Friday, 7 April 2017

Depression: #LetsTalk

All photographs in this post are part of a series documenting his experience of depression and anxiety by Edward Honaker.

This year’s world health day (WHD) theme is Depression: Let’s Talk! I’m so glad more awareness of Depression (clinically known as Major Depressive Disorder, for ease I’ll refer to it as MDD) is going around, but unfortunately I have a feeling it may be due to the increasing rates of diagnoses of the disorder itself.

So, big disorder, big problem, why don’t we fix it? There’s plenty of drugs around there, pop a pill and you should be alright, right?


Medicine and science may be the most advanced it has ever been, but MDD alongside other debilitating disorders (Cancer, HIV/AIDS etc.) remain a mystery. Our current understanding of MDD is vague, and the source of controversy in some areas of the scientific community. The major school of thought on the mechanism of depression is the Monoamine Hypothesis. The hypothesis states that the main cause of depression is due to poor monoamine function, which is backed up by the efficacy of antidepressants – Antidepressants work by targeting those specific neurotransmitters (Dopamine, Serotonin and Norepinephrine) and bring them back up to functioning level. However, it hasn’t worked in a certain population of people known to be “Treatment Resistant”, theorizing that the monoamine hypothesis may be either incomplete, or a completely different mechanism of function is involved.

Neuroimaging has been a huge help in our understanding of some aspects of MDD, mainly cognitive ability. There is an entire world of literature of cognitive dysfunction and MDD, but to sum it up for you – there are differences in the cingulate cortex, prefrontal cortex and amygdala between your average mentally healthy Joe, and chronically depressed Joe. With this in mind, it’s very important to remember that depression isn’t just being sad. Your brain anatomy is completely altered, so it’s no wonder you can’t get through the day without crying after a rubbish night of sleep, having poor concentration at work and subsequently getting fired. It’s been a tough week for depressed Joe, huh?
Although incurable, that’s not to say you should give up any hope of getting rid of the disorder. Cancer patients go through chemotherapy and go into remission don’t they? Same principle. 

Antidepressants have managed to help people go into remission, but it depends on a bunch of factors so it’s good to pay attention to your body and how you respond to different treatments. It’s not a one stop cure – you will have bad days, you will still have some symptoms that you can’t get rid of and that’s okay! The treatment is there to make things easier for you, and even if Joe has put on 5 stone in the last year and still has issues sleeping, a few OTC sleeping pills and a gym membership can help out (if Joe wants it, he may decide he likes his chunky new booty!), or a higher dose of medication, or a completely different kind of pill altogether! Joe felt awful on Sertraline but is living his best life on Citalopram, 2 different pills from the same pool of meds.

 I’ve been living with a depression diagnosis for around 7 years, and I’m genuinely surprised I’ll be making my 24th birthday next week. It’s a volatile mistress, very temperamental and can get very upset if not treated efficiently on time. She’s angry and wounded, out to hurt everyone and everything in her vicinity, but after so long she’s easier to control. I don’t completely understand her, but I understand what makes her tick; how to tame her. To me, it really is its own entity – you know those cartoons of black clouds to represent sadness? It’s very much like that. No matter how many shelters you hide under or how many umbrellas you hold up, nothing stops the rain soaking through. Luckily, I found a pill that worked the first time round, and have been on it for almost 6 years now. It’s an umbrella under the cloud, strong enough to handle the lightning that destroyed the others, a cage to keep the evil mistress inside, and an absolute life changer. Without it, I wouldn’t be where I am today. I wouldn’t be here telling you this.

Do I plan on going off it? I’ve tried several times and failed miserably, but I will try again when I’m ready. One bit of advice – just because you feel great after a few months, it doesn’t mean you’re ready. Imagine breaking your leg and being given crutches; after a few days you can walk using your crutches and you feel great! You decide you’re ready to start walking on your own and go outside into the sun and decide to go for a walk, but you fail miserably and fall to the floor, angry and hurt. What should you have done? Did you have something there to lean on in case you fell? Did you have a backup plan should you fall to help you get back up again? Was a friend there to help you? Did you prepare? These are things you need to consider – if you were to feel depressed again, do you have anything to fall back on? A support system? A coping mechanism? Anything to stop you going back on the pills again? Because once you get back on crutches you’ll not only be hurt, but angry at yourself, making things worse.

I hope the theme this year helps you to talk, seek help or understand a friend better. Depression is one of the biggest killers out there, it’s strong, merciless and once it gets hold of you, it’s very hard to get rid of. Let’s talk about it. 

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