Reasons to Stay Alive

  Reasons to be strong

  IT WAS 2002. I was at that point in my recovery where I was continually feeling well, but only in contrast to the much worse stuff that had gone before. Really, I was still a walking mass of anxiety, too phobic to take medicine of any kind, and convinced my tongue was expanding every time I consumed prawns or peanut butter or any other food it is possible to be allergic to. I also needed to be near Andrea. If I was near Andrea I was infinitely calmer than when I wasn’t.

  Most of the time, this didn’t make me feel like a weirdo. Me and Andrea lived together and worked together in the same modest apartment. We did not really know anyone socially. Out of the two of us, I had always been the one with the drive to go out and meet other people, and that drive had gone now.

  But in 2002 Andrea’s mother was diagnosed with ovarian cancer and things understandably changed. We went and stayed with her parents in County Durham while Freda underwent chemotherapy. Andrea, who had spent the last three years fixing a depressive boyfriend, now had a mother with cancer.

  She cried a lot. I felt like the baton was being passed. This was my turn to be the strong one.

  When she first found out her mum was ill she sat on the edge of the bed and cried like I had never seen her cry. I put my arm around her and felt that sudden shrinking of language you feel when something terrible happens. Fortunately, Andrea was on hand to help.

  ‘Just say it’s going to be okay,’ she said.

  ‘It’s going to be okay.’

  Two months later, I was alone in the house of my future in-laws, pleading with Andrea to go with them to the hospital.

  ‘I’ve got to take Mum to hospital,’ she had said.

  ‘Okay. I’ll come with you.’

  ‘They want someone to wait and let David in.’ David was Andrea’s brother, travelling up from London.

  ‘I can come with you.’

  ‘Matt, please.’

  ‘I can’t do this. Separation anxiety. I’ll have a panic attack.’

  ‘Matt, I’m asking you. My mum’s ill. I don’t want to stress her out. You’re being selfish.’

  ‘Fuck. Shit. I’m sorry. But you don’t understand.’

  ‘You can do this.’

  ‘I won’t make it. Can’t you just tell your mum and dad I’ve got to come too?’

  ‘Okay. All right. Okay. I will.’

  But then it happened. A switch flicked. ‘No.’

  ‘No what?’

  ‘I’ll do it. I’ll stay. I’ll stay in the house.’

  ‘Really?’

  ‘Yeah.’

  ‘I’ll leave the number for the hospital.’

  ‘It’s okay,’ I said, stupidly imagining these could be my last ever words to her. ‘I could find it.’

  ‘I’ll leave it anyway.’

  ‘Thank you.’

  ‘It’s okay. You’d better go.’

  While waiting for them to come home with Andrea from the hospital I paced from room to room. They had lots of porcelain ornaments. Little Bo Peep. A Pink Panther sitting cross-legged, his legs hanging down off the windowsill. His wide yellow eyes followed me around the living room.

  The first ten minutes my heart was pounding. I could hardly breathe. Andrea was dead. Her parents were dead. I was picturing the car crash too vividly for it not to have happened. Then twenty minutes passed. I was going to die. There was a pain in my chest. Maybe it was lung cancer. I was only twenty-seven, but I had smoked a lot. At thirty minutes, a neighbour came around to see how Freda was. At forty minutes, the adrenaline was starting to settle. I had been forty minutes on my own and I was still alive. By fifty minutes, I actually wanted them to be gone over an hour, so that I could feel even stronger. Fifty minutes! Three years of separation anxiety cured in less than an hour!

  Needless to say, they came back.

  It was a horrible summer, but the outcome was okay. Andrea’s mother was given terrible odds, but she beat them. We even managed to replace her daily breakfast of a biscuit with a kiwi fruit. I had reasons to force myself to be strong. To put myself in situations I wouldn’t have put myself in. You need to be uncomfortable. You need to hurt. As the Persian poet Rumi wrote in the twelfth century, ‘The wound is the place where the light enters you.’ (He also wrote: ‘Forget safety. Live where you fear to live.’) Also, I channelled my mind by writing my first proper novel. Not principally for career reasons (the novel was a reworking of Shakespeare’s Henry IV, with talking dogs, so hardly bestseller territory), but to occupy myself. Two years later, though, and with Andrea’s encouragement, it would be an actual published book. I dedicated the book to Andrea, obviously, but it wasn’t just a book I owed her. It was a whole life.

  Weapons

  MY AGENT. ‘YOU’VE got a publisher.’

  ‘What?’

  ‘Just had the phone call. You are going to be a published author.’

  ‘What? Seriously?’

  ‘Seriously.’

  This news kept me going for about six months.

  For about six months my lack of self-esteem had been artificially addressed. I would lie in bed and go to sleep smiling, thinking Wow, I’m quite a big deal, I’m going to be published.

  But being published (or getting a great job or whatever) does not permanently alter your brain. And one night I lay awake, feeling less than happy. I started to worry. The worries spiralled. And for three weeks I was trapped in my own mind again. But this time, I had weapons. One of them, maybe the most important, was this knowledge: I have been ill before, then well again. Wellness is possible. Another weapon was running. I knew how the body could affect the mind, so I started to run more and more.

  Running

  RUNNING IS A commonly cited alleviator of depression and anxiety. It certainly worked for me. When I started running I was still getting very bad panic attacks. The thing I liked about it was that many of the physical symptoms of panic – the racing heart, the problematic breathing, the sweating – are matched by running. So while I was running I wouldn’t be worried about my racing heart because it had a reason to be racing.

  Also, it gave me something to think about. I was never exactly the fittest person in the world, so running was quite difficult. It hurt. But that effort and discomfort was a great focuser. And so I convinced myself that through training my body I was also training my mind. It was a kind of active meditation.

  It also, of course, gets you fit. And getting fit is pretty much good for everything. When I became ill I had been drinking and smoking heavily, but now I was trying to undo that damage.

  So every day I would go running, or do an equivalent type of cardiovascular exercise. Like Haruki Murakami – whose excellent book What I Talk About When I Talk About Running I would later read – I found running to be a way of clearing the fog. (‘Exerting yourself to the fullest within your individual limits: that’s the essence of running,’ Murakami also said, which is something I’ve come to believe too, and is one of the reasons I believe it helps the mind.)

  I would come back from a run and stretch and have a shower and feel a gentle sense of release, as though depression and anxiety were slowly evaporating from inside me. It was a wonderful feeling. Also, that kind of monotony that running generates – the one soundtracked by heavy breathing and the steady rhythm of feet on pavements – became a kind of metaphor for depression. To go on a run every day is to have a kind of battle with yourself. Just getting out on a cold February morning gives you a sense of achievement. But that voiceless debate you have with yourself – I want to stop! No, keep going! I can’t, I can hardly breathe! There’s only a mile to go! I just need to lie down! You can’t! – is the debate of depression, but on a smaller and less serious scale. So for me, each time I forced myself out there in the cold grey damp of a West Yorkshire morning, and pushed myself to run for an hour, it gave me a little bit of depression-beating power. A little bit of that ‘you’d better be careful with who you are messing with’ spirit.

  It helped, sometimes. N
ot always. It wasn’t foolproof. I wasn’t Zeus. There were no magic thunderbolts at my disposal. But it is nice to build up, over the years, things that you know do – on occasion – work. Weapons for the war that subsides but that can always ignite again. And so writing, reading, talking, travelling, yoga, meditation and running were some of mine.

  The brain is the body – part two

  I BELIEVE THAT the term ‘mental illness’ is misleading, as it implies all the problems that happen, happen above the neck. With depression, and with anxiety in particular, a lot of the problems may be generated by the mind, and aggravate the mind, but have physical effects.

  For instance, the NHS website lists these as the psychological symptoms of generalised anxiety disorder:

  restlessness

  a sense of dread

  feeling constantly ‘on edge’

  difficulty concentrating

  irritability

  impatience

  being easily distracted

  But interestingly the NHS gives a much longer list for the physical symptoms:

  dizziness

  drowsiness and tiredness

  pins and needles

  irregular heartbeat (palpitations)

  muscle aches and tension

  dry mouth

  excessive sweating

  shortness of breath

  stomach ache

  nausea

  diarrhoea

  headache

  excessive thirst

  frequent urinating

  painful or missed periods

  difficulty falling or staying asleep (insomnia)

  One symptom missing from the NHS list, but found on others, is both physical and mental. Derealisation. It is a very real symptom that makes you feel, well, not real. You don’t feel fully inside yourself. You feel like you are controlling your body from somewhere else. It is like the distance between a writer and their fictional, semi-autobiographical narrator. The centre that is you has gone. It is a feeling of the mind and the body, once again proving to the sufferer that to separate the two as crudely as we do is wrong, and simplistic. And maybe even part of the problem.

  Famous people

  DEPRESSION MAKES YOU feel alone. That’s one of its main symptoms. So it helps to know you are not alone. Given the nature of our society, and a confessional celebrity culture, it is often famous people that we hear about having troubles. But it doesn’t matter. The more we hear, the better. Well, not always. Being a writer, I don’t particularly like thinking about Ernest Hemingway and what he did with his gun, or Sylvia Plath’s head in her oven. I didn’t even like contemplating too deeply non-writer Vincent Van Gogh and his ear. And when I heard about a contemporary writer I admired, David Foster Wallace, hanging himself on 12 September 2008 it actually sparked in me my worst bout of depression since the really Bad Times. And it doesn’t have to be writers. I was one of millions of people not just saddened by Robin Williams’ death, but scared of it, as if it somehow made it more likely for us to end up the same way.

  But then, most people with depression – even most famous people with depression – don’t end up committing suicide. Mark Twain suffered depression and died of a heart attack. Tennessee Williams died from accidentally choking on the cap of a bottle of eye drops that he frequently used.

  Sometimes just looking at names of people who have suffered depression – or are still suffering depression – but who clearly have (or had) other things that are great going on in their lives, gives a kind of comfort. So here is my list:

  Buzz Aldrin

  Halle Berry

  Zach Braff

  Russell Brand

  Frank Bruno

  Alastair Campbell

  Jim Carrey

  Winston Churchill

  Richard Dreyfuss

  Carrie Fisher

  F. Scott Fitzgerald

  Stephen Fry

  Judy Garland

  Jon Hamm

  Anne Hathaway

  Billy Joel

  Angelina Jolie

  Stephen King

  Abraham Lincoln

  Wolfgang Amadeus Mozart

  Isaac Newton

  Al Pacino

  Gwyneth Paltrow

  Dolly Parton

  Princess Diana

  Christina Ricci

  Teddy Roosevelt

  Winona Ryder

  Brooke Shields

  Charles Shulz

  Ben Stiller

  William Styron

  Emma Thompson

  Uma Thurman

  Marcus Trescothick

  Ruby Wax

  Robbie Williams

  Tennessee Williams

  Catherine Zeta-Jones

  And what does this teach us? That depression can happen to prime ministers and presidents and cricketers and playwrights and boxers and the stars of hit Hollywood comedies. Well, we knew that. What else? That fame and money do not immunise you from mental health problems. We kind of knew that too. Maybe it is not about teaching us anything except that knowing about Jim Carrey’s time on Prozac or Princess Leia’s bipolar disorder helps us because, while we know it can happen to anyone, we can never be told too many times that it can actually happen to anyone.

  I remember sitting in a dentist’s reading an interview with Halle Berry in which she was talking openly about the time she sat in her car, in a garage, and tried to kill herself via carbon monoxide poisoning. She told the interviewer that the only thing that stopped her was the thought of her mother finding her.

  It helped me, seeing her smiling and looking strong in that magazine. It may have been a Photoshopped illusion, but whatever, she was alive and seemingly happy, and a member of the same species as me. So yes, we like stories of recovery. We love the narrative structure of rise-fall-rise-again. Celebrity magazines run these stories endlessly.

  There is a lot of cynicism about depressed celebrities, as if after a certain amount of success and money a human being becomes immune to mental illnesses. It is only mental illnesses that people seem to say this about. They don’t say it about the flu, for instance. Unlike a book or a film depression doesn’t have to be about something.

  Also, one of the things depression often does is make you feel guilt. Depression says ‘Look at you, with your nice life, with your nice boyfriend/girlfriend/husband/ wife/kids/dog/sofa/Twitter followers, with your good job, with your lack of physical health problems, with your holiday in Rome to look forward to, with your mortgage nearly paid off, with your non-divorced parents, with your whatever,’ on and on and on.

  Actually, depression can be exacerbated by things being all right externally, because the gulf between what you are feeling and what you are expected to feel becomes larger. If you feel the same amount of depression as someone would naturally feel in a prisoner of war camp, but you are not in a prisoner of war camp, and are instead in a nice semi-detached house in the free world, then you think ‘Crap, this is everything I ever wanted, why aren’t I happy?’

  You may find yourself, as in the Talking Heads song, in a beautiful house, with a beautiful wife, wondering how you got there. Watching the days. Wondering how things get on top. Wondering what is missing. Wondering if every thing we have wanted in our lives has been the wrong thing. Wondering if the smartphones and nice bathrooms and state-of-the-art TVs we thought were part of the solution are part of the problem. Wondering if, in the board game of life, everything we thought was a ladder was in fact a snake, sliding us right down to the bottom. As any Buddhist would tell you, an over-attachment to material things will lead only to more suffering.

  It is said that insanity is a logical response to an insane world. Maybe depression is in part simply a response to a life we don’t really understand. Of course, no one understands their life completely if they think about it. An annoying thing about depression is that thinking about life is inevitable. Depression makes thinkers out of all of us. Just ask Abraham Lincoln.

  Abraham Lincoln and the fearful gift

&
nbsp; ABRAHAM LINCOLN, WHEN he was thirty-two, declared: ‘I am now the most miserable man living.’ He had, by that age, experienced two massive depressive breakdowns.

  ‘If what I feel were equally distributed to the whole human family, there would not be one cheerful face on the earth. Whether I shall ever be better I can not tell; I awfully forbode I shall not. To remain as I am is impossible. I must die or be better.’

  Yet, of course, while Lincoln openly declared he had no fear of suicide, he did not kill himself. He chose to live.

  There is a great article on ‘Lincoln’s Great Depression’ in The Atlantic by Joshua Wolf Shenk. In it, Shenk writes of how depression forced Lincoln into a deeper understanding of life:

  He insisted on acknowledging his fears. Through his late twenties and early thirties he drove deeper and deeper into them, hovering over what, according to Albert Camus, is the only serious question human beings have to deal with. He asked whether he could live, whether he could face life’s misery. Finally he decided that he must . . . He had an ‘irrepressible desire’ to accomplish something while he lived.

  He was evidently a serious person. One of the great serious people of history. He fought mental wars and physical ones. Maybe his knowledge of suffering led to the kind of empathy he showed when seeking to change the law on slavery. (‘Wherever I hear anyone arguing for slavery, I feel a strong impulse to see it tried on him personally,’ he said.)

  Lincoln is not the only famous leader to have battled depression. Winston Churchill lived with the ‘black dog’ for much of his life too. Watching a fire, he once remarked to a young researcher he was employing: ‘I know why logs spit. I know what it is to be consumed.’

  Indeed he did. He was – in terms of career achievements – one of the most active men who ever lived. Yet he continually felt despondent and full of darkness.

  The political philosopher John Gray – one of my favourite non-fiction writers (read Straw Dogs to see why) – believes Churchill didn’t ‘overcome’ depression to become a good war leader, rather that the experience of depression directly enabled him to be one.