My signs and symptoms of depression

Here’s the thing.  Depression is a stealthy foe. It is often only with hindsight that you can see what should have told you that you were disappearing down the rabbit hole.  When you feel better, and more yourself, you look back and think “doh!” and wonder how and why you struggled on for so long. Mild to moderate depression is incremental, it is an ebbing away of energy, vitality, enthusiasm, joy. It is not, in my experience, like the major crash of a major depressive episode. With mild to moderate depression, every day, you wake up, and feel 'meh', you stumble along and you get by…and after weeks of this, months of this, years of this, you realise that you no longer recognise yourself.

Over time, I have started to recognise my signs and symptoms - the signs and symptoms that are my red flags. If you recognise some or any of them, then maybe you need to talk to someone or see your GP:

Energy
I trudge through my days. They feel heavy and flat and joyless. I do stuff, the bare minimum, and get by. I nap if I can. Then at about 6pm I suddenly feel a lot perkier. I can tackle the washing up, I can pay some bills, I can get off the sofa…and often I go to bed later than I should because my evenings feel so much better than the days. And then I feel knackered in the mornings, and the cycle goes on.

Sleep
I could sleep forever, but usually at the wrong times. I yawn a lot. I wake in the early hours and lie there, feeling edgy and exhausted all at the same time. When I do sleep, I never feel refreshed.

Speech
I become inarticulate and much less fluent in my speech. I reach for words, and they are not there. I try to form a sentence but it comes out all wrong. I stumble over my words. I can’t gather my thoughts enough to formulate an argument or put across my point of view. I feel like I am slowly becoming mute. I can’t make small talk, and the cut and thrust of a witty conversation is totally beyond me.  I become the most boring person in the room.

Thick
My brain is a fog. I can’t concentrate on anything, my brain doesn’t skip from subject to subject, it plods – meaning that by the time I have the follow up thought to the first, I can’t remember what my original thought was.  It’s partly a memory thing, but I sense that my synapses aren’t firing quickly enough, they kind of know what they should be doing, but can’t be arsed.  So I walk into rooms to get a hairbrush, and stand there perplexed not remembering what I came for. I put frozen mince in the cupboard. I put concealer under my eyes but forget to blend it in so I look like a reverse panda. I feel like I am in the early stages of dementia. My brain aches with the struggle.

Craving
I crave carbs. I crave wine. I crave high calorie comfort food. I crave chocolate, fudge and Baileys. My body is crying out for something to give it an energy re-boot, a stimulant, and I oblige. I get fat and feel unhealthy, grazing on rubbish but not being able to stop. I have no energy for exercise even though I know it would help.

Glum
I wallow. Self-pity and woe follow me around like a Greek chorus. I feel low and sad and everything seems pointless. I cry a lot for no particular reason. Tears roll down my cheeks and I can't stop. If anyone is kind or gentle, I cry even more.

Numb
Sometimes I can't feel anything at all.

Worry
I whittle. I worry away at thoughts pointlessly, even when I know what course of action should be taken and what the solution is. I still have to chew those things over in my poor tired brain endlessly in some dreadful unproductive and tiring loop. I wake up with dread in the pit of my stomach, but I can't pinpoint what I'm afraid of.

Appearance
I have dead fish eyes. No sparkle, no shine – like a film is over them. My face ages, etched in a permanent frowning, jowly Bassett hound droop. I look knackered.

Cross 
I am a snappy, nagging, impatient, irrational harpy. I am never like this with friends or colleagues, but my poor children get growled at and hassled at every turn. I am permanent PMT mummy. I feel like a cow.

Clumsy
My movements seem bovine and I drop, bump into and trip over things. I burn my arms on the oven and cut my fingers chopping onions.

Immunity
My immune system is compromised and I catch every cough, cold and bug going. My eczema flares up and my hair falls out.

Copping Out
I give all my motivation, energy, commitment and sense of obligation to work. I am on tight rations for these commodities so anything else – baking buns for the school cake sale, taking on leading a Sunday School group, visiting friends and relatives – are unlikely to happen. They defeat me. I become a commitment-phobe and when I have too many social engagements lined up I feel panic and I invariably cancel them for the flimsiest reason. I am anti-social and lead a hermit-like existence.

This list is by no means definitive, and it is based on personal experience (and I am not a medical professional). However, I think it is fairly typical. The point is, depression can creep up on you and before you know where you are, you aren't functioning anymore. I will talk in other posts about what you can do when you are in this situation, but without a doubt, if you recognise any of these signs and symptoms you need to take action and tell someone. You can and will get better. Promise.

What are your signs and symptoms? With my beautiful brain, I've probably forgotten a few...

Food

My appetite is greatly affected by my state of mind. If I am really suffering, I lose my desire to eat completely. This is when I survive on bananas and coffee, a combo that is not ideal but just about keeps me going. When my mood has improved, but I am feeling weary, I reach for carbs and pile on the pounds. During my year of post-natal depression, I could eat four Chelsea buns in one go, and biscuits and cakes by the ton. Needless to say I became very tubby, which played havoc with my self esteem. Neither scenario is ideal, and when you are anxious or depressed, what you need is food that is dead easy to prepare, appetising to eat and offers you nourishment for brain and body. Here are my top tips:

Be prepared:

Go to the shops with a list of what you need. It is so easy to get to the supermarket, feel overwhelmed and come out with something useless or even nothing at all. Go to the shops when it is quiet, or shop online. I generally feel more perky in the evenings, so this is when I go food shopping. If you can't face a huge supermarket, go to a smaller Co-op or Tesco Local. If you really can't face it, this is the time to enlist a friend to help you, and ask them to do your shopping for you. Don't forget your purse/wallet, shopping trolley token and reusable bags - there is nothing more frustrating than getting there and not being able to complete the task because your foggy old brain has forgotten these items. Grr.

When I am having a good day, I try to batch cook as much as I can and freeze things, so I can have them on stand-by for when I am not feeling so great. Stews, sauces and cottage/shepherds pies are ideal for this, and I take great comfort in knowing my children are having home cooked food.

Some suggestions:

Pimped Up Pizza - buy a simple frozen or chilled margarita pizza (cheese and tomato), and add your own fresh toppings to make it more nutritious, along with a drizzle of olive oil. I like sliced pepper, onion, mushrooms and olives. It takes minutes to do, minutes to cook and is tasty (and cheap).

Jacket Potatoes - rub the skins with oil, prick the skin and smother with salt. Shove in the oven on a medium heat for an hour or so. Eat with cheese, coleslaw, beans, butter or tuna mayo.

Soup - tinned, fresh from the chiller cabinet or home-made. Ideally with decent bread. So easy to digest and so comforting. If you have a friend who has asked how they can help, ask them to make you some soup and you can have it in the fridge or in the freezer for when you need something quick and tasty. Chicken noodle soup is the best, but even good old cream of tomato from a tin can hit the spot.

Toast - old favourites like cheese on toast, eggs on toast (scrambled or poached), sardines on toast, peanut butter and jam on toast - ideal comfort food.

Sushi - slightly left field, but a good option if you really can't be bothered to cook but want something that you can buy from supermarkets and that is wholesome and tasty. 

Fruit - get the best quality and most delicious looking fruit you can afford. Lots of berries, bananas, apples, peaches and grapes that you can pick at when you are feeling the need for sustenance. Try to have it all washed, prepared and ready to eat (do this when you are feeling a little more lively, or ask someone to do it for you).

Smoothies - use up any fresh fruit that is no longer at its best, or have a stash of frozen berries you can blitz with a banana and some orange juice. Mix in yogurt for extra calcium and calories, and if you need some greens, shove in some baby spinach leaves and a squeeze of lemon juice.

Nuts - bags of unshelled and unsalted nuts are great snacks. I like Brazil nuts, cashew nuts and pistachio nuts, but any nuts are better than crisps or sweets.

Porridge oats - made in a microwave or on the hob, with loads of milk and sugar (or golden syrup), this is a perfect slow release energy food. I always have oats in my cupboards for porridge, making granola or flapjacks - all dead easy to do, and so filling and nutritious. 

Drinks - it is essential to stay hydrated. If you like herbal teas, make sure you always have your favourite tea bags on stand by. If you like cordials and squashes, have these on hand too, to encourage you to keep drinking. Don't get sugar free squashes with artificial sweeteners, go for the sort that are made with sugar and are 'high juice' so you get a little energy boost. I am a coffee drinker, and I do believe caffeine can really help give you a lift if you are feeling sluggish, but don't over-do it, particularly after 3pm as it can affect your sleep. Avoid alcohol at all costs - even a glass of wine can set you back (alcohol is a depressant and can interfere with anti-depressant medication) so it is just not worth it, even for the temporary relaxation it offers.

What are your tips for fast and nourishing food when you are feeling glum?

A Wise and Comforting Poem by Rumi

The Guest House

This being human is a guest house.
Every morning a new arrival.
A joy, a depression, a meanness,
some momentary awareness comes
as an unexpected visitor.

Welcome and entertain them all!
Even if they're a crowd of sorrows,
who violently sweep your house
empty of its furniture.

Still, treat each guest honorably.
He may be cleaning you out
for some new delight.

The dark thought,  the shame, the malice.
Meet them at the door laughing,
and invite them in.

Be grateful for whoever comes,
because each has been sent
as a guide from beyond.

Rumi

I read this poem in Ruby Wax's fascinating and very helpful book 'Sane New World: Taming the Mind'. It's a fascinating look "under the bonnet" to see how the brain works, with some practical advice and techniques mostly based on mindfulness meditation, as well as Ruby's own experience of depression. I am now going to seek out a mindfulness workshop - the evidence seems clear that this is a great way to tackle unhelpful thinking habits. I shall report back!

A picture by my daughter - it looks spookily like how my brain feels sometimes.

Bed

Adverts for mattresses remind us that we spend a third of our lives in bed. If you have depression, my guess is that during the rough times the amount of time we spend in bed increases a lot. My bed is like a raft on a stormy sea, it is my refuge and my haven, and because of this, I try to make my bed as comfortable as possible. If you have depression, I recommend you do the same. I truly believe that our environment has an impact on our well-being, and that a messy, stuffy and dirty bedroom will not lift spirits.

Tracy Emin's art installation 'Bed'

Mattress

Get the best mattress you can afford, and the type that to you feels most supportive yet yielding, that hugs the curves of your body and doesn't give you back ache. Check if the shop where you buy your mattress will take away your old one - this saves you a job. If you can't afford a new mattress, invest in a feather or memory foam mattress topper, which will add comfort and warmth.

Bed linen

This should be 100% cotton, so it is breathable and not hot and sticky. I like pure white sheets and duvet covers, there is something about its crispness that I find comforting. John Lewis, Argos and Ikea have good ranges of pure cotton bed linen. Get a lovely fluffy duvet or if you like the weight and heft of blankets, make sure you have enough to layer up. If you only invest in one thing, get a really good pillow.

Warmth

I absolutely love my electric blanket. I have a double bed and I can warm up one side of the bed, but keep the other side cool should I overheat. If I am spending the day in bed but I don't want to heat the whole house, I can make my bed a cosy sanctuary, and it definitely helps to relax tense muscles and warm cold feet. If you can't afford an electric blanket, a hot water bottle or one of those microwaveable heat packs is a useful alternative. No one wants to be cold in bed.

Entertainment

Bring your radio, or if you have a smartphone, get the BBC iplayer app and you can listen to the gentle sounds of Radio 4, Radio 3 or the World Service, or download podcasts. Choose history or nature documentaries - favourite Radio 4 programmes of mine are 'Something Understood' and of course, 'All in the Mind'. If you can cope with reading, choose books that are old favourites. If you want to watch TV, choose programmes that aren't going to make you feel anxious or that are too hard to follow. When I felt particularly bad, I could only face wildlife and gardening programmes. Avoid the news.

Attire

'Lounge wear' is ideal - so if you need to answer the door or have a visitor, it isn't too mortifying. Soft, flowing cotton jersey trousers, baggy layered tops, sweatshirts, hoodies - stuff that doesn't make you look too much like you've rolled out of bed. You can get lots of cotton, soft and comfortable pyjamas that don't look too pyjama-ey from Primark. Or if you are feeling lavish and want to shop online, Hush has some beautiful things that will wash really well and last for ages.

Clean

Sometimes this isn't possible because you feel too awful, but a shower and clean PJs can be a real pick-me-up. If you can't manage this, brush your hair and brush your teeth at least once a day. If you are feeling really low, and friends ask what they can do to help, ask them to change the sheets on your bed, have a quick tidy up, vacuum and air your bedroom. A little bunch of flowers will make the room more cheerful. While they do this, you have a warm deep bath with clean PJs on standby, and when you get in to bed, you will feel so much better.

Nourishment

Have some snacks by your bed and a jug of fresh water. Keep hydrated. If you venture down to the kitchen to make some tea or coffee, don't just make one mug, fill a Thermos. Good 'non-crumby' snacks to have on hand are almonds, dried fruit, flapjack and bananas. Keep your medications handy, so you don't need to get out of bed to take them on time.

Image courtesy of Nina Holst.

Mental Health Memoirs or '50 Shades of Grey'

Now, I love a good mental health misery memoir. I find them reassuring (“at least I’m not the only nutcase”), comforting (“at least I’m not as bad as that”) and the narrative arc they follow – back story, crisis, road to recovery, quietly optimistic finale – is satisfying when your own life fits no pattern or path, and you are navigating the wilderness without a route map.

However, these memoirs should come with a health warning. Inevitably they are chronicles of pretty bloody bad cases of mental distress. For the authors to be compelled to write them, and the publishers to publish them, they are dramatic tales of rock bottom and then recovery. There are no memoirs (to my knowledge) of the daily, mundane, tedious struggles with mild to moderate anxiety and depression that the vast majority of us face.

Many people who live with anxiety and depression are superficially functioning pretty well – holding down jobs, being parents, paying bills – but the toll that just getting by takes on battered psyches is huge. We self medicate (booze, carbs, recreational drugs, crap telly, excessive sleeping or even exercising), we flop on the sofa and lie there like Jabba the Hutt for entire weekends, we withdraw from anything vaguely sociable, much loved hobbies seem like chores, chatting on the ‘phone or making small talk is a struggle. This life, this shadowy, gloomy, one-foot-in-front-of-the-other life, is not the stuff of books and memoirs. It is boring to live it, let alone write about it.

So, that is why reading these memoirs can be dangerous if you are looking for clues about your own situation. You read them, and think, “blimey, I’m not that bad” and tell yourself you can’t have serious enough depression or anxiety to seek help. And you struggle on for longer than you ought to, with your little toolkit of props and crutches, rather than facing the fact that the life you are living is not really a life at all.

Depression and anxiety come in all different shapes and sizes, and medical people give them labels such as mild, moderate or severe.  I’ve had them all, and they are all grim - but for different reasons. Severe depression, the focus of many of the memoirs, is dramatic, obvious, life threatening and absolutely irrefutable. Your body and your mind, your very essence, have crashed and burned. Elvis has left the building. You look in the mirror and don’t recognise yourself. Getting through one minute at a time feels like a feat of endurance. Suicide seems a useful option. You are in crisis and everyone can see it. And that is the ‘joy’ (ha!) of severe depression. You can no longer function, and people will see you are folding in on yourself, you won’t be able to cope at all and I hope, for your sake, that something will be done. It is the car crash scenario, and people around you will ensure you are rushed into the mental equivalent of A&E for swift treatment with no questions asked.

Stretching the car accident analogy, mild or moderate depression is the whiplash of mental health – painful, debilitating and equally life-changing, but, because you can still trudge to school to drop the kids off, or show up to your desk at work, or shove some baked beans on toast at tea time – you and your friends and family might be fooled into thinking that things are OK, but just a bit crap. You have tiny glimpses of who you used to be, flashes of enthusiasm, bursts of energy…and you cling to these and hope they are the end of a rope that will pull you out of your mental quagmire. You spend an afternoon, doing the things you used to find satisfying or enjoyable (Housework! Shopping! Going to the gym! Having a proper laugh with a friend! Actually enjoying a game with your kids!). But, sadly, inevitably, you pay a price for believing you can put the ‘fun’ back into functioning. You hit a wall, your energy slumps and your mood flops back into apathy or the meat grinder of dread and worry.

And this cycle of feeling a modicum better and then feeling crap, getting through the days, is what ultimately can lead to a bigger mental crisis further down the line. It kids you into thinking you are OK, that if you can hang on till Christmas/summer/your holiday you will cheer up. Don’t be fooled. Get help. You are not living, you are surviving. And you could waste years of your life lying on the sofa, never smiling and feeling defeated.

Now, despite the health warning about mental health memoirs, and because I am a mass of contradictions, I’m going to list my fave reads down below.  Interestingly, they are all by people who write for a living (journalists, poets, authors), and I think that helps make them more satisfying to read. Just don’t believe they are in any way the only blue print for mental distress and because you are not that bad, you don't need treatment:

My Age of Anxiety by Scott Stossel

Fascinating and thoroughly researched, Scott Stossel shows how crippling anxiety doesn't have to hold you back.

Shoot the Damn Dog by Sally Brampton

Behind the glamour of editing fashion magazines, Sally Brampton wrestled with and prevailed over depression. Good 'useful stuff' section at the end with advice about what can help.

Sunbathing in the Rain by Gwyneth Lewis

A brilliantly comforting and positive book about depression.

The Devil Within by Stephanie Merritt

Vivid and eloquent descriptions of a life lived with anorexia, anxiety and post-natal depression.

The Woman Who Thought Too Much by Joanne Limburg

This memoir doesn't follow the usual narrative arc (which I like), but is so insightful and honest about living with obsessive compulsive disorder.

Through the Dark Woods by Joanne Swinney

This is written from a Christian perspective - and is excellent at looking at how the Church helps or hinders those with mental illness.

Just out of interest, do you have a favourite mental health memoir (not because I am a mental health memoir junkie or anything...)?

Hello!

Blogs. What is the point of a blog? I have never been able to keep a diary - it always seemed like too much of a commitment, and my day-to-day life is pretty repetitive. However, I have always kept scrapbooks - tearing things out of magazines, writing down quotes and excerpts from books and keeping mementos of special times. This is going to be the style of my blog - a virtual scrapbook of my experiences, combined with bits and bobs that have given me joy or pause for thought.

So who am I? I am a hardworking forty-something single mother, living in a university city in the East of England, who has Champagne tastes but a lemonade budget. I try to follow the maxim 'all you need is less', but I enjoy shopping, style and making my home lovely for my two girls and me. I love visiting museums and galleries, photography, the great outdoors, music, going to the gym and I read quite a lot.

The other thing my blog will focus on is mental health. After the birth of my first baby, I suffered from severe post-natal depression. This was a profoundly shocking experience, and remembering those early desperate days makes me feel sad - I missed out on enjoying my daughter's babyhood and I still grieve about that. Since then, I have wrestled with bouts of depression and anxiety, which is a big challenge as a lone parent. My ex is very supportive and our relationship is amicable, but battling through teatime and bedtime on your own when your children are bickering and you are feeling low can be extremely tough.

So I want to share what I have learnt, what lifts my spirits, the shortcuts that help me cope, what it feels like when your beautiful brain knocks you off stride - and how to get back on track again.