Akello - Interview 26

Age at interview: 45

Age at diagnosis: 44

Brief Outline:

Akello described suffering emotional distress after giving birth to her children in Uganda. She later realised that this could be described as 'postnatal depression'. She was diagnosed with depression in Australia in 2010 when she was put on antidepressant medication by her GP and referred to a psychologist as part of a mental health plan. Medication and counseling have been helpful and Akello now feels she is on the path to recovery.

Background:

Akello migrated to Australia in 2005. She is married with three school-aged children and works part time as a community worker and in office administration. Ethnic background' Ugandan.

More about me...

Akello was born in Uganda, the youngest of eight children. At age six she was sent to boarding school. Although this was normal in Uganda, Akello was very unhappy. She was also teased a lot by her older siblings and discouraged from her dreams of being a film star. When she was 10 her father took a second wife because he wanted to have more sons. While culturally acceptable, this was emotionally very difficult to accept for Akello and her mother, and has had a lasting emotional impact on her, despite the situation between her mother and stepmother now being amicable.

 

Akello wanted to go to university but didn’t complete her school studies. She later wanted to return to study but her family discouraged her. She trained to be a nurse but wasn’t able to complete the course so studied to be a secretary. Akello began working, and met her husband. After the birth of their first child, she felt ‘very sad and felt like crying all the time’. However, she didn’t talk to anyone about it because she was afraid to tell her family how she felt. She had a keen interest in reading and access to a library at work enabled her to read books about other women’s experiences with sadness after childbirth. Although this helped her ‘learn about postnatal depression’, she thought other issues in her life were the cause of her sadness.

 

After giving birth to her second child Akello describes ‘feeling numb’ and as though her emotions had ‘shut down’. In retrospect she thinks that she was so busy looking after her children by herself, working and running a household that she perhaps ‘shelved her emotions rather than dealing with them at the time’. When her third child was born Akello was very ill. She felt ‘numb, exhausted’ and couldn’t breastfeed. Her GP sent her to a psychiatrist. In Uganda there is a lot of stigma around mental illness, and there is not even a word for depression in Akello’s first language. The psychiatrist gave her medication but she only took it for one month because it made her feel unwell. 

 

Akello moved to Australia at the age of 39. The move was hard for her, in particular the loss of community life she had enjoyed in Uganda. Although joining a local church helped her regain a sense of community, she felt she was out of her comfort zone and missed her parents and siblings. Two years later she returned to Uganda for a wedding, expecting to feel better after seeing her family, but her feelings of sadness and isolation remained. By 2008 she was still struggling, which impacted on her ability to maintain employment. Many days she felt like she could not even get out of bed and had ‘feelings of worthlessness’. She felt like she wasn’t a ‘good mother or a good wife’, and worried about not having enough money. Weight gain resulting from comfort eating added to her unhappiness. 

 

A colleague at work suggested she see a GP. Akello followed this advice and was diagnosed with depression and prescribed antidepressants. She also saw a psychologist. Akello describes herself as still on a ‘journey of recovery’. She has learned to put herself first and be assertive with her husband and children. She has controlled her eating and shopping and doesn’t feel guilty about looking after her own wellbeing first Akello says finding time to ‘be happy and joyous' and helping people in her church community are also important aspects of her recovery.

Despite a complex set of life circumstances and difficult life events, Akello believed that her...

Yeah, so to me it’s, it’s helped, and I’ve also learnt that it’s, it’s a chemical imbalance in my brain. It has nothing to do with me. It’s, that’s what happens, so…

 

First of all I learnt it in - when I was doing my nursing training, and also reading a few books, it has helped me to know that, yeah, it’s got nothing to do with me, it’s a chemical imbalance in my brain. It’s - and the, the medication that I take helps balance out that bit in my brain that’s not balanced.

 

After her GP left the practice, Akello considered herself 'lucky' to find another one she liked....

The first GP I liked – I would talk to her the way I am talking to you, you know. she doesn’t have this air that I’m a doctor, I’m a medical doctor, I’m well learned, I’m very clever to be doing this, you know, sort of thing. She was so down to earth. And she’d also been seeing my children when they are like ill and she would laugh.

 

You know one day I took my son to see her and she just laughed and she - I said why are you laughing? She said, he’s got such an Australian accent, you know, he speaks - my children all speak like Australians. And I found that more relaxing. It’s not, you know, she made me - it’s like she released the tension I would be having and she didn’t make me feel like I’m much more sick than I thought I was, you know.

 

When I got out I would feel like I’m getting better immediately, not - normally when I get out of the doctors, some doctors, I feel like okay, what did he say to me and I feel like, ah I really didn’t understand this, I didn’t get this. But she seemed to understand me well, so - I maybe also just, just biased because she was not, she was - I thought she understood me better, she’s not an Australian. She’s not of Australian origin.

 

Akello's first experience with counselling in her country of origin in Africa encouraged her to...

So I went - at the time I was so religious. I belonged to a Pentecostal church and I went and sought help from them and I saw a counsellor who luckily for me wasn’t as religious as I was at that time and she did pray for me, but she didn’t look at it like a church - church people look at it. Church people – at the church I went to - were the sort of people who would say to you, oh no, this is the work of the devil. Should pray for you. Stop accepting this you’re a child of God. Stop accepting this. Stop letting the devil attack you. All sorts of things. 

 

So instead they, of treating - they didn’t look at it as a medical problem. They looked at it more like something between God and evil, so I saw the counsellor at the time and I remember what she told me - she said to me, from the time you’re a little girl, you’re not unwell, you’re unwell. So she said - she didn’t say I was unwell, but she said, these problems have come from many years ago, she said to me, and she said you have to go back into those times and get rid of those things that hurt you. If need be, talk to the people who have hurt you and get rid of that excess baggage.

 

Akello established some boundaries with her children, so they became more self-sufficient and...

They do and they give me space, especially my older one. He tells the younger ones to leave me alone, but I try to hide it so much. It’s only when I got to a point where I used to hit rock bottom and I wouldn’t take in anything, I would just be taken away by feelings that I couldn’t describe and the kids would know that it’s time to leave her alone. They wouldn’t ask me silly questions.

 

I had got to a point where I think I used to let my children use me or abuse - I can’t call it abuse, because they would ask for stupid things, you know, or they would cry because they can’t do a trick that they saw on telly - I can’t do this trick, I’m dumb, and that would affect me and I would try and tell them you know you’re not dumb, you’re alright, you’ll get to know it. They did going through practice but they would still cry, especially my middle child. 

 

And I got to a point where I thought, hey that’s enough. I don’t see why I should carry on their problems. They know - I stopped enabling them when they couldn’t do something and there’s - there are bits when they come crying, I can’t do this, I say of course you can. No I can’t. I say, it’s up to you. If you say you can’t then you won’t do it. How do you want me to help you? They say, I don’t know. I say, who can help you? It’s only you who can help yourself. I can’t help you.

 

Akello started various jobs and courses, but struggled to remain engaged due to her depression.

But after I went back home I thought, yep, I came back determined to get a job; not to heal myself but to, to get enough money and be able to go back home again. That’s when I got a job in (organisation name). I could only work there for three weeks. It was too much for me and…

 

It was really a good job, but I couldn’t do it. I just couldn’t. I couldn’t manage. I was finding it difficult and my supervisors asked me once, they said do you have to stop working now, today? I said yes. I was happy. I didn’t want to continue with the job, and I don’t know why. 

 

Anyway, so I finished with that job and 2008 I did a bit of cleaning work – community, really community work helping the elderly in their homes, you know, people who can’t clean up after themselves or who can’t - you know I had to clean - I had to vacuum clean the house and dust and wash and put clothes on the line. But even that was difficult.

 

I found fault with everything that I was doing. Everything that I was doing to better me I felt like it was wrong because I didn’t feel I was worth - I deserved anything better than what I was having.

 

In 2000 and ah 9 I applied to study nursing, because I thought yeah, in my nursing career there are many jobs; I’ll get a job and I did a bit of that - actually no, 2008 - 2009 - in 2009 yeah, because I started in about April 2009 and in December I said I’m sorry I can’t continue with the training. It was draining me. I just felt I couldn’t continue it.

 

There was so much. I couldn’t cope. But also when - I applied for what they call traineeship, that’s where you, the government subsidises your fees and you, you must work in an aged care facility and so I was able to get a job in an aged care facility and I was studying at the same time and studying was so difficult. I couldn’t concentrate on my books. I couldn’t concentrate on my studies. I didn’t understand anything that was taught. I don’t even know how I managed to pass the exams that I passed because I wasn’t understanding anything.

 

There were too many medical terminologies to learn and I just thought I’m pushing myself onto something yet I don’t feel confident enough to complete this training. 

 

Akello was critical about her first psychologist, whom she found more 'businesslike' than caring....

And my - the first psychologist I saw - didn’t click – ah, she was - I felt like she was more about her time than helping me, so…

 

...we finished a session which - they had - the only session I had with her and she said, oh it’s time up and let’s see, you have to see me - when should we book another session? Yet I had seen a counsellor before her and after each session she would ask me what I had got from the session, you know, to know exactly where I’m standing. She said what, if you had to go with something today, what would you tell me that you’ve learnt today? But she didn’t tell me. I felt like she was - it’s about her earning her money and coming in and going out sort of thing.

 

So I thought I haven’t come this far to work with someone who I’m not comfortable with so I asked, I changed, and I was also able to get vouchers from my GP and, yeah, so I had six sessions with another psychologist who was really, really nice and at the end of each session she would say to me, what have you, what are you going to take home?

 

Akello could not translate 'depression' into her own language. She described how people in her African country of origin hide mental health conditions because of fear of stigma, and talked about her friends' attitudes towards antidepressants.

I still don’t know it in my own language. Because depression is a mental illness and when they talk about mental illness nobody wants to identify themselves with mental illness, because mental illness means someone is crazy and of course the crazy people are seen as people who run in the street, they’re half dressed or they’re doing things that are not nice or they’re throwing stones.

 

There was one particular one who used to walk from one - round the city. He walked - they say he walked day and night - and one day he just collapsed and died.

 

So those are the sorts of people - they’re dirty, they’re, you know, that’s what - that’s - it’s stigmatised. Mental health is so stigmatised that people who are mad and crazy - and even the mental institutions, no one wants to identify with them because people who are mentally sick and mentally sick is crazy. Yeah, so, it’s not a good thing.

 

So where did you get - where is all this information - information were coming from?

 

From my friends. From my friends - mostly my Christian friends. One particular one said to me depression is from the devil and you should reject it, you should refuse it. You know, it’s - don’t take those antidepressants, they’re not good. You know, and I didn’t - I chose not to listen to them. And others who understood said to me – one particular one said to me did they put you on antidepressants? I said yes. She said, continue with them and just don’t talk about it with anybody.

 

So I’ve stopped, I haven’t, I don’t tell many people that I’m on antidepressants and I’m happy with that.

 

Akello was first diagnosed with perinatal depression by a gynaecologist in her home country in...

Yes that was the gynaecologist 

 

And, when the doctor told me I felt like, yes I already knew. That’s how I felt. I already knew that this was it, but I was too scared to say it because I could have been wrong. 

 

And so she sent you to a psychiatrist?

 

Yes. She sent me to a psychiatrist, and had he had time with me he would have explained the effects of the medication and told me what the medication was, because I don’t think he told me. Or maybe he did tell me but it didn’t register.

 

So because I had worked in an aged care facility, one evening I went to work and my supervisor in that facility - I got there and I said look I feel, I just didn’t feel like coming to work. She said why? I said, I don’t know. I just wanted to call in sick, but I don’t know how to tell lies and she said ah, why are you, why do you feel that way? I said I don’t know. She said have you worked anywhere else? I said no. I just woke up this morning, didn’t want to come to work; didn’t want to do anything.

 

So she kept asking me leading questions and then she said you know something, you should go and see your GP. You sound depressed. Talk to him about how you are feeling. That was my supervisor.

 

So a day later I went to my GP and the receptionist asked me, oh what can I do for you? I said I have come to see the doctor. My supervisor said to me I should come and see the doctor because she thinks I’m depressed and I think the receptionist knew there and then, she made an appointment for me immediately. 

 

And, I saw a doctor who I really like - a female doctor. She was very nice to me.