Ok so this is awkward

[Outside observing]

Hi! I am depressed!

I am also good at wearing a mask of calmness and concern for others at most times and so it feels awkward to be honest about it. At least I know I'm talking to people who know what it means to have depression.

Dysthymia has been with me since I was about 15. I have had about 4 major depressive episodes. I suffered alot of bullying by exclusion as a child and my family, well, I haven't spoken to my brother or sister for years (nor they to each other) and I do not speak with my parents about anything that concerns me or about my feelings in general. I haven't been able to do that since I was 9 or 10. I just shut up about what concerned me with them because well - they weren't very helpful. I was being bullied at school and their advice to me was to ignore it. So I ignored it and spent my lunchtimes in the library. I ignored the fighting in my home between my brother and sister and parents and spent my time in my room reading books.

I am 42 now. I have no kids (although I would have wanted them dearly, and am very maternal at heart) I do have a partner who is the most kind and patient person I have ever known. I withdraw from him too.

I was terribly depressed in my late teens and twenties. A few things worked for me to get me out of it though. I discovered there was a lot of meaning in giving to others and listening so I studied first to be a personal carer. An antidepressant also helped. I used a few CBT strategies. By my late 20s and early thirties I had a semblance of a normal life and studied medical sciences and then medicine (yes I am a doctor and yes I feel very awkward posting here because most of you guys come to see us for advice and it might make you lose faith in medicine if you knew your doctor wasn't doing very well in their personal mental health department. Please believe me, when you go to the doctor the time is yours, for you, not for the doctor. The doctor uses their professional knowledge to help you. )

I am now reaching a downward part of my cycle which goes like this... Be on antidepressants, give to others, work hard, have some achievement and social interaction at work, feel good enough. When feeling good enough; stop anti-depressant because don't like side effects. 6 weeks later feel like shit, don't get out of bed, think of all the terrible things that could happen to patients constantly. This cycle has been going on for five years now and am gearing up to tackle it again.

[Croix]

Dear Outside observing~

Thank you for posting, as we are completely anonymous there is no problem in talking about yourself, no matter what occupation. We do have here other health professionals here of various types, discussing and helping.

As one would expect you have a pretty clear grasp of the situation, and a personal and theoretical understanding of the problem.

You also have gold in the person of a supportive partner.

I guess you may be in an awkward situation concerning your profession – I have no idea, however I suspect that many occupations restrict activities of persons with mental illness. That combined with your phrasing leads me to question if you are self-treating or under proper qualified care?

This may seem an impertinent question and if so I apologize. Similarly if the following is inappropriate under the actual circumstances.

I know in my own case, I was a policeman, at a time when mental illness was not understood or catered for.

I hung on for years just getting the worst of the physical symptoms treated privately. Eventually I was referred to a psychiatrist who suggested stress related disorders but I refused to take that on board and minimized the problem. This was partly from ignorance and partly feeling that I was unable to lose my career and cope with any aftermath.

Unfortunately I reached the stage where I simply could not function, and was invalided out of the force. Due in part to the length of time involved, and also to the types of treatment available at the time (70’s-80’s) I am still not ‘cured’ but manage a pretty good, if rather restricted, life.

You can see the moral of the story from miles away. Appropriate timely professional help is a must, irrespective of occupational consequences. No, the resultant change in life after the force was not in the least easy, it is only many year later I can look back on it with a semblance of equanimity.

The point there is I can look back.

I’ve used up most of my allotted words talking about myself, hopefully having not missed the point.

Apart from that the obvious, which you would have already considered, is the AD on/off cycle. Can anything be done to modify that?

Although you seem satisfied with your life choices, are they good for you? Being a policeman – a lifetime ambition - wasn’t for me

Please post again, here is care & understanding

Croix

[Outside observing]

Thankyou for your reply Croix. I am not seeing a doctor currently. I need to though. I keep procrastinating on making the appointment. I just want to avoid it. I doubt there would be professional consequences at this stage. My performance at work is actually very good, certainly safe. My managers are happy with me. I have never self-treated. That would go strongly against my ethics. I also don't abuse drugs or alcohol (and never have) and that would be the biggie in terms of professional consequences/restricted practise in doctors. My biggest sin is smoking three cigarettes a day. In terms of work I believe I am safe - its just that work is one of the things that worries me most and wears me down and stresses me out. . Believe me, I would know if I stopped being a good doctor; I hold myself to unrelenting high standards and the more depressed I get the more I hold onto them and well - that's part of the problem.

I don't self treat but I have often withdrawn from treatment (antidepressants) thinking that I didn't really need it as my mood was good (although I know that if you've had 3-4 relapses of major depression, well, you're probably better off on antidepressants for life). That's where I fall down. I fall into a bit of a heap at home in order to continue to shine at work and that's the only thing that wakes me up. I go to some disinterested GP and tell them about the antidepressant which has worked for me in the past. They give me a script. If they're slightly interested they might give me a referral to a psychologist. I go to one appointment with the psychologist and feel slightly better having got out my story and don't go back.

What I need to do is this; trial an antidepressant with fewer side effects than the one I know that has worked for me and get some long-term psychotherapy.. I know this, but I don't act on it.

Croix, your post has helped to give me a necessary wake up call. If I don't get help now, then what? Your story reminds me I have an opportunity to catch this early. I have every opportunity handed to me on a plate to get this under control..hearing your story makes me feel like I really need to. You didn't have the opportunities, the supportive culture, the ease of accessing appropriate medical treatment like I do. I feel like a spoilt brat in comparison to what you must have gone through. The opportunities are before me...I just have to make those calls. Now that you have told me your story, I will remember it.

with thanks

[Croix]

Dear Outside Observing~

Your response and thanks is appreciated. I do believe you know what to do.

I'd hazard a guess as to your reluctance to follow though on psychological treatment and I believe you do know what is needed. Also as you would know the A/D on/off cycle is common and preventable.

So what does that leave me to say?

First my example will fade in your mind surprisingly quickly.

Secondly a partner who is supportive deserves better throughout his life than periodic withdrawals.

If you let things get to the stage you really crash -and that was for me unexpected, I froze in court - then you may go though your life, and no matter what else you do, you may think it second best.

You have my best wishes and sincere hopes

Croix

[Croix]

Dear Outside Observing~

I noticed you 'supported' my post here today and wish to welcome you back. I'm sure a lot has happened since we last spoke and would really like it if you felt like bringing us up to date.

I hope the depression is less now and you are able to resume doing all the things you  value

Croix