Shoot the Damn Dog: A Memoir of Depression (9 page)

I set myself tasks.

I would keep the flat clean. I would keep myself clean. I would look after my child. I would buy food and I would cook it, during the days that Molly was with me. The arrangement with Jonathan was that she spent five days with me, and five with him. When I was alone, I rarely bothered to eat, let alone cook. It was too much effort. Sometimes, as I ate my solitary supper of stale, toasted bread, I thought of a friend, who did not like to cook, and how she had told me that she had made herself cauliflower cheese.

‘What,’ I said, ‘you actually cooked?’

‘No, idiot,’ she said. ‘I ate a piece of cheese and a piece of raw cauliflower.’

That memory made my stale toast seem almost sensible.

On the days that Molly was with me, I would get myself up and dressed in the morning then wake her and get her ready for school. Once she had left, I usually crawled back into bed and stayed there. I was always up and dressed when she got home, and the flat was always clean. Mrs Twitchit, she called me, because I shook so much from the effort. And from the medication I was taking.

‘There you go again, Mrs Twitchit,’ she’d say, holding my hands in hers until they stopped shaking. ‘Better now?’

‘Better, darling,’ I would always say.

We ate supper together and watched television. It was a very small television, a portable perched on a chair. I didn’t have the energy to buy another, despite Molly’s protestations. She did not, bless her, protest too much. I think she understood the effort it took, just to sit in a chair. The thought of going to a shop or making a decision about what to buy terrified me. Crowds frightened me, going on the Tube frightened me. Being outside frightened me. Halfway down a street, I would start to cry, for no reason. People would stop and stare as I stood, motionless, tears running down my face.

I tried not to cry, ever, in front of Molly. I did not want to frighten her again, although sometimes, I would cry without realising I was doing it. Anything could start my tears. Moll says now that it was usually the news on television, particularly anything about children being abused.

Sometimes she would switch the TV off.

‘You’re crying, mummy.’

‘Sorry, darling.’

‘You’re not to watch it any more. You’re especially not allowed to watch it when I’m not here.’

She does not like me to watch the news, even now. Sometimes I catch a swift sidelong glance. I sense her tense as the reporter says a couple has been jailed for the torture and death of a child.

‘Hateful,’ I say, out loud. ‘
Hateful
.’

She likes it if I speak. When I was ill, I stayed mute. Every expression went inward, not outward. She would look up and find me white-faced and stricken, tears leaking slowly from my eyes.

I talk a lot now.

Moll played music constantly, perhaps to cheer me up. Her favourite, ‘our song’ as it came to be known, was Robbie Williams’s ‘Angel’.

‘Dance with me, Mummy, please.’

And I would try. We’d turn the music up loud, and lipsynch along to Robbie, using hair brushes as microphones. To this day, I am word perfect.

Angels played a big part in chasing away the demons, both mine and Molly’s. She found God a terrible trial, and still does.

‘God’s a poo,’ she said, aged seven.

‘Oh,’ I said, ‘and why is that?’

‘It’s all thou shalt not. What about, thou shalt? He’s so cross all the time. I don’t like him. I shan’t believe in him, whatever anyone says.’

And she didn’t. But she did believe in angels, and so it became the angels who looked over us. Angels, she said, were very good for chasing away depression because angels, as she announced with the irrefutable logic of a child, are light and depression is dark. The light will always cast out the dark. ‘If we turn on the light in my bedroom, Mummy, the darkness goes away.’

At night, if Molly couldn’t sleep, I lay with her on her bed and we summoned our guardian angels and dressed them like celestial Barbie dolls. Moll’s wore silver and white (she hated pink, ‘too girly’) and were dressed in Vegas showgirl lamé and marabou trim with plumy white feathers. Mine were kitted out in top of the range Prada, in spun gold.

She remembers little of all this now that she is a teenager and not given to believing in angels, but I do. I remember it well and sometimes, when sleep eludes me or the black dog bites, I summon that old gold Prada angel.

I remember, years ago, reading that at some point in their lives one in ten people would suffer from some form of mental illness. I looked around the office in which I worked. There were forty of us. Four of us would become ill. I wondered idly who it might be.

I was never on that list.

Nor, or so they think, are most people even though the figure these days is closer to one in four. At any one time, twenty-five per cent of us will suffer from ‘mental distress’, as it is sometimes called.

Let us, just for a moment, look at the implications of that ‘distress’. Severe depression affects more than 120 million people worldwide and more than 5 million in the UK. By 2020, according to the World Health Organisation, it will be one of the world’s most debilitating conditions, second only to heart disease.

Is that distress? Or is it a major illness? The danger in polite euphemisms is that they drive the condition underground. I constantly see people struggling with severe depression, clamping down on the pain so as not to bother anyone. I know how they minimise both themselves and the severity of their struggle. Mute, pale shadows, they are gagged by polite euphemisms and by misunderstanding.

Unless we tell it as it is—it is an illness just like any other—we will never defuse the fear and secrecy surrounding it. Phrases such as ‘mental distress’ (which are used, and I can hardly believe I’m writing this, even by some large mental health charities) stop people getting help when they most need it. They minimise the condition, reinforce stigma and impose a burden of secrecy that causes useless and unnecessary suffering. At their worst, they are a death sentence. The fatality rate among those suffering from severe depression is fifteen per cent. Many of those who kill themselves (particularly men) do so because they are too ashamed to admit they have the illness or to seek help.

One of the many letters I received after I wrote about my own experience of suicide and depression was from a man whose son had hanged himself.

‘The worst aspect,’ he wrote, ‘was that I hadn’t known that
depression was an illness
, [his italics] so hadn’t sought him out, even insisted upon trying to help.’

We are not easy to help. Nor are we easy to be around. Nobody with a serious illness is easy to be around. Although not obviously physically disabled, we struggle to get things done. Our energy levels are dangerously low. Sometimes, we find it hard to talk. We get angry and frustrated. We fall into despair. We cry, for no apparent reason. Sometimes we find it difficult to eat, or to sleep. Often, we have to go to bed in the afternoon or all day.

So do most people with a serious illness. We are no different.

It is just that we are seen that way.

‘Sometimes,’ says a fellow depressive, ‘I wish I was in a full body cast, with every bone in my body broken. That’s how I feel anyway. Then, maybe, people would stop minimising my illness because they can actually see what’s wrong with me. They seem to need physical evidence.’

Like most people, I have friends who have suffered from a severe illness—one from a stroke at an alarmingly young age, another from cancer. Both were angry, frustrated and despairing. Both were disabled by a lack of energy and found it difficult to eat or sleep. Often, neither of them wanted to talk, but they still wanted the company of those who love them. Neither wanted their friends to dwell on their illness, but neither did they want it ignored.

‘The people I found most difficult to be around,’ says one, ‘were those who tiptoed politely around my illness. There’s this huge great elephant in the room and they do everything they can to ignore it, but actually they can’t. Every time they bump into it, they act horribly awkward and embarrassed and it ends up being me who has to try to put them at their ease. That’s exhausting.’

That awkward embarrassment is even worse around severe depression, because of its inherent stigma—not to mention its intimations of weakness and indulgence.

The question I am most often asked as a person who is so ‘out’ about their illness (an absurd and sad word to have to use, but true) is ‘how do I help somebody who is depressed?’

The most important thing is to accept they have a serious illness. Once you do that, everything becomes easier. Treat them as you would anyone else who is ill. Understand that they will have good days and bad days. Ask them how they feel. Don’t expect them to get better overnight. Talk about the illness. Don’t shut them up by telling them that they’ll feel better soon. They might, but on their time and not yours. Don’t dismiss or minimise their condition with clumsy clichés such as ‘it’s not as bad as all that’ or, ‘you’ll feel better in the morning’. Depression is not a passing mood.

Neuroscientists believe, and are beginning to prove, that depression is more than an affliction from the neck up. It is a whole body disorder. Research shows that it can lead to heart disease in otherwise healthy adults and magnify existing cardiac problems. It can also accelerate changes in bone mass that lead to osteoporosis. Bruce Charlton, a research psychiatrist at the University of Newcastle, has even put forward the theory that depression, far from being a mental illness, is entirely a physical disorder, one that is misinterpreted by the brain. Sickness is read as sadness. The low mood characteristic of depression is merely a secondary response to a physical malaise that includes lack of energy, slowed movement, lack of pleasurable appetites (including sex) and an inability to concentrate.

Charlton suggests that depression is the body’s way of withdrawing to conserve energy—in an ‘evolved pattern of behaviour’ mediated by the immune system. ‘The trouble with malaise is that you don’t necessarily know you’ve got it, and you blame yourself for your condition of low performance. Major depressive disorder is sickness behaviour inappropriately activated and sustained.’

In that spirit, Charlton insists that antidepressants do not make people happy. They simply treat the state of unpleasantness. ‘Their effect on mood is no more remarkable than the fact that it is easier to be happy without a headache.’

While scientists debate whether depression is an illness of body or mind, or both, one thing is urgently true for the depressive. The sadness that comes from sickness needs addressing. One of the most corrosive aspects of depression is despair. I know it well, and it is catastrophic. It leads to hopelessness, helplessness and a terrible, frightening sense of loneliness. It feels impenetrable and unendurable. You know that you shouldn’t feel that way, but you do. It is real.

It is also, although magnified by a factor of thousands in depression, what most of us feel at one time or another. Severe depression, put simply, is an overwhelming and unmanageable onslaught of every normal, human fear and difficult emotion. It is a loss of and lack of perspective and proportion.

It is like living through a waking nightmare. What we most want is somebody to take our hand, to try to connect us back to the world. We don’t expect anybody to take our nightmares away but we do need help in seeing them for what they are—as inappropriate responses.

Everyone, not just the depressive, is familiar with those fears and difficult emotions. The way to help a depressive is to share that knowledge. If you want to help them, talk about loneliness and confusion and misunderstanding. Talk about your own too, not just theirs. Don’t abandon them to their illness. Share with them. Perhaps talk about a time when you felt that you couldn’t connect with other people. Everybody feels that way sometimes. It is just that in depression, that feeling is magnified to become a supreme, unsplendid isolation.

Talk about the human condition. Talk about how frightening and difficult life can sometimes be. Talk about the things that affect us all, not just depressives. In depression, those feelings sometimes overwhelm us. We feel we can’t climb out from under the weight of them. They are not, though, unique to depressives. They are the feelings that all of us feel.

Do it, though, with humour and wit. Life is richly comic, the mistakes we make are often absurd. Our fallibility makes idiots of us all. Our fears, brought out into the daylight of humour, are often laughable. Connecting our fears, our less governable emotions, makes them seem more manageable.

These days, when I collapse into one of my periodic bouts of depression, what I now call ‘negative head’, I call a friend—usually Nigel or Sarah. In that state, I used to hide myself away, too ashamed or embarrassed by my black nihilism to allow it to be seen. Now I know that the only way to bring it into proportion is to express it. If I don’t, it will feed on itself until it becomes, in every sense, unmanageable. The last time it happened, I called Nigel. When he arrived at my door half an hour later, I was still in bed, unwashed, unfed and in tears. Ignoring my protestations, he cheerily made me dress and eat something, then put me in his car and drove me to a park.

As we walked, he countered every one of my negative remarks. ‘That’s simply not true,’ he said, laughing. Or he would build one of my fears into some silly, fanciful story until the sheer absurdity of it made me laugh. Then he would confess one of his own, equally ludicrous, fears until I protested and pointed out the flaws in his thinking. At that point, I realised the flaws in my own.

I believe, completely, that life is about connection; that nothing else truly matters. People so often say, ‘I don’t know how to help.’ This is one way—through empathy but more importantly, through connection. Don’t think, as so many people do, that depressives are best left alone. They are not. Ignoring or dismissing depression only makes it worse. It never makes it better.

A friend once said to me that he didn’t know how to do small talk. The very effort of it shut him up.

Do big talk, I said. Talk about what really matters, say what you really mean.

I can’t, he said. People won’t like it.

I used to think that way too. If I had not been trapped in the prison that is depression and forced to bust my way out in any way that I could, I might feel that way still. We are never taught that it’s OK to be human and to be vulnerable, so now we’ve almost forgotten that it’s simply the way we are. And that goes for all of us. The way that I deal with my depression these days is to talk about the way I truly feel, and not the way I think other people would like me to feel. I am rarely right about that anyway. And I have discovered that when I break the treaty of silence, I am amazed to find how many people will join me.

I know that some people find such notions of honesty and vulnerability impossible, if not abhorrent. Most of us have never learned the vocabulary of intimacy. We simply don’t know how to express our feelings. Perhaps some of us don’t need to but it’s more, I think, that most of us are frightened to, myself included—although I have now lost that fear. There’s nothing like being locked away in three psychiatric units and crying in front of most of London to help you lose your inhibitions, or that carefully constructed social self we regard as so precious.

Much of that self is unhelpful; it is a brick wall behind which we find ourselves trapped, frightened and alone. It is fear, I think, that keeps us so locked down, fear of not being, as the therapeutic phrase goes, ‘good enough’.

It takes courage to be honest and open about our own vulnerability. But it is, at heart, what we all crave and need—not only to be listened to, but also to be heard. We want to be understood and accepted for the people we truly are. That’s all therapy is, understanding and acceptance. It is allowing somebody to speak until they feel heard. It is an acceptance of each other and of ourselves.

There is a word that’s forbidden in therapy.

Fine.

‘How are you today?’

‘I’m fine.’

In truth, I may be happy or sad, or anxious or irritable. I may be bewildered or lonely, perplexed or depressed. I may be elated or despondent, tired or confused.

But to you, I am just fine.

Fine, in therapy, stands for:

Fucked up

Insecure

Neurotic

Emotional

Fine is my word. It has always been my word.

I have been fine all my life. I have been fine even as my world fell apart. I have been fine as two marriages collapsed.

‘It’s such a meaningless word,’ says a fellow depressive. ‘It’s a word to hide behind when you’re not being honest. It’s a word that reveals nothing but is designed to keep people at a distance. There’s no comeback from “fine.” “OK” is open to interpretation. “I’m well”, means that, literally, all is well. But fine is such a non-word that it becomes a barrier to communication.’

I was fine until I had a nervous breakdown.

I was reminded of that, recently, when I had dinner with a friend, Betty. We have been friends for years and, just as she has never faltered in her friendship, she never faltered in her belief that I would get better. Sometimes I think that she held on to it long after I had let it go.

It is winter, and dark outside, but the restaurant I am sitting in is warm and garlanded with fairy lights, because it is nearly Christmas. I am early, because I always am. I suffer from an almost pathological punctuality.

Betty bursts through the door and gathers me in a hug. She has a way of bursting into rooms, as if she cannot contain her own energy. As she releases me from the hug, I register the relief in her face when she sees that I am smiling and happy. I sometimes forget the pain my friends went through, how helpless they felt in the face of my bleak despair.

We don’t often discuss my illness. But, tonight, perhaps because I am telling her about this book, and how well (or badly) the writing of it is going, we do. I want, anyway, to see my depression from a different perspective, to understand what it’s like to see it from the viewpoint of a friend.

‘There was one night when Sarah and I were sitting with you in your flat,’ Betty says. ‘You were quite mad. Is it OK to say that?’

I smile. ‘Yes.’