I really can't be bothered (part of a 'Uses for a maths teacher' cartoon by Miriam Slechter

Do you ever have days when nothing feels worth starting and everything is shades of grey? Days when the sun doesn’t shine, and getting out of bed is the hardest thing you’ve ever done? Periods when the smallest chore becomes an impossible task?

Well of course you do. You’re human.

I remember someone telling me that as a youngster he worried he’d inherited chronic depression from his Mum. Later at university he discovered that everyone feels down for a few days at a time, now and then. It’s normal.

Actually feeling like this in adolescence (call that ages 12-25 ) is common. The hormones are rampantly badly mixed, the challenges of life are to be faced without as yet the desired rewards. Who am I? What do I believe? What will I do with my life? How do I succeed? Am I happy? Do people like me? Does she love me?

I get this feeling of lethargy and inertia far more often, and sometimes far more severely, than people without clinical depression. But it’s basically the same feeling. Over forty five years I’ve had many tricks suggested to me. I’ve tried them out, and discovered other possibilities too. This series will be the things I have found work. For me. Often enough to be worth trying.

Imagine you are at the top of a hill and the enemy approaches. You need to roll that boulder down onto them. But at first it won’t shift. These will be tricks you can try that might get the boulder started rolling.

Miriam’s picture? Yes we know verticals should look vertical even in a cartoon, but it makes sense when you see the whole picture.

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Yes, I was traumatised for many years. The abuse was merely emotional, but it hurt. Like it or not memories of those days dogged me for years. They simmered just below the surface and distorted my thinking and my behaviour. They made it far harder to learn how to cope with my own depression. They made it less likely I’d make a good parent myself.

I was exceedingly fortunate. Over the years I made a number of friends who listened attentively as I rambled on about how bad things had been. Some experiences I recounted again and again. Gradually I got used to them and they lost their power.

We all have painful memories. By and large they can be left alone because we’ve grown beyond them, but sometimes there’s one worth dealing with because it’s having a damaging effect now. In a previous post I described some NLP work I did with a student which enabled him to recreate an alternate version of a true memory. In the alternate version he handled an embarrassing situation as he would now with his increased maturity and understanding. If the bad memory surfaces he has the option of switching to the modified version. Which version is true? In a sense neither. The actual events happened, but they do not describe who he is now. He is able to relax and shrug off the embarrassment because he knows he has now used that experience, he has grown up.

Some memories are like feuds between families or nations. What triggered things happened long ago and we should move on, but somehow we can’t. Someone, perhaps a parent, treated us in some unfair way which has crippled us, and we continue to resent what they did and suffer the after effects. This is frighteningly normal, but hardly rational and certainly not helpful.

The trouble is that we may need more than friends loving enough to listen to our memories. We may need the skills and expertise of a counsellor trained and experienced in working with destructive memories.

Psychodynamic counselling does far more than just deal with memories, but it is one approach that might prove useful. I suspect Post-Trauma counselling could also be useful, though I’ve not experienced that kind. A competent NLP practitioner should also be able to help.

A triplet of warnings:

• You need to let go of destructive memories, yet if you’ve been hanging on to them grimly for decades that will not be easy. Approach this with your eyes open: it will be hard work, and it may prove very painful for a short time. It is worth it.
• There is evidence that some hidden memories which are affecting you now may best be left alone. Dragging them to the surface and experiencing them again can make matters worse. I suspect whether or not this happens has a lot to do with the relationship you and your counsellor have with each other.
• There are examples of counsellors looking for repressed memories, and phrasing their questions so badly that false memories are created in the client. Beware of a counsellor who asks closed questions such as “did your father abuse you” when they should be asking open questions like “thinking back, do you think any part of your childhood might have been worse than it should have been?”. Police are increasingly being trained to interview witnesses using only open questions and non emotive words because otherwise they run a high risk of altering the witness’s memories just by how they phrase the question. Loftus and Palmer did a neat experiment on this in 1974. Google ‘Loftus and Palmer 1974′ or check out this site which describes the research.

If you know of any other types of counselling which includes constructive reprocessing of bad memories please let me know. Thank you.

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There’s a well-known saying about how to help people in poor countries: give a man a fish and you feed him for today, give him a fishing rod and he’s set for life. 

Of course if he’s too weak with hunger to fish for himself then a fish to eat first makes sense, but after that it’s wise to show him how you use the fishing rod to catch more fish, and then give him the rod.

In the previous post I described how I was helped after my first breakdown. I was referred to a doctor who specialised in student mental health problems. He first of all established a suitable relationship. Then he prescribed something to help with the immediate symptoms. After that he told me to try one possible strategy which should help, and it did. Since then I’ve been learning how to resolve many subsequent problems, and sometimes I’ve had guidance from counsellors – some of them doctors – on how to set about doing this.

The long-term target has been that I become someone who knows how to set about solving his own problems.

Arguably this should be a part of any type of counselling. It may not be an obvious part; if it’s there it may be hidden. Sometimes I’ve only realised afterwards that I’ve learned something by simply paying attention, observing the counsellor at work. This facet of their work might have been more effective if it had been conscious.

Everyone has problems; they’re a part of life. We start by passively letting someone else solve each problem for us. As we grow up we begin to understand how they have helped us. We begin to listen and to try things out for ourselves. Gradually we develop a stock of possible strategies to look through and experiment with. At this point we’re still immature. We need to learn how to deal with a fresh problem for which we currently have no solution: we need to learn how to solve problems ourselves. We need to move from being entirely dependent on other people like a baby to being independent.

Warning: independence is not the final goal. Adolescence is about becoming independent of our parents, finding out who we are. Full maturity requires us to move even further and to recognise the need to be interdependent, a member of society who helps and is helped by other people, a member of the family.

If you suffer the crippling effects of depression, or are human in any other way and face problems which appear insoluble, look for people who can help you. But don’t be passive. Do not look just for help with the most obvious current problem. Look beyond today and find out more about how you may be able to help yourself. Gradually begin to accept some responsibility for your own treatment. And if you are receiving counselling from someone who wants to do it all for you …

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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.

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Relax. I'll be bouncing around again in a few minutes.

There are moments when suicide makes sense.

That is, it feels like it makes sense.

In the moment.

Especially if that moment drags on for days or weeks.

Today we heard of the death of influential fashion designer Alexander McQueen. Someone very close to him had just died. It’s not known at this stage if he committed suicide, but the possibility has been mooted.

That got me thinking.

If my wife Jenny dies before me then I’m sure I will be devastated, and I’ll not be at all surprised if I feel there’s no longer any point in staying alive myself. Living with chronic depression is tough, and such thoughts can flitter though my mind. Usually they are weak and comfortably brief. But I have nearly lost Jenny several times so I have a sense of how I may feel.

What I’ve done is promise myself I will allow time to recover from the immediate grief before making any critical decisions such as whether to move house. I guess suicide also counts as a critical decision.

You see when emotions are strong or depression is deep we don’t think straight. During depression is exactly the time NOT to make important decisions. I’m lucky. I know my depression will ease, so I just postpone following through on any ideas till I’m feeling better. It works. Some of the ideas then make sense, and some I realise are just plain silly.

When depression first hit in 1970 and I had no idea what was wrong with me I felt a bit suicidal. I talked to friends and that helped. My Doctor referred me to a specialist and that started me on the road to understanding, learning to cope, and realising depression was only temporary. Mind you that temporary episode lasted over eighteen months, but I survived. And I’m glad I did.

Many years later one depressive episode brought extended thoughts of suicide, and a friend (Peter Jolly) helped me through the suicidal stage.

If you are feeling like death could be an option then please talk it through with a good friend, and if you’re not already receiving treatment for depression then please go and see a Doctor as soon as possible. There are medicines that can probably help you, although some take several weeks before you feel the effects.

Above all else, be patient. If you want to kill yourself now, it will pass. Life will get better. There will be times worth experiencing again.

Afterthought

When I suggest chatting with a friend I’m not suggesting you text everyone in your address book. Some depressed people contact all their friends saying where they are and that they are about to kill themselves. If that’s what you’re doing then you are in a rough state and you do need professional help, but maybe what you’re really doing is trying to attract attention. You may be trying to shout ‘HELP!’ or you may just like the fuss. The trouble is that friends rapidly become fed up with you if you try this more than once. And let’s face it, friends shouldn’t be abused like that. Or to put it from a selfish viewpoint (which is much easier to grasp when depressed) you need your friends to still be there if it ever gets really serious.

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Nothing special - just sunlight on some leaves by a town road I was walking along.

Nothing special - just one of the rocks bordering our lawn

Dare I say, nothing special - just part of a wall in the village of Robin Hood's Bay

Each of these cheered me up when I was a bit down. They’re nothing special, you just have to notice them. For the last it was an overcast day with rain coming, and we enjoyed ourselves. There was less than an hour of sun all day, and we were there for it.

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The winter makes me feel so lethargic and down

In the seventies a psychiatrist said my depression has a lot in common with hibernation in some other mammals. I’ve mentioned this before. I’ve no idea if the expects still believe that about some types of depression, but it’s a great metaphor, a great way of thinking about what’s going on, a great model to work with. Like all metaphors it doesn’t have to be literally provided it helps.

I’ve not been writing much lately because most times I’ve tried it’s felt like trying to run through foot-deep fresh snow (that’s a simile because I’ve made the comparison explicit by using the word ‘like’ – and yes I have tried running through such snow, in my younger days). The problem has been that right now my mind and body are trying to hibernate (that’s the metaphor).

Maybe not the day to go for a long run in the park - probably feel like trying to think when depressed.

What does hibernating feel like?

Rather nice, actually. I’m thinking of the many times in the last month when I’ve gone to bed in the middle of the day and let myself relax, possibly with the radio on. If I don’t sleep it still feels good to drowse. I envy the real hibernators.

Trouble is most of the time my head and body are telling me to hibernate, but I’m not set up to do it properly. Hedgehogs have no problem. My metabolism fails to fully respond.

Normally I do a lot of reading, both fiction and non-fiction. Recently I’ve tired after just a few pages. I can cope with maybe two hours of TV a day before that loses its appeal. Anything physical is unappealing (the chemical systems are telling me to hibernate, and exercise might wake me up – perishing brain is nothing if not logical).

Getting started writing is much harder, and the results not as good. I write a section and realise it is not that interesting; I need to come up with a different approach, maybe some good illustrations (metaphors? photos?). But I can’t be bothered. And if I do try then the cog wheels in my brain scream out for lack of lubrication (metaphor with alliteration ).

Sometimes I get going on some activity, but I’m far less likely to feel any pleasure from it. I’ve shifted from my normal atypical depression to a dysthymic state, which I find depressing.

So what do I do about it?

Decades of experience have taught me when it might be worth pushing myself, and when to stop worrying and go with the flow.

If I’ve also got some physical illness like a cold I know to take things more gently till those additional symptoms ease. This has become more important with age. Right now I have shingles, but am recovering nicely from recent chest and sinus infections. So today I tried writing this and it seems to be working.

Sometimes my head lies to me. I have got used to giving in to the feelings of lethargy. There comes a time when I need to try pushing myself a bit every few days just to check, and I know that one of those times I really will feel better once started.

I started today’s blog aware that I might need to take a break in the middle for a day or two, and that’s okay. I did not start assuming I wouldn’t finish. I did started hopeful.

It helps to let people and commitments jolly me into doing bits and pieces. I am tempted to get ratty when this happens, but actually it does me good in the long term to have to do a few things, to get out a bit, to have to meet people. I may or may not enjoy it, but it helps. We go out shopping. We have the occasional meal out. We visit with friends, but just not as often as normal, and we don’t stay as long. Real friends understand – partly because we’ve explained.

Getting some exercise most days is good too. Walking for quarter of an hour would be excellent since it would get me out as well, but it’s not attractive. Especially when it’s overcast, cold, raining or snowing. We recently bought a rowing machine, and five minutes on that is both bearable (most days) and makes me feel better. Jenny encourages me gently.

Then there’s the SAD light box. Theory is that lack of natural sunlight in the winter makes some people function less well, possibly by affecting serotonin production. A light box provides bright light with wave-lengths not available from normal artificial lighting. It’s much nearer to sunlight, though in my experience not as good. If the sun is shining I’m better off sitting in the front porch (a small conservatory) than using my light box, but otherwise the box is better than nothing. It makes a noticeable difference.

Ah, that's better. Even with your stupid light box half blinding me.

Here are some useful links if you’d like to know more (or just Google something like ‘sad light therapy’):

http://www.psycheducation.org/depression/LightTherapy.htm#which

http://depression.about.com/od/sad/a/besttreatment.htm

http://www.mayoclinic.com/health/seasonal-affective-disorder-treatment/DN00013

Does light therapy work? Scientific evidence seems confused, but personally I do feel better when I use my light box. It’s worth trying, but do read the instructions. Do buy the right one for you. Do consult experts.

My own box is some dozen years old, large and quite heavy. It still works providing I replace the tubes at worst every other year. I’m thinking of trying one of the new generation of smaller systems, perhaps a blue light or LED one. Must read that up.

Having depression which gets worse most winters is not the end of life. Yes it’s another obstacle, but one that can be overcome. If you’re patient. And realistic. And you want to.

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NO ENTRY !

There’s a classic TV sketch in which a one-legged actor turns up to audition for the role of Tarzan and is outraged that he’s not considered quite suitable. (Sorry, can’t remember the source. Probably Monty Python or Not The Nine O’Clock News.)

If you suffer depression it’s easy to think like this. You know what you’re capable of at your best, so why do you need to declare your disability in the job application?

Because it matters.

If you had a single episode of depression ten years ago, got over it, and have coped with a range of stressful situations since: yes it must be galling to have to declare it. On the other hand if, like me, you have repeating depression then you just have to accept that some roads are closed to you.

This is a tricky area. Depression affects individual people and jobs differently. Stephen Fry became an outstanding entertainer (comedian, actor, writer, presenter) despite major depressive problems. Other depressives who try to become actors find that profession makes them even less stable.

There are few solid rules. Obviously you should think very carefully before trying a career in school teaching. The hours are long in term time. Stress can be high. Abrupt switches several times a year from crippling levels of work to several weeks of nothing is arguably bad for a depressive. But it’s possible. It would seem equally daft for a depressive to go into national politics, but Winston Churchill is recognised as a great wartime Prime Minister of this country.

How about I describe what limitations illness forced on my own career? What no-entry signs were inevitable, even if it did take me years to accept them? I’ll cover them based on the reason they’re there.

I’ve been off ill a lot

Early in my career this would be the occasional half term off following a breakdown. Also depression may depress the immune system. I had more than my fair share of normal illnesses some of which also required sick leave.

In the final dozen years I was generally able to manage things better in the sense that I could usually see a breakdown coming and take a few days off to recharge. As stress built up in the last few years of teaching I was physically ill more often too.

When I was off ill someone else had to cover my lessons. With short-term absence this would be colleagues giving up non-teaching lessons. I would set work and phone it in. They would try to interpret my instructions but most teachers do not ‘teach’ cover lessons. They turn up, set the work, and get on with urgent marking. This is not ideal, but if you’ve ever tried teaching you’ll understand. With long-term absence a temporary replacement must be found from outside the school, but anyone good enough to be teaching Maths full time probably is, rather than sitting at home waiting for someone to be ill.

I was lucky. My various headmasters were sympathetic. It seems they wanted me back so chose to make the school put up with problems. Even so the last Head quite reasonably stopped me returning after my last breakdown and required a full medical report. I was five years from retirement. He offered a part-time teaching job coupled with maintaining pension payments at their full rate. This was a remarkable concession. He thought I was a good teacher, to be kept if at all possible. (Actually my consultant psychiatrist reviewed matters and rightly assessed I’d reached the stage where I wouldn’t cope with even part time teaching.)

Most teachers expect to be promoted during their career. There are a number of options. My preferred one was pastoral. I wanted to be Head of Year. More of that later. The obvious alternative was academic: become Head of Maths. Both roles must have someone who is going to be there pretty much every day. Neither person can do the job if they keep taking sick leave. This is not unfair, it’s in the nature of the job. We did find a unique alternate route for my skills plus illness, but repeated sick leave effectively banned me from reaching deputy head level whether I was otherwise up to it.

My mood changes according to how ill I am

Okay, I’ll be honest. When depressed I’m a moody git, and when stressed by teaching as well I became bad tempered and not entirely rational.

Imagine this:  they make me Head of year 9. John Smith, aged 14, has rich and influential parents who are far too busy with their own careers to spend time with their son. He is mixed up, attention seeking, and frankly lacking in moral awareness. Yesterday he was internally excluded (supervised while he worked but not allowed to go to lessons) for throwing his calculator at a teacher coupled with fairly explicit instructions where to go. It is 8.25am and I am just heading off to take year 9 assembly. Passing through reception I’m accosted by Mr Smith. He has no appointment but demands to speak with me “right now”. He is angry that he’s paying school fees for his son to not attend lessons. He is a busy man so requires instant attention – now I know where his son gets that from.

Okay, that’s the scenario. How do I deal with Mr Smith a) when I’m well, and able to respond calmly and professionally, b) when I’m struggling to stay afloat with depression, my head hurts, my back aches, and my subconscious keeps telling me to snarl at someone?

Enough said?

So what’s the good news?

More of what Nigel Day wrote for the school mag

I was in the right career for me.

I think the problems caused by illness were generally (though not for everone) outweighed by how I did my job.

Because they’ve told me: I know many that people have benefited from my work.

And being someone students knew well who was also known to suffer chronic depression was itself of value to quite a number.

One trick, which admittedly I was slow to learn, is to recognise the genuine limitations imposed by who you are and any problems your body or mind have. This is true for everyone, but more so when the disability is something as powerful as cerebral palsy or chronic depression.

Oh, and in case you missed it: the previous post was about the shame and stigma of depression. It may be just below. It is here.

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