Mind Control II: Overcoming Alan

“If you have HIV or cancer or athlete’s foot you can’t teach them anything.
When Ashley Stone was dying of meningitis, he might have known that
he was dying, but his meningitis didn’t know. Meningitis doesn’t know
anything. Buy my illness knows everything I know. That is a difficult
thing to get my head around. But the moment I understood it, my
illness understood it too.” – Matt Holmes, from The Shock of the Fall
by Nathan Filer

Since I read Man’s Search for Meaning (http://bit.ly/1Eag3f6), I have been trying to work out how I could use it to combat my own depression.  The thing that I have struggled with is whether, when I am at my worst, I retain the last “human freedom”, or can depression be defined as the inability to choose one’s response.

In my first post (http://bit.ly/1zGnn78) I described my breakdown as a complete loss of control of my own mind.  How could I have had a choice, if I had no control over my own thoughts?  Then again, I also felt that suicide was inevitable, that I would not be able to stop it.  If that was really true, then how am I still here? Did I still have the ability to choose? Was I able to regain control, even for a split second, or did I have control all along?  The problem is of course that I have no way of ever knowing for sure what happened, let alone what I was thinking at the time.

The quote above, from Nathan Filer’s moving and uplifting novel The Shock of the Fall, is written by the 19 year-old schizophrenic narrator Matt Holmes. Not only does this seem to describe one of the inherent problems in diagnosing, treating and even understanding mental illness (i.e. the fact that it is impossible to be objective about, or sometimes even describe your symptoms), it has been a useful weapon in my constant battle to stay in control.

Obviously, schizophrenia is very different to depression, but thinking of my illness as an “it”, or even better a “he”, can be very helpful in recognising when I am suffering, and most importantly giving me an early warning to seek help.  This idea was brilliantly articulated by Niall Breslin, well-known Irish musician and former gaelic football and professional rugby player, in a powerful and brave speech about his experience of general anxiety disorder.  If you have not seen it yet, you really should: http://bit.ly/1A50rIL.

In the speech, “Bressie”, as he is better known, explains how he personalised his illness, gave it the worst name he could think of, and fought back by doing things that he knew “Jeffrey” would hate, which, as Jeffrey was a part of him, meant facing his own fears.

I have fully adopted this approach, although my depression is called “Alan”.  Not only is this an incongruous name for something so powerful, but I imagine my depression having the voice, social skills and worldly experience of Norfolk’s most famous son, Alan Partridge. Although I am not going to buy a Mini Metro, or support the pedestrianisation of Norwich City Centre, I know that the two things that my Alan hates most are writing openly and creatively about himself, and running up mountains.

This is perhaps why the blog has been such a release for me, and a massive turning point.  Like Bressie, my life has become so much brighter as a result of telling the world about my experiences, and the incredible response that I have received has only made me wish that I had done it sooner.

This is not to say that anyone with mental health issues should do this.  Everyone’s story is different, and all I can do is tell my own.  More importantly, this is only a very small part of my treatment.  I am very, and unashamedly, reliant on fairly high doses of medication, regular therapy, and having so many people looking out for me.

Moreover, there is not, as far as I am aware, a cure for my illness, and my life will be a constant battle for control. At the moment, I seem to have the upper hand, but can I promise that I will never be back to where I was at around 5:30pm on 7 February 2014? No. But what I can promise is that I will do everything in my power to keep Alan from Bouncing Back.

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Mind Control I: The Last Human Freedom

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“Between stimulus and response is a space. In that space is our power to choose a response. In our response lies our growth and our freedom”
– Dr Victor Frankl, Man’s Search for Meaning

Of all of the quotations that I have, or will, post on my blog, this is probably the most powerful.  Dr Frankl was an Austrian psychologist and concentration camp survivor, who lost his father, mother, brother and pregnant wife to Auschwitz.

The German title of the book gives a much better idea of what it is about: “trotzdem Ja zum Leben sagen: Ein Psychologe erlebt das Konzentrationslager”, which roughly translates to “…to say Yes to life none the less: A psychologist experiences the concentration camps”.

The main message that I took from the book is that situations, circumstances or people can take away everything a person has, except the “last of human freedoms”; the ability to choose his or her attitude, to be “worthy of their suffering”.

To even survive what Dr Frankl had to endure, to rise above the unimaginable horror, let alone use it to create a school of psychotherapy that is still used today to treat a number of illnesses, is incredibly empowering. One of the main tenets of his theory, logotherapy, is that life has meaning in all circumstances, even the most miserable ones.

It was only while reading the book that I realised that I had received this message before, and in the context of running.  In 2012, I ran the Paris and Edinburgh Marathons in aid of the fantastic charity Freedom from Torture (http://freedomfromtorture.org). Many of its clients have been through horrific experiences, yet were able to establish a new life, and use what they had been through to help others, much like Dr Frankl.

I have used their example to get me through many a race or training run: to ignore the feeling that I can’t run another step or that I should never have started in the first place, and to remind me that whatever it is that I am experiencing, it is most definitely not torture.

I am reluctant to link the suffering of concentration camp inmates and torture survivors to running around two of the most beautiful cities in the world.  What makes me do so is one of the other powerful messages from Man’s Search for Meaning, which has been instrumental in helping me come to terms with my illness.

One of the most misunderstood aspects of depression seems to be that a person needs to have a reason to be depressed.  Compared to most, I have nothing to be “depressed” about. I have a stable, supportive family, a good job, nice house, great friends, a beautiful, loving and supportive wife and two boys who I could not love any more.  If people can live through persecution, torture, poverty and other extreme physical or mental suffering, how weak and cowardly must I be to be unable to cope with another day?

This does of course ignore the fact that depression is an illness, and in my case most likely caused by a chemical imbalance, so is in a way a “physical” rather than “mental” disorder, like diabetes or asthma.  At times I find it very difficult to remember or even believe this, particularly when I am feeling low, but I cannot argue with Frankl’s conclusion that:

“…a man’s suffering is similar to the behaviour of gas.  If a certain quantity of gas is pumped into an empty chamber, it will fill the chamber completely and evenly, no matter how big the chamber.  Thus suffering completely fills the human soul and conscious mind, no matter whether the suffering is great or little.  Therefore the “size” of human suffering is absolutely relative.”

This seems to me to be essential in combatting depression, both for the sufferer and those around them.  For the sufferer, one thing that he or she should never do is feel guilty or ashamed, or compare his or her situation to anyone else’s. As importantly, no-one should assume that an objectively “good” life makes a person immune from depression or suicidal thoughts.  Spotting the signs can be very difficult, particularly for long term sufferers that have become adept at hiding the inner turmoil, but talking openly, and reducing the stigma around depression and suicide, can, and indeed have been incredibly effective.

As described in the Guardian last week (http://bit.ly/1FohyM4), the NHS is running a number of pilot schemes to reduce the stigma surrounding suicide, based on the incredibly successful programme in Detroit, which has reduced suicide by 82%.   What someone suffering from depression needs most is professional medical assistance, in many cases (such as mine) it will take a family member, a friend or a colleague to get this.

Moreover, even a stranger could be the catalyst needed for a sufferer to get help, or to divert him or her from taking the final step.  The details of my darkest hour are for another post, but what I can say is that a woman who I had never met, and am very unlikely to meet again (particularly as I can’t really remember what she looked like), saved my life with the smallest act of kindness.

Injury

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“Pain is inevitable, suffering is optional”
Unknown (but definitely not Buddha)

Particularly if you are me (at least the first part)…

In addition to the idealistic reasons for writing this blog, one of the main drivers has been to stop me climbing the walls while recovering from the latest in a long line of injuries. Despite Mont Blanc Marathon only being 10 weeks away, I have managed no more than a dozen runs since October 2014, after giving myself capsulitis (basically a frozen hip), in a vain attempt to build a rudimentary level of upper body strength after slipping mid-way through a single-leg press up. The picture above is an x-ray of the cortisone injection that I had in my hip joint, on my birthday, earlier this year. It was by far the most pain I’ve ever experienced, at least physically. Hardened athlete that I am, I cried a little, almost passed out twice, and had to hold the nurse’s hand for most of the procedure.

In fact, this picture, or at least my attitude to it, was what finally made me start the blog. I happily posted the x-ray, of an intimate part of my body, during an incredibly painful procedure, on social media without a second thought.  However, at that stage I had not mentioned anything about my breakdown or struggles with depression. I felt compelled to share a great article by Yvonne Roberts about male suicide (http://gu.com/p/45t9n/sbl), particularly as it was written almost exactly a year after my breakdown, but it took me three hours to pluck up the courage to post it. As a strong believer that mental illness shouldn’t be talked about any differently to physical illness, I realised that not re-posting or telling people about my experiences would be hypocritical in the extreme.

Unfortunately, capsulitis was not my first injury, and definitely will not be my last. Except for an unavoidable IT band inflammation, and plantar fascitis, most of my injuries have been self-inflicted.  I have managed to do the following while exercising:

  • fracture my ankle and go face-first into a pavement while working out how to get past a slow moving bus (the bus was full so the embarrassment was as painful as the fall)
  • sprain my other ankle in confusion at seeing a parakeet on Peckham Rye Common
  • bruise my foot by kicking an umbrella on the sidelines after missing an open goal
  • hit myself in the face with a kettlebell
  • cut the bottom of both of my feet in an attempt to avoid a dropped milk bottle
  • trip over after being surprised by a family of racoons in Central Park
  • run crotch-first into a bollard after shouting at some teenagers for purposefully getting in my way

Like many amateur running obsessives, I am a terrible patient. I am grumpy, irritable and as soon as I am able to get back to it, I ignore doctor’s/physio’s/partner’s advice and try to pick up where I left off with my training.  One of the few advantages having an illness like bipolar disorder is that I can blame faults like this on the illness, rather than my own natural impatience and lack of discipline.

PS – I was tempted to write this week about a certain former Apprentice contestant and Hitler impersonator’s tweets about depression but: (1) I didn’t want to give her the satisfaction of mentioning her name, or by repeating her abhorrent and potentially dangerous opinions; and (2) Jenny Bede has already published a much better response than I ever could in her brilliant Marathon Woman blog in the equally brilliant Standard Issue magazine: http://standardissuemagazine.com/health/marathon-woman-weeks-11-12/.

This post is brought to you with massive thanks to Mike Davis and the rest of the team at HFS Clinics (http://www.hfs-clinics.co.uk/), for getting me back to running as quickly as possible on a regular basis.

07/02

“a man devoid of hope and conscious of being so has
ceased to belong to the future”
– Albert Camus, the Myth of Sisyphus and other Essays

Friday 7 February 2014, around 18:00.
Sitting at my desk (not unusual), staring at my screen.
Looked around, surrounded by piles of paper and coffee cups (also not unusual).
Photos of my wife and two boys looking back at me.
Got to focus. But on what?
Why are my hands so cold?
Right, no more messing around, just get this done and then go home.
Why is my hair wet, and what the hell is wrong with my hands?

Trying to get myself to concentrate, or think about anything at all, was like trying to start my first car (an H-reg Vauxhall Nova Flair). Turning the key pumping the accelerator, adjusting the choke, a splutter, then silence.  Try again, still no luck. Panic setting in, what if it never starts?

Like my beloved Nova, all of a sudden my brain kicked into life with a roar.  As soon as the noise died down it hit me, I had just come back to the office, but had no idea where I had been, or for how long.

It was at that point that I was forced to admit, for the first time, that something was very wrong, although I would only fully understand how wrong when I eventually worked out where I had been, and what I nearly did.

Up until 18:00, 7 February 2014, I had been convinced that I was a perfectly healthy, and very lucky person, the only problem being that I was too weak, too stupid and too selfish to function as a normal human.

And so it was, after 36 hours of blind panic, I found myself in bed, violently shaking but otherwise convinced that I could not move, even if the bed spontaneously combusted.

One of the best descriptions I have read of depression is that it is not the presence of sadness, but the absence of hope. For me though, at this point, it was the absence of anything at all, except for alternating feelings of panic and exhilaration that I had completely lost control of my own mind.

There has been a lot written about the state of mental health care on the NHS, but for me there is no better illustration than the conversation I had with NHS Direct, while I was lying in bed, shaking and terrified.  I was really only asked one question by the nurse and the doctor, and that was whether I was imminently going to harm myself or my family.  My honest answer to this was no, but this was not because I did not want to, in fact hurting myself was all I could think about, but because I felt incapable of getting out of bed.

I was thus informed by the doctor, and these words will stay with me forever, that NHS Direct “can only deal with urgent cases, and yours is not a priority…”. I was told to that I would have to wait to see my GP, despite the fact that my appointment was nearly two weeks away, and my wife had already asked for urgent help due to her concerns about my mental state and my denial of the situation.

From that point on, thanks to a swift intervention from my incredibly compassionate employer, and Bupa’s fantastic mental health team, my “non-urgent” case was taken out of the NHS system altogether.

I am painfully aware how lucky I am for this, and for the unerring support of everyone around me, particularly as many who suffer from mental health issues, particularly men of my generation, are not so lucky.  I am prone to melodrama, but in this case I do not think that it is in any way an exaggeration to say that it saved my life.

In addition to lots of running geekery, I am going to write a bit more about how I got to this point, and what I am doing now to stop myself from getting there again, which is really unavoidable, as running and my mental state are now fully intertwined.