So, I have depression. Didn’t think you were going to hear that as an opening statement, did you? I have suffered from depression since I was 15 years old, however was only formally diagnosed with Major Depressive Disorder this year. Like many people in the world, my symptoms got worse over the year due to the isolation and huge changes that occurred during the COVID pandemic however they started to come about again just after the Christmas period.
1999 and 2000 were extremely difficult periods in my life for a few reasons. I experienced some trauma, which ultimately left me feeling like I was not worthy of anything. Instead of dealing with that trauma and unpacking it in a healthy way, I pushed it aside and went on with my life. Typical rebellious teenager, the total opposite of my Brainiac brother, “the golden child” as I often refer to him, out partying, lying to my parents about my whereabouts, and not setting any real-life goals at all. I think my parents finally realized something was wrong when I told them that I didn’t apply for uni.
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I didn’t know what I wanted, I didn’t really love anything or have aspirations to do anything great with my life. So, when I was told by my parents you need to study if you want to live here I thought, well I may as well go to TAFE. I picked a community services diploma which I really enjoyed. I think it’s when I started to think to myself, well my life is in ruins maybe I can help other people and children so there aren’t.
I have now been working with Allambi now for 12 years. But these 12 years did come at a cost to me personally. In an effort to get any joy from my life I always had a self-sacrificing mindset. If I can make someone else happy, that will make me happy. And it did for so long. I just forgot about all the other things that weren’t going great for me, and lived, kind of vicariously through those around me.
2018 enter, baby number 3. Because you know, my husband and I both wanted a little girl and we got her. Happiness and Joy right? Because that is what you feel when you think you have finally conquered all the goals you set for yourself. You have achieved the final plan, that you have spent years creating. The loving husband, the business, the kids, the job that you love. But that’s not what happened.
I spiraled out of control, because after all of these years, building all these things that I thought were going to make me happy, because that’s what everyone wanted, that’s what society had led me to believe I wanted, I actually realized I have done nothing for me. Just for me. I became doubtful of every decision that I had ever made, doubtful of my parenting, doubtful of the love I had for my family, doubtful of my career choice, and doubtful that I wanted any of these wonderful things that were sitting in front of me. I hated myself and everything I had.
These were some of my darkest days, days when you have no emotion or energy to do anything, days when the only emotion you have is sadness, and days were you no longer want to live. Yep, I went there and it was the scariest moment of my life and my husband's life. I got help, I got out of that black hole that had opened up and almost swallowed me whole, and slowly over 6 months with medication and therapy got my life back on track. I had a pretty good last couple of months in 2019, things seemed normal again, and I thought after getting help things were on the up.
So now it's 2020, and the roll-on effect begins. Several big things happen just after Christmas. We get told we have to move as our landlords are selling and find a house within 4 weeks because that’s when the lease is up, my second son is starting big school, and our business has become much busier over the summer so, the husband isn’t around as much. In the midst of these things, I'm working full time and starting uni.
In comes the self-sacrificing to try and push all this negative energy away, but it becomes less and less viable, the things I used to think I got joy from like my job are becoming more tedious, I'm procrastinating for longer periods of time and my work is becoming less of a priority and the standard of my work well, let's just say not my best.
I would have these side conversations with my friends and colleagues and drop little tidbits of information to see if anyone would pick up on them but no one did, because I didn’t want to make them feel bad for me, why would I do that to them, why would I ruin their good vibes with my slowly falling apart mess of a life. But secretly all I wanted was to blurt out everything and for someone to scoop me up and say everything will be ok, don’t worry about it, what can I do to help, maybe you should take some time off, have a night to yourself, I will look after the kids.
And because I wasn’t courageous enough to have those conversations, and because we were all so isolated and turned into a community of people with no real physical connection due to COVID, I fell again. I think my relapse this time around has been much more different because I knew what was happening. I got to the edge of the black hole but didn’t fall in and knew exactly what steps I needed to take to make sure I never met my darkest days again, but it has been hard.
You know after 20 years of feeling that I am not really worthy of anything, and having always put everyone else first to ensure their happiness to try and make my own, I have finally realized that I need to “do me first” if I am ever going to get out of this terrible cycle of depression that happens so often for me and for so many other people in the world today.
Depression based on the fifth edition of the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5), is “a period of at least two weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities, and had a majority of specified symptoms, such as problems with sleep, eating, energy, concentration, or self-worth.” This definition excludes grief after mourning. All of these symptoms resonated with my initial post-natal depression in 2019 and again in 2020.
Depression is a common illness worldwide, with the WHO reporting more than 264 million people are affected. It's different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when long-lasting and with moderate or severe intensity, depression may become a serious health condition. It can cause the affected person to suffer greatly and function poorly at work, at school, and in the family. At its worst, depression can lead to suicide. Close to 800,000 people die due to suicide every year. Suicide is the second leading cause of death in 15-29-year-olds.
Factors contributing-
Depression results from a complicated interaction of Biopsychosocial factors, the social, psychological, and biological makeup of us. People who have gone through adverse life events (unemployment, bereavement, psychological trauma) are more likely to develop depression. Depression can, in turn, lead to more stress and dysfunction and worsen the affected person’s life situation and depression itself.
Let's look a bit more into these factors
Biological factors- Across many nations, cultures, and ethnicities, women are about twice as likely as men to develop depression, from early adolescence through to adulthood. A number of studies have shown that at certain periods during the life cycle of a woman, the prevalence of depression is increased. Lewin discusses these periods in the lifecycle of women and identifies them as the post-pubertal, perimenstrual, perinatal, and perimenopausal phases. By having more hormonal changes occur within our bodies, depending on how your body reacts to those changes will often relate to whether you have a mood disorder like depression or not. Yep, just being a woman increases your chances, you’re welcome fellas!
When looking at psychological factors Ghadirian notes the psychoanalytic theory stating “depression is interpreted as the result of aggression turned inward or against the self.” You could also look at it as the loss of an idealized love, object, person, or relationship. Based on cognitive theory, depression is the result of negative thinking, self-deprecation, cognitive distortion, or misperception of external life situations.
The cognitive and behavioral aspect of depression looks into those who are depressed, often becoming hypersensitive to rejection, and in the state of depression, they see everything as negative and pessimistic. Another aspect within this model is that of learned helplessness, stemming from some sort of trauma, which leads to vulnerability, failure, and social rejection thus increasing the symptoms of depression.
Then finally, those dreaded social factors. Societal norms are instilled in us from the moment we are born, from the family we grew up in. Nolen-Hoeksema wrote about Women’s lack of social power making them more susceptible than men to particular major traumas, especially sexual abuse. Traumas may contribute directly to depression, by making women feel they are helpless to control their lives, and may also contribute indirectly, by increasing women’s reactivity to stress. Adding to this, Women’s social roles also carry several chronic strains that might contribute directly or indirectly to depression including making less money than men in the same role, women are more likely to live in poverty, being more likely to be sexually harassed on the job, and often engage in full-time work whilst caring for children and doing most of the domestic work in the home. This role overload is said to contribute to a sense of “burnout” and general distress, including depressive symptoms, in women.
So after all this, how are you diagnosed and treated? Well from my own experience you have a major breakdown in every one of these factors in life, describe them to a doctor, in a complete mess and they say “Well it sounds like you have depression and have been suffering for some time.” Diagnosis is then backed up through the mental health plan you receive and the therapist who analyses every single word that comes out of your mouth. Questionnaires are completed, you recount almost your entire history, and over time you unpack it, you change your way of thinking, you realize you are more than all of those things you have in your life and where its appropriate medication can assist you to some extent but isn’t the only fix. It’s a whole transformation of mind, body and soul.
There are effective treatments for moderate and severe depression such as behavioral activation, cognitive behavioral therapy (CBT) interpersonal psychotherapy (IPT), or antidepressant medication.
For the most part, the treatment of depression in women is the same as in men. Clinicians often divide treatment into three phases, documented in the Harvard Mental Health Letter- women and depression:
- In the acute phase, the goal is to relieve symptoms which usually lasts six to 12 weeks.
- Then the continuation phase, the goal is to maximize improvements. At this stage, clinicians may make adjustments to the dose of a medication, which can last for several more months.
- Finally the maintenance phase, the aim is to prevent relapse, however, we all know this is something that no one can see coming.
With all these phases it's important to realize the unique differences in life experience, temperament, and biology; no single treatment is right for everyone. However, research suggests that many people benefit from a combination of medication and therapy.
So, that’s my essay on depression, on my depression. Something I have only recently come to terms with and been able to say out loud without feeling guilt or shame. Listen carefully to family, your friends your children, they could be crying out for help in the smallest way and sometimes we need someone else to tell us it's ok to be depressed, I will be here for you.
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