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If you imagine the Colosseum, and there's thousands of people in the Colosseum, and they're all
berating you and just insulting you and hurling abuse at you, and you're stood in the middle of the arena
totally defenseless against this mass crowd. So all those people are sort of myself,
and they're all my own thoughts, berating yourself, and you know, how do you fight yourself?
Color drains from your vision completely. It's as though you're wearing monochrome glasses,
and mostly the vitality of life sort of drains away in that whatever zest you might have had for
a day's activity or whatever may be going on in life, it suddenly vanishes, and you don't have that zest anymore.
I slow down. Even day-to-day movements like, say, showering or washing your hands
or getting dressed suddenly becomes very slow and like moving through treacle.
So I grew up in very rural Suffolk surroundings, every country stereotype that you can think of,
of being surrounded by farmers and tractors and not a lot of social life,
but when I arrived at university, it was suddenly a very loud, chaotic, very "on" sort of lifestyle
in that there was always something going on; there was no sort of down time.
I fell into that culture, and I was partying a lot. I was drinking a great deal.
It just was a horrible coming together of factors that almost conspired against me.
I would spend all day totally inert, totally stationary, in bed.
I had no luster for anything. I couldn't summon the energy to just do things,
to just go to lectures or socialize or anything that I would have normally done.
But then, the complete contrast to my days were my nights, where I suddenly got a great deal of energy,
and I would drink a great deal at my university's bars entirely as an isolated enterprise
in the sort of vain hope that it would somehow change my circumstances or change my mood state.
One of the key things about the, sort of, "self-laceration" that you get into when you're depressed
is, you compare yourself to what you used to be or to an ideal version of yourself,
so I would be sat there in my room, surrounded by these books, thinking,
"You used to be able to read this. Why can't you do it anymore?"
"You used to be able to shower. Why can't you do it anymore?"
"You used to be able to work. Why can't you do it anymore?" And so on and so on.
I was just constantly comparing myself to a previous version of myself.
So, one night at university, I was at one bar, and I thought, "I'm gonna make a last-ditch effort
to communicate, I'm going to try and tell people what's going on with me,
and I'm going to try and put a name to what's going on." So then suddenly, when I tried to express this,
my, sort of, mental state, it suddenly all exploded into a great deal of emotion,
and I was crying at the time, and sort of being quite loud.
I was sort of shouting without realizing I was shouting, and I generally wasn't aware
of the environment around me. I suddenly focused entirely on myself and what I needed to say
rather than what was going on around me, and it was quite a scene.
I woke up, and I didn't really know where I was. I had no clue. I was left thinking, "OK, am I in some kind of prison? Or am I jailed in this room?"
And it suddenly became very apparent that I wasn't allowed to leave,
which was infuriating for me. I had never had my sense of movement restricted that much before.
One of the things that I held onto so steadfastly was this ideal version of masculinity,
of not talking about how you feel or not talking about your feelings at all
and pulling your socks up, as the saying goes. I realised that that mentality wasn't doing me any favors
and was deepening my depression and just making my life worse.
No one in life is alone or they are never as alone as they think they are.
There's always a point of contact with the rest of the human race, even if you're not aware of it.
I do have depression still.
There's sort of a conception that you go into hospital and then you're cured of depression,
and then that's it for you. Whereas that's just not true.
And I deal with it in a variety of ways. I'm still on medication,
which in my experience has helped a great deal with my depression.
I exercise a great deal. I run a lot, which helps, and mostly I don't withdraw from the social world.
Now, I'm much better at dealing with the depression as it develops
rather than leaving it until it's, sort of, crescendoed and done its damage
and then dealing with it, because then it's a much larger animal to deal with.

Inside the depressed mind

Fighting yourself in a world with no color

Karl Knights, 22, describes himself as a “textbook case” of depressive disorder, having experienced recurrent depressive episodes since he was just 14 — a common age of onset.

His episodes “sneak in the back door,” he says, and when they strike, a battle begins -- against himself.

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Living with depression

At first, the fight was pointless, Knights felt. He didn’t know how to win, how to beat his depression.

More than 300 million people are estimated to have depression worldwide, accounting for almost 5% of the population, though some experts believe that rates are higher.

For half of people, one episode is all they’ll experience. But after three or more, these episodes are 90% more likely to become recurrent. This was the case for Knights.

When an episode hits, a feeling of inevitability sets in, says Knights, and he heads deeper down this road on which he must fight himself, with symptoms taking further hold.

As life becomes monochrome and energy fades away, the desire to do simple tasks also dwindles.

Growing up

Knights grew up in the coastal town of Leiston in the Suffolk countryside. With a population of only 5,500, it’s a small community.

At 18, he moved to Canterbury in nearby Kent for university. The district has a population of more than 162,000, and the university alone has 16,500 students – three times the size of his hometown.

Knights was in for a major readjustment, which experts believe can significantly affect mental health.

“The bigger the change, the more stressful, and that’s more likely to provoke mental health problems,” said Allan Young, professor of mood disorders at Kings College London. “If you go from very rural environment to a city, that’s going to be a huge adjustment, and for people with vulnerabilities, that’s going to lead to problems.”

That was true for Knights, who would soon spiral out of control.

New Environment

Drug and alcohol abuse are very common with depression and at university, Young said, adding that this further increases a person’s vulnerability to mental health conditions. “[Its] use just makes things worse,” he said.

This fueled Knights’ particular condition, known as melancholic depression, according to Young. It sees people waking up under a black cloud each day, with trouble concentrating and remembering things, unable to even read in Knight's case. The cloud often lifts by evening.

Knights lived with six flatmates whom he considered good friends. They tried to get him help, but for months, he ignored their attempts and continued drinking alone, night after night, waking up alone, unable to move.

Locked in his mind and his body, Knights would belittle what he had become.

Despite attempts to change attitudes around mental health globally, stigma remains, leaving people unable to open up.

Knights now recalls a sense of masculinity and pride that would stop him from seeking help, pushing him deeper into a cloud of hopelessness and desperation.

One night, he would try to change that. Unfortunately, he would fail.

Sectioned

Knights had tried to explain what he was going through to his friends -- but became unaware of where he was or what he was saying. Before he realized it, security had been called, and the police were there to take him away. They detained him under a section of the UK’s Mental Health Act.

Knights says he felt relieved because he knew that something would change. “This was enough for me to feel relief when they arrived.”

That is, until he woke up locked in a white room, with barred windows and doors. And once again, there was no one to talk to.

Recovery

Knights would first speak to someone three days later, when a psychiatric assessment board would descend upon his room to identify the best means of treatment.

Four people in four chairs in his otherwise empty room would determine his future and help him get better.

Knights consented to going into a rehabilitation hospital, a priory, where over many months he would receive therapy and medication.

He soon learned where he had gone wrong in his reactions to his depression, becoming equipped to learn more about himself and to explore his mind. “Depression is a lifelong condition,” he noted.

He still experiences at least two depressive episodes a year, but these now last a few weeks at a time instead of several months, because he now knows how to deal with it.

If you’re experiencing symptoms of depression the Anxiety and Depression Association of America is an international nonprofit organization providing current treatment, support and resource information. The UK charity Mind also provide advice and support to empower anyone experiencing a mental health problem.

Credits

Editorial: Meera Senthilingam

Design: Sarah-Grace Mankarious, Henrik Pettersson, Mark Oliver

Illustration: Woojin Lee

Development: Marco Chacon