On Wednesday I had my first appointment for Cognitive Behavioural Therapy. Because of my work patterns, it’s more convenient for me to attend at another surgery, the other side of the Wye Valley in the Forest of Dean. Wednesday afternoon was foggy and murky, and as I drove towards the surgery, getting more and more lost in the fog and the murk, I couldn’t help comparing the journey with a journey into my subconscious.
I eventually arrived in the right place ten minutes late. The therapist I saw, Jenny, was very pleasant. I’ve had psychotherapy before, and found it immeasurably helpful, but this had a different focus. One of the first things Jenny told me was that since I’ve suffered from depression so consistently for so long, I probably won’t ever get ‘better’. This appears to be clinical depression rather than reactive depression, and so rather than hoping for a miracle cure, I need to focus on management of the condition in order to live as fully and constructively, and happily, as I can.
This might sound like a bit of a pessimistic propsect, but in fact it was a breakthrough for me. Rather than feeling guilty that I can’t make the effort to get better, here is a medical professional telling me that this is no longer a concern. I felt it take a lot of pressure off.
In the course of the session we discussed many subjects, and came up with strategies for dealing with what evolved as issues. For instance – I don’t take care of myself properly. I always assumed I did, but on investigation, I feel guilty about any time or money I spend on myself. Part of that is ‘having three children’ syndrome. Because I am not the primary carer, any time I’m not at work I feel I ‘should’ be spending with the children, or doing housework, or just giving The Husband a break. The effect of this is that any time I do take for myself feels like an enormous effort. Whenever people suggest I should have some ‘me’ time, or do exercise for instance, in the back of my mind I’m thinking – but you don’t understand, you don’t have my life, my responsibilities, my time pressures. Perhaps it’s not surprising that the effort of getting out of bed in the morning, getting dressed and putting makeup on always seemed like an impossible mountain to climb.
But the effect of the outside observer’s opinion is quite astonishing. Because she has said I need to look after myself, I’m making more of an effort to do so. One of the things Jenny recommended was doing some more exercise. I’ve started up various exercise plans many times in the past, only to fail to keep to them and abandon them, feeling lazy and like a failure. But Jenny and I are both of the opinion that some of my exhaustion comes from a lack of exercise. So the middle ground is a ten minute walk in the fresh air every day. Enough to get the blood pumping, to raise the endorphins and seratonin and lower cortisol levels, but not enough to seriously inconvenience The Husband, or take too much time out of my working day. It’s also so little that even if I’m really quite unwell (as I am at the moment – terrible cold!) it’s manageable.
I did it yesterday – I just walked around the office grounds for a short while, and it really did lift my day. And I felt as if I had more energy this morning, even though I slept really badly. I also took the time to wash my face properly and use moisturiser this morning. It’s obvious now that I’ve slid into some very strange attitudes without noticing, which reinforce my feelings of worthlessness. So tackling those by challenging them in my own head is the way forward for now. And I can allow myself to do this because someone else gave me the permission to do so.
I’ve got another session in a month, and it’ll be a good time to review progress. In the meantime, I’m waiting for a good time to do today’s walk, and I have a haircut tomorrow. And I’m making a real effort to eat properly, take medicine when I’m in pain, and generally treat myself as if I’m a worthwhile human being. I’m 41. Why am I only just figuring out that this is the right thing to do?