This was another great documentary by the BBC for Mental Health Awareness Week; and again, it was great to see a public figure being so open in sharing their struggle with a mental health issue.
Like most words related to mental health issues, depression is wildly misused. As we saw with Alastair Campbell, depression is not just feeling sad or unhappy for a short while; it is a long term, daily struggle and it can make your mood change in split seconds.
The main question raised by the documentary was the use of medication as a treatment. It was plain to see that the medication Alastair was taking only helped to reduce the feelings of depression; his family were shocked that he could switch from feeling fine to being in a depressed state in just a matter of seconds whilst being on medication.
To see Alastair’s journey was really interesting and it showed how dependent we are on medication because he was only prepared to switch to an alternative if it was as convenient and if it did a better job.
In order to measure his mood, Alastair was asked to score it out of out of 10; 1 was feeling fine and 10 feeling suicidal. Scoring your mood is a great tool to use; Kim will often ask me how I am doing and my answers are ‘fine’, ‘struggling’ or ‘so, so’. The last one really doesn’t help her much so scoring out of 10 gives her a better idea of where I am and how I am really feeling. I would say that I generally hover around a 3 or 4 most days.
The other sign of how good, or bad Alastair was feeling was the blind on the staircase; if he could pull it up then he could go on to do other things that day, if the depression was too bad then the blind would stay down. I realised that I do a similar thing; if I am really bad then all the curtains and blinds will stay closed, if it is just a bad day then the living room blind will stay down; I guess this is the only window that people can see in from the road, so by keeping the blind down it blocks the world out and I feel more secure. I think it also has something to do with the comfort of being in the dark.
The documentary also showed that depression can hit anyone, and it doesn’t always make logical sense. Alastair admitted that he has a comfortable life, a loving family and had a good upbringing; so he often asks himself what reasons does he have to be depressed?
Depression is all about chemicals…. right?
This is quite prominent for me at the moment, as I am trying to work my way of my medication.
It was really interesting to listen to Dr Joanna Moncrieff of University College London; her view is that we are in a situation where GP’s feel they have to prescribe medication, and people expect them.
“Every prescription given out is telling people that they have a disease, it’s in their brain and there’s nothing they can do about it – just take this pill.” – Dr Joanna Moncrieff
Antidepressants are mind altering substances, and the general idea behind them is to tweak the parts of the brain we don’t like, but Dr Moncrieff says they are much cruder than this because they only alter mental function in a general way; no one has really investigated properly what sort of changes they produce.
“Depression is as varied as the people that have it.” – Dr Joanna Moncrieff
This is such a true statement because mental health issues are so specific to the individual and that means the approach to dealing with them is different for each person.
There is proof that traumatic life events are the biggest causes of mental illness so looking into the past is really useful when searching for the causes. Alastair’s partner, Fiona seemed more open to exploring these possibilities however, Alastair did not really agree with this way of thinking because despite his brother being diagnosed with schizophrenia, he saw no problems with his upbringing.
A lot of people deal with mental illness by keeping busy; a decade in politics certainly helped Alastair to keep a lid on his depression, giving him little time to focus on it. The problem is that it is impossible to keep up that pace of life for a long time, and it is exhausting to try and keep the mind and the body busy all of the time, so when he stepped down from politics the inevitable happened, the lid blew off.
What else is out there?
The principles in this part were interesting, but a bit limited because some of the treatments were in the experimental stage, so not really available to everyone.
The most interesting part for me was when he met Dr Golan Khanduker.
During his student years in Cambridge, Alastair drank heavily, smoked heavily, ate terribly and did no exercise; now he lives a much healthier lifestyle and it has had a positive effect on his mental health.
Dr Khanduker has studied the link between the immune system and mood. The immune system is there to protect us from infection and when doing this it creates a response called inflammation; some people’s immune systems behave as if it is fighting an infection all of the time. Studies have shown that one third of people with depression have an overactive immune system and that this comes first, closely followed by depression.
Stress, smoking, alcohol, obesity and lack of exercise will cause a higher level of inflammation, so it is important to control this to aid with depression. While there are no guarantees that a healthy body means a healthy mind this is an area we can all work on; living a healthier lifestyle has definitely helped me.
Dr Roland Zahn of King’s College London is studying Neuro Feedback; Dr Zahn is investigating how people’s brains deal with emotions in real time in order to understand how depression works.
Dr Zahn found that a key feature of depression is people feeling bad about themselves and feeling worthless. People often blame themselves for things that were out of their control which causes a vicious cycle. His aim is to try and break the cycle by diminishing self blame.
During a scan as part of Dr Zahn’s research, Alastair had to choose a word that would cause this self blame, and he chose ‘Donald’, his brother; so maybe the key to his depression does lie in his past after all?
I could associate strongly with Alastair when he said that the depression often makes him feel alone and unplugged from the world, even when you have people around you. It is really important to find things that bring you joy, and for Alastair football is one of the best things that helps him. He will travel from London to Burnley to see matches, and can cope with the journey and any challenges thrown up along the way.
Was I born with depression?
I have to admit that I have never really thought of mental health issues as being genetic, so it was interesting to see both Nadiya and Alastair asking the same question.
Dr Gene Austin, explained that in genetics a single gene can cause a condition, and this can be passed on however, in psychiatric disorders they have not yet been able to find a single gene variation that is either necessary or sufficient in order for somebody to develop psychiatric conditions. There are hundreds of genes, which when they act together may increase some people’s susceptibility to mental illness.
She explained it beautifully by using a mental health jam jar as an example:
People have two vulnerability factors; the first is Genetic and the second is Environmental (Experiences).
We all start off with a level of genetic vulnerability, and over the course of our lifetime the jar can fill up with stressful experiences; problems occur when the jar fills up until it over flows. The only way to change the size of the jar is to add rings to the top rim, each of these rings is a protective factor and as you add more rings, one on top of the other, they create more space at the top of the jar. Protective factors are things like sleep, good nutrition, exercise, good social support, and other things that make you feel good.
By extending the top of the jar, you are able to accommodate more environmental vulnerabilities without it ever getting full.
In short, life lived is more important than genes.
At the end Alastair came to the conclusion that there is no cure for depression, it is just about managing it. I agree to a point, but I feel there is a lot that neither Alastair nor Nadiya explored, and these are the natural therapies, but I will pick this up in my next blog……
Thank you, thank you, thank you.