I listened to a very interesting piece on Radio 4 yesterday about depression. Gwyneth Lewis, Wales’ first National poet, was talking about her experience with depression, in the segment “What Disability Means.” If you want to listen to it yourself, here’s a link.

It got me thinking about how my view of depression has shifted recently. Nowadays depression is considered as an illness, something far more complex than just a mood problem, something that has as much of a physical cause and effect as a mental one. In one way this is a good thing, since it treats depression with the seriousness that it deserves. But at the same time, it gives the impression that when you are suffering with depression, it is a transient problem, a disease that can be cured, something you will eventually shake off, like the flu. At least, that’s how it appeared to me. It seemed that one day I was feeling fine, and the next day, bam! I’d caught a nasty dose of depression. Pop along to the doctors and get a prescription for something to clear it up.

And of course, it’s not that simple. There is no magic pill, there is no therapeutic formula. Doctors talk about ‘remission’ from depression, rather than recovery, because once you have experienced a bout of major depression, your chances of suffering a recurrence are very, very high, even with correct treatment. Around 80% of people who have had clinical depression will experience a relapse at some point in the future.

(Of course, it’s important to acknowledge that this also means that 1 in 5 people who have a bout of depression will recover from it, and not experience a relapse.)

But this is not something you want to hear when you are undergoing treatment for depression. You want to believe that you will get better and stay better. You want to live without the fear that the big black cloud will descend upon you again. You want to be free, to live your life to the full, to be joyful and at peace, instead of watching yourself all the time for signs that you are backsliding. But I am beginning to realise that as long as you have that attitude towards depression, you are making everything much harder for yourself. You are placing far too high expectations on your treatment plan, whether that is medication, therapy, nutrition, herbal, or anything else. You are placing too much pressure on yourself too. Perhaps you do well for a while, feel really good, think you are cured. Then you hit a bad day/week/month. The bubble bursts. Your worst fears are realised. Nothing works! You’ll never be well, never be free. You plunge even further into the depths. Everything goes on hold, waiting for that day when you are finally ‘well’.

I’m coming to realise that, as with most difficulties in life, acceptance is the key to dealing with depression. Not a passive acceptance, because there is so much you can do to help yourself. But acceptance that this is now a part of who you are, and that you need to make room in your life for it. Acceptance that there will be good days and bad days, and that both will pass. Acceptance that bouts of depression may recur, and that there may be little you can do about it when they do, except to face them with courage and patience. Acceptance that this is your life right now, and recognition that you still have the choice to live it however you want to, despite the depression. I think that acceptance brings strength with it.  

And that strength, that courage, is the strongest tool we can fight depression with.