Ali - Interview 33

Age at interview: 27

Age at diagnosis: 26

Brief Outline: Ali, 27, was born in Pakistan and has been studying and working in the UK. Ali says that although it's easier to explain things to professionals from the same culture, as long as the other person is understanding, you can always clarify things.

Background: Employed, single. Ethnic background/nationality: Pakistani (born in Pakistan).

More about me...

Ali is 27 and was born in Pakistan. His parents separated when he was very young. He says he had a “strange upbringing” because his mother would regularly make unfounded accusations about him being sexually abused by people, including his father. When he was in his late teens, his mother told him that the man he knows as his father was not really his father. He says that in his culture, this was something to be ashamed of. Ali says he became depressed from this point. He says that although his parents have been very supportive, he doesn't feel close to them. Although Ali thinks his upbringing played a part in his mental health problems, he also thinks it could be a chemical imbalance or genetic.

Ali's symptoms come in cycles include feeling sad, lethargic, useless, and ugly. His mind focuses on negative thoughts and he can feel suicidal, although these feelings give him a sense of relief from his depression. As a result of his depression, Ali says he finds it difficult to have a relationship, although he makes friends easily and is able to work.

Ali has no one to talk to about his experiences. He has only told his story to two or three people and having no one to confide in made it difficult for him. When he told his father, he says he didn't understand. At first, he didn't seek help for his mental health problems because he felt it was a taboo subject in his culture. He feels that if people found out they would gossip about him and it would have consequences for his marriage and work prospects, so he feels it's best to keep it secret. 

Ali described himself as not very religious and says he sometimes feels as if God is out to get him. He hasn't found prayer helpful for his depression. One thing that does help Ali with his mental health problems is his imagination. He has imaginary friends who he talks to and shares jokes with. He is in complete control of these characters, and emphasises that he does not have schizophrenia. Ali also takes Fluoxetine and finds this helps to level out his moods; he doesn't think talking therapies helped him much because he is too impatient and wanted the quick fix offered by medication. Ali says he's willing to try anything to get back to normal.

When it comes to speaking to professionals, Ali says that although it's easier to explain things to people from the same culture, as long as the other person is understanding, you can always clarify things to them. He recommends that professionals show kindness and understanding towards their patients. His message to other people in the same situation is fight and keep looking for new ways to tackle your mental health problems.

Ali says his antidepressant is the best medicine in the world and although it gives him some side...

And is the medication that you're taking helping?

It gives me a limit of going down. It's like a threshold. I wouldn't go down below that. I wouldn't feel worse than this. It's' Yeah, simply yes, it does help me. But it kills my, I don't know. I'm a very expressionful person, but it sort of kills everything. It's, it makes you a bit more bland. But yes, it does help me, in terms of bad mood swings. Yes.

Levels you out?

Yeah, yeah. I think that's what I wanted to say.

Does... Because you seem to suggest as well that it, it stops you from dipping down

Yeah

but it doesn't necessarily bring you up?

No

Is that right?

Yes. Yes. That's exactly what I wanted to say. Yeah, yeah, it definitely doesn't bring you up. It doesn't make you happy. No. But it doesn't, it doesn't let you become sad. That's I think what it's doing.

Ali says he didn't want to seek help because mental health is a taboo and because he was worried...

I never believed in psychiatric, that's the thing. I always, I think this is probably the culture that I'm brought up in, that is basically first of all mental health is a taboo issue, secondly it's, it's always when you hear about patients who are mentally ill, they always seem to go to doctors like ten years, for ten years, or five years, or you know, they have been a mental patient for life. They have chronic depression for the past twenty years, so, like they never tend to get fixed like other diseases. If you have a problem with your appendix you go to the surgeon and he takes it out. But if you have a mental problem it's like you take the medicine for the next twenty years, you know? That's, that's absurd. So I think that sort of made me stay away from psychiatrists. 

But anyways, since I've been here in my college, I came here to do my MSc at University of [name removed], and over there, there was quite a bit of awareness about mental issues. So I used to read all these pamphlets and this and that, depression, everyone suffers from depression, one in three persons feel anxiety blah blah blah. So, you know, that sort of made me a bit more confident about, 'Okay, so I'm not alone and, you know, it might not be such a taboo issue' and you know. But I didn't seek help back then.

Ali feels professionals can sometimes be like a "robot" and could show more kindness and...

And also do you have any messages that you'd like to give to health professionals, you know, GP's, psychologists, psychiatrists those sort of people?

I think mental patients are a lot more vulnerable, because of their condition, and that's why treat them a bit more seriously and with a bit more enthusiasm, rather than just trying to be a professional robot. I think that's, that's something really important. Because the person is already damaged mentally, which you can't see, but you know that he is damaged. He has come to you for help. So try, try to help him as much as you can. And be, you know, sort of show some kindness, and some sort of understanding towards it, so that the other person feels like, 'My doctor cares about me.'

Ali believes his mental health problems are caused by a chemical imbalance. (Played by an actor).

I think it's a chemical thing. Because I'm personally come from a science background, that although I'm not a doctor, but I do understand okay, so it's chemistry. It's some sort of chemical that's, chemical level that's high or low in my brain that's causing all of this, so I think medication probably is the best way to fix that, personally.

And I mean so how does that fit with, if you think it's a chemical imbalance, how does that fit with what we talked about earlier about some of the things that you thought had maybe had led to your depression. Do you see what I mean?

Yeah. No I think the chemical balance obviously is something to do with your moods and, you know, you've had these ups and downs, and ups and downs, and that sort of probably created the imbalance permanently. It's like you're in a void, you get your leg amputated. So, you know, what I mean? Like it's unusual circumstances that get you damaged. So I think it's trauma, up down, up down, and your brain sort of becomes, you know, unstable.

Ali sometimes wonders whether God is out to get him. (Played by an actor).

And personally my relationship with God hasn't been very smooth. I tend to complain a lot, but I do tend to believe that God does exist, although I don't offer my prayers and I don't do the usual religious stuff, but I do tend to believe that God does exist, and he's probably there to get me or something [laughs] torture me, give me a bad life.

Yeah, this is actually my belief that if God goes after someone then he just completely annihilates their life. It's like, you're born poor, and without legs, and you'll have all sorts of tragedies going on in your life. It's like, I don't know, you'll be born in a famine-ridden country and this and that. It's just absurd. It's, I don't know if God does that or, but, it's, I can't explain it. You'll probably have to improvise on my relationship with God, but it's sometimes, I don't know, I believe he doesn't exist. I want to believe that he doesn't exist, but I can't believe that he doesn't exist. I think that's, that's probably the correct statement.

Ali believes that his depression is caused by a chemical imbalance that will cause permanent...

No I think the chemical balance obviously is something to do with your moods and, you know, you've had these ups and downs, and ups and downs, and that sort of probably created the imbalance permanently.

Right.

It's, it's like you're in a void, you get your, you get your leg amputated. So, you know, what I mean? Like it's unusual circumstances that get you damaged. So I think it's trauma, up down, up down, and your brain sort of becomes, you know, unstable.

Mmm' I mean in the analogy you've just used, your leg being amputated is pretty irreversible isn't it?

Yes.

Do you think that a chemical imbalance is something that's irreversible?

I think it's permanent damage, I think. For the time that I've had, I think I believe that it's permanent damage. It's I don't see it to be fixed in the near future. I don't. All I probably now expect is for it to come to a certain level, let me accept who I am, and probably move on from there'

I suppose my main question would be is there a cure? How, how the hell can you cure it permanently? Just get rid of it and be normal again. That's what I want to do. That's what my goal is.

Ali says he has problems with women and can't get a girlfriend, although he's always been able to...

So basically I had, I've had massive huge problems with women. It's like some how I repulse them. I'm okay, I'm actually excellent with people who I want to be friendly with and I have, I would consider, excellent people skills. Wherever I go, everyone knows me, I know everyone. But starting the relationship with a girl is something that I've found near impossible. It's like, I don't know what is wrong with me in that respect. I've tried to analyse it so much, so much, but I couldn't. Sometimes I would come to a conclusion that, 'Okay, I'm not good looking enough', but then later on, you know, I would see that, okay, there are people out there who have good personalities and that's I think all there is that counts. But I think it's something in my head that stops me from doing it. I don't know what that is. I've never been able to identify it. Friends have always been there. I've always been able to make friends'

There was a period, about one year period, in the past two, three years where I couldn't even speak to a woman. That was something that was - and then people started judging me, and people started making remarks, and I became a real weirdo. It was like a very anti-social person who lost all the confidence, and very, very self conscious. I am all those things right now, but I sort of put a mask on me successfully. And I think it worked anyway. And that, I think that was the lowest point of my life, where I would feel so sad and so down that it was unbelievable, it was beyond help. And I don't think it was beyond help, but I never seeked help, that's the thing'

I mean I mentioned women. I mentioned my lack of competition, self esteem, confidence, but I think these things are lost because of depression. Depression is not there because of them. I think they are because I had depression and lost all these things.

Ali tried talking therapy and although he felt better he found it boring and wanted something...

So anyways I went directly to the psychiatrist and he told me that, 'I'm not going to give you any medicine.' Maybe he would have given me the reason that I was too young or something like that, which I can't remember. But mainly he told me, 'Look, this is a psychologist. She works in this hospital. Go and see her, and have a few sessions with her, and then we'll see how things go.' I said, 'All right.' So I went to see her I think altogether about three times, where we had a one hour session each time, more or less, and she didn't charge me anything or anything like that. She was very nice. She listened to everything. She was actually a college professor, and a psychology professor. So she listened to me quite a lot. And she gave me quite a bit of time, and I felt actually better during that therapy. 

But at the end of the day I think I was just too young to be patient enough to keep on going to therapy and talking about rubbish. I think it becomes a bit boring as well after a while. You know, 'This happened, and that happened.' You need a fix. You know what I mean? Like your mind isn't working properly. You are in pain, you need a fix. You don't want to talk rubbish for months. You just need a fix. So I think I was just too impatient. I was probably doing drugs as well. So, you know, I thought, 'Sod it.' And that's it.

Ali feels guilty and helpless, and has suicidal thoughts which seem to help to lift his spirits. ...

I feel guilty. I think that's probably a part of depression. That's, guilt is something that - and I think it's probably because of my upbringing as well, because guilt was something that my mum used quite often to manipulate things wherever she could, and I think she still uses it. Not to the extent that she used to, but she still does use that. So I think that feeling guilty for no reason comes from that. And it's, it's a really pathetic feeling, but I even know that I'm feeling guilty without any reason, but I can't help it. So that's... you know what I mean? Like if you know what the problem is and you can't solve it, then you feel helpless, and when you feel helpless then, you know, you feel helpless. You feel more and more down. You feel like you can't do anything about it, so how do I solve it?

So the eventual solution that you think in your head is, 'All right, so kill yourself or something.' But I haven't actually attempted it, ever. I've always thought about it and suicide always gives me a sort of relieving feeling. It's like when I hit the pit and I'm thinking, like, 'What the hell should I do?' and my mind is basic, my mind just starts killing myself. And at that point, I think, I think to myself, 'Okay, if worse come to worse happens and I can't do absolutely anything, then I'll kill myself. But am I ready to do that?' And then my, I sort of start thinking, 'No, I'll give it another shot. Maybe next night.' And that sort of lifts me up, actually, in a funny way. It's, suicide is like I use it as a counter-suicide mechanism [laughs], if you will.

Ali has created imaginary friends to ease his depression.

Is there anything else that helps you manage your, you know, your symptoms?

My talking to myself. I have a complete - yeah, I never mentioned that. I have a complete imaginary life'

OK. So I have imaginary friends. I have , I can't see them, that's the main thing. I'm not schizophrenic. I can't see them. I know they are imaginary and they have their own personalities. We have loads of fun. This can - again sense of humour is a huge part in there. Anything that I can't have in the real world I tend to sort of get that in my imaginary world. I talk to myself quite a lot. Sometimes it's actually the other person talking to me, my imaginary friend, but I know it's the imaginary friend talking to me, but I still like to verbally say it out loud, and I do say it. And I think that's, that's actually a, like a constant source of amusement for me that I can switch on any time I want to. I have complete control over that.

And for example, I'm here, sitting in a room, waiting for someone, I have nothing to do. I can just switch it on. And I can spend fifteen, twenty minutes with my mates. And it's not like, it's not that easy. It has some sort of mental exercise involved in it. But most of the time, 60, 70, 80% of the times I can switch them on, switch them on and they tend to provide me amusement and this and that. And I'm, for example, I'm feeling really down. I'm feeling like shit. And you know, but I can switch on my imaginary friends and they would throw in a few comments here and there, and be funny, and I have the ability to laugh at myself. That's one thing, you know, that helps me quite a lot in my depression. And they'll make a few comments on myself and I would make a few comments on them. And that would, that's one thing that can lift me up. That's, that's a big, big counter - what do you call it? - counter-measure towards depression, I think.

Mm. And how long have you done that for? 

I think this has been there since I was about 12, 13. This has been there. This was I think because no-one ever listened to me. I was surrounded by adults in my childhood, most, most of the time. My mum always used to object to all my friends. I did have friends, but there was a limited relationship with them. Cousins were not there that often. I didn't have many cousins who were my age anyway, they were again quite different age groups. So this, this was as a result of no-one actually listening to me, so I created my own world where people would listen to me. 

And you said you're completely in control of that?

Yes.

So the, the responses of your imaginary friends are responses that you imagine. You make them say what you want them to say?

Yeah, but it's still funny to me, which is strange. It's still funny to me, although I'm thinking myself indirectly, but it's still funny to me'

And I mean, do you think that is something that other people do or do you think it's something that's quite unique to you?

No, I think it's unique. I wouldn't think any one else. Not many people, I've known people do it, but I don't think many people do it. I think even talking to yourself is probably unique. But that might be a bit more common though. Because I know people babbling to themselves time and again. But I think I do it more than any other person. But this thing, the imaginary friends and, they're sort of, they are like mood enhancers and also boredom killers, and whatever you want to call them. They can just chip in any moment. 

Ali says keep struggling and maybe you'll find a solution.

I haven't found a cure, so I can't give like a very optimistic message to everyone, but I suppose 'Fight' would be the best thing. 'Don't give up and just keep struggling, keep trying. And maybe you'll find something, a decent solution one day', you know? It's all about fighting. But you do tend to feel unfortunate that, 'Why the hell do I have this?' But I suppose these feelings don't help. So at the end of the day, 'Just keep trying, keep fighting, keep trying to find new ways to tackle it.'

Ali's considering going to a support group, but finds the idea a "bit daunting". (Played by an...

Have you been to any support groups or anything like that?

No.

Is that something you don't'?

I don't know of any. If you know of any, phone me references, I'll go there. I'm willing to try anything. I'm, I'm sick of it. I'm as sick as you get.

Is it something you think that would be helpful, talking to people?

I don't know. I don't know. If there's anything you try it and then you see how it goes. But being in a lot of people itself might be a bit daunting for me. Sometimes it is, sometimes it isn't. That's again undefinable. I don't know. But yeah, I'll probably give it a shot. Yeah.