“He often thought it deeply ironic that if a depressed person walked into his office and said the world was so grim that he could not face it, he had to treat him as a sick man. Actually, the patient was right. He saw the truth only too clearly. But he was sick, because he had lost certain basic defences – or, if you will, he no longer had the normal illusions that keep us sane.”

Gerold Frank – The Boston Strangler (1966); speaking about Dr Leo Alexander

I like this quote. I am not sure I fully understood it when I first read the book, but now it resonates with me. I don’t think I agree with it completely. It has elements of truth, like many of these things. It is a nice illusion to think that I am seeing things the way they really are. It gives me a little smile when I think about it. I may be depressed, but I am depressed because I see things as they are. I am seeing the world for what it really is. Welcome to my Matrix. Behold, this is the Thirteenth Floor. Darkness? That’s not darkness, man. This is the Dark City.

Darkness… I think of my depression as my darkness.

Depression is a strange thing. It will affect many of us differently and in different ways. The NHS website has pages and pages of symptoms and signs to look for. Depression can strike you like a lightning bolt and just come from nowhere. You find that you’ve been struck before the sound has a chance to warn you. Or it could be like a slow mudslide, seeping its way forward. By the time it is on top of you, it is already too late. I sit firmly in the latter grouping. I cannot, even now, say that one thing pushed me toward the edge. It was a slow descent into darkness. I was heading down an incline, and by the time I realised that the quagmire of depression was at the bottom, it was too late.

It was a decade ago, and the world seemed a different place. I cannot praise Somerset NHS  or more specifically, Glanville House enough. Without them, I do not think I would be here today. They helped me when I was at my worst, and I really cannot thank them enough. When I needed help again, I found that the NHS’s beating heart had been scarred by austerity. It still beats; it will help where it can. Those scars had been caused by deep cuts, and it will take a long time for things to get back to how they were. Love the NHS, support the NHS and respect the NHS. We’ll all miss it when it is gone.

I wake in the morning, and a lot of the time, my first thought is, “Oh no, not again.” My brain is the home of the bowl of petunias from A Hitchhiker’s Guide to the Galaxy. The bastard of all this is that if someone asks me, “How are you doing?” ninety-nine point nine nine nine times out of a hundred, I will reply with “I am fine.” It is instinctive; it is raising your hands in the air when a ball is heading towards your face. I may be fine, or I may not be fine. It is just a spontaneous reaction. And this is important. Your friends and family may do this, too. They won’t be doing it because they do not care. They won’t be doing it because they do not trust you. They will do it because it is the natural thing. I’ll often say the words before I even realise they have burst from my lips.

The internet has an excellent synonym for this auto-response. “Meh.” “I am fine” placed into google translate should come back as “meh.” That would be the truth.

Depression can be hard to spot in others, and it can be even harder to admit to yourself. You may experience feelings of being low, or of a sadness that washes over you. You may feel able to see your friends, or indeed, you may find that you are not interested in things that you would usually enjoy.

“Want to do that thing that you have been on about since, well, forever?”

“Meh, sure, why not.”

But the internal dialogue runs like this: ‘I will just drag myself along with all the enthusiasm of a really listless sloth.’

This isn’t just someone who has lost their enthusiasm. This is someone who feels no pleasure. The zip that they once had has gone.

You may find yourself feeling unimportant or of no value to society. Maybe a friend asks:

“Going to apply for that job?”

“What is the point? They’ll never accept me.”

And you would really feel that you mean it. Why would you be accepted? Who would accept you? Look at you! You are worthless.

It’s the depression speaking but its voice is as true as if it were your own.

There are many symptoms, there are many things to look for. I could list every single one here and give examples for them all. I would no doubt miss so many more. Look out for yourself. Look out for your family, and look out for your friends.

Ten years on, and I rattle. I am sure that by mid-morning, I sound like a jar of smarties on an old boneshaker train. The pills do not work for some; they do work for me. So, for that reason, I continue to take them. The pills do not cure; they do not heal. What they do is give me a certain numbness. An apathy that, while frustrating at times, I could not function without.

Here’s an analogy: without the pills, the pain of my depression is like a song I don’t like, played at top volume through the world’s best headphones straight into my ears. With the pills, my neighbour is playing something. I can still hear it; I can just about put my finger on the tune, but not quite. It is the dull thud of the foundations being laid in a building site that is just far enough away to forget…at times. An annoyance, but one that you will omit to register occasionally, and it will drift into the abyss that is the back of your mind.

It is vital that people grasp this fact: depression is not unhappiness. I look at my life, and I have ups and downs. In recent years it has been more ups. I have a good life; I have very little to be unhappy about. My life is more good than bad. It is not just a case of saying to someone, “ahh, pull yourself together,” or “cheer up.” I used to think like that. I used to feel that way about these things. But mental illnesses need to be handled with just as much care as we would a physical illness.

When I was at my worst, when I was stuck in the very centre of the bog, the swamp had swallowed me, and I was struggling to survive. At those times, my depression could be just as debilitating as any illness that you could have seen. My body was fine; my mind was stuck deep in tar. Doing the most simple things required me to drag myself from that tar. It took everything that I had. With help from friends, family, and the NHS, I made it through the deepest parts. I will never be free, but I am, now, able to cope with the worst.

So how can you help someone suffering from depression? Be there for your friends. Support your siblings and family members. Empathise with your fellow employee. Listen, don’t judge. What may seem a minor irrelevance to you could be pounding like a jackhammer in their minds, rat-a-tat tatting throughout their every minute.

Don’t push, be there for them when they are ready, not when you think it is time. When I was pushed, I got worse. I had ‒ what seemed like ‒ an infinite number of things that were depressing me, and then I had to start worrying about what people thought of me. Worrying about my family and how they perceived me. Pushing can make a dangerous situation worse.

Most of all, look after yourself. Depression isn’t contagious, but it sure as hell feels like it at times. The feeling of worthlessness when you can’t help in a way that you would like. Feeling guilty for not being able to pull that person back from the edge. The dread of not knowing what to say or what to do. Sometimes when you grab someone sliding on that incline, you can get dragged along, too. Just remember. Be there, listen, and know that it is okay to not be okay.