and didn't want any contact with the world. Having been practically bed-bound with ME/CFS and NMH, it was weird to end up feeling like I didn't WANT to get out of bed, when I've fought so so hard to rejoin the outside world.
It's also an important reminder that illnesses don't occur in isolation- you can have both physical and mental health problems, and like in my case, you can have 1 for many years before developing the other, so it's important to remain vigilant.
If anybody out there is struggling with their mental health, I would really really strongly advise you to speak to a doctor or other professional. Even if you feel like no one will be able to help and your situation is hopeless- give it a chance. I'm so glad I was open and honest with the right people and I'm feeling SO much better thanks to the help I have received. I'm still a bit anxious, down and lacking motivation to some extent, and there are things I can't bear to properly think about or tackle, but I'm certainly nowhere near the dark place I was in. Therapy/Counselling can seem daunting, but give it a chance and they'll soon put you at your ease- it's what they do all the time; if you don't get on with the first one you go to- don't give up, try another. And don't be afraid to give medication a go- it might be just what you need to get you through. Obviously meds aren't for everyone, but they are necessary and helpful for some- if you decide against them, that's fine, but make sure it's for logical reasons. I was a little reluctant, although I'd reached the point of desperation for help, but I'm so glad I started on my medication- I don't think there's any way I could've coped without it (Note: if you have ME/CFS, remember many of us are sensitive to meds- I started on a very low dose and slowly increased until things were bearable- oral drops meant I could increase 2.5 or 5mg at a time which was great, and I'm now tolerating 4x my initial dose absolutely fine). I didn't fully realise how abnormal I felt until things started to get back to normal.
I don't want to be on antidepressants forever, and I don't think I'll need to be, but for now they're doing a fantastic job, and are managing symptoms that had got unmanageable- just the same as all the other meds I'm on.
It's weird how it feels different when the medication is an antidepressant. I was scared I'd feel falsely happy or out of control, but it's not been like that at all- it's just taken the edge off the horribly extreme emotions I was experiencing and made me feel more like my usual self. Because it's an antidepressant, I'm not quite so comfortable with mentioning that I'm on it. I worry what people would think and I feel uneasy about the fact I'm medicating my moods/emotions. But I know it became necessary, and I also know I shouldn't feel like this, as it's only the same as needing a medication for any other condition/symptom. As my physiotherapist said- sometimes brain chemistry goes wrong too.
I must say, I've been incredibly impressed by the way my medical team, the uni counselling team and a couple of other members of staff I told have dealt with my recent mental health challenges. The people I told have encouraged me when I mentioned I was having counselling. I know it's difficult for people to understand what it's like unless they've been through it themselves, but people have tried and have been non-judgemental, which is all I ask. My doctors have been amazing; my GP was simply surprised I've held things together as long as I have. All my medical team have acted really calmly and have been incredibly supportive. I think it's important to remember that as a patient it may be the first time you've been through anything like this, but they're dealing with patients experiencing these difficulties all the time.
Lots of people live hiding these sort of difficulties, and because they're invisible, you don't know who is and isn't struggling with these problems. If this is you though, please don't hide them from the people who could help you, you deserve to feel better, and there are people who can help that happen. There were times when I thought I'd never get through these problems and come out the other side, but, with the help of support, counselling and medication, I largely have, and am feeling about 85% back to my normal self. Because of the invisibility of mental health problems, there is a real risk of people not getting the help they need, so please be vigilant and keep an eye out for those around you showing signs of struggling.
It's scary how fast your world can seem to fall apart around you, but reach out and tell people and they can help you piece it back together.
PS this post actually encouraged me to speak out and I think has some important reminders: http://www.buzzfeed.com/timetochangecampaign/10-things-we-can-all-do-to-challenge-mental-health-1gemw Remember 1 in 4 of us experiences mental health difficulties every year, and the risks are even higher among those with chronic health problems, so if you're struggling, you're certainly not alone, despite how it might feel. If you ever need someone to talk to who understands, do feel free to give me a shout.