Yes, we get depressed. Here's my story

I hated everyone, I was angry and unable to work. The beast clung to my back. I was not crazy, just unwell...

My father keeps telling me NOT to be so honest about getting depression or taking medication or going to a shrink. He thinks it will affect my chances of getting married. But at a chronically single 36 years, I think it's safe to say many more extenuating factors are at work there.

There are two reasons I have always been brutally honest about having had depression.

1. As a journalist, at my core is always a hankering for the truth, telling the truth and being unafraid to do so. Morally speaking, I would be a hypocrite if I expected other people to tell the truth about their lives but didn't apply the same principle to myself.

2. I have found that telling people honestly that I have had depression helps them - especially the ones with depression but too scared to seek help. Over the years, scores of young people who have heard me make fun of my own depression in gatherings, have contacted me later bashfully, to ask for help. The classic line is:

'I have a friend who has depression, is there a doctor you can recommend?'

I am not suffering from depression now and have been depression-free for a nice long break. But there are plenty of days I come home from work in the newsroom and feel very down. But, if you do some research you will find that clinical depression is different from having a bad day, which all of us encounter several times a month. The problem is when it lasts more than a few weeks and is accompanied by other symptoms.

And people who breezily declare they've never had depression in their life are probably lying.

I am writing this today because I met a young woman B this week who had no idea she was suffering from postpartum depression after having a baby. Her husband is a friend of mine and he brought her and the baby over to my house for a cup of tea. We chatted for a bit and then I realised slowly that she was just sitting colourless, with a drained face, on the edge of the sofa, away from her husband and baby. I inquired if she was feeling alright and the floodgates opened on how ill she was. As she went on, I realised just how deeply depressed she was. She was spiralling and her marriage and mothering was being affected badly.

This is what I told her.

1. No one can help you with your depression. You have to do something about it. Depression scares people; they don't know what to do about it. They will talk to you for one time, two times and then they will get frustrated and start avoiding you.

Your husband cannot fix your depression - even if you think he is the cause of it. B was blaming her husband and in-laws for her depression. The outcome was that her husband got sick of hearing he was the cause of her depression and any motivation he had to help her dissipated.

2. Anti-depressants are not addictive. And if you take them you can get off them easily. So many people make the excuse about not going to a psychiatrist because they know and assume they will be prescribed medication. This makes them feel that they are succumbing to a drug that they will have to take for life. That is not true.

I have taken anti-depressants ranging from Prozac to Seroxat. They take about three weeks to kick in and when you think you don't need them anymore the doctor will gradually lower your dosage to take you off. The science of anti-depressants has advanced and the best thing to do is ask your doctor about the side effects or possibility of getting addicted if you are worried.

The anti-anxiety pills are entirely another ballgame. They CAN be addictive. I am talking about Xanax and Lexotanil. It is dangerous to take them on your own without a prescription because they can actually have a downer effect, which will make you feel worse.

3. Just taking a pill won't necessarily fix your problem - talk therapy is needed too sometimes. There are roughly two types of depression I have experienced: chemical and situational. If I have been in a prolonged crappy life situation it has led to depression. Sometimes we are stuck and can't change or remove people or conditions that are depressing us. In that case we either have to learn how to adjust or extricate ourselves.

The chemical depression, as I call it, is linked to the 'happy chemical' called Serotonin in my case. As it would not circulate long enough in my bloodstream, I had to take SSRIs (Prozac etc), which are Selective Serotonin Re-uptake Inhibitors. A very low dose has always worked for me.

During several times in my life I was so deeply depressed that talk therapy wasn't going to work alone because the chemicals were all messed up. So I started taking a medication and combined that with Cognitive Behavioural Therapy (CBT) to get better. I swear by CBT. The medication takes the edge off the blackness and helps you work with a psychologist to figure out how things can be fixed.

Just to be clear - psychiatrists prescribed medication and psychologists don't. They offer therapy. And going to either of them doesn't mean you are crazy. Of the two people I sought help from in Karachi, one was a psychologist with a PhD in counseling psychology from an institution in California and the other is a psychiatrist with qualifications from Brown University.

4. Some lies people tell you. People mean well but in my experience there are certain things that won't help alone with depression if you've got it bad. When I used to be depressed people would tell me that I wasn't grateful enough for what I had in life. Or that at least I wasn't blind, or missing a limb. According to their reasoning, if I would just be grateful enough for what I did have, my depression would go away.

First of all, I am grateful for what I have. But there are certain things I want in life that I feel I can't get. Everyone experiences that. This is not linked to my depression as my well-wishers tried to convince me. Depression is far more complicated a phenomenon to just go away by saying 'thank you'. I can be grateful and depressed.

From time to time I suffer from existential dread: meaning, why am I here, what am I doing, what's the point of all of this. I get anxiety, high levels of anxiety, about my parents dying, me staying single for the rest of my life, not being able to financially support myself. Never being truly loved. Becoming redundant at work. Persistent anxiety can drill a hole in your head, and be linked to depression so sometimes it is a good idea to meet a psychologist to get proper perspective on them.

Second, people tell you to pray and meet friends for coffee and your depression will go away. The truth is that these two things IN ISOLATION are unlikely to totally take your depression away. I use prayer, namaz, Zikr and Tahajjud, in COMBINATION with therapy and medication. I rely on a network of friends to get support. Yes, miracles do happen, but if you are depressed and going out of your mind, do yourself a favour and see a doctor as well. And to use the cliché, you'd see a doctor for an infection, so why not for depression?

If you read up on depression you'll find that the more you leave it unattended, the worse it gets. It affects the brain the long run. It affects your relationships, work, self care, ability to exist.

Some people think of suicide but are too chicken to actually go through with it. That is called suicide ideation and it is a hellish place to be in. You are stuck in limbo, miserable, desperate, isolated and unable to do anything.

When depression has crept up on me, I have barely noticed it. That's the hard part. Then I found I couldn't get out of bed but the more I lay there the more my self loathing grew. I was not able to go to work. I hated everyone at work. I had anger. I hated myself. I hated the world. I couldn't read, couldn't watch films, didn't go for pedicures or haircuts. I felt cursed. The beast clung to my back.

I am sorry if any of you reading this are depressed. I wrote this for you. I know how bad it can get. I know that people don't understand. I know you feel it will not end. But listen, the Cold War ended, so will your depression. You are not crazy, just not well. It takes a lot to be a 'crazy' person.

Make an appointment to see a doctor and grab a rickshaw and go see them. Your first try might not seem like it will make it instantly go away, but understand that you have to keep at it. Ask your doctor about medication and therapy. The sessions can be expensive, the highest I have paid is Rs2,500 per hour. But she was damn good. The medication will cost Rs1,000 plus per fortnight and it varies. I saw my last therapist for three years. It takes time. I could have bought a lot of shoes with that money I spent but I would have never enjoyed them.

Depression goes away. But you have to do something about it. And even if you're really at the bottom of the barrel, make that appointment.

(Note: As with all medical matters, medication, advice and explanations, please see your doctor as each patient's needs are different. Always consult before taking medication)

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Here are few reliable resources that can help you figure out depression:

The symptoms of depression:

http://www.webmd.com/depression/guide/depression-symptoms-and-types

http://psychcentral.com/disorders/depression/

Finding a doctor

Government hospitals have Psychiatry wards but they are usually places you wouldn’t want to go.

Instead your best bet is to approach a large private hospital you personally trust and ask what their mental health department offers. Ask for a list of doctors.

Getting an appointment with either a psychiatrist or psychologist can take weeks, so be patient. Feel good about making the first step of making one. Better than dying in bed, I said to myself. If they ask which one you’d prefer, just say anyone who can see you quickly. If you cannot explain to your family or have the money to go, try calling a hotline (see below).

Sometimes your first appointment doesn’t go well, don’t panic. You should tell the doctor what the problem is, what you think it is at least, where you need help and ask them what they can do for you. Ask them how they can help you.

Here is a short list of places that offer help. 

The Pakistan Association of Mental Health helps people at their free clinic. Walk in and ask for an appointment. Medication is also free. But I make a donation when I go to help them.

http://www.pamh.org.pk/

Free Depot Line Clinic:
Room # 19, 21-23 Rehman Plaza,
90-A, Depot Lines, Karachi
021-32257245-32232423
Email: [e-mail]

The PAMH head office is here in Clifton, Karachi
Room # 13-Hilal-e-Ahmer House, Clifton Road, Karachi
Phone # [phone]
Fax: [phone]
Email: [e-mail]

The Aman Foundation has plenty of resources and a hotline just in case you can’t physically go to a doctor

http://amanfoundation.org/about-aman/the-aman-foundation/faqs/

Karwan-e-Hayat is a welfare non-government organisation active in caring for mentally ill indigent patients. It is the only NGO of its kind in Karachi, providing both outpatient as well as inpatient facilities. Over 80% of Karwan-e-Hayat’s patients are treated free of cost. Located in three convenient areas of the city, Karwan-e-Hayat is one of the largest facilities for inpatient care available in Karachi. http://keh.org.pk/

Therapy Works is an organisation that provides a number of services in Karachi
http://www.therapyworks.com.pk Phone: [phone]

In Islamabad one resource is:

http://www.rozan.org/reach_us.php

Rozan

In Lahore two resources are:

http://fountainhouse.com.pk/

Fountain House or the Lahore Mental Health Association (LMHA)

http://www.pimh.gop.pk/

The Punjab Institute of Mental Health

Read more by Mahim here or follow her on Twitter @Mahim_Maher