Nigel 
March 30th, 2010
I was 21 when I had my first breakdown. I’d been suffering teenage depression on and off for six years but not known what it was, never questioned it. Suddenly I was too ill to go to lectures. In those days there was no specialist student health care, but a local GP (family doctor) had become increasingly concerned by the mental health problems he saw in his student patients. A year or two earlier he had decided to specialise in treating this epidemic. I was lucky enough to be referred to him by my own GP.
I don’t know what he prescribed me. Almost certainly a tricyclic antidepressant (this was autumn of 1970). I’ve just looked them up on the net and I certainly gained several recognised side effects: increased heart rate, drowsiness, blurred vision, dizziness, confusion. Mind you I was pretty confused when he first saw me.
The first consultation was weird. Okay so he sat behind a large desk and I had a traditional upright surgery chair. But he offered me a coffee, which was shrewd. It worked in much the same way as being given a drink when you arrive at a party. I had something to hold on to, something to take sips from as if I felt confident and purposeful.
His overall approach was way ahead of its time, perhaps because he had not been trained as a psychiatrist so came at the problem with fresh eyes. The starting point was medication, but he made it clear that the antidepressant was only to give me the opportunity to work hard at learning to cope with depression. So that’s what this was. Depression. Hmmm.
“The trouble is that when you feel down you have only the one escape route: running.”
I was a keen member of the university cross-country and athletics teams, and hell I enjoyed running. Best of all was ten or fifteen miles at relaxed pace through the beautiful countryside around Durham. That’s Durham England. If I felt a bit rough I went for a run. But if I felt seriously rough any attempt to run would be frustrating because the energy was gone. Clinical depression affects you physically. I would try to train and fail. The harder I worked at it the worse I got, which was absurd. Races were a waste of time.
“You try to escape by running and find that route is closed to you. What do you do? Nothing. You do nothing because you have no other escape routes set up apart from friends who are usually not available because they’re working or having a life of their own.”
I must have looked blank.
“When I get home from work I’m often feeling pretty rough. What do I do? I knock hell out of the garden. Do I like gardening? Sometimes. Not always. But I do it anyway, and it helps me feel better even when I don’t think I’m enjoying it. But some evenings it’s too dark or it’s raining heavily.”
What did he do then? Sorry, I can’t remember.
“Now you’re too depressed to run what other hobbies do you have?”
- I write.
“When was the last time you wrote?”
- well, er, I wrote a novel two years ago …
“Are you well enough to write?”
- er … well … I read a lot. I listen to music.
“You just told me you’re picking up books, trying to read them, and giving up after just a page or two. You said music isn’t doing anything for you anymore. In fact you have nothing but friends to fall back on when you’re this ill.”
I doubt I nodded, but he was right.
He told me I must find at least one new hobby. How? Well I could try browsing the local bookshop to see if anything caught my eye.
“This is your homework. You find one new activity to try. I don’t care what it is so long as you try it. No matter whether you find a new hobby first time off, the key thing is to try something. And then something else. And we keep going till you have a battery of escape routes to fall back on when you’re depressed. See you next week. Good luck.” He smiled and shook my hand firmly.
I went to the local bookshop (these days a Waterstones but not then). It was an Aladdin’s cave, but cold and dark and grey with the air like treacle. I kept wanting to cry but I made myself work through every single shelf of non-fiction. I read every title. I took some books off the shelf for a browse.
I have no idea what activity I picked, but I do remember the faint glimmer of light that doing something, anything, left me feeling ever so slightly better. No, I didn’t feel happy. No, I still couldn’t think straight. No, the future was still black. But something eased just a tiny bit, barely enough to notice. I had made a crucial discovery: when you’re depressed doing anything is better than just sitting around thinking about how bad you feel.
Actually there were two other long-term results: a lifelong love of browsing bookshops (which fortunately my wife shares, though it’s cost a lot of money over the years), and a tremendous variety of interests. To focus enough on writing to produce the next book for my agent to try and sell I’ve had to be brutal in sidelining many hobbies.
The doctor cum counsellor I saw in Durham from 1970 through 1972 used a range of techniques. The one I’ve described above would probably now be called solution-focused therapy. It was exactly what I needed at the time, and has benefited me ever since. I’ve sometimes used it with people I’ve tried to help, but rarely as forcefully as it was used on me: once I had a really bad weekend and made an appointment to see this doctor. What was I supposed to do when I realised I was getting worse? Anything but sit around moping. What had I done over the weekend? Sat around moping. There’s your answer so next weekend have stuff planned and do it no matter how you feel. Just do it. He then warned me that if I ever came back complaining of being worse yet had not followed this strategy then he’d not see me again. Hard words, but spoken forcefully at exactly the right time. The next weekend I had planned in detail, and I stuck with the plan. I didn’t feel okay. But I didn’t feel worse. Success! Often success for a depressive is entering a bad situation and simply not feeling worse than before.
If your counsellor proposes some action on your part then you have only two rational choices: you can give it a go, or you can stop seeing that therapist. And what harm is it going to do trying out their suggestion? After all, it might work. You’ll be sure it won’t, but give it a go. Give it a serious go, and in so far as you can when ill be open minded. Not every suggestion will work, but you can be almost certain that when you first hear of something that can help you’ll try to reject it; that is part of depression.
