All posts tagged illness

  • The Weekend Australian Magazine story: ‘Dying Wish: In-home palliative care nursing’, February 2017

    A feature story for The Weekend Australian Magazine, published in the February 11 2017 issue. Excerpt below.

    Dying Wish

    Few terminally ill Australians get to spend their final days at home. When it happens, it can be the greatest gift of love.

    The Weekend Australian Magazine story: 'Dying Wish: In-home Palliative Care Nursing' by Andrew McMillen, February 2017. Photo by Justine Walpole

    It begins with the lighting of a candle, the bright tone of a ­ringing bell, and a card plucked from a deck of Buddhist prayer cards then read aloud: “Now may every living thing, young or old, weak or strong, ­living near or far, known or unknown, living or departed, or yet unborn – may every living thing be full of bliss.”

    On this Monday morning in a northern suburb of Brisbane, six clinical nurses and support staff are gathered around a table inside a building known as Karuna House. Its walls are painted pale blue, its ceilings are high, and pinned to a corkboard are dozens of booklets gathered from funerals and memorial services. These are some of the organisation’s recently deceased clients, for the nature of Karuna’s work is to offer support to ­people who are terminally ill, providing in-home palliative care services to about 50 families at a time. ­Written in red on a whiteboard is the number four – the tally of clients who died the previous week in mid-November; the same as the week before.

    In a corner of the room beside an open ­window sits Camille Doyle, 40, who listens intently while making handwritten notes on a printed page that shows her clients’ names, addresses and current assessment: “stable”, “unstable”, “deteriorating”, or “terminal”. This fourth stage is followed by bereavement, which involves caring for those left behind. Today Camille will visit four homes; by now, she knows these people ­intimately and the routes to their houses so well that she doesn’t need a map.

    On a bushy block in Samford Valley, 25km north-west of Brisbane CBD, sits a large timber house owned by a married couple of 49 years. When Camille knocks on the door at 11.30am, she is greeted by Sandra Huelsmann, a 73-year-old grandmother who wears pearl earrings and a ­silver heart necklace. “Hello, Millie,” says Sandra, smiling. They hug, and Sandra welcomes the nurse into a home she has visited regularly for the past six months, an unusually long relationship for Karuna. The longer duration reflects the complex nature of this particular palliative situation.

    On an adjustable bed in a room towards the front of the house is Tony Huelsmann, a retired dancer, choreographer and dance instructor whose skills were once in high demand at schools throughout Melbourne and Brisbane. Sandra was one of his dance students. He was 30 when they met, seven years older than her, and it was love at first sight.

    Born in Germany, Tony has spent much of his life in Australia. Now 80, he is dying from complications associated with several internal and ­external cancers, including a rash of angry red squamous cell carcinomas that have colonised the skin of his swollen upper thighs. These painful sores require daily dressings, performed by a personal care worker, while Karuna’s rotating ­roster of nurses help with symptom management, bed-baths, toileting and bedding changes, as well as emotional support for both husband and wife.

    Since May, Tony’s world-spanning life has been confined more or less to these four walls while Sandra cares for his every need. At night, she snatches sleep where possible. It is their wish for Tony to die at home and they are both determined to see this wish fulfilled.

    To read the full story, visit The Australian. Above photo credit: Justine Walpole.

  • Qweekend story: ‘School Of Hard Knocks: Lady Cilento Children’s Hospital School’, April 2016

    A feature story for Qweekend magazine, published in the April 9-10 issue. The full story appears below.

    School Of Hard Knocks

    Sick children need schooling too. At Lady Cilento Children’s Hospital School, learning proves positively infectious.

    Qweekend story: 'School Of Hard Knocks: Lady Cilento Children's Hospital School' by Andrew McMillen, April 2016


    In a light-filled corner room of a high-rise building overlooking inner-city Brisbane, a visiting local artist leads a class of six rowdy students. Aged between five and seven years old, they are tasked with creating artworks that illustrate their lives. A handful of the best drawings from this schoolwide project will be sent to China, where a school has a reciprocal arrangement. But it’s unlikely the Chinese students will be able to relate to the experience of these children – they are enrolled in a school very few families in Queensland choose to attend. This is the state’s only dedicated hospital school.

    Sam Cranstoun presents a cheerful front to the kids’ steady stream of questions and comments. The 28-year-old artist asks the four boys and two girls to use crayons to draw what they like to do. Camping, swimming, board games and PlayStation 4 rank highly, before one boy offers another option with a quizzical look. “School?” he asks, unsure of himself. He is testing the waters: is it cool to admit, at age seven, that you like school? “I’m sure your teacher will love hearing that!” says Sam, flashing a smile to the adults across the room. Gemma Rose-Holt, six, draws a swimming pool at the bottom of an enormous piece of paper, then a sun shining high in the sky. In the last couple of years, she has seen her father’s health rapidly decline for reasons she can’t quite fathom.

    Sam continues with the exercise by asking them to consider their place in the world. “Is China bigger than Gladstone?” asks one boy. They talk about their families and school. “Do you guys think about home?” asks the artist. “Yes!” they reply as one, before throwing their talents into happy drawings of the back yards and bedrooms they have left behind.

    “There’s an amazing view out the window,” says Sam, pointing behind the students. “Do you guys ever look out there?” At this, the six kids scamper to the windows, pressing their faces against the glass and pointing out the landmarks they can see from the eighth floor of the Lady Cilento Children’s Hospital in South Brisbane, which the Prep to Year 2 pupils are visiting for their art class. They can see Mount Coot-tha, the murky river, the Story Bridge in the distance. “I can see the cat-boat!” announces one boy, spying a blue, white and yellow ferry as it powers against the tide. “I can see bull sharks!” suggests another, prompting a laugh from the teaching staff. Not many schools have a helicopter pad on the roof, nor a giant pink bunny rabbit sculpture standing sentry near the entrance. Lady Cilento Children’s Hospital School (LCCHS) has both of these, and when its students are asked to sketch the school, these two features inevitably emerge on the page.

    For their final task, Sam turns these young minds toward imagining their future. “What do we want to be?” he asks them, prompting a flurry of ideas. Teacher? Doctor? Journalist? Soldier? McDonald’s worker? Power Ranger? “I don’t know what I’m going to be when I grow up,” says Gemma. She draws a nurse standing beside a bed-bound patient wearing a big smile. That’s her father, Damien. He has no hair because the medicine took it away. “The medicine’s yuck, but he has to have it,” she tells Sam. Little Gemma lives with her mother near the RNA Showgrounds, away from her Sunshine Coast home in accommodation subsidised by the Leukaemia Foundation, while Damien receives treatment.

    The students who attend this school are bound by a common experience of illness: either their parents’, their siblings’, or their own. They are from Emerald, Cairns, Chinchilla, Bundaberg and Hervey Bay; from every corner of the state. For some of them, it is their first visit to Brisbane, and the circumstances are less than ideal. Entire families are uprooted from their normal lives and relocated to temporary housing reserved for people in crisis. Their parents have got so much on their plates when they come here that sometimes the last thing on their mind is phoning a school, notifying a teacher about what might become an extended absence from their normal classroom. These tasks fade from view when the spectre of death suddenly appears in sharp focus. Into the breach rush 24 hospital school teaching staff, a compassionate, capable bunch of professionals adept at crafting an individualised education that will define these stricken children.

    The school’s impact is wide-ranging, and it sees a diverse population. In 2015, Lady Cilento hospital had 3159 registered students, more than two-thirds of whom normally attended state schools. Of that number, the largest cohort of 21 per cent (663 students) presented with medical conditions; 17 per cent (538) were there for oncology; 13 per cent (410) attended the school because a member of their family was ill, and nine per cent (284) were patients with the Child and Youth Mental Health Service –  which is also located on level eight at the hospital – while the remainder found their way there for reasons related to the likes of surgery, diabetes, rehabilitation and heart disease.

    More often than not, the hospital teachers’ efforts work wonders for the children and their families. During a midweek excursion to the Gallery of Modern Art at nearby South Bank, Mitchell Cawthray, 12, cautiously approaches a teacher watching over the group of about two dozen students as they eat lunch. He wears a black T-shirt that reads “The Force is Strong In This One”, reflecting an indelible truth of this blue-eyed boy’s tough character. His light brown hair is shaved close to his scalp, and when he turns his head, you can see the scar on the back of his neck where the life-threatening medulloblastoma tumour was removed from the top of his spine almost a year ago. “Are you having a good day so far?” asks the teacher cheerfully. “Great day,” Mitchell replies, nodding. He pauses, weighing his words carefully, then looks around to make sure none of his peers overhear his next words. With a shy smile, he says, “I’ve never really said this before, but I think I like school now!”


    Most children go through childhood without great complications, and without seeing the insides of healthcare waiting rooms for longer than it takes to receive an immunisation jab, to set an accidental bone fracture in plaster, or to go through the motions of a doctor’s check-up. Mitchell, Gemma and their peers are the unlucky few, and the LCCH treats Queensland’s sickest of the sick. All of the “first-world problems”, as Mitchell’s mum, Janine Cawthray, puts it, fade into irrelevance when your child is diagnosed with brain cancer.

    In Mitchell’s case, he and Janine relocated to Brisbane at Easter time last year for his treatment, while his father stayed home in Hervey Bay, managing their small business and caring for Mitchell’s sister as she completed Year 12. “I take my hat off to the teachers,” says Janine. “They not only have to deal with normal academic requirements as per the curriculum; they have to deal with a multitude of personalities – from parents, medical staff – as well as medical requirements and children’s individual needs. They also have to report back to the children’s mainstream school. They’re juggling all of that, and that’s a hard call, but they manage it very, very well.”

    In the middle of the building, on level eight, is a place where a familiar timetable reigns between the hours of 9am and 3pm each weekday. It is a place of whiteboards and colouring-in; of assigned readings and class discussions. It is a place of boring adult words such as literacy, numeracy, curriculum, assessment and “personal learning plans”. For some families, the hospital school quickly becomes the only constant in a life now marked by endless blood tests, chemotherapy and invasive surgery, and – sometimes – dramatically shortened horizons.

    None of these horrible things happen on level eight, however, where the LCCHS middle and senior classrooms serve an ever-changing cohort of students from Years 5 to 12. Nor do horrible things happen on the ground-floor junior school next door, on Stanley Street inside the old Mater Hospital building, where Prep to Year 4 students are taught. In young lives that have suddenly been dropped into seas of anxiety, pain and uncertainty, these two campuses emerge as towering islands of normality.

    There are no school bells here. No uniform, and no rules, per se, only three expectations: be safe, be respectful, and be responsible. Teachers are not known by stuffy honorifics; the students are on a first-name basis with their educators and support staff from the first day. Though visits to these islands of normality are usually short-term matters, these two school campuses can easily act as a home base for months on end, depending on circumstances.

    This unique style of teaching has its roots in doctor-soldiers and military nurses returning from World War I in 1918 and concerning themselves with the rehabilitation, retraining and education of limbless soldiers. From that point, it took only a short leap of logic to twig that children ensconced in hospitals required special schooling, too. The Sick Children’s Provisional School opened at the Hospital for Sick Children in the bayside suburb of Shorncliffe on August 11, 1919; it was the nation’s first such educational institution. Since then, it has been relocated several times. A purpose-built school at the Royal Children’s Hospital in Herston opened in 1978; in 2009, it celebrated 90 years of service to more than 60,000 pupils.

    Vicki Sykes was the longest-serving principal of Mater Hospital Special School in South Brisbane, which opened in 1983.  Appointed in 1986, she served 23 years before retiring in 2009; today, the junior school playground is dedicated in her name with a handsome plaque. In 1986, Sykes described her workplace. “Students come to school from the wards in pyjamas and wheelchairs,” she wrote in an unpublished memoir. “Some are on crutches or have their arms or legs bandaged. During the day some students may need to go off for operations or medical treatment. Teachers don’t know from day to day how many students will be coming to school.”

    In that sense, little has changed since the Lady Cilento Children’s Hospital School opened on December 1, 2014.  Its purpose is defined by Professor John Pearn in his 2009 history of Queensland’s hospital schools, To Teach The Sick. “Unrealised long-term educational potential has, in the past, been an under-acknowledged legacy of childhood illness,” wrote Pearn in the book’s introduction. “In the context of life’s fulfilment, such may be more serious than any medical after-effects.”


    The school’s average weekly enrolment is about 150 students, and the student-to-teacher ratio is about seven-to-one.  About half of the students are too ill to make it to either of the two campuses at Lady Cilento, so the teachers come to them, providing bedside tuition. They set daily assignments, and return regularly to check their progress. Depending on scheduling, these ward visits might only last 15 minutes if a teacher has a long list of inpatient appointments. But for the bed-bound students, they might also be the only minutes in a day where they are given a task and purpose that’s divorced from their unfortunate medical reality.

    When visiting a couple of beautiful sisters from Springfield Lakes who have been diagnosed with cystic fibrosis, a palpable sense of cabin fever permeates their immediate environment. Their world has shrunken to a cruel size. Little girls aged six and eight don’t belong in a small room separated by white curtains, behind a door that must remain closed at all times, and where visitors must wear gloves and gowns before entering to minimise the risk of transmitting infections.

    “Homework” is an imperfect word to describe the learning tasks set by these teachers, since the sisters’ entire lives are confined to this room. The hospital, for now, is both their home and classroom. Mid-lesson, a nurse enters to prick their fingers for a blood test. As the precious red liquid is squeezed from a tiny finger, the blonde girl calmly continues reading along to a picture book named Mr Gumpy’s Motor Car with her impromptu teacher, who leaves several worksheets for her to complete. She has long since been conditioned to something that would prompt tears from most other six year-olds.

    For these teachers, visiting inpatients on the wards requires a sense of persistence, positivity and optimism. Every day, these teachers see amazing and terrible things, such as degenerative neurological conditions that strip language and meaning from a young boy’s life with each passing week.

    From his bedside, it’s a short walk to visit a young girl in a wheelchair whose body hosts a flesh-eating viral infection that has left her face disfigured and her forearms resembling those of a burns victim, wrapped in plastic for her protection. Tourism is her passion, and so the ward teachers resolve to bring her homework that suits this interest.

    These teachers are not medical professionals. They cannot fix these problems or treat pain. They can, however, provide stimulation for young minds, if only for 15 minutes each day.


    After lunch on Thursday, the junior school students file into the flexi-room on level eight for school assembly.  Only Prep to Year 4 are in attendance, as the middle and senior grades are still on an all-day excursion to GoMA. Brianna Iszlaub, 11, with patchy tufts of blonde hair, couldn’t attend the latter as her blood count was down today. She stands beside a girl in a wheelchair as the two of them co-host the weekly event, beginning with an Acknowledgment of Country and an energetic, indigenous-flavoured rendition of the national anthem. “Thank you, please be seated,” says Brianna at its conclusion. School staff and a few parents are scattered around the edges of the dozens-strong group, while the students sit in chairs or on cushions.

    Once Brianna finishes reading from the prepared script, hospital school principal Michelle Bond says to her, “Good girl.” A short and energetic woman who radiates positivity, Michelle, 49, welcomes the younger students to stand up and present their handmade graphs based on a recent visit to a petting zoo downstairs. The principal – who led Royal Children’s Hospital School since April 24, 2006, and LCCHS since it opened – then presents a handful of awards: to an outstanding student who has shown consideration to his peers; to one who has overcome challenges; to one who has made a positive start after joining the school this week. The group sings happy birthday to a shy blonde girl. “Some of these kids would never be chosen to lead an assembly at their own school; they usually choose the school captains and the sporty kids,” Michelle tells Qweekend quietly. “I’ve had parents come and tell me that their child has never received an award before coming here. It’s lovely that we can do that for them.”

    The class’s guest for the day, University of Queensland PhD candidate Maddie Castles, cues a PowerPoint presentation loaded with photos from her recent visit to Namibia. The title slide shows a selfie of her grinning wildly into the camera while a giraffe munches on some leaves behind her. She tells the group about her job studying giraffe social interactions, or “who they’re friends with,” as she puts it. A teacher aide quietly brings a boy in a wheelchair into the room. He is barely conscious, his head held in place by brackets. As time passes, he shuts his eyes and dozes while his classmates leap up for a group photo with Maddie, who might be the first scientist they’ve ever met.

    Posted on the door inside Brianna’s Year 7/8 composite classroom is a photo of her before treatment. Her glorious, long locks are framed by a beaming face. The photo was taken when she first arrived at the school from Townsville in January, after being diagnosed with an aggressive lymphoma in late November. Her chemotherapy has stolen her hair and some of her energy. Sometimes she prefers to hide her changing scalp beneath a black beanie with devil horns. But none of this is discussed during school hours.

    Brianna’s teacher is Anna Bauer, 35, a bespectacled brunette with sparkling brown eyes who has worked in hospital schools for three years and now can’t imagine teaching anywhere else. “No one here will ask you a medical question,” she says of her classroom. “The kids are so tolerant … You can walk in with a nasal gastric tube and a drip tree, and that’s it. We might give the drip tree a name, like ‘Molly’, and then everybody gets on with what we’re doing. It’s what I wish the real world was like.” Working here sometimes demands that the adults develop coping strategies for their own emotional protection, too. “I have to believe that, when they walk out the door, they live happily ever after,” she says.

    In Anna’s current class, Brianna has cancer; the mother of a bubbly Bundaberg girl is being treated for leukaemia; and the fiercely intelligent girl who co-hosted assembly is temporarily in a wheelchair after two recent strokes. But the students she sees aren’t confined to physical illness. “I have so many kids with mental health issues who don’t look sick,” Anna says. “They walk around without baldness, or a nasal gastric tube, or a limp, or a drip tree. There’s no physical evidence, so there’s a real lack of recognition that there’s something wrong with your child. I’m not a parent yet, but oh my God – how awful must that be?”

    During Anna’s second week of teaching at the hospital, a student from the previous day didn’t arrive. When she asked a colleague about their sudden absence, she learnt they were being treated in the emergency department after attempting to end their life. “I took that quite badly,” says Anna quietly. That was when her happily-ever-after belief began to cement itself, as a self-protective measure.

    Some days are worse than others. “You’re on and lifting, all of the time,” says Anna. “But I find it quite humbling, and incredibly powerful, that it’s my job to make their lives feel normal. It can be sad sometimes, but most of the time, it is not; it is joyous, happy, friendly, loving and supportive. The children are sick, but I’m not a health worker. When I’m in here, and they’re so excited to see me, because I’m not a doctor or a nurse, there’s no time to be sad. You’ve got spelling and times tables to do, and we’re going to have fun while we do it.”

    Posted on the door inside Anna’s classroom, beneath the class photos of smiling children at eye level, is a laminated A4 page consisting of a paragraph of white text against a black background, framed by a pink border. I want a life that sizzles and pops, it begins. That first line popped into Anna’s head a little while ago, on a particularly bad day, when her class of six teenage girls were all in a low mood. “And I don’t want to get to the end, or tomorrow even, and realise that my life is a collection of Post-its and unwashed clothes, bad television and reports that no-one’s ever read,” it continues.

    The teacher was getting nothing out of them, that day, so she put the spelling lesson aside and assigned the girls a task: to write about what makes them feel better. Anna kicked them off with that first sentence, and encouraged them to fill the page. She did, too. “I want to see what I see through the lens of a camera and drink wine like it’s real grapes and wrap myself in warm towels that smell like my mum’s washing and dance to songs I don’t even like,” she wrote.

    The girls pasted the text into an online image editing program, fiddled with the design, printed the results and took them home to stick on their walls. These pages were intended to act as a reminder of all that is good in this world, especially on the blackest days. Anna stuck hers to the wall of a classroom where nobody will ask medical questions, in a building that none of the children particularly want to be in. Her paragraph concludes, “I want to wrap my hands around warm cups of tea with friends that will make me laugh so hard I wee a little bit, and I want every day to belly laugh with my people, glad and grateful, that I love the life I have.”


  • GQ Australia story: ‘Shock To The System: Electroconvulsive therapy’, March 2012

    My first story for GQ Australia magazine: a 4,200 word feature about the psychiatric treatment electroconvulsive therapy, otherwise known as ECT or ‘electroshock’. This story appeared in the Feb-March 2012 issue of GQ.

    Click the below image to read the story in PDF form (link will open in a new window), or scroll down to read the article text underneath.

    Shock To The System

    Electroconvulsive therapy has long been the stuff of cinematic nightmares. But after nearly four decades since One Flew Over The Cuckoo’s Nest, many are arguing it does much more good than harm.

    Words: Andrew McMillen

    As the young man is led into the operating theatre, the smell of salt water and sterilisation fluid hangs in the air. The room is unremarkable; all greys, blues and whites, just like any other theatre in hospitals across the country, except for a couple of innocuous-looking machines stacked on a bench. Twenty-five-year-old John Vincent doesn’t know it yet, but those machines would soon change his life.

    Helped onto a gurney, Vincent lies flat on his back as a clamp is placed on his index finger to monitor his oxygen levels. He feels the cold wipe of saline solution on his collarbone, biceps and forehead, before a nurse applies several electroencephalography (EEG) electrodes to trace his brainwave activities. Moments later, a general anaesthetic makes its way up his arm, and he drifts out of consciousness.

    Having been sedated, he doesn’t remember what happened next, but it goes like this. A specialist affixes an electrode to the middle of his forehead, and another one above his left temple, then switches on the Thymatrons – those machines in the corner – sending a series of short electric shocks coursing through his brain, bringing on a grand mal seizure. Fifteen seconds later, it’s all over. The current is switched off, the electrodes removed, and Vincent is wheeled into an adjacent recovery room.

    It might sound like a scene from a ’70s movie, from the days of roguishly experimental medical procedures, but this was Boxing Day 2010, and Vincent had just received his first course of electroconvulsive therapy (ECT) at Toowong Private Hospital in Brisbane. A psychiatric treatment most commonly used on those with severe depression, ECT – better known by its outdated term, electroshock – is also called upon to treat patients suffering from acute mania or, in Vincent’s case, bipolar disorder. And despite the popular public perception of ECT as a barbaric, archaic practice, the treatment is administered on a daily basis at both public and private hospitals all over Australia.

    Growing up, Vincent was a happy kid. He had lots of friends, enjoyed playing soccer, and loved going fishing with his younger brother while on regular camping holidays with the family. Then, aged 17, in his final year of high school, Vincent was diagnosed with bipolar disorder.

    As he got older, his mental illness became harder to manage. “John was existing, but he wasn’t happy,” recalls his mother, Tina, a kind woman in her early fifties with a fair complexion and green eyes who runs a small business alongside her husband. “He wasn’t right, and at some stage he decided to go off his medication. Unfortunately, with his type of bipolar – type one – when he goes off medication, he goes into a state of catatonia. Everything shuts down; no communication, nothing happens.”

    Things worsened as the years passed, and by late 2010, Vincent was living a life of isolation in Townsville, north Queensland. He’d withdrawn from the people around him: friends, family, even the younger brother he lived with. “You know those wildlife documentaries on TV, where they record the animals’ every move, behaviours and moods, and all that?” he asks, his hazel eyes burning with intensity. “I felt like I was an animal; like I was being surveyed.”

    This was a dark time for Vincent, who says he spent a lot of time in his room “trying to hide away”. He constantly felt as though there was someone outside looking through the windows at him, recording his behaviour.

    One Friday in December, his parents went to Mackay for their first trip away together in a year. The next morning, Tina and her husband received a call from their youngest son. “He didn’t think John was all that well,” she says. “We jumped on the first plane and came home. We spent all Saturday with John. He continued to decline into a catatonic state; not eating, not talking. It was almost like he was in a coma.”

    By 5pm, Vincent’s movements had become “robot-like”, with his body barely responding to the signals sent by his brain, and the famil rushed him to the emergency ward at Townsville General Hospital, before he was transferred to the mental health hospital. “It’s pretty sad, because there just aren’t enough facilities,” says Tina, remembering how they how desperate they were for a solution to their son’s illness. “We turned to friends in the medical profession, who gave us a great deal of support and help.”

    A man named Dr Josh Geffen was mentioned, who specialised in ECT at Toowong Private Hospital. Vincent had never heard of ECT before his parents brought it up, but since he was in such a low mental state at the time, he didn’t argue. “I just went with it,” he shrugs. “I cooperated, and followed my parents’ advice. I did what I was told.”

    He hardly remembers a thing about the journey. His mother continues: “We got John down to Brisbane straightaway, and when Dr Geffen saw the state John was in, the first thing he recommended was ECT,” she says. “We were pretty horrified; we’d heard stories from the olden days of ‘shock treatment’ and that sort of stuff. We hadn’t really given ECT a lot of thought. It’s a little bit frightening, because you really don’t know what’s involved. But Dr Geffen explained everything to us, showed us a DVD, and put our minds at ease. We consented to John having the ECT, and he agreed to it, too.”

    They got to work immediately. Doctors warned Vincent that the muscles in his arms, legs and shoulders might feel sore once he came to, after receiving the electric shocks. And indeed, he did feel uncomfortable for a couple of hours – he likens the muscle soreness to the day after a big gym workout – but says, “Afterwards, I felt fine. It took a while for the anaesthetic to wear off, but after that I was OK.”

    Vincent’s story is more common than you might think. Statistics from the Australian Institute of Health and Welfare show that in the 2009-2010 financial year, 26,848 individual ECT sessions were administered throughout Australia – although the exact number of people treated is unclear, as patients tend to have multiple sessions. “A typical course of ECT involves between six and 12 treatments,” explains Dr Aaron Groves, the director of mental health in Queensland, adding that, while ECT can be used on people of all ages, since depression is more common in adults than in children, around 80 per cent of treatments are on patients aged 30 to 80.

    Based on those figures, on any given day here in Australia, 73 people get hooked up to a machine and jolted with electricity in the name of medicine. What’s more, far from being a curiosity from the past that hasn’t quite died out, it’s actually on the rise. Why? Well, because it works.


    Electroconvulsive therapy has its roots in early schizophrenia research. In 1934, Hungarian neuropsychiatrist Ladislas Meduna saw improvements in schizophrenic patients after seizures were induced with chemicals such as camphor and Metrazol. Three years later, Italian neuropsychiatrists Ugo Cerletti and Lucio Bini discovered that these seizures could be more easily induced by electricity. In a presentation uploaded in October 2007, an American surgeon and author named Dr Sherwin Nuland relayed an eyewitness account of the first time ECT was performed on a human in 1937.

    “They thought, ‘Well, we’ll try 55 volts, two-tenths of a second. That’s not going to do anything terrible to him.’ So they did that… This fellow – remember, he wasn’t even put to sleep – after this major grand mal convulsion, sat right up, looked at these three fellows and said, ‘What the fuck are you assholes trying to do?’ Well, they were happy as could be, because he hadn’t said a rational word in the weeks of observation. They plugged him in again, and this time they used 110 volts for half a second, and to their amazement, after it was over, he began speaking like he was perfectly well.”

    “It eventually became apparent that it was a much better treatment for depression than schizophrenia,” says Dr Jacinta Powell, clinical director of mental health at the Prince Charles Hospital in Brisbane. “This is how these things develop: psychiatrists make leaps of logic, they try them out, and see whether it works.”

    What they hope for with any treatment is remission. So, how does ECT stack up against other methods of treating depression?

    According to statistics presented in May 2011 at the American Psychiatric Association Conference in Hawaii, 34 per cent of ECT patients were in remission after two weeks of treatment. Four weeks later, that had risen to 65 per cent; and after a full course of ECT, that figure reached a 75 per cent remission rate. Those success rates aren’t just good; they’re remarkable.

    So, why are we still so scared? Perhaps Dr Geffen [pictured right] – the man who treated John Vincent – would have some answers. A stocky, silver-haired man in a dark suit, he leads me into the theatre where John was first treated on Boxing Day. He drags in a couple of chairs from the waiting room, which is adorned with intricate paintings of wildflowers and a poster entitled ‘Understanding Depression’. We sit in the middle of the theatre and begin talking ECT. “Intuitively, it does seem like a worrying thing to do,” he admits, “to pass a dose of electricity through somebody’s brain in order to treat them.”

    And he’s right. A seizure-inducing electrical current sent through the brain, where all our memories, emotions, likes, dislikes, fears and secrets are stored; where our very personality is kept? The mind recoils in horror at the thought alone.

    That’s partly because, for the majority of us, who haven’t had any first-hand experience of ECT, our knowledge is mostly based on what we’ve seen in movies. Take One Flew Over the Cuckoo’s Nest – the 1975 Miloš Forman adaption of Ken Kesey’s 1962 novel.

    You’ll remember the scene when the main character, Patrick McMurphy, played by Jack Nicholson, is judged to be so disruptive to the daily routine of his fellow psychiatric ward patients that doctors see no alternative but to treat him with ECT.

    McMurphy is led to a bed, his hairline coated with a conductive gel and a piece of leather placed between his teeth. Electrodes are applied to each temple, and his brain is exposed to a current of electricity. There’s no anaesthetic, nor is the patient forewarned of what’s about to happen. McMurphy appears to be in severe pain, with several men restraining his wildly convulsing body. It’s unclear whether McMurphy’s treatment is an attempt to ‘fix’ him psychologically, or simply to punish him for being a trouble-maker, but it was a very convincing performance that won Nicholson an Oscar, a Golden Globe, and a BAFTA for Best Actor.

    “It’s a great movie. I love Jack Nicholson; he’s fantastic,” says Dr Geffen, with a grin. “It’s also nothing like modern ECT. It was set during a time when anaesthesia was already involved, so a bit of creative licence has cost us quite a lot of bad press.” He continues with his list of ways the film misrepresents modern ECT. “No treatment electrodes are placed on people until they’re asleep, because it’s not a very pleasant feeling if you’re coming in for your first treatment,” he says. “It’s much kinder for the person who’s anxious about what’s going on.”

    It’s also worth noting that the vast majority of treatments do not induce enormous, full-body convulsions like the reaction portrayed by Nicholson. In most cases, the only physical sign of the electrical current is a slight twitching of the patients’ fingers and toes.

    At the Prince Charles Hospital, Dr Powell shows me a segment from the 1990s-era television program Good Medicine, in which a greying man in his mid-forties is treated with ECT. The footage of his treatment is so incredibly mundane and unremarkable that I can’t help wondering what all the fuss and controversy is about. Particularly given the guidelines adopted by the Royal Australian and New Zealand College of Psychiatrists in 1982, which note that it’s “among the least risky of medical procedures carried out under general anaesthesia, and substantially less risky than childbirth.”

    “It’s a very effective treatment for very ill people,” agrees Geffen. “It’s more likely to get you into remission than any other treatment.” Success rates with medication when used as a first-line therapy are only 30 per cent, he says. After a year of trying different strategies, this may rise to around 60 per cent in a best-case scenario.

    And what about therapy for depression – you know, the kind where you lay on a couch and talk things through?

    “The type of depression we see here, people are too sick to be having much talking therapy. Not that talking’s unimportant, but that’s part of the post-recovery.”

    Yet somehow, even though lying on the therapist’s couch isn’t the right thing, and months of antidepressants aren’t very effective, people are instinctively more keen to stick to those methods than to volunteer to be subjected to a series of electric shocks.

    “A few things soften that,” says Geffen, ever the salesman. “The dose of electricity is quite small; 0.8 to 1 amp. I was treating an electrician, and I asked him, ‘How can I explain it to people?’ He said, ‘Well, it’s about 10 per cent of what a toaster puts out.’ Now I always tell people, ‘Don’t stick forks in toasters, please!'”

    Geffen breaks into a wide smile and continues, “Another way to put it is that the current is enough to light up a 25 watt bulb for about one second. Once or twice in the process, I’ll pass the electricity across my hand, and feel a little jolt. But it doesn’t throw me to the ground.”

    And of course, ECT isn’t the only instance of doctors using electricity to reset an organ that’s not operating properly; cardioversion, for example, applies the same theory to correct a malunctioning heart. “I do wonder, sometimes, why the person who cardioversed Tony Blair is the ‘cardiologist hero’,” Geffen says, “but I can be painted as a ghoul for trying to treat people’s depression.”


    Part of our reluctance to embrace ECT, though, may well be because, despite years of research, it’s still a bit of a mystery. We know it works best when used to treat severe depression, but when it comes down to it, we don’t really know why. “At one level, that’s true,” agrees Geffen. “We don’t fully understand all of the mechanisms of its action. However, that’s true of many treatments in medicine. We do know how damaging severe depression is to people’s brains and their lives. At another level, we’re understanding a lot more about how it works, as well as the key chemicals involved in depression: serotonin, adrenaline, dopamine, and this – being a powerful treatment – influences all of them. Most antidepressants work on one, or – at most – two of those. ECT is a potent stimulus for brain cell growth.”

    His sentiments are echoed by Dr Daniel Varghese, a Brisbane-based psychiatrist in both the private and public health fields. “I think it’s true to say we don’t really know why or how it works,” Dr Varghese says.

    “But then again, we don’t know why or how people get severe mental illness either, because the brain is clearly an inherently complex thing. That’s something that psychiatrists and people with mental illness have to deal with in a range of illnesses: we don’t really know why, but we do know some strategies and treatments that we’ve found to be helpful.”


    Of course, it’s important to make it clear that ECT is not a catch-all miracle cure for depression, and some of the fears surrounding its usage are real. It certainly has its fair share of detractors.

    On a chilly morning in the Brisbane suburb of Highgate Hill, I meet with Brenda McLaren, a spritely woman who loves to talk. Her face is riddled with deep wrinkles, which make her appear far older than her 57 years. Her memory is shot, however, and she has prepared notes in an A5 notebook ahead of my visit. Her relationship with ECT has not been an altogether pleasant one. She was first treated in 1988, as a severely depressed 34-year-old. At first she consented, as she wanted to get better and believed that the doctors at Prince Charles Hospital were acting in her best interests. Over 20 years later, she’s not so sure.

    Brenda smokes a cigarette on the sun-soaked front balcony of the Brook Red Community Centre where she works as a peer support worker, and reads her handwritten notes. In 1988, her youngest son was six. “I can’t remember him between the ages of six to 15,” she says. “In some ways, [ECT] must cause some sort of brain injury for that to occur. He talks to me about things, and I honestly don’t remember.”

    “My other children would come up to visit me at that time,” she says, “and I wouldn’t know who they were. This would happen quite regularly after ECT. This made them hate the whole system, which is still a big thing with them. It created relationship problems within the family. I’m not saying there weren’t already problems, but it didn’t help. Because… how can a mother forget her children?”

    She looks up with sadness in her eyes, and it’s clear the memory loss still hits her hard. “It made me feel very guilty. When you really think about it, in some ways you lose your identity,” she says. “You lose who you are.”

    “I would be the most forgetful person here,” she says of her peers at the Centre, which supports people living with mental illness. “I put things down constantly, and never know where they are. I lose things. I believe it’s affected that part of the brain that makes you remember things, long-term. I find it hard to retain information. I find it hard to bring information out. That’s why I’m reading this.” She points at her notebook.

    McLaren says she received “dozens” of courses of ECT in her life, the last of which took place around 13 years ago. “I know they do it as humanely as possible,” she says, “but I think it’s barbaric, and in some ways, it’s a form of torture. If I was told I needed ECT today, they would have to take me screaming. Because I will never sign to have ECT again. Ever.”


    In an adjoining room to the ECT theatre at Toowong Private Hospital, Dr Geffen and his colleagues have written some literary quotes on a whiteboard to keep them focused on the job at hand. “Diseases desperate grown by desperate appliance are relieved, or not at all” – William Shakespeare. “Diseases of the mind impair the bodily powers” – Ovid. “When you treat a disease, first treat the mind” – Chen Jen.

    I tell Brenda McLaren’s story to Geffen, interested to hear his thoughts. “I feel sorry for her,” he says, after listening carefully. “I believe her when she says that ECT has damaged her memory, and that this affects her sense of identity. Recurrent ECT of this nature is a difficult scenario; if she was severely suicidal or malnourished from depression it may have saved her life, although obviously at some cost.”

    What Brenda described is, he says, a mixture of the common side effect of peri-treatment amnesia – loss of memory of the period around treatment – as well as the rarer retrograde amnesia, which is the loss of memory for “weeks, months, even years” before being treated. “With modern techniques, the peri-treatment amnesia is less severe and retrograde amnesia is even rarer,” he says.

    That’s partly thanks to the more recent side-lining of a variation of the treatment, called bitemporal ECT, in which an electrode is placed above each temple (as seen in One Flew Over the Cuckoo’s Nest). ECT guidelines note that “bitemporal ECT is associated with greater cognitive impairment, but these effects vary from patient to patient. Any memory impairment is usually resolved by 4-6 weeks following ECT, but a number of patients report persistent difficulty with retrograde memory.” The other, now more popular, method is unilateral ECT, where one electrode goes above the temple on the non-dominant side of the brain, while the other sits in the middle of the forehead.

    We return to Brenda McLaren’s experiences. “The issue of difficulty learning new information some 13 years later is more problematic,” says Dr Geffen. “It’s not generally described in the literature, and may be contributed to by age, depression, and the impact of lifestyle factors like smoking. But,” he admits, “it is hard to rule out ECT as a factor.”

    Geffen has been immersed in this world of ECT for more than 15 years. “We start at 6.30am every Monday, Wednesday and Friday, and we’re done by 9am; 10am if we’ve got a long list,” he says. “It’s generally done in the morning; it’s a lot kinder to do it then, as our patients fast from midnight.”

    As he said earlier, it’s a treatment for the very ill, and here in this room, Geffen only sees those closest to the brink. I wonder whether the constant exposure to the severely depressed takes a mental toll on him. “When you see patients who are distressed coming in, or patients who have a really good response, you take that home with you and think about it a little bit,” he says, and then smiles. “My wife works in mental health, so it allows for a bit of pillow talk. She’s very familiar with all of this.”

    What does he say when asked what he does for a living? “I talk quite openly and freely to my children about what my job is, and explain to them about this,” he says, gesturing at his workspace, with a hint of pride. “Although it’s a stigmatised area, there’s nothing terrible that we do here. We help people who haven’t done anything wrong; they have a brain illness. In that sense, in my social life, I do carry on that view that you can de-stigmatise this.”


    John Vincent isn’t sure whether he received eight or nine treatments of ECT in total, as he, too, experienced peri-treatment amnesia. “I can’t remember a lot of things that happened when we were back at school,” he says with a shrug. “Birthdays, big events, I can’t remember so much. Things close to me I still remember, though.” Childhood camping and fishing trips, for example, take a while to recall, but his foggy mind does eventually reach back to find the details.

    It can be difficult, but he’s philosophical. “I’d rather feel happy, and more myself, than have memories,” he says with a tone of finality. “My health is worth more than having memories.”

    Vincent says his course of ECT made him feel more lively. “I’m not so anxious anymore. I’m not short-fused or jumpy. Now I feel more cooperative; I get along a lot more with people.” Not that ECT was a quick fix. “It was a gradual recovery. It wasn’t as though, when I got out, I was right as rain again. It took a while to slowly get to that stage where I felt comfortable.”

    His parents stayed at John’s bedside for 12 hours a day through his month-long stay at Toowong Private Hospital. His mother remembers that, within 24 hours of John receiving his first treatment of ECT, she and her husband could see a “definite improvement”.

    “John’s had very good results with it. It’s been really quite incredible,” she says. “It’s almost like having a flat battery in a car. You put the jumper leads on and give it a bit of a boost, and it comes back again.”

    She doesn’t really understand how it works, and she doesn’t care: she’s just glad to have her eldest son back again. It’s been two months since his last treatment. “He’s on track, and everything is going well. Geffen says, ‘If you go for three months and you don’t need any more ECT, and the drugs are keeping you level, everything’s good,'” Tina says.

    “We had no knowledge about ECT until John went into this meltdown and went into hospital,” she continues. “I think the more people talk about it, the better it’ll be. The more I can tell people, and the more open you are about it, the more it will become accepted.”

    As for Vincent, now that things are on the up, he’s looking forward to returning to work at his parents’ small business in Townsville. He’d like to settle down with a girl and he can see himself – one day – getting married and having kids, “but they’re a while away yet,” he says with a grin. Vincent isn’t sure what career path he’ll take – something to do with machinery, perhaps, as he’s always had an interest in that area – but he knows that, thanks to ECT, he’s in a better mental state to confront the future than ever before.

    *Names have been changed.

    Note: due to an error in the production process, a photograph of Dr Josh Geffen’s father, Laurence, appeared in the original article, rather than Josh himself. This error has been corrected in this blog entry.

    For more on electroconvulsive therapy, visit Wikipedia. If you are feeling depressed or suicidal, please contact Lifeline on 13 11 14, which is available 24 hours a day.

  • Australian Penthouse story: ‘The Low Down: male mental health and Soften The Fuck Up’, March 2012

    A story published in the February 2012 issue of Australian Penthouse.

    Click the below image to read as a PDF in a new window, or scroll down to read the article text.

    The Low Down

    Feelings. We don’t like them – they’re awkward and can suck the joy out of a night on the town with the boys. But can deliberately avoiding our emotions be killing us? New website campaign Soften The Fuck Up believes so, and with youth suicide statistics showing a disproportionate number of men are killing themselves, they might just have a point.

    Story: Andrew McMillen


    Ehon Chan, 24

    I grew up in Malaysia. When I was 16, my best friend died in a drowning accident. For three months, I went through a period where I was, in some sense, questioning what life was all about. I asked myself, “If everyone lives to die, why do we all live?” I found it really hard to understand that we all could die tomorrow. I did what every man does at that time; the whole “suck it up, just move on,” kind of thing. I kept thinking, “I have to be strong for everyone else”. I kept a very strong face; on the outside I was normal, I was happy. When I’d get home and be in my bedroom at night, all these self-reflective questions would come up.

    When I moved Australia in 2006, I discovered that there is a really low level of mental health literacy in this country; for men, even moreso. Australian men generally can’t pick up mental health signs and symptoms. They don’t know where to get help. A lot of people don’t know that their first point of call could be their GP, or they could call Lifeline. I decided to start something to challenge that knowledge gap. What’s the most common thing that Australian men get when they talk about any kind of weaknesses? The response is generally, “Harden the fuck up.” There’s no equivalent phrase for that in Malaysian!

    My friend said, “why don’t we call it Soften The Fuck Up?” Initially it was a joke; we all laughed at it. It’s currently an online campaign (, launched in July 2011), but we also want to make it an offline conversation. We want to take the conversation to the next level, so it’s not just about having a conversation with your mates, but equipping young people – in particular, men – with an idea of how to recognise signs and symptoms of mental health issues. And also, when someone comes up to you and says “I’ve got depression”, or “I haven’t been feeling well for the past five days”, what do you tell that person? What are the things you can and can’t say? Where do I get help?

    I was hesitant when the name was first suggested, because the word ‘fuck’ was in there. I wasn’t comfortable going ahead with it, but the more we thought about it, the more we decided, “you know what? That’s the whole point of this campaign”. We want to be unapologetic, we want to be in your face, and we want to push the extreme because we really want to change the culture. The more extreme we go, the more conversation it’s going to generate.


    Paul Klotz, 51

    At the age of 13, I suffered sexual and physical abuse at the hands of the Catholic boarding system in Brisbane. After many months of being abused in every form you could imagine, I was then beaten with a leather strap for being a ‘bad boy’. After 36 years of hiding in a false existence and having to support a facade of a personality, I finally collapsed, and all of my defences began to crumble. I told a very select group; immediate family, my psychiatrist, and a few other friends. They were shocked, angry, and frustrated in terms of not knowing all these years. It’s not something that was easy to talk about.

    I’ve spent most of my life under the influence of drugs or alcohol to pretend that I was a normal, sane person. Despite that, I was extremely successful throughout my business career. But I’ve always lived with that self-destructive path. Once I achieved, I didn’t feel worthy. Because of this lack of self-esteem and self-belief, I was just continually and totally despising myself. Two years ago, I was able to look in the rear vision mirror, look at all those demons that had been there for the last 35-plus years and say, “enough’s enough; I need to deal with this”.

    This decision came at a huge cost. It’s doubtful if I’ll work again in anything near the capacity that I was before, because I’ve withdrawn from society. I feel uncomfortable around people, moreso than I ever did. It’s great to finally confront those demons and understand and recognise that I’ve suffered from severe depression, and severe post-traumatic stress disorder. I see a psychiatrist. I’m on all sorts of drugs and pills to try and keep that balance of life.

    In the last eight months I’ve been through five suicide attempts, and I’ve had to resign from the last two jobs because of the impact that my mental condition was having, and the episodes of depression, and being put into hospital. That started a period of living on the streets. I have nothing to hide. I’m quite comfortable in saying that if it wasn’t for my four beautiful boys, I wouldn’t be here. I have no doubt about that. During the last few suicide attempts, when I was fading away, it was the image of those guys that allowed me to get some strength, and fight back.

    If I get through all of this, my burning ambition is to assist other males out there. I want to let other males know that it is okay to put your hand up, it is okay to cry. It is okay to say, “I have been abused”, as difficult as that is. It is okay to say, “I’m suffering from depression”. It is okay to say, “I feel suicidal”. I live with the thoughts of suicide every single day of my life. We need to break down all these stereotypes that my generation – and I suppose it continues on, of – “Harden up son. Big boys don’t cry. You’ve just gotta suck it in, and move on,” because that’s such a narrow-minded, dead-end approach. Those feelings of discomfort, unhappiness, pain, guilt, shame; if they’re left inside, they do fester, and fester badly.


    Nick Backo, 23

    I’ve lived in the same house in Parramatta all my life. I’m a social worker for child protection services, as well as studying post-graduate psychology and refereeing soccer. When I was 15, my Dad died. There was a lot of shock initially, because his death was unexpected. I became the eldest male in the house. I felt that I had to be strong, and look after my family. I saw a counsellor for two years, on and off, which was really useful for just talking with someone who was neutral, and who could give me some strategies around managing grief. I had a lot of support from friends, who gave me someone to talk to, even if it was just, “hey, I’m feeling shit”.

    It was hard to talk about. It brought up a lot of my own emotions, and you feel vulnerable sharing that sort of experience with people. It was also hard because a lot of people wouldn’t know what to say, or how to manage it. They were generally lost for words, so it was an awkward experience for me in bringing that up with them. To an extent, it’s something that you’ve got to live to understand. It would be beneficial for others to learn about grief, though. More broadly, it’s about educating people on supporting their mates, and being open to those types of conversations. Even if you don’t know what to say, just being there to listen and saying how you feel during those conversations is helpful.

    It’s important to embrace the characteristics of masculinity. One of those is ‘being strong’, and it’s not necessarily a bad thing. It’s also really important to talk about how you’re feeling, and your experiences. When Dad died, I was at that ‘coming of age’ stage in life. A lot of people were saying to me, “make sure you look after your Mum”, or “you’re the man of the house now”. I don’t think they were meaning it to put pressure on me. I guess it’s just what people say.

    For people currently experiencing grief, I’d tell them that it’s OK to feel however you’re feeling. If you’re angry or upset, or if you’re feeling okay or happy, that’s all part of the experience of grief. It’s fine to have those emotions. I’d really encourage them to talk to people that they feel comfortable with, and to talk about their grief and the person who has died. Even if it seems a bit crazy or unusual, that’s OK, because it’s an unusual experience to go through. I think about Dad every day, but as I’ve gotten older, I’ve learned how to manage my grief better. I took away a lot of positives from it, as well. I think I’m a better person because of that experience. On the same hand, if I could change that and have Dad back, I would in a second.


    Ben Pobjie, 32

    I only recognised this year that I am suffering an illness. Since I was a teenager I’ve suffered periodical depression; I’d sink into a deep low for no particular reason. In the past I’ve been advised by people close to me that I should seek counselling. I’d shrug it off, saying “no, no, I’m just sad. Just going through a bad patch.” Which is not the right thing to do, really. You try and fight through it, because I didn’t want to appear weak or like I was making a big fuss over nothing. It builds up and gets worse and worse, and you have to admit that it’s not nothing. I broke down early this year, then realised that it’s not normal. I generally write jokes, and comedy. I’ve been writing more serious reflective things, having admitted to this. It’s possibly made me a little bit more honest as a writer. I’m on medication now, and I’m seeing a therapist.

    When I’ve been at my worst, I’ve self-harmed. I’ve cut myself. It’s hard to explain after the event, when you’re not in that headspace, exactly why you did something like that. It’s a culmination of trying to distract yourself from an emotional pain by giving yourself some physical pain. It’s a confusing time because when you go through those episodes, because obviously you’re not thinking rationally, and you don’t react to your own feelings rationally.

    When you’re depressed, you feel ashamed of yourself. It feels like something that you shouldn’t talk about. But I came to the realisation that if I didn’t tell people about it, then this can’t really be recognised as an illness. It couldn’t just be a secret that I kept. It takes courage to admit that you have a weakness. Everyone has weaknesses. It’s gutsy to own up to that. Most people are very willing to understand, and to show sympathy and support if it’s brought out into the open. That’s what I’ve found.


    William Wander, 24

    I’m Brisbane born and bred. I went through various Catholic schools, though I’m definitely not Catholic. I work in sales for a software company. By night, I’m a writer and blogger. I’m that guy in their group of friends who always says the things that nobody really wants to hear. I’m a little bit too honest. I’ve always had something to do with depression, even from the age of 11 or 12. I had a very rough childhood; I had an abusive father, and was quite sick as well, while growing up. From the age of 13 or 14, I was on anti-depressants. For me, having depression is like having asthma; it’s just part of your genetic makeup, and you learn how to appropriately deal with it.

    I hadn’t been on anti-depressants for years until the GFC hit. I lost my job, I was unemployed for the first time in my life. I applied for 250 jobs and couldn’t get a single one. I hit rock bottom. The thing about depression is: it’s a hole that you can’t get out yourself. I’ve spoken to a lot of people about depression, and I’ve never met anybody that’s got out of it by themselves. I don’t think it can happen, honestly. You need to have somebody else, or some other group that helps you get out. You can take the first step, obviously, and say “I need help”. But in the end, it’s the support of other people that helps you to get out of that, and start to feel better.

    Depression is a disease that you can’t see. If you get hit by a car and your leg is twisted, that’s very visible and we can understand that. When people talk about depression, they feel weird about it for one of two reasons: they’re experienced it and they’re embarrassed about it and don’t know how to talk about it, or they have never experienced it and they can’t conceptualise it in their own head.

    I don’t care who you are, or how in touch with your emotions you are; it’s never easy to admit that you’re depressed. It’s always difficult, because the nature of depression is that you don’t want to acknowledge it. It’s easy to talk about it now, but when I am actually depressed, it is hard to acknowledge that, even to myself. I’m a very emotional guy. At the same time, I’m a fairly typical Aussie bloke, but I’ve always thought it’s ridiculous how closed-up guys are in general in Australia. Let’s not skirt around the issue. Let’s be men about it. Which, ironically, means approaching something, rather than just avoiding it.

    An enormous thanks to the brave men I interviewed for this story, and to Australian Penthouse for publishing.

    For more on Soften The Fuck Up, watch the below video and visit their website.

    For more about depression, visit Beyond Blue.

    If you are distressed after reading this story, please call Lifeline immediately on 13 11 14 (free call from all telephones in Australia).