Julie*, 27, has suffered from chronic depression for more than a decade. Depression is a mood disorder, and one of the most common mental illnesses. Symptoms of the condition can include sadness, irritability, anxiety, loss of confidence and motivation, and a withdrawal from society. Statistics show that one in 20 Australians will experience a depressive illness at some time in their lives.
Julie spoke to myDr about coping with depression and dealing with common misconceptions about mental illness.
‘I’d always felt different when I was a child; I was very sensitive and introverted. I also suffered from insomnia from a very early age, without realising it wasn’t normal not to sleep,’ Julie says. ‘It’s these kind of things that make me think that my tendency for depression is something that I’ve inherited, and that it isn’t my fault.’
Julie had her first depressive episode when she was 15.
‘My behaviour was erratic, I was constantly upset, and I was preoccupied with thoughts of suicide. I just wanted to end it all. I didn’t want to leave the house, I wanted to stay in my room alone all the time. Looking back, I should have sought help then, but I didn’t really understand what was going on, and neither did my parents. This first episode lasted for about 6 months.’
Since then, Julie has experienced several severe episodes of depression, some of which she can relate to stressful periods in her life, and others that she cannot explain.
‘It’s unpredictable, which I think helped me understand that it isn’t my fault. It’s taken me a long time to be able to admit that to myself. What I am really trying to do now is understand it as much as I can, and not let it get the better of me,’ she says.
‘Taking that first step to go and try to explain to my doctor how I was feeling was really hard,’ says Julie. ‘I felt like it was the last option left to me. I think in the back of my mind I had put off going in case they couldn’t help me, and it was a waste of time.’
Julie first spoke to a doctor about her depression when she was 20, and was initially prescribed Aurorix (moclobemide) antidepressants.
‘It seemed like a really big decision to start taking them, it was like I was finally admitting defeat,’ she says. ‘But I was definitely hitting rock bottom and they couldn’t have made me any worse.’
Julie found the daily medication initially helped her depression. ‘The Aurorix first started to work about a month or so after I began taking it, and I really felt that things had changed for me. It was a new experience to wake up in the morning and look forward to the day. I think I finally understood what it was like to be normal.’
Julie says that her initial diagnosis came as a relief after years of wondering what was wrong.
‘It scared me, but at least someone was acknowledging that I had a problem and that it wasn’t in my head,’ says Julie. ‘The funny thing was, the doctor never actually said the word depression. The first time I saw that was on my medical certificate; it was a pretty scary moment.’
After initially being prescribed Aurorix, Julie stopped taking the medication after about 6 months when her depressive symptoms began to reappear. She acknowledges now this was the wrong way to handle the situation.
‘I didn’t realise then that it was a matter of finding the right medication for you: I thought that if they didn’t seem to be working, then what was the point? I was going to be depressed forever.’
Julie says this became one of the lowest periods of her life, as she tried to convince herself she could cope without the medication.
‘There was a part of me that still felt taking the medication made me a failure,’ she says.
It was another year before Julie spoke to a doctor about her depression, and she was again prescribed Aurorix. After about 3 months with no success, she was prescribed Zoloft (sertraline). Julie says she had a bad reaction to this medication, but tried to persist with it.
‘I felt like I wasn’t in touch with reality anymore; I was feeling weak and confused all the time.’
Julie persisted with the medication for about 6 months. ‘I wanted it to work so badly, it was like this was my last chance,’ she says.
Julie was then prescribed Cipramil (citalopram), which she continues to take now.
‘I honestly don’t know if this is right for me, but I do definitely feel better,’ she says. ‘It’s really a case of wait and see how I go.’
Julie admits she gets frustrated with trying to find the right medication, but has come to appreciate that the alternative is worse.
To ensure you get the appropriate support and consistency in treatment, Julie recommends finding a reliable doctor with whom you can establish a relationship.
‘You really need to find a doctor that you can stick with, otherwise you seem to be explaining your problems over and over,’ she says. ‘If they haven’t seen how you reacted to different types of medication and been there with you, you might end up getting the wrong treatment.’
Julie stresses the need for perseverance, saying that the first medication you are prescribed may not necessarily be the right one.
‘It is really a case of trial and error, because everyone is different,’ she says. ‘But it is worth the effort to feel normal and happy again, even though it gets frustrating, and I have had times when it seemed completely hopeless.’
Julie knows too well how the stigma of mental illness can affect someone with a condition such as depression.
‘I have lost a few friends since I decided to be more open about my depression, but I needed to do it for my own good. Some people don’t want to try to understand it, but there are a lot of people who have experienced the same thing and never knew it was depression,’ she says.
‘I think there is a perception that you’re just lazy, and can’t be bothered trying to cope,’ says Julie. ‘Some people just can’t see that it’s not your fault. Even now, I dread my employers ever finding out: I definitely think it would undermine me.’
Julie admits she had a lot of preconceptions about mental illness before her diagnosis.
‘Even in my worst times, it had never really occurred to me that I was mentally ill, even after my diagnosis with depression. I think I removed myself from that,’ she says.
At first, Julie found it difficult to talk to family members about her problems, fearing that they would see her as weak. ‘But it reached the point that I had to tell them or risk alienating myself from the family for good; I didn’t really have a choice in the end,’ she says.
Julie says that even her family baulked at using the term ‘mental illness’.
‘They all referred to it as my breakdown,’ she says. ‘I thought they would be afraid of me, but most family members and friends have been quite positive about it, but really, it’s not something we talk about that much. I think it’s hard on everyone.’
Julie admits that the idea of talking to someone about her depression was daunting, and that she initially dismissed the idea of counselling.
‘I didn’t really feel comfortable with telling someone I didn’t even know about how I felt. I didn’t know how to explain why I was so sad, why I didn’t want to get out of bed in the morning, and why I seemed to be constantly crying,’ she says. ‘If I couldn’t understand it, how was anyone else going to?’
Julie says that her first counselling sessions were difficult.
‘At first I couldn’t understand why I had to be there when I was feeling OK; I would dread it. I didn’t want to give the counsellor a chance to connect with me: I was scared of what she would think,’ she says. ‘But after a few weeks I began to relax and try to put what I was feeling into words.’
Julie attended regular counselling sessions for 4 months, and now attends only when she is experiencing difficulty or feeling particularly stressed.
‘I think it has taken me a long time to admit to myself that I won’t find some miraculous cure that will fix all of my problems,’ says Julie. ‘But I’ve come to terms with the fact that this is something I have to deal with, and that it is obviously in my best interests to keep on top of my depression.’
‘You have to learn about yourself and what makes you feel good. I find that exercise helps me to stay on top of things, it’s such a good stress release,’ she says.
Julie also uses aromatherapy for relaxation and to try to keep her stress levels down.
‘I still have days when I don’t want to go on, but I think the important thing is that I have learnt to recognise my symptoms, and try to do something about them. You don’t have to live with depression: it isn’t something you deserve, and it isn’t something that’s going to go away for me,’ she says. ‘All I can really do is try to be happy within myself, and not to give up’.
* Name has been changed.
Last Reviewed: 08 March 2001