Shoot the Damn Dog: A Memoir of Depression (3 page)

But there is hope. It is just that we need to look further for it than in a handful of pills. We need to see depression holistically, as an illness of mind, body and soul (I hesitate to use that word but I can think of no other) and treat it accordingly.

John F. Greden, MD, the Rachel Upjohn Professor of Psychiatry and Clinical Neuroscience in the University of Michigan Medical School calls depression the ‘under’ disease—as in underdiagnosed, undertreated and underdiscussed. As for its treatment, he is on record as saying,

I believe that, just as I believe that there is no one theory or therapy or drug that can make you, or me, better. Or keep us better. There is no simple cure or magic remedy and there are no happy pills, much as we would like to believe in them. And we do like to believe. I have lost count of the number of people who have said to me, as if it is both an admission of defeat and the end to all their problems, ‘I suppose I had better go on antidepressants.’

Well, why not? If they work, then wonderful. Every weapon in the fight against depression is worth considering and there may come a day when a daily pill is all that’s needed. Until then, for those like me who find that antidepressants are of little or no help there is a different path.

It is not easy, but it is possible. It embraces the various talking therapies and the daily disciplines of walking, yoga and meditation. It uses love and trust and faith—not purely spiritual faith, but faith in life itself. It requires acceptance, humility and a willingness to be open as well as constant self-examination and lacerating honesty. Those are all the tools that I have used to get better and I know that they work. Not just on me but on the others who use them too. Even those who find that antidepressants are an answer to their prayers may find some of the methods in this book useful.

The relapse rate for depressives relying on medication alone is eighty per cent. Nobody knows quite why. Some schools of thought believe that the brain becomes habituated to a particular drug, which then loses its efficacy. Still others believe that the illness mutates or that it is not a singular illness but a cluster of conditions that, at any one time, need different treatments. The illness, like the cure, remains a mystery. When I said to my psychiatrist that it seemed to me that we were no further along than bedlam and leeches, he said that at least we knew what leeches did.

It was that, more than anything, which brought me to the writing of this book. I may have, as the scientists put it, ‘an enduring, debilitating disease’ but I prefer to think of it as an illness that never entirely leaves us but can, with full knowledge and attention, be managed with some degree of grace.

Nigel got his test results back and they were OK. His liver is fragile after many years on a great deal of medication. He still swears by it to control the depression he has suffered since he was in his teens. I don’t, but anything that keeps him away from those sharp corners is fine by me too.

I am walking down the corridor in my flat. The monster is at my throat, claw stuck fast. I cannot eat. I can scarcely breathe. It is ten months since I was diagnosed with severe clinical depression, months without beginning or end. Time moves like treacle, running thick and heavy through my days.

I hate this flat. It is beautiful, a mansion flat two floors up with high ceilings and ornate fireplaces, but I know that behind the façade, the walls are running with tears. My tears. Pain has seeped into the plaster.

The flat is laid out in two parts, with a long, narrow corridor connecting the two. At one end there is a large, light-filled sitting room and two bedrooms, Molly’s and mine. The rooms are painted cream and white, testament to an earlier time when I tried to decorate myself out of the dark.

My bedroom is small; kept dark by the linen curtains which I made myself and which I keep shut fast against the day. The white duvet cover has scorch marks in it from the cigarettes I smoke in the dead of night when I am dragged from sleep by some unknown, unseen terror, but too dazed with sleeping pills to know what I am doing.

At the other end of the corridor is the kitchen, and my study, where I rarely go. Sometimes I venture in to sit at my computer in front of the dead, blank screen and flick idly through my piles of books. They are dusty and sad, with a long neglected air. I never stay in there for long.

The kitchen is huge and half finished, as if somebody has abandoned it in despair. They have. It was me. I decorated half of the flat and then I simply gave up. There are no units, just a few rudimentary cupboards; the fridge is ancient and most of the shelves in it have collapsed. The hot water tap is stuck fast. I haven’t the energy to call a plumber. I’m not sure that I even know how. Sometimes this strikes me as odd. I used to head up a staff of forty and handle a budget of millions. Now, I can’t even call a plumber so I wash up by boiling a kettle for hot water. I no longer think that’s strange. I think it’s normal. When they come to visit, I see the way my friends look at the kettle and then at me. I don’t know how to explain, so I say nothing.

As I walk down the corridor, I keep my hands pressed to the wall because I am shaking so hard I can hardly stand. The next thing I know, I am flat on the ground, my face pressed into the carpet. I think, how did this happen? Did I stumble and fall? I have no recollection of it. It was as if some great hand took me by the throat and flung me to the ground. If I hadn’t been here, I wouldn’t have believed me. I tear at my throat, uselessly, trying to pull the monster away. I think, I will die now. There is no other way.

Or, just one. Vodka. When the pain is this bad, I know of no better anaesthetic than vodka. No prescribed tranquilliser comes close. Believe me, in the past few months I’ve taken them all, with my psychiatrist’s blessing.

He does not bless alcohol but then he’s not in the state I’m in. Nor, oh lucky man, has he ever been. Sometimes I think only those who have suffered severe depression should be allowed to treat those with severe depression. I am sick and tired of theory. I have put on a stone in six weeks. My body feels spongy and heavy, weirdly unfamiliar. It is as if my flesh has been pumped full of a thick viscous liquid. I complain about this to my psychiatrist.

‘You should not put on weight on these particular pills.’

‘Well, I have. And I hardly eat.’

‘There is no evidence to suggest that this medication affects the metabolism.’

I say, ‘I am the evidence.’

Just as I am the evidence that antidepressant medication does not work. Or at least, it does not appear to work on me. We have tried four different types; nothing seems able to lift this dark despair. The most recent makes me shake so badly that at times I can’t hold a cup of tea or a pen. I cannot even write my own name. It also, if that is possible, makes the throat monster worse.

‘It may be the illness reasserting itself,’ says my psychiatrist.

‘Perhaps it’s the medication,’ I suggest. ‘I think it’s poisoning me.’ I don’t show him my tongue, which is coated a deep, dark brown from all the chemicals I daily ingest.

My psychiatrist frowns. Paranoia is a symptom of extreme depression. I hate my medication. I am never happy.

Once the irony of that thought would have made me laugh.

He says, ‘The shaking and the throat may be symptoms of anxiety, which often comes with depression.’

‘I don’t suffer from anxiety. It’s the side-effects of the medication.’

I have been in two psychiatric units. I have seen severe anxiety disorder at first hand. I have, at least, been spared that.

He says nothing.

‘This is all bollocks,’ I say.

I am not a patient patient.

I stumble to my feet and inch along the corridor, hands pressed fast to the wall to steady myself, and knock a framed photograph askew. I collect black and white photographs. There are Norman Parkinson’s women, serene, glacial and unaccountably chic and Andrew Macpherson’s modern girls, smiling and sexy. There is Matt Dillon, from an early photo shoot I did with him on
Vogue
, when he was just another handsome boy and not a famous movie star. And there is Bruce Weber, photographer, filming in Cannes.

I love them. They are beautiful. Now, I knock past them clumsily, as if they do not matter.

My kitchen looks peculiar, as if it is both intensely familiar yet a room I scarcely know. I scrabble in the freezer, pull out a bottle of ice-cold vodka and pour a measure into a glass. My hands are shaking badly. Some of the vodka spills on the wooden table, which I used to polish weekly, with beeswax and soft cloths. I leave the wet puddle, allow the ethanol to eat into the wood. I haven’t the energy to find a cloth.

The vodka burns at my throat but gradually, the heat penetrates and the claw lessens its grip slightly. What time is it? A little after ten in the morning. I try to remember what ten in the morning means, how it feels. But I cannot. Time means nothing to me any more. I stagger back to bed, and try to sleep. Try to pass out. I don’t want sleep. I want oblivion.

There’s a pounding in my ears. It’s muffled as if somebody has put a sack over my head. I open my eyes. My bedroom is dark, the curtains drawn to block the sun, which is shining merrily. I hate the sun. When the sun is shining, I should be happy. I should. I should.

The darkness gathers in my head. It is black, this day. Blacker than black, heavy and suffocating. And the monster is still at my throat. Its form is that of a serpent, with a thick, muscular tail covered in scales that wraps round and around my neck, pulling tight. At its head there is no mouth or eyes, just a single bird’s talon, a black claw tipped with sharp silver. The claw sinks into the front of my throat and hangs fast. I try to reduce its horror by giving it a name, the throat monster. Various therapists suggest that I go one step further and try to befriend it. I think this is facile and ignore their suggestions. I don’t want a cute cartoon, a puppy dog living in my throat. I don’t want it to be my friend. I hate it. I want it to go away. I want drugs, to stop it. Where is modern science when I need it? Why is so little known about mental illness? What is it I am suffering from?

Grief, said a therapist. Unexpressed grief. It’s got you by the throat.

Don’t be absurd, I said at the time. Don’t be so fanciful.

But when I am alone and the monster is tearing at my throat, I think that, whatever it is, it’s going to kill me.

According to my psychiatrist, the monster is not real. He tells me this apologetically, as if I know it already. Which I do. Of course it is not real. It’s not even a monster, but a somatic manifestation of my illness, a mere, clinical symptom of major depressive disorder. The throat monster has a proper psychiatric name, he says, but not a name I’ll like. It is called
Globus hystericus
, a psychological term for ‘lump in the throat’ given to it by Freud. Of course, it must be Freud. Of course, it must manifest most often in women. My psychiatrist’s expression is grave. He knows that I resent that association of hysteria and women.

Even so, I am comforted by the word ‘symptom’ and its cool, empirical note. The reality, even if the lump in my throat is not actually real, is not comforting. It hurts, like a knotted rope thick around my neck, the knot pressed hard to my windpipe. And it never goes away. It is the sensation you get when you are struggling to hold back tears, the tight, aching ball that grows and grows even as you try to swallow it down. I read, somewhere, that crying can relieve the symptoms. It can’t, or not for me anyway. I cry and I cry. I cry so much that sometimes I am astonished there is any water left in my body.

I close my eyes. Time passes. I don’t know how much time. Is it day or is it night? I hear kids shouting on the streets. ‘Fucking wanker.’ School must be out. The shouts are too loud, banging in my head. I put a pillow over my face and push it down to cover my ears. I feel suffocated. The monster rears in my throat. I take the pillow away again.

The shouts diminish, gradually. It is so dark. Why is it so dark? Am I awake? Am I alive? I am. Fuck. I want more vodka, I want a sleeping pill, I want anything to stop me being awake, or alive, but I force myself out of bed to make a cup of tea and a cucumber sandwich. It is the only thing I can eat. That’s if I eat at all.

I slice the cucumber thin, shave butter off a cold block, and lay it on squares of foamy white bread. I hate white bread. Don’t I? I used to. I cut the crusts off, slice the sandwich in neat triangles, and put it on a white plate.

Once I have made the sandwich, I don’t know what to do with it, or where to go. I stand in the kitchen for a while, staring at the plate, at the steaming mug of tea. I remember this mug, remember buying it and how it had to be white and of a certain thickness of china and the handle must be curved just so.

I was standing in Heal’s, during the sale, and I bought six mugs, at half price. They came in a thick brown cardboard box, held shut by wide black staples. It took me hours to get those staples out.

A friend called the other day.

‘How are you?’ she said.

The sun was shining, the sky a merciless blue. It was only eleven in the morning but I had been awake since three twenty. I was in bed because, as usual, I could think of nowhere else to go. I said that I was feeling low. Low is the depressive’s euphemism for despair.

She said: ‘How can you be depressed on a day like this?’

I wanted to say: ‘If I had flu, would you ask me how I could be sick on a day like this?’

I said nothing. She meant well.

People send me cards. The images on the front are inoffensive watercolours of flowers or bland, abstract art. Inside, they write that they are sorry to hear that I’ve been unwell. That they have always thought of me as ‘such a strong person’. My sickness has a moral tone. I am reduced, made feeble. I think, well there is some truth in that. I am a shadow of the self I used to be.

I feel caged, suddenly, impossibly restless. It goes like this, inertia and then profound agitation. I must do something. But what? My daughter, Molly, is with Jonathan, her dad, for three more days. She lives with him for half of the time.

I miss her so.

I am so glad she is not here. The effort of trying to be that person she knows as Mummy is overwhelming.

I want to say to her that I am sorry, I am sorry that it is me who has taken her mother’s place. I want to tell her that she deserves better, that she should have a mother like the mother I used to be, who laughs and bakes and loses gracefully when her daughter cheats at Monopoly. But I can’t. I can’t tell her that her mother has gone, that her mother is lost.

It would break her heart.

And so I struggle on. I drink some tea, retching against the taste, the monster tightening in my throat as if in sympathetic recoil. I pick up the sandwich to take a bite, but abandon it halfway through.

There must be something I can do. Should do. I always did something. I was never still. There was always work to be done, a deadline to meet, a child to look after, a house to run, a garden to tend, books to read, films to see, friends to enjoy. There was never enough time.

Now, there is too much. And there are too few people. And I feel that they have nothing, any longer, to do with me.

I look at the sandwich, at the perfect half circle my teeth have formed. I must eat, I know, but it seems such a laborious process, to pick up the sandwich, to bite, to chew, to swallow.

I get up and look out of the window. People are walking briskly up and down the road. I try to imagine what I would do, if I were out on the street. Where would I be going? I can think of nowhere. The newsagent’s, perhaps, to buy a newspaper. Have I read a newspaper today?

I used to write for the newspapers. Almost all of the nationals, in fact. What was it I had to say? I can see myself, sitting at my computer, head bent, writing furiously, hands flying over the keys. I can’t imagine what must have been in my head to make my hands go so fast.

I look at the bed. I can see no newspaper. Not that I ever read them. I can no longer read. It is the greatest tragedy of my present existence. By the time I get to the end of a sentence, I have forgotten the beginning. Words are no more than patterns on a page. Sometimes, it is better. Sometimes I can manage a few paragraphs, but later I can never remember what it is they said.

It is like being bereaved, this lack of reading, like losing an old and dearly beloved friend. A lifelong friend. I used to read four or five books a week.

I remember reading something by Goethe, about losing reading and losing oneself, and how it struck me at the time.