Dr Nadine Leese

I thought for a long time before proposing this blog post. I thought, because my depression hasn’t been a bar to my achievement, I’ve never been bedridden or kept from working by it, despite sometimes constant thoughts in that direction I’ve never attempted suicide, and I only self-harm very occasionally, my anxiety triggers are largely avoidable and I currently feel relatively OK (thanks, pharmaceutical industry!), it might come across as a bit whiny and unworthy in comparison to the experiences of those with ‘real problems’. But I spoke to a friend about it and she pointed out that I would raise awareness that depression comes in all shapes and sizes, and that just because someone is functioning well doesn’t mean they’re mentally healthy.

I’ll start with my depression story. It doesn’t really have a beginning because I’ve been depressed for as long as I can remember. A few years ago, an old childhood friend I hadn’t been in contact with for a long time commented that I sounded much happier than when I was at primary school. I guess she was the only one who noticed that early, but – being a child – she hadn’t really known what to do with that information. I don’t remember a time when I didn’t think of suicide in some way, but my anxiety kicked in at 13, thoughts of self-harm at 14 and actual self-harm at 19. After years of denial (it was ‘normal’ for me, plus an ex-boyfriend told me I was depressed and I desperately wanted to prove him wrong), things reached a crescendo at 22. Underemployment after my BA brought on a black cloud more intense than any I’d ever experienced before, I decided enough was enough and went to the doctor, who gave me antidepressants, which I do think saved my life in some way.

I sailed through my GCSEs, A Levels and BA unmedicated and with all this stuff going on inside my head. Even when the aforementioned cloud descended I was still able to go about my business as normal – at one level I’d be going about my unsatisfying retail job, smiling at customers and doing what I was told, but at another there would be a voice in my head constantly bullying me. I think the reason I’ve always functioned so well is that I’m so accustomed to feeling bad about myself that it’s just my normal life. I never ‘tuned out’ the inner bullying so much as I just managed to carry on while it ranted at me. I guess I’m lucky I can do that, but I don’t think it makes my illness any less valid – after all, I take medication to muffle it (it still gets loud on occasion) and I think most people would agree that it’s undesirable to be going round thinking of killing yourself all the time, as I was. I hate it when people think depression is just ‘sadness’ you can ‘get over’ – I felt like I was enveloped in a thick mist that rarely cleared, and only ever briefly.

So, where am I now? Spurred on by a course of counselling that gave me the confidence to do more than just coast along in my job, I did my MA last year and I started my PhD in History last October. I have the occasional flare-up where I feel awful, but fortunately can keep going. I’m always hearing about how bad a PhD is for your mental health, and I’m particularly scared that it’s going to become really bad again after I finish, as it did after my BA. Then, I was on the dole, before getting a job where I wasn’t valued or using my talents. I also worry that it’ll flare up if I have a bad supervisory board or hit a wall in my research. At the moment, I’m buoyed by the fact I am using my talents and qualifications, people are praising me, and I’m doing work I’m interested in and passionate about. The PhD may prove to be bad for my mental health, but for now, at least, I can’t imagine it being as terrible as menial work was for me. When I wasn’t using my brain or being appreciated at all, the negative thoughts were louder and easier to succumb to.

One thing I do find I have to do as a high-functioning depressive is keep an eye out for subtle changes of mood. Because I managed, albeit unhappily, for all that time, my mood might drop, but I don’t take enough notice because I’ve felt worse in the past, whereas someone who’d never been depressed in their life would be horrified if they knew what I was thinking. I have six-monthly medication reviews and my doctor has insisted that I go back in between if things get worse. I’ve had a few ‘episodes’ recently but it’s hard to know if it’s worth increasing my dosage. I want to avoid having more side-effects: the cinematic dreams are quite fun, but the complete inability to lose weight despite going to the gym five or six days a week is deeply annoying.

  I’ve read a lot of academic mental health blog posts that mention self-care, and I find that I’m doing most of the things they suggest already, especially regarding rest. If anything, I’m often too generous when it comes to giving myself breaks from work, and I’m not sure whether that’s due to ingrained coping mechanisms I’ve unconsciously developed over the years, pathological tiredness/apathy (which could itself be down to pretty much anything, including my depression) or just being lazy (depressed students aren’t lazy; lazy students are lazy). I’ll write 1,000 words and take the rest of the day off, for example, or read a few chapters and then attempt to look at the whole of the internet. However, I’m keeping on top of things and hitting my targets, and it’s awful to see students who have worked themselves into illness because they feel they should be working all the time. I often feel guilty that I don’t work more, but one of the tips from a previous post on here struck a chord: doing a PhD demands significant levels of concentration and intellectual engagement. Besides, there’s no point in working if your eyes won’t stay open.

So I guess this post has a few messages. Just because a student isn’t showing outward signs of mental distress doesn’t mean they’re OK; a smile can hide so much. The medication may be working, but the fact that it’s required at all means something. Don’t be afraid of medication: it really helps some people and doesn’t mean you’ve ‘failed’ or are ‘weak’. Take lots of breaks and don’t feel guilty about it.

A note on why I’ve chosen to remain anonymous: it’s in case potential employers google my name and come across it. Even though I’ve just explained that it’s completely possible to be depressed and fulfill all your duties to a high standard, no doubt there are still people out there who see ‘depressed’ and think ‘liability’. I would personally never disclose my depression because it’s never affected my ability to work (apart from one day off in 2011, ironically because my initial antidepressant dosage was too high!). Also, I want to avoid confrontation with certain senior family members who don’t see why I’m not ‘happy’ when I have ‘everything going for me’, or see my lifelong depression as somehow their fault. Some friends who read this may be able to identify me from my description of my life, but that’s fine.