How do you write about depression from within it? I can barely walk some days, let alone summon words. I wonder if Plath worked when she was sick or waited for the clarity of the in-between days. When did Les Murray write Corniche? It is a poem I come back to every time I’m in this because, despite the variations of our experiences, nothing else describes mine so well. This is the thing – I’ve never been able to describe mine so well. When I’m in it I’m under water under granite and when I’m out of it the experience is a smudge I can’t draw details from. That they made potent, accurate work from either position is testament to their genius. And that of the others who have done so in various fields – William Styron. Allie Brosh, who did it recently and so perceptively in comic form. Speculatively – Michael Leunig. Lars von Trier, whose remarkable film Melancholia may well have been inspired by a stanza in that Murray poem above.
The rogue space rock is on course to snuff your world,
sure. But go acute, and its oncoming fills your day.
The brave die but once? I could go a hundred times a week,
clinging to my pulse with the world’s edge inches away.
(Except it wasn’t: Melancholia was inspired by von Trier’s own depressive bouts, a conversation with his analyst regarding the calm nature of depressives during emergencies, and a series of letters to and from Penelope Cruz.)
As Corniche does from the page, Melancholia to me presents the most familiar and thus most confronting depiction of this type of depression I’ve seen on screen. It’s scary to see something of your own terrifying experiences in the cinema. There is, though, some comfort in this recognition too. Kirsten Dunst’s character’s inability to lift herself into a bathtub, say, is tough to watch in its familiarity, but also reassuring as it marks a leaden body and complete exhaustion as clinical symptoms shared by sufferers – rather than as dramatic exaggerations or as laziness. I can’t find that scene online (nudity, I guess), but this one, despite its apparent ridiculousness, is equally faithful. These artworks are important to me. They serve almost as a validation of my own experience. (Why would I doubt an illness I am currently living? Stigma is strong.) I use them to seek out a particular stanza or scene to match a specific stretch of mental or physical horror. Symptoms outlined on a page can't describe the hell of this – literature has to, film has to. These works, and others, have become my medical texts.
To some degree, they also take the place of the conversations I wish I could have with friends. They are open and unflinching accounts. Conversations are largely shielded and careful. At my weakest and in intense distress I need to find energy in order to downplay and act to make sure friends are comfortable. (This is why people with depression may decline invitations from well-meaning friends to catch up or chat. We don’t have the energy to moderate symptoms.) A cruel jab, that depression is so isolating by nature and often becomes more so when you reveal it honestly. I’m so tired of concealing, though – it’s exhausting and dishonest. It adds to the already pervasive confusion surrounding the condition. It says nothing real about the illness or its effects or what people can do to help.
Over time, I’ve revealed things increasingly honestly. So have others. A long-term drip feed that’s been quickened by the internet, where, slightly detached, I/we can tell the story more frankly. The story’s worth telling. Many people are still uncomfortable about this condition, and this is potentially damaging. Mental illnesses are illnesses like any other and when I am suffering one I don’t feel I should, for example, have to invent other reasons to tell clients why their work is late. So I don’t. I don’t understand the hushed tones. Don't really want them. Using them denotes something shameful. I’m not ashamed and am not crazy, mad, unhinged. I get sick sometimes – with an illness that has a long history of misunderstanding and demonisation that we need to excise ourselves from, because its lingering, muddy residue is terrible for sufferers.
I understand the public difficulty here, though. It’s an elusive condition. Scientifically, we’re still working out why depression and its related illnesses occur and how best to treat them. In an article on the development and era of Prozac and other commonly prescribed SSRI/SNRI family drugs, Pulitzer Prize-winning Siddhartha Mukherjee writes:
“We possess far fewer devices to look into the unknown cosmos of mood and emotion. We can only mix chemicals and spark electrical circuits and hope, indirectly, to understand the brain’s structure and function through their effects. In time, the insights generated by these new theories of depression will most likely lead to new antidepressants: chemicals that directly initiate nerve growth in the hippocampus or stimulate the subcallosal cingulate. These drugs may make Prozac and Paxil obsolete — but any new treatment will owe a deep intellectual debt to our thinking about serotonin in the brain. Our current antidepressants are thus best conceived not as medical breakthroughs but as technological breakthroughs. They are chemical tools that have allowed us early glimpses into our brains and into the biology of one of the most mysterious diseases known to humans.”
The word ‘depression’ itself is arguably a factor in this muddiness too. Late novelist William Styron wrote in his groundbreaking 1989 account of his depression that it is “a true wimp of a word for such a major illness.” He went on, “[...] nonetheless, for over seventy-five years the word has slithered innocuously through the language like a slug, leaving little trace of its intrinsic malevolence and preventing, by its very insipidity, a general awareness of the horrible intensity of the disease when out of control.”
To me, the mildness of the word is not the only problem with it. Its murky definition is key, too. It has broadened and blurred, and this impacts the way the disease is understood. Depression is commonly associated with feeling sad or down, or a little bit mopey. This is the tiniest part of what the illness entails. The in-depth Wikipedia entry on major depression notes: “The term "depression" is ambiguous. It is often used to denote this syndrome but may refer to other mood disorders or to lower mood states lacking clinical significance. Major depressive disorder is a disabling condition that adversely affects a person's family, work or school life, sleeping and eating habits, and general health. In the United States, around 3.4% of people with major depression commit suicide and up to 60% of people who commit suicide had depression or another mood disorder.”
Brutal. Even within medical definitions of depression, there are many subcategories. There are variations of depression, and within those countless triggers and experiences. This isn’t the article for defining them, or for outlining my own medical background. But here, to give some idea of what a severe and debilitating depressive episode is like, is a short account I wrote a couple of weeks back. It was all I could manage at the time and covers only physical symptoms – hence my admiration for those who have communicated more.
I’m groggy. It’s been about ten days and I’m fighting it with all I’ve got. Today was a slight reprieve – enough to try to write from within it, so I’m trying. I’ve never managed this before and then when it’s over I don’t want to think about it and I lose all the details.
Yesterday wasn’t good. I slept on and off from maybe 4am until 2pm. A sweet dream trailed me out into the afternoon and was knocked out within a few seconds by a boulder that pinned everything to the mattress. And so I stayed there for another eight hours until my boyfriend came home. I tried to get up and shower four times but failed so gave up. A couple of days before I had gotten there on the third attempt so knew it was possible.
So yesterday, I would lower myself out of bed and onto my knees on the carpet. I’d wait for the strength to come then crawl forward a few lengths, maybe getting to the bedroom door. At some point there’d be a dilemma – I could crawl further forward and try to reach the kitchen and a snack that might sustain me through the shower process, or I could lay down. Exhausted, I would likely lay down, or if I made it to the kitchen I’d lay down there. And by this point the snack and the shower were not worth it, so after recuperating on the ground I’d make the reverse journey back to bed. The closest I came was my final effort, when I made it to a jar of golden syrup and spooned it in like a desperate woman throwing petrol at a cold fire.
So my days go. Time does its own thing – there’s no relationship between us anymore. I’m on my knees and elbows on the ground, working out whether to move forward or lower myself to the carpet. Twenty minutes pass and all I have done is compute this. By the time I return to the bed I have always been gone for more than an hour.
Les Murray’s more rounded version in his excellent book Killing the Black Dog goes:
"...helpless, bottomless misery in which I would lie curled in a foetal position on the sofa with tears leaking from my eyes, my brain boiling with a confusion of stuff not worth calling thought or imagery: it was more like shredded mental kelp marinaded in pure pain."
I haven’t really defined what depression is here. I’m not even sure. (If anything, it is the words in bold above). I just wanted to talk about it. The links throughout are worth reading – they help to broaden things.
As a post-script, and to come full circle: a poem and an article about loved ones who are lifelines. Who you never have to act for and on whom the burden is massive. I am incredibly lucky, and very grateful.
From Mark Lukach's account of helping his wife through her illness:
When the suicidal feelings gripped her tightly, her whole body groaned and wailed over the loss of control of mind and feelings. I would hold her, but I learned that all I could do in those moments was to sit there and let it be, so I did. And then the fog would clear, the suicidal impulses would slip back under the surface, and the muted, agreeable Giulia would return.
“Are you O.K. now, honey?”
“Do you know how proud of you I am, and how much I love you?”
“Are you ready to get back on the bike and go home?”
And this, from Murray. I wish I'd written it.