I Couldn't Care Less: Caught in a Spiral

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A hypodermic needle and a vial

Caught in a Spiral

Thinking about what to write this week, I couldn't help considering the recent death of Robin Williams. I thought about the issues raise around depression being a hidden problem in men, and about the questions raised about the press reporting of a suicide. Then I thought about the people who had been trying to support Robin during his life, and perhaps trying to him them safe. I wondered what their job, on the road to the end, was like, and how it compared to mine. Then I wrote this.

The first step on the road, I have noticed, seems to be fatalism. That is the notion that you are not in control of events, and that everything is bound to go wrong in any situation. This is very difficult to wrestle with for, in my experience, two reasons. It's worth noting that, as far as I know, there does not need to be any intrinsic problem to cause depression. That said, people I have known with serious depression often have life problems, such as health issues, money worries and so on. I suspect that plenty of people with depression find that they fall into these sorts of problems, for reasons we shall come to later. The point here is that it is considerably harder to persuade someone that everything (or indeed anything) is going to be fine when it quite clearly isn't. Jobs don't appear out of thin air, illness doesn't magically get better and money doesn't grow on trees. Problems also seem more insurmountable when you suffer depression. On the whole I find I am able to maintain a hope that things will improve even when an empirical argument is hard to construct. When even my mild depression gets on top of me, however, this attitude is harder to keep hold of. The second reason I mentioned is simply that, even if you can point to good reasons why things will get better, this simply doesn't hold water against depression.

Well this leads us on to the second phase and, for me, the toughest real challenge. What's the point? When you're fairly well entrenched in the state of mind I've scribbled about already, it seems quite reasonable to ask yourself why you should bother. Why go to the job interview when you'll only get rejected? Why take the exam when you'll only fail? Why bother getting out of bed? Your task as a carer here is somehow to keep the person moving. The theoretical insight that I picked up somewhere and am still trying to make work in practise is: don't challenge the fatalism. Don't say'I'm sure it'll be fine' or 'oh, we'll buy you a false leg'. I gather this can seem as if you aren't listening, and in any event it won't work. The advice, seemingly, is to engage them about the perception, ask them why, try to talk about it. Well, that's the theory, in reality I use a combination of encouraging, cajoling, bribing and blackmailing to get R moving. I don't honestly know how you respond to someone who is seriously considering taking their own life. Do they talk about it and threaten to do it? Or is that just what people who don't really mean it do? Whatever the case, it must make it even harder for them not to end up in the final stage.

At some point you start to frazzle. However much of a sparkly sunbeam you are normally, the constant demands of propping up someone so bereft of emotional energy can drain your resources. When you're tired and you've had a bad day and you've run out of things to say, the point comes when you snap and say something you'll regret. The resultant turmoil would probably not been hugely problematic with a less fragile person. But with a person suffering depression you are just feeding the beast. I can imagine it would not be beyond the bounds of possibility to find yourself shouting 'well, why don't you just kill yourself then, if that's what you want?' That is something that could all too easily haunt you forever.

All of which is pretty bleak, really. For that I'm afraid I make no apologies. Depression is a nasty and debilitating disease and, sometimes, a killer. That is very bad, that is how bad it is. So take it seriously, if you are a carer. Apart from anything else, you may well start to suffer from it yourself. But whether you do or not, if you are caring for someone who does, treat it as you would a serious physical illness. Get advice, get support, get help. And make sure you get time for yourself, because this is going to be tough.

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