I wrote this after reading some ignorant comments on the internet. Sorry for it being a bit lengthy: What is depression? That is the burning question. There is the common perception of what depression is and how the media portray it, and then there is the reality of depression. We are all familiar with the “head clutcher” photos over the internet, and we all hear about “tragic” stories in the newspapers about how people with mental illness have been let down by the mental health services. To some, depression and mental illness is just a cop out and an excuse to be lazy. Others pity us and feel sorry for us. But I am not lazy, nor do I want to be pitied or have anybody feel sorry for me. It’s not always so easy to “cheer up” and “suck it up”. Depression isn’t just feeling sad. It isn’t feeling sorry for yourself and not wanting to do anything, or not wanting to get better. I’m going to use the famous cliché of “If I could wave a magic wand, I’d make this go away”. It’s true, I would in a heartbeat but the reality is, I don’t have a magic wand and I don’t know if this will ever go away. Most people go through low periods in their life. Feeling low is not the same as being depressed. I remember the first time I realised I was truly depressed. I was 13 years old and amongst the usual troubles and hormones of being a teenager I dealt with (or rather did not deal with) being bullied, the pressures of school and some very unfortunate events that happened to me, I began to feel really low. I dealt with this by lashing out at my teachers and other students, which only made me dislike myself more and it confirmed my beliefs that I was a terrible person and that I deserved what I got and that I deserved to be punished. If all the negative self-talk and essentially bullying myself wasn’t punishment enough I stooped to a new low. After the continuous barrage of abuse I had given myself, I got out a drawing pin and I scraped it across my skin multiple times causing multiple scratches on my arms. It hurt. It felt good. The physical pain eased the emotional pain that I was feeling and I calmed down. I felt an immense amount of relief, even though the scratches that I had made were very superficial. Just imagine wearing a very uncomfortable pair of shoes that are 2 sizes too small that you are forced to wear for 12 hours. They are rubbing against the back of your feet and your toes, causing blisters that pop and the shoes continue to rub, making your wounds very sore and sting. Your toes are so scrunched in your shoes that they become numb. The pain is unbearable and no matter how bad the amount of pain you are feeling is, you cannot take those pair of shoes off. Suddenly you are allowed to take these shoes off, and the relief you feel is indescribable, but soothing. That is how it feels when you have all these thoughts ruminating in your mind constantly with pangs of despair and sadness and you relieve yourself by self-harming. After a few hours and the endorphins had eased off, guilt, self-hatred and shame made itself known. I was ashamed of what I had done and I was left with the evidence all over my arms. It became my seedy little secret, and I became embroiled in a vicious cycle of mentally torturing myself, self-harming and mentally torturing myself, so on and so forth. Superficial scratches were no longer enough to sustain my hunger for relief, so I found new ways to self-harm and I found new instruments to do it with. With each cut, the self-hatred and shame grew and grew until one day I decided that I was going to end my life. I’m not really sure to this day if my heart was really in it and I think I acted more on impulse as it wasn’t planned, but the intent was there. I wanted the pain to stop. I wanted the thoughts and the voices to stop. At the moment I swallowed several pills, I did genuinely wish to cease to exist. The world would be better off without me, without a useless waste of oxygen that nobody liked and nobody wanted. I was so wrapped up in the voices inside my head that were telling me how horrible and useless I was, I failed to see how my behaviour was affecting everybody around me who I loved and I never considered the pain and hurt they were feeling when I attempted to commit suicide. Was I really selfish? After all suicide is a selfish act isn’t it? Or was I just going to extreme lengths to try and stop the pain? The reason I didn’t tell anybody about how I was feeling was because I DIDN’T want to hurt them. I was trying to protect them. I was trying to put them first. I thought that their lives would be much better without me burdening them. But I was wrong. I saw the devastation my suicide attempt had caused, and I hated myself even more for it. I felt guilty, ashamed, a burden, worthless, useless and wished I had succeeded. So back to the original question, what is depression? I wish I had a simple one liner to explain it, but the truth is, I don’t. At the moment, I am fighting an extremely unpleasant bout of depression so I will explain the daily struggle I go through. After an extremely crap night’s sleep, I awake at 5am to get up and get ready for work. I’m tired, my body aches and my chest feels heavy. I really don’t know how I am going to get through a 12.5 hour shift. I don’t know if I can physically, emotionally and mentally invest in looking after 11 patients for 12.5 hours. But I know I must go to work. I can’t let my colleagues down, I can’t let my patients down and most of all I can’t let myself down. But it would be so much easier to stay in bed and hide all day and shut myself off from the world. It would be easier not to think at all. I now begin to be critical of myself. I tell myself I am pathetic, and that I should stop being so fucking stupid and just get up and go to work. The mental battle has already started and it’s not even 5.15am yet. I have several voices in my head telling me I should do different things. Get up, stay in bed, you’re pathetic, you’re better than this, you’re incompetent etc. Sometimes I cover my ears and shut my eyes so there’s just silence, but it never works. It’s now 5.30am and I am now starting to run behind. I make the decision to go to work but getting out of bed is difficult. Imagine you’ve got a 50 stone sumo wrestler lying on your chest and you are fighting him off. You know you have to get up, but you’ve got 50 stone laying on your chest, making it almost impossible to even move. You’re suffocating, you’re fatiguing and you feel so helpless because you can’t actually move anywhere. It becomes a simple decision of mind over matter. Eventually I wrestle with myself, using every last bit of energy in my body, using everything I have physically and mentally have to just get out of bed, reassuring myself that I can do this. Then I fight the same battle to shower, get dressed and drive to work. I am normally too tired to think too much and too hard on the drive to work but fleeting thoughts of how much better off the world would be without me do pop into my head from time to time amongst other negative and self-sabotaging thoughts. I park up at work and take 5 minutes to gather my thoughts together and compose myself. My breathing becomes more rapid because I am anxious about what the day will have in store for me and my focus is on getting through the day without breaking down and ensuring that I am a competent nurse. I practice my smile in my rear view mirror and spend a couple of minutes smiling and telling myself that I can get through the day. I can’t let my colleagues, patients or their relatives know that I am weak. I have to be strong. I can’t be selfish and wallow in my own self-pity and misery. I have to “pull myself together” and ensure I get through the day relatively unscathed.