oakleythoughtso

The other thing that makes depressive illness a little difficult to understand is that it affects people so differently. And there is no true way to quantify it. Yes, there are surveys, and scores, and all that. But many practitioners in the field of mental health are wary of those, and so they are not always utilised. 

So it was with some trepidation that I made an appointment to see my GP. She was wonderful, and offered to put me straight onto anti-depressants. I was concerned on a number of fronts, and asked about other options. I argued that I wanted to continue breastfeeding, and that I didn't want the drugs to be anywhere near my baby. I was under-informed at this point, but my GP recognised a brick wall when she saw one. She referred me for some counselling [and later linked me up with a PND group called "Moving Forward"]. 

Counselling. I was actually quite looking forward to it. Having a chance to air my thoughts with a professional. I went to see one of the Maternity Support Workers who was based at the hospital where I had given birth. She was a former psychiatric nurse. Problem number one: I believe she had seen so many people in terrible psychological states that anyone who could string a sentence together was perceived by her to be 'fine'. She was, therefore, a minimiser. Lesson number one: it doesn't help to downplay the situation, to point out that it's 'not really all that bad'. That just makes a depressed person feel that they are being a malingerer, and should really just pull their socks up and get on with things. (The truth is that they actually can't. If they could 'shake it off' or 'snap out of it', don't you think they would?)

Problem number two: I just didn't like her. Now, I know that sounds petty, but it's actually a key factor in determining how successful counselling will be. Lesson number two: find a counsellor that you respect, and can easily talk to. You don't always need to agree. You don't have to feel an affinity for them as you would a friend. You do need to be able to spill your mind's inner workings. And you do need to be able to stomach what they might say. Some of what a good counsellor will say will be tremendously encouraging and affirming. Some of it will be tough to hear, and even harder to implement. But a good counsellor is paramount to good management of depression. I would go out on a limb and suggest that you cannot reach a good level of mental 'wellness' without some counselling, even if you have no significant traumas to re-hash. The reason I say this is that, especially during early parenthood, it is well nigh impossible to find the time to commit to thinking about all the dross you need to work through, let alone making any sense of it. 

Problem number three: my first counsellor was not all that sure I had depression. She cast doubt after doubt on the diagnosis, which left me feeling confused and even more angry. If it wasn't depression, what was it? Go down that thought-path for too long and all you're left with is the conclusion that there is something very wrong with you. This is a particularly common experience for depressed mothers: "I'm a terrible mum" is a regular self-accusation.

Lesson number three: high-functioning does not necessarily mean that everything is alright. People who have a high capacity to push through immense pain can really look fine, when inwardly they are far from it. Just as people have differing pain thresholds in the realm of physical pain, some people are better at holding things together in the arena of mental anguish. I might venture to add that this is particularly the case with mothers of small children. They are physically forced to attend to their children's needs. They must function. It takes a greater crisis to knock them flat. If they have a breakdown, they appear like a car driving along the road on a couple of blown-out tyres, rather than a smoking, stationery vehicle with its hazard lights blinking. 

Lesson number four: if you see someone struggling, it's quite possibly worse than it looks. Offer help. What is the worst that could happen? That you'll be knocked back? Well, then the ball is in their court. That you'll be asked to do too much? Well, then set some sensible boundaries around what you're willing to do. People - especially mothers of small kids - do need help, and don't like to ask for it. Accepting help is easier. And you know what the best thing is? Offering something specific. Handing over a lasagne is much more helpful than asking, "Is there anything I can do to help?" People who are struggling to survive depression have trouble thinking. It's just so much effort. For me, it was as though my mind was filled with mud. Thinking through this mud was slow, difficult, and required more effort sometimes than I could find the energy for. 

I was blessed, again, with a wonderful GP who took me seriously when I said the counsellor wasn't helpful. She referred me to a fantastic counsellor with a good deal of experience with female mental illness. She became an important helper in my recovery process. 

My final note today is an example of what NOT to look for in a counsellor.