As my Facebook feed filled with people mourning the death of Robin Williams, seemingly by his own hand, I thought back to a conversation I had with my psychiatrist less than a week ago.
I only see him every few months now, more for a catch up than anything particularly medical, and he remarked on how mundane my issues were: professional stuff, logistics for my upcoming wedding, other domestic trivia, normal life stuff. And he also pointed out how it contrasted with what we’d discussed not 18 months earlier when I’d been explaining, in some detail, how I planned to kill myself.
“You’ve written about how difficult it is to go through therapy,” he said, “but have you thought about writing something about how much it’s helped you?”
And I said no.
How insufferably smug such a piece would be, I pointed out. If anything, it seemed to be tempting fate – like those New Idea happy couple celebrity photo spreads that turn up on the newstands just ahead of the divorce announcement.
And, I added, it’s hardly a big selling point to say to someone “once you get over your overwhelming desire to vanish, you’ll have the energy to deal with sorting out your mortgage”.
And then the Robin Williams news came through, and I was reminded of how much I’d notice every suicide when I was seriously depressed. “The writer and humourist Spalding Gray opted out,” I’d tell myself, “and he was a hell of a lot smarter, funnier and more accomplished than you. Can’t help noticing you’re still here, though. Why is that?”
And so I wrote this.
In my experience, depression is a condition as mundane and annoying as diabetes: once you have it under control and make some lifestyle changes it’s pretty straightforward to maintain, and if you ignore it, it will absolutely, undoubtably kill you.
Everyone has their own metaphor for it. A friend of mine once referred to depression as “soul cancer”: deeply personal, infuriatingly hard to treat, and coming back just when she thought she’d beaten it. Others talk of the Black Dog or The Pit or The Tunnel.
For me, it’s always been a whirlpool. I can hear it rushing away behind me and the closer I am to the lip the more effort is required to paddle enough to retain my position, and I know that once I finally tip over I’m never going to be able to row my way back up again.
And there is nothing more tiresome than someone’s depression memoir (summary: depression is arse) so I’ll spare you the tales of unceasing lethargy, the inability to care less about anything, the bone-crushing certainty that things would never relent, much less improve, the vast swathes of wasted time. I’ll also leave out the nightmarish effect it had on the people I love most – my parents, my siblings, my partners, my friends – and the emotional debts that I’m never going to come close to repaying.
Instead, I want to tell a story that doesn’t get told all that often. It’s about how I found the right doctor and how then things started to get better.
I’ve seen psychiatrists, psychologists and counsellors on and off since I was 15 years old and dealing with my father’s death from cancer, and every single one of them was useless.
Some were well meaning. Some were indifferent. Some attempted to convince me that I was a special precious snowflake that just needed to learn to love my own precious specialness. Some told me that the problem was that I was insufficiently motivated to try, with which I’d have argued had I any energy left after getting out of bed and putting on pants.
None of them – not one – was any help to me whatsoever.
Similarly, the medication I was put on was at best useless and at worst harmful. Most gave me side-effects that I was assured weren’t important enough to worry about, like the inability to concentrate and comprehensive sexual dysfunction. Being told that the ability to experience orgasm was trivial did little to convince me that these people weren’t idiots.
In any case, I had convinced myself through hard experience that meds and therapy were useless and dangerous for me and therefore I had zero intention of ever riding that particular pony again. Until I got seriously, suicidally depressed once again despite things being objectively decent in my day-to-day life and seriously doubted that I had the fortitude to cope.
My GP, bless him, listened to me as I broke down in his consulting rooms. He knew me well enough to know what a difficult, bloodyminded bastard I am. And he made a referral.
I saw my shrink for the first time and poured out how much I hated therapy, was not going to consider meds, and what a waste of time this all was and how I’d be better off walking into the ocean.
And he listened. And he asked some questions. And he took me seriously.
And then he said that he could help.
It would be hard, he made clear. There would be dead ends. He’d need me to trust him, and to be honest about my expectations and my experiences. And meds would probably be involved, but that he understood and agreed with my problems with side effects. “By the time someone walks in here, they’ve probably tried all the obvious solutions and they haven’t worked,” he explained.
And it did take a while. And it was hard. But – and this is important – it was not quite as hard as I expected. And each step made the next one easier.
So what’s the point of this?
It’s to let someone – maybe you – know that if you’ve been through the wringer of meds and shrinks and feel like it’s all bullshit, then you’re absolutely right. Those people you saw, unfortunately, were the wrong people. It’s like online dating: almost everyone you meet will be wrong for you. On the plus side, you’ve now eliminated them from the search.
And once you find that right person and things click, you’re more than halfway there.
Go to your GP and tell them that you’ve seen nothing but jerks so far, and add you’ve only got a finite amount of strength for this fight left so they’d better find you a therapist that’s pretty damn good. Be clear, and be blunt. And if you meet that therapist and think “…you have no idea”, go back to your GP and tell them to try again.
It made all the difference in the world for me.
These days I feel like I’m a mile or so upstream from the whirlpool. I can still hear it, and I probably always will. But the current is lazy and right now I can maintain my position without paddling furiously.
One day, if I’m not vigilant, I might drift further down and then I’ll be dashed to pieces. But not today.
Seriously. One more go. This could be the one, you know?
For help or information regarding depression, call Lifeline on 131 114 or visit beyondblue.org.au.
Thank you. That was wonderful to read, for a dozen reasons.
Thanks. I really needed to read this. Was just referred to a new psychiatrist this morning.
Thanks, I really needed this.
Believe it or not, the last GP I saw about a psychologist just gave me a website to visit and told me to ‘choose one myself from the list’.
I’m going to try your approach.
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Wow, what a thought provoking piece. As a mental health professional, my first thought was to think “surely we’re not all useless?” But then I thought a bit more, and you know what? I agree whole heartedly with you. I’m useless some times, for some people. I don’t have what they need, I’m not right for them, it just doesn’t work. And other times (hopefully!), I am useful and I can offer some help.
So I just wanted to say that it would be awesome if the first person you saw was right for you (and I think that does happen sometimes). But if they’re not, go to the next one. This sucks, of course, that the first person didn’t work out, but the next one may, and someone definitely will. But… from my perspective, I’m really sorry I’m not right for you, but don’t be shy about moving on. I won’t take it personally, and meantime maybe I will be right for the next person I meet. So don’t feel like you have to pretend it’s working for you. It’s OK to shop around – or more than “OK”, probably more like “essential”. Hope this makes sense!
Absolutely makes sense! Thank you for sharing your perspective Duncan. It’s so fabulous this is being discussed.
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Great read thank you.
Oh what a refreshing and honest post!
Encouraging. The advice practical – telling the Dr you have little energy left is so important.
I’ve tried numerous therapists too, with variable results. Some were so unscientific about their approach I wondered if we’d really come far from witch-doctory.
The dating analogy is apt and freeing from persisting with someone not totally committed and knowledgable.