I suffered from severe depression. Self-empowerment, not just drugs and therapy, helped me to recover | thearticle

When I wrote a book about suffering from severe depression in 2014, the most common reaction was that I was brave to open up about the condition. Stigma was real. I myself struggled to

understand why a privileged life – which I undoubtedly enjoy – had been no guarantee of a privileged mental health. Five years on, the landscape is different. Mental health is firmly on

multiple agendas. Everyone from the Duke and Duchess of Cambridge to the Prime Minister talk of the need to look after our psychological wellbeing: we are all aware of mental health now. The

empathy and openness with which mental health is treated now should be welcomed. Yet as one battle fades, another emerges: the nature and quality of treatment. You might have thought by

now, given the focus on mental illness and the increased government expenditure – the Health Secretary Matt Hancock announced in January this year that the biggest single rise in budgets was

in mental health services – that those who suffer would be delightedly discussing their improved care. Yet my experience running workshops alongside mental health charities, as an

ambassador for Rethink Mental Illness and Sane, is a disillusionment among many of those who suffer with the help they are receiving.   The two standard approaches offered by the NHS are

medication, chiefly in the form of antidepressants, and cognitive behaviourial therapy: a talking treatment, which aims to change the way people respond in thought and action to the world.

Currently, these are the best options we have, but neither are perfect solutions.   First medication. 7.3 million people were prescribed antidepressants in England in 2017. Many of those

same people are long-term users of the drugs: 4.4 million of them were also prescribed such drugs in both of the two previous years. Millions of people are therefore not sufficiently cured

of their mental health problems that they are able to stop taking the drugs after one year. I’m no scientist and it is not for me to pronounce on how effective various chemical compounds are

at producing changes in the brain. And yes, I took drugs over many years and did recover. Medication may well have been part of that recovery (though this is a subject of much debate, with

some trials suggesting that in some cases placebos achieve strikingly similar results to the real thing). But in an ideal world, I would rather have avoided the side-effects of

anti-depressants, sleeping pills, anti-anxiety medication and the feeling that I had to rely on drug-taking over a long period. The second established treatment is a course of cognitive

behaviourial therapy. Over the years, I have felt warmly towards various counsellors who have tried to help me, talking sympathetically and listening to my problems. And I have undoubtedly

been helped.   So conventional treatments have been of benefit, and my lesson here isn’t to disregard either drugs or CBT. But I do increasingly feel there is a third element to my own

current sense of calm and wellbeing, and that is a belief in my own agency. Boosting my sense of self-empowerment is a third leg on the stool of recovery, and one I feel is at times

neglected in the mental health world where it is easy to become dependent on others, whether psychiatrist or therapist. It’s impossible to disentangle all the different elements in my own

recovery. But what I do know is that feeling passive, and powerless to do anything about my condition, was part of being depressed. The more I discovered my own ability to take action, the

better I felt. This insight is the basis for my current approach to managing my own mental health. Every day I remind myself that I can make a difference. This begins as soon as I wake. The

first thing I do is to make my bed, the white duvet perfectly aligned and my pillows plumped. A small gesture to be sure, but one that reminds me that if I take control of small decisions in

this way I will feel my own power to affect larger decisions. In addition, I can take care with the language I use to myself and to others. Instead of saying ‘I’m at the mercy of my

depression’ I might say ‘I can choose how to respond to my low mood’. Or instead of saying ‘I can’t deal with this stress and worry’, I might say ‘I can’t deal with this stress and worry

_yet_.’ My approach, and the creation of a practical workbook of ideas and exercises for readers to complete, has evolved with the help of many others, including mental health nurses,

psychiatrists, therapists and psychologists, as well as those who come to my workshops. Together we have developed practical steps you can take to feel empowered, be it writing an

appreciation letter, cooking with your mental health in mind, or composing a poem to process difficult feelings. There is a place in my day for thinking and reflection, but I’ve found that

while pondering often makes me sad, doing rarely does. Little by little, I’ve taken on more responsibility for my own mental health. No one says it’s brave to have done so in the way it was

once to talk about mental illness. The story has moved on, and so have I.