It’s a question I’m sure many people with a mental health condition grapple with: Where can I seek refuge? Where will I feel safe?

The lack of clear answers leads some to seek refuge in the oblivion that can be found at the bottom of a bottle, or by swallowing, smoking, sniffing, injecting substances that can alter minds in other ways. Some try to fill in the blanks with empty calories; chasing the short-lived dopamine highs of ultra-processed junk masquerading as comfort. Others simply retreat into darkness, silence, sleep or worse.

I’ve tried plenty of the above, with the exception of hard drugs, and the finality of the very last option.

It was probably a no-brainer, excuse the pun, that I would develop some sort of mental health struggle. There were cases of serious depression on both sides of my family, one of whom was my late father. His illness manifested itself in personal drive, implacable anger, an over-fondness for alcohol and the apparent need to obliterate the confidence, spirit and cheer of the two people unfortunate enough to share his home. Me and my mother.

So perhaps it was the double whammy of genes and a hateful parent. Who knows. But by late teens/early twenties there was no doubt that depression had settled itself into my psyche: rooted in for the long-haul like a Soviet dictator.

For all the mornings I open my eyes, yawn, get out of bed and simply get on with my life, there are a similar number which see me open my eyes and immediately wish I had died in my sleep. Days where every act of self-care: washing, teeth-cleaning, dressing, nourishing myself, hydrating myself… even breathing, take a super human effort (interestingly one of the first signs I am heading downhill is dehydration, I just stop being able to drink what I need). A lump settles in my diaphragm to slur my speech and shallow my breaths. The pressure in my head builds like a swarm of irate wasps, and a slow drag of dread and self-loathing flays me to raw vulnerability.

It’s not as fun as it sounds, so by my late 20s I had booked an appointment with a psycho-something in the French town in which I lived at the time. I can’t recall exactly what her credentials were, but, despite assuring me in typically brusque French manner that all my problems were due to my immaturity, and insisting that comfort eating could be resolved by boiling chicken instead of roasting it, she did prescribe me my first anti-depressants.

It took me a while to pluck up the courage to start them.

It is patently absurd that while we quite rightly don’t think twice before reaching for medication to relieve the symptoms of physical illnesses – I am a lifelong asthmatic, and I’m sure nobody would judge me for staving off death with an inhaler and the occasional course of steroids – when it comes to mental health, depression in particular, medication is seen as weakness.

But start them I eventually did, and they revolutionised my life. I still had very dark periods, but they were fewer and further between, and I found coping with the rest of Life’s slings and arrows a simpler task than it had been up to that point.

So on I trotted, occasionally seeing doctors in order to adjust the dosage, or to try a new type of medication. I also allowed people who drifted into my life to shame me into weaning myself off medication from time to time, only for the subsequent dive into the pits of hell to remind me that the alternative to appearing weak, was the risk of reaching a point of no longer being seen at all.

After my experience with the French psycho-something, I put my mental health care into the hands of doctors back in the UK: even for nomadic polyglots, there are situations and topics where only the familiarity of your mother-tongue and the comfort of a shared cultural background will do.

It certainly stood me in good stead when I developed pre-natal depression while pregnant in Italy. My doctor had warned me to look out for signs of post-natal psychosis, which new mothers with my issues can be prone to, and reassured me I was unlikely to develop the more common post-natal depression, but the subject of pre-natal depression had not arisen and I was utterly unprepared. An emergency appointment with an Italian psychiatrist resulted in her expressing doubts the condition even existed, and insisting, with disapproval and reproach oozing from every pore, that I stop any depression-related medication immediately.

A woman with a long history of depression, in the middle of a serious mental health crisis, pregnant (with the hormonal, mental and physical burden pregnancy puts on even a healthy mind and body) on the cusp of motherhood (with the even greater mental burden that entails) ordered simply to forgo the medication that keeps her more or less upright. It was not an evidence-based order: if UK doctors were able to educate themselves on pregnancy-compatible drugs, presumably Italian medics could too. No, it felt suspiciously like a harking back to the good old days, when a pregnant woman was nothing more than a vessel who should willingly sacrifice her own wellbeing at the altar of motherhood.

I sincerely hope that Italian mental-health professionals have improved their knowledge and technique since then.

Fast forward to today. Not actually today, but to fairly recently. The tail-end of 2024 to be completely accurate, and there I am: around 20 years on from my initial appointment with the French pyscho-something and her boiled poulet, and almost eleven years on from my run-in with pre-natal depression. I am trying my best to do the right things – I take my pills and walk the dogs and breath in the fresh air. I have tried talking therapy, Cognitive Behavioural Therapy, hypnotism. But it has dawned on me that, rather than maintaining a certain mental equilibrium, my mental health is instead getting progressively worse.

I am also getting older, and the thought of hitting the age of 50 without ever having managed to free myself from the prison of my own mind has suddenly become an unbearable prospect.