Depression: Let’s build the fencing at the top
The tragic death of talented, respected and well-loved broadcaster Greg Boyed is reverberating around New Zealand. The man who gave us news and current affairs probably never imagined he’d become an integral part of the soulsearching we’re doing around mental health.
Decades ago I almost died following suicide attempts that put me into intensive care. My late teens and entire 20s were written off to chronic depression, suicidality and anxiety. I write as a former sufferer of emotional difficulties, of poor mental health. I know what it is like to be in a place so dark that nothing can live.
I survived — then thrived — thanks to long-term talk therapy. It was not quick. It took more than 10 sessions, more than six months. In fact, it took a good deal of time to really work through the issues.
I had tried everything before then, this technique, that strategy, but did not resolve what was wrong.
And that’s the thing. We think we know what is wrong, but this is often the surface manifestation of deeper issues and hurts, scars that we are not conscious we carry.
For the past 25 years I have been a psychotherapist working with others who struggle to cope emotionally — that’s what poor mental health is — a struggle to cope emotionally. It might be helpful if we started calling it that.
Many of us try to overcome emotional suffering through exercise, and while this may provide a temporary lift, if exercise resolved depression our sportspeople would not suffer from it like many do. And what happens if we reduce exercise, say during illness? We should not plummet into depression because we haven’t exercised.
There is much advice out there about balance and taking time out. This message leaves some more despairing. They do all of that, but it doesn’t change anything.
We pretend emotional suffering is about needing a holiday or a run or spending time with friends and family. It’s not. Those things can sometimes, but not always, provide some pleasure, but they do not replace the emotional work that’s needed. Spending time with loved ones may make someone struggling with false self, for example, feel increased despair.
In a nutshell, what happens is that typically, people arrive at therapy with a current stressor, but with exploration find they are carrying other pain and baggage.
Talking about what’s happening and making sense of what may not have made sense, allows things to shift emotionally. Connections are made, feelings are felt and with this comes some relief, while continuing to work through what needs to be worked through.
That this occurs in the presence of an experienced and understanding other who is not afraid of our feelings, and helps us to bear those feelings even when we want to flee, helps develop emotional strength, capacity and robustness.
From both sides of the couch I have learned that the past is influencing all of us. And something else — we have an unconscious, and the unconscious is involved in our struggles, driving us in all sorts of ways. We think we know what is going on but we can only know part of the story, the conscious part.
A huge amount of money — though never enough — has been thrown at drivethrough treatment in mental health centres where people are expected to pick up a quick order and move on as fast as possible, so the next in the queue can be served. Staff are often running at, or near, burn-out levels, with pressure on them to resolve other people’s emotional problems, when this is not possible.
The resolution of emotional problems is the work of the individual, when provided with therapy that will meet their needs.
Mental health campaigner Mike King, and psychotherapist Kyle MacDonald’s calls for help for those at the low or middle ranges of depression is a sound one. We have long needed a national therapy service. Different people will need different approaches and this must be factored in to any service provided. We’ve been talking about the ambulance at the bottom of the cliff for decades. It’s time to build the fencing at the top.