I haven't written anything for my blog for some time and wanted to explain why.

Currently there are thought to be some 8.6 million people in England routinely taking anti-depressants. This year I became one of that 8.6m. I developed a depressive illness. I was tired most of the time. No matter how long I slept, it never seemed long enough. I would wake up 2-3 times during the night and struggle to get back to sleep. Left to myself I would probably have spent most of my mornings in bed, waiting for that golden moment when my mood improved around midday, and I felt human again.

Whilst I was never so desperate as to commit suicide, I saw with a new clarity how appealing it was. One painless bottle of Oromorph with some paracetamol and I would fall asleep and not wake up. I worried about how much this would hurt my wife and decided that I was not that angry. Someone’s death from natural causes is difficult to process. Death by suicide is an emotional tsunami, leaving chaos, havoc and pain in its wake. I wasn’t going to do that to her.

Reading those last few sentences helps me realise how relatively lightly I got off. A few surface wounds which are fast healing - albeit still painful at times. Having been a psychiatric nurse for nearly 30 years and a therapist for about fifteen more, I’ve worked with patients who are far more disturbed and distressed than I ever was. 

I can think of two of my patients who killed themselves. One was in his early 40’s with a young family. He was admitted to hospital and very quickly placed on constant supervision, never let off the ward. Even on the ward we kept him within arm’s length of a nurse as he was profoundly depressed and considered a suicide risk. Despite these precautions, he still found a way to kill himself. His wife had brought him a new pair of trainers in a plastic bag. Like good nurses we checked the bag for anything dangerous before giving them to him. Two hours later, he was dead having asphyxiated himself by pulling the bag over his head and tied it in place with the laces from his trainers. The impact of his death reverberated around the ward for several months. I don’t want to think about the impact on his family. 

Another patient whom I cared for was a young man in his mid-twenties who killed himself by setting himself alight, having first doused himself with petrol. He waited until his mother had gone shopping and his father was at work. What a terrible scene to come home to and an awful phone call to have to make.

In his essay “Mourning and Melancholia” Freud says “In mourning it is the world which has become poor and empty; in melancholia it is the ego itself.” Albrecht Durer’s wood carving above called “Melancholia” chimes with Freud’s interpretation of depression, or melancholia as it was originally known. The central character sits surrounded by all imaginable riches but is still unhappy. In Freudian terms, her ego is not able to be comforted. Everything turns to ashes in her mouth. Depression can do this to us. It sucks all the joy and pleasure from our life, leaving us feeling permanently unsatisfied. It exacts a high toll on those nearest to us who are caught in the crossfire of our varying moods, which in turn leaves them unsure who they are going to meet on today’s battlefield. (A loud round of applause, please, for my wife who has been outstanding over the past few months. I love you!! Thank you.)

This has been my experience of depression. I hope not to repeat it too soon or too often. But I fear that despite so many good things in my life, I seem to be vulnerable. I need to keep vigilant. As Thomas Jefferson put it “The price of liberty is eternal vigilance”.

I’ll come back to this theme again. Please share your thoughts with others so we all learn from each other.