reach out. hold on. we’ve got you. you’re safe
The quick guide to getting help if you are suffering from depression and/or feeling suicidal:
Step 1: Forget your pride. Don’t worry about the stigma.
Step 2: Call the doctor or get someone to call the doctor for you and make an appointment.
Step 3: Go to the doctor and establish the extent of your mental chaos. It can be heartbreaking to realise how fucked up you are. It is also liberating.
Step 4: With the doctor’s help, establish a plan of action that seems right for you. Take the therapy that will be offered if you are suicidal.
In Finland,I went from 1 to 4 within 10 days .
Step 5: Treatment will need to be agreed upon with the doctor and therapists. Follow the course of treatment. Adopt the new ways of thinking offered. Be open to new ideas. Alter previous habits as you will need to change your thinking. Be patient. Be kind to yourself. It is a slow process.
Step 6: Stay in therapy or establish some sort of self-help partnership with someone who understands.
The long version:
You know we’ve got to find a way to bring some lovin’ here today. Talk to me. What’s going on?
Stigma is a killer. Who wants to be classified as someone suffering from depression or some other form of turmoil in the mind? No one.
But if you would like to start receiving help sooner rather than later and with less despair; if you wish to better help those who love you and who you love; if you want to survive: lay down that female self-R.E.S.P.E.C.T. Put aside your manly pride. Call the doctor. I waited too long. Don’t think you can cope alone like I once did.
I know what calling the doctor and swallowing your pride and self-respect will mean to you. You’ll lose part of your identity. You will have to talk about yourself in great detail to doctors, therapists and maybe even loved ones. You will have to admit you are ill and can’t cope.
So what! It.Is.Normal. It.Is.Commonplace: You Are Not Alone
Ultimately, confessing that you need assistance to live your life will be worth it.
A caveat. I live in Raisio, Finland, so I can only convincingly talk about my experiences here. I don’t see why the process would vary elsewhere in Finland though. And I know the process is similar in Britain but agonisingly less efficient and life-threateningly underfunded.
Here is how I ended up in hospital for depression and suicidal thoughts: I realised my father was going to die not long after the Ex and I separated. I knew that would be a catalyst for a suicide attempt. I told Ex – in a completely melodramatic and unhinged way – that I was going to kill myself. On the third time I said it, I think she believed me. She asked me if she could call a doctor on my behalf. I was stunned it hadn’t occurred to me that I could do that. I came to my senses for once. I swallowed my pride and choked out a very weak, bewildered and lonely: “Yes!”
Step 1: Call a doctor. Or. Have someone call a doctor for you.
Say it is because you are depressed. You will get a time to visit. Depression is normal. It doesn’t give a shit who has it. It is like the common cold. It doesn’t differentiate between race, wealth, gender and class. Depression, just like the common cold, can stop you working and it can become life-threatening if the circumstances are right.
Ex called the doctor for me the first time. The second time I entered a really suicidal period was for different reasons but that time I was able to call. I was aware enough to know where I was going. If needs be, you can even reserve a time online.
Calling was simple. The receptionist was helpful, no questions, no judging.
Step 2: Go to the doctors.
I nearly didn’t go. I went because Ex had set up the appointment. I knew I owed it to her and my children.
At the doctors I broke down. My pain flooded out. I spoke through choking sobs and tears. The doctor had tissues ready for this. She knew tears would flow and incoherence would babble. That preparation was comforting and reassuring, it was obviously a familiar path.
She asked me to fill out a form. It asked questions like: Do you have any interest in sex? Have you lost weight recently? Do you consider yourself to be unattractive? There were questions about your capacity for work and doing chores.
There are English, Swedish and Finnish language forms for this. I answered all the questions. Where it asked how much I worried about my health, I wrote: “I don’t care about my health”. I didn’t, I wasn’t planning on living beyond 2015.
One of the first questions, maybe the first question the doctor asked was: “Do you have a plan for committing suicide?”
I had several, I know complicated and maybe painless, I know relatively pain free and quick but ugly, I know which methods are most likely to succeed and which stand the greatest risk of failure. As the Finns would have it: “I was self-destructive”.
If I had just had depression my treatment would have been different. If I had belonged to a place of work or a union that provided occupational health my route to treatment would be slightly different. I’m sure I would have been referred to the psychiatric clinic though.
As an aside, anecdotal evidence indicates I got better treatment than I would have done going via an occupational health doctor. Occupational health brings more people into play in the decision making. Some of those people have a vested interest in treating you as a unit of production and do not want to see the mental tumult in a healthy physical body. They want you to reach targets and don’t really see the long-term benefits of a grateful and happy employee.
My doctor was good. She quickly determined that I was risk to myself. She told me I was severely depressed and arranged an appointment within three days at the local psychiatric clinic where I was to meet a therapist. She made me promise not to harm myself and gave me the numbers of people I could call if I was going to. A figurative safety harness was slowly being applied.
She also prescribed pills for coping with anxiety and to help me sleep. They were non-addictive and bloody good, helping me to calm down just enough. When taking the pills, follow the medical instructions. Read the fucking manual and take the drugs like you are supposed to. Give them time to take effect, which might be days…
Step 2: Go to the psychiatric clinic
Telling the doctor how I felt was liberating. I shed a layer of pride and gained awareness in its stead.
However, I was sceptical of meeting a therapist. You see, Ex and I had been to couples therapy and only one of the several we saw had seen that I was depressed and asked about things from my perspective. But I couldn’t talk, my self-esteem had been killed by that point.
There was a time I went to see a therapist on my own. The bloke missed all my sub-text, he side-stepped all the important stuff I told him and saw the issue in terms of his specialty: couples therapy.
In the session I ended up blaming myself for the problems and he let me blame myself.
The lesson: Not all therapists are good for you, shop around until you find the right one.
The therapists employed by my local council were good for me. They asked me the same questions the doctor had, I told the same story and gave the same reasons for my condition. I sobbed and shed tears, I dried my eyes with a different brand of tissue.
The therapists gave me time to speak. It felt like a circular process and it hurt my mind but it was freeing it at the same time. They listened, didn’t hurry me or question my shite Finnish pronunciation and creative use of Finnish grammar. They made me think a bit more positively and arranged a series of weekly appointments. They were in contact with those who could provide medical help. A plan for treatment was suggested. Until the time for that treatment could be given, I continued the therapy sessions.
The process felt normalised but I didn’t talk about it. It felt great, somebody cared. I often cried out of relief. More importantly, the beginnings of a new way of looking at the world had developed.
Step 3: Treatment
I wish I could remember all the options offered to me but I chose Electro Convulsive Therapy (ECT) after I read up on it and liked what I heard about it. It seemed less dependent on drugs and I like electronica. 😉
To go on the course of ECT, which was ten sessions over 10 weeks, I would have to go into the psychiatric unit of the regional hospital, TYKS.
Step 4: Take the treatment. Follow it and abide by the rules. Abide because if the treatment doesn’t work or falls short, you will be better able to categorically state that and look for another alternative.
In 2015 the ward I was on was a long corridor with a food and rec room near the entrance and rooms off the corridor with psychiatric nurses and doctors always available. Patients shared a room with another person. Over the 10 weeks, both my roommates were fine people. You wouldn’t know they were unstable if you were to meet them outside TYKS.
I say it was a place of calm because it was. They interviewed me. Established my mental state at the point when I entered and asked what I needed help with. They had someone on hand to sort out and help with applying to Kela for child benefits and housing benefits. At no point did I consider going on sick leave because work kept me going back then. It took my mind off suicide. Made me consider the future, made me beholden to other people. That is not always the best way but I was freelance and could work in hospital.
I was there two months. I did go home to spend time with my children. I went out for walks with people who I cared for and who cared for me. I did some DJ work. I did not drink. I gave up alcohol for almost a year.
If possible cultivate friendships with someone who understands. I did. We were lucky to find each other at the right time.
While in TYKS, I took to going for lunches with another person in therapy. We went to Roots, a vegetarian restaurant in the market hall in Turku, and talked about our situations, mocking our lives, laughing at them and finding commonalities that helped us both improve our mental health. Not eating meat on these occasions seemed right. I can’t explain why.
The psychiatric ward at TYKS provided me with peace and quiet. It organised my day around sleeping and eating and mental recovery. It took all the pressure of day-to-day living away from me and filled it with hope and security. It stabilised me. It saved my life. I felt alive when I left, so much better than the empty person I was when I went in. I felt joy, happiness, I had more energy, I wanted sex, though I didn’t want a relationship. I did some household chores even though I had got used to living in a pigsty.
My experience of being on a mental rehabilitation ward in a pyschiatric unit was not Jack Nicholson fighting against the system in One Flew Over the Cuckoo’s Nest. This was practical and sensible. It was enjoyable.
Step 5: More therapy and follow the programme
After leaving TYKS, I went back to the psychiatric clinic in Raisio and was given therapy there. That only lasted a short time. They provided me with state support to find a therapist from the private sector. My list of options from the private sector was quite narrow but I knew I wanted a cognitive psychologist who could speak English. Having quite specific demands actually helped in the end.
The first therapist I requested a trial session with didn’t initially answer my email. Maybe there was the establishing of protocol and the guarantee of the financing of the therapy.
On the first meeting, she said she would only work with me if she thought we could work together. I retold my story (you will retell and retell your own). I sobbed and cried. I wasted another family pack of tissues.
She was insightful, she said a couple of things that made me realise I was using the words of others to describe my situation, that I was seeing the world through the eyes of people who might not have my interests at heart.
Due to the way she quickly identified my low self-esteem and inability to defend myself from manipulation, I was impressed by her. I was happy with the way she did not blame me but also offered the mental tools to look at the world in a different way. I wanted to learn from her.
We could work together.
Choose a therapist you can work with.
Step 6: Stay in Therapy
Depression doesn’t evaporate into nothing. It lingers and can descend like a sea mist leaving you cold and blind, buffeted by waves that are unpredictable and nigh on impossible to steer through.
New depressions unrelated to anything previously experienced can lay you low. You will have become susceptible.
Stay in therapy if you can.
Apply the knowledge you are given. Talk with your friends. Seek help. People will give it.
Some people are very kind.