Lies, Damn Lies and Statistics

Statty-Wats

The latest post on Karita’s blog, where she talked about having filled in the Goldberg Depression Scale, inspired me to find out exactly where I am vis a vis my depressive symptoms. My guess would have been that I was in a moderate depression, because although I’m not exactly running through fields of corn with fluffy puppies and a smug, fat grin exercising my facial muscles (though I like my face to be fit, which is why I normally wear a frown instead), I feel like I have a certain amount of cope left in me. Serious depression doesn’t have that feature, in my experience. This current state, relative at least to the rest of those over the past three-ish years, is about as close to ‘normal’ or ‘OK’ as it gets.

The first test I took was the same one that Karita had consulted. This is how it’s scored:

54 & up – Severe depression

36 – 53 – Moderate/severe depression

22 – 35 – Mild to moderate depression

18 – 21 – Borderline depression

10 – 17 – Possible mild depression

0 – 9 – No depression likely

I scored 82. 8fucking2!

Alright, then, I thought. That’s just one test. Try some of the other ones, and see if you still get that kind of result.

So, once again I made contact with everybody’s favourite detective, the omnipotent DI Google, this time searching for the Beck Depression Inventory (BDI). The scoring for it is as follows:

0 – 10 – not depressed

12 – 18 – depressed

20+ – very depressed, take action

I scored 33.

This was not turning out well.

The next test was the Hamilton Depression Scale (HDS). A score of 28 or over indicates severe depression. I scored 43.

Finally, for a laugh I completed the Modified Scale for Suicide Ideation inventory (MSSI). I think it’s important to bear in mind that I am probably at my least suicidal than I have been in years, so the results of this one were especially interesting.

The MSSI is scaled as follows:

0 – 8 – Low Suicidal Ideation

9 – 20 – Mild – Moderate Suicidal Ideation

21+ – Severe Suicidal Ideation

My result was 32.

EDIT 13 February 2011: Purple Sapho has written her own version of this post, in which she includes another scale – The Burns Depression Checklist (BDC) – across which I’d not yet come.  So I took it today.  It is scored thus:

0 – 5 – not depressed

6 – 10 – normal but unhappy

11 – 25 – mild depression

26 – 50 – moderate depression

51 – 75 – severe depression

76 – 100 – extreme depression

My score?  90.

I know that these scales aren’t always to be considered as 100% accurate, and to that end I am regarding these results with a pinch of salt. However, that the results were so consistent on all of them is possibly telling. Have I lost my conceptions of what suicidal ideation and depression actually are? Am I so normalised to them, so absolutely inured, that I underestimate just how ill I am?

In the spirit of empirical results, I went back and did each test a second time, picking the absolute lowest value possible in each question rather than the statement that is most frequently true. For example, at one point the MSSI asks…:

Over the past day or two, when you have thought about suicide, have they been intense (powerful)? How intense have they been? Weak? Somewhat strong? Moderately strong? Very strong?

…the possible answers to which are as follows:

0. Very weak.

1. Weak.

2. Moderate.

3. Strong.

Over the past few days, I would say that my modal answer to this question would be ‘2. Moderate’. However, there have been a few occasions when the strength of the ideation could have been described by the lesser value of ‘1. Weak’, so instead of the picking the most frequent description in my second round at the test, I chose the latter.

The reason for this is that apparently I’m a histrionic, exaggerating freak when it comes to psychological scaling. I therefore felt like I had to prove to myself that my responses were as honest and non-dramatic as possible, but if anything, the answers I gave the second time round felt dishonest, as they aren’t a fair reflection of the frequency or intensity of those very things that they’re supposed to assess. Even so, it seemed the only feasible way of making sure I wasn’t being melodramatic.

My new results were as follows:

Goldberg – 67

BDI – 29

HDS – 29

MSSI – 29

EDIT 13 February 2011: BDC – 81

29 must be my unlucky number. So even when I am downplaying my symptoms, I am still considered severely depressed and/or suicidal.

What is depression, anyway?

If this is severe depression, what the fuck have my darkest days been? A literal manifestation of hell? A delusion? I’m not under some impression that I’m doing well at the minute, but I really would never have supposed that clinically speaking, things are as serious as they are. This makes me question the very nature of major depression: what even is it? I know what it feels like – or, according to all these testwankthings, I don’t, but you know what I mean – but I can’t quantify it well in words. My first reaction is the word ‘black’, which is certainly accurate, but a small word compared to the magnitude of the actual condition. I described it on my other blog as a “crippling treacle of blackness”, a quote that someone apparently viewed as “poetic”, which was a welcome compliment. I’m not sure I’d use that term myself, but it does serve as very brief description of such levels of depression.

In my experience the worst forms of depression are when suicide is about as unlikely as it’s ever going to be. Although you wish that you were not, you just don’t care enough about anyone or anything to have the motivation to hit your own ‘off’ switch. Perhaps that’s one over-riding characteristic of this state; complete and utter apathy. It’s inherently narcissistic too, but I don’t mean that in an offensive way; you are utterly consumed by yourself, but only because depression forces you to be. It’s full of hatred, mainly for the self. It’s irrational, it’s bleak, and it’s so, so lonely. In the unlikely event that a severely depressed person were in a room full of people, he or she would still be utterly alone.

Is it possible to just ‘get used’ to being severely clinically depressed? I know that it can certainly be done for certain types of physical pain, but I also know that I’d rather experience a lot of physical pain before I experience the bleakest days of depression. So how can you just not react to it being there? Being miserable every day is my norm, but it seems ridiculous to think that one can take a stoic attitude towards it. It just seems completely inconsistent with the reality of the illness.

What does depression mean to you? How do you demarcate between levels of it?

Lies…

To topically diverge completely, I have good news. The Social Security Agency have finally paid me the oodles of lovely cash that they owed me! I mean, they were completely full of shit when they told me, when I lodged my original complaint, that I’d be paid within a week; it was nearly three weeks later. But at least it’s there now, and fuck am I relieved. Not as jump-up-and-down-and-open-the-Champagne excited as you might expect when I’ve just found almost £2,000 in my bank account (probably as a lot of it will go on bloody bills), but I’m glad to finally have the matter sorted.

I took a deep breath and phoned the fuckers yet again on Friday. After 700 parsecs of Vivaldi and a string of utter fallacies about how my call was important to the Agency, I finally spoke to a helpful geezer named Alan. He said that the money had been paid on Wednesday, the day after Pamela had phoned them, and that the reason that I then still didn’t have it was because it tokes three days for the bank to process. There was no money on Friday, but on Saturday – hark! ‘Twas there, in all its glory. I was stunned at this because, even though all transactions are surely computationally automated, banks use any excuse to get out of doing their jobs, and the weekend would surely be the perfect opportunity for them to do fuck all.

On the point of Pamela, I told Alan that she had called me and was seeking my dubious company at what would no doubt be a wonderfully helpful and interesting “interview.” I asked him to confirm that I was, indeed, in the ‘support’ group of Employment and Support Allowance (ESA).

He looked at the records, and then reported that yes, I had been in the ‘support’ group since week 14 of my original claim for ESA (about July 2009, although that was retrospective in that I first had to appeal against their original decision, which I won in June 2010).

To that end, I asked Alan why I had been “invited” to a “work focused interview”. He asked me to hold the line whilst he consulted his manager. Though he was, overall, helpful, I couldn’t help but think that I knew more about the fucking benefit than he did.

Anyhow, back he came after a few minutes, sounding rather perplexed. He said that he and his boss had no idea why Pamela wanted to see me, stating that I was correct in my understanding that her “interviews” are not a requirement whilst in the support group. He asked was I certain that she knew my group allocation.

I relaid a redacted version of my conversation with her. “I did tell her that I’d won the appeal about my original placement in the work group,” I told him. “So she cannot fail to know the present circumstances.”

I could almost hear the cogs of his brain whirring on the other end of the phone, as he searched for possible reasons for her behaviour. Eventually, he simply said, “all I can suggest is that you ring her back and make sure she knows that you’re in the support group, and that attendance is not required.”

My mother rang me about an hour later, and I reported Alan’s advice to her. She said that she would ring Pamela and get back to me. She rang back about five minutes later; Pamela only works to 2.30pm so had gone for the weekend, but Mum did manage to briefly converse briefly with another member of staff, who confirmed that support group claimants are not required to attend this shite. The woman said she’d pass a message to Pamela and get her to ring my ma back on Monday.

I am cautiously hopeful that maybe this bollocks can be avoided after all.

…and Damn Lies

***Beware of sex abuse triggers***

Last night after a few pints and half a bottle of wine, I admitted something big and dark to A. Well, in the grand scheme of things it’s not that big and dark – but in my life, it is. I was once (I think it was merely once) penetrated (or ‘raped’, if you prefer) with some sort of pole thing – my adult self supposes that it was the end of a brush or mop or something, but the child couldn’t figure out its use in this world. I don’t suppose it matters, at the end of the day. And it was just an inanimate thing, so I suppose I shouldn’t really care. But I do care, unfortunately; perhaps it’s because the inanimate, non-living thing seemed to me to be a reflection of how Paedo viewed me. A useless piece of crap that serves only one purpose in this sorry world. The whole sordid business seems even more degrading than actually being fucked by him – I mean, he had to put some effort into fucking me, an indication of giving a shit on some level. Or something. A pole doesn’t possess any such considerations.

Anyway, I don’t know why I wrote that paragraph, because it isn’t true. None of my allegations of sexual abuse are true, and I am nothing but an evil Münchhausen-esque, attention-seeking liar of epic proportions. I know that Paul and, when I see her later in the month, NewVCB, will respectively say that “denial is easier than facing the ‘truth’,” and that I am in another “delusional psychosis”, but what do they know? They didn’t bear witness to my childhood.

It disgusts me that I have sucked people into this little web. What kind of vile human being creates such a saga, especially when it inevitably has an impact on other lives? Why have I done this? What an evil, twisted bitch I am. There are no words strong enough to articulate what a repugnant human being I am.

I’m sorry.

(I’ve just read over this and find it interesting that I’ve ended on such a hideously depressing note, when I was earlier stating that I was surprised to find that I am “severely” depressed. Ah well. Its just more of those defining, idiosyncratic contradictions).

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20 thoughts on “Lies, Damn Lies and Statistics

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  2. Pan I am so sorry I accidentally hit 3 stars’ rather than the 5 I intended! I hope others will make up for my mistake!! SO sorry 😦

    I’m sure you won’t believe me but as Paul said to you recently your history is consistent. It does not sound like the story of a liar in the least. I hope he can help you see that and face it.

    I agree that depression at it’s worst disables you too the point where you dont care about _anything_. The word I often use is “paralyse” cos you might as well be for all you can move. I must have a go at these questionnaires and see what I get!!

    I’m glad about the money and hope you dont have to see Pamlea. And I hope Paul can help you through this.

    Best wishes
    Kate

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  6. Hi Pan, probably easier to do this in order so…

    Depression scale huh? I can honestly say that taking the tests would reveal my deep self loathing and my desire to depart this existance in one form or another. Am I always sad? No, but the base level for me is the desire to just not be here anymore. So yeah, you can get used to it, it’s the only way to survive I guess. As for describing it, I wrote the following whilst in hospital in an effort to get people who have no experience of depression to know what it’s like;

    ‘It’s hard to get those who’ve never experienced depression to understand the thought processes which occur. Try to think of it as listening to a scratched record which is stuck saying something along the lines of “You’re shit”. Of course you want to change the tune but the player is in a sealed box which you can rage against eyt you’re unable to do anything that’ll actually make a difference. Sometimes something will happen and the player will stop or change tune, you don’t forget the scratched bit but you can ignore it and get on with life. Then it starts again. Any strength gained from the respite soon leaves you, and over time, depending on the person, your spirit is broken and you’ll do whatever it takes to make it stop.

    For some this means they’ll ask for help, for others there’s self harm, the brilliant glare of pain blocking out the bad thoughts as if your mind has emerged from a dark room into the full power of the sun, giving even just a moment of relief. And for the rest, death is the only way out from the mental torture because that’s what it is. Torture. An interogation technique is to sit someone down in a room, switch on a TV and then leave them listening to the white noise. It’s only a matter of time before the person breaks and when they do it’s TV off and lots of questions from serious people.

    So yeah, this is a form of mental torture except there’s no-one to turn off the TV or change the tune. There’s no way out apart from death, there’s only the ways to cope and the strength of the persons will between them and either a wooden box or a padded room being spoon fed soup as your brain can’t handle something as complex as chewing.’

    Hope that clears things up a little.

    Congrats on getting to the botom of the whole ESA crap, although it’s not quite over yet with Pamela to finally get straight.

    Finally, you made it all up did you? All the sexual abuse was imagined for some reason? Ok, complete bullshit but ok, if that’s what you want to believe. I’ve met many who have gone through such experiences and I know that some will put their stuff online and so the concept of someone taking snippets and mutating them for their own means, in a Munchausen method is feasible. From what I’ve seen from your writings? I still say bullshit but then that’s not going to convince you one way or another is it.

    I know, not exactly nice of me but then I’m not trying to be nice, just honest. Take it or leave it but you know the truth deep inside regardless of what anyone says.

    Null

  7. Pan, I dont’t know what to say that isn’t going to sound load a load of diconjointed psychobabble, but I still want to give it a try.

    I agree with what Null said. We cannot know on our end what is the “truth” or not. Honestly though, I have been able to identify with countless amounts of things you’ve said about your past and your therapies, counseling, medication…ways your mind has built walls around things… (again, I can’t know for sure) but if you’ve been through all or anything of what you’ve dictacted in your blogging, I can see the reasons why you’d say/think it didn’t happen. It may help, it may hinder, but it’s something.

    Either way, I think continuing with Paul would be good for you. & no matter what’s really gone on…in my mind, it changes nothing about you. You ARE a wonderful person. Hell, stumbling across your blog has helped me on nights when I need support & its not like we’re personal mates. I’m fucking rambling, sorry.

    In short, there’s always truth here, it doesn’t matter how horrible (or not) your past has been. ThereKs always honesty, bravery and the air of an incredibly strong woman.

    Remember that.

  8. This is my first comment here, though I’ve been an admirer for ages.

    Of all the troubling, difficult things you have written about… I think doubting yourself, even perhaps believing yourself to be a liar, a fraud – this is one of the hardest topics you’ve come up against. And I feel like the objections raised by Paul, by commenters – well, they’re probably spot on, actually – but there’s something lacking, isn’t there? After all, it’s possible that you’re lying. People lie. It happens.

    So worst case scenario? You’re making things up? (I don’t believe this for a second, by the way, but it’s worth mooting.) If so… you’d be doing it for a reason. Because something terrible happened to you, and because lies, no matter how terrible, are easier than the truth.

    There’s no getting out of it, lovely Pan. You’ve been hurt terribly, in all kinds of ways, and you deserve to get better and you deserve forgiveness and you have every right to lie if that’s what you need to do. You also have every right to find your way to the truth, all of it, and the support you need to deal with that truth – in all its terror, whatever it is.

  9. HI Pan,
    I can relate to getting used to being mental. Even though I’ve never been depressed, I have the same with my sensory issues and anxiety. You certainly can get accustomed to feeling severely depressed. Besides, I don’t think these scales adequately reflect profound depression, because as you say then you are completely apathetic.

    I hope for you that the benefits thing works out.

  10. I also was surprised to note that I scored as severe depression. But kept thinking back on my answers over the weekend and realised that I had indeed been honest. Crappity crap.

    You are not a horrible, evil person. You’ve been through some serious shit, for a long time, in your childhood when you should have been protected. I agree with Paul and NewVCB. I also happen to think that you’re lovely, and I have thought this for some time now. I am a very stobborn person and you cannot dissuade me of this opinion. 😉

  11. Funnily, I also immediately started doing the depressive scales again when I saw Karita’s post. I was curious to see where I stood as although I am a lot better than I have been in the past, I was well aware I was struggling again.

    I think my Goldberg was 61, Hamilton was 30 something.. I did the BDI-II full version, so my scores were different there and I’ve just done the MSSI you’ve suggested and got 31. I’ve not done that one before. My mood has been somewhat all over the place, so I think the agitated side is possibly affecting my results, but the depressive symptoms are definitely there.

    I do think you can become desensitised to the nature of severe depression. When you have lived with it, those feelings can easily become normal, so far harder to identify as serious. For someone that has not been depressed before then those feelings are a shock to the system and even mild or moderate depression is out of the ordinary, but for us it just kinda creeps up on us. I think my whole concept of depression and mood is skewed these days. I forget what is “normal” pretty quickly when my mood drops. Even if I am well, I am fairly sure I’d still rate as mildly depressed a lot of the time. Even when my mood is agitated or even high, some of the depressive symptoms don’t necessarily go away – they are in the background most of the time.

    Also with the suicidal ideation test – a lot of it hinges on whether you have an established plan and whether you have the courage to do it. If you’ve tried before then you usually have the courage because nothing stopped you the last time. You also usually have a plan, because you will have thought about it enough times before then! I may not be planning to do it in the next week or fortnight or whatever, but when/if I do decide a date, everything is in place already, so I score on those points regardless of whether or not I would consider myself severely suicidal right now.

    I also really understand how you could feel the pole was more degrading. I can’t imagine what it is like to go through the trauma of that, but the logic definitely makes sense. How did A take it?

    As for the other matter of you being a liar and making it all up. I think you know that Paul and New VCB have a point and just because you try to convince yourself it never happened, it doesn’t make you a bad person. Even if you did make it up, that doesn’t make you a bad person, just a confused one?

    take care x

  12. For the depression scales, this is the solution I tend toward: When we’ve been so depressed for so long (i.e. so far above the “severe” cut-off point that the categories become meaningless), a little improvement can be a huge relief. It feels SO much better. My baseline is very low, so anything above that feels “good”, but most people’s baselines are much higher that what I would consider “elation” would still rank as “depression” for them. It’s relative. Just as the depths of my depression are incomprehensible to them, the heights of their joy tend to be incomprehensible to me.

    Also, I’ve not been around here much, but I’ve started finding a lot of parallels between what you are going through now with what I am going through now. It makes it feel ever so slightly less lonely.

  13. Pingback: Depression severity evaluation « Purple Sapho

  14. I agree with Jessa about the feeling of improvement, even if you’re still off the charts in severity.

    I keep thinking I’m not really depressed and just making it up for whatever reason, and it helped to take the tests and realize how deep I am into it, even though my scores definitely weren’t as bad as yours. (66 – 20 – 18 and “not suicidal”). Thanks for posting all of this, I had been meaning to take severity scale questionnaries before but never got around to it, seems simple but I make it complicated in my mind. Same happens with commenting on people’s blog posts, and that’s the reason why I’m so late to do that in here.

  15. Ha, I do the same thing with taking tests numerous times, in case I’m exaggerating.
    Definitely, the lowest point of apathetic depression is not when people commit suicide. They just don’t have the energy. That’s a recognised thing, even by MH professionals ;-). It’s in agitated depression/ dysphoric mania when people are likely to try to off themselves if they ever are. Weird.
    I think it’s definitely possible to get used to being depressed, even severely. It’s what humans do, get used to things, no matter how shit those things are. We just do.
    You did it – you picked up on how you started the post saying you were OK. It’s so easy to think and say we’re OK, I often catch myself having done that when later I realise I am clearly not. Yeah agree with ITS, I think ‘normal’ for me is still mildly depressed, because I’ve been depressed for so long that mildly depressed feels pretty good…have felt ‘normal’ for the past while as I blogged about…bah.
    I rate depression on functioning. It’s not crying every day that I mind, it’s whether I can get out of bed before noon, keep myself and my home clean, talk to people in a somewhat normal manner…bah.
    You’re not making that awful abuse up…you don’t sound like someone who would do that (and anyone who would has some pretty severe MH issues anyway, so…) It sounds trite, but don’t talk about yourself in such a cruel way, you’re *not* a bad person, not any of those horrible things you said. Honestly.

  16. I wish I could show you my diaries from a time in my life where I didn’t feel sure about the veracity of my childhood memories. I was very sadistically sexually abused by my adoptive father over a long period of time. I disclosed it first five years ago. I desperately wanted to be believed whilst concurrently feeling utter self-loathing when I was. I wrote in my diary that I was “a sick and sordid human being indulging in my own repulsive fantasies and deceiving everyone else in the bargain.”

    As I started to move on (I had psychotherapy three times a week) I started to see – only intellectually at first – that I was in a real conflict because I didn’t want those things to be true yet I didn’t want to feel I’d made them up either. Real acceptance came at the point that my father’s sister told me that their father had done the same to her and I realised I hadn’t pulled this from the air.

    I don’t know why I’m sharing all of this – I guess that I recognised an earlier part of myself in so much of what you’ve written and I wanted to let you know that things can be different and better. I experienced a range of problems in the context of BPD / complex PTSD from the age of 12 – depression, anxiety, bulimia nervosa, self-harm and a dissociative disorder. I was offered intensive 3 times a week psychotherapy at the age of 24 – and now at 29 I’ve resolved all of those difficulties with just some residual difficulties with occasional dissociation, I still have an exaggerated startle and some interpersonal anxiety related to my abandonment fears. BUT from where I was at, this is incredible progress. Nothing is insurmountable………

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