Depression - Stefan's story

Blog by Dr Imren Sterno – Lead Consultant Clinical Psychologist, AXA Health

A story about depression….

Depression – it’s a word we hear a lot, but how it feels and what it looks like can be hard to describe.

Below is Stefan’s story of his depression and how it impacted his life, his loved ones and his ability to work and engage in the world. I was part of Stefan’s story, as I was his treating therapist, and I have written this story with his consent and have changed his name and some of the details to maintain his confidentiality.

An overview of my experience

When I was 27 years old, I started to notice a change in myself. It wasn’t obvious to anyone else and it wasn’t overnight. It was like a ‘slow burn’ and build up into something I never imagined could ever affect me.

At the age of 28 I was diagnosed formally with depressive disorder (commonly known as depression) and sectioned for 2 weeks in hospital due to my sense of hopelessness and risk to myself. If someone had said to me when I was in my early 20s, at university in London, that I would be sectioned under the mental health act at the age of 28, I would have laughed.

This is my story, and my experience I am sharing with Imren (Dr Sterno), in hope that it starts a conversation about clinical depression and the taboo of men’s mental health in general.

The early years

I grew up in a big city, was one of 4 children. My parents were in IT and we had a comfortable life. I never wanted for anything, went to a private school with all my siblings and had a lot of friends. During my teenage years I was a keen swimmer, won medals and took part in a lot of regional and national competitions, and played the trumpet in the school orchestra. I was active, busy and took part in all aspects of school life.

When I was 12 years old I went to national swimming competition and was desperate to do well, I trained too hard and got myself worked up. I ended up coming third and did my worst time for that race. I remember everyone watching me, my family, my team, and feeling like I had let everyone down. My coach said it was fine, but I could see in her face it was not fine. I will never forget that feeling of not being good enough and her face. After that I didn’t want to swim anymore.

Looking back, I can see now how I always struggled a little when I was alone, when I didn’t have things to keep me busy. I guess when I was alone, I was with my own thoughts, and I often felt not good enough or that I wasn’t sure what I wanted to be or do with my life.

I’m sure many teenagers feel like this, and I never told anyone, as I thought it is how we all feel. So, I filled my time up, kept busy, didn’t allow myself to be alone with my thoughts.

University

I got into a top university in London, moved out and fully embraced university life. My close friend from swimming went to the same university as me and we are still good friends now. We stayed together a lot and lived together in a house share in the final two years of my degree.

University was wild. Looking back, I drank a lot, and probably a lot more than anyone else but I thought it was normal, part of university. I drank when I was alone more than when I went out. When I was with others, it was easy to feel part of something, I felt I belonged, but when I was alone, self-doubt crept in and my thoughts were negative and dark and I didn’t like them, so I drank, as it made me feel better.

Working life

I got a first-class degree and went to work for a large corporate firm in the city. It was what I thought I wanted, and everyone was happy for me. I am ashamed to admit it but studying came easy for me and working life was the same. Well, the work side was easy, but the social side was different. I ended up getting a house share with people I didn’t know in London; I had no choice.

I was alone a lot in the evenings, didn’t really have a lot of friends left in the city as it was too expensive, and I had no girlfriend. In the evenings I drank a lot and worked hard during the day. I hated being alone and I started to have lots of negative thoughts. I felt like I didn’t belong and not good enough and, the truth, I felt alone. I ended up working longer hours in the office and spending all my time working when I was out of the office.

How my mental health declined…

At first, it felt good to work hard, and to drink a lot whenever I wasn’t working, as it was my ‘reward’ for all my hard work. I started disengaging from my small circle of friends, called my family less, spent longer and longer on work tasks but things started to change.

Slowly I started having more negative thoughts about myself, my ability and whether I belonged. I threw myself more and more into my work but found it got harder and harder. I started to make mistakes, I started to notice that I wasn’t able to keep up.

It got so bad I dreaded opening the laptop… I got angry when I got asked to take on more work and when I got a promotion, I went to the toilets and cried in the cubicle. I started to care less about work, felt overwhelmed all the time and didn’t want to engage with anyone or anything. I ended up feeling low, hopeless and not wanting to get out of bed.

After a week of not returning my sister’s calls, and all her calls going to answer phone, she drove to London to see me, and that is when everything changed.

I hadn’t left the house for 12 days straight or washed and had hardly eaten. I had written a note saying I didn’t want to live anymore as I was no use to anyone. I felt like an empty shell with nothing left to give or to look forward to. All memories of life were gone, and I did not see the point of my existence.

Getting help

She called my GP and we got help quickly. I was lucky, they sent out an AMHP (Approved Mental Health Professional) and Psychiatrists, and I was assessed and detained under the mental health act due to my suicide risk.

I was in hospital for 2 weeks, was given a diagnosis of clinical depression and put on medication. When I left hospital, I had a home treatment team look after me for a further 10 days. After that, I left London, moved in with my sister and her family and slowly started to live again.

My sister made me join a group for men who have had depression and suicidal thoughts. At first, I didn’t want to go, but my brother-in-law took me every week. After a month of going, I spoke for the first time and after 3 months of going, I started therapy.

I was in therapy for 4 months; it did help me and I still use the skills I learnt every day to help me get out of bed and to live my life. My sister, her family and that group saved me. I would have never gone to therapy if I had not had the dedication, love and support from my family and from the men’s group.

My life now...

I never went back to the city, instead I live near my sister and her family, and have dinner with her once a week and have a part time job in a local farm shop. I am rebuilding my life.

It has been two years since I was in hospital for depression and I am slowly gaining confidence and starting to enjoy life again. My next challenge is to start swimming again, it was a future goal I set for myself when I was in therapy with Imren, and it is something I finally feel I am ready to try.

Stefan’s story could be anyone’s story, mental health can affect anyone. When it comes to clinical depression, it is so much more complex and debilitating than ‘have a bad day’ or ‘feeling a bit down’.

What is depression and how can it impact you?

The key symptoms include:

• Lack of motivation
• Sleep pattern changes/problems
• Poor concentration
• State of overwhelm
• More irritable
• Appetite is reduced
• Feeling tearful
• Feeling different and alone

Depression also impacts on an individual’s behaviour. Often, they stay indoors, reduce contact with their friends and stop socialising. It also effects their working life, as concentration and motivation is poor.

Depression also impacts on relationships and family members, as the individual withdraws socially and some families describe their loved one as ‘being lost’ and ‘lifeless’ when they experience a depressive episode. This often makes those who care about the individual helpless and feeling like they don’t know what to do to help.

Another common feature of clinical depression is self-criticism and negative thought patterns. For example: ‘I am not good enough’, ‘I don’t fit in’, what’s the point’.

If any of this sounds familiar, there is help available. If you are worried about yourself or someone else, reach out to and get help.

Getting help

A GP is a good place to start, as you can be referred to have a full assessment and offered medication or talking therapy. There are also a lot of charities that support individuals and families, such as, Support groups - NHS and MIND’s Find local Minds.

Treatments

When it comes to treatment, research evidence has found that a combination of anti-depressants and talking therapies are the most effective for clinical depression. This is usually in the form of Cognitive Behavioural Therapy (CBT), however, other therapies such as Compassion Focused Therapy (CFT) or Acceptance and Commitment Therapy (ACT) have also been found to be effective.

The key is that there is that one size doesn’t fits all, and treatment should all be driven by a thorough assessment and an agreement between the individual and the treating clinician.

The main message from Stefan’s story is that clinical depression can happen to anyone, but there is help out there, please reach out and seek support if anything in this article applies to you, or someone you know. No one has to suffer or be alone.

Blogs by Dr Imren Sterno:

• What role does comparison play in your life?
• Is it stress or burnout?