I was on the adult psychiatric ward, seated on a plastic NHS chair. Our conversation was strangely mundane for such extraordinary circumstances. I said as much and we fell silent, the enormity of what was happening suddenly hitting us.
My ears were on high alert; every cry and mutter made my head spin. I was acutely aware of the man sitting opposite, growling to himself. The two security guards stationed either side of him exchanged knowing glances every few seconds. I was terrified.
Mum said she should pop home to get me some bits and pieces, while Dad stayed with me. That’s when I lost it. I sobbed with no thought of my appearance because I felt at that moment, as I had felt before, that my heart was cracking open in agony. It was as if my pain was permeating the atmosphere.
I was the girl who had planned to go to Bible college and become a minister. But the girl who stood before her dad now, eyes wild and wearing a paper hospital gown – the girl who sat among the other people whose minds were bowing under the pressure of mental illness – had tried to end her own life. This was not how the story should have panned out.
Without any warning, the muttering man began to take his clothes off. His voice rang through the humdrum of the ward, and the security guards pounced as his behaviour became steadily more erratic, expletives falling from his lips like acid rain. I grabbed my iPod and, trembling, chose a recent sermon. I turned the volume up to maximum and the calming voice filled my ears. I closed my eyes as Mum clung to me and closed her eyes, shutting out the distressing scene before us. Through the earphones I listened to the preacher’s mellow voice: “But here’s the gospel truth: ‘The Word became flesh’. God has a human face in Jesus. God knows what it’s like to be human. God is not indifferent!”
John Swinton, professor of theology at the University of Aberdeen, writes: “As one reflects upon the nature of depression it becomes clear that it is a profoundly spiritual experience that cannot be understood and dealt with through drugs and therapy alone. Its central features of profound hopelessness, loss of meaning in life, perceived loss of relationship with God or higher power, low self-esteem and general sense of purpose-lessness, all indicate a level of spiritual distress.”
The psalms stand against the empty “I’m fine, thanks” expressions that are regularly exchanged in churches and youth groups across the land
What is depression?
The overwhelming experience of depression for me and many young people is one of exhaustion. Sleep is never enough to lift the tiredness that seeps into my body, making every step feel as though I’m trudging through lead. It’s unending grief, terror and blankness, and a sense that you are experiencing the world through a dirty lens, so that everything is dimmer and murkier.
The range of symptoms that can present themselves as part of depression are as varied as the people who are afflicted by it. Some young people find their movements become laboured and slow, while others experience restlessness and racing speech. These polar opposites also exist in terms of sleep. Some, like myself, find sleep a constant struggle, running the gamut of early morning waking, disturbed nights and nightmares. For others, wakefulness never happens. Their eyes are impossible to open, and their bodies feel like they are filled with lead.
For me, disrupted sleep is usually the first sign I’m getting ill. It’s important to figure out how depression affects the young people we support and note the early signs of struggle.
The defining aspect of depression is not just the symptoms it evokes but also the way these symptoms affect a young person’s ability to live their life. The symptoms themselves may occur in many of us, but it’s when they begin to interfere with life that a diagnosis of depression may be made. Depression makes the best days of your life feel like a distant dream and the worst days feel inevitable. Learning how to live with and around depression is not something that can be achieved overnight.
I clearly remember walking around my garden trying to hold back the tears and wondering if I had depression, before chastising myself that I was too young for that and was being melodramatic
The cycle of struggle
One of the defining symptoms of depression is anhedonia (the inability to enjoy things that used to give you happiness). You find the things that would usually give you pleasure no longer lift your mood. It might be a lack of interest in reading, sport or shopping, but this dulling of joy can make you feel as though life is very far from the promises of Jesus when he declared that he was coming to bring life to the full. It’s perhaps among the most paralysing of symptoms, because one of the first things we often do when we’re feeling low is try to comfort ourselves with things we enjoy, yet anhedonia makes this almost impossible.
During periods of depression I found that I had to develop new ways of passing time. Reading tired me out too quickly and going out filled me with anxiety, so I began to make a scrapbook of happier times. I watched endless reruns of Friends on DVD and filled in Disney princess colouring books (there weren’t many other options at the time!).
A child’s experience
It’s hard to pinpoint when depression became an unwelcome guest in my own life. There had certainly been shadows for as long as I can remember – times when thoughts became clouded and tears fell swiftly; times when, as a young child, I recall feeling an inexplicable sadness that usually resulted in spending playtimes alone singing Celine Dion ballads. But the idea that I was actually ill didn’t emerge until I was 14.
The preceding year hadn’t been particularly eventful. School had been difficult, I’d had a few arguments with friends and a distant uncle had died. But while these things weren’t easy, they certainly weren’t catastrophic. There was nothing I could pinpoint to explain the fog that seemed to be filling my mind.
I can clearly remember walking around my garden trying to hold back the tears and wondering if I had depression, before chastising myself that I was too young for that and was being melodramatic. It was a thought that would return and be dismissed numerous times before I finally sought help, and a further five years before I was given a diagnosis.
The summer before my GCSEs I went on a Christian holiday camp with a few church friends. I wasn’t well suited to a week of outdoor activities or sleeping in the open. I was, and still am, an indoors kind of person.
In the week before camp my anxiety grew and I cried from the moment I arrived until I saw my mum at the end of the week. At the time it felt like homesickness, but in retrospect it was a week-long panic attack. Even when I returned home I felt uncomfortable. When school began a few weeks later I cried every day for two weeks. Never one to embrace change out of choice, I found the new classes and pressure of being a GCSE student paralysing. I couldn’t explain what was going on in my head other than an overwhelming sense of isolation.
My friends tell me now that I preferred the company of small groups and hated eating in public. In truth, I can’t remember much about that time; I see it through a haze. Elizabeth Wurtzel, author of Prozac Nation, wrote one of the best descriptions of depression I’ve ever come across: “That’s the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it’s impossible to ever see the end.”
I spoke to my youth pastor and the minister of my church, probing as to where the tears were coming from. I clung to the promise of Revelation 21:4 with a ferocity that I had never before needed. In the sea of endless tears, I had to believe there would be a day when: “He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away.”
I felt like friendships that had been solid were faltering as I withdrew into my head, sick of who I was becoming. The nagging adolescent discomfort within my skin grew and morphed into a hatred that I carried around with me. The more people told me that I was precious and worth investing in the more it hurt, as if I was harbouring something disgusting that would make everyone run from me.
I began to convince myself that I didn’t deserve God’s love. People gave me verses from Psalm 139: “For you created my inmost being; you knit me together in my mother’s womb. I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well.” These uncomfortably familiar words became acutely painful. I managed to twist each phrase that was meant to build me up to justify my self-hatred. I didn’t understand how I could be a Christian and feel so low. I thought I must be a bad Christian, because Christians are meant to share the joy of the Lord and I didn’t see how I could do that when I was crying all the time.
A biblical response
In my desperation and guilt I studied the Bible like never before. I clung to verses I’d been given by my friends and youth worker, trying to squeeze as much hope as I could from each word. One came from Paul’s second letter to Timothy: “For God has not given us a spirit of fear but of power and of love and of a sound mind” (1:7, NKJV). Paul was Timothy’s pastor, and he writes to him here in such a tender and caring way. Verse four says that Paul recalls Timothy’s tears, which reminds me of the shepherd of Psalm 23 leading his flock home.
It’s a vision for what good mental health can look like, and it is something I’ve returned to in the years that have passed since. I didn’t want to be afraid of life, I didn’t want to hate myself, I didn’t want to feel like I was losing my sanity. These words offered me hope to fix my eyes on when all else seemed hopeless. Power, love and a sound mind were exactly what I craved.
I tore through the pages of my Bible, desperate to find some comfort. Time and again I was drawn back to the psalms. They expressed something in me that I couldn’t articulate, especially then.
Psalm 88 has been called the saddest psalm. Its words are unrelentingly sad and express how depressed people can feel in themselves and appear to others. It is a psalm that has no resolution or reminder of God’s steadfastness amid the pain. Indeed, the only hopeful reference comes in the first line: “Lord, you are the God who saves me; day and night I cry out to you.” The hope lies in the declaration that God is God, and the acknowledgement that in him lies salvation, and that he remains present and loving even when we feel most unlovable.
It was the honesty of this psalm that captured my imagination as a young person. Old Testament scholar Walter Brueggemann writes that Psalm 88 “is an embarrassment to conventional faith”. It is not the image people want to portray in their churches. It has no ultimate celebration, no triumphant confession of faith. Yet Psalm 88 spoke to me as a teenager as I constantly fought to hide behind the smile I felt was expected of me.
The psalms stand against the empty “I’m fine, thanks” expressions that are regularly exchanged in churches and youth groups across the land. When I felt unable to connect with anyone else in my life I started being honest with God.
I remember being surprised the first time I read Psalm 88 that it had no happy ending. It concludes: “Darkness is my closest friend.” Not only was that how I felt as a teenager, but the very inclusion of these words in the Bible gave me, and continue to give me, great hope.
How to support young people with depression:
- Listen to them and allow them to tell their stories
- Encourage them to seek medical help
- Help them to think about what they want to say before attending medical appointments
- Look at the psalms together, explaining to your young people that they aren’t alone and can bring their pain before God
- Use national awareness days and weeks to promote mental health in your youth and children’s programmes
- Don’t be afraid to say that you don’t understand but that you want to walk alongside them