Looking back, I’m astonished that it took me two major breakdowns, one in 1997 and the second in 2004, before I began having therapy. Even though, during the second episode, I was bed-ridden for nearly a year, I was prejudiced against seeing a therapist. I thought therapy was for losers. My family motto was ‘Keep calm and carry on’; don’t make a fuss and don’t talk about your problems. Deep down, I was also frightened of what therapy might reveal. It was easier to trust my psychiatrist and his antidepressants and sleeping pills.
But something changed after my second major depressive episode. I knew I needed to keep working at recovery. A history of depression makes you more likely to relapse. Subsequent episodes tend to be worse and more difficult to recover from. I needed to try to pre-empt depression and minimise the risk of its recurrence.
In the end it was my psychiatrist who persuaded me. A person, unlike a pill, can listen to your story when you are well enough to tell it, and give you a fresh perspective, he said. There was a limit to what he and his prescriptions could do.
But, even after accepting the need for therapy, I still thought I could bypass a therapeutic relationship. I first tried to teach myself cognitive behavioural therapy from a book. Though I made tentative steps in being able to rethink difficult situations, I remained highly anxious and dipped in and out of depression.
I thought perhaps learning more about psychotherapy would help so I signed up to the Foundation Course at Regent’s College. Studying therapy was safer than having it myself. Then I realised that undergoing therapy was one of the requirements of the course. I had no choice.
My tutors were persuasive about the importance of working with a therapist. We gain our sense of self from our interaction with others. Therapy is about a relationship between two people, in a room and, importantly for me, in the moment. This has become a key to my recovery: learning to stop regretting the past and worrying about the future; enjoy the present moment.
It took me three tries to find the right therapist. My first therapist was sympathetic and helpful, but she lived more than an hour away and, with five small children, I couldn’t find the time to commit to seeing her. With my second, more local therapist, I was doing all the talking. This can be a good approach for some but I needed more interaction and for my therapist to actively try to help me with strategies and approaches to reverse my negative thinking.
Therapist number three was recommended by a friend with similar symptoms and behaviour to mine. Sarah worked by helping me identify my feelings, root them out, classify them and investigate how they had solidified into beliefs. By acknowledging my feelings, especially those of anger, I came to accept them, and became less judgmental of myself and others in the process. Under Sarah’s supervision I would write letters to my different selves and plot maps of how I moved between them and the rules of behaviour I had created around them, many from long ago when I was an anxious child. I no longer needed to behave like that.
Sarah worked with my own love of words. One of my chief consolations during my depressive episodes, along with the love of my family, was poetry. When I was well enough to concentrate, short, accessible poems pinned me in time. They also worked outside of time, connecting me to another person, sometimes centuries old, who felt the same as me. Sarah encouraged me to use poems, and added breathing as another way to stay in the moment and reduce my anxiety.
She was both guide and instructor. Her aim was to encourage me to rely on myself, to trust my own feelings and ultimately become my own guide.
Sarah and I ended our therapy last year, after two years. Since then, I feel I have my Black Dog on tight leash. Therapy taught me to be easier on myself, and to find a more compassionate voice. I only wish I hadn’t had to endure two breakdowns and too many wasted years before realising what an immensely powerful tool it can be in the battle against depression.
Rachel Kelly’s memoir, Black Rainbow: how words healed me – my journey through depression, is published by Hodder & Stoughton.