Nigel 
November 28th,2009
Life is an infinite flight of stairs that has to be fought up,and I know I can't even manage the first step.
So I wake up wanting to lie there for the rest of existence. Something to dull my senses would be good. When hedgehogs feel like this they hibernate.
But I’m not a hedgehog. I have to take responsibility for part of my recovery. I need to train myself to do stuff even when the world is just blurred shades of grey and I know I can never feel pleasure again. Why? Some answers are here,posted two days ago.
Okay,I need to make a start on my own recovery. I want to have a life once more. How do I set about it? Here are some thoughts based on decades of study and experimentation:
Be clear what the problem is
I am ill. There is a chemical imbalance in my brain that is making me feel like this and is twisting my thinking. It’s not my fault I feel like this,any more than it’s my fault when I catch a cold. But I can fight it. The fight may be long and hard,but there will be better times along the way. If I’m not being treated by a psychiatrist then I need to seek medical advice. If I’m on an anti-depressant I may need to be patient,or it may be the wrong medicine,or I might need a higher dose for a while –so I may need to return to the Doctor. Once the chemical problem is a bit less crippling I might well find some form of counselling helpful.
But given all of that,I am living TODAY,and I have the ability to at least make a start. I can make one step towards my own recovery right now. My brain is for the while a bit damaged and tells me I can’t,but it lies. I can.
Start tiny,think small
I’m not out to run a marathon,just to make one faltering step and then rest. The thought of going through all the rigmarole of getting dressed is overwhelming,so forget that. Maybe I could run some warm water and rinse my face with a flannel. This usually makes me feel a tiny bit less rough,but if not that doesn’t matter because I have achieved something.
I enjoy coffee. How about I make myself a cup and then drink it while I rest.
Start from where I am
If I’m still lying in bed with the light off maybe I could simply sit up,maybe turn on the light. If I’m moping in a badly lit room I could get up and turn on the light. If I’m up and have had breakfast but still feel useless then for me opening this blog and starting to write is a good next step. Telling myself to go for a half hour walk is not. I may be up to that later,but not yet.
Break things down into the smallest parts
As a teacher I used to set out everything that would be needed to start marking a pile of books. I’d get it ready for someone else so all they had to do was sit down at the table,pick up a pen,and they were off. I wasn’t going to actually mark those books,just get them ready.
Some mornings I can’t face getting dressed so I tell myself all I need to do is clean my teeth. If that is too much and I can’t move then how about filling the glass with water and rinsing my mouth? Still too much? Go to the bathroom and move the glass from its hiding place behind the curtain to where I’ll see it next time I’m there. Some days it takes me four separate goes to get dressed:put clothes out for the day (rest),clean teeth,(rest),shave (rest),shower and dress (rest). And then I almost always can cope with a bit of real life.
Failure happens,move on
There are days,not often now but they happen,when I not only don’t get dressed but don’t even clean my teeth. Not good,but it happens. Okay,so that was a bad day. I’m going to make today better. My challenge,should I choose to accept it:at least run the electric toothbrush over my teeth and rinse. Ideally include tooth paste. But the key is to accept bad days as part of the illness and move on. If I fail it’s the illness. If I succeed it’s me. A day back is bad brain chemistry. A day forwards is an achievement.
If you feel the slightest bit better once you start,keep going
Have you ever helped push a stalled car that needs to be bump started? The hard bit is getting it going. Once it’s on the move keeping it moving,and even speeding up,is easier. Depression is usually just the same. Once I’ve made the first move I can often cope with the one after that. If I’ve set myself the challenge of cleaning my teeth,nothing else,but once that’s done I feel up to it I just keep going and shave,and the logical next step is to shower and maybe even wash my hair. If I make it to fully dressed I’m usually okay to get some more stuff done,to have a life.
Don’t be fooled by how your brain says you feel
I don’t like it when the sun doesn’t shine,but I work hard at not worrying about it.
Telling myself I’ve taken the first step may not feel like anything,but it is having an effect. Recent research suggested that although patients do not realise an antidepresssant is helping them for anything up to six weeks it is actually having some effect from the first day (easy article here,more technical stuff here).
A depressed brain distorts everything. It's just a normal flight of stairs,with a beginning and an end. The sun isn't shining,yet,but all I need to do is put one foot on the first step,move slightly,and sit on the next step for a rest. I can do that.
I remember clearly the summer of 1971 when I was severely depressed and there was no antidepressant that helped. I’d been depressed for nearly a year and it wasn’t letting up at all. Nothing was pleasurable. I was living with my parents at their retirement bungalow in Sidmouth,Devon. A college friend invited me over for the day. He lived in Paignton. The journey required I catch a bus to Exeter and then train the rest of the way. Pretty easy for normal people,but a mountain to climb then. I made it. He met me at the station and spent the whole day arranging activities that I might enjoy. I can still feel the overpowering sense of gloom that I knew I should be having a good time,but wasn’t. Every single thing we did was for me just going through the motions. On the way home I sat on the sunny side of the railway carriage staring blankly at scenery that my intellect said was beautifil,but it left me cold. I just wanted to cry.
BUT at some level I couldn’t sense that day out helped me towards recovery. Cheers Steve. I felt no pleasure. Every activity was tedious. But it was the most active day I’d had since becoming depressed the previous November. I was moving on. I was building in the habit of doing stuff no matter how I felt. As a teacher I must have often been pretty bad when depressed,but I know there were black days when somehow my professionalism kicked in and I gave some good lessons. I didn’t need to FEEL happier as a result because I had made progress. Not much,but a bit.
Recognise when to rest
Yes,sometimes I’ve pushed myself and collapsed. Let’s consider that in the next post.
As the last two articles,this is the first draft,raw and unedited. Hope it helps someone.
