March 15, 2012

Mark Rice-Oxley, Guardian Journalist and Time to Change bloggerDepression is an illness of paradoxes. The harder you fight it, the harder it gets. The more you think about it, the more convoluted the conundrum becomes. As soon as you think you're well again, bang, it hits you harder than ever.

And it is the loneliest condition on the planet - even though tens of millions of people suffer from it. Why? Because most of us still prefer to suffer in silence. There are clear downsides to "coming out", reasons to be terrified. Friends might desert us; partners might turn their back on us. Employers won't want us. People will give us funny looks, and start crossing the street to avoid us. Being open may put us in a pigeonhole from which we may fret that we'll never emerge.

Some of these concerns may be well founded. Employers still have much to do before they can say they treat the mentally ill just like anyone else. And some people will indeed have a hard time understanding exactly what is wrong. Despite its prevalence this is still a deeply misunderstood condition. There - another paradox.

But speaking out is the first step back from the brink. I did so and it only had positive effects. It is remarkable just how many people sought me out, called me up or accosted me in the playground or at work to speak with me - about themselves, a partner, a relative or somebody they used to know. There was a snowball effect. And it was virtuous.

Because the first thing you realise is: you're not alone. This is not a unique horror that you are enduring but a ubiquitous one. People have endured, and are enduring, the same thing as you. There is a whole pathology, a literature, a community out there which can tell you what to expect, what to consider, what to avoid and how to accept what is happening to you.

The second thing that you realise is what a powerful release it is to spend time with people in the same boat as you. Within weeks, I had a small network of the broken and the beleaguered. We swapped stories and symptoms over camomile tea, or occasionally something stronger if times were suddenly on the up again. We would ask each other how we were coping, what we did to fill the long days, whether we had a back-to-work plan and bigger questions: what we wanted from the rest of our lives; what our depression had taught us. And then we would leave each other feeling slightly more secure about our illness.

This is particularly important when it comes to rumination. Obsessive negative thoughts are a defining symptom of depression. Initially the sufferer finds it hard not to shrink in the face of these terrifying statements: "I'll never get better," "I can't do this much longer," "what's to become of me?" It is only when we meet other people having exactly the same thoughts that we have a sudden moment of marvellous insight: these thoughts are not specific to me; they are symptomatic of the illness; they tell me nothing about me and my life, they are just the sinister agitprop of a mind in meltdown. Once we can see our thoughts with this detachment, it becomes easier to avoid buying in to their nefarious suggestions.

Coming out was the first big step I took. Not back to where I'd come from, but forward to a new resolution. From there it was a short step towards acceptance, which is still for me the biggest element in recovery. For ironically it is not until we and the world around us have properly accepted our condition that we can put it behind us. Like I said, depression is all about paradox.


Mark Rice-Oxley's is an assistant news editor at the Guardian. His book Underneath the Lemon Tree is published by Little Brown. Follow him on Google+


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