It might seem odd to hear someone who has had most of their adult life blighted by depression describe themselves as lucky but, in reality, I have been very lucky. I've managed to hold down full-time jobs since my mid-twenties and – barring one episode in 2010, which saw me signed off work for three weeks while I waited for new medication to kick in – I've managed to restrict my periods off work to a week or less. I've also been blessed with very understanding and sympathetic employers who never made me feel like my absences were an inconvenience or a burden. So, like I say – I've been lucky.
But everyone who deals with the day-to-day realities of depression is aware that your luck can change – I know full well that it could strike again at any moment, and do so with a severity I have yet to encounter. That Sword of Damocles is one that we just have to live with. One thing is certain: if I ever find myself in a situation where I am out of work for a considerable amount of time, then I really will know that my luck's run out if the Conservative party go ahead with mooted plans to slash the sickness benefits of depression sufferers who refuse treatment, because, as it stands, I am one of the refuseniks.
"Depression and anxiety are treatable conditions," said a Tory source earlier this month. "Cognitive behavioural therapies (CBT) work and they get people stable again, but you can't mandate people to take that treatment. But there are loads of people who claim ESA who undergo no treatment whatsoever. It is bizarre. This is a real problem because we want people to get better. The taxpayer has committed a lot of money, but the idea was never to sustain them for years and years on benefit. We think it's time for a rethink."
There's so much going on in this statement that it's hard to know where to start. I'll get the ball rolling by rubbishing the pat finality of the statement "cognitive behavioural therapies work" – well, yes, they do for some people. For others, they prove to be about as useful as a chocolate fireguard. There's a very strong inference here that depression sufferers on benefits are wallowers who are not willing to make the effort to get better. Through the brilliant, life-saving services of the Depression Alliance charity, I've met a great many other depression sufferers and it's safe to say that they all definitely want to get better.
So why would anyone refuse CBT and medication? Well, one of the pesky paradoxes of depression is that the things that are meant to make you better can actually exacerbate existing problems – for anyone whose depression is rooted in past trauma, talking therapies can be a harrowing experience, especially if you fail to find a sympathetic therapist. Again, this has been an area in which I have been fortunate, but I've heard horror stories – one friend of mine, a music journalist and severe anxiety sufferer, was referred to a counsellor who would try to blag gig tickets in session time and take personal phone calls while his patient was talking.
As for medication, the search for one that suits you may well be long and frustrating – and when you have settled on one that works, it will almost certainly come with unpleasant, possibly embarrassing side effects that diminish your quality of life as much as they improve your mood. Prozac, for example, necessitates a bedding-in period that can last a few weeks, during which it effectively takes you further down before getting you better – going on Prozac was what kept me off work for three weeks, experiencing brutal, suicidal lows. Citalopram made me balloon in weight and torpedoed my libido, so any positive effects it may have had were countered by the fact that I felt fat and disinterested in sex. My most recent medication, Sertraline, gave me extreme insomnia and luminous yellow diarrhoea.
So there are valid reasons why people might forego these methods of tackling depression in favour of a more holistic, root-and-branch approach – changes in diet, avoiding alcohol, exercise, meditation. Of course, all of these things are less easily policed than therapist visits and medication prescriptions, which is perhaps why the Conservatives seem so keen to not bring them into the equation.
There's an unpleasant whiff of sufferer-shaming coming from the Tories' idea, and the last thing that any depression sufferer needs is to feel as if they should be ashamed of decisions that are, and should be, personal. Shame can be deadly for depressive people, and yet we get to experience so much of it – shame because you haven't bathed in days; haven't fed yourself properly; have missed social engagements; feel like you have let people down; or have been behaving erratically. It's that accumulation of shame that can get you into the mindset where you begin to imagine harming yourself. Having an actual punishment imposed on you for not agreeing with the Conservatives' preventative model – well, that's the very definition of kicking someone while they're down, and it would just add more stress and shame to the lives of people already struggling to cope.
The bottom line here is that this idea would punish people for not accepting the route one version of how to combat an extremely complex and multi- faceted condition, one which experts are constantly labouring to better understand. Thankfully, the proposals have already met with opposition – "Frogmarching someone into therapy with the threat of a loss of benefits simply won't work" is the assessment of Lib Dem health minister Norman Lamb. I'll go further – it won't just not work, it could potentially be fatal for vulnerable people. One hopes that by the time the 2015 Tory party manifesto sees the light of day, common sense will have prevailed. If not – well, it's one more reason to be depressed.
Pete Cashmore tweets at @TweetCashmore