‘I am useless’, ‘I haven’t achieved anything,’ I used to tell my therapists who presumably had heard that sort of thing a million times before. But I also said some slightly odd things like ‘I don’t make decisions,’ ‘My seven-year-old daughter knows more than I do’ and most peculiar of all ‘After I had a car accident and my one-year-old daughter, my youngest, was in the back crying I felt that I went to check on her, not because of any instinctive feeling, but more because I knew that was what other mother’s would do in that situation’.
I thought I had these feelings because I was depressed – and that’s what the many therapists and psychiatrists I saw thought as well. But now I know differently, I know that my problem is neurological, not psychological – I have frontal lobe epilepsy − my brain activity is abnormal (but I am not having obvious seizures) and my processing, decision making, memory, attention and awareness are impaired and this, my primary diagnosis, is making me depressed.
It has taken me 20 years of seeing therapists, psychiatrists, neuropsychiatrists and neurologists to come to this conclusion. And along the way I have also discovered that I am not alone in having a neurological condition that makes me depressed. People with undiagnosed ADHD, Autistic Spectrum Disorder, dyslexia, epilepsy and other neurological conditions often feel, as I do, in some way different from others and it leads them to the therapist’s door. The statistics prove the point – ‘Forty percent of people on the autistic spectrum experience at least one anxiety disorder at any time’ (The Autistic Society); ‘lifetime prevalence of depression with people with epilepsy could be as high as 55%’ (Journal of Neurology, Neurosurgery and Psychiatry) and ‘adolescents with ADHD are 10 times more likely to develop depression than those without ADHD’ (University of Chicago Medicine). But it’s also intuitive – if you feel different but don’t know why and you try time after time, and fail time after time, to be like everyone else, it is almost inevitable that you are going to get depressed.
Yet even though the evidence is there to see most therapists and, in my experience, most psychiatrists just aren’t trained to recognise atypical processing, memory or communication skills. No more so than for therapists – it’s not their bag – they deal with the psychological. But the impaired or atypical neurology impacts hugely on the psychological and I believe that those in the profession should become more aware of that. Although most psychiatrists should up their game and find out more about these conditions, many depressed people might not see a psychiatrist, or only rarely. Therefore other mental health professionals such as therapists and social workers (and even GPs) should also be trained to recognise symptoms. It doesn’t mean that they should diagnose or treat these people – they should just be trained to recognise symptoms and then, if appropriate, refer them to a suitable professional for assessment.
I still have a significant journey to go on. Epilepsy is not an easy or straight forward condition to treat. But I am convinced now that I need to find an effective treatment plan for my epilepsy and if I find that then my mood will improve. I don’t need to see a therapist, even though I am depressed. My case is complex – but shouldn’t have taken me 20 years to get this far – but without appropriate changes to the system others, with far less complicated conditions, will be doing the same thing.
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The research quoted in this article can be found at the following websites
Epilepsy – http://jnnp.bmj.com/content/76/suppl_1/i45