What's Normal Anyway? Celebrities' Own Stories of Mental Illness (25 page)

But I guess there is a context. My parents were Londoners who, through the prescience of my father who saw the onset of war four years before a lot of other people did, moved my mother out to the Chilterns in 1936. I think it was a culture shock for both of them, moving into a quite conservative rural area. I'm not sure my mother was ever entirely happy with – no, happy's the wrong word, I'm not sure she was ever
comfortable
with – the edge-of-market-town kind of culture. She didn't make friends very easily so I think she was always a slightly lonely woman, although I would never have thought she was depressed at the time I knew her. She died twenty years ago now, before I had my serious illness, and in retrospect I suspect she probably
was
depressed.

My father seemed okay, not a greatly emotional man, but he was wrecked in his forties by having a premature heart attack and couldn't reconcile himself to the disappointments of a ruined career. He took to drink quite heavily, to the extent that he had more heart attacks, and then became a bed-bound alcoholic who ruled our household from his bed by the rather ruthless tactic of withholding money. So if we'd done things that appeared to be rather impertinent to him as a self-made man, like wanting to go to university, he wouldn't pay the electricity bill for a month. We'd live in the dark. And probably that made for a more troubled adolescence than it might otherwise have been. It meant, I suppose, that I had a greater responsibility as the man about the house when I was a teenager, which is not something you want on your shoulders at that age. And I think I was conscious of finding that irksome. Having subsequently been through a couple of years in which my own ambitions were totally (if temporarily) destroyed, and I started behaving in much the same way as him – retreating to my bed and drinking a lot – I now have a profound understanding of what he was going through. But at the time it was tough and I hated and resented my father for it.

However, one reason why I'm reluctant to put too much weight on that – even though it sounds like a classic dysfunctional family situation – is because I was showing symptoms typical of anxiety disorder from a very early age. My first things were gastrointestinal complaints at the age of about five. And I once had, when I was seven, hystericus globus – which is that sensation of a thing stuck in the throat – which enabled me to escape from the classroom and to run wildly about the town in a state of panic. In retrospect I can see that many of these devices, along with many psychosomatic exhibitions, are devices to get you back to a place of safety. And at that stage certainly I regarded home as being a much safer place than the outside world and school. So I got pretty skilled at hypochondriasis quite early on, although I don't think I had anything particularly original to say in the great drama of that art.

So maybe, if there was anything in that early period that triggered a tendency to retreat – to use the theatre of the body as a way of demanding attention from other people, and sometimes blame them at the same time: ‘Look what you've done to me!' – I would say that it was not anything negative in those early years, but maybe a lack of anything positive. My parents weren't a demonstratively loving couple. I don't mean they didn't like each other, but they were not openly huggy and lovey, either to each other or to us. They weren't cold but there were no strong positive signals about the virtues of family life that radiated from the environment I grew up in. So if I'm to intellectualise what happened to me subsequently, it would be to do with a failure to be imprinted with the virtues of family life.

But really I'm disinclined to look for explanations. One ends up with a cocktail of influences going back generations, plus one's genetic makeup, through individual incidents, through atmospheres at particular moments in one's life. And one ends up who one is and I'm inclined to start with that rather than delve about looking for blame or seeking explanations, which one could never prove in any case.

***

I think the build-up to my breakdown in 1999 was a long, slow one. I suppose the first significant event was my mother's death. She'd had Parkinson's disease for twelve years and my younger sister and I had looked after her. We had professional help but basically she was ill at home and we stayed there, both of us, partly because of that. And, of course, as the confessions of many other anxiety sufferers and depressive hypochondriacs will tell you, there is nothing like the excuse of your own or somebody else's illness to keep you safe from more adult courses of life. So, retrospectively, I can see that as well as genuinely feeling it was a thing I should do as a moral duty – I loved my mother – I know that also there was a sub-agenda, that this gave me an infallible excuse for not having to go out and do that bit of growing up that I'd shunned or shied away from for so long.

So when she died that cut the ground out of that excuse, and at the time – that was 1993 – I was working on a very big book,
Flora Britannica
, which, in a way, occupied all my time and energy and commitment. And I can remember my very good, literate and insightful psychiatrist once saying: ‘So you nursed the book instead', which I thought was a brilliant piece of insight. And I think that was true. But then the book was finished and I was in a curious position: living in a house which was mine by dint of being one of the family, with no big project on the stocks, feeling quite rocky. And knowing that my sister, contrary to me, feeling that now the maternal link was broken was all for getting on and starting her own life with her partner elsewhere. So I felt as if the kind of pegs I'd had in the ground – my sister and I looking after our mother, and the obsessive book work – were no longer there. And my troubles just started kind of insidiously at that point.

It began, I think, with generalised anxiety. Just a real uncomfortableness, waking in the morning. Sometimes you sleep well and then you wake up and you have a few seconds' peace, then it snaps in. I used to dread the mornings and that feeling. And the thing that happened, I suppose, was that it also began to be a self-generating process: that I began to be anxious about the anxiety that I knew was about to hit me. And so the whole thing began to be a vicious spiral that fed on itself until it was the only thing that I was thinking about. I was feeling anxious, and feeling anxious about feeling anxious, and feeling anxious about not knowing how the hell I was going to get out of it.

That then began to stop me doing things: I was reluctant to get out of bed because that started a cycle of new situations, which contained within them the potential for new actual anxieties, not just the intrinsic one. And I felt safer just being in that embryonic curl-up position in the bed for as long as I could. I used to go out at lunch and drink a great deal, go back, lie in the bed again. I stopped answering the post. I'd stopped being able to do any work at all, and I just ceased to be anything other than a person who is trapped in a toxic worry about their own worry. Bubbles like this occur: they are completely separate from what's outside. You are trapped in this self-referential cobweb of negativity.

At that point, drawing a line between anxiety and depression is, I think, one for the professionals. If you actually go through the scales of anxiety and depression, there ain't a great deal of difference between them. I suppose the thing that I didn't have that would have utterly, that would have comprehensively, put me in the depressive rather than the anxiety mode, was that I didn't have much problem with self-esteem. I didn't think I was a bad person. I felt a lost person, I didn't know why the hell this had happened to me and I wanted it to go away. But I didn't feel, for instance, that I was being punished for anything and I never really had any serious wishes to self-harm or take my own life.

Although I think one symptom that probably is depressive rather than anxious is to do with denying the good things that happened in your past, which is different from self-esteem. It is not being able to remember what it felt like to have done good things, to have done happy things, to have been an achiever. Lying in bed with a shelf of my own books looking at me, I was astonished, for instance, that I had ever been able to do that. It seemed inconceivable, with how I felt at that moment, that I once felt differently. You can remember the facts, you can remember that you did things, but you can't tag on to what it felt like. I couldn't click into how I could possibly have done them: what started them or what gave me the ideas. But regardless of what any specialist might label it as, certainly my internal experience was much more of a paralysing anxiety than of a depression.

So that's how it got to the stage where I went to seek professional help. I have to say I'm a lifelong believer in the welfare state, but the total lack of help I had from the national health system during my illness was just criminal, actually. I'm not blaming anyone, because I know the astonishing stress on their resources, but when I did go once I was given an appointment for an assessment
eighteen months
hence which, in fact, turned out to be much longer. I was patently in a bad state at this point and it must have been evident to the person who examined me that I was, and all he said was: ‘We can offer you group therapy at some stage in the future but there is a long waiting list.' Then, after I had moved house and got better – three years down the line! – I actually got a letter through saying: ‘We are now available to offer you an appointment for an assessment for group therapy.' I must have hit a very bad corner of a very stressed local system, but it was quite shocking.

So all the clinical help I got, I got privately, mainly with a doctor who was a straightforward talk-therapy man with CBT preferences. But although he was a fantastic man – extremely bright, we talked the same language – the sessions with him really didn't do much to help me and I think the reason I stayed with him was because I actually really liked him. He was an extraordinary guy with a great sense of humour, very well read, so we had agreeable sessions together, although they were not exactly cost-effective. I think people often go on with therapy for so long because it becomes terribly interesting to pry into one's past. But I think the statistical record for psychoanalysis, for instance, as a curative agent is very poor, and certainly the length of time that people are required to have it would suggest that it's not really a therapy at all. It's more a kind of intellectual . . . not game . . . but a support activity rather than a therapy, I think. When you engage in these dialogues about matters of the mind with another person who may or may not be interested in you, but is interested in hearing you talk, that is very flattering and it gives you something to look forward to. So theoretically – no, not theoretically, intellectually – I am now much more attracted by the theory of cognitive behaviour therapy, as it seems to me to wash away all that archaeology which can be seductively fascinating, but irrelevant.

I suppose maybe six months into that process – this must have been in about 2000 now – he recommended that I went as an inpatient to St Andrew's hospital in Northampton, where I was dried out and put on heavy duty drugs. I was on the maximum dose of – what was it at that point? – probably Paroxetine, I think, which is an SSRI. I was also on Heminevrin, Librium and Trazodone, which is halfway between an SSRI and a tricyclic, a sort of quadricyclic. And for the last few weeks of my second stay in St Andrew's I was given Risperidone, a major tranquilliser, although not for very long as it was quite zombie-making. But it really did calm me down more than anything else did. But in the end, although the drugs may have drawn a line in the sand and stopped me getting any worse and enabled me to actually get out of hospital, I was told by my doctors that I was then going to have to go to an institutional halfway house, rather than home, which I think they had correctly identified as being the pit in which I'd been immured and which, if I returned to, I would return to my old ways of thinking and probably drinking.

I think this was metaphorically also a piece of electric shock treatment, because I was totally horrified by this possibility, the weirdness of it and the absolute stripping away of the one place that had been my refuge and security. I've never had agoraphobia to the point of not being able to get out of the house but I had a long period when I was terrified of going abroad, that might even have started with my mother's illness. I mean it sounds a bit tidy, but I travelled on the continent when I was a student and had huge fun. But then there was a gap of maybe twenty years before I went again and it was a kind of ill-defined anxiety of not being safe when away from home. It absolutely dates back to running away from kindergarten with bouts of bad indigestion. And I suppose that is a kind of agoraphobia, it is an unwillingness to leave one's complete comfort zone, where you know you are in control, and that's an important thing for me. I'm not a control freak but I know I get most discomforted and confused when I am not in control of what I'm doing.

So they said: ‘You're going to have to go to a halfway house.' But they did give me an alternative, which also makes me think that it was a slightly calculated threat. They said: ‘If friends will look after you we will accept that.' I hadn't been sectioned but I had voluntarily given some of my friends power of attorney over me at the point when I was not paying bills and things like that. So there was no way that I could, legally, do a runner. I had to take one of those two options because, in the strict letter of the law, decisions of that sort now rested with my attorneys not with me. So that was the deal that was worked out: that I would not go fleeing back to the Chilterns – and crawl back to my bed, with cycles repeating themselves – but that I would go to friends.

And, bless their hearts, a succession of them worked out this rota for me, most of it in north Norfolk, which they turned into a kind of boot camp on the way. The first two friends that I stayed with for some weeks on the Norfolk coast really put me to work. I'd put on a lot of weight, so I was fed properly, and I was expected – and this is why I call it boot camp – to do more than my fair share of housework: washing and washing up, tending the vegetables. And I found it really hard work to start with because I'd been so inactive; I was physically in a very run-down state as well. People who've never been depressed don't understand that depression is a physical illness as well as a mental one. I was very weak, my muscles were very weak, and I found all these things quite a labour. And when I was taken out for my daily walk – on a lead almost – I was completely gutted after about a quarter of a mile. But, week on week, all these things started to improve. And as I toured round various friends, miraculously, or mysteriously, or maybe very obviously under that sort of normal, rather strict – but very affectionate – attention, I began to get better, very, very slowly. My senses began to come alive again.