Interview 01

Age at interview: 75

Age at diagnosis: 35

Brief Outline: Treatments have included ECT (Electroconvulsive Therapy), hospitalisation, talking therapies, lithium and medication. He was on a preventative, low dose of Zoloft (sertraline 100mg/day) due to his wife's death.

Background: A former brewer, feels he was probably depressed even as a child. He has had a number of bouts of depression and currently has cancer.

Explains how he considers depression a sign he is going to get better.

It's [pause] I always try to think that there's a sort of beneficial flip side to these problems. And I tell myself that if you don't hit the bottom, you don't really know what the good things are. So when I felt absolutely as if I'd hit the rock bottom, it was starting then to feel quite joyful because I knew it was going to get better, and gradually it did'

Compares cancer with depression and says there is more professional support for cancer, and because depression affects the mind, it is difficult to fight it.

Four or five years ago I was diagnosed as having cancer, and I made comparisons between having cancer and having depression. And cancer is [pause] there is so much help and people are so kind, particularly the professionals because they are geared up. They know the emotional problems people have. And there's a lot of backup. And I've received kindnesses beyond words [pause]. 

But with depression that's a different ball game really. And [pause] its'The two are so different. One is at one end of the scale, and one at the other. It's the loneliness and the feeling of being utterly down and out with depression. With cancer you can say, "Oh, I've got to have a treatment, lets see if that does any good.' And there is a sort of progression. 

But being involved inside the depression, you can't see the wood for the trees, and you depend on people close to you to point the things out that you are unaware of. So you are sort of running in blinkers with depression, which isn't the case with cancer. And I've found that people, not everybody, but lots of people involved in helping people with depression can say quite hurtful things. And that you're in a pretty low ebb when you've got it anyway, so I've found that much more difficult.
 

Although he denied being depressed, he was referred to a psychiatrist who understood how he felt, which was a great relief to him.

And the company which took over the firm I was working for was an international firm. And they had a company doctor, so they asked me to go and so see him and I did, and he asked me to explain how I felt, and he said, 'I think you are depressed.'

When was that?

That was in 1963 and [long pause] I was most offended. I thought I'm not, and what's he talking about. So he gave me a letter to give to my GP and my GP arranged for me to go and see a psychiatrist at a big hospital. And when I got there my wife came with me and he asked me questions about how I felt. And I should have told you that I was normally about 11 stone. But by this time I was down to about 7 stone. 

And so I felt pretty ill and I got to the point where I would sit in a darkened room and not want to talk to anybody. So I was totally withdrawn, and I explained all this to the psychiatrist. And then when I'd finished, which was a terrible ordeal because I was loathed to talk about myself, he then said, 'I'll tell you a bit more about how you feel'', which was the most wonderful relief because I thought this was just peculiar to me. And he took a great burden off my shoulders.
 

He lost his faith in psychiatrists when his hair fell out. His psychiatrist initially said it was to do with stress, but later said it was due to too much lithium.

And I didn't know if they would do any good or not, but I added up one day that I would, over the years, I had taken almost 20 different sorts of pills of one description or another. And had all the dry mouth and all the side-effects that were unpleasant.  

So I tried, I'd try anything to get out of it so I went onto the lithium salts, and one day I was washing my hair over a sink and when I opened my eyes the sink was lined with masses of hair. So I pulled my hands through my hair and I could pull it out and over the next 2 or 3 weeks I guess it all fell out. 

So I had no hair at all and I saw this psychiatrist and he said, 'Oh, don't worry about it, I'll send you to a skin specialist, its come out because you've had a great deal of stress.' So I went to see the skin specialist and by a piece of good luck he said, 'I get depressed as well.' And he said, 'And I know what lithium salts do.' 

And by examining my scalp he said, 'I can assure you it will grow again.' Which it did, so that was a relief  [pause]' And to continue that story I was expected to become depressed when my wife died. The bereavement was thought'.[to perhaps trigger depression]. 

But I didn't really feel that ill at that time. And I saw this same psychiatrist. This was about another 10 years after the first visit to him when he had prescribed lithium. And when I walked in he said, 'Oh, I remember you, you had an overdose of lithium!' And I said, 'You told me it was stress.' And he said that he could have made a mistake. So all my faith in psychiatrists went zooming out the window with one man.
 

He 'swallowed his tongue' during ECT (Electroconvulsive Therapy) and had to try to alert the anaesthetists, and lost memory of a holiday and work practices.

I think I had about 20 sessions. And I would come out of it with a splitting headache, and no memory. Couldn't remember where I lived, and how I was going to get home. But my wife was there, and she took me home. And one day it was rather a terrifying experience because in order to have the treatment, as I said I had a general anaesthetic. And they would give curare to relax the muscles and so forth. 

And so I was strapped onto a trolley, and up round my feet and waist and chest and my arms at the side. And then I was in that state, with two anaesthetists who stood by me talking about something I don't remember what. And I swallowed my tongue and I couldn't move or shout, so I thought 'I'm going to die if these two don't soon notice what's happening'. 

So I moved my body as much as I could and hit the one of them with the trolley, and they were terribly apologetic and asked me if I wanted to go on with it. And I did, but ever since then I've had quite a lot of surgery. And I always ask the anaesthetist to be careful not to let that happen again. 

So that period then I was taking quite a lot of anti-depressants drugs as well and I was off work for about 6 weeks'. 6 months, I mean 6 months. When I went back to work I had no recollection of what had happened while I was away. And I knew the job well enough to go on doing it, but my memory was bad so'

While I was off, we went on holiday. And to this day I have no recollection of where we went or what happened or anything. So that was a bit frightening. And then I was determined to go back and do the job so my memory was affected by this time so I got into the habit of carrying a note book and putting everything down that I'd to do. And so to all intents and purposes, I was back to normal, or I felt I was.
 

Describes a suicide attempt where he was not met by empathy by hospital staff.

I did take an overdose on one occasion, when things were quite desperate. Some of these well'. quite a lot of antidepressants and paracetamol' That was a pretty horrendous experience. And my wife helped me out of bed because she could see there was something wrong, and pulled me down the stairs and got me into the car. Took me to hospital where they pumped me out. 

And'. I can remember being almost unconscious, and with a doctor and nurses around the bed. And the doctor said to one of the nurses, "Go and get so and so' we've got about 10 minutes or he'll be gone". And I could hear him, and I just thought, "I wish you'd leave me alone. I'm warm and comfortable. I don't want this". But they did their stuff and got me round [pause]. And that was'. that was not nice because I'd frightened my wife, which wasn't fair. 

And I also had to run the gauntlet with the medical people who were something less than sympathetic. But they were looking at it from a medical point of view. So that's not my place to judge what they were saying. But it was not any easy thing' and I must have been in quite a deep state of depression to' to contemplate that [pause]'. Yeh I regret doing that.
 

Through noticing forerunners to depression, and adjusting his medication, he could manage his bipolar depression better.

Yeah I could then see this cyclical pattern, it was like being on a scenic railway you know. You'd drop down into the depths and then hit the heights. The heights were very good for thinking up schemes, and some of them were a bit over the top maybe, but I got to use it if that's the right thing. It sounds as if I'm so clever, but at the time I didn't feel it. But I was able to use it to my advantage and trim it to suit the situation, and I'd quite a lot of drive and I could get people to become enthusiastic about doing certain things and it worked very well for me. And then I thought, well that's the easy part. It's the depression is the bit that's difficult, and I then began to notice sort of [pause] forerunners if that's the right expression, little things that would tell me that the depressed state was about to start. So I was then able to increase some of the anti-depressants.

After yes'. after recovering if you like'.. but there were still periods when instead of being like this in the swings [motions with his hands a roller coaster ride] it's more like that it's manageable [motions with his hands a much flatter roller coaster], and it's got to the point where the depression is a feeling of being just fed up, plus a fraction. But not the absolute withdrawal, that's'. that's ghastly. That is awful. So that's something I've experienced.
 

His wife helped a lot by looking after the children and household duties, but he regrets the family still 'missed a lot' through his depressive episodes.

Yep, [sigh] my wife'was very supportive over a long period. Many years. And in the worst periods'.she found it difficult to relate. That it was going on so long. And since there were sort of about 3 major bouts of it. The ones where I needed'. [laugh]. She found it' trying and who wouldn't. Because I think it's harder for the person living with, in many instances, than the actual patient really. Because things are very slow to change and improve. 

So she also had to take on the role of a sort of go-between the children and me. She did sort of protect them, if that's the right word, from the worst part of it. I would do'. Oh you know, the garden and things around the house, and all that sort if thing, which was my job to do in a way, as well as the work. But I found it difficult to relate on the day-to-day things, which is where she was so good. She took over those things, and that was very helpful. But I' I feel that we missed a lot because of it. My sons were very good, but they missed a lot because of how I was. And they would have to make allowances, which isn't really what you should have to do when you're growing up. So she stepped in there and took the edge of it.
 

Argues that the depressed person is the best person to overcome the depression, but they need to get professional help from wherever they can.

You are stuck. They are stuck with the professionals. That... that does not sound very complimentary to the professionals, but initially, they [sufferers] need to get help from wherever it comes. I would like to think that today, people are more compassionate than maybe they were when I was depressed. Perhaps they are I would think there were more skilled people about. And you need to take help from wherever you can get it, but equally it's [pause] Really, the bottom line is the person who's got it is the best person to overcome it. The only person to overcome it.
 

Argues that very depressed people need to accept help from doctors, including medication, at least initially.

I mean it obviously needs to be a medical person. And I've met with such a lot of kindness from the medical world that... you've got to trust them. And accept that they are giving you drugs for your benefit. You've.... you've nowhere to go. So your back's to the wall, so the only way to get better is to... let the medical people help. 

I mean I can judge situations in retrospect, but at the time, I was almost immobilised, inert really. Yeah it was.... I would sit in a darkened room with my arms over my head for hours, feeling so wretched I didn't want to eat or drink. So I was totally.... almost totally withdrawn, so you're not really able to make any judgements and that's it....