Calendar An icon of a desk calendar. Cancel An icon of a circle with a diagonal line across. Caret An icon of a block arrow pointing to the right. Email An icon of a paper envelope. Facebook An icon of the Facebook "f" mark. Google An icon of the Google "G" mark. Linked In An icon of the Linked In "in" mark. Logout An icon representing logout. Profile An icon that resembles human head and shoulders. Telephone An icon of a traditional telephone receiver. Tick An icon of a tick mark. Is Public An icon of a human eye and eyelashes. Is Not Public An icon of a human eye and eyelashes with a diagonal line through it. Pause Icon A two-lined pause icon for stopping interactions. Quote Mark A opening quote mark. Quote Mark A closing quote mark. Arrow An icon of an arrow. Folder An icon of a paper folder. Breaking An icon of an exclamation mark on a circular background. Camera An icon of a digital camera. Caret An icon of a caret arrow. Clock An icon of a clock face. Close An icon of the an X shape. Close Icon An icon used to represent where to interact to collapse or dismiss a component Comment An icon of a speech bubble. Comments An icon of a speech bubble, denoting user comments. Comments An icon of a speech bubble, denoting user comments. Ellipsis An icon of 3 horizontal dots. Envelope An icon of a paper envelope. Facebook An icon of a facebook f logo. Camera An icon of a digital camera. Home An icon of a house. Instagram An icon of the Instagram logo. LinkedIn An icon of the LinkedIn logo. Magnifying Glass An icon of a magnifying glass. Search Icon A magnifying glass icon that is used to represent the function of searching. Menu An icon of 3 horizontal lines. Hamburger Menu Icon An icon used to represent a collapsed menu. Next An icon of an arrow pointing to the right. Notice An explanation mark centred inside a circle. Previous An icon of an arrow pointing to the left. Rating An icon of a star. Tag An icon of a tag. Twitter An icon of the Twitter logo. Video Camera An icon of a video camera shape. Speech Bubble Icon A icon displaying a speech bubble WhatsApp An icon of the WhatsApp logo. Information An icon of an information logo. Plus A mathematical 'plus' symbol. Duration An icon indicating Time. Success Tick An icon of a green tick. Success Tick Timeout An icon of a greyed out success tick. Loading Spinner An icon of a loading spinner. Facebook Messenger An icon of the facebook messenger app logo. Facebook An icon of a facebook f logo. Facebook Messenger An icon of the Twitter app logo. LinkedIn An icon of the LinkedIn logo. WhatsApp Messenger An icon of the Whatsapp messenger app logo. Email An icon of an mail envelope. Copy link A decentered black square over a white square.

Malcolm Harvey: Even the most vocal mental health advocates can struggle to ask for help

Sometimes it can be hard to notice the return of the black dog, and even harder to ask for help.

Stigma around depression can stop those who could benefit from therapy or medication from seeking it out (Image: FTiare/Shutterstock)
Stigma around depression can stop those who could benefit from therapy or medication from seeking it out (Image: FTiare/Shutterstock)

I didn’t really want to write this column, but I think I needed to.

My depression is back.

At first, I didn’t really recognise it or acknowledge it. Then I didn’t want to admit it. Then, when I admitted it, I didn’t want to get help. Then when I got some help, I wondered why I hadn’t acted sooner. My past experience taught me that recognising, acknowledging and acting are key to dealing with it, so why was I so reluctant to do so?

I was first diagnosed with depression in 2014. Irritability, lethargy, overeating, oversleeping, napping, obsessing over minor things, avoiding company, hiding out at home – the whole nine yards. Initially, I buried my head in the sand, but the news that Robin Williams had taken his own life was a lightbulb moment, and I went to see a GP.

Multiple avenues for help were offered – and accepted. Self-help, counselling, CBT – none of those really worked for me. But, after some experimentation, medication did. I was on antidepressants for around four years. And I got better.

Better. Not cured.

I got to be good at managing my mental health. I prioritised exercise. I kept myself organised. I planned meticulously. I carefully analysed every conversation. And there was the small matter of a global pandemic – which, I guess, I managed about as well as most people did.

But all of that takes a toll. Micromanaging yourself to that degree just to keep functioning at a “normal” level is exhausting. And, when there’s an interruption to that – in my case, a parasitic infection that led to a severe sickness bug and a week of no food – the delicate balance is thrown off. No food meant no energy, no energy meant no exercise, no exercise meant no serotonin, no serotonin meant a decline in my mental health.

I felt like a failure – and a fraud

It started slowly; imperceptibly. Those around me didn’t even really notice. I could mask it better, and it definitely wasn’t as severe as 2014 – I was getting out of bed, for a start. However, it was there, and I knew it was happening. But I didn’t want it to be.

My experiences with this before led me to write several articles about depression, get involved in my workplace mental health initiatives and become very vocal about the fact that “it’s OK to not be OK”. I knew that medication was what would help me and, yet, I was very reluctant to do take it. Why?

Well, the experience of coming off antidepressants wasn’t much fun. I spent a couple of days too dizzy to get out of bed. And the initial side effects weren’t great either. But some slight discomfort and a few days of dizziness seems like a decent trade for relatively “normal” functioning, so why put it off?

Antidepressants help many people around the world to deal with symptoms of depression. Image: Yavdat/Shutterstock

The truth is: I felt like a failure – and, worse, a fraud. I’d spoken a lot publicly about my experiences, extolling the virtues of exercise, self-managing symptoms and medication.

I’m sure I even said something like: “If I ever get to the point where I need antidepressants again, I’ll have no hesitation in taking them.” And, yet, here I was: hesitating.

It felt like a backward step; an admission of defeat. It felt like I couldn’t cope by myself, like I’d put myself in a position where I’d talked the talk and couldn’t walk the walk. And, with that, came the feelings: anguish, shame, guilt at hiding how I was really feeling.

We’ve made progress but there’s still stigma

There wasn’t really a point at which things came to a head; no pivotal moment of clarity. I think I had a couple of conversations during which I realised that I was struggling and that I needed help.

I got an appointment with a GP who very quickly agreed to write a prescription. I’ve had regular appointments to review my progress, including an increase in dosage, and things seem to have levelled out some in the four months I’ve been back on medication.

It can feel fraudulent when you’re giving advice to others that you can’t seem to follow yourself

I’ve written previously about how we’ve made so much progress in this area. We have, and that should be recognised. But, as my own experience attests, there’s still a bit of a stigma attached: a concern that admitting you are struggling will be seen as weakness. It can also feel fraudulent when you’re giving advice to others that you can’t seem to follow yourself.

For my part, my colleagues have been incredibly supportive, particularly those who share similar experiences with the black dog. The kindness of others in these circumstances is an unbelievable help – even better than sertraline, at times – and I think that’s the biggest change we need to see.

Yes, of course, much more financing of mental health provision, counselling services, more doctors recognising these symptoms earlier – all of this is sorely needed. But, as a society and as individuals, the best thing we can do is support one another.

  • If you are struggling with your mental health, you can phone Breathing Space on 0800 838587 or Samaritans on 116 123 right now

Dr Malcolm Harvey is a lecturer in politics at the University of Aberdeen. He wrote this piece in a personal capacity.

Conversation