I have depression.
It’s not something I tend to talk about, well, ever really. It doesn’t normally impact on my daily life. It’s not something I’ve ever gone to my GP to get medication to treat and it’s not something that I manage using talking therapies.
I thought I was pretty much free of it until recently. Let me explain.
I’m not going to talk about ‘when you have depression this, that and the other happens..’ because I don’t know what other people experience. I’m going to talk about what I personally experience when I notice my depression rearing its ugly head.
My life is pretty good at the moment. I have a wonderful fiancé who cares deeply about me and who is kind, considerate and generally a lovely chap. He tells me that he loves me constantly and shows me that he loves me in all of his actions. We have a manageable mortgage on a nice house, a couple of very low maintenance guinea pigs and a completely adorable new kitten. We’re financially comfortable and are planning a wedding for next year. All of my family are in good health and generally in good places right now. There’s a lack of drama surrounding me and I’m taking a break from work following a stressful few months.
As part of this comfortable place we find ourselves in, I was able to pause and reflect on where I would like to go next in my career. I decided that midwifery was appealing in all sorts of ways and applied for a place on a post-registration, fully funded course. Very competitively fought for places but a really amazing opportunity and the secondment would mean that I’d still be earning a good wage while I trained. Perfect.
I got an interview and then was offered a place. A place for the course starting in January 2014.
My world fell apart around me.
Suddenly, I wasn’t a capable adult. I was a failure and more importantly, everybody knew it. I shut down and hid from the world. No matter what anyone was actually saying, I knew that really, everyone was laughing at me. That I visibly tried and missed.
This is part of what dealing with a different way of engaging with the world means. If I were a teenager again, I would probably have self-harmed, again. I have better coping strategies now and a good support network. I cry and ask for a hug and feel sorry for myself and then I make plans.
I don’t cut my skin, I don’t burn or hit or drink a bottle of whiskey or shout or even play Mozart’s requiem loudly. Not any more.
The feelings are the same though, that narrowing of vision, the falling away of all the options that seemed so neatly laid out. You lose all perspective and suddenly have no choice but to panic and despair.
For me, it’s always about me too. It’s never something I encounter when someone else ‘fails’ or needs help or has flaws, It’s a particular brand of self-hatred that probably has its roots in family histories and my introverted nature. If something is wrong, it’s in my nature to assume that it’s because of something that I’ve done, not someone else. I very rarely point fingers at others in anything other than jest.
The thing is, when asked to disclose if I have a mental illness, I will generally say no. I’ve previously said yes in the spirit of full disclosure and then when I’ve inevitably been called in to see occupational health, they agree that actually, it’s not really a current anything and really wasn’t worth putting down on the form. They’re very nice about it, always reassure me that should I feel the need for a chat or support then they’re always available.
I’ve not felt the need yet.
It’s not something that affects my working life in any way other than a slightly more rigorous ongoing reflective process in my practice. It’s something that all nurses should be doing, this constant examination of what you’re doing and why and how it’s affecting you. I’m starting to realise that it’s not something that all nurses are doing though.
There’s a crossover that must be avoided though. I can only guess at what was going on for Jacintha Saldanha, and I’m sure it was more complex than the single fact that she forwarded a call that another individual then disclosed confidential information to but I suspect that she experience that despair and closing down of perceived options and outcomes that comes with a feeling of failure.
It’s so important that those of us who have these tendencies be supported by people who can hold us steady through the times when the blinkers come down. Jacintha was living in hospital accommodation, away from her family and it remains to be seen whether the hospital anticipated how deeply affected she could be and provided adequate support.
I don’t want to focus on Nurse Saldanha though. I didn’t know her and although the circumstances surrounding her death are tragic and prompt something in me, I started writing this at the end of October and it sat unfinished and unpublished until thinking about her prompted me to return to it.
In the interim a place has become available on the January 2013 intake for my midwifery training but even if it hadn’t, I would have coped. I’d managed, I’d unfrozen and got an interview for a local job in an area that I was interested in to fill that year. I’d actually talked to the people around me about the feelings that seemed to crush my ribcage and fill me with that panicked feeling of falling. I’d not felt the need to do anything horrible to myself. I kept telling myself that it wasn’t a failure, it was a delay and I heard the people around me who were saying the same (completely sensible) thing.
When I got the news that I wouldn’t have to wait a year, I was happy but I think that having to recognise that I still need to be wary of those blinkers was a good thing. It pays to not get too complacent and it pays to have people around you who will remind you to do unto yourself as you would do to others.