While fear may not be a symptom of depression, it is certainly something that has become tightly woven into the fabric of my illness. When I am well, I am fearful of when the next relapse might be, when the ground might disappear beneath my feet. When that relapse happens, I am terrified – here we go again with yet another tidal wave to wash my life away. And as a depressive episode stretches out, I am scared that I won’t get better, that I will drown in this mental pain.
What is probably the most frightening is the lack of control. I can be doing what would appear to be all the right things, and I will still get sick. As the years have passed it has become harder and harder to control my illness, so the fear only escalates. This current episode has lasted for almost a year and a half, and I am utterly terrified that I will never get my well self back again. I miss her so much, but she is either gone, washed away in the tsunami of my depression, or drowning in a dark basement somewhere. If only there was a “find my iPhone” for the real me, to give me a life preserver to hold on to.
A few years ago I was making my case before a review board about why I should not remain committed to the psychiatric ward. As a mental health nurse, I’m a bit of a research geek, so I was talking about the STAR*D research study, which essentially showed that the more treatment failures a patient has the worse the prognosis. I argued that my suicide attempt stemmed from “evidence-based hopelessness” (although looking back, I’m not sure why I thought that would help my case). Perhaps a better way to put it, though, would be evidence-based fear – fear based in the evidence of my personal experience and reinforced by the research evidence I was reading. If I am already fearful that I won’t get better, it becomes very hard to challenge that kind of thinking.
I’ve been learning recently about acceptance and commitment therapy (Russ Harris’s ACT Mindfully site is a great resource if you’re interested in reading more), and contemplating how fear fits in with this idea of acceptance rather than resistance. Is this fear a form of resistance? And if so, maybe it’s resistance in a good way – a reason to keep fighting for recovery. Or maybe acceptance lies in making space for this fear, acknowledging it as a neighbour that’s not going to be moving away any time soon.
As I struggle to tread water in the sea of my depression, perhaps I have to both accept and resist. Resist the urge to stop struggling and just drown already, and accept that another wave might come at any time and push me under. In the end, whether I feel fear or not, que sera sera.