Depression Squared: Calming Down

In Depression the emotional thermostat is fundamentally broken. It whizzes up and down on a whim and with seemingly little control. And so you can find yourself suddenly, apropos of nothing, on the verge of despair, gasping for breath, without any ability to climb back to normal range.

Sometimes there are triggers which with a fair wind can be noticed and the subsequent descent avoided. A trigger can be the smallest thing — a word, a flavour, a smell which throws you right back into the midst of an emotional waterfall. But worse are the times when there are no obvious triggers — you just wake up feeling broken and each breath you take, each step through the day makes you feel worse. There is nothing to explain, rational or irrational, the chaos is just there and overwhelming.

What starts in the mind can swiftly take over the body. At the beginning there is a slight restlessness. It increases to drumming the leg and twisting the hands, to an unheard rhythm. And it grows until it is impossible to stay still. The heart is pounding, the skin is sweating, muscles are tensed to the point of pain, thoughts race too fast, breathing, and particularly breathing deeply is an effort, and you pace or race around and around unable to stop.

In theory this is the point at which to breathe carefully in and out, to imagine yourself somewhere else, gentle and peaceful, to bring yourself back down to the ground. In practice, those deep breaths become gasps for air, and it may well not be possible to retrieve control, to stop the cycle.

It is not necessarily an easy thing to reach out for help, internal or external. A hundred reasons can kick in to explain why support is inappropriate and undesirable, as the brain spirals turn and turn, increasing the torment.

Caught up like this, twisting from the pain, it can still seem that everyone else has bigger, more important issues with which to trouble the nursing staff. I have walked in circuit after circuit of the hospital space, whispering the words I need to utter, unable to say them aloud to someone who could help. With each circle I have travelled further from the ground, further into myself, but have convinced myself of the impossibility of speaking up.

I have waited and waited — pointlessly — for someone to spot me and my distress, to skip over the whole process of asking for help. If the meltdown is dramatic enough — a full blown panic attack, hyperventilating and shaking from head to foot — maybe, without asking, someone will come to the rescue. But most of the time all the turmoil is inside and it needs me to stretch out my hand for help.

The remedies are there when you do — a voice to help to calm rushed breathing, tactile plastic to squeeze to death instead of using your own body, an ice pack with which to cool down, a weighted blanket to counteract the tension, and, most valuable, a specially furnished space to sit in and return to yourself.

The room is pure vanilla, soft and devoid of all sharp edges. It is safe and calculated to soothe. You can throw yourself against the surfaces without harm. In the corner a tube of fish bubbles through one colour and then another. Counting them the panic slows, you can breathe more deeply, sweat dries, the need for self-harm ebbs away, other thoughts of continuing life edge in, the body comes back under control.

But then comes the challenge of leaving — of returning to the real world of sharp corners and hard edges, in which it is necessary to battle demons again and again.