Around December 2017, I became concerned that my husband wasn’t ok. He was moody and he was distant.
He was often miserable and snappy and it was exhausting. I spoke to him about it a few times, and he eventually opened up that he wasn’t feeling ok, but he didn’t understand why.
We’d had a difficult couple of years, and so I thought it had probably taken his toll on him; he also has a history of depression, so we talked about him going back to the doctors, which he did come the January 2018.
The doctor put him on citalopram, a fairly standard medication for depression, that he’d taken before and had seemingly worked for him, and told him he would feel worse before he felt better. I thought at the time that was a weird thing to say to him, but put my faith in the professionals.
He did feel worse, a lot worse, but carried on, because that’s what he’d been told to expect. No one followed up to see how he was, and he didn’t ask for more help, because as far as he knew, that’s what was meant to happen.
Just over four weeks later, after a blazing row after I had been away in Benidorm for the weekend, he told me he didn’t see the point in life anymore, before storming out and not returning for three hours.
In those three hours, he had tried to take his life.
The following day, he reluctantly signed off work, not wanting to tell anyone what had happened, and went back to the doctors. The doctor upped his dosage of the medication he was already on, and told him to self-refer for therapy.
He again reluctantly did that, and when his appointment finally came through, was told by the mental health professional who he saw that he was already doing everything right, and that he should continue to go to the gym and read a few books to try and get a healthier mindset.
Before leaving he was given a leaflet with contact details on if he needed to get back in touch.
Yes, you read that right, he had gone back to the doctors and to a mental health team, following an actual suicide attempt, and was told to do a bit of exercise, read a book and sent on his (not so) merry way.
That still makes me so furious that I could cry thinking about it. We argued when he got back, because I couldn’t get my head round how that was sufficient support.
He, in an obviously very dark place got angry with me, because he was doing what he was meant to do, and was frustrated that I still didn’t think that was enough. He couldn’t see through his own depression that I wasn’t blaming him, but I was terrified, every moment of every day, that I was going to lose him.
Over the next few weeks I pushed and pushed him to go back, and we argued regularly. I’m still not sure that was the right thing to do, especially as it was at a time when I was terrified that one more push could literally kill him; but if I hadn’t, I dread to think what story I’d be telling now.
Now we may have just been unlucky in who he saw, I certainly hope we were. But either way, self-referral and no follow up simply isn’t good enough; in fact, it’s a disgrace.
Nobody would go to the doctors saying they thought they had broken a bone, to be told to self-refer for more help if they thought they needed it. They would be fully assessed, referred for x-rays and all of it would be handled by the doctor.
If someone has taken the enormous leap to get an appointment with their doctor, then they should be supported there and then to fill out the necessary forms needed to book the next appointment, and leave not needing to do anything else.
Furthermore, if someone is coming to you saying that they feel suicidal, that they’ve tried to take their life, or that someone has intervened on them in the process of doing so, then surely the first step has got to be to ensure they get a psychiatric assessment and/or see someone with medical expertise in mental health.
In our case, getting him to self-refer again, nearly ended our marriage. As far as he was concerned, he’d seen a doctor, seen a mental health nurse and there was nothing more he could do, he just had to accept he might always feel like this.
I’m still a little ashamed to say that an explosive row started over nothing, which resulted in us saying some of the most awful things we’ve ever said to each other, some I think we’re probably both still scarred by now. I ended up screaming at him to leave and not come back until he’d spoken to someone again.
It was about 6 weeks since the night he’d tried to take his life, and things were worse than ever. My world was dark, and it was miserable, and the weight I was carrying felt crippling.
I was desperately trying to hold down a high pressured full time job in condensed hours, parent a 4 year old and 18 month old with enough love and positivity that they weren’t fully aware of what was going on around them, whilst every day feeling like I was on suicide watch, unsure if I was going to return home from work to find that note, or worse. I sobbed on him that I couldn’t physically or mentally do anything else to help him, that it was breaking me, and that he needed medical help.
I am so incredibly proud to say that he did self-refer again (now his 4th time of having to ask for help), which is probably the single, strongest thing I have ever seen anyone do. As it turned out, he’d been ending up at ‘suicide spots’ two to three times a week, without any real idea how he had got there, or why.
It took him telling the triage nurse that his suicidal thoughts were so strong and frequent that if they didn’t do something, he would die, for him to finally get an urgent referral for psychiatric help from a senior mental health consultant.
That appointment took place less than a week later, during which the consultant took one look at him and said he didn’t even want to talk about therapy until they’d sorted his medication. He could see just from watching him, that his anxiety was through the roof, his mental health was about to implode and that urgent action needed to be taken.
He asked how he had come off citalopram in the past and whether it was managed with his doctor, it wasn’t and my husband explained that he had just stopped, because the medication had worked and he felt better. The consultant then explained a concept he referred to as ‘bounce back’, where a patient develops a tolerance to medication by not phasing it out gradually, and this is something that is apparently quite common with citalopram.
This meant that my husband had spent four months gradually increasing the dosage of a medication that was having no effect. His prescription was changed immediately, and within days, it was like a switch was flicked. For the first time in months, I felt like I had started to get the boy I’d fallen in love with back.
I will be both eternally grateful and angry about that. It should never have taken that much fighting through the system to get him the help he needed. I don’t wholly blame the medical professionals that my husband saw, I blame the people who allow the system to be so chronically underfunded, whilst simultaneously crowing about how important mental health is.
Their decisions have a direct impact that makes actual experts in the field difficult to access, and puts enormous pressure on GPs to be experts in everything, and not the general practitioners that their very name tells us that they are. It makes me feel sick when you see the social media campaigns of how high the statistics for suicide are, and to think how many people are out there, who just need the right medication, but can’t get the right help, even if they are in the minority of people who have found the strength to ask for it.
We are quick to now say and recognise that depression is an illness, but we still don’t treat it as one. I understand that not all depression needs to be medically treated, and that for many, the standard prescription will work; but I don’t understand how if someone is actually telling you they’re suicidal, further psychiatric help, and a proper look at medication isn’t the first step. I mean, if it turns out it was unnecessary, there’s literally nothing lost.
I have to be honest, since everything that’s happened, the awareness campaigns around mental health scare me. Now let me preface that by saying that I think they are brilliant and well needed, but they’re not enough.
I’m well versed in awareness campaigning, I really don’t mean to belittle the importance of the incredible work they have done and continue to do; but it strikes me that the narrative around mental health is still very much aimed at telling an ill person that they’re not asking for help enough, or telling their loved ones that they should be doing more.
Scroll through social media and there will be dozens of accounts and awareness campaigns who are telling you what to do to look after someone else; but they don’t tell you what that might do to you mentally and emotionally.
They’ll tell you to make sure that the person you’re supporting knows they’re not a burden; but they don’t tell you that sometimes it really feels like they are. They’ll tell you just to be there, and listen, and understand; but they don’t tell you that sometimes you won’t understand, because it’s not logical, and that will make you angry and feel like the worst person in the world.
After my experience of trying to support my husband overcome the huge hurdle of talking and reaching out for help, only to be let down by an underfunded system – it worries and scares me that so much focus is put on getting people to confront real and dangerous demons, to then either fob them off and/or not have the help they need readily available.
If the services were better invested in and resourced, people might not even have to ask for help or have to wait until things literally can’t get worse before they get it. Awareness and understanding are so very important, I don’t doubt that, but without campaigns that include tangible change and action it just all seems a bit futile.
I spent the best (worst) part of 2018, feeling like I was on suicide watch. I lived in constant fear that I wasn’t doing enough to help, or the help I was trying to give wasn’t good enough, and that at any moment my world could fall apart.
I vividly remember, about a month after everything happened, ringing him to see if he could collect the children from nursery, as a meeting at work was overrunning. He didn’t pick up. That’s fine I thought, maybe his phone is on silent, he’ll call back in a minute.
He didn’t. So, I called again, and he didn’t pick up. And again, and no answer.
By the time it got to the 7th call, I started to panic. I needed to leave work at that point as if I didn’t, I wouldn’t make it to nursery in time. I flew out of work with barely a goodbye to anyone, and my heart was racing – every single scenario going through my head.
I was terrified. I picked both children up and tried to act as normal as possible, wondering whether to drop them at their Nan’s, in case we were going home to our worst nightmare. I thought I was going to be sick.
As it turns out, he’d fallen asleep whilst playing Xbox that afternoon. In that moment, I felt like I truly hated him. My stress levels were through the roof, and he was spending his days playing Xbox and napping.
But however much I thought I hated him, I hated myself more for not being the person who the awareness campaigns were telling me to be.
I promise this isn’t just a rant at awareness campaigns and well-meaning people on social media, but I think it’s important to note, because when I was in the thick of it, it just made me feel even more like a failure than I already did.
Everything those campaigns say is true, and for the large part, it’s what I did, even if I didn’t believe it at the time. However, looking after someone who’s struggling with their mental health isn’t easy – it’s draining and sometimes it feels endless, and we need to be more honest about that.
We need to let those who are in the thick of it know that it’s OK to not be perfect. We need to be telling them that you can’t fix someone else by breaking yourself, that it doesn’t make you a bad person and it doesn’t make you selfish to get it wrong, or to walk away if you’ve done everything you can.
A very good friend said to me “you know whatever happens, it’s not your fault, if you stay or go, and if the worst happens, it won’t ever be your fault”, and that is probably the most valuable thing anyone said to me, those words lifted a little bit of the weight I was carrying.
My husband’s depression won’t ever fully go away, it’s part of who he is and how his brain works and we still, very occasionally, have difficult times; but with the right support and medication it can be managed.
So, if I could give one piece of advice to anyone currently going through this, it would be to make sure you get that appointment with someone who has medical expertise in mental health. If it turns out medication isn’t the answer, then you’ve literally lost nothing, but if it is and you don’t get it, you could lose everything.
And finally, please know that how you feel is temporary, I promise you it will get better, and that suicide is never the answer.