My experience with depression - Dr Raquel Thomas-Caesar

(The University of Guyana held Turkeyne & Tain Talks 2 on Monday 12 September, 2016 on Suicide Prevention . Dr Raquel Thomas-Caesar made a presentation based on her experience. This is the text of the presentation)

by Raquel Thomas-Caesar

I am not an expert on the issue of Suicide and Depression but this is my personal journey dealing with such issues. I have never spoken publicly about this at such a forum and I hope that it serves to help others even if only a small way- Dr Raquel Thomas-Caesar

South East London,  June 9, 1995
As I sit under the tree, hidden from all eyes…I wait….to go. I wait to die. Then it hits me…OMG. I really don’t want to die. What have I done? My head is swinging, fuzzy, I can hardly walk. But I barely make it up and up the hill…I see two young black men in the distance…they come towards me, I could only imagine they thought I was on drugs..I beg for help. My Angels.  I wake up in the hospital.
This was me- 21 years ago.  In a foreign land, dreary British weather, lack of sunlight, struggling to come to grips with feelings of failure for a PhD I had hardly started, a broken relationship, a new one that should have never begun,   broken relationship with my parents at the time (in Guyana), feelings of nowhere to turn, feelings like I was alone.  Feelings like I was going mad…was this what a nervous breakdown felt like?????…. I quickly realized that there is a very fine line between sanity and madness.
Never could put a name to what I was feeling. Until a few days after, An Oprah Winfrey show on Depression really showed me the light.

While I am not clinically diagnosed with depression, I know what it feels like. And for persons who have never experienced it….. you cannot even begin to imagine. The feeling of loss of self worth, of hopelessness, the sometimes loss of rational thinking, the joylessness, the loss of energy, the numbness….. And then there is the pretending, that all is well when really all is not…….and it is just easier to isolate yourself rather than explain. Why? Because many just expect you to snap out of it. Many are not sympathetic, or it may just be many just don’t want to see a ‘strong’ woman having a weak moment ……

It took me a long time to be able to speak about it, 16 years of shame eventually caught up with me, and the fact that other persons close to me were suffering- made it easier to speak out. Understanding it more as well, now knowing that there is a genetic link and once in your family it could predispose you to the condition. Then there is the stigma- She! No way. She has it all, why would she suffer depression? Then there are those who would tell you- you are not mentally ill. Do not use those words. Yes MENTAL ILLNESS seem to be cuss words in our society. You are deemed MAD! It is so much easier to say look I have cancer or a physical condition it seems.

Mental health issues… In the past five years I personally know SIX persons who have committed suicide… 2 years ago a colleague at work drank poison (at work)- shocking as I thought I would know the signs of a persons on trouble, then there was Laleta (former colleague) who went via Kaieteur, a friend’s brother who shot himself, Zenita the activist, and a friend whose mother took her life. Then recent case of the miner that shot himself (after shooting wife), a relative who also suffered depression.

And I ask What If!
What if I had chosen a different route, what if it wasn’t just pills. What if I didn’t make it up the hill to get to the young men…. I try not to dwell too much on this. My thoughts: There is a reason for me being here in this world to share my story and maybe it helps someone else.

This is my story, but it could be the story of many.

• My episodes comes in waves…sometimes there and sometimes not… when it lifts I feel like a butterfly emerging from a cocoon
• Unless I tell you, hardly likely you would know when I am suffering a depressive episode. I am highly functional and don’t like to talk about it. And this is the reality of many I believe.
• I went to a doctor on the insistence of my father, ONCE, 21 years ago in Guyana when I returned from the UK to do my field work for my PhD, but he never counselled me and handed me a bag of pills. PROZAC I believe. I took one and then threw the rest away. Always had a big fear of becoming too dependent on them. I do not take meds. I just do not feel this is the solution for me. But I understand that for some this is absolutely necessary
• I do not trust many people to talk about how I feel when in an episode… I do not trust many counsellors, I have heard too many stories of confidentiality issues so this makes me very hesitant. This may be misplaced thinking but there is a level of narrow mindedness in this country on so many issues. I have my little circle of friends that have my back…and this works for me. Another reason not to talk to folks is that I feel it is a burden that they cannot really handle too well. This also maybe misplaced thinking but that is my feeling. But really what do you say past- I am feeling depressed!!! And I know, unless you have been depressed you truly never understand…what it feels like.

BUT it is not all negative

• I have learnt to say NO without apology and very confidently. I refuse to take on more that I can deal with.
• This journey has taught me so much compassion for what others go through
• I would like to believe that I have helped many others this far in my journey

WHERE DO WE GO
I am no expert, I speak only from my observations and there are many many recommendations by the NGOs that are working in this arena.

• Do we really have the political will in this country to deal with this issue? When I hear a comment like ‘happy people do not kill themselves’ I feel a bit hopeless because I really feel the issue is not understood by some that stand at podiums to speak on this issue. How do we reach our leaders who have no experience with this issue? What is said in a speech can have a tremendous effect on someone that is feeling very low. And to be honest I was a low point when that above comment was made by our President. And I hope that he hears this. I feel almost that while there is the problem, the Government seems almost crippled to deal with the issue. Yes there are the ‘here and there’ interventions but we need a holistic and really truly collaborative plan to tackle these issues. Government, NGOs, Academic institutions etc need to work together. I personally would like to see more about the National Suicide Prevention Strategy in the public domain…it is there but quite invisible.
• Minister of Education (Sept 2016)- I understand is committed to counsellors in school and with a special unit set up. I hope we see urgent action on this
• I commend all efforts this far on this issue. We all have a role to play. Developing a superior attitude about one’s interventions helps no one. We need to stop fretting about what the Government is not doing or who else is not doing and continue or work. We need to help the Government, the Government needs to be open and willing to listen and accept help. We also have to hold the Government accountable. This is a human resource issue, human resources is one huge pillar that holds up an economy. So it also is about dollars and sense. If the stats are showing the top candidates for suicide are between ages 12-34, it is so worrying. We need to encourage other NGOs or organisations in their fight and also support their way of doing things and not take the moral high road when others are not doing things the way we want to see it down. We need to stop ‘JUDGEMENTAL ACTIVISM’ something I often see these days and really bothers me.
• University of Guyana, NGOs, Government- has a responsibility to conduct proactive, stats based and peer reviewed research for GUYANA. This is so needed to provide information for interventions. The government and donor agencies need this.

• And to NGOS and your campaigns…. Vidya Kissoon did a powerful piece yesterday called ‘Suicide Prevention without empathy’. Everyone should read this. One part that resonated with me is the campaigns and who they target. I really feel walking around with slogans that say ‘Choose Life’; ‘I LOVE LIFE’ etc… really is not for people suffering from mental illness…But it is GOOD as it targets people that are not suffering and starts creating awareness. I hope that it helps to create EMPATHY and COMPASSION. But in my view there needs to be a two pronged approach as folks who are depressed do not want to hear about vigils, walks, etc (in my experience)…. So one approach that targets the population and creates the awareness (the walks, the vigils, panel discussions etc) and an approach that targets those that suffer are needed. Interventions should include the development of support groups (with strict guideline on operation), improve access to info on the suicide hotlines (show hands in this audience who has the suicide hotline number saved in your phone), educate our society about mental illness so we can remove the stigma so that when folks feel ill, they know what it is and they can get the correct support.

• We need to be honest about the cultural learning of suicide. In some parts of this country, suicide has nothing to do with mental illness ( I believe) but is more a learned coping mechanism for dealing with problems. This has to be tackled. We have some movies (Ethnic movies) that actually glorify suicide. How do we deal with this? Every day there is a story….and we only hear of the deaths…what about the many that attempt and do not succeed. Happy to hear that Liza’ study is addressing the latter issue.

• Pesticides- on a policy level it is crucial that we deal with this and issues of easy access must be addressed. Many NGOs have been advocating this for a long time. The Government just needs to take the bull by the horns and do it. Minister Norton is here and I hope that there will be urgent action on this.

• Workplace awareness. I recommend this highly along with awareness on other issues including labour laws, rights of women, gender issues, gay rights, NIS etc. We need to teach others some signs to look for if a colleague may not be doing too well. This may really help save a life!

• Finally, I really would like to ask that people be kind to others, we never know if the words we say can make or break a person. ‘ Connect, Communicate, Care’. And please put the Suicide Hotlines in your phones. It may save a life!

Some studies/newspaper articles

• Epidemic of suicide by malathion poisoning in Guyana. Report of 264 cases. 1973 Nalin DR.
• Toxoplasma's Dark Side: The Link Between Parasite and Suicide. 2012. Scientific American 
• Guyana-based American University of Research (AUOR) on ‘Suicide Prevention and Self-Awareness in the Essequibo’ 2013.
• The Guyana Foundation study 2014 
• http://guyanachronicle.com/regional-health-conference-hears-suicide-appears-to-be-a-culture-among-east-indians-in-guyana-suriname-and-trinidad-and-tobago/ 
• What is Indigenous Health and Well Being, Celine Tschirart. 2016 . Cobra Project

(The Guyana help line numbers are 223-0001, 223-0009, 223-0818; cellphone numbers include – 600-7896 / 623-4444. )