Andrew Lawes explains how depression affected him, his advice on how to love someone with the illness and how the focus of mental health support needs to change.
* Trigger warning – self harm discussed *
Depression always seemed so easy to understand … until the day it turned my life upside down.
A therapist once suggested that mild-grade depression had been present since the age of four. It’s an opinion with merit, one backed up by my being a messed-up kid. Binge-drinking. Drug and solvent abuse. Self-harm. Razorblades and cigarette burns were my thing; the scars adorn my body today. Smoking cannabis was the only way to medicate my disorder enough to function in the world. The legality doesn’t matter – it’s the only medication that stopped me self-harming, and the only medication that has prevented suicidal thoughts. You do what you have to do to stay alive.
It was at the age of 25 that depression truly took control of my mind.
On the walk to work, the acidy taste filled my mouth. That strange ache in the teeth that you get made me aware what was happening. The dry-heaves; the bile in my throat … the back of my mouth … palms cold and clammy, bent double on the grass, the vomit left my mouth. Once. Twice. Three times. Putting it down to a hangover, my excuses were made with work. It was only one day, it didn’t matter really.
One day turned into two; three days turned into a week. Every day it got harder to wake up. My energy levels were depleting rapidly. It was a struggle just to stay awake, never mind get out of bed. Talking to people was out of the question – far too draining. The doctors suggested it could be stress-related burnout. That made sense: working in a care home, with all the pressure to work overtime, the lack of support for staff and the nature of the challenging behaviour; it must have got too much. A few days off would do me good. Except it was now two weeks off and counting. An antidepressant called Citalopram was prescribed; the doctor said this would make things better. Nothing could have been further from the truth.
Over the next few weeks, the prescribed medication sent me insane. Throughout the days, the Citalopram detached me from everything. It felt like my mind was a step behind my body; everything felt almost dream-like, but not in a nice way. To look in the mirror was to stare at a stranger; a gaunt, prescription-drugged-up shell of a man. It wasn’t me in the mirror. It felt like there was no way back to the pre-illness Andrew – he’d gone, and there was no way to find him again.
Yet the days were a blessing compared to the nights.
Sleep was impossible because of the endless stream of thoughts. Not just suicidal thoughts, but worse; thoughts so dark and obtrusive that they seemed to be coming from a mind that wasn’t my own. The thoughts of suicide were, in a strange way, a blessing. They were the only thing that made me feel like there was some escape from the madness enveloping me. It was the thoughts of living; the thoughts of impending insanity and institutionalisation; those were the thoughts that terrified me. At times it felt almost schizophrenic; my thinking patterns seemed so alien that it felt like it must be someone else’s thoughts. The doctors had warned that the Citalopram could take up to 6 weeks to work, but this was destroying me, not helping me.
It culminated one night in October, where the strongest urge overcame me. It was time to meet my old friend, to go back to the only thing that made sense in times of emotional breakdown. It had been 7 years since the blade last penetrated my skin, but at this moment, it was the only thing that offered any semblance of sense, of control. There was no other way to feel something real … to know this wasn’t a nightmare … there was no other way to feel alive.
The kitchen knife was used this time. Slowly and deliberately, the blade cut into my left forearm. Not too deep, never too deep. It was never about scarring or injury with me. It was always about the blood. The warm, comforting sensation of feeling alive. As it ran freely, the thoughts in my head slowed. A dark calmness crept over my body. It was nice. Placing the blade against my skin, the process was repeated. One cut became two; two cuts became four. The kitchen knife, more commonly used for cutting chicken or beef, instead cut me open again. And again. And again. By the end of the thirty minutes of sanity disguised as madness, my arms were covered with shallow cuts, from forearm to shoulder. The blood streamed down both limbs, dripping from my hands until it covered the kitchen floor. If my parents had come downstairs, they would have witnessed a scene to grace a Stephen King novel, but they slept soundly.
For the first time in months, amidst all the chaos, my mind felt relaxed. My soul was at peace. It was a nice feeling.
Depression is devastating. For someone afflicted with the illness, life becomes a war; each day bringing another epic battle, each hour a struggle just to survive. But the person touched by darkness isn’t the only one who struggles. The people who are often forgotten are the loved ones of a person with depression. No-one tells them how to cope, no-one offers them support, and because of the stigma that surrounds mental differences, they are too scared to ask for help.
The situation leaves you feeling powerless. You search for the right words, but there’s nothing anyone can say. You attempt to create special moments, but there’s nothing anyone can do. You try a gentle approach; you try a firm approach. You give them space; you try to get them to open up. You suggest things that might make a difference. You buy them presents. You say encouraging things; you get frustrated and shout. You try everything you can think of, but it’s all in vain. At least, that was my experience. With hindsight, my mistake was to treat depression as a mood. Depression isn’t a mood; it’s cancer of the soul, and it eats away at the mind until all that remains is fear, anxiety and pain.
Try to envision depression as like being alone in a dark tunnel, bereft of even a hint of light. Every sound is amplified, every fear is magnified. All the person wants to do is get out of the tunnel, but they can’t see where to go, they don’t know what to do. Your natural reaction is to lead them out of this dark tunnel, back to the light, but this is the wrong approach. It may seem the logical thing to do, but for the person with depression, nothing makes sense. That’s the nature of the illness. Nobody can be led out of the tunnel; the fear is too great, the darkness too dark.
What you need to do is be there for them. If they talk, just listen. Stay quiet, avoid offering opinions and just really listen. During my depression, it felt like nobody wanted to listen; they just wanted the problem to go away. Everybody seemed to have ideas on how to make that happen but the only need of mine was to verbalise my story. It was finding someone to listen, give me a hug and reassure me that things would be ok that proved impossible. Nobody listened. They talked, and they advised, and they suggested, and they dictated, and they shouted, and they cried, and they tried to help, but they didn’t listen. More than anything else, that’s what you need to do. Sit with your loved one and let them talk. However upsetting or shocking what they say is, just listen. When they finish, hug them, tell them you love them, and that however long it takes, you will be there until they find the strength to get better.
You will never be able to lead someone out of the dark tunnel. All you can do is stay in the tunnel with them until they feel strong enough to lead themselves out. Yes, it’s hard. In many ways, hearing my loved ones tell me about their darkness was worse than living in my own. Yes, it’s often thankless. And yes, at times, you will feel rejected. But don’t give up on them. Support them, love them and be there for them until they find the strength to get better.
But most of all, when they talk, just listen.
Cancer is an illness that ravages the body, draining it of vitality and strength. A disease that dominates the life of every person afflicted with it. Even the treatment is physically destructive: chemotherapy can leave someone without hair, nauseous and confined to their bed. It is a devastating illness; one that affects not only the patient but everyone else in their life.
Cancer is something that can manifest in every single person in the world, and that is why it is so scary. The reality is that cancer is a catch-all term for over 200 individual cancerous growths, and despite decades of research, there is no concrete answer to what causes it – all we have are theories and ideas. It is only once cancer is diagnosed that we can begin to manage the illness.
The only difference between cancer and depression is that cancer attacks the physical self, whereas depression decimates the mind and soul. Having depression is like having two brains controlling your body, except one of them is an enemy, one that learns every doubt, regret, insecurity and fear you have, then whispers them to you in your own voice, utterly indistinguishable from your normal thoughts. No-one, not even the person with depression, can be sure where they end and their illness begins. Experiencing the void of emotion, the absence of hope and the absolute bleakness of depression leaves permanent scars. There will never be a cure for depression, because no-one will ever be naïve enough to believe they have beaten it.
We are nice to people with terminal cancer because we know they are going to die, but the thing is, we are all going to die. Life itself is a terminal illness. Some of us will face long fights with illnesses that are immediately apparent, others will wage internal wars for decades, never quite sure if they are winning or losing.
None of us know what is going on in the lives of strangers. Nobody can comprehend the depth of the torment someone else is struggling with. By treating people with the respect and decency that comes with understanding we are all terminally ill, a lot of the stresses of life ease away, people become more pleasant and polite to each other, and the worlds we create for ourselves become places that aren’t so scary to live in. It is my belief that the illness of depression manifests when fear overloads the mind. Sometimes, that fear is created by a chemical imbalance in the brain; sometimes, the chemical imbalance is lesser, but the experiences of life cause the fear level to build until depression manifests. Occasionally, the illness is created by external factors – learned behaviours impressed on people, often during their formative years, which combine to create enough fear and anxiety to result in depression.
My name is Andrew Lawes, and depression is one of the key elements that comprise the Lawes Disorder. It’s taken thirty years to develop my ability to manage my illness. While therapy and antidepressants have played a part, the only thing that has offered a long-term solution to me is to break my fear down. By identifying the things that scare me, it enables me to seek the appropriate support to minimise that fear. Every mental breakdown of mine has come at a time of great uncertainty; periods of my life where there seemed to be little to no possibility of a happy ending. If mental health support focused more on working with people to identify, plan and work towards their personal ambitions; if it prioritised building a future for individuals, while still affording time to work through the issues of the past; then my belief is that the suicide rate would fall, the negative impact of mental health issues on individuals lives would be lessened, and people, on the whole, would feel more optimistic about life. It’s the only approach that has offered me hope that my nightmare illness can be turned into a fairy-tale ending.
Photo: Flickr/ Rick Cooper