Durban - When Daryl Brown threw himself in front of an oncoming underground train in London last year, he didn’t expect, or want, to live.
The 27-year-old masters in marketing student from Cape Town had told friends he was returning to South Africa, deleted his Facebook account and had sent a goodbye e-mail to his parents’ work address so they would get it the next day.
But the train didn’t kill him. It injured him so badly that his legs had to be amputated, something that would change his life drastically.
He believes he attempted suicide because of depression, a misunderstood and misdiagnosed condition that affects one in 10 people at some point in their lives.
Daryl shared the story of his struggle with depression, his suicide attempt and recovery at the Mental Health Press Summit, hosted by the South African Depression and Anxiety Group (Sadag) in Johannesburg recently. The event brought together experts in the field of mental health.
Daryl is an ambassador for Sadag and writes a blog (darylb.com) in which he eloquently shares his journey.
Depression, he said, began during troubled teenage years when he became aware of his homosexuality and was bullied at school.
“I became secretive with my thoughts and emotions, putting up walls against the bullying, a pattern that ultimately led to my suicide attempt. After school, I became more involved at a local church, and for years I prayed that God would ‘heal’ me and make me straight.
“I tried one thing after another to cure my increasing depression, but a new job, hobbies and qualifications didn’t help. I made new friends, but I never felt that I fitted in. Eventually I came out as being gay, thinking that would solve my depression, but of course it didn’t.”
He moved to London hoping a new environment would lift what he described as “a heavy bucket of water on my shoulders”.
“I didn’t realise that the problem was not my circumstances, but my mind. I felt worthless and hopeless.
“I decided to end my life. I chose a Sunday so the train station would be quiet and waited until there was nobody around. Then I saw a train coming and stepped off the platform.”
A psychiatrist visited him in hospital and diagnosed depression. Sessions with a psychologist during a four-week stint in rehab made him realise that depression was treatable. He said the physical and emotional rehabilitation in the UK and here, involving medication and cognitive behavioural therapy, had set him on the path to living a productive life while managing depression.
The failed suicide attempt has changed his life dramatically and he has had to come to terms with losing mobility and independence.
“As much as I want to be independent, the support of my family and friends is essential, not just for my disability but also my depression. And they really don’t mind being there for me, it’s just that I’d never asked before.”
Daryl did not believe that a psychologist would be able to help him feel better, so he tried to fix himself. Like many people, he thought depression was something you could just snap out of.
“Being diagnosed had a very positive effect. I realised I was not the only person who felt this way, nor was I ‘crazy’. With cognitive behaviour therapy, my psychiatrist has taught me to look at all situations objectively and consider the many different interpretations that could equally be true.
“One of the most difficult things to come to terms with after losing my legs was the fact that I did this to myself. That contributed to my negative self-image, but it also became a motivation to move on with my life: whenever I was feeling sorry for myself, I would think that I had no right to sit and mope about being disabled, because I had brought it on myself, so I should just toughen up and deal with it.
“I still struggle to think of my depression as an illness, rather than a weakness of character. I’m not just ‘moping’ or ‘feeling sorry for myself’.
“Now I know better, I can say that my suicide attempt (and thus my disability) was a result of my illness, depression. That doesn’t stop me from sometimes retorting, ‘Yes, but you’re still an idiot’. We all want someone to blame, and with depression, that ‘someone’ is always oneself.”
Daryl keeps active with work and playing sitting volleyball.
“I am more active than ever. I go to gym twice a week. Last week a colleague invited me to go sport climbing with him and I managed to climb a 10m wall with just my hands! But my activities are driven by necessity – I must maintain my strength and keep fit – and my desire to socialise.
“The times I miss my legs the most are those moments when their absence takes me by surprise – making habitual movements that have been trained into my body’s memory, like sitting up and swinging my legs out of bed in the morning.
“The rest of my body remembers the movement and plays its part, but then suddenly there’s a piece missing and it hits me with a shock.
“It is so important to educate people about depression, the symptoms and that there is treatment available.”
Psychiatrist and psychologist Dr Frans Korb stressed that early diagnosis and treatment are imperative.
“The more depressive episodes you have, the more difficult it is to treat,” he said. “Depression is a medical disorder and PET scans show that large parts of the brain are affected. If depression goes untreated it leads to a cascade of events. There is also a point of no return and if untreated, the damage is irreversible.”
Worldwide, depression is increasing at an alarming rate and the World Health Organisation estimates that by 2030 it will be the leading cause of disability.
A study of 9 351 homes in South Africa found that almost one in 10 people suffers from it and 90 percent of respondents said they had some kind of impairment as a result.
Cassey Chambers, operations director of Sadag, said depression had many possible causes. An event could lead to depression or it could come on for no apparent reason.
“It involves your whole body, your mood and your thoughts,” she said. “It affects the way you eat and sleep, the way you think about yourself and the way you see the world. Depression is not the same as blues or sadness that we all feel at times, it is not a sign of weakness and people with depression can’t just pull themselves together and get better.”
In South Africa there are 23 suicides a day and 230 attempted suicides.
More men than women commit suicide, and while women attempt suicide, men are more likely to succeed because of the methods they use. Men are also less likely to seek help for emotional problems than women are.
Change your thinking
Change your thoughts and you can change the way you feel is the message behind cognitive behaviour therapy (CBT), the treatment that has helped Daryl Brown deal with depression and adjust to a new way of living.
The benefits of the therapy were highlighted at the Mental Health Summit by Professor Stephan Hofmann of Boston University, a leading CBT specialist.
“CBT is not psychoanalysis,” he said. “We do not look at what has caused the problem, but we look at what is needed to change the maintaining factors. It is a here-and-now approach focusing on current problems and how to overcome them.”
CBT was the most cost-effective treatment as between eight and 10 sessions with a psychologist were usually sufficient, said Hofmann. CBT alone was often sufficient for mild depression and could be used with medication for severe depression.
He said it was being used in the UK very effectively and he believed it would benefit many South Africans. According to Sadag, one in three people in this country may suffer from a mental health problem in their lifetime.
To find out more about CBT, contact Sadag (details at the end of the story).
Signs of depression
* Sadness most of the time, feeling anxious, and empty mood.
* Feeling of hopelessness about life.
* Feelings of guilt or helplessness.
* Loss of interest in hobbies and activities.
* Losing or gaining weight by not eating or overeating.
* Less energy than usual, tired all the time.
* Restlessness, irritability and anger.
* Difficulty concentrating, remembering things and making decisions.
* Physical symptoms that don’t respond to treatment, like headaches, stomach pain, back pain, chest pain, even if they have been checked by a doctor.
Depression is one of the most treatable mental illnesses and eight out of 10 people recover. A medical check-up is necessary to ensure there are no other medical causes.
Depression is treated with:
* Anti-depressants: Eight out of 10 people made a good recovery on these. Sometimes it is necessary to try a few to see which work, and it usually takes about three weeks before an improvement is noted.
* Psychotherapy or talk therapy: A psychologist, social worker or counsellor gives the patient skills to cope with their illness and the stress it causes.
* Support groups: This is a good way to get support and advice from people who know how you feel because they have felt the same way.
* For information on depression, mental illnesses or support groups, call Sadag at 0800 20 50 26, SMS 31393 and they will call you back, or visit www.sadag.org
Daily News