Almost all the people we talked with had been diagnosed with depression, most by their GPs and some by psychiatrists or psychologists.
For some, non-mental health specialists such as gynaecologists or oncologists had picked up on their depression. A few people were advised by work colleagues, friends, or family to seek help.
Reactions to being diagnosed varied from relief at being able to name their distress to discomfort about being diagnosed with a mental health condition. In some cases the diagnosis was carefully and compassionately conveyed by a health professional, while other people were told in a way that caused them additional distress. Most people talked about feeling sad, lonely or ‘different’ for a long time before they were diagnosed (see ‘Stories of growing up’).
Most people had been through several episodes of depression and said the first encounter with a medical professional regarding their emotional distress was crucial. Being treated with understanding, care and support and having enough time to talk were much appreciated. Stewart said being diagnosed made him feel as if a ‘weight had been lifted off my shoulder’. While still in her country of origin in Africa, Akello was diagnosed with perinatal depression but received little useful help. After immigrating to Australia, her work supervisor advised her to seek help after noticing she was experiencing emotional distress. She saw a supportive GP and her experience of being diagnosed was positive.
Akello migrated to Australia in 2005. She is married with three school-aged children and works part time as a community worker and in office administration. Ethnic background' Ugandan.
Yes that was the gynaecologist
And, when the doctor told me I felt like, yes I already knew. That’s how I felt. I already knew that this was it, but I was too scared to say it because I could have been wrong.
And so she sent you to a psychiatrist?
Yes. She sent me to a psychiatrist, and had he had time with me he would have explained the effects of the medication and told me what the medication was, because I don’t think he told me. Or maybe he did tell me but it didn’t register.
So because I had worked in an aged care facility, one evening I went to work and my supervisor in that facility - I got there and I said look I feel, I just didn’t feel like coming to work. She said why? I said, I don’t know. I just wanted to call in sick, but I don’t know how to tell lies and she said ah, why are you, why do you feel that way? I said I don’t know. She said have you worked anywhere else? I said no. I just woke up this morning, didn’t want to come to work; didn’t want to do anything.
So she kept asking me leading questions and then she said you know something, you should go and see your GP. You sound depressed. Talk to him about how you are feeling. That was my supervisor.
So a day later I went to my GP and the receptionist asked me, oh what can I do for you? I said I have come to see the doctor. My supervisor said to me I should come and see the doctor because she thinks I’m depressed and I think the receptionist knew there and then, she made an appointment for me immediately.
And, I saw a doctor who I really like - a female doctor. She was very nice to me.
Age at interview:
Age at diagnosis:
Millaa is a full-time student. He lives at home with his parents and three siblings. He runs a weekly radio program looking at issues in relation to Queer-identifying youth. Ethnic background' Welsh, French, New Zealand and Australian.
I was about 15, so I didn’t really, I didn't really understand anything at all, really. Looking back, you know, you were 15, what do you know. You know, you think you know everything but you know nothing. … you know, I was really well read, so I did, I did have an idea of what depression was – like I had what I thought depression was I should say. I didn't really. I … found out it was more faceted than just being sad and lonely and… feeling distressed all the time. I felt, I found that it was a lot more deep and a lot more intense than that could possibly be. It’s a lot more than sadness. People think depression, they think sadness. Depression and sadness are quite different I think. ‘Cause, sadness is, is a baby compared to the mother that is depression, you know, it’s – yeah.
And what I got from the diagnosis was that you know, it's a treatable disorder. It's not something that's – you know, it's not terminal, it's not - it's chronic, yes, but it's not something that can't be managed or fixed. Well, not fixed but managed and to a point where you can still live as a person, wanting to do the things you want to do. You just need a lot of therapy and some, maybe drugs, you know, it’s...
It was common for people to describe being diagnosed with depression as bringing a sense of relief after living with emotional turmoil, in some cases for years. People reached this point via different routes. For those with multiple mental health conditions and other health issues, having their depression diagnosed was not straightforward. Some people had been diagnosed with dyslexia, anxiety, hearing voices, anxiety, post-traumatic stress disorder, eating disorders, attention deficit hyperactivity disorder (ADHD) or a combination of these conditions before depression was introduced into the mix. Clinton said that he had stopped searching for a label, as felt his mental health condition was more complex than a single label could convey.
Chloe works at a youth homelessness agency. She lives with her partner of six years. Ethnic background' European.
Well… it’s hard to remember. I guess… in a way it did make me feel a little bit better because all those things that I’d been experiencing were caused by something and that was comforting. But then you know, you go through the whole, ‘What’s wrong with me? Why do I have this? Why don’t they have this?’ And then, then yeah. But , it was good because then you had a label for it so when you were like seeking help or looking for a service provider or another doctor you could say, you know, ‘I need help with depression,’ rather than, ‘Oh this is going on; I don’t know what it is’, and yeah. So it was good in a way. Yeah, it was good.
Age at interview:
Age at diagnosis:
Alice is a qualified lawyer who works as an academic. She has five children and a close group of friends. Her main pastimes are reading and fishing. Alice is separated from her husband. Ethnic background' Anglo-Australian.
So…yeah, and I needed to hear what he had to say ‘cause he didn’t - I said something to him and he said, ‘I’m not, I – save that for the counsellor’. I thought, ‘Ooh, lots of empathy here, come on’, but I know what you know, he, he was after diagnosis, a diagnosis not , not to listen to the sad story kind of thing, so, ah, and that was good ‘cause that was the approach I favoured anyway by that stage… and I was able to walk out saying, ‘Well OK, no I’m not this, I’m not that, I’m, you know, basically I’m, as he said, severely depressed’. And he said, ‘You suffer severe depression, it’s been getting worse since your mother died, you probably had the foundations for it long ago in your childhood but it’s come, it’s built up, you know, since she, she died and , and, and it’s severe depression,’ and he said, which I found at the same time as challenging, also reassuring, he said, ‘You do know it cost you your career,’…and I thought, ‘Yes, you know, it did’. I resigned a few years ago, …and I resigned from tenure…So, yeah, it did…It – and that, that, it was challenging to hear that but it was also an enormous, it was also an enormous relief because I felt, I felt someone had now diagnosed what it is I can actually now deal with it. I don’t have to, you know, take a medication that I don’t know anything about or don’t know what it’s for or you know, so it was the best thing I’ve ever done.
Age at interview:
Age at diagnosis:
Clinton is an entertainer and musician who lives with his wife. Ethnic background' Anglo-Australian.
A lot of conflicts. I was caught stealing when I was young, and all those sorts of things. But when I was 19, and I had that dream, the next day I went to a sexual assault counsellor, and the floodgates opened, and I could recall every single thing about, the place where the abuse happened. I could've drawn a map of it and shown where the skateboard was, and where this was and that was - the smells, everything. But once the floodgates were kind of opened, and that - and I thought well here I've got a - I've got a starting point.
So the sexual assault counsellor suggested I go and seek, you know, some information, and just start a - a journey, if you will, to find, to learn about what was going on. So I went to a doctor who diagnosed me as having depression.
It's really interesting to try and make the connections, and even psychiatrists who diagnose me now, normally the diagnosis will start with, ah, Clinton's mental history is complex, and then go into a five page analysis of it.
And in some ways I've stopped searching for - for actual labels to what I - to what I have. The last diagnosis that I got was very helpful, but if you look back across the last five diagnoses I've had you can include ADHD, bipolar two, post traumatic stress disorder, major depression, general anxiety disorder, and a list - there's - there's a - there are other - other ones in there as well.
And - so what I've had to teach myself is, I guess, that there's this spectrum, and that I'm contained somewhere within that spectrum, but it's not a straight line. It's almost a three dimensional plane. And this might be the bipolar spectrum, this might be the depression spectrum, and I'm over here somewhere, you know. And I have to take into account that there may be questions that I'm seeking to answers about what's going on in here that I'll never find the answers to. And so I more look at - at the history, but also the reactions that I have to situations that I'm faced with, and I try and learn from my reactions, and see if they give me some...
A few people could not recall ever being ‘officially’ diagnosed with depression, but didn’t mind as their emotional distress was acknowledged and addressed by their doctors. Comodor only learned of his diagnosis with depression (which he disputed) when he read his discharge letter following a cancer operation. While he never accepted the diagnosis, he permitted his GP to refer him to a psychiatrist and took antidepressants. Instead of being told they had depression, some people were given neurological explanations by their doctors – that they had a ‘chemical imbalance in their brain’ or an ‘imbalance of serotonin’.
Stephanie works full-time as a teacher and is currently single. Ethnic background' Hispanic.
She was a German lady and she didn't say that I was depressed; she said that she thought I had some imbalance in my serotonin and that I probably should take some medicine and to give it a go. She didn't use the word depression at all and I was ready to give anything a go and so I did and I - the way I felt when I was depressed, it was just like unhappy but in not being able to cope with anything, starting to cry at nothing.
I'm a very strong person and people expect me to be able to do pretty much everything that needs to be done, and whenever I was upset I'd just start crying, usually with my boyfriend, who wasn't a very good boyfriend, and so that probably helped for it to not be good. And I would feel - how would I feel? Yeah, just anxious, really anxious and then not being able to let things go; let problems go, and I would cry and I would cry and not be able to stop crying.
And then one day I decided she - one day it was really bad and like I was just upset, crying, not wanting to do anything and the main feature of my depression was crying; crying and not, and not doing anything, not wanting to do anything. And she (a friend) said, I think this is - this is medical. This is - you have to go back to your doctor; you have to go back to your doctor, and so I did. And I went back to the doctor and I walked into the doctor and sat down and just started crying and she just said okay, I think you need to go back on the medication and I don't even know if we even used the word depression. I can't remember, but it was definitely understood. Yeah, it was interesting.
Some people told us they struggled with their distress for many years before being willing to confront it. Kymberly said a history of depression and suicide in her family made it difficult for her to acknowledge her own emotional distress as depression and she only talked to her GP when she had reached a crisis point. Another woman initially rejected her diagnosis as she did not want to acknowledge that she was not well.
Jane is married with two children. She works as a consultant. Ethnic background' Anglo Australian.
Okay. So I've had two rounds of depression. One wasn’t diagnosed but looking back it was depression, and the second one was diagnosed. Both of them were to do with small children and giving birth. So both – the second one was diagnosed as antenatal depression, I was diagnosed at five months with my second child, five months pregnant.
I was diagnosed with antenatal depression and that diagnosis then seemed to just carry over. So because I'd been diagnosed with depression during pregnancy and the symptoms hadn't alleviated then I got rolled in. So it wasn't - the diagnosis of antenatal depression, my stomach fell and I thought, oh great, because I'd been there. And so, yeah, I wasn't very happy. In fact, I got quite cross at the doctor at the time. And it took me a few days to get my head around it, that, you know, things were going to have to change and I was going to have to become active and actually do something about managing myself. And I wasn't very happy about, you know, it wasn't fair.
It really didn't feel fair about why, I've already been through this once and managed to get through it, why does this have to happen again? And then the guilt started. Well, if I'd, you know, tried to get help the first time would I be going through it the second time and blah, blah, blah. And I really wasn't going to go through another year of what I'd been through with [daughter].
Some people also suffered from serious physical conditions, including cancer, diabetes, kidney problems, or adjusting to organ transplants in addition to depression.
Andrew is widowed, lives alone, and works as a storekeeper. He is a member of a peer support mental health group. Ethnic background' Australian.
We left [place name] at when I was 14. We come up to [place name] with the family ‘cause both my sister and myself had to go onto dialysis. Yeah that was a harrowing experience.
Ah I think I grew up, grew up in the state of mind, sorry not grew up, but had that state of mind every time you went into hospital was this going to be it? Was I going to die? Because when you went in there it was like Russian roulette. Three people passed away on the machine. And my perception now is and what I’ve learnt is that as a child and you’re in that formative years yeah it can seem like that. So I was 16, I was offered a kidney transplant, my sister also had one six months before me. So my sister and I have very similar lives. Ah, we’re the best of friends. I’m always there to support her cause she’s worse off than me. That’s my perception.
That was the first time I was actually diagnosed with depression and that was the first time I was introduced to antidepressants. There is, sorry there was mentioned that there is a very good possibility that I, from an early age, was on that gradual decline to depression.
Some people initially saw their doctors about physical symptoms and had various medical checks before being diagnosed with depression. In the process, a few were misdiagnosed and prescribed inappropriate medication, but eventually their emotional distress was addressed. Some continued to question their diagnosis.
Belinda is a solicitor who works full-time in a community legal service. She finds her work enjoyable and her colleagues supportive, and enjoys spending time with her network of close friends and family. Ethnic background' Malaysian Chinese.
I was told in about 1999 that I had possibly some type of anxiety issue, because I kept collapsing for no reason. So I was…I’d be walking down the street and just collapse, but I was awake and I was fully lucid and everything but I just was collapsing for no reason. So then I was referred to a neurologist who believed I had epilepsy and it made perfect sense that he would think that and I was put on anti-epileptic medication for about a year and a half, but it still didn’t stop, my collapsing didn’t stop and I was feeling really sad as well and very upset with my job that I was having at a particular time. I found it very difficult to get out of bed to go to work.
And so it got to the stage where I was at my job and I ended up collapsing so much that I couldn’t actually get up and then I was taken to hospital. And when I was taken to hospital the doctors worked out that the anti-epileptic medication I was on was actually causing me to sort of collapse even more and not be able to get up and that it was unlikely that I had epilepsy.
So I took a few months off work, because I was forced to take some months off work to try and work out what was happening. And after I was given some type of test to check all the electrons in my head, not the electrons in my head, sorry, I had this like sort of thing on my head where it was conclusive proof that I didn’t have epilepsy. Then a psychiatrist was referred to me. The psychiatrist spoke to me about essentially about my anxiety. And I was feeling very anxious about my job, about what was going on generally in my life. And so then she suggested that I might have some form of depression. And so she suggested that I try Zoloft (sertraline), which is a type of anti-depressant. I was on a very small dose for about a year. Then I took myself off Zoloft, with the assistance of my GP.
So after that I was feeling pretty good for a while and I had always believed that I had anxiety rather than depression.
Dani realised ‘things were not right’ when she was teenager and began neglecting her diabetes care. Her GP referred her to a psychologist who diagnosed her with depression. Ivan was diagnosed by his ‘regular’ GP after reading a brochure on depression and recognising the symptoms listed. His initial reaction was disbelief and fear of stigma, but after the initial shock he felt that ‘finally his symptoms made sense’.
Ivan is a retired speech pathologist who migrated to Australia from Croatia. He is divorced with two adult sons and lives with his current partner. He enjoys working part-time at a radio station, gardening and the arts, and is a Christian. Ethnic background' Croatian.
I remember that my GP showed me a brochure, a plain brochure about depression, asked me to read it and tell him which of the listed symptoms I could recognise. And of course I ticked all the listed categories which were typical for general clinical depression. Then we took my blood sample for analysis. What did he do, how did he do it…
I assume there are some alternative methods - but then it was easiest to apply the classical method, medication, biochemical substances ‘Here is a tablet for you, your serotonin will be increased, you will be better, but it would be useful to find yourself a psychiatrist. It would be good to empty your soul or perhaps fill it with new ideas and see where you can modify your life’. Certainly, as a person of similar profession and experience I had nothing against his suggestions. Everyone needs a shrink in our world, which is demanding, difficult, and very often troublesome, it was good…
A few people went online in search of an explanation for their distress, some self-diagnosing before they consulted their GP.
John is married with three children. He works part-time as an education officer. Ethnic background' Australian-Chinese.
So it wasn't until I got on the website that I actually found out what I had' depression and anxiety and - I ended up going to see a doctor. I guess it's the way for most people that you wait until you really hit the wall and it's - your life is falling apart, for you to sort of say, well something must be wrong. And so my marriage was nearly falling apart, my job, I couldn't do that anymore, so that was kind of not going well and - and being suicidal, I went and saw a doctor and I explained to him how I was feeling and, what was going on and he just said straight out, you've got depression and, and I'm prescribing a medication for you which is more on the anxiety side of things.
I reckon it took me about three months before I filled that script. I just - it took me a long time to see a doctor because I didn't want him to actually confirm my worst fears, which was that I would have depression. I mean I'm - I'm in the prime of my life I was doing quite well in terms of my career. I'm married, I've got three kids, I'm financially secure, I'm fit, I'm healthy, and I just thought, I just can't have depression, I just can't. I mean, I don't have any other health issues, I don't, you know - at the time I didn't smoke, drink or - I drink now, but - self medication.
But I just thought, I can't have – I’m, I'm educated, I've always done well career-wise. I couldn't face it, so it took a long time to even see a doctor, but even longer to fill the script. I just couldn’t take pills, I just could not take anti-depressants, I'm just sort - because to me that was like the weakest thing in the world. I just thought, I just must be weak if I've got to take anti-depressants, so there's something that sort of says, you know, just cut it out, just push on, get through, you'll - it'll - you'll get over it, it'll work out. So I kept going.
A few people acknowledged the complexity of diagnosing mental health conditions such as depression. Some contemplated the human condition and wondered why some people seemed less resilient than others.
Kim Hai works part-time and is married with one son. She came to Australia as a refugee. Ethnic background' Vietnamese.
Some people are more resilient than others. Why so I don’t know. It could be half genetic, half you know childhood, upbringing. Ah, it may just be luck. It may be just their supportive network, not just themselves that they are that resilient.
Some people break - very fragile and break very easily. That is a mystery to me too, and there would be a link, you know, ah, between all of us human beings in that kind of relation of various types of emotion. I think we all can become psychotic given enough trauma, though. So I think it is very hard to make list and to tick and categorise people in diagnosing mental health.
So that's, that’s my point anyway. I don't think the diagnosis criteria here now is covering enough, is in-depth enough to detect in a less clinical way either depression or more severe or psychotic tendency. But to give some constructive feedback on those criteria I am not a professional, I cannot do that yet.
Acknowledging emotional distress and accepting a diagnosis of depression was difficult for some, particularly men. Some feared being thought of as ‘weak’ by their peers and this prevented them from disclosing their distress and seeking help. Ralph who refused to see a psychiatrist his GP referred him to explained' ‘I suppose being a bloke; they don't do those things I guess’. Similarly Amelia said being diagnosed with depression made her feel ‘like a total failure, terrible, a real loser’. Others said being diagnosed with depression was made more difficult when GPs or other health professionals failed to provide them with meaningful information.
Ron is a community mental health worker who lives alone with his cockatiel. He is divorced but is in another relationship, and has an adult son from his first marriage and a close circle of friends. Ethnic background' Scottish / Irish.
And no-one’s really ever died of, for example, panic attacks, which I had gone through - I didn’t mention that before but I had probably a year or so of really bad panic attacks and I grew out of that, because I realised that it was just panic and uh occasionally I had to stop the car because I was afraid that I would be - get so panicky I would run off the road or crash or something. And thankfully I've realised I’ve beat the bluff in that way.
So yeah , your sense of self diminishes the more you just see yourself as a depressive or a schizophrenic or as a, you know, eating disorder, because people often are labelled that and they become that and they live down to it. And that - they make that as an exc-excuse, ‘Well I can’t do anything because I’m a bipolar two, there’s my excuse’. And then people will say, ‘Okay,’ and they don’t challenge us to live above that. I don’t believe that.
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