What is it really like to suffer from depression? Emma Gilkison, now 34, spent seven years battling the illness. Here, in the midst of mental health awareness week, she recounts her darkest days and her eventual triumph over the disease. Her hope is that other sufferers may also find a way through.
Not so long ago I was happy. I got up in the morning and made plans. Now, I've forgotten how normal living is done. Thinking is hard. The cogs in my brain have slowed. It's difficult to find words, construct phrases. It's as if my brain has taken leave of absence and left me with an unsatisfactory auto-pilot service.
The brochures tell me this will pass. I will find land. But it is very hard to believe.
This is how I felt during the worst times of depression. I suffered from bouts of it for seven years, during my late teens and early 20s. Depression caused me to leave jobs, abandon friends and hole myself up for months at a time. It saw me pop pills, talk to psychiatrists, pay energy healers, pray to angels and burn sage. Understanding its causes and finding cures was like walking through a confounding M.C. Escher maze. Depression is the most frightening thing I have ever encountered.
The first time I did, I was 18. I was in my first year at university. I began to feel strangely anxious around people. I wrote in my diary: "Nothing to say, nothing to say for myself. My thinking blunt, my sentences wishy-washy and muddled.
I can't laugh when other people laugh. I can't become involved in conversations.
"I sit silent, spectating."
I'd never been a social butterfly, but I'd always had friends in the past. Now I had became withdrawn and stopped studying too. I couldn't face exams when they came around and so failed every BA paper I was enrolled in, bar a French one, which had been internally assessed.
Up until that point, I'd been a straight-A student. I was Miss Extra-Curricular at high school and had worked hard. I couldn't believe I'd done so catastrophically badly at uni. I told no one. Who do you tell about a problem you don't know how to explain to yourself?
This is one of hardest things about being young and depressed. You don't know what's happening. I didn't know that due to a combination of physiological and psychological factors, the chemistry in my brain was altered and my perception distorted. I didn't know this was a classifiable state. Instead, I wondered why I was acting like such a freak.
There was no obvious reason for me to be depressed. No great tragedy had befallen. I was young and the world was supposed to be my oyster. Instead, it was a frightening place.
I lied to my family and said I'd passed my exams. I tried to hide my social discomfort. At a first-year uni toga party, certainly I wasn't going to admit: "actually my heart is in my throat and this conversation is scaring me. I could hardly leave the house this morning and God knows what will become of my life".
At the end of that year I got a part in a Summer Shakespeare play. It was King John and I was Princess Blanche. The blackness lifted. I found I could socialise within the cast. I loved the botanical gardens performances, my silver velvet costume, the group hugs every night. When the season finished I decided to get a cafe job and take a year out. The year before now seemed a weird aberration, a place I'd never return to. If only.
Six months later, just before I flew to Sydney to audition for drama school, the black dog returned. I felt inadequate and full of dread but I dragged myself to the audition. I didn't get a recall and I wasn't surprised. After Sydney I flew to Liverpool for Christmas, where my family had recently moved. Mum thought I was terribly jet-lagged at first - that's how she explained my flatness - but the jet lag never went away. After a while I didn't bother with the facade that I was okay. I stopped talking. I wanted to do nothing, see no one. On New Year's Day at 3am, Mum came to my bedroom with wet eyes. She wanted to know what had happened to her daughter. I said that I didn't know but I thought I might need antidepressants. She said they shouldn't be used as a crutch.
It's hard for people who have not experienced clinical depression to understand the lows you hit. They are irrational. Unfathomable. You can't just buck up your ideas. The periods of sadness I have known in my life have been like standing in a paddling pool compared to drifting on the lonely sea of depression. Just before I left England something shifted, light peeped through and in a few weeks I was my normal self again. It was as if my moods were being governed by a mysterious flick of a switch.
I'd got into journalism school and, while the year started with a bang, that switch flicked back. I went to see a doctor at a student health clinic. I'd decided I would try antidepressants. This felt like a rock bottom, last resort. Antidepressants were for nutcases weren't they? Was I a nutcase? This was offset by my fear I was going to fail journalism school.
I was prescribed a drug called Aropax. One small, white oval pill that promised happiness, to be taken every morning. I hoped like hell it was going to work.
But how, exactly, did antidepressants work? There are ideas about serotonin uptake and inhibitors, but the chemistry of the brain remains enigmatic. I wondered whether they would result in an altered, falsified version of me. Or was I suffering from an imbalance in brain chemistry that was unrelated to my soul and simply needed to be corrected? There were no answers. There was no guarantee the antidepressants would work at all.
The doctor warned it would take up to six weeks before they kicked in. Six weeks is a long time for a depressed person. In the meantime, things deteriorated. It was the mid-year school holidays. I had schoolwork I was supposed to be doing, but felt incapable of picking up a pen. I shut myself away and barely left the house. Out of the blue, my flatmate announced that he was shifting out in two weeks' time. Unless I wanted to take on the lease - impossible financially - I'd need to move out too. I couldn't even imagine how to go about looking for another flat at that point. I contemplated suicide.
I didn't have many close friends, but there was one - Hester - whom I confided in. She was two years older and I'd told her more bits of the truth than anybody. When I said I'd thought about killing myself, she made an appointment for me at the psychiatric ward of Wellington Hospital.
The psychiatrist was an American woman with a hard stare. She seemed irritated. I don't think I fell within the classifications of mental illness that were supposed to be seen there. I wasn't schizophrenic or hallucinating or a danger to others. After about 10 minutes of questioning she told me she thought I was mildly bipolar and suggested I try the mood stabiliser lithium. Lithium? Did that mean I was crazier than I thought?
I was stunned by what had transpired, how my life had fallen apart. I'd now missed weeks of journalism school and didn't think I could return. I craved a kind of abstinence. Extended leave. A plain white room to lie down in. Yet, a few weeks later, the clouds began to part. Somewhere, somehow, my normal self miraculously began to re-emerge. Was it the antidepressants kicking in? It was around a month since I'd started taking them. (I never had taken the script for lithium to the pharmacy.)
I decided I would get back on the horse; I returned to school.
Simultaneously, I started to see a psychiatrist and began unpicking the roots of my depression. I realised as a teenager I was a success junkie. Depression removed my ability to achieve and with it the basis of my self-worth. I thought if I was not some sort of all-star-super-bright-young-thing, the world would find me unacceptable. This was the central, aching tension for me when I was depressed. The difference between how I wanted to be perceived and how I was in reality.
As I got better, my mood segued into one of effervescence. I fizzed and popped. I had feature stories published in newspapers. I went out wearing sparkly headbands and got myself a boyfriend. It was early summer and during a concert on the waterfront, after a few glasses of bubbly, I got up on stage and danced with the band, waving my arms in the air. I was later described in a gossip column as looking like an out-of-control windmill. Was I out of control? I felt like the life of the party.
I didn't recognise this state as mild mania. I didn't know enough about what mania was. I felt wonderful, but the period was destructive in certain ways. What goes up must come down.
Over the next few years it became clear, as the psychiatrist at Wellington Hospital had said, I had Bipolar II, formally known as manic-depression. With Bipolar II, the high moods are less severe than the mania of Bipolar I. In between the highs and lows you get some normal times. This cycle shaped my life in my early 20s, each phase lasting a couple of months.
I was now working as a freelance journalist and had a newspaper column called "City Girl". I could write the lightweight banter just fine when I was well or high, but it was very difficult, farcical almost, when I was depressed. Then I would rather lie in bed between dirty sheets than get up and face the world. The last thing I wanted was for anyone to see me like this. People, if possible, were to be avoided.
I feared taking on full-time employment in case I had to bail. While I lusted for travel, I was scared of what would happen if I was overseas and got depressed. I recognised the pattern, I could almost set my watch by it, I just didn't know how to stop it.
The motivation-sapping nature of depression makes it hard to do the things that might help you get better. When I was well, however, finding the cause of my mental illness became a quest. Was my depression caused by a build-up of emotional ashes? Was I suffering from karmic retribution? Did I live too close to power lines? Was my diet deficient in an essential vitamin or mineral? Did I get enough sunlight? Was it my mercury fillings? Did I drink too much coffee? Maybe it was the madness of living in the 21st century?
I tried many potential cures. An acupuncturist stuck needles into me. A cognitive behavioural therapist had me keep a diary of my emotions and plotted my highs and lows on a graph. The hands of a cranial sacral therapist soothed my subtle energy systems. An iridologist analysed the dots in my eyes. I bought jars of Vitamin B, C, fish oil and a full-spectrum light bulb. I saw a homeopath, who gave me remedy of sodium chloride.
Could any of these people save me? I desperately wanted someone to say, "Yes, I can see exactly what is causing your mental illness and this is how we shall fix it." If I had been told that eating three fistfuls of dirt every day and dressing in yellow silk robes was the cure, I would happily have followed the instructions.
Unfortunately depression is a slippery and non-linear illness, with more exceptions than rules. Some of these things were helpful, but not an end in themselves.
Still, I'd travelled through the cycle enough times now that even in my bleakest moments I had to wryly admit I had felt this way before and things had got better. I learned that I couldn't trust my own perception when I was depressed. Also, knowing that others didn't judge me as I judged myself helped me to unstitch myself from some of the shame. Instead of thinking, "I'm such a despicable creature" when I got depressed, I began to steer towards, "Oh poor you. This is hard. I'll do my best to get you through this."
At 25, I got my first proper full-time job as a communications adviser for an economic development agency. I was afraid I might not be able to sustain it, but it was worth trying. I could hardly believe it when I made it through the whole year without an episode of depression. I was filled with wonderment, gratitude. How had this happened?
There was no magic moment of change. No great epiphany. No elixir of unicorn tears wonder cure. I think it was more a combination of things gradually changed, until the tide of depression was out. It was a multipronged attack that addressed the physical, psychological and spiritual. For me, the strands came together over years - not weeks, not months - little by little, bit by bit. It's now eight years since I was in that Underworld.
Depression was a teacher, just a bloody hard one. It challenged me to accept myself, even at my lowest. I don't underestimate its power. Being depressed made me feel there was no point to life. In searching for a point I had to define what I believe in - the framework by which I assess what is valuable and meaningful; my views on God and spirituality. Depression shaped and moulded me and I am a stronger and more integrated person for that. These are treasures brought back from the Underworld that I hold fast to.
Several years ago I read in the newspaper that a girl I knew, Sylvie, had committed suicide. We'd waitressed together in our early 20s. Sylvie was effervescent, articulate, beautiful. I hadn't known, but she had battled with depression for 10 years until she took her life, aged 29, on a beach. I was shocked and sad when I heard. Equally so when I heard about my former boss. James had had an illustrious career in foreign affairs before he became a chief executive. His intellect was razor-sharp and he set the bar high for everyone who worked with him. He was receiving treatment at a mental health facility when he took his life. The world is a poorer place for losing Sylvie and James.
I wish I could say to someone who is depressed: "Just do this or that and you'll be cured." To hand out happiness on the street corner. It doesn't work like this. It seems that it's an underworld we have to find our own way out of.
While I eventually found a way out of my cycle, for many people mental illness is a permanent backdrop to life. The challenge must be to manage to live with it.
I salute all those who must deal with depression. I wish you all the strength in the world. I wish for a brigade of angels to stand by your side. For friends to say the right things, for sunlight to shine in your window. For you to believe in the possibility of transformation.
Emma Gilkison is based in Wellington, where she works in public relations. She has been free from depression for eight years, "during which time I've taught English in France, lived in Mexico, volunteered in Peru and generally been a much happier camper". She regards herself as recovered from her illness.
"I think some in the medical profession view bipolar as a permanent state with mainly physiological roots, but this has not been my experience. I guess you can never say never, but at this point I can't see myself going back there."
This story details Emma Gilkison's recovery from Bipolar II. She has decided to write her story in order to provide inspiration to others struggling with mental illness. She is not a doctor or medical professional and does not intend this piece to replace the advice of physicians or healthcare practitioners, nor does this story intend to diagnose or prescribe treatment for any illness or disorder. It is her personal story only. To seek help for a mental health illness, visit mentalhealth.org.nz
* October 10 is World Mental Health Day and the theme is "Depression: A Global Crisis". Mental Health Awareness Week is from October 8-14.