0:00:02 > 0:00:07This programme contains some strong language.
0:00:07 > 0:00:08It's like a black cloak.
0:00:08 > 0:00:10You feel like your brain is crushed,
0:00:10 > 0:00:14all you want is to be on your own, isolated.
0:00:14 > 0:00:16It's like a wheelchair in your head, Stephen.
0:00:19 > 0:00:24Only someone who has had it knows how paralysing depression can be.
0:00:26 > 0:00:29You don't want to go to the toilet, you don't want to make any food.
0:00:29 > 0:00:32Never mind look in the mirror to see what your appearance is like.
0:00:34 > 0:00:36No-one is immune.
0:00:37 > 0:00:41You just get to a point where you just think, you know what,
0:00:41 > 0:00:42I'm too much of a burden.
0:00:45 > 0:00:47It's so terrifying,
0:00:47 > 0:00:52and you are in an absolute inner turmoil of despair.
0:00:59 > 0:01:02There's a one in four chance
0:01:02 > 0:01:06that depression will affect YOU at some stage in your life.
0:01:10 > 0:01:14Don't tell me to pull myself together,
0:01:14 > 0:01:18don't hurt me because I've got an illness called depression.
0:01:22 > 0:01:24Understand me a bit more,
0:01:24 > 0:01:28don't be hard on me. Don't stigmatise me.
0:01:30 > 0:01:36It's bad enough to get it, but the stigma can make you feel much worse.
0:01:36 > 0:01:40This is the truth about depression.
0:01:50 > 0:01:53Cathal is facing a milestone, it's his 40th birthday
0:01:53 > 0:01:56and he's putting on a good front.
0:01:59 > 0:02:02This club, for me, is familiar to me, so it is.
0:02:02 > 0:02:03It is one of my safety nets,
0:02:03 > 0:02:05so I'm comfortable
0:02:05 > 0:02:08with this actual arena here that we're in tonight.
0:02:10 > 0:02:17But it's at its limits, the sooner I get home and out of these silly clothes the better,
0:02:17 > 0:02:18get a cup of tea in front of me,
0:02:18 > 0:02:21and it'll probably take me a long time to wind down tonight,
0:02:21 > 0:02:24I don't know if I'll get to sleep because I'm on a high now,
0:02:24 > 0:02:28but I don't know, maybe it'll all come shortly after, I don't know.
0:02:36 > 0:02:43For the past 20 years Cathal has battled with chronic depression.
0:02:43 > 0:02:47If and when I'm told I've got an incurable condition,
0:02:47 > 0:02:49sometime later on in life,
0:02:49 > 0:02:50I'll accept it better,
0:02:50 > 0:02:53but it will be nothing compared to the death
0:02:53 > 0:02:56that I have lived the whole of my life.
0:02:56 > 0:03:01Every day I have went through death with this depression.
0:03:04 > 0:03:07It is extraordinary that thousands of us
0:03:07 > 0:03:10in Northern Ireland will suffer from depression,
0:03:10 > 0:03:14and yet so many people will feel the need to hide it.
0:03:14 > 0:03:16Why?
0:03:16 > 0:03:17Because of the stigma.
0:03:18 > 0:03:21People with depression are judged to be weak.
0:03:22 > 0:03:27Some people even go so far as to think it does not exist.
0:03:27 > 0:03:31I wanted to find out the real truth about depression.
0:03:33 > 0:03:37Cathal's depression hit him suddenly
0:03:37 > 0:03:40when he was a student coming home from Belfast.
0:03:43 > 0:03:46I remember shouting at the bus driver, "Stop!" And I had to get off.
0:03:46 > 0:03:48What was happening to you?
0:03:48 > 0:03:53There was a fear, a cloud just came all over me, so it did,
0:03:53 > 0:03:59sheer panic, rush of emotions, I didn't know, Stephen.
0:03:59 > 0:04:04It was like a deathly feeling, so it was, and I had to get out.
0:04:04 > 0:04:07So I was standing on the side of the motorway
0:04:07 > 0:04:09and rang for my father to come and pick me up
0:04:09 > 0:04:12and that was the start of my mental health problems.
0:04:14 > 0:04:17Cathal didn't leave the house for a year.
0:04:19 > 0:04:21It's not the thing you want to turn around and say to somebody,
0:04:21 > 0:04:23I think you're mental.
0:04:23 > 0:04:27You know, which, undeniably I am.
0:04:27 > 0:04:30Whatever way you want to butter it up, I have a mental health problem.
0:04:30 > 0:04:32Are you frightened of saying that out loud?
0:04:32 > 0:04:34No, I'm not afraid to say it now.
0:04:34 > 0:04:41I have absolutely no fear of that stigma that's attached to it.
0:04:41 > 0:04:45Accepting the fact that I have a severe mental illness
0:04:45 > 0:04:48was the first thing in curing myself.
0:04:51 > 0:04:55But for those not able to see their depression as an illness
0:04:55 > 0:04:58it is really important to show
0:04:58 > 0:05:01what is actually happening inside the head.
0:05:01 > 0:05:07Examining the brain through imaging is a relatively new area of science,
0:05:07 > 0:05:11it's only been studied over the past 15 years or so.
0:05:12 > 0:05:16I've come to the University of Manchester,
0:05:16 > 0:05:21one of the main centres in the UK for brain imaging.
0:05:24 > 0:05:26The part of the brain
0:05:26 > 0:05:31responsible for memory and emotion is the hippocampus.
0:05:31 > 0:05:35It is here that depression shows up.
0:05:35 > 0:05:39What's fascinating is that the hippocampus in depressed people
0:05:39 > 0:05:45behaves differently than the hippocampus in those without the illness.
0:05:45 > 0:05:46This is a cut through the brain
0:05:46 > 0:05:49and I've just outlined in black the areas with were...
0:05:49 > 0:05:53Professor Ian Anderson is leading the research.
0:05:53 > 0:05:55There's been quite a number of studies
0:05:55 > 0:05:57which have suggested that people who are depressed
0:05:57 > 0:06:00don't just have an alteration in how the brain's working,
0:06:00 > 0:06:03but also actually in the structure of the brain.
0:06:03 > 0:06:05The hippocampus has been one of the areas
0:06:05 > 0:06:09that's been most found to be smaller in people with depression.
0:06:09 > 0:06:10- Smaller?- Smaller.
0:06:10 > 0:06:12So you've got the hippocampus
0:06:12 > 0:06:15which is this part of the brain which deals with emotion.
0:06:15 > 0:06:16Yes, and memory.
0:06:16 > 0:06:19And if someone develops depression,
0:06:19 > 0:06:21are you telling me part of the hippocampus,
0:06:21 > 0:06:24the grey matter, shrinks?
0:06:24 > 0:06:26Well, that's what we've found.
0:06:26 > 0:06:28So a bit like if you don't exercise your muscles shrink,
0:06:28 > 0:06:31it may be that the same happens with the brain.
0:06:31 > 0:06:35If a bit of the brain that's important isn't functioning so well,
0:06:35 > 0:06:38that area becomes essentially smaller.
0:06:40 > 0:06:44Prof Anderson explained to me how his studies show
0:06:44 > 0:06:48this change in the brain and how treatment affects it.
0:06:49 > 0:06:53Our group of patients were people who had been depressed on average about five months,
0:06:53 > 0:06:57people who would be getting treatment from their general practitioner.
0:06:57 > 0:07:00And what we found was that if we looked at the hippocampus
0:07:00 > 0:07:04we found a striking decrease in the amount of grey matter,
0:07:04 > 0:07:07that's the part of the brain that's got nerve cells
0:07:07 > 0:07:09and the connections between nerve cells in,
0:07:09 > 0:07:10in people who are depressed
0:07:10 > 0:07:13and this was about a 25% decrease,
0:07:13 > 0:07:17so it's quite a striking and staggering change, in fact.
0:07:17 > 0:07:18You're dead right it's staggering.
0:07:18 > 0:07:21So people with depression in your study
0:07:21 > 0:07:26had 25% less grey matter
0:07:26 > 0:07:28than those non-depressed people.
0:07:28 > 0:07:30In this area of the hippocampus, that's right.
0:07:37 > 0:07:42I find it amazing that the brain shrinks when you're depressed.
0:07:42 > 0:07:47And that it is actually possible to see those changes for yourself.
0:07:51 > 0:07:54What we found after eight weeks' treatment
0:07:54 > 0:07:56is we that had a partial, a significant increase
0:07:56 > 0:07:59in the amount of grey matter in these areas.
0:07:59 > 0:08:01These yellow dots.
0:08:01 > 0:08:02These yellow dots are the increase,
0:08:02 > 0:08:04but it was nowhere near back to normal.
0:08:04 > 0:08:07This increase is only the order of a few percent,
0:08:07 > 0:08:10so you're still way down compared to how you would be normally.
0:08:10 > 0:08:13If we then look at a group of people who have been well for years
0:08:13 > 0:08:15we find that it goes completely back to normal,
0:08:15 > 0:08:19so somewhere between eight weeks and a few years
0:08:19 > 0:08:22the brain seems to recover fully in people who recover and stay well.
0:08:22 > 0:08:26So, I'm sorry to make this so simplistic,
0:08:26 > 0:08:30but the better chance you give yourself of recovery,
0:08:30 > 0:08:33in other words treatment, getting the right advice,
0:08:33 > 0:08:36whether it is talking therapies, antidepressants,
0:08:36 > 0:08:40over a longer period of time,
0:08:40 > 0:08:45the better chance you have of growing all that grey matter back.
0:08:45 > 0:08:46That's what we think.
0:08:51 > 0:08:53For those of you who are doubters,
0:08:53 > 0:09:00there is evidence that depression actually exists in the brain.
0:09:09 > 0:09:11It wasn't always the case.
0:09:11 > 0:09:14In the past, people with the illness
0:09:14 > 0:09:17sometimes disappeared for months at a time.
0:09:21 > 0:09:24Let me just give you a sense of this stigma that there was,
0:09:24 > 0:09:26in terms of the infrastructure.
0:09:26 > 0:09:32So the main hospitals were located very close to Belfast city centre.
0:09:32 > 0:09:35You've got to go a lot further out
0:09:35 > 0:09:39for the hospitals for infectious diseases,
0:09:39 > 0:09:44and then outside of Belfast, in the depths of the countryside,
0:09:44 > 0:09:47the old lunatic asylums.
0:10:01 > 0:10:02This is Holywell Hospital,
0:10:02 > 0:10:05it was actually built about 120 years ago
0:10:05 > 0:10:09for patients who were mentally ill to find sanctuary.
0:10:09 > 0:10:12The Belfast asylum was at bursting point
0:10:12 > 0:10:14and they needed somewhere like this.
0:10:14 > 0:10:18It would be said that when people came out here,
0:10:18 > 0:10:21big sweeping driveways in the middle of nowhere,
0:10:21 > 0:10:23that once they turned that corner,
0:10:23 > 0:10:24they wouldn't be seen for quite a while.
0:10:24 > 0:10:27And actually, that's where the phrase comes from,
0:10:27 > 0:10:29going round the bend.
0:10:36 > 0:10:41In the past, people with depression were called lunatics.
0:10:43 > 0:10:46I've been looking through the records of the old Belfast Mental Hospital
0:10:46 > 0:10:50that used to be here in Knockbracken.
0:10:55 > 0:10:57Here's John.
0:10:57 > 0:11:0211th of May, 1944. The war years.
0:11:02 > 0:11:08And look, he came in here with a ration book and an identity card.
0:11:08 > 0:11:10John didn't have much else.
0:11:10 > 0:11:15He had one pair of socks, one shirt, and a gas mask.
0:11:20 > 0:11:23Here's Charles. Came in in 1941.
0:11:25 > 0:11:28Not very many possessions marked down here at all.
0:11:28 > 0:11:29He had one vest,
0:11:29 > 0:11:32two pairs of socks, one shirt,
0:11:32 > 0:11:34look what it says up the side.
0:11:34 > 0:11:36Deceased, no friends.
0:11:36 > 0:11:39All property to be destroyed.
0:11:50 > 0:11:56This new ward in Knockbracken doesn't even look like a hospital.
0:11:56 > 0:11:58Things are very different these days.
0:12:08 > 0:12:12Heather had no history of depression.
0:12:12 > 0:12:14Everything was great.
0:12:14 > 0:12:17She was newly married, and loved her job as a nurse.
0:12:17 > 0:12:20She was a first aider on a summer camp,
0:12:20 > 0:12:24and then one day her life changed forever
0:12:24 > 0:12:27when a child suddenly became ill.
0:12:27 > 0:12:31The child came to me saying that he was feeling short of breath
0:12:31 > 0:12:33and things just deteriorated very quickly.
0:12:33 > 0:12:34What happened?
0:12:34 > 0:12:37I don't really want to go into this too much.
0:12:37 > 0:12:40Don't go any further than you want to.
0:12:40 > 0:12:43He just had a severe asthma attack on the field,
0:12:43 > 0:12:47and we rung for an ambulance,
0:12:47 > 0:12:50but by the time the ambulance had got there, we had to start...
0:12:50 > 0:12:53before they arrived we had to start CPR,
0:12:53 > 0:12:54and...
0:12:54 > 0:12:57I can see the pain on your face now.
0:12:57 > 0:13:01So obviously that's a really traumatic event in your life.
0:13:01 > 0:13:04And essentially, Heather,
0:13:04 > 0:13:06a little boy died in your presence
0:13:06 > 0:13:10and that's something the majority of us will never experience.
0:13:10 > 0:13:12Yes.
0:13:12 > 0:13:16You know, when you're having a camp and it's all supposed to be fun,
0:13:16 > 0:13:20you never think that anything like this would ever happen.
0:13:22 > 0:13:26At the time of the child's death Heather was pregnant.
0:13:26 > 0:13:30Her depression began when she became a mother herself.
0:13:31 > 0:13:35I was starting to panic over things, I'd never panicked before.
0:13:35 > 0:13:38I couldn't catch a breath,
0:13:38 > 0:13:41my heart was racing in my chest,
0:13:41 > 0:13:46I was having chest pain, and just couldn't breathe.
0:13:46 > 0:13:48Were you sleeping much?
0:13:48 > 0:13:49No. I couldn't sleep.
0:13:49 > 0:13:53My head was filled with thoughts of, just,
0:13:53 > 0:13:57thoughts of what happened, thoughts of things that could happen,
0:13:57 > 0:13:59is something going to happen to my child?
0:13:59 > 0:14:02And I would sit and watch her at night.
0:14:02 > 0:14:05Heather felt she had to cover up her illness.
0:14:06 > 0:14:08On the outside when I went out through the doors
0:14:08 > 0:14:12I gave people the impression that everything was OK,
0:14:12 > 0:14:14because I didn't want people looking down on me,
0:14:14 > 0:14:18or saying, it's just attention-seeking behaviour.
0:14:18 > 0:14:22And what people were going to think about me.
0:14:37 > 0:14:41America always seems to be a few steps ahead of us
0:14:41 > 0:14:43in medical matters,
0:14:43 > 0:14:46and I wanted to find out what they were doing.
0:14:46 > 0:14:48So I headed off to Missouri.
0:14:55 > 0:15:00'ECT, or electroconvulsive therapy, has got a bad reputation,
0:15:00 > 0:15:06'thanks in part to films like One Flew Over The Cuckoo's Nest in the 1970s.'
0:15:06 > 0:15:10If not a little bit heavy.
0:15:10 > 0:15:11- Hello, Dr Conway.- Hey.
0:15:11 > 0:15:16I'll tell you what, you turn that on and I'll be suing you for millions, Dr Conway.
0:15:19 > 0:15:21'I wasn't going to have the treatment, of course,
0:15:21 > 0:15:23'but I was curious about it, and how it worked.
0:15:23 > 0:15:25'It's hard to understand
0:15:25 > 0:15:29'how a bolt of electricity to the brain could help depression.'
0:15:29 > 0:15:32The whole point of ECT is to induce a seizure.
0:15:32 > 0:15:34What a seizure essentially is
0:15:34 > 0:15:38is a massive discharge of neurones in the cortex moving in a wave.
0:15:38 > 0:15:41Why would you want to do that, how does that help depression?
0:15:41 > 0:15:43Over time, when you repetitively do this,
0:15:43 > 0:15:46when you repetitively induce these seizures,
0:15:46 > 0:15:49it's signalling to the different parts of the brain
0:15:49 > 0:15:51that are responsible for maintenance of mood
0:15:51 > 0:15:54to produce the normal amount of receptors on the neurones
0:15:54 > 0:15:57so that they go back to normal.
0:15:57 > 0:15:59Sort of compare it to defibrillating a heart.
0:15:59 > 0:16:03'In other words, it's like a computer reboot to the brain.'
0:16:03 > 0:16:06Usually about after five treatments or so
0:16:06 > 0:16:08the person starts to feel not depressed.
0:16:08 > 0:16:10Why the controversy if it's all proven?
0:16:10 > 0:16:15I think the whole idea of introducing electricity into someone's brain
0:16:15 > 0:16:17is a frightening thing,
0:16:17 > 0:16:20and the type of ECT that's sometimes pictured in movies,
0:16:20 > 0:16:22like One Flew Over The Cuckoo's Nest,
0:16:22 > 0:16:26we've come such a long way since then, so it's very safe now,
0:16:26 > 0:16:29and some people would even argue it's safer than medicine,
0:16:29 > 0:16:31cos very few people have any problems with it.
0:16:42 > 0:16:47Dr Chris Kelly is one of Northern Ireland's leading experts in depression,
0:16:47 > 0:16:51he's been working as a psychiatrist for 30 years.
0:16:52 > 0:16:57ECT doesn't seem to have the same scary reputation nowadays.
0:16:57 > 0:17:01In the City Hospital in Belfast
0:17:01 > 0:17:04Chris carries it out on around five patients a week.
0:17:04 > 0:17:06We don't use ECT a lot,
0:17:06 > 0:17:10it's only for the most severe or refractory forms of depression,
0:17:10 > 0:17:14or perhaps in an individual who's had a particularly good response, we would use it.
0:17:14 > 0:17:17So it is a very rarely used treatment,
0:17:17 > 0:17:20but still the strongest treatment that we have,
0:17:20 > 0:17:24and it's really used more as a life-saving treatment
0:17:24 > 0:17:29to relieve extreme suffering when no other treatment has really worked.
0:17:33 > 0:17:37Anne has had ECT in the past.
0:17:37 > 0:17:41When you come out, Stephen, you feel in a daze
0:17:41 > 0:17:44and you feel your head is not thinking,
0:17:44 > 0:17:47and then through time you feel that this depression is lifting
0:17:47 > 0:17:51and you feel elated, you feel, God, I'm not in this black hole,
0:17:51 > 0:17:54I feel like I'm alive again.
0:17:55 > 0:17:59But it only lasts for a certain time, Stephen.
0:17:59 > 0:18:05Because depression is so severe an illness it doesn't cure it.
0:18:12 > 0:18:16Anne has had a serious mental illness for the past 40 years.
0:18:16 > 0:18:19On top of that she has depression.
0:18:20 > 0:18:22How does the depression make you feel?
0:18:22 > 0:18:25It feels as if you're just totally alone,
0:18:25 > 0:18:27your totally alone within your head.
0:18:27 > 0:18:29And then maybe
0:18:29 > 0:18:32you get up, dress, you wash, and you look the part,
0:18:32 > 0:18:35say, "God, you look well today."
0:18:35 > 0:18:37But inside your head you're so depressed,
0:18:37 > 0:18:41you feel tired, you feel lethargic,
0:18:41 > 0:18:45you feel, you put the kettle on to make a cup of tea
0:18:45 > 0:18:47and you haven't got the energy to even make a cup of tea,
0:18:47 > 0:18:49you feel so depressed,
0:18:49 > 0:18:50you just...
0:18:50 > 0:18:53Life is just going on around you
0:18:53 > 0:18:55and you don't know what's happening to you.
0:19:05 > 0:19:08My sister suffers from MS and I'll say,
0:19:08 > 0:19:10"But her head's all right."
0:19:10 > 0:19:15She has a physical disability, everybody can see that and help her.
0:19:15 > 0:19:19But they think, "Oh, my Aunty Anne's all right, our Anne's all right,"
0:19:19 > 0:19:21but our Anne's not all right.
0:19:21 > 0:19:25Our Anne has this black hole in her head.
0:19:25 > 0:19:28Like a wheelchair in your head, Stephen.
0:19:30 > 0:19:35Anne knows only too well the stigma that comes with depression.
0:19:36 > 0:19:40People that will say to you the silliest thing in the world,
0:19:40 > 0:19:42"What have you to be depressed about?
0:19:42 > 0:19:45"You've everything, you've got a good home, you can go here.
0:19:45 > 0:19:50"You can take a beer, you can go and visit your friends."
0:19:50 > 0:19:52"You're the life and soul of the party."
0:19:52 > 0:19:54"You were always good craic when you were young.
0:19:54 > 0:19:56"What happened to you?"
0:19:56 > 0:19:58It's a state of mind.
0:19:58 > 0:20:00Which you can't explain.
0:20:00 > 0:20:03People say, "Pull yourself together." "Get yourself on."
0:20:03 > 0:20:06- That's the worst thing to say, Stephen.- Why?
0:20:06 > 0:20:08Cos if you could, you would.
0:20:08 > 0:20:11You're so depressed you can't do that.
0:20:22 > 0:20:26'You have already seen how Cathal struggles with depression,
0:20:26 > 0:20:30'what you don't know is that he is a wealthy businessman
0:20:30 > 0:20:33'running this engineering plant outside Coalisland.'
0:20:33 > 0:20:36You're financially secure?
0:20:36 > 0:20:39I'm financially secure. At the minute, yes.
0:20:39 > 0:20:43And could probably take retirement.
0:20:43 > 0:20:45He's so successful he's been shortlisted
0:20:45 > 0:20:47at the Mid-Ulster Business Awards,
0:20:47 > 0:20:51but his struggle against his illness is a lifelong battle.
0:20:52 > 0:20:55Cathal thought he had his depression under control,
0:20:55 > 0:20:59but then, a few years ago, he had another breakdown.
0:20:59 > 0:21:03Just as he was trying to expand his business.
0:21:03 > 0:21:08Resources were all looked at carefully, and location,
0:21:08 > 0:21:10and market,
0:21:10 > 0:21:14and the only thing that wasn't factored in
0:21:14 > 0:21:16was my mental health resource.
0:21:16 > 0:21:21That stress was making his depression worse.
0:21:21 > 0:21:25He went from never touching alcohol, to drinking heavily.
0:21:25 > 0:21:30The culmination of going on and off medication,
0:21:30 > 0:21:32stronger, less,
0:21:32 > 0:21:34sleeping tablets,
0:21:34 > 0:21:39uppers, downers, alcohol,
0:21:40 > 0:21:43coming in the evenings, more alcohol,
0:21:43 > 0:21:45to get to sleep, more alcohol,
0:21:45 > 0:21:48and then it got to the stage, getting up, more alcohol.
0:21:48 > 0:21:50Again, it's hard for me to imagine,
0:21:50 > 0:21:55because I see you as this healthy, robust, strong businessman.
0:21:55 > 0:21:58We're in a two-storey house, Stephen, as you know,
0:21:58 > 0:22:02and I jumped out of the top-storey window.
0:22:02 > 0:22:05So how does depression get you to jump out a window?
0:22:05 > 0:22:09The thoughts in your head are that nonsensical
0:22:09 > 0:22:13that I don't even know what, I was trying to get away from something,
0:22:13 > 0:22:16I don't know, I was trying to get away from Cathal, so I was.
0:22:21 > 0:22:24Like many people with serious depression,
0:22:24 > 0:22:27Heather reached a stage where she didn't think she could take any more.
0:22:29 > 0:22:32It was her thoughts of her family that kept her going.
0:22:34 > 0:22:36You just get to a point where you just think,
0:22:36 > 0:22:38"I'm too much of a burden,"
0:22:38 > 0:22:42and I think you get to the point where
0:22:42 > 0:22:44you nearly do think that it'd be easier for them,
0:22:44 > 0:22:45and you know, looking back now,
0:22:45 > 0:22:48I know that it definitely would not have been easier,
0:22:48 > 0:22:52and it was definitely the wrong thing for me to think.
0:23:03 > 0:23:04Stephen, I'm 61,
0:23:04 > 0:23:09I'll have had this ongoing all my life from when I was 19.
0:23:09 > 0:23:14I've attempted suicide, I've been so low, I just can't see a way out.
0:23:15 > 0:23:21But with the backup that I've got, there's people out there to help.
0:23:21 > 0:23:24Why, Anne, why does it get so low
0:23:24 > 0:23:28that you decide to try to take your life?
0:23:28 > 0:23:31You just feel you're in the way, Stephen,
0:23:31 > 0:23:34you just feel everybody's going to be better off without you.
0:23:34 > 0:23:37Depression is so severe.
0:23:37 > 0:23:39And you attempted it recently?
0:23:39 > 0:23:42I attempted it about six to eight weeks ago.
0:23:42 > 0:23:44What happened recently?
0:23:44 > 0:23:46The police caught me, Stephen.
0:23:48 > 0:23:50And got me to hospital.
0:23:50 > 0:23:55Because I'd mentioned to a stranger I felt so depressed,
0:23:55 > 0:23:58and they must have picked up the sign
0:23:58 > 0:24:01and rang to get them to the house.
0:24:04 > 0:24:07Did they have to break the door down, or what happened?
0:24:07 > 0:24:10They came and they got the key off my neighbour,
0:24:10 > 0:24:12my neighbour keeps the spare key,
0:24:12 > 0:24:15and they found me in bed with the tablets in me.
0:24:17 > 0:24:21And got to hospital and got sorted out, thank God.
0:24:27 > 0:24:33In the United States it's estimated that 10% of people
0:24:33 > 0:24:37with treatment-resistant depression take their own lives.
0:24:37 > 0:24:39Vagus nerve stimulation therapy,
0:24:39 > 0:24:41VNS therapy,
0:24:41 > 0:24:43has unique mechanism of action.
0:24:43 > 0:24:46But now there's an experimental treatment available,
0:24:46 > 0:24:49even for the very severe cases.
0:24:49 > 0:24:53The vagal nerve stimulator is like a pacemaker
0:24:53 > 0:24:56planted under the skin that sends a signal to the brain.
0:25:00 > 0:25:04Susan is a teacher who decided to get one fitted
0:25:04 > 0:25:07after suffering severe depression for most of her life.
0:25:07 > 0:25:10The pulse comes from the battery pack,
0:25:10 > 0:25:14it travels along the wiring to the vagus nerve,
0:25:14 > 0:25:17and that impulse travels into the brain.
0:25:17 > 0:25:19It's no big deal, I can show you the scar.
0:25:22 > 0:25:25So that's literally where the little battery pack is.
0:25:25 > 0:25:27That's right, it's right in there.
0:25:27 > 0:25:29And then they had to make an incision in your neck, did they?
0:25:29 > 0:25:36Yeah, I looked like the bride of Frankenstein for a few days!
0:25:36 > 0:25:38They typically make the incision in the neck
0:25:38 > 0:25:43in the fold, in the natural crease, so as it heals it's less noticeable.
0:25:43 > 0:25:45I don't know that you can even notice it now.
0:25:45 > 0:25:47I can't notice it, actually, no.
0:25:50 > 0:25:52My psychiatrist told me
0:25:52 > 0:25:55about this experimental study down at St Louis University,
0:25:55 > 0:25:59and I'm so grateful, it's helped me enormously.
0:25:59 > 0:26:01I'm still on a lot of medications,
0:26:01 > 0:26:04but this has kind of put a floor under me,
0:26:04 > 0:26:07below which I can't go,
0:26:07 > 0:26:12and if it weren't for VNS and modern psycho-pharmaceuticals,
0:26:12 > 0:26:15I would just be curled up in a corner somewhere,
0:26:15 > 0:26:17I would just be unable to function.
0:26:17 > 0:26:19MACHINE BEEPS
0:26:19 > 0:26:21So it's going to run through
0:26:21 > 0:26:24and it's going to send a signal to test that the communication
0:26:24 > 0:26:27within that whole system is operating correctly.
0:26:27 > 0:26:29Oh, it's working.
0:26:29 > 0:26:31What do you feel, Susan?
0:26:31 > 0:26:34Just feels like a pain in the neck.
0:26:34 > 0:26:36It's a stimulation.
0:26:36 > 0:26:39You sometimes get an area where it makes you cough.
0:26:39 > 0:26:41Are you all right?
0:26:41 > 0:26:42Yes, I'm OK.
0:26:42 > 0:26:44Can you tell me what you feel, Susan?
0:26:44 > 0:26:47Yes, it's just a sharp pain, but it's very brief
0:26:47 > 0:26:51and when that happens I know that it's working, so I don't mind.
0:26:55 > 0:26:59That's for really severe cases, most people will never be that bad.
0:26:59 > 0:27:04I wanted to find out about other treatments available.
0:27:04 > 0:27:07The starting point for most doctors are those
0:27:07 > 0:27:10modern psycho-pharmaceuticals Susan talked about.
0:27:10 > 0:27:12The main ones, antidepressants,
0:27:12 > 0:27:15which balance the chemicals in the brain.
0:27:16 > 0:27:19They're of moderate effectiveness.
0:27:19 > 0:27:22I would say that if you treat somebody with a good course
0:27:22 > 0:27:25you'll probably get 6 to 7 people out of 10 better
0:27:25 > 0:27:27with an antidepressant trial, in the first trial.
0:27:32 > 0:27:38Antidepressants are now one of the most prescribed drugs in the world.
0:27:39 > 0:27:42And we take a lot here in Northern Ireland.
0:27:42 > 0:27:48In 2011, over two million prescriptions were written here.
0:27:51 > 0:27:54Do you never think depression for you will go away?
0:27:54 > 0:27:55Never. I know for a fact
0:27:55 > 0:28:00that the tablets that my doctor has prescribed,
0:28:00 > 0:28:01I have to take them
0:28:01 > 0:28:05equally as much as a person with asthma has to take an inhaler.
0:28:05 > 0:28:09I have to take my tablets for the rest of my life,
0:28:09 > 0:28:13because if I didn't, then my life would be shortened.
0:28:18 > 0:28:23Doctors rate depression on a scale from mild, moderate to severe.
0:28:24 > 0:28:29When you're on medication they want you to stick to it.
0:28:29 > 0:28:32It is important to adjust your lifestyle,
0:28:32 > 0:28:35adjust your view to cope with that depression.
0:28:35 > 0:28:37And what I mean by that, what I basically mean, is
0:28:37 > 0:28:39if you are a diabetic
0:28:39 > 0:28:41you would be careful about what you eat,
0:28:41 > 0:28:42you would be careful
0:28:42 > 0:28:44that you took your medication and your insulin,
0:28:44 > 0:28:46and you would moderate your lifestyle.
0:28:46 > 0:28:48For severe forms of depression
0:28:48 > 0:28:51I do think there is an importance about compliance with the treatment,
0:28:51 > 0:28:54whatever that treatment is, that keeps you well,
0:28:54 > 0:28:56and an awareness that that may need to go on
0:28:56 > 0:28:58for a longer period of time
0:28:58 > 0:29:01than perhaps other illnesses, other treatment.
0:29:01 > 0:29:06MUSIC: "Coronation Street theme"
0:29:13 > 0:29:16Denise Welch, star of Coronation Street and Loose Women,
0:29:16 > 0:29:20has decided she is not going to hide the illness
0:29:20 > 0:29:23she has suffered from for most of her life.
0:29:31 > 0:29:33- Hello.- Hello, Denise, how are you?
0:29:33 > 0:29:36- I hope you like dogs.- Good to see you. I'm terrified of them!
0:29:36 > 0:29:39- She's as soft as anything. Come on in.- Thank you very much.
0:29:39 > 0:29:44- Come on, I'll get the kettle on. - Thank you very much.
0:29:44 > 0:29:46Can you describe what depression does to you,
0:29:46 > 0:29:48what words would you put to it?
0:29:48 > 0:29:50It's so terribly frightening.
0:29:50 > 0:29:54I can't eat anything when I have it, I have absolutely no appetite,
0:29:54 > 0:29:56it's like putting sandpaper in my mouth,
0:29:56 > 0:29:59I lost two stone in three weeks once
0:29:59 > 0:30:01when I had to pull out of a pantomime
0:30:01 > 0:30:03and I collapsed in my dressing room with it.
0:30:03 > 0:30:06It had a physical manifestation at some points,
0:30:06 > 0:30:09my face would twist,
0:30:09 > 0:30:12and my hands would... it was almost like
0:30:12 > 0:30:14I had Bell's palsy or some kind of arthritic condition,
0:30:14 > 0:30:17the depression was so bad.
0:30:17 > 0:30:19If someone came to the door
0:30:19 > 0:30:22and said, "You've won 23 million on the National Lottery,
0:30:22 > 0:30:26or they said, "Your family have been wiped out in an aircraft disaster,"
0:30:26 > 0:30:28it would be like that. Nothing.
0:30:30 > 0:30:33You are void of feeling and emotion.
0:30:33 > 0:30:36And that is the most horrible thing,
0:30:36 > 0:30:39for someone who loves their family as much as I do.
0:30:39 > 0:30:42And if you lose that and think you won't get better
0:30:42 > 0:30:45you will probably end up killing yourself.
0:30:45 > 0:30:49And I used to use thought of suicide as a comfort blanket.
0:30:49 > 0:30:51What do you mean?
0:30:51 > 0:30:54If I don't get better I can always kill myself.
0:30:54 > 0:30:56And everyone will be better off without me
0:30:56 > 0:30:58because I'm not ever going to be able to live like this.
0:30:58 > 0:31:00I can't live like this.
0:31:01 > 0:31:0523 years ago, when her son Matthew was born,
0:31:05 > 0:31:08depression struck out of the blue.
0:31:10 > 0:31:12I remember looking at the sterilising bottles, and my mum,
0:31:12 > 0:31:16she'd say, "Go and get the bottles ready, it's four hours, he's ready for his feed,"
0:31:16 > 0:31:19and it was like someone had said to me,
0:31:19 > 0:31:22"There's Everest, go and climb it now."
0:31:22 > 0:31:25That's how it felt, to get off the settee and go and do the bottles.
0:31:25 > 0:31:29'It was getting harder and harder for Denise to cover up her illness.
0:31:29 > 0:31:31'She was a big star...'
0:31:31 > 0:31:35I don't like Duggie asking you to do things that he's too scared to do himself.
0:31:35 > 0:31:37'..but was hiding a big secret.
0:31:37 > 0:31:40'She was leading a dangerous double life
0:31:40 > 0:31:43'when she was filming Coronation Street.
0:31:43 > 0:31:46'People just didn't have a clue what was really going on
0:31:46 > 0:31:48'behind-the-scenes.'
0:31:48 > 0:31:51The police don't look too kindly on people who demand money with menaces.
0:31:51 > 0:31:54'I was self medicating, I was using drugs.'
0:31:54 > 0:31:56I got myself into some terrible situations.
0:31:56 > 0:31:58I was working on drugs.
0:31:58 > 0:32:02I was a mess, physically, emotional wreck.
0:32:03 > 0:32:05I was driving to get drugs at three o'clock in the morning.
0:32:05 > 0:32:08And you crashed, big time, didn't you?
0:32:08 > 0:32:11You had the profile, the drink, the drugs,
0:32:11 > 0:32:14was it self-destruct
0:32:14 > 0:32:16because of depression?
0:32:16 > 0:32:20Well, all I thought about was,
0:32:20 > 0:32:24I need respite from this feeling,
0:32:24 > 0:32:28if alcohol numbs it for a bit,
0:32:28 > 0:32:31if cocaine numbs it for a bit,
0:32:31 > 0:32:32that's what I'm doing.
0:32:32 > 0:32:36CHEERING AND APPLAUSE
0:32:43 > 0:32:49So, which mystery star will be the first to stare into fame's unforgiving abyss?
0:32:49 > 0:32:52Denise was just about holding it together,
0:32:52 > 0:32:55but the depression was taking over.
0:32:55 > 0:32:58I remember when I was doing Celebrity Stars in Their Eyes
0:32:58 > 0:33:01and there was a wardrobe in my dressing room at Granada television,
0:33:01 > 0:33:04and I was in the wardrobe, with the door closed,
0:33:04 > 0:33:09thinking that they might think that I'd gone away or left...
0:33:09 > 0:33:12I was lucid and I can remember doing it,
0:33:12 > 0:33:15but I was so terrified of how I felt.
0:33:15 > 0:33:20Denise Welch is Petula Clark!
0:33:23 > 0:33:25Metaphorically there's so much in that,
0:33:25 > 0:33:28because you're going to walk out a few minutes later...
0:33:28 > 0:33:30Being Petula Clark.
0:33:30 > 0:33:34But what you're hiding is what you're really like.
0:33:34 > 0:33:35Your cowering in a wardrobe.
0:33:35 > 0:33:38- And of course... - ..because of an illness.- Yeah.
0:33:38 > 0:33:41# When you're alone and life is making you lonely
0:33:41 > 0:33:42# You can always go
0:33:42 > 0:33:45# Downtown... #
0:33:45 > 0:33:47Denise talks openly,
0:33:47 > 0:33:49because she's sick and tired
0:33:49 > 0:33:52of those people who say depression isn't a serious illness.
0:33:52 > 0:33:54I went to see a GP in London,
0:33:54 > 0:33:56and I'd never seen this GP before.
0:33:56 > 0:34:01So I'm so depressed, my mum takes me down there, to get some help,
0:34:01 > 0:34:03and she said to me,
0:34:03 > 0:34:06"Well, you see, dear, I had five children,
0:34:06 > 0:34:08"now I just didn't have time to get depressed,"
0:34:08 > 0:34:10that's what she said to me.
0:34:11 > 0:34:14That's a common reaction to depression,
0:34:14 > 0:34:17some commentators have described it
0:34:17 > 0:34:19as a designer illness.
0:34:20 > 0:34:22How does it make you feel when you hear them say that?
0:34:22 > 0:34:25It makes me feel very angry, they've never had it.
0:34:25 > 0:34:27"I'm all right. "Pull your socks up and get on with it."
0:34:27 > 0:34:32Because the two standard phrases are, "Snap out of it." "Pull yourself together."
0:34:40 > 0:34:43HEATHER: When people do say that to you
0:34:43 > 0:34:45it puts an awful pressure on you,
0:34:45 > 0:34:48because you can't actually do it,
0:34:48 > 0:34:51and when you can't, it's like a failure as well,
0:34:51 > 0:34:55so I think it makes you worse.
0:34:55 > 0:34:56Well, it made me worse.
0:35:02 > 0:35:05For Anne, coping with that stigma
0:35:05 > 0:35:09is one of the worst aspects of her mental illness.
0:35:10 > 0:35:13How do you feel when someone says to you, "Pull yourself together"?
0:35:13 > 0:35:16You feel like saying, "You take my head and you be depressed."
0:35:16 > 0:35:19Cos people are totally ignorant, Stephen.
0:35:19 > 0:35:22Ignorant in both senses of the word,
0:35:22 > 0:35:24they're ignorant of ill manners
0:35:24 > 0:35:27and ignorant of the knowledge of depression.
0:35:27 > 0:35:30Nobody wants to feel depressed.
0:35:30 > 0:35:32Do you think I want to feel...
0:35:32 > 0:35:35If I could pull myself together, of course I would.
0:35:35 > 0:35:39But it's so deep in your head, Stephen, you can't.
0:35:41 > 0:35:44I can't pull myself together like a pair of curtains.
0:35:45 > 0:35:47The depression is that severe.
0:35:49 > 0:35:55Don't shout at me, don't tell me to pull myself together,
0:35:55 > 0:35:58don't hurt me any more.
0:36:00 > 0:36:04Don't hurt me because I've got an illness called depression.
0:36:08 > 0:36:12Understand me a bit more, don't be hard on me.
0:36:12 > 0:36:14Don't stigmatise me.
0:36:17 > 0:36:19It's nothing to be ashamed of,
0:36:19 > 0:36:22it is an illness, depression is an illness.
0:36:30 > 0:36:33Those tears aren't running down your cheek
0:36:33 > 0:36:35because of your depression,
0:36:35 > 0:36:37they're running down your cheek
0:36:37 > 0:36:41because you feel that people don't understand.
0:36:45 > 0:36:47Exactly, Stephen.
0:36:47 > 0:36:49They're judging you.
0:36:49 > 0:36:52They judging me, putting a label on me, Stephen.
0:36:54 > 0:36:56That is an attitude
0:36:56 > 0:36:59that psychiatrists are all too familiar with.
0:36:59 > 0:37:00I've worked as
0:37:00 > 0:37:02a psychiatrist for 30 years,
0:37:02 > 0:37:04and I sadly have looked after people
0:37:04 > 0:37:09where depression has been the fundamental cause of them taking their own life.
0:37:09 > 0:37:13I have also seen people who come into hospital severely malnourished,
0:37:13 > 0:37:16who have been lying in their bed neglecting themselves,
0:37:16 > 0:37:18it exists.
0:37:18 > 0:37:20I've seen it for 30 years.
0:37:20 > 0:37:24Trust me, it exists, it's severe, it's life-threatening.
0:37:31 > 0:37:33When Heather got the help she needed
0:37:33 > 0:37:37she was found to have had post-traumatic stress disorder,
0:37:37 > 0:37:41because of the trauma of a child dying in front of her.
0:37:41 > 0:37:45She had to wait for sessions of cognitive behavioural therapy,
0:37:45 > 0:37:48so-called talking therapy.
0:37:49 > 0:37:51Luckily for her
0:37:51 > 0:37:55her church paid for her to go to England for intensive treatment.
0:37:55 > 0:37:57And, it worked.
0:37:59 > 0:38:02They reprogramme your thinking,
0:38:02 > 0:38:07and try to get you to look at things differently.
0:38:07 > 0:38:11Are you able to tell me in layman's terms what they actually do,
0:38:11 > 0:38:16they sit down and they talk to you, think positive, or what?
0:38:16 > 0:38:19One of the issues I had was I found it difficult
0:38:19 > 0:38:21to go into crowded areas,
0:38:21 > 0:38:25because I was so afraid of somebody taking unwell,
0:38:25 > 0:38:27and what they made me do
0:38:27 > 0:38:31was put me into those situations
0:38:31 > 0:38:33and I had to keep going back
0:38:33 > 0:38:36until the fears and anxieties lesson.
0:38:36 > 0:38:40Some of them were just very simple things
0:38:40 > 0:38:43like I had to go for a walk, had to sit down,
0:38:43 > 0:38:46and I had to do stuff that I've enjoyed.
0:38:46 > 0:38:50As he said, it's like resetting the balance in your brain.
0:38:54 > 0:38:57It's about a person being challenged by the therapist
0:38:57 > 0:38:59with regard to the negative views,
0:38:59 > 0:39:01their negativity, their assumptions,
0:39:01 > 0:39:04and doing homework on the basis of that
0:39:04 > 0:39:06to try and restructure their view about things,
0:39:06 > 0:39:09and look at a different way of perceiving themselves
0:39:09 > 0:39:12and perceiving what is happening outside.
0:39:17 > 0:39:23Science has been investigating just that type of negative thinking.
0:39:23 > 0:39:27I went to the Oxford Centre for Brain Research
0:39:27 > 0:39:32where they have been examining activity in the brains of depressed people.
0:39:33 > 0:39:36Their work centres on the amygdala,
0:39:36 > 0:39:38a tiny area that's like
0:39:38 > 0:39:40the computer hub of the brain.
0:39:40 > 0:39:43Just like we saw with the hippocampus,
0:39:43 > 0:39:47the amygdala behaves differently in depressed people.
0:39:50 > 0:39:54This area here is the amygdala that we're interested in looking at.
0:39:54 > 0:39:56Just right in the centre there.
0:39:57 > 0:40:00Research scientist Catherine Harmer
0:40:00 > 0:40:02took a sample of depressed people
0:40:02 > 0:40:06and showed them negative images as she was scanning their brain.
0:40:12 > 0:40:15Her results are fascinating.
0:40:16 > 0:40:22They show that depressed people's brains exaggerate negative images.
0:40:24 > 0:40:26So these are all slices in the brain
0:40:26 > 0:40:30taken at different angles showing the response,
0:40:30 > 0:40:32the difference in response,
0:40:32 > 0:40:35in the amygdala in people who are depressed
0:40:35 > 0:40:37and people who aren't depressed.
0:40:37 > 0:40:43So what the activity level that you can see in red here
0:40:43 > 0:40:47is the difference between those two groups,
0:40:47 > 0:40:49the statistical difference.
0:40:54 > 0:40:57In other words, the science clearly shows
0:40:57 > 0:41:01that people with depression lose perspective,
0:41:01 > 0:41:07and part of their brain is much more sensitive to negativity.
0:41:08 > 0:41:12So, in someone who has never suffered from depression,
0:41:12 > 0:41:15we wouldn't see that orange blob at all.
0:41:15 > 0:41:16That's right.
0:41:16 > 0:41:19So when people are depressed,
0:41:19 > 0:41:23they showed an exaggerated, much bigger response of the amygdala
0:41:23 > 0:41:27to these kinds of negative cues from these facial expressions.
0:41:27 > 0:41:30So, what an amygdala, with someone who's depressed does,
0:41:30 > 0:41:34it makes a mountain out of a mole hill.
0:41:34 > 0:41:40It looks at a sad face or a sad incident and it exaggerates it.
0:41:40 > 0:41:42That's right, it's more tuned into picking up
0:41:42 > 0:41:45even mildly negative or ambiguous cues,
0:41:45 > 0:41:49and reacting as if it was a much more negative or much more important stimulus.
0:41:54 > 0:41:56But, there is hope.
0:41:56 > 0:41:59They also found the amygdala
0:41:59 > 0:42:02does respond positively to treatment,
0:42:02 > 0:42:07like antidepressants or talking therapies.
0:42:08 > 0:42:10Do you know what's crazy about this, Chris?
0:42:10 > 0:42:13Here we are, you and other experts
0:42:13 > 0:42:16clearly showing me how science
0:42:16 > 0:42:19can actually detect literal changes in the brain
0:42:19 > 0:42:22and yet we have very educated people
0:42:22 > 0:42:26questioning whether depression actually exists.
0:42:26 > 0:42:31Yes, and if you actually do a CT, or computerised tomographic image
0:42:31 > 0:42:33of the size of people's adrenal glands,
0:42:33 > 0:42:35this is not in the brain, this is in the body,
0:42:35 > 0:42:38the stress hormone,
0:42:38 > 0:42:40they are significantly larger in people with depression,
0:42:40 > 0:42:46so you have a toxic environment in severe depression of people
0:42:46 > 0:42:49pumping out stress chemicals that are much higher.
0:42:49 > 0:42:51Those chemicals are also in the brain as well.
0:43:07 > 0:43:11This is a place where history and memory meet.
0:43:12 > 0:43:15I'm in the Ulster Museum in Belfast,
0:43:15 > 0:43:17at the Troubles exhibition.
0:43:20 > 0:43:23It's a quiet, serene sort of place.
0:43:24 > 0:43:31You can feel the sadness of the 3,700 deaths we had here.
0:43:31 > 0:43:35It's all recent history for many of us.
0:43:39 > 0:43:43Researchers have found that 40% of people here
0:43:43 > 0:43:47have suffered some sort of traumatic event.
0:43:47 > 0:43:51According to a study carried out at the University of Ulster,
0:43:51 > 0:43:55Northern Ireland has the highest recorded rate
0:43:55 > 0:43:57of post-traumatic stress disorder,
0:43:57 > 0:43:59in the world.
0:44:01 > 0:44:05And here's something that might surprise you.
0:44:05 > 0:44:10It is still going on, years after the Troubles have ended.
0:44:25 > 0:44:28Here, at the Everton Centre in North Belfast,
0:44:28 > 0:44:30they know all about it.
0:44:30 > 0:44:33This unique centre is on the interface
0:44:33 > 0:44:36between Protestant and Catholic areas.
0:44:38 > 0:44:43What we found is that when you're traumatised you live in the past,
0:44:43 > 0:44:45you live with a past events,
0:44:45 > 0:44:47it's nearly like you're stuck in the past.
0:44:47 > 0:44:49You live in terror of the future,
0:44:49 > 0:44:52because you're always waiting for the next bad thing to happen to you,
0:44:52 > 0:44:54and you miss the present,
0:44:54 > 0:44:56and what we hope to offer here
0:44:56 > 0:44:58is an opportunity to give people a chance
0:44:58 > 0:45:01to live back in the present in their daily lives.
0:45:06 > 0:45:09This is the only place of its type for people
0:45:09 > 0:45:12with Troubles-related depression,
0:45:12 > 0:45:15and provides a safe place for them to tell their story.
0:45:15 > 0:45:16And get help.
0:45:18 > 0:45:20We would have
0:45:20 > 0:45:23many, many of our clients with the past addiction issues, for example.
0:45:23 > 0:45:26Alcohol and trauma, drugs and trauma,
0:45:26 > 0:45:29any kind of addiction and trauma is very related,
0:45:29 > 0:45:30because how else do you cope?
0:45:30 > 0:45:33How else do you get by, how else do you survive?
0:45:36 > 0:45:42I was really surprised that most of the people using this centre
0:45:42 > 0:45:46are men between the age of 25 and 40.
0:45:46 > 0:45:51Many of them are under threat from their own side.
0:45:53 > 0:45:56Many of our young people would see the people who either shot them,
0:45:56 > 0:45:58took them away, tortured them,
0:45:58 > 0:46:00on a regular basis,
0:46:00 > 0:46:03and so can you imagine how that heightens their fear
0:46:03 > 0:46:06and their terror and many suffer from anxiety and depression,
0:46:06 > 0:46:10particularly many of them suffer from a lot of isolation,
0:46:10 > 0:46:14and do present with the symptoms of the complex post-traumatic stress.
0:46:15 > 0:46:18The ripple effect of the Troubles on families
0:46:18 > 0:46:20has never been measured,
0:46:20 > 0:46:23but if your parents were directly affected,
0:46:23 > 0:46:27the chances are your life will be too.
0:46:42 > 0:46:45Back in North Belfast I'm in St Patrick's College,
0:46:45 > 0:46:49a stone's throw from the Everton Centre.
0:46:56 > 0:46:58Depression, talking about depression.
0:46:58 > 0:47:01The charity Aware Defeat Depression
0:47:01 > 0:47:05is trying to teach young people what to look out for in this talk
0:47:05 > 0:47:07for 12 and 13-year-olds.
0:47:07 > 0:47:10I'm going to give you situations in a day,
0:47:10 > 0:47:12and if I puts you in better form, say higher,
0:47:12 > 0:47:14if it puts you in worse form, say lower.
0:47:14 > 0:47:17You wake up in the morning, boys, and it's Monday morning.
0:47:17 > 0:47:18Lower.
0:47:18 > 0:47:22Straightaway yous are a wee bit below par, aye?
0:47:22 > 0:47:24You get to school, you spent all weekend doing a bit of homework
0:47:24 > 0:47:26and you forgot it.
0:47:26 > 0:47:27Lower.
0:47:27 > 0:47:31Then your friend bounces over and tells you teachers off today,
0:47:31 > 0:47:34we're going to have free period for two periods and do nothing.
0:47:34 > 0:47:35Higher.
0:47:35 > 0:47:37You go into the canteen at lunchtime,
0:47:37 > 0:47:40your friends are all over there and they're completely ignorant you,
0:47:40 > 0:47:41you don't know why.
0:47:41 > 0:47:42Lower.
0:47:42 > 0:47:45One of them comes over and says, "I didn't see you,"
0:47:45 > 0:47:48- tells you the craic, and you play football and you have a laugh. - Higher.
0:47:48 > 0:47:51- You're on your way home from school, you fine 20 quid lying in the street.- Higher.
0:47:51 > 0:47:54Somebody accuses you of stealing the money and takes it off you.
0:47:54 > 0:47:56Lower.
0:47:56 > 0:47:59Then your friend phones or texts to tell you
0:47:59 > 0:48:01the wee girl that you've liked for a long time likes you too.
0:48:01 > 0:48:03- Higher.- Tell the truth!
0:48:03 > 0:48:05Somebody fancying you.
0:48:05 > 0:48:08See with your mood, boys, that's healthy,
0:48:08 > 0:48:10it goes up and it goes down.
0:48:10 > 0:48:13Now, if you were suffering with depression it would look more like this,
0:48:13 > 0:48:17thinking your friends aren't speaking to you does that to your mood.
0:48:17 > 0:48:19Realising they are does that your mood.
0:48:19 > 0:48:22Finding 20 quid lying in the street, does that to your mood,
0:48:22 > 0:48:24accused of stealing it does that to you mood.
0:48:24 > 0:48:28Being told that the wee girl fancies you, you probably just wouldn't believe it.
0:48:28 > 0:48:29Does that to your move.
0:48:31 > 0:48:32You see what I mean.
0:48:32 > 0:48:38Depression is a very sad mood that doesn't change.
0:48:38 > 0:48:42The things that normally would have lifted you, given you a wee lift,
0:48:42 > 0:48:44aren't lifting you any more.
0:48:44 > 0:48:47That's depression, does that make sense?
0:48:47 > 0:48:50Michaela knows too well the pain of depression.
0:48:50 > 0:48:54I lost my sister to suicide when I was 16. She was 18.
0:48:54 > 0:48:57And as I always say in the presentations,
0:48:57 > 0:49:01I genuinely believe that if somebody had have come into our school
0:49:01 > 0:49:04and told us what I now tell the young people,
0:49:04 > 0:49:07she may not have become so unwell that suicide was an option.
0:49:07 > 0:49:10I believe very strongly that it is the stigma
0:49:10 > 0:49:12that stops people from getting help.
0:49:12 > 0:49:14Ideally a healthy mood,
0:49:14 > 0:49:17you will be happy and you will be sad,
0:49:17 > 0:49:19but it won't go to the extremes.
0:49:19 > 0:49:22The talk was changing the boys' thinking.
0:49:22 > 0:49:24Do you think you would judge someone?
0:49:24 > 0:49:28Not now, like, I wouldn't judge them.
0:49:28 > 0:49:31- Why?- Because I fully understand why.
0:49:31 > 0:49:37And it's not fun to make fun of people with depression,
0:49:37 > 0:49:41because it could happen to me or anybody else,
0:49:41 > 0:49:46so I wouldn't do it now.
0:49:46 > 0:49:50There's people you can just ring up and talk to them about it
0:49:50 > 0:49:51and let it out,
0:49:51 > 0:49:54and you don't have to wreck stuff and stuff like that,
0:49:54 > 0:49:57just to get it out, just talk to someone.
0:49:57 > 0:50:01When more and more people say the same thing about something,
0:50:01 > 0:50:04there's a power behind it, a momentum behind it.
0:50:04 > 0:50:08Depression will probably go down in numbers instead of up.
0:50:08 > 0:50:10Depression is a disease, like cancer,
0:50:10 > 0:50:12and you shouldn't slag anyone about.
0:50:12 > 0:50:14Why do so many people do it?
0:50:14 > 0:50:16Just cos they think they're different,
0:50:16 > 0:50:19but they're not, they're just like everybody else.
0:50:25 > 0:50:28You would think we, here in Northern Ireland,
0:50:28 > 0:50:29would be a special case,
0:50:29 > 0:50:32when you hear about the ripple effect of the Troubles.
0:50:32 > 0:50:35But it doesn't sound like it.
0:50:36 > 0:50:39In 2011, Professor John Appleby,
0:50:39 > 0:50:41a top economist,
0:50:41 > 0:50:43reported that Stormont
0:50:43 > 0:50:48spends up to 30% less on mental health than England,
0:50:48 > 0:50:51despite having over 30% more cases.
0:50:58 > 0:51:00We are running considerably
0:51:00 > 0:51:03off the pace compared to our cousins across the way.
0:51:03 > 0:51:06Is this government, this local administration,
0:51:06 > 0:51:08taking mental health seriously?
0:51:08 > 0:51:10Well, that's a good question.
0:51:10 > 0:51:11What do you think?
0:51:11 > 0:51:13I think we could do more.
0:51:13 > 0:51:15What type of things do people get
0:51:15 > 0:51:18in England that they don't get here in Northern Ireland,
0:51:18 > 0:51:19in terms of depression?
0:51:19 > 0:51:22Probably better access to psychological services,
0:51:22 > 0:51:26specialised doctors with experience in that area.
0:51:26 > 0:51:28So you can get talking therapy
0:51:28 > 0:51:31far easier on the NHS in England than you can in Northern Ireland?
0:51:31 > 0:51:33That would be my understanding.
0:51:33 > 0:51:35You can get counsellors, counselling,
0:51:35 > 0:51:38easier than you can get here in Northern Ireland?
0:51:38 > 0:51:40And yet we pay the same level of tax,
0:51:40 > 0:51:43we're not at a discount here in Northern Ireland,
0:51:43 > 0:51:48the tax rate isn't cut from 40% to 30% for us here in Northern Ireland.
0:51:48 > 0:51:50Yet we are getting a worse deal.
0:51:50 > 0:51:52Be better if we had a better deal.
0:51:55 > 0:52:00So, how much are things really improving in mental health?
0:52:00 > 0:52:03It seems to me like we have a way to go.
0:52:06 > 0:52:08If you go back to the '60s,
0:52:08 > 0:52:10I think cancer has now made the jump
0:52:10 > 0:52:13from a stigmatised disorder to one that is not,
0:52:13 > 0:52:17so we live in hope and I hope that that will change,
0:52:17 > 0:52:21but we do need to have champions, politicians,
0:52:21 > 0:52:25willing to move further in order to improve the treatments,
0:52:25 > 0:52:28the access to treatments, for the population of Northern Ireland.
0:52:28 > 0:52:30Do you know what strikes me, Chris?
0:52:30 > 0:52:33We're educated in modern living now,
0:52:33 > 0:52:35how to look after our bodies,
0:52:35 > 0:52:39I'm know I'm no shining example of having listened.
0:52:39 > 0:52:42Do you not think we should be educated in how to look after our brain?
0:52:42 > 0:52:46We're told, go to the gym three or four times a week,
0:52:46 > 0:52:47eat vegetables, eat fruit.
0:52:47 > 0:52:50So what do you do to protect your brain?
0:52:50 > 0:52:53What do you do to protect yourself against depression?
0:52:53 > 0:52:56Sleeping well, trying to keep a sensible sleep pattern,
0:52:56 > 0:53:00eating regularly, trying to keep a sensible balanced diet,
0:53:00 > 0:53:02and having time, some time,
0:53:02 > 0:53:05away to have your own, to relax,
0:53:05 > 0:53:08as well as avoiding too much alcohol,
0:53:08 > 0:53:10and other substances,
0:53:10 > 0:53:12these are good things in terms of
0:53:12 > 0:53:16trying to avoid depression and mental difficulties generally.
0:53:18 > 0:53:22Cathal still manages to be at the top of his game,
0:53:22 > 0:53:23but at the Business Awards
0:53:23 > 0:53:27he can only get through the night with careful planning.
0:53:29 > 0:53:32It's quite an ordeal, I've already planned my day out,
0:53:32 > 0:53:34as in number one, I'm beside an exit.
0:53:34 > 0:53:37In case you think that happened by chance, no, it wasn't,
0:53:37 > 0:53:41I asked for our table to be put beside an exit, so I did.
0:53:41 > 0:53:46It's a safety net that I've learnt to put up throughout my life,
0:53:46 > 0:53:50and I've also had a few tablets before I came here tonight.
0:54:00 > 0:54:03Sport is a big part of Cathal's life.
0:54:03 > 0:54:07He's decided to take things into his own hands.
0:54:07 > 0:54:12He had Derrytresk GAA ground on the shores of Lough Neagh,
0:54:12 > 0:54:18he's using his business skills to plan a £1.5 million centre
0:54:18 > 0:54:22to ensure faster treatment for depressed people in his area.
0:54:24 > 0:54:25What's your dream here?
0:54:25 > 0:54:27On this car park here that were standing on,
0:54:27 > 0:54:29hopefully within a year
0:54:29 > 0:54:32will be the start of the first ever centre of excellence
0:54:32 > 0:54:35for emotional health and well-being in Northern Ireland.
0:54:35 > 0:54:36And so because you've suffered from it
0:54:36 > 0:54:39you've realised there's not enough help,
0:54:39 > 0:54:41so you're going to build a whole facility,
0:54:41 > 0:54:43or at least make it happen?
0:54:43 > 0:54:47If they build it, they will come, Stephen.
0:54:47 > 0:54:51The need for it is overwhelming.
0:54:51 > 0:54:56If you're coming here straightaway, you're getting immediate expert help.
0:54:56 > 0:55:02Cathal has successfully negotiated a grant of £860,000
0:55:02 > 0:55:04to make that dream a reality.
0:55:15 > 0:55:18Anne keeps herself well with her medication
0:55:18 > 0:55:20and help from Mind Wise,
0:55:20 > 0:55:23a charity for people with mental health problems.
0:55:23 > 0:55:25That's it, keep going.
0:55:25 > 0:55:28I go to Mind Wise in Lurgan, I do boxercise.
0:55:28 > 0:55:30- Boxercise?- Yes.
0:55:30 > 0:55:33- You box? - I could knock you out, Stephen.
0:55:33 > 0:55:38I think one of my nightmares would be if I was sent down to the BBC, for you lot to practice on me.
0:55:38 > 0:55:43I'd be a woman and you could sort me out too, boy.
0:55:43 > 0:55:45Does the boxercise help you in terms of your depression?
0:55:45 > 0:55:49Yes, it relieves all the stress in your head, Stephen.
0:55:49 > 0:55:52They do have a lot of things
0:55:52 > 0:55:55that is around depression to get your mood lifted.
0:56:01 > 0:56:04Psychiatrists say that most depression
0:56:04 > 0:56:07can be cured within three to six months.
0:56:07 > 0:56:12Heather is proof that depression doesn't have to be a life sentence
0:56:12 > 0:56:15and it's possible to be cured.
0:56:16 > 0:56:19She's made great strides in her recovery.
0:56:21 > 0:56:23I feel that I'm getting my life back,
0:56:23 > 0:56:26more than I have ever felt.
0:56:26 > 0:56:31And every day I still have to make an effort,
0:56:31 > 0:56:34I still have to say, right, this depression could be here,
0:56:34 > 0:56:37but I just have to stop it, I have to push it away.
0:56:37 > 0:56:39You're back to having a life again.
0:56:39 > 0:56:40I am back to having a life,
0:56:40 > 0:56:43my husband's getting his dinner cooked for him again!
0:56:43 > 0:56:45You should be proud of yourself.
0:56:45 > 0:56:48I am, I am proud of myself,
0:56:48 > 0:56:51but I think one of the important things,
0:56:51 > 0:56:53and one of the things that the doctor over in England,
0:56:53 > 0:56:57the specialist, he said to me, one day you can use your experience to help somebody else.
0:56:57 > 0:57:01And he says you can't just put it in a box
0:57:01 > 0:57:05and put it away and forget that difficult period in your life,
0:57:05 > 0:57:10you have to one day use that experience and help somebody else.
0:57:16 > 0:57:20After around 20 years of suffering, Denise had a breakthrough
0:57:20 > 0:57:25when she heard about a doctor who specialised in hormone treatment.
0:57:28 > 0:57:33It was a gel treatment and I started to get better.
0:57:33 > 0:57:37I always believed the origin was hormonal,
0:57:37 > 0:57:39you're not depressed, you have a baby,
0:57:39 > 0:57:43and you become seriously depressed, post-natal depression.
0:57:43 > 0:57:46You've given birth to another human being in your body,
0:57:46 > 0:57:49chemical chaos is so great and greater in some people,
0:57:49 > 0:57:51it doesn't balance itself out.
0:57:54 > 0:57:58Denise knows how tough depression is,
0:57:58 > 0:58:02but she also knows that you don't have to let it beat you.
0:58:04 > 0:58:06There is a philosophy that some people have
0:58:06 > 0:58:09that it's a form of weakness, you're weak if you get it,
0:58:09 > 0:58:11if you get through it
0:58:11 > 0:58:13you're fucking strong, let me tell you.
0:58:13 > 0:58:15You are strong to get through it.
0:58:41 > 0:58:45Subtitles by Red Bee Media Ltd