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Anguish

Since this week saw World Mental Health Day, I thought I'd talk a little bit about the two mental illnesses I've been diagnosed with - depression and homosexuality. Thankfully, in 1992, I was cured of one because it was removed from the list of psychiatric disorders by the World Health Organisation. Job done, though the effects of that designation still rumble on in personal and societal ways. If nothing else, it proves that mental health isn't just personal anguish; how societies choose to categorise, medicalise and stigmatize can be the different between health and illness in an individual.

Anguish is a great word. It means 'tightness' or narrowness and is the word I would choose to describe how depression affects me. When depression visits, it is like putting on a set of blinkers and losing 75% of my lung capacity. I can only focus on that stuff that is doable, and doesn't take up too much emotional energy or call for any big decisions. I must blocking out the other stuff and oftenradio silence is the result for those with whom I collaborate. Added to that, I seem to get out of puff much more easily and sometimes the simplest tasks take an enormous feat of strength, leaving be exhausted.

Externally, most of the time, everything seems utterly fine. People ask me how I am and I can only respond, 'fine!' because, internally, my emotions are out of control. I feel like the proverbial swan, appearing effortless, but who needs the frantic paddling just to keep afloat.

Thankfully, depressive episodes are rarer than they were and not as severe. However, I am still learning how to deal with it all in the context of a responsible job, a supportive partner and caring friends. I used to see the presence of depression in my life like cancer, an unwelcome intruder who needed to targeted with intensive treatment in order to be eradicated for good. It was an aberration and, with luck, could be removed from my life.

Increasingly, I am coming to see my depression like alcoholism: something triggered in response to something else going on in my life and, with the right support, treatable. It is part of who I am and I will always be living in 'recovery'. Every day, it involves making choices and limiting exposure to the things that caused it in the first place. So it is a symptom and provides a biological and pschological alert, calling me to pay attention to an aspect of my life.

Winston Churchill spoke of his depression as a visit from the 'black dog'. The metaphor of a visitor is one I am coming to see has value, someone who often turns up out of the blue, at exactly the wrong time, but who demands all my attention. Rather than a needy animal who comes to disrupt, my visitor is a person who is exhausted and difficult, taciturn and enigmatic. I have a feeling I know him very well, but the features of the face are hidden for the time being. There is both a deep connection and a palpable distance. I feel that I must concentrate on this visitor's needs and that, in doing so, his presence will become less disruptive and even positive.

When the visitor leaves, the ideas flood back and the energy levels rise to very high levels. That's the other side of the coin to this whole business, but there's more to it. I want to get a better idea of when a visit is immanent so that I can make the proper arrangements. I want to be able to trust friends and colleagues more so that I can hand off some work without a huge feeling of shame and failure, or a worry that I will have gained a reputation as unreliable. In Biblical terms, I want to use the seven years of plenty to prepare for the seven lean years.

There is skill and support out there to help and I am beginning to use it. I owe a huge amount to people who have persisted with me and helped me to let go of the unrealistic and unreal. My life is a work in progress, but most importantly, it is also a precious, precious gift.

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