The Trick is to Keep Breathing

Self portrait with bandaged head (Viveca Koh)

I made this image a while ago in an attempt to describe visually what depression feels like.  It was done from ‘memory’, some stages away from the depths of true despair (for if I were there, I would not have been able to work at all), the title indicative that if I can only summon up sufficient energy and courage to take another breath, I can keep going.

Some may think that this is self-indulgent, but for me it is cathartic and therefore moderately therapeutic, as is what follows.

I am emerging from another Worst Week of my Life.  ‘Another’ because I have been almost catatonic with depression on a few occasions before now, since the age of eighteen, and am therefore no stranger to what Winston Churchill referred to as ‘The Black Dog’.  It always starts with a vague sense of unease, that something isn’t quite right yet it is very difficult to pinpoint exactly what that is, and I like to think that I hide it well but those closest to me may tell another story.  The worse it gets the harder it is to cover it up with a grin and a casual remark, yet still I persist in trying, only to feel empty and exhausted after the event but always trying to push away the growing sensation of fear that something is very wrong.  This has been going on for the best part of a year now.

I start to avoid people.  I am barely working so this is not hard.  Sometimes I don’t set foot outside the house for days.  Communication: such an effort.  I find it hard to write, very hard to speak, impossible to concentrate as my mind dances with thoughts veering crazily from one subject to another in a matter of seconds.  I don’t want to interact online.  I don’t want to read about photography, to do photography, to work on photographs on the computer.  I have zero talent anyway so what’s the point?  I know then that this is serious – if I don’t want to do the things that I love and am thinking like this, then this is not just a ‘low patch’ that I can get through on my own, it is something bigger than me, bigger than the world, bigger than the whole planet, and I am being sucked inexorably in, always in and never able to get out.

Eventually something has to give and suddenly I am in freefall, hurtling through the darkness to the bottom of the pit.  I have very bad thoughts.  The pain is intense, unrelenting, I can’t bear to be inside my own head, my own body.  In a futile attempt to release all of this I scream and howl, hit my head on the wall, hard, maybe ten times over, which makes my nose bleed and terrifies my poor cat.  And then I am so sorry.  I go to bed and cuddle up with my cat, head in shock, feeling as if someone is pulling my hair really tight and twisting.  I am frightened, wonder if I have done something really bad to myself this time – I’ve done this before but my nose has never bled like that.  Eventually I sleep and I continue to sleep throughout the next day and the night and the morning of the following day.  On that afternoon I see my doctor.  She says I have concussion but other than that I’ll be fine.  I tell her that I have been taking the anti-depressants she prescribed last time for two weeks now, and she says I need to give them longer to start working, the average being two to six weeks.  She signs me off work for two months, refers me for counselling at the surgery, gently tells me I just need to wait for the pills to start taking effect and sends me on my way, there’s nothing more she can do.

I sleep a lot for the remainder of the week.  As the anti-depressants really take a hold of my body the side-effects become more pronounced: nausea, churning stomach, light-headedness, tiredness and disturbed sleep.  I have a persistent headache.  I am exhausted and want to sleep but lie awake until two or three in the morning, mind pirouetting in a jig, tossing and turning, hot and cold, unable to switch off.  When I wake in the morning the emptiness is there.  I lie there staring at the wall and am literally unable to move under the huge waves of hopelessness.  “Get up get up get up get up get up get up getup getup getup getup getup getupgetupgetupgetupgetupgetupgetupgetugetup” my mind torments me, but I can’t.

Friday: I wake up and I know immediately that I feel marginally better.  It is almost imperceptible but it is undoubtedly there.  It is like the lifting of a shutter.  Physically I feel appalling: sick, headache, no appetite, but mentally I at least feel that I can get out of bed and face the day.  I know as I write this that I still have some considerable way to go, but it is a small victory.


There is now more here on my separate blog Black Dog Journals

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36 Responses to “The Trick is to Keep Breathing”

  1. Daisy Juarez says:

    You’re very good at visualizing, no doubt of it, one of the best I follow online. As a lifelong suffer of Depression/mental problems i often like to think of those wise words, i have been discussing my depression with friends recently and am coming to the conclusion that if i can embrace it then i may change the power it has over me !

    • Viveca Koh says:

      Thanks so much Daisy, this really means a lot to me – I am so happy to be able to offer help/comfort to any fellow sufferers of depression through what I write. I truly believe now (through long experience) that if we can accept that this is just another facet of ourselves but not US in our entirety we can put the Black Dog in the corner where he belongs. We are not our depression, our depression is part of us, but only one part – hold on to those valuable other parts and sense of self. Stay strong, you are never alone. X

  2. Hi V.
    Man, at first I just saw this image of yours as a “you might also like” thumb, and had to see the bigger version.
    I saw this incredible intense photo, it’s hard to pinpoint exactly what makes it so intense. Maybe the despair, maybe the hints of claustrophobia or maybe just the idea of this being some degree of mental state, that both interests and offends.

    I really liked the picture, I couldn’t stop looking, and later couldn’t keep it off my mind.
    And then! I read your thought and text and I suddenly could not help being ashamed of being so in love with the picture.
    You’re very good at visualizing, no doubt of it, one of the best I follow online.
    So when you visualize this in such an intense way, I realize what hell you must have been through, and I wish you’d made a less intense picture proving you in a better state.

    I really hope you are going through better times now!

    • Viveca Koh says:

      I really appreciate you taking the time to write all this Felix, a response like this means a lot, especially given the nature of the post in question. There will be happier pictures to follow in time, of that I am quite sure! Still going through it a bit at the moment but just taking things one day at a time and trying not to get too stressed about it. I know this wasn’t a comfortable image to look at, but I hope that in producing it I have gone some way to helping others understand what it feels like which may in turn bring understanding between sufferers and their loved ones. Thanks again for all that you said.

  3. […] and combined it with an older photograph of myself from the bandaged head series (used to create The Trick is to Keep Breathing).  I was aiming for something vaguely disturbing and unsettling, with a surreal edge and a very […]

  4. Finally had a chance to catch up on your writings. This is an absolutely stunning image that visually describes your stirring words below it. Wishing you well from across the pond Viveca!

  5. Andy Gregor says:

    Hello Viveca,

    I had seen your picture before and even then it evoked a strong reaction from me, through adding these words it is a lot more poignant.
    I wish you all the resolve you need too see you through too some brighter days. My anti-depressant have helped me by making the tough bearable and giving me a chance to enjoy the happy moments.

    All the best

    • Viveca Koh says:

      Thank you SO much to everyone has responded here. Please forgive me for not replying directly to you all, but please know that all of your words mean a great deal to me and have helped me to feel better about the world. For that I cannot thank you enough.

  6. Hey, Thats one of the best posts i have ever seen about depression !

    A friend of mine once told me about when he was ill with depression, his dad came to see him and suggested a walk, as they walked they made their way through a graveyard and his dad said quietly “they would all give anything to feel what you are feeling now” ! i always thought that was good advice.

    As a lifelong suffer of Depression/mental problems i often like to think of those wise words, i have been discussing my depression with friends recently and am coming to the conclusion that if i can embrace it then i may change the power it has over me ! almost treat depression like an old friend, you know the one, its one of those friends you have to spend time with but really you would rather not if you could help it.

    one last bit of advice is to smile…..i know what you are going to say, but if you smile (even a forced, false type of smile, like the ones you do at the bosses crap jokes) it makes it much harder to feel down, try it and see.

    Stay strong, gotta go i am off for CBT in 2 hours


  7. manish2010 says:

    Hello Dear Viveca,
    I have found your photography skills very effective and expressive and whatever you have written in your post is just very touchy and realistic…don’t ever underestimate know dear…there are many people in this world who are in so much depressions but they don’t have such kind of talent which you have….they don’t know how to get rid of that….And Viveca you are the inspiration for those people…so try to give some happiness to them with the help of your photography and writing talent.

    manish2010 recently posted..Matching Stainless Steel Kitchen AppliancesMy Profile

  8. Gregory Romany says:

    Hi Viveca,

    Your ability shows in your photography and expressive writing. You are very talented. I cannot claim to know what you are experiencing as each person’s feelings are differently magnified. I am very encouraged by your progress as you have taken the time to write and share with others. Keep taking those steps forward to reclaiming your joy. “Profound happines comes to the person who is truly grateful”. You have so much going for you. Don’t underestimate your value or trivialise your contributions. You will become stronger and a pillar of strength for others.

    Take care 🙂

  9. Dez Dallow says:

    Hi V,
    Very moving blog and brave of you to open up in that way. As I said in a previous comment I would never have thought that you had times like this. Seems strange to think that it’s the same woman that I saw produce Ghost photo’s in Talgarth Asylum! You were confident and fun. She is still there V, she is waiting. Take care V, keep plugging at it.


  10. Kevin H. says:

    Keep breathing V 🙂

  11. Viveca Koh says:

    Dear Andy, Brian, Jesse, Dave, Michael, Shando, Eric, Cat, Toad, Erik, Al, Jack, Kristi and Shelly,

    Please forgive me for not making an individual response to all of your comments, but I would like to thank you all from the bottom of my heart for all that you have said, for your love and support, for taking the time to read and comment on my post. It means more than you can possibly imagine, and I have been overwhelmed by the level of support shown to me by my lovely on-line friends. Thank you all again, and I hope to be gradually catching up with everyone properly in the not-too-distant future.

    V x

  12. Kristi Hines says:

    There’s nothing self-indulgent about this post. Most (myself included) wouldn’t have the courage to reveal such a personal experience. Just remember any improvement is a step in the right direction, even if it is just something you may consider small.

  13. Dear Viveca,

    what a stirring read. I am no stranger to depression but I confess whilst I have watched the black clouds ascend, I have always had absolute faith that they will also pass overhead at some point…maybe a couple of days, maybe a week or so, but they will leave me and I will recognise myself again. So I have been very very lucky indeed and recognise that. Sometimes we amaze ourselves how far deep we can dig.

    Thank you for sharing your emotions and darkest hour with us all. I sincerely hope it brings you strength to share and I hope the comments made by friends and likeminds strengthen your resolve further.

    Most of all I hope that sometime very soon you will not only see the clouds pass over, but that you will again feel some joy in life. Your work I have no doubt brings joy to others, so I hope the joy will return to you soon.

    My very best wishes
    Shelly x

  14. Jack says:

    Viv, I will not comment here except to say thanks for sharing. You know I support and understand…as best I can. No cliches, no “feel good” thoughts for the day here. Sharing this is a big step, and for that I am grateful.

  15. Al says:

    Hi V

    I am so sorry to hear that you’ve been unwell. I can’t begin to know what pain you’ve been in but I know that you will come through it. Your work is an inspiration and you are a vastly talented person. If you ever need to talk, I am always at the end of the phone.

    Take care.

  16. Hi

    Very powerful image to describe a very powerful ailment – I know how you feel.
    I know it is a Cliche, but it is always darkest just before the Dawn!

    Kindest regards, Erik

  17. Viveca,
    This image is hauntingly beautiful, and incredibly honest. Your talent is only matched by your courage to bring this very real issue that affects so many people out into the open in such a way that we are able to feel it, in some way. We can all take a lesson in the personal strength that you show, and just know that somewhere out there is someone who will see your photo and it will help them to feel less alone. You are truly one of the most profound artists of our generation and your work is vitally important. We can all learn a little of ourselves by looking at the world through your lens. Just know that we are there with you, in spirit.
    Toad Hollow Photography recently posted..Maple Bay Wooden Boat FestivalMy Profile

  18. Catherine says:

    Dear V,

    I am so, so sorry that you have been suffering like this; but writing this post and sharing so honestly what your world has been is, as others have said, incredibly brave, and a sure sign of your beginning to recover.

    Thinking of you with love, and all good wishes as you find your way back into being the beautiful and talented person that you always are.

    XX Cat

  19. Eric Leslie says:

    Hi Viveca,

    What a harrowing act of bravery to share where you’re at in life with all of us. I want to let some scriptures I found encourage you and offer you some hope and peace.

    “These things I have spoken to you, that in Me you may have peace. In the world you have tribulation, but take courage; I have overcome the world.” John 16:33

    “For I am convinced that neither death, nor life, nor angels, nor principalities, nor things present, nor things to come, nor powers, nor height, nor depth, nor any other created thing, shall be able to separate us from the love of God, which is in Christ Jesus our Lord.” Romans 8:38-39

    “I can do all things through Him who strengthens me. ” Philippians 4:13

  20. onwards and upwards V, feelin your sense of hoplessness. Had a severe mental breakdown last year, not depression but nervous exhaustion caused by stress, lack of sleep due to insomnia and a general inability to cope with life. Meds only made it worse as I suffer from just about every side effect possible. All came to a head when I began to get got lost coming home from work, a journey I’d done over 100 times before, amnesia & confusion were the cause of it 2 of the main side effects from the meds I was on! The worst part is the realisation that it’s starting, and trying to convince myself everything is okay, trying hard to keep it all together then the feeling of complete hopelessness as I begin to crumble from the inside out. I know it will happen again 😉
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  21. Thank you for sharing this, as your words are just as enlightening and inspiring as your images. I know I always look forward to your blog and image posts.
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  22. Dave says:

    Though I can’t begin to imagine what it feels like to be in that situation I am relieved to see that you are coming out of this dark place; as this truly honest and emotional post shows. Everyone else has voiced all the things I would’ve said, I’m not sure what else I can add other than you have my best wishes in your recovery. Take care and I hope our paths will cross again one day.
    Dave recently posted..Old Buoy at Birling GapMy Profile

  23. V,

    The courage you display just in writing a post like this is beyond admirable. I truly wish you the best in overcoming these demons and can see you are clearly on the right path. All the best.

  24. Brian Matiash says:

    I could echo what everyone has written (all wonderful, mind you) and express how sorry I am for this affliction. But I won’t do that. The fact of the matter is that you’re likely stronger in mind and overall fortitude than most people I know. I can tell this simply by the sheer strength of your work. There is some serious strength there. The shot above is just a small sliver of proof in a portfolio that I’d be supremely proud to call my own if I could.

    There are demons there, as well. But you fight through them. You keep shooting for yourself. You live the best you can for yourself. Share what you can, when you can. It’s good to see raw talent in action. Don’t think you don’t have support systems, even ones that exist in the digital ether.

    I’m so happy that you’re at least on a path out of that void (I do know it, too). You just have to keep on – take the punches but do not forget to throw some yourself. If I can ever help, don’t hesitate to reach out.


  25. Viveca Koh says:

    Dear Jim, Chris, Richard, Mark, Tom, Bob and Dave:

    I am so moved by everyone’s heartfelt comments, and it sounds like a cliche to say but your words truly do mean so much to me. I feel as if I have made many good friends online at Twitter (and Flickr too), and that much is evident when I read what you have all written. I am just some person whom most of you have never met, yet you all care, and this goes a long way in restoring my faith in others and in life itself. Thank you all so much for reading the above and taking the time to share your words – you really have helped me to feel better.

  26. andy teo says:

    Sorry you are going through it in this season. Glad you are in the beginnings of recovery.

  27. Dave Wilson says:

    The other commenters have already said everything I would have said (and said it in a far more eloquent way). Your heading image is astonishingly powerful and a testament to your talent. I hope you understand how many of us are out here rooting for you during this tough time and realise how much your work is enjoyed by us lurkers who visit frequently but seldom comment.
    Dave Wilson recently posted..View from 8A – Window SeatMy Profile

  28. Bob Lussier says:

    There is nothing self-indulgent about this at all. I admire your courage in writing it and I pray that your recovery will by quick and complete. I also think your post can be of great value to those with a loved one battling depression. Its not easy for an outsider to understand. On a positive note, I am happy to hear you are on the right road and look forward to seeing and reading more from you. We’ve missed you.
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  29. Tom Barnett says:

    Viveca, I’m so sorry. I go through small battles with depression. I understand some of your pain in not wanting to do anything photographic and the horrible thoughts that go with it. But my depression is nowhere near what your’s is. You are so brave for expressing this and a very talented photographer. I pray your small victory leads you back into the light.

  30. Viveca
    I’m moved. I’m sad, but also hopeful. I believe you can get through this. Like Jim, I have no direct experience with this and little ability to fully comprehend what you’re going through, but I know it is hard. That is clear. And because it is hard, I have to believe that some with your strength of vision must have an advantage when dealing with it. Again, that is not to minimize your plight – I simply believe that no matter how tough this is and will be for you, that you are capable of pulling through.

    The word “helpless” usually means that one feels cut off from desperately needed help, but it also describes the feeling I get when i see a friend in need and I do not know how to help. All I know to do is to state my support and encouragement, and to hope that in some small way it is of some benefit. I also know how to pray so I’ll do that too (which may or may not be your thing, but I figure if Christopher Hitchens can accept prayers with an open heart, so can anybody else). All my best,


  31. We all have our off days/weeks, when we feel stressed and even what we might term depressed. It’s when reading an account such as yours that I realise that I have absolutely no idea what real depression is like and how it can affect daily life right down to grass roots level.
    Looking at your images they are inspirational – you do have talent and you (the real you) knows this. Take heart with the small victory; there are those of us who await a larger, more significant, one that sees you back doing those things that you love.

    Thoughts and best wishes


  32. Chrisdmrf says:

    V. I think I will not be alone in saying this but say it I will, no your post is not self indulgent, it is brave, harrowing, cathartic, eloquent and inspirational.
    One look at the image above shows the talent that you truly have, it is without doubt one of the best images I have ever seen, it conveys a strong and powerful message and one which will stay with people for a long time.
    I count myself as lucky to have met you and am sure we will meet again, your work inspires me to try harder with my own.
    I have known mild depression, more a result of extreme stress and not really comparable but I feel your pain and despair, I can only offer the following, “The darkest hour is just before the dawn…”
    I hope you are seeing the 1st threads of daylight illuminating the black of night, for they will come and with them bring a new day and a new outlook.

    Thinking of you


  33. Jim Denham says:

    It is hard for someone who is not dealing with what you are to fully understand what you’re going through, so I will not pretend to do so. I hope and pray that your small victory gives way to improved overall health and you start feeling better soon. From a selfish perspective, I miss your participation on the web and miss seeing your posts – I think you have an impressive gift of expression in your art. I hope a full recovery is in order soon.
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