Shoot the Damn Dog: A Memoir of Depression (5 page)

After a long while, the therapist looks at the rest of us. ‘Would anybody like to say anything to Susie?’

I look at Susie, her hands clenched across her face, knuckles white, as she fights the urge not to hit herself. I used to do the same thing, slap myself to stop my own tears.

‘If I was crying,’ I say, ‘would you tell me to shut up?’

She lifts her face from her fists in astonishment. ‘No, of course not.’

‘Then why are you doing it to yourself?’

‘Because I hate myself when I’m like this. I want me to stop.’

I understand that. I wanted me to stop too.

So, we’ve heard it all. We’ve heard it from friends, from family, from meaningless strangers. But, most of all, we’ve heard it from ourselves.

Pull yourself together
.

There are lots of people worse off
.

It’s not that bad
.

Get over yourself
.

Get a life
.

I did not, could not, blame anybody who offered me such advice. It was no more than I told myself daily, even hourly. I developed terrible pains in my face. It took me a long time (and a dentist) to realise it was because I kept my jaw clamped tight. I was gritting my teeth to get through the days.

Only once did I answer back. It was a bloke on a building site, just trying to be cheery, just being normal.

He called out: ‘Cheer up love, it might never happen.’

I turned on him and I said: ‘Well, it fucking well has happened. And what are you going to do about it?’

I might just as well have hit him. He was shaven-headed and built like a brick shit house but he spread his hands beseechingly and blushed. He said nothing. Nor did I. I was trying too hard not to cry.

There were men like him in the hospital. One was a cab driver, huge and burly. He looked like a hard man but his expression told another story. He was terrified his mates would discover he was in a loony bin. He did not want to share his feelings or tell us how he felt, which was bad. Very, very bad. He thought about dying, about hanging himself by the neck. ‘I don’t understand,’ was all he said.

The group murmured in assent. Nor did we.

None of us understood why we had been singled out for depression. None of us knew how we came to be shut away in a psychiatric hospital, compelled to spill out our emotional guts to strangers. It was not the way we saw ourselves. It was not the way that we wanted others to see us.

If there is one fact about depression on which all the experts agree, it is that there is no single cause but rather a number of contributory factors that come together and may trigger a depressive episode in people who are vulnerable.

I say, may, because nobody knows which combination of triggers is liable to be explosive nor why one person should be affected when another, given the exact same set of factors, should remain untouched.

But it is generally agreed that major depression is the result of a number of difficult events (known as stressors) that, coming in quick succession, affect the chemical balance of the brain. Depression, literally, changes your mind.

Those stressors may include a relationship breakdown, the loss of a job, the death of a loved one or financial problems. Loss of any kind seems to be a significant trigger. Depression often runs in families so there may also be a genetic susceptibility—but it is a predisposition rather than a predetermination. It does not mean that everyone with depression in the family is destined to develop the illness. Nor is everyone who experiences difficult events destined to become seriously depressed.

My descent into depression was steady, textbook, even. I began to wake, every morning, at twenty minutes past three. My head was an alarm clock, set to the minute; to the not-so-sweet spot.

Early morning waking is one of the classic symptoms of depression, but I had no idea so I paid it little attention. I had a lot on my mind and anyway, I have suffered from insomnia since I was a child, although it used to be of the not being able to get off to sleep variety.

This was a new form. I fell asleep as if I had been hit over the head, too fast, too violently. And then, a few hours later, I was awake again and always at the same time. I began to dread the clock, my startled, suddenly awake eyes staring at those luminous hands that always pointed at the three and the four; pointing the way, I began to imagine, towards hell.

I felt odd in other ways. Food tasted strange, or dry, like dust. I lost weight quickly, about a stone in a few weeks. I was pleased in a vague, detached, way although I sometimes thought I should be happier about losing weight without even trying. In those odd moments of clarity, I was surprised by my lack of pleasure. I was thin and in my world, thin was good. I worked in magazines. I went to fashion shows. People told me how fabulous I looked while all the time I wondered who this stranger was who inhabited my skinny Earl jeans.

I lost interest, too, in everything that I had once loved. My garden deserted me. It grew, unwatched and unappreciated. I felt indifferent to it and it, in turn, seemed indifferent to me. It did not seem to matter whether I was present or not. After a time I became resentful, feeling that the flowers mocked me, blooming in defiance of my listless misery.

I did not pay much attention. My mind was on other, more important, things. If I could not sleep or eat or garden, it was for a reason. My ten-year marriage was dying and crawling painfully towards its conclusion. My husband, Jonathan, and I had begun to bicker destructively.

‘Does everything I do annoy you?’ he asked.

‘Yes.’

He turned away.

I put my hands on my hips, addressed his reproachful back. ‘Well, that’s what you wanted to hear, isn’t it?’

He said nothing but I could hear, in his silence, the acid bite of my words.

We had developed our own sad pattern. I attacked, he withdrew. There was no war, more an empty sense of defeat. Our misery was played out in a sniper’s no-man’s land, and there seemed nothing we could do to change the view. Or perhaps it was that neither of us wanted to.

My life had changed in other ways. I had gone back to working in magazines, as the editor of
Red
, after a decade working as a writer in absolute peace and quiet. I was not used to so much noise, or the incessant, urgent demands of a staff of thirty, and found it, frankly, difficult.

I had worked in magazines before; I loved the drama and the chaos of them. It did not occur to me that this time it would be different. Perhaps it was simply that I was older or perhaps it was merely my state of mind but I found the consuming obsession with celebrities and shopping trivial and infuriating. It was fine, in its place; but its place, to my mind, was small.

I thought, too, that I understood the Machiavellian politics of office life. I thought, even, that I enjoyed them. I ignored the way they stuck, like the food I ate, in my throat.

My marriage finally ended. There was no real resistance, just the occasional flurry of emotion; as much out of politeness or habit as regret. I found a flat and moved out. Jonathan could not, he said, face moving himself. He finds it hard. I do not, having spent my childhood doing it; or at least, I thought I didn’t, but that understanding came later, by which time I was drowning in an emotional backwash I could neither handle nor understand.

I found a flat near the house so Molly could move easily between us. It was difficult, but curiously easy. We talked about it a lot. We stayed close friends.

Jonathan went to see a therapist, about the marriage breakdown and other things. It did not occur to me that I needed to. I thought therapy was for other people but I was up to my neck in the denial that, as so many therapists have told me, I am so consummately good at.

Jonathan reported back from his therapy sessions. ‘He says we’re so polite and considerate with each other, we’re like something out of the
Guardian
.’

Yes, I thought, passionless. Dead. Beyond hope.

‘He wants to know why we don’t shout or throw china.’

I laughed. So did Jonathan.

‘Has he understood nothing at all?’ I asked.

Jonathan shrugged.

At about the same time, I fell in love. Absurdly, insanely and catastrophically in love and with somebody I should not have been in love with. I had felt the pull of it for months, but had done nothing about it. I thought, even, that I might be going insane, thought that I was making the whole thing up. It was only, finally, when we came together that I knew that I had been right all along, that the hugeness of the emotion I was feeling did not exist in isolation.

It didn’t help. I felt madder still, an insanity compounded by guilt and impossibility. Love, as the scientists tell us, is enough to change anybody’s brain chemistry. And I was in love, not just with my head and my heart but with my body and soul too. The connection was inexplicable, even to myself. And so I did not try to explain it.

I was more lost than I have ever been. His name was Tom. It still is. When we met, he was with somebody else, in situation, but not emotion. We did nothing. It was like watching a car crash. There were children involved. We talked, we kissed, we made no plans. There were none to be made. There was just us, this thing that we could do nothing with, or about.

We could not even ignore it.

He sent me an email.

I went to see my doctor for some sleeping pills. She told me that early warning waking was a sign of depression and prescribed antidepressants. I didn’t believe her, told her that I was not depressed but simply tired from getting so little sleep, that I had a few too many things on my mind.

I was vaguely outraged by her suggestion that I was depressed. I am not a person who does depression. I am a person who always copes. I am strong. Or so my thinking went at the time.

She listened to me patiently then suggested a counsellor. The NHS waiting list was, at minimum, six months. I let her put my name down although I knew that, in six months’ time, I would be better.

I insisted, again, on sleeping pills. She refused, prescribed me antidepressants, explaining that as the depression lifted, so my sleeping patterns would return to normal.

I took the pills. I continued to wake at three twenty every morning. I thought that she was wrong in her diagnosis. The antidepressants did nothing for me so I could not be depressed. I just had too much on my mind.

Two months later, I started to cry. I woke, crying, and I went to sleep crying. In between, I washed my face, got dressed and went to work. It still did not occur to me that I was depressed. I was just sad, about the ending of my marriage, about loving somebody who I should not love.

Four months after we separated, Jonathan became involved in another relationship. I was pleased for him. I wanted him to be happy. I knew, from my lack of jealousy or pain, that our marriage was truly over. Even so, I carried the guilt of its ending like a thundercloud. I was the one who had moved out. Was it all my fault? Had I not tried hard enough?

‘You did try,’ Jonathan said. ‘You kept trying to talk about it but I wouldn’t. I just hoped it would go away. I knew it was over, that we had been unhappy for a long time. I couldn’t face doing anything about it; I couldn’t even face facing it. So, thank you for being strong enough to do it.’

‘That’s OK.’

He grinned at me. ‘I couldn’t have done it without you.’

We are still good friends, even now. We see each other often and not just because we share a child. I call Jonathan in times of trouble, or celebration. And he calls me. This confuses some people. They think we are weird to be so happily separated. They wonder why we bothered. We don’t. We both know we have the sort of relationship that survives separation, but not intimacy.

Nor did our friendship stop the pain of a marriage ending. It did not diminish the agony of ripping apart a ten-year marriage, a house, and a life. Perhaps, even, our friendship made it worse.

‘Why are we doing this?’ I said, one day, as we were packing up the family home.

Jonathan looked sad. ‘Because there is no other way. We both know that.’

‘Yes,’ I said, and went back to packing up boxes of china and glass.

We dismantled our marriage slowly; it took us over a year to sell the house. During that time, I moved twice, into different flats, and moved in and out of the family house twice too. It was unsettling, but I was already unsettled.

I kept on taking the antidepressants. They did nothing, but my life was a mess. No drug has the power to tidy away that degree of mess.

I was physically unwell too, with an underactive thyroid, or hypothyroidism as it is known, diagnosed a year previously. ‘It’s only mildly underactive,’ my GP said. ‘Borderline. Nothing to worry about.’

And so I didn’t.

Mental health professionals, however, take malfunctioning thyroid glands very seriously, for good reason. The thyroid, which governs everything from metabolism to mood function, used to be known as the gland of emotion. It is hugely implicated in depression. According to one report, twenty-five per cent of women in psychiatric units have an underactive thyroid. Often, it is only borderline, which is why its implications regarding severe depression are often missed by general practitioners who tend to regard a mildly under-functioning thyroid as bothersome but not serious. There is, too, an enormous variation in function.

As my own psychiatrist told me later, ‘Normal is a piece of string. What’s normal for one person is off the chart for another. And NHS blood tests for thyroxin are notoriously insensitive.’

I knew none of this at the time and, taking my lead from my GP, did not take its implications seriously even though I had felt extremely unwell before I was diagnosed. I was tired all the time and not normal fatigue but bone-weary exhaustion. I slept as if I had been knocked unconscious and struggled to wake in the morning, dragging my leaden limbs through the day. I was always cold; my fingers white and numb even during the summer, when I kept a heater going at full blast in my study. If I got too cold, I found it almost impossible to get warm again and resorted to lying in a bath with the hot water running. My arms and legs ached constantly, so painfully that, at times, I took painkillers every four hours. And my weight, which had been the same all my life, kept going up despite eating very little. Stranger still, my eyebrows started to fall out and my skin was so dry I was almost bathing in moisturiser. I felt constantly low and depressed but I was working too hard and had a small child who needed me. I was ripped in half by guilt. Of course I was depressed and tired.

‘It’s your age,’ a locum GP said. ‘You’re probably menopausal.’

He was a young man, with ears that stuck out and were so red and shiny it looked as if he scrubbed them daily.

‘I am in my forties,’ I said with as much outraged dignity as I could muster in the face of his blank, young indifference.

He did not look up from his notes. ‘Exactly.’ His eyes flickered across the pages. ‘And you have a small child and you work.’ He looked over at me as if to say, what did you expect?

Eventually, my own GP put me on a small dose of thyroxin, 50 mgs a day. ‘To see if it has any effect,’ she suggested. My body temperature shot up. The weight fell off. My energy returned. But still, I couldn’t throw off the mood, the low feeling that seemed always to envelop me like a cold, grey blanket.

When, eventually, I was taken into hospital with severe depression, they trebled the dose of thyroxin, to 150 mgs a day. The maximum dose is 200 mgs a day. The amount I had been taking was far too low, even though the blood tests my GP had done indicated that the levels of available thyroxin were back to normal.

My ruinous love affair continued. We fell more and more in love, ran towards each other and away again. We were as intimate with each other, and as estranged from each other, as it is possible to be. We did not see each other for weeks on end and then came together in cataclysmic passion.