Читать книгу Reasons to Stay Alive - Matt Haig - Страница 10

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Falling

‘But in the end one needs more courage to live than to kill himself.’

—Albert Camus, A Happy Death

The day I died

I CAN REMEMBER the day the old me died.

It started with a thought. Something was going wrong. That was the start. Before I realised what it was. And then, a second or so later, there was a strange sensation inside my head. Some biological activity in the rear of my skull, not far above my neck. The cerebellum. A pulsing or intense flickering, as though a butterfly was trapped inside, combined with a tingling sensation. I did not yet know of the strange physical effects depression and anxiety would create. I just thought I was about to die. And then my heart started to go. And then I started to go. I sank, fast, falling into a new claustrophobic and suffocating reality. And it would be way over a year before I would feel anything like even half-normal again.

Up until that point I’d had no real understanding or awareness of depression, except that I knew my mum had suffered from it for a little while after I was born, and that my great-grandmother on my father’s side had ended up committing suicide. So I suppose there had been a family history, but it hadn’t been a history I’d thought about much.

Anyway, I was twenty-four years old. I was living in Spain – in one of the more sedate and beautiful corners of the island of Ibiza. It was September. Within a fortnight, I would have to return to London, and reality. After six years of student life and summer jobs. I had put off being an adult for as long as I could, and it had loomed like a cloud. A cloud that was now breaking and raining down on me.

The weirdest thing about a mind is that you can have the most intense things going on in there but no one else can see them. The world shrugs. Your pupils might dilate. You may sound incoherent. Your skin might shine with sweat. But there was no way anyone seeing me in that villa could have known what I was feeling, no way they could have appreciated the strange hell I was living through, or why death seemed such a phenomenally good idea.

I stayed in bed for three days. But I didn’t sleep. My girlfriend Andrea came in with water at regular intervals, or fruit, which I could hardly eat.

The window was open to let fresh air in, but the room was still and hot. I can remember being stunned that I was still alive. I know that sounds melodramatic, but depression and panic only give you melodramatic thoughts to play with. Anyway, there was no relief. I wanted to be dead. No. That’s not quite right. I didn’t want to be dead, I just didn’t want to be alive. Death was something that scared me. And death only happens to people who have been living. There were infinitely more people who had never been alive. I wanted to be one of those people. That old classic wish. To never have been born. To have been one of the three hundred million sperm that hadn’t made it.

(What a gift it was to be normal! We’re all walking on these unseen tightropes when really we could slip at any second and come face to face with all the existential horrors that only lie dormant in our minds.)

There was nothing much in this room. There was a bed with a white patternless duvet, and there were white walls. There might have been a picture on the wall but I don’t think so. I certainly can’t remember one. There was a book by the bed. I picked it up once and put it back down. I couldn’t focus for as much as a second. There was no way I could express fully this experience in words, because it was beyond words. Literally, I couldn’t speak about it properly. Words seemed trivial next to this pain.

I remembered worrying about my younger sister, Phoebe. She was in Australia. I worried that she, my closest genetic match, would feel like this. I wanted to speak to her but knew I couldn’t. When we were little, at home in Nottinghamshire, we had developed a bed-time communication system of knocking on the wall between our rooms. I now knocked on the mattress, imagining she could hear me all the way through the world.

Knock. Knock. Knock.

I didn’t have terms like ‘depression’ or ‘panic disorder’ in my head. In my laughable naivety I did not really think that what I was experiencing was something that other people had ever felt. Because it was so alien to me I thought it had to be alien to the species.

‘Andrea, I’m scared.’

‘It’s okay. It’s going to be okay. It’s going to be okay.’

‘What’s happening to me?’

‘I don’t know. But it’s going to be okay.’

‘I don’t understand how this can be happening.’

On the third day, I left the room and I left the villa, and I went outside to kill myself.

Why depression is hard to understand

IT IS INVISIBLE.

It is not ‘feeling a bit sad’.

It is the wrong word. The word depression makes me think of a flat tyre, something punctured and unmoving. Maybe depression minus anxiety feels like that, but depression laced with terror is not something flat or still. (The poet Melissa Broder once tweeted: ‘what idiot called it “depression” and not “there are bats living in my chest and they take up a lot of room, ps. I see a shadow”?’) At its worst you find yourself wishing, desperately, for any other affliction, any physical pain, because the mind is infinite, and its torments – when they happen – can be equally infinite.

You can be a depressive and be happy, just as you can be a sober alcoholic.

It doesn’t always have an obvious cause.

It can affect people – millionaires, people with good hair, happily married people, people who have just landed a promotion, people who can tap dance and do card tricks and strum a guitar, people who have no noticeable pores, people who exude happiness in their status updates – who seem, from the outside, to have no reason to be miserable.

It is mysterious even to those who suffer from it.

A beautiful view

THE SUN WAS beating hard. The air smelt of pine and the sea. The sea was right there, just below the cliff. And the cliff edge was only a few steps away. No more than twenty, I would say. The only plan I had was to take twenty-one steps in that direction.

‘I want to die.’

There was a lizard near my feet. A real lizard. I felt a kind of judgement. The thing with lizards is that they don’t kill themselves. Lizards are survivors. You take off their tail and another grows back. They aren’t mopers. They don’t get depressed. They just get on with it, however harsh and inhospitable the landscape. I wanted, more than anything, to be that lizard.

The villa was behind me. The nicest place I had ever lived. In front of me, the most glorious view I had ever seen. A sparkling Mediterranean, looking like a turquoise tablecloth scattered with tiny diamonds, fringed by a dramatic coastline of limestone cliffs and small, near-white forbidden beaches. It fit almost everyone’s definition of beautiful. And yet, the most beautiful view in the world could not stop me from wanting to kill myself.

A little over a year before I had read a lot of Michel Foucault for my MA. Much of Madness and Civilization. The idea that madness should be allowed to be madness. That a fearful, repressive society brands anyone different as ill. But this was illness. This wasn’t having a crazy thought. This wasn’t being a bit wacky. This wasn’t reading Borges or listening to Captain Beefheart or smoking a pipe or hallucinating a giant Mars bar. This was pain. I had been okay and now, suddenly, I wasn’t. I wasn’t well. So I was ill. It didn’t matter if it was society or science’s fault. I simply did not – could not – feel like this a second longer. I had to end myself.

I was going to do it as well. While my girlfriend was in the villa, oblivious, thinking that I had just needed some air.

I walked, counting my steps, then losing count, my mind all over the place.

‘Don’t chicken out,’ I told myself. Or I think I told myself. ‘Don’t chicken out.’

I made it to the edge of the cliff. I could stop feeling this way simply by taking another step. It was so preposterously easy – a single step – versus the pain of being alive.

Now, listen. If you have ever believed a depressive wants to be happy, you are wrong. They could not care less about the luxury of happiness. They just want to feel an absence of pain. To escape a mind on fire, where thoughts blaze and smoke like old possessions lost to arson. To be normal. Or, as normal is impossible, to be empty. And the only way I could be empty was to stop living. One minus one is zero.

But actually, it wasn’t easy. The weird thing about depression is that, even though you might have more suicidal thoughts, the fear of death remains the same. The only difference is that the pain of life has rapidly increased. So when you hear about someone killing themselves it’s important to know that death wasn’t any less scary for them. It wasn’t a ‘choice’ in the moral sense. To be moralistic about it is to misunderstand.

I stood there for a while. Summoning the courage to die, and then summoning the courage to live. To be. Not to be. Right there, death was so close. An ounce more terror, and the scales would have tipped. There may be a universe in which I took that step, but it isn’t this one.

I had a mother and a father and a sister and a girlfriend. That was four people right there who loved me. I wished like mad, in that moment, that I had no one at all. Not a single soul. Love was trapping me here. And they didn’t know what it was like, what my head was like. Maybe if they were in my head for ten minutes they’d be like, ‘Oh, okay, yes, actually. You should jump. There is no way you should feel this amount of pain. Run and jump and close your eyes and just do it. I mean, if you were on fire I could put a blanket around you, but the flames are invisible. There is nothing we can do. So jump. Or give me a gun and I’ll shoot you. Euthanasia.’

But that was not how it worked. If you are depressed your pain is invisible.

Also, if I’m honest, I was scared. What if I didn’t die? What if I was just paralysed, and I was trapped, motionless, in that state, for ever?

I think life always provides reasons to not die, if we listen hard enough. Those reasons can stem from the past – the people who raised us, maybe, or friends or lovers – or from the future – the possibilities we would be switching off.

And so I kept living. I turned back towards the villa and ended up throwing up from the stress of it all.

A conversation across time – part one

THEN ME: I want to die.

NOW ME: Well, you aren’t going to.

THEN ME: That is terrible.

NOW ME: No. It is wonderful. Trust me.

THEN ME: I just can’t cope with the pain.

NOW ME: I know. But you are going to have to. And it will be worth it.

THEN ME: Why? Is everything perfect in the future?

NOW ME: No. Of course not. Life is never perfect. And I still get depressed from time to time. But I’m at a better place. The pain is never as bad. I’ve found out who I am. I’m happy. Right now, I am happy. The storm ends. Believe me.

THEN ME: I can’t believe you.

NOW ME: Why?

THEN ME: You are from the future, and I have no future.

NOW ME: I just told you . . .

Pills

I HAD GONE days without proper food. I hadn’t noticed the hunger because of all the other crazy stuff that was happening to my body and brain. Andrea told me I needed to eat. She went to the fridge and got out a carton of Don Simon gazpacho (in Spain they sell it like fruit juice).

‘Drink this,’ she said, unscrewing the cap and handing it over.

I took a sip. The moment I tasted it was the moment I realised how hungry I was so I swallowed some more. I’d probably had half the carton before I had to go outside and throw up again. Admittedly, throwing up from drinking Don Simon gazpacho might not be the surest sign of illness in the world, but Andrea wasn’t taking her chances.

‘Oh God,’ she said. ‘We’re going now.’

‘Where?’ I said.

‘To the medical centre.’

‘They’ll make me take pills,’ I said. ‘I can’t take pills.’

‘Matt. You need pills. You are beyond the point at which not taking pills is an option. We’re going, okay?’

I added a question mark in there, but I don’t really remember it as a question. I don’t know what I answered, but I do know that we went to the medical centre. And that I got pills.

The doctor studied my hands. They were shaking. ‘So how long did the panic last?’

‘It hasn’t really stopped. My heart is beating too fast still. I feel weird.’ Weird nowhere near covered it. I don’t think I added to it, though. Just speaking was an intense effort.

‘It is adrenaline. That is all. How is your breathing. Have you hyperventilated?’

‘No. It is just my heart. I mean, my breathing feels . . . weird . . . but everything feels weird.’

He felt my heart. He felt it with his hand. Two fingers pressed into my chest. He stopped smiling.

‘Are you on drugs?’

‘No!’

‘Have you taken any?’

‘In my life, yes. But not this week. I’d been drinking a lot, though.’

‘Vale, vale, vale,’ he said. ‘You need diazepam. Maximum. The most I am able to give for you.’ For a doctor in a country where you could get diazepam freely over the counter, like it was paracetamol or ibuprofen, this was quite a significant thing to say. ‘This will fix you. I promise.’

I lay there, and imagined the tablets were working. For a moment panic simmered down to a level of heavy anxiety. But that feeling of momentary relaxation actually triggered more panic. And this was a flood. I felt everything pull away from me, like when Brody is sitting on the beach in Jaws and thinks he sees the shark. I was lying there on a sofa but I felt a literal pulling away. As if something was sliding me towards a further distance from reality.

Killer

SUICIDE IS NOW – in places including the UK and US – a leading cause of death, accounting for over one in a hundred fatalities. According to figures from the World Health Organization, it kills more people than stomach cancer, cirrhosis of the liver, colon cancer, breast cancer, and Alzheimer’s. As people who kill themselves are, more often than not, depressives, depression is one of the deadliest diseases on the planet. It kills more people than most other forms of violence – warfare, terrorism, domestic abuse, assault, gun crime – put together.

Even more staggeringly, depression is a disease so bad that people are killing themselves because of it in a way they do not kill themselves with any other illness. Yet people still don’t think depression really is that bad. If they did, they wouldn’t say the things they say.

Things people say to depressives that they don’t say in other life-threatening situations

‘COME ON, I know you’ve got tuberculosis, but it could be worse. At least no one’s died.’

‘Why do you think you got cancer of the stomach?’

‘Yes, I know, colon cancer is hard, but you want to try living with someone who has got it. Sheesh. Nightmare.’

‘Oh, Alzheimer’s you say? Oh, tell me about it, I get that all the time.’

‘Ah, meningitis. Come on, mind over matter.’

‘Yes, yes, your leg is on fire, but talking about it all the time isn’t going to help things, is it?’

‘Okay. Yes. Yes. Maybe your parachute has failed. But chin up.’

Negative placebo

MEDICATION DIDN’T WORK for me. I think I was partly to blame.

In Bad Science Ben Goldacre points out that ‘You are a placebo responder. Your body plays tricks on your mind. You cannot be trusted.’ This is true, and it can surely work both ways. During that very worst time, when depression co-existed with full-on 24/7 panic disorder, I was scared of everything. I was, quite literally, scared of my shadow. If I looked at an object – shoes, a cushion, a cloud – for long enough then I would see some malevolence inside it, some negative force that, in an earlier and more superstitious century, I might have interpreted as the Devil. But the thing I was most scared of was drugs or anything (alcohol, lack of sleep, sudden news, even a massage) that would change my state of mind.

Later, during lesser bouts of anxiety, I would often find myself enjoying alcohol too much. That soft warm cushioning of existence that is so comforting you end up forgetting the hangover that will ensue. After important meetings I would find myself in bars alone, drinking through the afternoon and nearly missing the last train home. But in 1999 I was years away from being back to this relatively normal level of dysfunction.

It is a strange irony that it was during the period when I most needed my mind to feel better, that I didn’t want to actively interfere with my mind. Not because I didn’t want to be well again, but because I didn’t really believe feeling well again was possible, or far less possible than feeling worse. And worse was terrifying.

So I think part of the problem was that a reverse placebo effect was going on. I would take the diazepam and instantly panic, and the panic increased the moment I felt the drug have any effect at all. Even if it was a good effect.

Months later a similar thing would happen when I started taking St John’s Wort. It would even happen to a degree with ibuprofen. So clearly the diazepam wasn’t entirely to blame. And diazepam is far from being the strongest medication out there. Yet the feeling and level of disconnection I felt on diazepam is something others claim to feel on it too, and so I think that the drug itself (for me) was at least part of the problem.

Feeling the rain without an umbrella

MEDICATION IS AN incredibly attractive concept. Not just for the person with depression, or the person running a pharmaceutical firm, but for society as a whole. It underlines the idea we have hammered into us by the hundred thousand TV ads we have seen that everything can be fixed by consuming things. It fosters a just-shut-up-and-take-the-pill approach, and creates an ‘us’ and ‘them’ divide, where everyone can relax and feel ‘unreason’ – to borrow Michel Foucault’s favourite word – is being safely neutered in a society which demands we be normal even as it drives us insane.

But anti-depressants and anti-anxiety medication still fill me with fear. It doesn’t help that the names – Fluoxetine, Venlafaxine, Propranolol, Zopiclone – sound like sci-fi villains.

The only drugs I ever took that seemed to make me feel a bit better were sleeping pills. I only had one packet of them because we’d bought them in Spain, where the pharmacists wear reassuring white coats and talk like doctors. Dormidina was the brand name, I think. They didn’t help me sleep but they helped me be awake without feeling total terror. Or distanced me from that terror. But I also knew that they would be very easy to become addicted to, and that the fear of not taking them could rapidly overtake the fear of taking them.

The sleeping tablets enabled me to function enough to go home. I can remember our last day in Spain. I was now sitting at the table, saying nothing as Andrea explained to the people we were working for and technically living with (it was their villa, but they were rarely there) – Andy and Dawn – that we were going home.

Andy and Dawn were good people. I liked them. They were a few years older than me and Andrea, but they were always easy to be around. They ran the largest party in Ibiza, Manumission, which had begun as a small night in Manchester’s gay village a few years before and morphed into a kind of Studio 54 in the Med. By 1999, it was the epicentre of club culture, a magnet for the likes of Kate Moss, Jade Jagger, Irvine Welsh, Jean Paul Gaultier, the Happy Mondays, Fatboy Slim and thousands of European clubbers. It had once seemed like heaven, but now the idea of all that music and all those party people seemed like a nightmare.

But Andy and Dawn didn’t want Andrea to leave.

‘Why don’t you stay here? Matt would be okay. He looks fine.’

‘He’s not fine,’ Andrea answered them. ‘He’s ill.’

I was – by Ibiza standards at least – not a drug person. I was an alcohol person. A Bukowski-worshipping eternal student who had spent my time on the island sitting down in the sun selling tickets at an outside box office while reading airport novels (during my day job selling tickets, I had befriended a magician named Carl who gave me John Grisham novels in exchange for Margaret Atwood and Nietzsche) and drinking booze. But still, I wished madly I’d never taken anything in my life stronger than a coffee. I certainly wished I hadn’t drunk so many bottles of Viña Sol and glasses of vodka and lemon during the last month, or had eaten a few proper breakfasts, or got a bit more sleep.

‘He doesn’t look ill.’ Dawn still had glitter on her face from wherever she had been the night before. The glitter troubled me.

‘I’m sorry,’ I said, weakly, wishing for a more visible illness.

Guilt smashed me like a hammer.

I took another sleeping pill and then my afternoon dose of diazepam and we went to the airport. The party was over.

While on diazepam or the sleeping pills, I never felt any closer to being ‘fixed’. I stayed exactly as ill as ever. The most pills could do, I supposed, was place a distance there. The sleeping pills forced my brain to slow down a bit, but I knew nothing had really changed. Just as, years later, when I was back to drinking alcohol again, I would often cope with lower-level anxiety by getting drunk, all the time knowing that it would be there waiting for me with a hangover on top.

I am reluctant to come out and be anti all pills because I know for some people some pills work. In some cases they seem to numb the pain enough for the good, real work of getting better to happen. In others, they provide a partial long-term solution. Many people can’t do without them. In my case, after my disorientating diazepam panic attacks I had been so scared to take pills that I never actually took anything directly for my depression (as opposed to panic and anxiety).

Personally, for me, I am happy that I largely mended myself without the aid of medication, and feel that having to experience the pain minus any ‘anaesthetic’ meant I got to know my pain very well, and become alert to the subtle upward or downward shifts in my mind. Though I do wonder whether, if I’d had the courage to battle those pill-fearing panic attacks, it could have lessened the pain. It was such relentless, continuous pain that just to think about it now affects my breathing, and my heart can go. I think of being in the passenger seat of a car, as leaden terror swamped me. I had to rise in my seat, my head touching the roof of the car, my body trying to climb out of itself, skin crawling, mind whirring faster than the dark landscape. It would have been good not to have known that kind of terror, and if a pill could have helped, then I should have taken it. If I’d had something to lessen that mental agony (and really that is the word) then maybe it would have been easier to recover from. But by not taking it, I became very in tune with myself. This helped me know what exactly made me feel better (exercise, sunshine, sleep, intense conversation, etc.) and this alertness, an alertness I know from myself and others can be lost via pills, eventually helped me build myself back up from scratch. If I had been dulled or felt that otherness meds can make you feel, things might have been harder.

Here is Professor Jonathan Rottenberg, an evolutionary psychologist and author of The Depths, writing in 2014 words that are strangely comforting:

How will we better contain depression? Expect no magic pill. One lesson learned from treating chronic pain is that it is tough to override responses that are hardwired into the body and mind. Instead, we must follow the economy of mood where it leads, attending to the sources that bring so many into low mood states – think routines that feature too much work and too little sleep. We need broader mood literacy and an awareness of tools that interrupt low mood states before they morph into longer and more severe ones. These tools include altering how we think, the events around us, our relationships, and conditions in our bodies (by exercise, medication, or diet).

Life

SEVEN MONTHS BEFORE I first swallowed a diazepam tablet I had been in the office of a recruitment agency in central London.

‘So what do you want to do with your life?’ the recruitment agent asked. She had a long solemn face, like a sculpture on Easter Island.

‘I don’t know.’

‘Do you see yourself as a sales person?’

‘Maybe,’ I lied. I was mildly hungover. (We were living next to a pub. Three pints of lager and a Black Russian or two was my nightly routine.) I had very little idea of what I wanted to do with my life but I was pretty sure it didn’t involve being a sales person.

‘To be honest, your CV presents something of a foggy image. But it’s April. Not graduate season. So we should be able to find you something.’

And she was right. After a series of disastrous interviews, I got a job selling advertising space for journalist trade paper the Press Gazette in Croydon. I was placed under the supervision of an Australian called Iain, who explained to me the fundamentals of selling.

‘Have you heard of Aida?’ he asked me.

‘The opera?’

‘What? No. AIDA. Attention. Interest. Desire. Action. The four stages of a sales call. You get their attention, then their interest, then their desire to do something, before they want to commit to an action.’

‘Right.’

Then he told me, from nowhere. ‘I’ve got an enormous penis.’

‘What?’

‘See? I’ve got your attention.’

‘So, I should talk about my penis.’

‘No. It was an example.’

‘Got it,’ I said, staring out of the window at a bleak grey Croydon sky.

I didn’t really get on with Iain. True, he asked me to ‘join the boys’ at lunch, and have a pint and a game of pool. It was all dirty jokes and football and slagging off their girlfriends. I hated it. I hadn’t felt this out of place since I was thirteen. The plan – mine and Andrea’s – had been to sort our lives out so we didn’t have to go back to Ibiza that summer. But one lunch break I felt this intense bleakness inside me as if a cloud had passed over my soul. I literally couldn’t stomach another hour phoning people who didn’t want to be phoned. So I left the job. Just walked out. I was a failure. A quitter. I had nothing at all on the horizon. I was sliding down, becoming vulnerable to an illness that was waiting in the wings. But I didn’t realise it. Or didn’t care. I was just thinking of escape.

Infinity

A HUMAN BODY is bigger than it looks. Advances in science and technology have shown that, really, a physical body is a universe in itself. Each of us is made up of roughly a hundred trillion cells. In each of those cells is roughly that same number again of atoms. That is a lot of separate components. Our brains alone have a hundred billion brain cells, give or take a few billion.

Yet most of the time we do not feel the near-infinite nature of our physical selves. We simplify by thinking about ourselves in terms of our larger pieces. Arms, legs, feet, hands, torso, head. Flesh, bones.

A similar thing happens with our minds. In order to cope with living they simplify themselves. They concentrate on one thing at a time. But depression is a kind of quantum physics of thought and emotion. It reveals what is normally hidden. It unravels you, and everything you have known. It turns out that we are not only made of the universe, of ‘star-stuff’ to borrow Carl Sagan’s phrase, but we are as vast and complicated as it too. The evolutionary psychologists might be right. We humans might have evolved too far. The price for being intelligent enough to be the first species to be fully aware of the cosmos might just be a capacity to feel a whole universe’s worth of darkness.

The hope that hadn’t happened

MY MUM AND dad were at the airport. They stood there looking tired and happy and worried all at once. We hugged. We drove back.

I was better. I was better. I had left my demons behind in the Mediterranean and now I was fine. I was still on sleeping pills and diazepam but I didn’t need them. I just needed home. I just needed Mum and Dad. Yes. I was better. I was still a little bit edgy, but I was better. I was better.

‘We were so worried,’ Mum said, and eighty-seven other variations of that theme.

Mum turned around in the passenger seat and looked at me and smiled and the smile had a slightly crumpled quality, her eyes glazed with tears. I felt it. The weight of Mum. The weight of being a son that had gone wrong. The weight of being loved. The weight of being a disappointment. The weight of being a hope that hadn’t happened the way it should have.

But.

I was better. A little bit frayed. But that was understandable. I was better, essentially. I could still be the hope. I might end up living until I am ninety-seven. I could be a lawyer or a brain surgeon or a mountaineer or a theatre director yet. It was early days. Early days. Early days.

It was night outside the window. Newark 24. Newark was where I had grown up and where I was going back to. A market town of 40,000 people. It was a place I had only ever wanted to escape, but now I was going back. But that was fine. I thought of my childhood. I thought of happy and unhappy days at school, and the continual battle for self-esteem. 24. I was twenty-four. The road sign seemed to be a statement from fate. Newark 24. We knew this would happen. All that was missing was my name.

I remember we had a meal around the kitchen table and I didn’t say much, but just enough to prove I was okay and not crazy or depressed. I was okay. I was not crazy or depressed.

I think it was a fish pie. I think they had made it especially. Comfort food. It made me feel good. I was sitting around the table eating fish pie. It was half past ten. I went to the downstairs toilet, and pulled the light on with a string. The downstairs bathroom was a kind of dark pink. I pissed, I flushed, and I began to notice my mind was changing. There was a kind of clouding, a shifting of psychological light.

I was better. I was better. But it only takes a doubt. A drop of ink falls into a clear glass of water and clouds the whole thing. So the moment after I realised I wasn’t perfectly well was the moment I realised I was still very ill indeed.

The cyclone

DOUBTS ARE LIKE swallows. They follow each other and swarm together. I stared at myself in the mirror. I stared at my face until it was not my face. I went back to the table and sat down and I did not say how I was feeling to anyone. To say how I was feeling would lead to feeling more of what I was feeling. To act normal would be to feel a bit more normal. I acted normal.

‘Oh, look at the time,’ Mum said, with dramatic urgency. ‘I have to get up for school tomorrow.’ (She was a head teacher at an infant school.)

‘You go to bed,’ I said.

‘Yes, you go up, Mary,’ Andrea said. ‘We can sort out the beds and stuff.’

‘There’s a bed and there’s a mattress on the floor in his room, but you are welcome to have our bed if you like for tonight,’ said Dad.

‘It’s okay,’ I said. ‘We’ll be fine.’

Dad squeezed my shoulder before he went to bed. ‘It’s good to have you here.’

‘Yes. It’s good to be here.’

I didn’t want to cry. Because a) I didn’t want him to see me cry, and b) if I cried I would feel worse. So, I didn’t cry. I went to bed.

And the next day I woke up, and it was there. The depression and anxiety, both together. People describe depression as a weight, and it can be. It can be a real physical weight, as well as a metaphorical, emotional one. But I don’t think weight is the best way to describe what I felt. As I lay there, on the mattress on the floor – I had insisted Andrea sleep on the bed, not out of straightforward chivalry but because that is what I would have done if I was normal – I felt like I was trapped in a cyclone. Outwardly, to others, I would over the next few months look a bit slower than normal, a bit more lethargic, but the experience going on in my mind was always relentlessly and oppressively fast.

My symptoms

THESE WERE SOME of the other things I also felt:

Like my reflection showed another person.

A kind of near-aching tingling sensation in my arms, hands, chest, throat and at the back of my head.

An inability to even contemplate the future. (The future was not going to happen, for me anyway.)

Scared of going mad, of being sectioned, of being put in a padded cell in a straitjacket.

Hypochondria.

Separation anxiety.

Agoraphobia.

A continual sense of heavy dread.

Mental exhaustion.

Physical exhaustion.

Like I was useless.

Chest tightness and occasional pain.

Like I was falling even while I was standing still.

Aching limbs.

The occasional inability to speak.

Lost.

Clammy.

An infinite sadness.

An increased sexual imagination. (Fear of death often seems to counterbalance itself with thoughts of sex.)

A sense of being disconnected, of being a cut-out from another reality.

An urge to be someone else/anyone else.

Loss of appetite (I lost two stone in six months).

An inner trembling (I called it a soul-quiver).

As though I was on the verge of a panic attack.

Like I was breathing too-thin air.

Insomnia.

The need to continuously scan for warning signs that I was a) going to die or b) go mad.

Finding such warning signs. And believing them.

The desire to walk, and quickly.

Strange feelings of déjà vu, and things that felt like memories but hadn’t happened. At least not to me.

Seeing darkness around the periphery of my vision.

The wish to switch off the nightmarish images I would sometimes see when I closed my eyes.

The desire to step out of myself for a while. A week, a day, an hour. Hell, just for a second.

At the time these experiences felt so weird I thought I was the only person in the history of the world to have ever had them (this was a pre-Wikipedia age), though of course there are millions going through an equivalent experience at any one time. I’d often involuntarily visualise my mind as a kind of vast and dark machine, like something out of a steampunk graphic novel, full of pipes and pedals and levers and hydraulics, emitting sparks and steam and noise.

Adding anxiety to depression is a bit like adding cocaine to alcohol. It presses fast-forward on the whole experience. If you have depression on its own your mind sinks into a swamp and loses momentum, but with anxiety in the cocktail, the swamp is still a swamp but the swamp now has whirlpools in it. The monsters that are there, in the muddy water, continually move like modified alligators at their highest speed. You are continually on guard. You are on guard to the point of collapse every single moment, while desperately trying to keep afloat, to breathe the air that the people on the bank all around you are breathing as easily as anything.

You don’t have a second. You don’t have a single waking second outside of the fear. That is not an exaggeration. You crave a moment, a single second of not being terrified, but the moment never comes. The illness that you have isn’t the illness of a single body part, something you can think outside of. If you have a bad back you can say ‘my back is killing me’, and there will be a kind of separation between the pain and the self. The pain is something other. It attacks and annoys and even eats away at the self but it is still not the self.

But with depression and anxiety the pain isn’t something you think about because it is thought. You are not your back but you are your thoughts.

If your back hurts it might hurt more by sitting down. If your mind hurts it hurts by thinking. And you feel there is no real, easy equivalent of standing back up. Though often this feeling itself is a lie.

The Bank of Bad Days

WHEN YOU ARE very depressed or anxious – unable to leave the house, or the sofa, or to think of anything but the depression – it can be unbearably hard. Bad days come in degrees. They are not all equally bad. And the really bad ones, though horrible to live through, are useful for later. You store them up. A bank of bad days. The day you had to run out of the supermarket. The day you were so depressed your tongue wouldn’t move. The day you made your parents cry. The day you nearly threw yourself off a cliff. So if you are having another bad day you can say, Well, this feels bad, but there have been worse. And even when you can think of no worse day – when the one you are living is the very worst there has ever been – you at least know the bank exists and that you have made a deposit.

Things depression says to you

HEY, SAD-SACK!

Yes, you!

What are you doing? Why are you trying to get out of bed?

Why are you trying to apply for a job? Who do you think you are? Mark Zuckerberg?

Stay in bed.

You are going to go mad. Like Van Gogh. You might cut off your ear.

Why are you crying?

Because you need to put the washing on?

Hey. Remember your dog, Murdoch? He’s dead. Like your grandparents.

Everyone you have ever met will be dead this time next century.

Yep. Everyone you know is just a collection of slowly deteriorating cells.

Look at the people walking outside. Look at them. There. Outside the window. Why can’t you be like them?

There’s a cushion. Let’s just stay here and look at it and contemplate the infinite sadness of cushions.

PS. I’ve just seen tomorrow. It’s even worse.

Facts

WHEN YOU ARE trapped inside something that feels so unreal, you look for anything that can give you a sense of your bearings. I craved knowledge. I craved facts. I searched for them like lifebuoys in the sea. But statistics are tricky things.

Things that occur in the mind can often be hidden. Indeed, when I first became ill I spent a lot of energy on looking normal. People often only know someone is suffering if they tell them, and with depression that doesn’t always happen, especially if you are male (more on that later). Also, over time, facts have changed. Indeed, whole concepts and words change. Depression didn’t used to be depression. It used to be melancholia, and far fewer people suffered from that than they do from current depression. But did they really? Or are people more open about such things?

But anyway, here are some of the facts we have right now.

SUICIDE FACTS

Suicide is the leading cause of death among men under the age of thirty-five.

Suicide rates vary widely depending on where you are in the world. For instance, if you live in Greenland you are twenty-seven times more likely to kill yourself than if you live in Greece.

A million people a year kill themselves. Between ten and twenty million people a year try to. Worldwide, men are over three times more likely to kill themselves than women.

DEPRESSION FACTS

One in five people get depression at some point in their lives. (Though obviously more than that will suffer from mental illness.)

Anti-depressants are on the rise almost everywhere. Iceland has the highest consumption, followed by Australia, Canada, Denmark, Sweden, Portugal and the UK.

Twice as many women as men will suffer a serious bout of depression in their lives.

Combined anxiety and depression is most common in the UK, followed by anxiety, post-traumatic stress disorder, ‘pure’ depression, phobias, eating disorders, OCD, and panic disorder.

Women are more likely to seek and receive treatment for mental health problems than men.

The risk of developing depression is about 40 per cent if a biological parent has been diagnosed with the illness.

Sources: World Health Organization, the Guardian, Mind, Black Dog Institute.

The head against the window

I WAS IN my parents’ bedroom. On my own. Andrea was downstairs, I think. Anyway, she wasn’t with me. I was standing by the window with my head against the glass. It was one of those times when the depression was there on its own, uncoloured by anxiety. It was October. The saddest of months. My parents’ street was a popular route into town, so there were a few people walking along the pavement. Some of these people I knew or recognised from my childhood, which had only officially ended six years before. Though maybe it hadn’t ended at all.

When you are at the lowest ebb, you imagine – wrongly – that no one else in the world has felt so bad. I prayed to be those people. Any of them. The eighty-year-olds, the eight-year-olds, the women, the men, even their dogs. I craved to exist in their minds. I could not cope with the relentless self-torment any more than I could cope with my hand on a hot stove when I could see buckets of ice all around me. Just the sheer exhaustion of never being able to find mental comfort. Of every positive thought reaching a cul-de-sac before it starts.

I cried.

I had never been one of those males who were scared of tears. I’d been a Cure fan, for God’s sake. I’d been emo before it was a term. Yet weirdly, depression didn’t make me cry that often, considering how bad it was. I think it was the surreal nature of what I was feeling. The distance. Tears were a kind of language and I felt all language was far away from me. I was beneath tears. Tears were what you shed in purgatory. By the time you were in hell it was too late. The tears burnt to nothing before they began.

But now, they came. And not normal tears either. Not the kind that start behind the eyes. No. These came from the deep. They seemed to come from my gut, my stomach was trembling so much. The dam had burst. And once they came they couldn’t stop, even when my dad walked into the bedroom. He looked at me and he couldn’t understand, even though it was all too familiar. My mum had suffered from post-natal depression. He came over to me, and saw my face, and the tears were contagious. His eyes went pink and watery. I couldn’t remember the last time I’d seen him cry. He said nothing at first but hugged me, and I felt loved, and I tried to gather as much of that love as I could. I needed all of it.

‘I’m sorry,’ I think I said.

‘Come on,’ he said, softly. ‘You can do this. Come on. You can pull yourself together, Mattie. You’re going to have to.’

My dad wasn’t a tough dad. He was a gentle, caring, intelligent dad, but he still didn’t have the magical ability to see inside my head.

He was right, of course, and I wouldn’t have wanted him to say much else, but he had no idea as to how hard that sounded.

To pull myself together.

No one did. From the outside a person sees your physical form, sees that you are a unified mass of atoms and cells. Yet inside you feel like a Big Bang has happened. You feel lost, disintegrated, spread across the universe amid infinite dark space.

‘I’ll try, Dad, I’ll try.’

They were the words he wanted to hear so I gave him them. And I returned to staring out at those ghosts of my childhood.

Pretty normal childhood

DOES MENTAL ILLNESS just happen, or is it there all along? According to the World Health Organization nearly half of all mental disorders are present in some form before the age of fourteen.

When I became ill at twenty-four it felt like something terribly new and sudden. I had a pretty normal, ordinary childhood. But I never really felt very normal. (Does anyone?) I usually felt anxious.

A typical memory would be me as a ten-year-old, standing on the stairs and asking the babysitter if I could stay with her until my parents came back. I was crying.

She was kind. She let me sit with her. I liked her a lot. She smelt of vanilla and wore baggy t-shirts. She was called Jenny. Jenny the Babysitter Who Lived Up the Street. A decade or so later she would have transformed into Jenny Saville, the Britart star famed for her large-scale painted depictions of naked women.

‘Do you think they’ll be home soon?’

‘Yes,’ said Jenny, patiently. ‘Of course they will. They’re only a mile away. That’s not very far, you know?’

I knew.

But I also knew they could have got mugged or killed or eaten by dogs. They weren’t, of course. Very few Newark-on-Trent residents ended their Saturday night being eaten by dogs. They came home. But all my childhood, over and over again, I carried on this way. Always inadvertently teaching myself how to be anxious. In a world where possibility is endless, the possibilities for pain and loss and permanent separation are also endless. So fear breeds imagination, and vice versa, on and on and on, until there is nothing left to do except go mad.

Then something else. A bit less ordinary, but still in the ballpark. I was thirteen. Me and a friend went over to some girls in our year on the school field. Sat down. One of the girls – one I fancied more than anything – looked at me and then made a disgusted face to her friends. Then she spoke words that I would remember twenty-six years later when I came to write them down in a book. She said: ‘Ugh. I don’t want that sitting next to me. With his spider legs on his face.’ She went on to explain, as the ground kept refusing to swallow me up, what she meant. ‘The hair growing out of his moles. It looks like spiders.’