Interview 04

Age at interview: 31

Age at diagnosis: 17

Brief Outline: Has responded very well to Prozac (20mg/day) and cognitive behavioural therapy.

Background: A married teacher living in London. Multiple episodes of depression starting in childhood, bouts tend to occur when he is doing well. (Played by an actor.)

Describes a GP who demonstrated caring and confidentiality, as well as acknowledging what it...

He was a nice man and he was a good sort of '. just warm and tender kind of chap. And he said, "Well we're going to give you something just to stop your mind whizzing," I remember him saying that. I don't even know what it was, probably nothing'. He was like, he made me feel okay my mum was not there, this is you and me, you're an adult, this is between you and me, which I don't think I kind of understood that actually. I didn't think he was ever' I don't think I ever really realised he was my GP, I think he though, I thought he was our GP.  

I'd never made an appointment to see the doctor off my own back, I'd never phoned up and said, "Can I see my doctor?", probably would never have gone to see him if it weren't for my mum making the appointment. Interesting isn't it.   

So that was helpful, and he was a kind of, I suppose before he'd always seemed a sort of, kind of rather you know, a figure of authority to go with all the other ones. Then when he starts to talk to you, then you sort of you realise, God this man in his fifties knows what it's like to be sixteen, talks to a lot of sixteen-year-olds, knows what it feels like to feel shit. And lots of people have felt the way I feel, and that really helps. And it sounds trite but it's true. He was a good GP, he was a good GP.

Found he could not ejaculate or have an orgasm on Seroxat (paroxetine), but the side effect was...

I've taken fluoxetine (Prozac), and Seroxat (paroxetine). With Seroxat the first thing I noticed was, [laughs] this is a bit embarrassing, but I couldn't ejaculate' It's extraordinary, absolutely extraordinary, so you have no erection problems as such and you can have sex you know, but you just don't come [laughs]. And it's kind of a weird'

Is that a good or a bad thing?

There's a question. You feel like a sort of porn star, you can go for hours you know [laughs]. On the whole I would say it was a bad thing, because you just think whoa, there's something fucked up in my body [laughs], this isn't the way it was supposed to be. You actually get over it, that lasted about a month, about two or three months I think I can't remember if you could, yeah because you' you just can't you just can't ejaculate. I'm trying to remember if you can actually orgasm, I can't remember, I'm not even sure you can actually, no you can't'You know you can put up with not ejaculating in return for not wanting to die you know.

Believes he has a chemical imbalance and that the benefits of antidepressants outweigh potential...

I mean in all my episodes it's been drugs that have helped me, not just drugs, but drugs have been the safety net. I've no problem about taking drugs, never have. I'm still taking them. I can't, I won't, I don't, I can't imagine coming off them at the moment. I don't feel safe enough to come off them, I don't really worry about taking them. 

I'm certainly not one of these people who thinks, "Oh God, some kind of poison in my body.'" It's like no, it makes me feel better'. you know I'm quite, you know I'm quite happy to admit there's something screwed up about my brain chemistry, you know. But you know, some people are diabetic, they take drugs, you know.

And I'know people say, "Oh, it's not the same.'"But I'm afraid it bloody well is. It's just, you know, you're trying to undo several hundred years of cultural difference between the brain and every other organ. But you know, some people are just not built the same way, a lot of people actually. You know I wear glasses, I'm short sighted, I take anti depressants, I get depressed you know. [taking medication has] never been something that's bothered me. 

That might be partly family as well, my family has never been sort of anti taking things to make you feel better. And when people say to me, "Oh I'd be worried about the long term," well alright let's say Seroxat is more likely to make me'. I don't know. Let's say, or even to take five years off the end of my life. I'd say well it's better than feeling fucking awful now. Which is, you know, I can honestly say antidepressants work, work well.

He initially thought therapy was for the mad upper classes and anorexic girls, but then found...

I don't come from the kind of background that goes to therapy. Therapy is anathema in my family, you know you just, we're not from that world, we're not from' that class. And so it took a hell of a lot for me to go to therapy. You know A' nutters go to therapy, B' therapy makes you a nutter. These were the kind of things that I grew up with. And it doesn't help. You know, so hostile kind of lower middle class sort of feeling about that sort of thing. We're not the sort of people that do it, do you know what I mean, it's like people from Hampstead go to therapy, we don't'. 

I was sent to the counselling at university, and I fucking hated that, it was probably just the wrong time of life'. The sort of walking in, and you're surrounded by pale skinny fucking anorexics you know and you think A' I'm a bloke, B' I'm not one of you lot. I'm sorry I'm voicing what I felt then, I'm not saying what I feel now. You know, I looked around the room and there was these sobbing anorexics and I'm just thinking fuck you, you know what am I doing here? 

And you get in there and there's the little box of tissues and you just think oh piss off. And, "How did you feel?" and all that stuff, that's how I felt it was just like my whole thing was completely negative about it. So you can see where I was coming from. It's not easy for blokes, especially not blokes from that kind of background. 

You know if you've got parents who've been through this stuff then it's alright, I'm not sure many people have, but I can still access the kind of hostility I felt then. So it was hard first of all to get over the thing. But I liked the therapist, she was good, and I felt it was practical, it wasn't about saying oh yeah I really feel your pain. I think again, getting over your prejudice is extremely important. 

It was actually about problem solving and at first it was about, "Okay what can we do about this?" And we did talk about experiences, I accessed you know, I don't know what her method was, I'm not really interested, but we talked a lot about childhood experiences and we, I definitely, it sounds clich'd but I did reconnect the pain that I felt as a child, and that I hadn't properly processed or hadn't been told it was okay. That was incredibly powerful and it hurt a hell of a lot'.

I tended to lead it wherever I wanted to go you know. I found it very good, I quite like, I like talking, it makes me feel better.  It was nice to be paying someone [laughs] a lot of money to talk.
 

Initially he doubted that slow deep breathing could help him feel better. (Played by an actor)

Other things have been very practical things, just breathing [laughs]. I couldn't believe what a difference that made when the therapist first said to me, "Okay, so try actually breathing in, really you know fill yourself up as far as you can possibly go and then breathe out." And you think yeah right. I told you about my, that was my feeling about a lot of these practical things was yeah alright mate, whatever. But they work, they work.

Describes the varying success he has had with trying to defeat the negative voice in his head. ...

It's almost you've got this voice, and it is a voice sometimes of just' that has this incredible power of right about it. And no matter what you try and do, sometimes you just think okay I'll argue with it, that exhausts you. 

Sometimes you think I'm not listening, I'm not listening, not listening, almost like you know when kids sort of put their fingers in their ears and try and pretend something that goes away'Getting better is about thinking no that's [thinking is] wrong actually, and moving on, it's not about fighting. 

Fighting you have to do sometimes'. I'll tell you, there are some moments when you're depressed and you say, "Oh right, yeah, oh well I can probably live with that, you now I can live with the rest of my life being shit basically, you know that's fine, I can get on with that." 

And you have this sort of' and you think' you think well that's the good times, you know you think, 'Oh yeah, okay'. But there's other times when you sit there sort of going, 'No, no, no.' And that is really hard. The thing I remember'. and it was the beginnings of getting better because you try it many, many times and it doesn't work, you have to stick with it. It's not so much that wrestling, because when you are alright of course you're not wrestling, you just go "No, actually that's wrong." 

And' it never even comes to mind that's health. There's a sort of intermediate phase where they come, but you just bat them away quite easily, no great fuss'.. But I think you have to' you do have to sort of fight a bit. But it's tiring and sometimes you just want to give up you know, and just say, 'Okay have it your way, yes that's right actually.'  And that's really not nice, not nice at all.
 

Describes noticing how depression for him meant a racing and negative mind. (Played by an actor)

And just, I remember nights you know, I couldn't sleep and I'd be… my mind would be really buzzing and racing. Somebody would tell me they'd been depressed and they feel sort of dead and numb. I never felt that. My depression is always about your mind zooming into miserable places, never about…some people say to me when I'm depressed I just, I can't feel anything. That's not my experience, it's just about racing. I remember lying in my bed and it would be, I can kind of see it you know [laughs] the light on the landing, and it would be getting later and later and later and I couldn't sleep and I'd be crying and I'd be upset and then my parents would say, "Well what's wrong?" you know, they'd take me into their bedroom and sit with me.

His doctor recommended physical activities, so he took up gardening, even though sceptical, but...

I remember once I'. when' in my second episode I had when I was about seventeen'And I remember a particular time, it was a hard time, it really was a hard time. The day that I suddenly felt things picked up, I wanted to do something, I wanted to do something physical. I'd been told, my doctor said to me, "You're not allowed to read any books, you've got to do just physical things." 

So I started to garden, I've never been in the garden before. And it was crap at first, but gradually it was alright, you know you start to think, 'Yeah, this is kind of distracting me a bit.' And there was one day I remember having my Walkman on [laughs] and I was trying to listen to a record, I can't even think what it was now, and of course the bad stuff comes, the bad thoughts come. And I remember the first time that I felt, 'Oh, I'm winning here.''And for the first time I felt hey, this fighting is working' 

People tell you to do things, they say in this case you know, work in the garden. And you do it the first few times and you just think, 'Oh fuck off, this isn't going to work.' And strangely, these sort of laborious tasks do begin to work, so you have to stick at it.

Has accepted that he will have depression again, he knows the signs of a looming depression,...

The signs (of depression) are panic, yeah you just think "I'm panicking." And that's physical, you know your heart rate goes up, the old classics of waking up early in the morning, that happens, the fear of being on your own, that you recognise. And just the sheer onslaught of negative thoughts that you just can't push out. And then you know, you know when it's coming, you know this is a bit different from just feeling shit.  

You know I have crap days, you can come home from work, and you think, "Oh shit, that was awful, I feel crap.'"And you know, maybe you've got some kind of material problem in your life, we all have them you know that's different, there's a very different' Quality, a panicky quality, a dark kind of' it's a very different texture that kind of anxiety from'. and depression from the kind of stuff that we deal with every day, or you know sometimes you have a couple of days of feeling, 'God, I didn't feel that great last week.'  

But you know it's very different from what'.. yeah that, when you see it coming I think, I remember saying to myself, "Oh no, not again." Really you know, I know, I've got over this once, surely, I thought I was over it and it's back. Now if it happened to me again, which I dare say it will, I'll never think, "Oh God, I thought I was out of that", because I think I've kind of accepted that  it is something that's there now. And people will say oh how sad that is, and I don't think it is really, without saying yeah it's something that's there, but I know the signs, and I know what to do, and I know you get better.

Says the models of being male are either macho or too soft, with little middle ground, so it is...

I mean I think one of the problems is that you sort of lack a kind of middle ground between being kind of really macho and emotionless, and kind of tough for want of a better word, or kind of emotionally constipated which I kind of put together, do you know what I mean? And then the other thing you don't want to be is a kind of wet bugger, you know you don't want to be kind of... You know the kind of world I came from was pretty... I went to a boys' school it was pretty rough [laughs]. You know it had its rough old moments, and it just wasn't the kind of place you admitted vulnerability.
 

For him overcoming depression involved the realisation he was not as different as he thought, and...

I mean getting over depression is about discovering that, I mean discovering I could have decent relationships was the same kind of.... Again it's about that thing of joining the rest of the human race, thinking actually I'm not different. That's, I know that makes me sound like a natural conformist, I don't think I am, that's not what I mean. It's just like yeah, you can also have access to the same bank or pool or account of experience that everyone else can draw on, and that's... as I've grown up 

I've discovered that I'm not that weird, not that different and things that I thought were denied to me, you know if you'd said to me in my mid twenties, even in my happiest time I would've said to you, "Yeah, I'm a happy guy, I'll probably never manage a relationship, a long term relationship or get married to anyone but that's absolutely fine."

About two weeks before I met my wife I remember going to a wedding and looking at these people and thinking, "How does anyone do that, how does anyone think they're that secure with anyone?" And just thinking, "Well, that's denied to me, and that's okay. That's fine, I can live with that. You know some people never, I don't know visit you know visit Africa or something, I just won't be doing that." And then sure enough, I discovered that I could do it, and it worked, and it was a shock to me and a wonderful surprise.

Urges very depressed people to get medical help without delay because they are not in a position...

You go and see the doc, you've got to go straight away... you won't do it without some help, it's as simple as that... you feel really alone, you feel weedy, you feel cack, you just think that you're no good. I would say that you're wrong [laughs]. Point one. And just accept you're wrong, say no that's wrong I'm probably.... also accept you're not well, and therefore you not thinking right, so anything you think now is probably not right. 

That's hard to do because we tend to trust what we think, especially if we think it is as powerfully as we do. But if you can just say, "No, actually at the moment, I'm ill and what I think is probably wrong," that's good... the voice that says to you bad things seems incredibly undeniable and it's not. And if you could just try and say, try to act as if it's not, then that's really good. And again you will not believe it, but you get better and not very, not very far away from now, you will feel better.