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Depression: A how-to guide

By Sarah Tastard

A wise man once told me that a wise man once told him that life is a bitch. For me, sobbing my heart out during another episode of crushing depression, that statement was a strange relief. Sometimes things just suck. But that doesn’t mean you have to just sit there and let it suck.

I’ve had depression and anxiety for about three years, and I’ve become pretty good at coping with the monsters in my head. By “pretty good” I mean that I’m not dead yet.  In fact, these days I distinctly want to live, and I also very much want to tell y’all out there fighting the same war as me that there’s a way out.

You might not like this, but the way out is you.

That’s it. You.

There’s no magic pill, no cure-all, no doctor or counsellor or psych on this earth that can be your saviour unless you happen to be thinking of Jesus.

There sure as hell are things you can do to get better.

For starters, what is depression?

It’s not a figment of your imagination, and don’t let anyone tell you it is. Depression is a legitimate, scientifically identified condition that affects your brain, and then everything else about you. It’s more of an outward expression of a deeper problem than an illness, but it is nevertheless very serious.

The critical symptom that differentiates it from “having the blues” is feeling low for over two weeks.

It can be triggered by past or present trauma, or it can be caused by nothing at all. Essentially, the levels of dopamine and serotonin in your brain, which control things like sleep, happiness, and reward, plummet to catastrophic levels. Stress hormone levels rise and effectively sear the cells in your brain. It could take a whole year to repair the damage, but in the meantime, you feel like crap and probably have zero motivation to help your ailing brain get back on track.

So what do you do?

IF YOU ARE SUICIDAL. DROP EVERYTHING. NOW. Get your ass to a doctor. Go to reception. Tell them you are depressed and need to see a doctor urgently. The triage nurse should give you a form to fill out that allows them to assess the severity of what’s going on for you. You might have to wait a while since clinics are unfortunately understaffed and overburdened. I recommend taking someone like your mum or your best friend to wait with you. In fact, definitely make sure you’ve got someone with you the instant you start thinking about suicide.

It may be expensive. I know. I got hit with a $90 bill for seeing the doctor who diagnosed me with depression, but I was utterly suicidal and miserable at the time and I don’t regret it one bit. If it makes you feel any better, a visit to the doctor is actually worth $300-$400 to the District Health Board because of a crapton of overheads and paperwork. Even though it’s heavily subsidised, paying up still isn’t fun. I know, I know, just do it and worry about money later. If you’re really stuck, MUSA has hardship grants available for which you may be eligible. To find out more, visit musa.org.nz and click on “Advocacy”. At the end of the day, your life is worth more than a doctor’s bill. JUST GO.

ARE YOU REGISTERED WITH MASSEY HEALTHCARE? If you enroll with Massey Healthcare as your PHO (Primary Health Organisation), visits to the doctor are free on the Manawatu Campus and only $10-$12 on other campuses.

If you’re not immediately suicidal:

Step one:

You talk. Talk to someone you really, truly trust. Tell them how you feel. If they react badly, try someone else. Unfortunately, depression is very hard to understand for those who have never had it, or perhaps they just have no idea what to say and in desperation end up blurting out completely the wrong thing.

In my experience, telling your best friend that you want to die/hurt yourself/have cried yourself to sleep for a week results in them looking like they’ve been hit by a dead fish. It’s bloody traumatic for everyone involved. For that reason, you might choose to chat with someone older who is less likely to panic. If you have a good relationship with your parents or even your bestie’s parents, they’re definitely worth having a chat with. I recommend talking to several people – each one will have something different to contribute and is able to support you in a different way. You can arrange to meet up with them on a regular basis, or you may choose to meet as and when needed. Your need for emotional support will depend on the severity of your depression and the stage you are at on your journey of recovery. It may take some trial and error to find your “support crew” but it is an essential part of recovery.

Step two:

You see a doctor. Why? Because they can assess the severity and possible cause of your depression. That’s another good reason to register with Massey healthcare.

You go to the front desk and you ask for an appointment with the doctor. If you really wanna make sure they understand what you need, tell the receptionists that you’re seeing the doctor because you want to be assessed for depression. When you get to your appointment, explain to the doctor that you have been feeling low for weeks/months/years/centuries and that you have tried exercise/contemplative underwater basket weaving/kale smoothies and nothing is working. Communication is key here. They are probably going to ask you a lot of questions, and the more you answer truthfully and accurately, the more they can help you. They may well ask you about diet and exercise, and whilst that might feel like a slap in the face, it’s because those really truly do help. Depression can in some instances be caused by vitamin B deficiency and most certainly is alleviated by exercise. Doctors typically want to know about how long you’ve been feeling low, how low you are feeling, what your sleep habits are like, is there anything stressing you out and so forth. It might help to have a think about those questions before you go.

It’s common to be given a form where you read a sentence about the way you might feel when depressed and circle a number that corresponds to how much you identify with that statement. This form will be used to determine how severe your depression could be.

From there, the doctor will give some suggestions about what they think you should do. Trust them.  Yes, they are human and make mistakes BUT many of them have had over a decade of training, and all of them really do want to help you. If by some chance you find that the doctor is not taking you seriously, try another. Be persistent.

You might require a blood test for various viruses or vitamin deficiencies, or perhaps you might be told to try exercising more and eating more vegetables. Actually, doctors ALWAYS tell you to do those latter two because they are just always important.

You may be prescribed an antidepressant.

Now, these little bastards take some figuring out, but they can be brilliant. Firstly, they aren’t magic pills. Don’t be disappointed if they aren’t prescribed to you, and don’t be discouraged if you have to try a few different kinds. Antidepressants are not for everyone. Follow the doctor’s instructions to the letter, and take careful note of how the pills make you feel. It’s very common for them to not take effect for up to six weeks, or even make you feel a little worse. Again, the doctor will tell you about all of this and more.

You might get headaches or nausea or insomnia. It will pass. Take care of yourself, rest well, and eat as well as you can. Eventually, all going well, you will start to feel a bit better, then a bit more, and then maybe even a LOT better. Usually, you’ll need to keep taking the pills for about a year, but it varies from person to person. LISTEN TO YOUR DOCTOR.

Being referred to a psychiatrist is rare, as they are not only few and far between thanks to government budget cuts to healthcare, but also they’re really only necessary for those with very severe depression or complex disorders like Bipolar Disorder.

Step three:

Antidepressants are like crutches. They help your brain heal, but they aren’t the be-all and end-all. Guess what I’m going to say next?

DIET AND EXERCISE AND SLEEP. Yes. Those things. Those things are bloody essential. You can’t. get. Better. Unless. You. Take. Care. Of . Yourself.

Got it?

It’s fun though. No, really. You don’t have to spend hours doing and eating things you hate. Try dancing or walking or kayaking or mountain biking or yoga. Fitstar is a great app that offers free workout videos on “Basic” and if you’ve got the money then Premium is more affordable than your average annual gym subscription.

And eating healthy is…. Great actually. It’s super. I can’t recommend it enough. Try Healthy Food Guide for some ideas.

Sleep. Aw yiss sleep. The one thing 99 per cent of us really love doing. Figure out how much you need and make it a priority. I personally need a monstrous ten hours of sleep, but who knows, you might do best on seven. You get the best quality sleep if you go to bed before midnight and wake up before 9 am. If you can’t sleep, then have a chat to your doctor about that too. And for Pete’s sake, turn your damn phone off before you go to bed. Mute it. PUT IT AWAY.

Another thing that helps is counselling. The Massey counsellors are great, although you might sometimes have to wait a week to get an appointment. If it’s urgent (i.e. you are suicidal or self-harming) tell the nice ladies at the front desk and they’ll see what they can do.

Step four:

Be kind to yourself. It is not your fault, you aren’t worthless or hopeless or unloved or any of those other stupid things in your head. YOU WILL GET THROUGH THIS. My best buddy always tells me that I’m doing great and making progress, and I’ve really come to appreciate that. We humans tend to focus on the bad stuff and all the things we’re doing wrong before we even think about what is going right or what we did really well. Often you’ll be doing far more than you think you are, so give yourself a break. Take a step back, look at all the things you are involved in and decide on what responsibilities you could drop, at least for a little while.

If you are struggling with university, e-mail your lecturers and explain that you are struggling with mental health at the moment and might need a little assistance with and time to complete assignments. This shows that you respect them and often helps them understand what’s going on for you. Once they know that the reason you aren’t in class/completing assignments on time/performing as well as usual is that you are sick rather than slacking off, it makes them far more likely to want to give you extensions. I have personally found that at least three quarters of lecturers are at least sympathetic to those with mental health problems, and many of them have been incredibly kind to me.

In the case that your performance is seriously impaired during an exam or a test, you can apply for a derived grade. It’s easier than you think and I would totally recommend it if you’re really struggling with mood and focus and can get your doctor to verify that you are going through such challenges.

Last of all,  let me make you a present of a secret.

Ready?

This present darkness will pass.

I promise it will. If you push through, if you keep going, you will get better.

It will take time and the journey is different for everyone. But one day, you are going to look up at a sky so blue you can scarce believe such a colour would exist and feel the sun on your face and the breath in your lungs. And I promise you that on that day you will realise that your heart is still beating in your chest and perhaps for the first time in forever, you feel good. After that, it gets easier, and in a strange kind of way, all of the colours and beautiful things in the world seem brighter. I wish I could show you this right now, but I am sure that one day you will see it for yourself. Believe me, it’s worth it.

 

 

 

 

 

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