Living with a high functioning depression sufferer

Colour photograph of a sunset at sea shot through a wet window

This was originally posted on my old blog but I wanted to share it here too. These are not my words. They belong to a friend who asked for them to be shared in the hope that by opening up about the experience of living with and loving someone who has high functioning depression, even anonymously, it might help others to understand that this is not an isolated issue. Her aim in writing this piece is to break down myths and encourage those who are suffering to feel less afraid to ask for help.

It’s been a few years since the last break down. Life with someone who has depression, but is high functioning, can be an emotional rollercoaster. It’s not that every day is a battle to get them out of bed, or that they spoil the good things by being anxious or depressed. It’s not them being down all the time. It’s not any of the things people think it is. It’s not even the stuff people often talk about with mental illness. It’s admitting you’re ill, hitting rough patches and talking it through with close friends. It’s dark and largely unseen. So I want to explain, for my benefit in getting these thoughts down, reading through them and opening up a little, but also for those who have a loved one who is a high functioning chronic depression sufferer.

My partner and I have been living together for the better part of a decade now and those years have been filled with a lot of love and a lot of laughter. He’s a funny person who is social and gets excited about things.  He likes books and binge-watches TV series with me. We play games together and go for walks. He doesn’t take the washing out of the machine or put his socks in the basket. It’s a normal relationship in almost every aspect, but in the background there’s a shadow. Sometimes referred to as the black dog, or the cloud, this shadow isn’t cast on every day. I’m not having to push him through that black shadow and he isn’t taking antidepressants or suffering regular panic attacks, but it’s always there at the back of my mind.

An unexpected bill might make it descend or a pile of work added to his week, months of late nights being social and having fun, or working late. It could simply be a few weeks of being physically unwell, having a cold or something that breaks his routines or adds pressure. There are rarely many signs. He will get short with me, not want to go out or play a computer game, or he will skip a meal or two, but generally he keeps going. For those who don’t know him extremely well, what happens next can be completely unseen.

Depression hits. With high functioning depression, it’s often not a can’t-get-out-of-bed situation. Its not just feeling off or really emotional. It can be drinking and drugs, or a suicidal break down. It’s 24-72 hours of emotional turmoil. It’s a sudden, and often unforeseen, critical break down. It’s a breaking point in the person’s head and they’ll have bottled it up for so long that it breaks hard. Then, as long as they have the support they need, as long as someone catches them as they fall, the light turns back on and they start to fight through the depression and anxiety. They push through the harsh words, the regret and guilt, and they may weep over their actions. But to the outside world, especially if the person living with high functioning depression has a good support system in place, things appear to go back to normal quickly.

What is it to be a high functioning depression sufferer? Well, there’s no standard type. They often tend to be the people holding down good jobs. They may have degrees and can be very intellectual. They might live seemingly perfect lives with stable relationships and a nice home. They are the “normal” ones with a good sense of humour. They often do well in work. They have friends and a family.

But they hide big dark issues, such as a tendency to hide money or work or relationship problems. They rarely disclose to others their feelings in any situation, not even telling lovers how they feel. Sharing positive emotions can sometimes be as hard as sharing negative emotions. They often have borderline drinking habits, or low level drug habits. They self-loathe, though they will often make humour of it. They rarely see personal achievements and can be very critical of themselves. They will throw themselves into work, even to the point of being workaholics, and yet those who know them well will see that they can find elements of the work that they seem to strive in difficult or a slog.

These behaviours aren’t uncommon but because the person is “doing great” to the outside world it’s always a “shock”, “out of character” or “so unexpected” when they break. Often it’s the headline after a train jumper, or a celebrity suicide – “it was out of character”. But for those living with someone who suffers from this it’s rarely entirely unexpected, though no less devastating. For years the people we love who battle depression will have episodes and for those who are high functioning these episodes can be the result of a relationship break down, financial crisis or a family crisis. Or they can be the cause of these issues.

Sometimes it’s hard to separate cause and effect. What was a minor financial blip turns into major debt as they try to cover up their fear of inadequacy and hide their “failures”. They start off drinking wine after work then one day they’re standing on a  train station platform with an empty bottle of vodka. Sometimes the things they do can make situations worse and other times it’s simply a terrible situation to begin with. It’s why PTSD and  the like don’t affect everyone in terrible situations and for some the symptoms and signs go unseen for so long until one day it’s too late.

The scary part is that catching them before they fall isn’t always easy and, devastatingly, not always possible. Knowing the signs helps and can literally save a life. The person will often become less communicative and less confidence. They may become work-obsessed or very focused. They might be a little more evasive and moody. But generally the symptoms and signs that a break is coming are brief and can be missed. So how do you deal with that, knowing that someone you love is at a higher risk of suicide or a violent or sudden break down?

It’s hard and support for you is as important as support for them. While it’s great to encourage them to get help, and getting medication and treatments such as CBT can make a difference, they need to want help and sometimes they are just too ill in the moment to recognise that. Helping them through to a point where they see they need help takes time and strength and a lot of love.

But you need support too, friends or family you can confide in, people you can call on. Knowing the services that are out there, like charities and emergency services, is important. Don’t be embarrassed or scared to use them – it’s what they’re there for. The emergency service personnel are often trained to deal with situations where a person may be a danger to themselves, and charities and medical services can provide emergency treatment or even just a conversation that can talk someone down in a dangerous situation. Using these resources can help and encouraging your loved one to have contact numbers to hand might help to.

When my partner had a break down, it seemed like a normal day. He had a normal work schedule and we had our normal routine. But that day he just couldn’t. He walked to the door but could go no further. He wanted nothing more than to just disappear. So he tried to. When it happened, we kept it between close friends. We told ourselves this comparative secrecy was because we didn’t want to risk his job. In reality, I was scared that the shame and regret he would have felt if people knew might have pushed him to the edge again.

But I learnt that day that our experience wasn’t unusual. I learnt how seriously the police take a phone call from a panicked member of the public concerned that a missing loved one is suicidal. I learned what measures are in place for emergency mental health assessment and I learnt that I wasn’t the only person to go through this, even within my circle of friends. That day I realised that while, for his sake, keeping it quiet might have been best, talking about it with those I trusted actually might be my only solace at a time when my best friend hated himself and his life so much he was willing to escape it one day, but the next would bottle it all up again and put on that mask, pick up his briefcase and go into work like nothing was ever wrong.

It’s up to those who know their loved one is still ill to be strong and constant for them. I sat in a mental health ward waiting area and in an emergency nurses office while he discussed what he may or may not have taken, how he was feeling and if he still felt suicidal. I let him talk through his options with a professional and tried so hard not to cry when they suggested overnight hospital care. I talked to a doctor for him when he started to feel embarrassed and I shared elements of our private lives with people I’d never met before in a cold white room while they scribbled notes.

But we survived. We got help. He had an appointment to see a mental health therapist who specialised in one-on-one treatments, CBT, hypnotherapy, meditation and relaxation methods. But the journey back to “normal” took time. To those who don’t know him well, it was a few weeks off work with stress, a case of over-worked-and-a-bit-tired. Those who helped us in the days after though, they spoke with us both about their experiences and we realised then that “normal” was just a mask that we put on every day.

Ultimately this is quite a scary and seemingly lonely experience. But there are lots of people out there who suffer from mental illness and those who are high functioning are actually quite common. There are support networks, social media groups and charities that can bring people together. Breaking down the taboos of mental illness is the best way forward but this is slow going, myths remain and sigma surrounding the unhealthy life styles that these illness can lead to often force the issue further under the radar.

But you are not alone. There are lots of us out there and we can support each other. We know what it’s like, how someone’s refusal or inability to open up can be maddening. We know those fears when someone you love is down and won’t talk to you. We know that little worried voice that says they might have an episode and that you might not be able to reach them to help. Being honest and opening up, both with your loved one who suffers and with others, helps. It helps you to see there are more people on your side. It helps them to see the love, respect and time you have for them. It shows them the safety net that’s there. Whether a lover, a parent, a sibling or a friend, someone with high functioning depression needs that person who knows, who can work through each issue with them. Talking about it might not make it go away but it doesn’t hide it, and hiding it is the most dangerous thing to do.

It’s been a few years since my partner had his worst episode. It was traumatic but through it we grew closer. He sought help, he’s getting better and we communicate more. I don’t stop worrying but I don’t hide away. I live every day and I don’t let that worry stop us planning our future, booking holidays and starting to watch a new series on Netflix together. But when he doesn’t answer his phone or he is very late home from a football game with his mates, a trip to the pub or a normal working day, I won’t lie – there’s a bit of me that gets scared. It’s an illness like any other and as yet there’s really no cure, just treatments, so we take each day each day as it comes.

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