I have learned, too, to take life less personally. That sounds odd, I know, for what is my life if it is not personal? Well, it is simply life, for a start, and learning to look at it in a new way, or ways, is one of the keys not simply to unlocking depression but keeping it at bay.
It is by breaking old habits (also known as ‘old behaviour’ or ‘old thinking’) and instilling new ones that we change the way we think. And one of those old habits might be a sort of ingrained cynicism, a refusal to try new things or ideas simply because we think, at least from the outside looking in, that they are ridiculous, or embarrassing, or both.
Cynicism, or a closed mind, is a refuge depressives can’t afford to have. It may, even, be what got us there in the first place. In my entirely subjective research into what makes happiness, or freedom from depression, I’d say that the single most effective habit is an open and receptive mind.
16
The Second Loony Bin
Depression is melancholy minus its charms.
Susan Sontag
Tom drove me to the mental hospital. I don’t mean that he drove me via love to madness, although part of that is true, but that he put me in his car and took me there for my second stay. It was here that I met Kate, and Susie and Nigel, whose friendship was to become invaluable.
It had been eight months since I left the first hospital. This time, I asked my psychiatrist to admit me. The bleakness of my mood was unrelenting. I was in pain, physically, either from the effects of depression or the side-effects of the antidepressants—or perhaps both—and suffering emotionally from the black violence of my mood. The only times I did not feel pain were when I was asleep, knocked out by pills, or drunk.
By then I was playing with my medication, as so many depressives do. The high dose of antidepressants I was taking seemed to have no effect but I discovered that if I took a tranquilliser (or two, sometimes three) on top of a bottle of wine (a good French white burgundy was my drug of choice) I could achieve a state of relative peace. I measured out the wine in increments and never more than two bottles in a day; a lot, I know, in any normal life, but my life was not normal. It was then that my alcohol dependency really kicked off. I did not drink for the taste. It became my anaesthetic, the only thing that came close to relieving the terrible stranglehold at my throat. To put it bluntly, I liked to be mildly but consistently drunk all day, every day.
I found that a steady stream of alcohol together with Valium or Xanax, whatever my psychiatrist prescribed, taken slowly, could ease me through the blackness of my days and into the night when I took a sleeping pill and found complete oblivion, at least for a few hours. I loved my sleeping pills; they were the only moments of peace I could find during that wretched year when my depression was at its worst.
If someone had taken them away, as one well-intentioned GP threatened to do, and removed those few hours of unconsciousness (and my psychiatrist was too clever, or too understanding of my mood and character, to do any such thing, although lesser men might have tried) I would certainly have killed myself. As it was, they were my passport to sanity or the only sort of sanity that I could manage at that time. If I knew that the night would bring me sweet oblivion, I could just about make it through the day.
It was a good system, in that I knew it worked. It was a bad system in that I knew that I would die, and in not too long a time, perhaps a few years, as a result of the quantities of alcohol and prescription drugs I was consuming daily. I confronted my death with grim ambivalence. If I died, I won because I was free from pain. If I died, depression won because it was the cause of the pain from which I wished to be free. I could not decide whom I would prefer to see as the victor.
Nor could I square all this with the person I used to be, with the life I used to love and which now seemed like some lovely reverie I once had dreamed. Just as my daughter was a lovely reverie, so blue and gold and sweetly innocent that I was mortally afraid that, just by being alive, I would infect her with my darkness. But if I died, I would leave the stain of my death on her long after I had ceased, physically, to exist. I had done enough reading to understand the terrible effects of a parent’s suicide on a child and be fully aware of the heightened incidence of future mental disorder it imposes on children, including depression.
The last thing I wanted to do was inflict the horror of this illness on my beloved child.
The last thing I wanted to do was to stay alive.
So what to do?
It was in this mood that I lay on my sofa and watched 9/11 played out on the tiny screen of my portable television. I felt nothing, neither horror nor outrage. It seemed to me inevitable that such things would happen in the world. It was that lack of moral outrage and absence of any feeling that more than anything else, convinced me that I had to do something to ease the terrible grip depression had on me. I was so lost in my own world that I had ceased to have compassion or feeling for any other. If the sight of bodies dropping from a burning building did not horrify me, that absence of feeling did.
The next day, I called my psychiatrist and asked him to admit me to hospital. I also asked Tom to come and sit with me while I waited for a vacant room—not as easy to find as it might sound. Even private psychiatric units are woefully over-subscribed, which says much about the mental health of this nation.
A word about Tom here. We were still seeing each other, although our relationship was erratic and more highly charged than was comfortable, or even tolerable. He had by then separated from his partner who had, some months before, discovered our affair and was justifiably furious, even though as she herself admitted, their relationship had been dead for years.
I felt badly about it. I had betrayed her, and was wretched with guilt and shame; emotions that I could do nothing about because I was, in every respect, in the wrong. That did not change my feelings for Tom; it just made them more complicated and uncomfortable. Nor did the fact that we were both free mean that we were free to settle into a relationship or to love each other well. A good relationship requires more than simple availability.
I loved him, absolutely. If there is such a thing as a complete, all-embracing love for another person who is not our child and is not a part of us, then I felt it for Tom. He was my intimate in every sense. But love goes wrong. Sometimes, it goes so badly wrong even when it is infinitely right, that the pain is catastrophic. And so it was with Tom and me. There were children involved and he put his children, rightly, above all else, above himself and above me. He had known the burden of an absent father and was determined that his children should not suffer in the same way. His unhappiness and his own feelings did not, as he put it, matter. And neither, by extension, did mine.
But strong emotion and need has a habit of making itself felt, even when every right and rational part of us is pushing it away. There are brief glimpses of time when we think we might be happy, when we allow ourselves to feel hope. And then, just as quickly, we realise that we were mistaken and the failure of that hope is more terrible than had it never existed at all.
It was in this way (he was by then fighting as hard for custody of his children as I was fighting severe depression) that we crashed through that year; a most terrible year, for both of us. We loved and fought, were kind and hurt each other, came together and fell apart. We could not be together and we could not stay away from each other. I don’t mean that in any great romantic sense. It was not romantic. It was ugly and bruising and underneath it all was the recognition that we loved each other and recognised some unswerving connection but could not find a way to manage it. There was very little bliss. It was, in its own particular way, hell.
That ruinous love affair did not cause my depression, although it was one of the reasons why it continued, inasmuch as the constant re-experience of hope and loss and profound disappointment is a good enough reason for depression.
I felt, that year, as if my heart broke over and over again. Our inability to sort out or even to embrace the mess that surrounded us
and the weeks or months when Tom disappeared, physically as well as emotionally, into his own misery seemed to lock into some part of me that was already fragile, that part where I felt a sense of profound abandonment, perhaps, or emphasised my unswerving belief that the people I love most will never respond to my unhappiness. I was, by then, too ill to be able to reach out to him or to do anything about the pain that he was so obviously suffering, so felt more than ever helpless and hopeless.
While difficult relationships can cause intolerable pain, to ascribe to a love affair the entire cause and continuation of depression is to profoundly misunderstand the illness. Once severe depression has a hold, it is unshakeable until it has run its course or that course has been diverted by treatment. There were times, weeks and even months, when I thought that Tom and I would be together, and happily. That had no effect at all on the severity of my depression. It carried on, regardless and relentless. It did not lift when he was present and nor did it suddenly return when he left. My mood might have changed. The depression did not. But then you would not expect any other illness to lift according to the person who is standing in front of you, however happy they might make you feel.
As we waited for a vacant hospital room, we lay on my bed at home and Tom read to me from the book On Liberty, by the nineteenth-century philosopher and political economist John Stuart Mill; a particular passion of his at the time. As a teenager, inflamed by social inequities and the rights of women, I too had loved John Stuart Mill, so it seemed right and familiar that Tom should be reading his words to me. I remember the sound of his voice and my head pillowed on his chest and the irony, which did not escape me, of listening to Tom read about liberty as I waited for a call from the loony bin.
This time, rather than being treated in a psychiatric unit in a general hospital, I was admitted to a dedicated mental hospital. When the call came, we loaded a few possessions into Tom’s old VW Beetle and drove the short way to the hospital in silence. Tom carried my case through the smart reception and into the shabby corridors that lay behind it and I felt the sharp click of the metal security doors lock securely behind me.
We stood in the empty room that was to become my home, at least for a while. It held a single bed with a green and brown striped cover, a so-called easy chair covered in worn green nylon that had scratched wooden arms, and a vanity unit of cheap wood veneer that sat squarely below a mirror, stuck firmly to the wall. The window was barred and locked into place, allowing barely two inches of air.
We stared at each other.
‘It could be worse,’ I said, meaning the room.
Tom shook his head sharply and looked away but not before I saw the expression on his face and I knew that it couldn’t. It couldn’t possibly be worse. A psychiatrist appeared to give me an initial assessment and I saw, through Tom’s eyes, the shocking gravity of my situation. I had not, until that moment, truly thought about where I was and why. I was in a mental hospital because I could not manage to stay outside of one and alive, in any meaningful sense.
Tom left soon after.
The first evening, Molly came to visit me wearing her school uniform, and that innocent grey pinafore and red and white gingham shirt looked so out of place under the harsh fluorescent strip lights of the sad green hospital corridors that, had I had the energy and strength, I would have bundled her up and scooped her right out of the door. Instead, I diverted both of us by taking her down to the canteen to have supper, which was served at six o’clock.
I was hoping for pizza or burger and chips, but there was not much she wanted to eat, except white rolls and butter. The catering staff seemed particularly taken with Quorn, that chalky vegetarian substitute for meat. There was curried Quorn, Quorn sausages and Quorn casserole and I remember wondering if there was some weird connection between meat substitutes and mental illness.
Across the room, which was decorated in bright chintz with white painted bamboo furniture like some cheap gastropub, a table of people discussed me in that obtrusive way that people have when they are trying to be discreet. As I buttered Molly’s rolls, I was tempted to stop and write my diagnosis, Severe Clinical Depression, in large black letters on a paper napkin and attach it to my forehead together with a list of my medications. I was by then enough of an old timer to know there are only two pieces of information that are of passionate interest to inmates of a psychiatric unit. ‘What are you in for?’ with its resonance of prison and long sentences and ‘What have they put you on?’
Later, a doctor (medical rather than psychiatric) came and gave me a routine physical check-up. This is usual, for in some cases, depression has a physical cause. Depressed people are also less likely to take care of themselves so are more likely to be suffering from malnutrition or some other condition that may exacerbate their illness. Many of them, too, have been abusing alcohol, with its attendant physical damage.
As the doctor went about his work, he asked me why I was in hospital.
‘I have severe depression.’
‘And why do you think that is?’
Because I enjoy it? ‘I have no idea.’
I was slightly taken aback. It is not usual for medical doctors to embark on psychiatric questions, even in a mental hospital. But this particular doctor seemed intent on blurring the disciplines.
‘You must have some.’
I mumbled something about a marriage breakdown.
He had his face very close to mine, he was checking my heartbeat with a stethoscope at the time. He said, ‘Do you hate men?’
At first, I thought I had misheard him, so I asked him to repeat himself. He came out with the same, trite phrase. I was so angry, I was tempted to hit him but I knew the consequences on my mental health record. ‘Don’t be a fucking idiot,’ I said, and burst into tears, more out of fury than anything else.
Wearing a smug, knowing expression, he tucked his stethoscope back into his pocket.
My mother was there at the time, the only time she was ever present when I was in hospital.
‘Don’t upset yourself,’ she pleaded, after he had left.
‘I am not upsetting myself,’ I said, sobbing. ‘I am being upset by somebody else.’
My mother left soon after.
Later, I wondered if the doctor was actually a patient who had nicked a stethoscope.
I was lucky, inasmuch as I was able to be fairly active. I felt bleak despair, could not eat, read or sleep and was constantly preoccupied with death and dying, but I could get up, get dressed, walk and talk.
Across the hallway, there was someone who could do none of those things. She lay immobile, head covered by a sheet, her inert body forming a long hump like a dune of heavy, wet sand moulded to a single bed. Her open door, through which you could see her terrible immobility, was guarded day and night by a nurse who sat in a grey plastic chair that squeaked as she bent to pick up another back issue of Hello! from the pile of magazines at her feet. Her mind was on Posh and Becks, but her eyes were on suicide.
I never did find out the patient’s name. I knew only that every few hours or so, she would get out of bed and throw herself with thunderous force against the walls, bruising herself badly and cracking her head against the plaster. And then they would pick her up and put her back into bed. And so it went on.
Suicide attempts in psychiatric units are, not surprisingly, frequent and the desperation of the suicidal is, in the old sense of the word, pathetic. The cutlery is plastic and so are the cups in order to avoid serious injury (broken china makes too effective a sharp edge to be allowed) but that does not stop people sawing at their wrists with a barely serrated plastic knife. When I was there, a woman soaked her bed pillows in water then climbed into a full bath and held them over her face. When the staff found her, she was very cold, with skin like a prune. She was also alive and inconsolable at the thought. Another gouged bloody holes in her wrists with a pair of eyebrow tweezers. There was nothing to be done about the glass light bulbs and most of us in there wondered why
it was that they were not used more often, either as blades or ground up and eaten.
The hospital was divided into floors, according to particular conditions. I was on the ground floor, with the depressives—‘the saddos’ as we were known—as well as those suffering from severe anxiety disorders, or both, as depression is often accompanied by severe anxiety. On the floor above us, there were more saddos, depression being the most prevalent of the mental illnesses, and above that was another floor containing the sectioned patients, put there against their will because they were too sick, too violent or simply too unwilling to be admitted voluntarily. On the top floor was the detox unit, for alcoholics and drug addicts (‘alkies and druggies’), who were often moved down to be with the saddos, once they had cleaned up. Then there was the eating disorders unit across the road, containing mainly teenage girls but some older, long-term anorexics and bulimics.
All of us, with the exception of the sectioned patients (or ‘sections’ as they were known) ate together in the canteen. Most conditions clustered at tables together, saddo with saddo, alkie with druggie and the anorexics with a nurse, to supervise their eating. The talk was always of medication (depressives sound like they’ve swallowed medical textbooks whole) or therapy, with particular attention given to the inadequacies, real or imagined, of each therapist.
It was like being back at school; the therapists, like teachers, were each given nicknames, none of them flattering. But that’s what happens when the balance of power is catastrophically disrupted; when you are incapable of fending for yourself or staying alive and feel powerless to do it in any adult sense, you slip easily into the role of the dependant.
It was not long after I had been admitted, perhaps the second day, when I was confronted as I helped myself to a plate of food.
Shoot the Damn Dog: A Memoir of Depression Page 18
