Feeling downtrodden

From Linda, age 48
Dear Carole, The last decade has been a pretty awful one with bad things happening one after the other. My husband had a heart attack and treble heart bypass. This was followed by his being made redundant not once but twice in a relatively short space of time, with all the consequent money worries and stress that brought.

My one and only professional job ended in disaster due to bullying. After this, I vowed I would never work for anybody again because I was sick of the nastiness of some women in the workplace as well as the failure of organisations to do anything about it. I have since set up a little business from home as a freelancer providing editorial services but seem even to have failed at that.

Then, a year ago I was diagnosed with breast cancer. To this day, my family say I coped with it wonderfully, just getting on with it, never letting it get me down, etc, etc. The awful truth was, a part of me was secretly pleased. It was meant to be my escape route from all these terrible things that kept on happening.

I know I'm depressed but can't find any help. I used to be on Citalopram, but guess what, I can't take that antidepressant because it reacts with Tamoxifen.

And it turns out that the cancer wasn't my escape route after all; it seems to have been just another crap thing that happened to me.

I feel utterly worthless, a failure at everything I've ever done. This wasn't the life I dreamed of for myself when I was younger. I used to have what was described as "so much potential". I used to be a confident, vibrant person and I've changed into this downtrodden, miserable, 48-year-old woman and I don't know where to turn to stop feeling like this.

Carole replies:
There are a number of significant things that divide humans from the other apes, language being one of them. You need to talk your problems through with someone. You don't mention whether you have had counselling, but from your description I think professional counselling would be of benefit.

Your first port of call should be your GP. You say you can't take the antidepressant that was working for you before because you're now on Tamoxifen. Your doctor may advise a course of cognitive behavioural therapy (CBT), which has been shown to be an effective treatment for depression. The Royal College of Psychiatrists has some very helpful information on CBT on its website, including helpline numbers and links to further information sources such as the Depression Alliance.

It seems you blame yourself for many things, but haven't you had enough punishment? Self-reflection has evolved in humans to allow us to examine our past behaviour and adapt it as necessary. With hindsight we can understand the part we played and prepare ourselves for similar events in the future. In general, women are more self-reflective than men, but some people (you might be one of them) are overly self-reflective, to the point of dwelling on past problems to an unhealthy extent.

You say you have "withered". Certainly you have been through a great deal of pain and anguish, but humans are highly adaptable animals and can overcome a great deal of hardship.

You are the result of a long line of survivors: your ancestors survived long enough to breed, when many, many others did not. Just the fact that you were born makes you a success story.

From now on, if you find yourself in a situation where people are bullying you – which is typical hierarchical behaviour among primates – cut your losses immediately. Try to recognise the types who treat you this way, and once you've moved on, don't waste time looking back and reflecting on their unjust behaviour.

Freelance work ebbs and flows, so stick with it.

Please organise counselling for yourself and most importantly of all talk to those who think you "coped wonderfully" and tell them the truth. You must learn to ask for help and state what you need rather than expecting to be empathised with. Others, even family members, may not be able to feel your feelings no matter how obvious the situation seems to you or how many hints you drop.

It seems you have cared for your family and struggled through the past 10 years without much support or understanding in return. You have become isolated and depressed. But our personalities are hardwired, so the confident, vibrant person you always were remains. Delve deep, get back in touch with your hopes and your potential. Put yourself first for the next six months and every day do things that make you happy.

But do give your rehabilitation time. Apes are long-lived animals. At 48 you may be only half way through your journey.

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2. Sprecher, S, Fehr, B, Zimmerman, C (2007) Expectation for mood enhancement as a result of helping: the effects of gender and compassionate love. Sex Roles; 56: 543-549.
3. Parks, CD, Rumble, AC (2001) Elements of Reciprocity and Social Value Orientation. Society for Personality and Social Psychology.
4. Kimura, D (2002) Sex Differences in the Brain. Scientific American, 3 May 2002.
5. Taylor, SE, et al (2000). Biobehavioural responses to stress in females: Tend-and-befriend not fight-or-flight. Psychological Review; 107: 413-429.

6. Harlow HF, Dodsworth RO, Harlow MK (1965) Total social isolation in monkeys. Proceedings of the National Academy of Sciences; 54 (1): 90-97.

Carole is UK-based and as such any advice she gives is intended for a UK audience only.