Following my first neuropsych assessment, it turned out that I had actually lit up a lot of the depression screening questions. Having studied depression, I wasn’t surprised – clinicians tend to look out for reduced concentration, fatigue and lack of energy, reduced appetite, short attention span and low mood. Which, unfortunately, is exactly what happens to you after you’ve had a brain haemorrhage. For the non-medical students reading; please be aware that depression is a very multifactorial condition and manifests in more ways than just “feeling sad”. This is very important. Never, ever say to anybody “but you don’t seem sad, therefore you can’t be depressed”!
Anyway, back to our regularly scheduled programme.
Armed with a strong feeling of exasperation that I didn’t need therapy, I was just suffering the effects of an SAH, I turned up to my first session of four and was greeted by a pleasant woman, different to the doctor who had assessed me. To keep a long story short, I spent most of the session crying. Telling my peers about my condition and what had happened to me seemed easy, almost like a joke. “I had a stroke! Isn’t that crazy?!” But for some reason, talking about my story to an somebody in a position of importance – whether that be the finance officer at my university, student finance, or my new therapist – seemed to release some deep seated, subconscious anguish. I suppose in a way, talking to somebody that wasn’t part of my social circle made it “official”, and made it real. Perhaps I did need therapy after all.
I left my first session feeling numb. Neuropsychologists seem to know how to ask very hard questions. I found the technique quite interesting, actually; I was not asked pointed questions that elicited a single word answer, but rather asked questions that made me think and essentially made me say out loud my own issues and answers. In a way, it was helping the patient help themselves to deal with their concerns. My neuropsychologist commended me on my insight and progress, and was particularly impressed on the steps I was taking to try and ensure a complete recovery, physically and psychologically. She ended our first sesssion with this simple question: “What goals do you want to achieve out of these sessions?” It took me by surprise. I had never considered this. It’s not like an outpatient’s appointment with my surgeon, where essentially the unspoken, fairly obvious goal was to eradicate the growth and figure out a treatment plan. This was deeper. After some thought, I simply replied with “Acceptance”. To which she said “That’s a very big word, and a very big goal.” I left, full of thought over what we had discussed, and went to the toilet. Where it completely overwhelmed me and I spent a good ten minutes or so sobbing to myself in the cubicle.
The next three sessions went by with a similar format, albeit with fewer toilet-crying incidents. We had planned the sessions to be interspersed with my exams, as I had officially entered exam season so I could finally finish my BSc. Each session became easier as I got used to the novel interaction of somebody asking very stark, probing questions that made you consider parts of your emotional state that had never been brought up before. My goal was acceptance: To accept that my brain will never return to the state that it was before March 2014, and to be okay with that fact. This goal seemed more manageable after I had taken the first of my three BSc exams, which I had approached with great trepidation. I had no idea what to expect from my first exam. I was rife with paranoia that my concentration would fail, the mental strain would make me to physically fatigued to continue, or I just would simply not remember the content that I had been revising solidly for the past year. However, I came out of the exam filled with the realisation that actually, I could do this. Despite receiving an extra two hours per exam, I actually finished at the same time that the “normal” students would have had to finish by. To me, that in itself was a massive achievement.
It’s funny how a life changing event and subsequent therapy reorganises your priorities in life. There was a moment during the revision period of May 2015 where it struck me that I was now able to revise whilst listening to music. A small feat, yes, which many people might take for granted. But I had not been able to juggle the stimuli of two different senses at the same time for well over a year. You learn to appreciate the little things in life, the small miracles.
It became apparent to me after my first therapy session that whilst many people asked me how I was physically, very few had actually asked me how I was coping mentally. Perhaps this is due to the stigma that still surrounds mental health today, or perhaps it’s because some people don’t want to ask because they’re afraid they’ll feel uncomfortable with the answer, or not know how to respond. Even I have been subconsciously affected by the stigma of mental health: after my final therapy session, I thought about writing this blog post, but thought “do I really want everybody to know that I’ve been through therapy?”. Then I realised: Why should that matter? Why am I so open about blogging about my physical state, but not my mental state? This kind of subconscious attitude that has infiltrated through our society is exactly what contributes and fuels the stigma of mental health.
So I’m posting this, and exposing myself when I was quite vulnerable. I hope you’ll forgive me, and not feel too uncomfortable whilst reading this. Next time you see a friend who went through something terrible, be it health related or otherwise, ask them how they are. And just listen. Sometimes, that (and a hug or a cup of tea) is all that is needed.
(P.S. My therapist concluded after our sessions that I did not have depression, but rather just a normal reaction to something terrible.)