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Reasons to Stay Alive

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Aged 24, Matt Haig's world caved in. He could see no way to go on living. This is the true story of how he came through crisis, triumphed over an illness that almost destroyed him and learned to live again.

A moving, funny and joyous exploration of how to live better, love better and feel more alive, Reasons to Stay Alive is more than a memoir. It is a book about making the most of your time on earth.

'I wrote this book because the oldest clichés remain the truest. Time heals. The bottom of the valley never provides the clearest view. The tunnel does have light at the end of it, even if we haven't been able to see it . . . Words, just sometimes, really can set you free.'
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hey im here nice book
23 June 2017 (20:54) 
thanks , sei molto gentile
13 December 2018 (18:46) 
Thanks, for this site I am able to educate myself. I love you all, so kind for you. I hope that I can donate to you in the future when I have my job. For now, all I can do is to thank you. I appreciate every one of you.
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The Last Family in England
The Dead Fathers Club
The Possession of Mr Cave
The Radleys
The Humans
Humans: An A-Z


Edinburgh · London

Published in Great Britain in 2015 by
 Canongate Books Ltd,
 14 High Street,
 Edinburgh EH1 1TE
This digital edition first published in 2015 by Canongate Books
Copyright © 2015, Matt Haig
For permissions credits please see here.
Every effort has been made to trace copyright holders and obtain their permission for the use of copyright material.
 The publisher apologises for any errors or omissions and would be grateful if notified of any corrections that should be incorporated in future reprints or editions of this book.
The moral right of the author has been asserted
British Library Cataloguing-in-Publication Data
 A catalogue record for this book is available on request from the British Library
ISBN 978 1 78211 508 3
 eISBN 978 1 78211 509 0
Typeset in Granjon 12.5/20pt by Palimpsest Book Production Ltd, Falkirk, Stirlingshire.

For Andrea

This book is impossible
A note, before we get fully under way
1 Falling
The day I died
Why depression is hard to understand
A beautiful view
A conversation across time – part one
Things people say to depressives that they don’t say in other life-threatening situations
Negative placebo
Feeling the rain without an umbrella
The hope that hadn’t happened
The cyclone
My symptoms
The Bank of Bad Days
Things depression says to you
The head against the window
Pretty normal childhood
A visit
Boys don’t cry
2 Landing
Cherry blossom
Unknown unknowns
The brain is the body – part one
Jenga days
Warning signs
3 Rising
Things you think during your first panic attack
Things you think during your 1,000th panic attack
The art of walking on your own
A conversation across time – part two
Reasons to stay alive
How to be there for someone with depression or anxiety
An inconsequential moment
Things that have happened ; to me that have generated more sympathy than depression
Life on Earth to an alien
White space
The Power and the Glory
Reasons to be strong
The brain is the body – part two
Famous people
Abraham Lincoln and the fearful gift
Depression is . . .
Depression is also . . .
A conversation across time – part three
4 Living
The world
Mushroom clouds
The Big A
Slow down
Peaks and troughs
Things that make me worse
Things that (sometimes) make me better
5 Being
In praise of thin skins
How to be a bit happier than Schopenhauer
Thoughts on time
Images on a screen
How to live (forty pieces of advice I feel to be helpful but which I don’t always follow)
Things I have enjoyed since the time I thought I would never enjoy anything again
Further Reading
A note, and some acknowledgements
Permissions credits

This book is impossible
THIRTEEN YEARS AGO I knew this couldn’t happen.
I was going to die, you see. Or go mad.
There was no way I would still be here. Sometimes I doubted I would even make the next ten minutes. And the idea that I would be well enough and confident enough to write about it in this way would have been just far too much to believe.
One of the key symptoms of depression is to see no hope. No future. Far from the tunnel having light at the end of it, it seems like it is blocked at both ends, and you are inside it. So if I could have only known the future, that there would be one far brighter than anything I’d experienced, then one end of that tunnel would have been blown to pieces, and I could have faced the light. So the fact that this book exists is proof that depression lies. Depression makes you think things that are wrong.

But depression itself isn’t a lie. It is the most real thing I’ve ever experienced. Of course, it is invisible.
To other people, it sometimes seems like nothing at all. You are walking around with your head on fire and no one can see the flames. And so – as depression is largely unseen and mysterious – it is easy for stigma to survive. Stigma is particularly cruel for depressives, because stigma affects thoughts and depression is a disease of thoughts.
When you are depressed you feel alone, and that no one is going through quite what you are going through. You are so scared of appearing in any way mad you internalise everything, and you are so scared that people will alienate you further you clam up and don’t speak about it, which is a shame, as speaking about it helps. Words – spoken or written – are what connect us to the world, and so speaking about it to people, and writing about this stuff, helps connect us to each other, and to our true selves.
I know, I know, we are humans. We are a clandestine species. Unlike other animals we wear clothes and do our procreating behind closed doors. And we are ashamed when things go wrong with us. But we’ll grow out of this, and the way we’ll do it is by speaking about it. And maybe even through reading and writing about it.

I believe that. Because it was, in part, through reading and writing that I found a kind of salvation from the dark. Ever since I realised that depression lied about the future I have wanted to write a book about my experience, to tackle depression and anxiety head-on. So this book seeks to do two things. To lessen that stigma, and – the possibly more quixotic ambition – to try and actually convince people that the bottom of the valley never provides the clearest view. I wrote this because the oldest clichés remain the truest. Time heals. The tunnel does have light at the end of it, even if we aren’t able to see it. And there’s a two-for-one offer on clouds and silver linings. Words, just sometimes, can set you free.

A note, before we get fully under way
MINDS ARE UNIQUE. They go wrong in unique ways. My mind went wrong in a slightly different way to how other minds go wrong. Our experience overlaps with other people’s, but it is never exactly the same experience. Umbrella labels like ‘depression’ (and ‘anxiety’ and ‘panic disorder’ and ‘OCD’) are useful, but only if we appreciate that people do not all have the same precise experience of such things.
Depression looks different to everyone. Pain is felt in different ways, to different degrees, and provokes different responses. That said, if books had to replicate our exact experience of the world to be useful, the only books worth reading would be written by ourselves.
There is no right or wrong way to have depression, or to have a panic attack, or to feel suicidal. These things just are. Misery, like yoga, is not a competitive sport. But I have found over the years that by reading about other people who have suffered, survived and overcome despair I have felt comforted. It has given me hope. I hope this book can do the same.


‘But in the end one needs more courage to live than to kill himself.’
—Albert Camus, A Happy Death

The day I died
I CAN REMEMBER the day the old me died.
It started with a thought. Something was going wrong. That was the start. Before I realised what it was. And then, a second or so later, there was a strange sensation inside my head. Some biological activity in the rear of my skull, not far above my neck. The cerebellum. A pulsing or intense flickering, as though a butterfly was trapped inside, combined with a tingling sensation. I did not yet know of the strange physical effects depression and anxiety would create. I just thought I was about to die. And then my heart started to go. And then I started to go. I sank, fast, falling into a new claustrophobic and suffocating reality. And it would be way over a year before I would feel anything like even half-normal again.
Up until that point I’d had no real understanding or awareness of depression, except that I knew my mum had suffered from it for a little while after I was born, and that my great-grandmother on my father’s side had ended up committing suicide. So I suppose there had been a family history, but it hadn’t been a history I’d thought about much.
Anyway, I was twenty-four years old. I was living in Spain – in one of the more sedate and beautiful corners of the island of Ibiza. It was September. Within a fortnight, I would have to return to London, and reality. After six years of student life and summer jobs. I had put off being an adult for as long as I could, and it had loomed like a cloud. A cloud that was now breaking and raining down on me.
The weirdest thing about a mind is that you can have the most intense things going on in there but no one else can see them. The world shrugs. Your pupils might dilate. You may sound incoherent. Your skin might shine with sweat. And there was no way anyone seeing me in that villa could have known what I was feeling, no way they could have appreciated the strange hell I was living through, or why death seemed such a phenomenally good idea.
I stayed in bed for three days. But I didn’t sleep. My girlfriend Andrea came in with water at regular intervals, or fruit, which I could hardly eat.

The window was open to let fresh air in, but the room was still and hot. I can remember being stunned that I was still alive. I know that sounds melodramatic, but depression and panic only give you melodramatic thoughts to play with. Anyway, there was no relief. I wanted to be dead. No. That’s not quite right. I didn’t want to be dead, I just didn’t want to be alive. Death was something that scared me. And death only happens to people who have been living. There were infinitely more people who had never been alive. I wanted to be one of those people. That old classic wish. To never have been born. To have been one of the three hundred million sperm that hadn’t made it.
(What a gift it was to be normal! We’re all walking on these unseen tightropes when really we could slip at any second and come face to face with all the existential horrors that only lie dormant in our minds.)
There was nothing much in this room. There was a bed with a white patternless duvet, and there were white walls. There might have been a picture on the wall but I don’t think so. I certainly can’t remember one. There was a book by the bed. I picked it up once and put it back down. I couldn’t focus for as much as a second. There was no way I could express fully this experience in words, because it was beyond words. Literally, I couldn’t speak about it properly. Words seemed trivial next to this pain.
I remembered worrying about my younger sister, Phoebe. She was in Australia. I worried that she, my closest genetic match, would feel like this. I wanted to speak to her but knew I couldn’t. When we were little, at home in Nottinghamshire, we had developed a bed-time communication system of knocking on the wall between our rooms. I now knocked on the mattress, imagining she could hear me all the way through the world.
Knock. Knock. Knock.
I didn’t have terms like ‘depression’ or ‘panic disorder’ in my head. In my laughable naivety I did not really think that what I was experiencing was something that other people had ever felt. Because it was so alien to me I thought it had to be alien to the species.
‘Andrea, I’m scared.’
‘It’s okay. It’s going to be okay. It’s going to be okay.’
‘What’s happening to me?’
‘I don’t know. But it’s going to be okay.’

‘I don’t understand how this can be happening.’
On the third day, I left the room and I left the villa, and I went outside to kill myself.

Why depression is hard to understand
It is not ‘feeling a bit sad’.
It is the wrong word. The word depression makes me think of a flat tyre, something punctured and unmoving. Maybe depression minus anxiety feels like that, but depression laced with terror is not something flat or still. (The poet Melissa Broder once tweeted: ‘what idiot called it “depression” and not “there are bats living in my chest and they take up a lot of room, ps. I see a shadow”?’) At its worst you find yourself wishing, desperately, for any other affliction, any physical pain, because the mind is infinite, and its torments – when they happen – can be equally infinite.
You can be a depressive and be happy, just as you can be a sober alcoholic.

It doesn’t always have an obvious cause.
It can affect people – millionaires, people with good hair, happily married people, people who have just landed a promotion, people who can tap dance and do card tricks and strum a guitar, people who have no noticeable pores, people who exude happiness in their status updates – who seem, from the outside, to have no reason to be miserable.
It is mysterious even to those who suffer from it.

A beautiful view
THE SUN WAS beating hard. The air smelt of pine and the sea. The sea was right there, just below the cliff. And the cliff edge was only a few steps away. No more than twenty, I would say. The only plan I had was to take twenty-one steps in that direction.
‘I want to die.’
There was a lizard near my feet. A real lizard. I felt a kind of judgement. The thing with lizards is that they don’t kill themselves. Lizards are survivors. You take off their tail and another grows back. They aren’t mopers. They don’t get depressed. They just get on with it, however harsh and inhospitable the landscape. I wanted, more than anything, to be that lizard.
The villa was behind me. The nicest place I had ever lived. In front of me, the most glorious view I had ever seen. A sparkling Mediterranean, looking like a turquoise tablecloth scattered with tiny diamonds, fringed by a dramatic coastline of limestone cliffs and small, near-white forbidden beaches. It fit almost everyone’s definition of beautiful. And yet, the most beautiful view in the world could not stop me from wanting to kill myself.
A little over a year before I had read a lot of Michel Foucault for my MA. Much of Madness and Civilization. The idea that madness should be allowed to be madness. That a fearful, repressive society brands anyone different as ill. But this was illness. This wasn’t having a crazy thought. This wasn’t being a bit wacky. This wasn’t reading Borges or listening to Captain Beefheart or smoking a pipe or hallucinating a giant Mars bar. This was pain. I had been okay and now, suddenly, I wasn’t. I wasn’t well. So I was ill. It didn’t matter if it was society or science’s fault. I simply did not – could not – feel like this a second longer. I had to end myself.
I was going to do it as well. While my girlfriend was in the villa, oblivious, thinking that I had just needed some air.
I walked, counting my steps, then losing count, my mind all over the place.
‘Don’t chicken out,’ I told myself. Or I think I told myself. ‘Don’t chicken out.’
I made it to the edge of the cliff. I could stop feeling this way simply by taking another step. It was so preposterously easy – a single step – versus the pain of being alive.
Now, listen. If you have ever believed a depressive wants to be happy, you are wrong. They could not care less about the luxury of happiness. They just want to feel an absence of pain. To escape a mind on fire, where thoughts blaze and smoke like old possessions lost to arson. To be normal. Or, as normal is impossible, to be empty. And the only way I could be empty was to stop living. One minus one is zero.
But actually, it wasn’t easy. The weird thing about depression is that, even though you might have more suicidal thoughts, the fear of death remains the same. The only difference is that the pain of life has rapidly increased. So when you hear about someone killing themselves it’s important to know that death wasn’t any less scary for them. It wasn’t a ‘choice’ in the moral sense. To be moralistic about it is to misunderstand.
I stood there for a while. Summoning the courage to die, and then summoning the courage to live. To be. Not to be. Right there, death was so close. An ounce more terror, and the scales would have tipped. There may be a universe in which I took that step, but it isn’t this one.

I had a mother and a father and a sister and a girlfriend. That was four people right there who loved me. I wished like mad, in that moment, that I had no one at all. Not a single soul. Love was trapping me here. And they didn’t know what it was like, what my head was like. Maybe if they were in my head for ten minutes they’d be like, ‘Oh, okay, yes, actually. You should jump. There is no way you should feel this amount of pain. Run and jump and close your eyes and just do it. I mean, if you were on fire I could put a blanket around you, but the flames are invisible. There is nothing we can do. So jump. Or give me a gun and I’ll shoot you. Euthanasia.’
But that was not how it worked. If you are depressed your pain is invisible.
Also, if I’m honest, I was scared. What if I didn’t die? What if I was just paralysed, and I was trapped, motionless, in that state, for ever?
I think life always provides reasons to not die, if we listen hard enough. Those reasons can stem from the past – the people who raised us, maybe, or friends or lovers – or from the future – the possibilities we would be switching off.
And so I kept living. I turned back towards the villa and ended up throwing up from the stress of it all.

A conversation across time – part one
THEN ME: I want to die.
NOW ME: Well, you aren’t going to.
THEN ME: That is terrible.
NOW ME: No. It is wonderful. Trust me.
THEN ME: I just can’t cope with the pain.
NOW ME: I know. But you are going to have to. And it will be worth it.
THEN ME: Why? Is everything perfect in the future?
NOW ME: No. Of course not. Life is never perfect. And I still get depressed from time to time. But I’m at a better place. The pain is never as bad. I’ve found out who I am. I’m happy. Right now, I am happy. The storm ends. Believe me.
THEN ME: I can’t believe you.
NOW ME: Why?

THEN ME: You are from the future, and I have no future.
NOW ME: I just told you . . .

I HAD GONE days without proper food. I hadn’t noticed the hunger because of all the other crazy stuff that was happening to my body and brain. Andrea told me I needed to eat. She went to the fridge and got out a carton of Don Simon gazpacho (in Spain they sell it like fruit juice).
‘Drink this,’ she said, unscrewing the cap and handing it over.
I took a sip. The moment I tasted it was the moment I realised how hungry I was so I swallowed some more. I’d probably had half the carton before I had to go outside and throw up again. Admittedly, throwing up from drinking Don Simon gazpacho might not be the surest sign of illness in the world, but Andrea wasn’t taking her chances.
‘Oh God,’ she said. ‘We’re going now.’
‘Where?’ I said.
‘To the medical centre.’
‘They’ll make me take pills,’ I said. ‘I can’t take pills.’

‘Matt. You need pills. You are beyond the point at which not taking pills is an option. We’re going, okay?’
I added a question mark in there, but I don’t really remember it as a question. I don’t know what I answered, but I do know that we went to the medical centre. And that I got pills.
The doctor studied my hands. They were shaking. ‘So how long did the panic last?’
‘It hasn’t really stopped. My heart is beating too fast still. I feel weird.’ Weird nowhere near covered it. I don’t think I added to it, though. Just speaking was an intense effort.
‘It is adrenaline. That is all. How is your breathing. Have you hyperventilated?’
‘No. It is just my heart. I mean, my breathing feels . . . weird . . . but everything feels weird.’
He felt my heart. He felt it with his hand. Two fingers pressed into my chest. He stopped smiling.
‘Are you on drugs?’
‘Have you taken any?’
‘In my life, yes. But not this week. I’d been drinking a lot, though.’

‘Vale, vale, vale,’ he said. ‘You need diazepam. Maximum. The most I am able to give for you.’ For a doctor in a country where you could get diazepam freely over the counter, like it was paracetamol or ibuprofen, this was quite a significant thing to say. ‘This will fix you. I promise.’
I lay there, and imagined the tablets were working. For a moment panic simmered down to a level of heavy anxiety. But that feeling of momentary relaxation actually triggered more panic. And this was a flood. I felt everything pull away from me, like when Brody is sitting on the beach in Jaws and thinks he sees the shark. I was lying there on a sofa but I felt a literal pulling away. As if something was sliding me towards a further distance from reality.

SUICIDE IS NOW – in places including the UK and US – a leading cause of death, accounting for over one in a hundred fatalities. According to figures from the World Health Organization, it kills more people than stomach cancer, cirrhosis of the liver, colon cancer, breast cancer, and Alzheimer’s. As people who kill themselves are, more often than not, depressives, depression is one of the deadliest diseases on the planet. It kills more people than most other forms of violence – warfare, terrorism, domestic abuse, assault, gun crime – put together.
Even more staggeringly, depression is a disease so bad that people are killing themselves because of it in a way they do not kill themselves with any other illness. Yet people still don’t think depression really is that bad. If they did, they wouldn’t say the things they say.

Things people say to depressives that they don’t say in other life-threatening situations
‘COME ON, I know you’ve got tuberculosis, but it could be worse. At least no one’s died.’
‘Why do you think you got cancer of the stomach?’
‘Yes, I know, colon cancer is hard, but you want to try living with someone who has got it. Sheesh. Nightmare.’
‘Oh, Alzheimer’s you say? Oh, tell me about it, I get that all the time.’
‘Ah, meningitis. Come on, mind over matter.’
‘Yes, yes, your leg is on fire, but talking about it all the time isn’t going to help things, is it?’

‘Okay. Yes. Yes. Maybe your parachute has failed. But chin up.’

Negative placebo
MEDICATION DIDN’T WORK for me. I think I was partly to blame.
In Bad Science Ben Goldacre points out that ‘You are a placebo responder. Your body plays tricks on your mind. You cannot be trusted.’ This is true, and it can surely work both ways. During that very worst time, when depression co-existed with full-on 24/7 panic disorder, I was scared of everything. I was, quite literally, scared of my shadow. If I looked at an object – shoes, a cushion, a cloud – for long enough then I would see some malevolence inside it, some negative force that, in an earlier and more superstitious century, I might have interpreted as the Devil. But the thing I was most scared of was drugs or anything (alcohol, lack of sleep, sudden news, even a massage) that would change my state of mind.
Later, during lesser bouts of anxiety, I would often find myself enjoying alcohol too much. That soft warm cushioning of existence that is so comforting you end up forgetting the hangover that will ensue. After important meetings I would find myself in bars alone, drinking through the afternoon and nearly missing the last train home. But in 1999 I was years away from being back to this relatively normal level of dysfunction.
It is a strange irony that it was during the period when I most needed my mind to feel better, that I didn’t want to actively interfere with my mind. Not because I didn’t want to be well again, but because I didn’t really believe feeling well again was possible, or far less possible than feeling worse. And worse was terrifying.
So I think part of the problem was that a reverse placebo effect was going on. I would take the diazepam and instantly panic, and the panic increased the moment I felt the drug have any effect at all. Even if it was a good effect.
Months later a similar thing would happen when I started taking St John’s Wort. It would even happen to a degree with ibuprofen. So clearly the diazepam wasn’t entirely to blame. And diazepam is far from being the strongest medication out there. Yet the feeling and level of disconnection I felt on diazepam is something others claim to feel on it too, and so I think that the drug itself (for me) was at least part of the problem.

Feeling the rain without an umbrella
MEDICATION IS AN incredibly attractive concept. Not just for the person with depression, or the person running a pharmaceutical firm, but for society as a whole. It underlines the idea we have hammered into us by the hundred thousand TV ads we have seen that everything can be fixed by consuming things. It fosters a just-shut-up-and-take-the-pill approach, and creates an ‘us’ and ‘them’ divide, where everyone can relax and feel ‘unreason’ – to borrow Michel Foucault’s favourite word – is being safely neutered in a society which demands we be normal even as it drives us insane.
But anti-depressants and anti-anxiety medication still fill me with fear. It doesn’t help that the names – Fluoxetine, Venlafaxine, Propranolol, Zopiclone – sound like sci-fi villains.
The only drugs I ever took that seemed to make me feel a bit better were sleeping pills. I only had one packet of them because we’d bought them in Spain, where the pharmacists wear reassuring white coats and talk like doctors. Dormidina was the brand name, I think. They didn’t help me sleep but they helped me be awake without feeling total terror. Or distanced me from that terror. But I also knew that they would be very easy to become addicted to, and that the fear of not taking them could rapidly overtake the fear of taking them.
The sleeping tablets enabled me to function enough to go home. I can remember our last day in Spain. I was now sitting at the table, saying nothing as Andrea explained to the people we were working for and technically living with (it was their villa, but they were rarely there) – Andy and Dawn – that we were going home.
Andy and Dawn were good people. I liked them. They were a few years older than me and Andrea, but they were always easy to be around. They ran the largest party in Ibiza, Manumission, which had begun as a small night in Manchester’s gay village a few years before and morphed into a kind of Studio 54 in the Med. By 1999, it was the epicentre of club culture, a magnet for the likes of Kate Moss, Jade Jagger, Irvine Welsh, Jean Paul Gaultier, the Happy Mondays, Fatboy Slim and thousands of European clubbers. It had once seemed like heaven, but now the idea of all that music and all those party people seemed like a nightmare.
But Andy and Dawn didn’t want Andrea to leave.
‘Why don’t you stay here? Matt would be okay. He looks fine.’
‘He’s not fine,’ Andrea answered them. ‘He’s ill.’
I was – by Ibiza standards at least – not a drug person. I was an alcohol person. A Bukowski-worshipping eternal student who had spent my time on the island sitting down in the sun selling tickets at an outside box office while reading airport novels (during my day job selling tickets, I had befriended a magician named Carl who gave me John Grisham novels in exchange for Margaret Atwood and Nietzsche) and drinking booze. But still, I wished madly I’d never taken anything in my life stronger than a coffee. I certainly wished I hadn’t drunk so many bottles of Viña Sol and glasses of vodka and lemon during the last month, or had eaten a few proper breakfasts, or got a bit more sleep.
‘He doesn’t look ill.’ Dawn still had glitter on her face from wherever she had been the night before. The glitter troubled me.

‘I’m sorry,’ I said, weakly, wishing for a more visible illness.
Guilt smashed me like a hammer.
I took another sleeping pill and then my afternoon dose of diazepam and we went to the airport. The party was over.
While on diazepam or the sleeping pills, I never felt any closer to being ‘fixed’. I stayed exactly as ill as ever. The most pills could do, I supposed, was place a distance there. The sleeping pills forced my brain to slow down a bit, but I knew nothing had really changed. Just as, years later, when I was back to drinking alcohol again, I would often cope with lower-level anxiety by getting drunk, all the time knowing that it would be there waiting for me with a hangover on top.
I am reluctant to come out and be anti all pills because I know for some people some pills work. In some cases they seem to numb the pain enough for the good, real work of getting better to happen. In others, they provide a partial long-term solution. Many people can’t do without them. In my case, after my disorientating diazepam panic attacks I had been so scared to take pills that I never actually took anything directly for my depression (as opposed to panic and anxiety).
Personally, for me, I am happy that I largely mended myself without the aid of medication, and feel that having to experience the pain minus any ‘anaesthetic’ meant I got to know my pain very well, and become alert to the subtle upward or downward shifts in my mind. Though I do wonder whether, if I’d had the courage to battle those pill-fearing panic attacks, it could have lessened the pain. It was such relentless, continuous pain that just to think about it now affects my breathing, and my heart can go. I think of being in the passenger seat of a car, as leaden terror swamped me. I had to rise in my seat, my head touching the roof of the car, my body trying to climb out of itself, skin crawling, mind whirring faster than the dark landscape. It would have been good not to have known that kind of terror, and if a pill could have helped, then I should have taken it. If I’d had something to lessen that mental agony (and really that is the word) then maybe it would have been easier to recover from. But by not taking it, I became very in tune with myself. This helped me know what exactly made me feel better (exercise, sunshine, sleep, intense conversation, etc.) and this alertness, an alertness I know from myself and others can be lost via pills, eventually helped me build myself back up from scratch. If I had been dulled or felt that otherness meds can make you feel, things might have been harder.
Here is Professor Jonathan Rottenberg, an evolutionary psychologist and author of The Depths, writing in 2014 words that are strangely comforting:
How will we better contain depression? Expect no magic pill. One lesson learned from treating chronic pain is that it is tough to override responses that are hardwired into the body and mind. Instead, we must follow the economy of mood where it leads, attending to the sources that bring so many into low mood states – think routines that feature too much work and too little sleep. We need broader mood literacy and an awareness of tools that interrupt low mood states before they morph into longer and more severe ones. These tools include altering how we think, the events around us, our relationships, and conditions in our bodies (by exercise, medication, or diet).

SEVEN MONTHS BEFORE I first swallowed a diazepam tablet I had been in the office of a recruitment agency in central London.
‘So what do you want to do with your life?’ the recruitment agent asked. She had a long solemn face, like a sculpture on Easter Island.
‘I don’t know.’
‘Do you see yourself as a sales person?’
‘Maybe,’ I lied. I was mildly hungover. (We were living next to a pub. Three pints of lager and a Black Russian or two was my nightly routine.) I had very little idea of what I wanted to do with my life but I was pretty sure it didn’t involve being a sales person.
‘To be honest, your CV presents something of a foggy image. But it’s April. Not graduate season. So we should be able to find you something.’
And she was right. After a series of disastrous interviews, I got a job selling advertising space for journalist trade paper the Press Gazette in Croydon. I was placed under the supervision of an Australian called Iain, who explained to me the fundamentals of selling.
‘Have you heard of Aida?’ he asked me.
‘The opera?’
‘What? No. AIDA. Attention. Interest. Desire. Action. The four stages of a sales call. You get their attention, then their interest, then their desire to do something, before they want to commit to an action.’
Then he told me, from nowhere. ‘I’ve got an enormous penis.’
‘See? I’ve got your attention.’
‘So, I should talk about my penis.’
‘No. It was an example.’
‘Got it,’ I said, staring out of the window at a bleak grey Croydon sky.
I didn’t really get on with Iain. True, he asked me to ‘join the boys’ at lunch, and have a pint and a game of pool. It was all dirty jokes and football and slagging off their girlfriends. I hated it. I hadn’t felt this out of place since I was thirteen. The plan – mine and Andrea’s – had been to sort our lives out so we didn’t have to go back to Ibiza that summer. But one lunch break I felt this intense bleakness inside me as if a cloud had passed over my soul. I literally couldn’t stomach another hour phoning people who didn’t want to be phoned. So I left the job. Just walked out. I was a failure. A quitter. I had nothing at all on the horizon. I was sliding down, becoming vulnerable to an illness that was waiting in the wings. But I didn’t realise it. Or didn’t care. I was just thinking of escape.

A HUMAN BODY is bigger than it looks. Advances in science and technology have shown that, really, a physical body is a universe in itself. Each of us is made up of roughly a hundred trillion cells. In each of those cells is roughly that same number again of atoms. That is a lot of separate components. Our brains alone have a hundred billion brain cells, give or take a few billion.
Yet most of the time we do not feel the near-infinite nature of our physical selves. We simplify by thinking about ourselves in terms of our larger pieces. Arms, legs, feet, hands, torso, head. Flesh, bones.
A similar thing happens with our minds. In order to cope with living they simplify themselves. They concentrate on one thing at a time. But depression is a kind of quantum physics of thought and emotion. It reveals what is normally hidden. It unravels you, and everything you have known. It turns out that we are not only made of the universe, of ‘star-stuff’ to borrow Carl Sagan’s phrase, but we are as vast and complicated as it too. The evolutionary psychologists might be right. We humans might have evolved too far. The price for being intelligent enough to be the first species to be fully aware of the cosmos might just be a capacity to feel a whole universe’s worth of darkness.

The hope that hadn’t happened
MY MUM AND dad were at the airport. They stood there looking tired and happy and worried all at once. We hugged. We drove back.
I was better. I was better. I had left my demons behind in the Mediterranean and now I was fine. I was still on sleeping pills and diazepam but I didn’t need them. I just needed home. I just needed Mum and Dad. Yes. I was better. I was still a little bit edgy, but I was better. I was better.
‘We were so worried,’ Mum said, and eighty-seven other variations of that theme.
Mum turned around in the passenger seat and looked at me and smiled and the smile had a slightly crumpled quality, her eyes glazed with tears. I felt it. The weight of Mum. The weight of being a son that had gone wrong. The weight of being loved. The weight of being a disappointment. The weight of being a hope that hadn’t happened the way it should have.

I was better. A little bit frayed. But that was understandable. I was better, essentially. I could still be the hope. I might end up living until I am ninety-seven. I could be a lawyer or a brain surgeon or a mountaineer or a theatre director yet. It was early days. Early days. Early days.
It was night outside the window. Newark 24. Newark was where I had grown up and where I was going back to. A market town of 40,000 people. It was a place I had only ever wanted to escape, but now I was going back. But that was fine. I thought of my childhood. I thought of happy and unhappy days at school, and the continual battle for self-esteem. 24. I was twenty-four. The road sign seemed to be a statement from fate. Newark 24. We knew this would happen. All that was missing was my name.
I remember we had a meal around the kitchen table and I didn’t say much, but just enough to prove I was okay and not crazy or depressed. I was okay. I was not crazy or depressed.
I think it was a fish pie. I think they had made it especially. Comfort food. It made me feel good. I was sitting around the table eating fish pie. It was half past ten. I went to the downstairs toilet, and pulled the light on with a string. The downstairs bathroom was a kind of dark pink. I pissed, I flushed, and I began to notice my mind was changing. There was a kind of clouding, a shifting of psychological light.
I was better. I was better. But it only takes a doubt. A drop of ink falls into a clear glass of water and clouds the whole thing. So the moment after I realised I wasn’t perfectly well was the moment I realised I was still very ill indeed.

The cyclone
DOUBTS ARE LIKE swallows. They follow each other and swarm together. I stared at myself in the mirror. I stared at my face until it was not my face. I went back to the table and sat down and I did not say how I was feeling to anyone. To say how I was feeling would lead to feeling more of what I was feeling. To act normal would be to feel a bit more normal. I acted normal.
‘Oh, look at the time,’ Mum said, with dramatic urgency. ‘I have to get up for school tomorrow.’ (She was a head teacher at an infant school.)
‘You go to bed,’ I said.
‘Yes, you go up, Mary,’ Andrea said. ‘We can sort out the beds and stuff.’
‘There’s a bed and there’s a mattress on the floor in his room, but you are welcome to have our bed if you like for tonight,’ said Dad.
‘It’s okay,’ I said. ‘We’ll be fine.’

Dad squeezed my shoulder before he went to bed. ‘It’s good to have you here.’
‘Yes. It’s good to be here.’
I didn’t want to cry. Because a) I didn’t want him to see me cry, and b) if I cried I would feel worse. So, I didn’t cry. I went to bed.
And the next day I woke up, and it was there. The depression and anxiety, both together. People describe depression as a weight, and it can be. It can be a real physical weight, as well as a metaphorical, emotional one. But I don’t think weight is the best way to describe what I felt. As I lay there, on the mattress on the floor – I had insisted Andrea sleep on the bed, not out of straightforward chivalry but because that is what I would have done if I was normal – I felt like I was trapped in a cyclone. Outwardly, to others, I would over the next few months look a bit slower than normal, a bit more lethargic, but the experience going on in my mind was always relentlessly and oppressively fast.

My symptoms
THESE WERE SOME of the other things I also felt:
Like my reflection showed another person.
A kind of near-aching tingling sensation in my arms, hands, chest, throat and at the back of my head.
An inability to even contemplate the future. (The future was not going to happen, for me anyway.)
Scared of going mad, of being sectioned, of being put in a padded cell in a straitjacket.
Separation anxiety.
A continual sense of heavy dread.
Mental exhaustion.
Physical exhaustion.
Like I was useless.
Chest tightness and occasional pain.
Like I was falling even while I was standing still.

Aching limbs.
The occasional inability to speak.
An infinite sadness.
An increased sexual imagination. (Fear of death often seems to counterbalance itself with thoughts of sex.)
A sense of being disconnected, of being a cut-out from another reality.
An urge to be someone else/anyone else.
Loss of appetite (I lost two stone in six months).
An inner trembling (I called it a soul-quiver).
As though I was on the verge of a panic attack.
Like I was breathing too-thin air.
The need to continuously scan for warning signs that I was a) going to die or b) go mad.
Finding such warning signs. And believing them.
The desire to walk, and quickly.
Strange feelings of déjà vu, and things that felt like memories but hadn’t happened. At least not to me.
Seeing darkness around the periphery of my vision.
The wish to switch off the nightmarish images I would sometimes see when I closed my eyes.
The desire to step out of myself for a while. A week, a day, an hour. Hell, just for a second.
At the time these experiences felt so weird I thought I was the only person in the history of the world to have ever had them (this was a pre-Wikipedia age), though of course there are millions going through an equivalent experience at any one time. I’d often involuntarily visualise my mind as a kind of vast and dark machine, like something out of a steampunk graphic novel, full of pipes and pedals and levers and hydraulics, emitting sparks and steam and noise.
Adding anxiety to depression is a bit like adding cocaine to alcohol. It presses fast-forward on the whole experience. If you have depression on its own your mind sinks into a swamp and loses momentum, but with anxiety in the cocktail, the swamp is still a swamp but the swamp now has whirlpools in it. The monsters that are there, in the muddy water, continually move like modified alligators at their highest speed. You are continually on guard. You are on guard to the point of collapse every single moment, while desperately trying to keep afloat, to breathe the air that the people on the bank all around you are breathing as easily as anything.
You don’t have a second. You don’t have a single waking second outside of the fear. That is not an exaggeration. You crave a moment, a single second of not being terrified, but the moment never comes. The illness that you have isn’t the illness of a single body part, something you can think outside of. If you have a bad back you can say ‘my back is killing me’, and there will be a kind of separation between the pain and the self. The pain is something other. It attacks and annoys and even eats away at the self but it is still not the self.
But with depression and anxiety the pain isn’t something you think about because it is thought. You are not your back but you are your thoughts.
If your back hurts it might hurt more by sitting down. If your mind hurts it hurts by thinking. And you feel there is no real, easy equivalent of standing back up. Though often this feeling itself is a lie.

The Bank of Bad Days
WHEN YOU ARE very depressed or anxious – unable to leave the house, or the sofa, or to think of anything but the depression – it can be unbearably hard. Bad days come in degrees. They are not all equally bad. And the really bad ones, though horrible to live through, are useful for later. You store them up. A bank of bad days. The day you had to run out of the supermarket. The day you were so depressed your tongue wouldn’t move. The day you made your parents cry. The day you nearly threw yourself off a cliff. So if you are having another bad day you can say, Well, this feels bad, but there have been worse. And even when you can think of no worse day – when the one you are living is the very worst there has ever been – you at least know the bank exists and that you have made a deposit.

Things depression says to you
Yes, you!
What are you doing? Why are you trying to get out of bed?
Why are you trying to apply for a job? Who do you think you are? Mark Zuckerberg?
Stay in bed.
You are going to go mad. Like Van Gogh. You might cut off your ear.
Why are you crying?
Because you need to put the washing on?
Hey. Remember your dog, Murdoch? He’s dead. Like your grandparents.
Everyone you have ever met will be dead this time next century.
Yep. Everyone you know is just a collection of slowly deteriorating cells.

Look at the people walking outside. Look at them. There. Outside the window. Why can’t you be like them?
There’s a cushion. Let’s just stay here and look at it and contemplate the infinite sadness of cushions.
PS. I’ve just seen tomorrow. It’s even worse.

WHEN YOU ARE trapped inside something that feels so unreal, you look for anything that can give you a sense of your bearings. I craved knowledge. I craved facts. I searched for them like lifebuoys in the sea. But statistics are tricky things.
Things that occur in the mind can often be hidden. Indeed, when I first became ill I spent a lot of energy on looking normal. People often only know someone is suffering if they tell them, and with depression that doesn’t always happen, especially if you are male (more on that later). Also, over time, facts have changed. Indeed, whole concepts and words change. Depression didn’t used to be depression. It used to be melancholia, and far fewer people suffered from that than they do from current depression. But did they really? Or are people more open about such things?
But anyway, here are some of the facts we have right now.

Suicide is the leading cause of death among men under the age of thirty-five.
Suicide rates vary widely depending on where you are in the world. For instance, if you live in Greenland you are twenty-seven times more likely to kill yourself than if you live in Greece.
A million people a year kill themselves. Between ten and twenty million people a year try to. Worldwide, men are over three times more likely to kill themselves than women.
One in five people get depression at some point in their lives. (Though obviously more than that will suffer from mental illness.)
Anti-depressants are on the rise almost everywhere. Iceland has the highest consumption, followed by Australia, Canada, Denmark, Sweden, Portugal and the UK.
Twice as many women as men will suffer a serious bout of depression in their lives.
Combined anxiety and depression is most common in the UK, followed by anxiety, post-traumatic stress disorder, ‘pure’ depression, phobias, eating disorders, OCD, and panic disorder.
Women are more likely to seek and receive treatment for mental health problems than men.
The risk of developing depression is about 40 per cent if a biological parent has been diagnosed with the illness.
Sources: World Health Organization, the Guardian, Mind, Black Dog Institute.

The head against the window
I WAS IN my parents’ bedroom. On my own. Andrea was downstairs, I think. Anyway, she wasn’t with me. I was standing by the window with my head against the glass. It was one of those times when the depression was there on its own, uncoloured by anxiety. It was October. The saddest of months. My parents’ street was a popular route into town, so there were a few people walking along the pavement. Some of these people I knew or recognised from my childhood, which had only officially ended six years before. Though maybe it hadn’t ended at all.
When you are at the lowest ebb, you imagine – wrongly – that no one else in the world has felt so bad. I prayed to be those people. Any of them. The eighty-year-olds, the eight-year-olds, the women, the men, even their dogs. I craved to exist in their minds. I could not cope with the relentless self-torment any more than I could cope with my hand on a hot stove when I could see buckets of ice all around me. Just the sheer exhaustion of never being able to find mental comfort. Of every positive thought reaching a cul-de-sac before it starts.
I cried.
I had never been one of those males who were scared of tears. I’d been a Cure fan, for God’s sake. I’d been emo before it was a term. Yet weirdly, depression didn’t make me cry that often, considering how bad it was. I think it was the surreal nature of what I was feeling. The distance. Tears were a kind of language and I felt all language was far away from me. I was beneath tears. Tears were what you shed in purgatory. By the time you were in hell it was too late. The tears burnt to nothing before they began.
But now, they came. And not normal tears either. Not the kind that start behind the eyes. No. These came from the deep. They seemed to come from my gut, my stomach was trembling so much. The dam had burst. And once they came they couldn’t stop, even when my dad walked into the bedroom. He looked at me and he couldn’t understand, even though it was all too familiar. My mum had suffered from post-natal depression. He came over to me, and saw my face, and the tears were contagious. His eyes went pink and watery. I couldn’t remember the last time I’d seen him cry. He said nothing at first but hugged me, and I felt loved, and I tried to gather as much of that love as I could. I needed all of it.
‘I’m sorry,’ I think I said.
‘Come on,’ he said, softly. ‘You can do this. Come on. You can pull yourself together, Mattie. You’re going to have to.’
My dad wasn’t a tough dad. He was a gentle, caring, intelligent dad, but he still didn’t have the magical ability to see inside my head.
He was right, of course, and I wouldn’t have wanted him to say much else, but he had no idea as to how hard that sounded.
To pull myself together.
No one did. From the outside a person sees your physical form, sees that you are a unified mass of atoms and cells. Yet inside you feel like a Big Bang has happened. You feel lost, disintegrated, spread across the universe amid infinite dark space.
‘I’ll try, Dad, I’ll try.’
They were the words he wanted to hear so I gave him them. And I returned to staring out at those ghosts of my childhood.

Pretty normal childhood
DOES MENTAL ILLNESS just happen, or is it there all along? According to the World Health Organization nearly half of all mental disorders are present in some form before the age of fourteen.
When I became ill at twenty-four it felt like something terribly new and sudden. I had a pretty normal, ordinary childhood. But I never really felt very normal. (Does anyone?) I usually felt anxious.
A typical memory would be me as a ten-year-old, standing on the stairs and asking the babysitter if I could stay with her until my parents came back. I was crying.
She was kind. She let me sit with her. I liked her a lot. She smelt of vanilla and wore baggy t-shirts. She was called Jenny. Jenny the Babysitter Who Lived Up the Street. A decade or so later she would have transformed into Jenny Saville, the Britart star famed for her large-scale painted depictions of naked women.

‘Do you think they’ll be home soon?’
‘Yes,’ said Jenny, patiently. ‘Of course they will. They’re only a mile away. That’s not very far, you know?’
I knew.
But I also knew they could have got mugged or killed or eaten by dogs. They weren’t, of course. Very few Newark-on-Trent residents ended their Saturday night being eaten by dogs. They came home. But all my childhood, over and over again, I carried on this way. Always inadvertently teaching myself how to be anxious. In a world where possibility is endless, the possibilities for pain and loss and permanent separation are also endless. So fear breeds imagination, and vice versa, on and on and on, until there is nothing left to do except go mad.
Then something else. A bit less ordinary, but still in the ballpark. I was thirteen. Me and a friend went over to some girls in our year on the school field. Sat down. One of the girls – one I fancied more than anything – looked at me and then made a disgusted face to her friends. Then she spoke words that I would remember twenty-six years later when I came to write them down in a book. She said: ‘Ugh. I don’t want that sitting next to me. With his spider legs on his face.’ She went on to explain, as the ground kept refusing to swallow me up, what she meant. ‘The hair growing out of his moles. It looks like spiders.’
At about five that afternoon I went into the bathroom at home and used my dad’s razor to shave the hairs off my moles. I looked at my face and hated it. I looked at the two most prominent moles on my face.
I picked up my toothbrush and pressed it into my left cheek, right over my largest mole. I clenched my eyes shut and rubbed hard. I brushed and brushed, until there was blood dripping into the sink, until my face was throbbing with heat and pain from the friction.
My mum came in that day and saw me bleeding.
‘Matthew, what on earth has happened to your face?’
I held a tissue over the fresh, bleeding scar and mumbled the truth.
That night I couldn’t sleep. My left cheek throbbed beneath a giant plaster, but that wasn’t the reason. I was thinking of school, of explaining away the plaster. I was thinking of that other universe where I was dead. And where the girl would hear I was dead and the guilt would make her cry. A suicidal thought, I suppose. But a comforting one.
My childhood went by. I remained anxious. I felt like an outsider, with my left-wing, middle-class parents in a right-wing, working-class town. At sixteen, I got arrested for shoplifting (hair gel, Crunchie bar) and spent an afternoon in a police cell, but that was a symptom of teen idiocy and wanting to fit in, not depression.
I skateboarded badly, got eclectic grades, cultivated asymmetric hair, carried my virginity around like a medieval curse. Normal stuff.
I didn’t totally fit in. I kind of disintegrated around people, and became what they wanted me to be. But paradoxically, I felt an intensity inside me all the time. I didn’t know what it was, but it kept building, like water behind a dam. Later, when I was properly depressed and anxious, I saw the illness as an accumulation of all that thwarted intensity. A kind of breaking through. As though, if you find it hard enough to let your self be free, your self breaks in, flooding your mind in an attempt to drown all those failed half-versions of you.

A visit
PAUL, MY OLD shoplifting partner in crime, was in my parents’ living room. I hadn’t seen him in a few years, since school. To me, it might as well have been millennia. He was looking at me like I was my former self. How could he not see the difference?
‘Do you want to go out on Saturday night? Come on, mate. Old times’ sake.’
The idea was ridiculous. I couldn’t leave the house without feeling an infinite terror. ‘I can’t.’
‘What’s the matter?’
‘I’m just not feeling well. My head’s a bit whacked.’
‘That’s why you need a good night out. If you’re feeling down. Get Andrea to come too. Come on, mate.’
‘Paul, you don’t understand . . .’
I was trapped in a prison. Years before, after spending a few hours in a police cell for that Crunchie bar, I had developed a fear of being locked in places. I never realised how you could be locked inside your own mind.
Act like a man, I told myself. Though I had never really been good at that.

Boys don’t cry
I WANT TO talk about being a man.
A staggeringly higher number of men than women kill themselves. In the UK the ratio is 3:1, in Greece 6:1, in the USA 4:1. This is pretty average. According to the World Health Organization, the only countries in the world where more women than men kill themselves are China and Hong Kong. Everywhere else, many more men than women end their own lives. This is especially strange when you think that, according to every official study, about twice as many women experience depression.
So, clearly, in most places there is something about being a man that makes you more likely to kill yourself. And there is also a paradox. If suicide is a symptom of depression (it is), then why do more women suffer depression than men? Why, in other words, is depression more fatal if you are a man rather than a woman?
The fact that suicide rates vary between eras and countries and genders shows that suicide is not set in stone for anyone.
Consider the UK. In 1981, 2,466 women in the UK took their own lives. Thirty years later that number had almost halved to 1,391. The corresponding figures for men are 4,129 and then 4,590.
So back in 1981, when the Office of National Statistics records began, men were still more likely to kill themselves than women, but only 1.9 times more likely. Now they are 3.5 times more likely.
Why do so many men still kill themselves? What is going wrong?
The common answer is that men, traditionally, see mental illness as a sign of weakness and are reluctant to seek help.
Boys don’t cry. But they do. We do. I do. I weep all the time. (I wept this afternoon, watching Boyhood.) And boys – and men – do commit suicide. In White Noise, Don DeLillo’s anxiety-ridden narrator Jack Gladney is tormented by the concept of masculinity and how he measures up: ‘What could be more useless than a man who couldn’t fix a dripping faucet – fundamentally useless, dead to history, to the messages in his genes?’ And what if, instead of a broken faucet it is a broken mind? Then maybe a man who was worried about his manliness would feel he should be able to fix that on his own too, with nothing but silence amid the ‘white noise’ of modern life, and maybe a few litres of alcohol.
If you are a man or a woman with mental health problems, you are part of a very large and growing group. Many of the greatest and, well, toughest people of all time have suffered from depression. Politicians, astronauts, poets, painters, philosophers, scientists, mathematicians (a hell of a lot of mathematicians), actors, boxers, peace activists, war leaders, and a billion other people fighting their own battles.
You are no less or more of a man or a woman or a human for having depression than you would be for having cancer or cardiovascular disease or a car accident.
So what should we do? Talk. Listen. Encourage talking. Encourage listening. Keep adding to the conversation. Stay on the lookout for those wanting to join in the conversation. Keep reiterating, again and again, that depression is not something you ‘admit to’, it is not something you have to blush about, it is a human experience. A boy-girl-man-woman-young-old-black-white-gay-straight-rich-poor experience. It is not you. It is simply something that happens to you. And something that can often be eased by talking. Words. Comfort. Support. It took me more than a decade to be able to talk openly, properly, to everyone, about my experience. I soon discovered the act of talking is in itself a therapy. Where talk exists, so does hope.


‘ . . . once the storm is over you won’t remember how you made it through, how you managed to survive. You won’t even be sure, in fact, whether the storm is really over. But one thing is certain. When you come out of the storm you won’t be the same person who walked in. That’s what this storm’s all about.’
—Haruki Murakami, Kafka on the Shore

Cherry blossom
A SIDE-EFFECT OF depression is sometimes to become obsessed with the functioning of your brain.
During my breakdown, living back with my parents, I used to imagine reaching into my own skull and taking out the parts of it that were making me feel bad. From having spoken to other people with depression, and having even come across it in other books, this seems to be a common fantasy. But which parts would I have taken out? Would I take out a whole solid chunk, or something small and fluid?
Once, during a dip, I sat on a bench in Park Square in Leeds. It was the sedate part of the city centre. Victorian townhouses now turned into legal offices. I stared at a cherry tree and felt flat. Depression, without anxiety. Just a total, desperate flatness. I could hardly move. Of course, Andrea was with me. I didn’t tell her how bad I was feeling. I just sat there, looking at the pink blossom and the branches. Wishing my thoughts could float away from my head as easily as the blossom floated from the tree. I started to cry. In public. Wishing I was a cherry tree.
The more you research the science of depression, the more you realise it is still more characterised by what we don’t know than what we do. It is 90 per cent mystery.

Unknown unknowns
AS DR DAVID Adam says in his brilliant account of obsessive compulsive disorder, The Man Who Couldn’t Stop: ‘Only a fool or a liar will tell you how the brain works.’
A brain is not a toaster. It is complex. It may only weigh a little over a kilo, but it is a kilo that contains a whole lifetime of memories.
It is worryingly magical, in that it does so much with us still not understanding how or why. It is – like all else – made out of atoms which themselves came into being in stars millions of years ago. Yet more is known about those faraway stars than the processes of our brain, the one item in the whole universe that can think about, well, the whole universe.
A lot of people still believe that depression is about chemical imbalance.
‘Incipient insanity was mainly a matter of chemicals,’ wrote Kurt Vonnegut, in Breakfast of Champions. ‘Dwayne Hoover’s body was manufacturing certain chemicals which unbalanced his mind.’
It is an attractive idea. And one that has, over the years, been supported by numerous scientific studies.
A lot of the research into the scientific causes of depression has focused on chemicals such as dopamine and, more often, serotonin. Serotonin is a neurotransmitter. That is a type of chemical that sends signals from one area of the brain to the other.
The theory goes that an imbalance in serotonin levels – caused by low brain cell production of serotonin – equates to depression. So it is no surprise that some of the most common anti-depressants, from Prozac down, are SSRIs – selective serotonin reuptake inhibitors – which raise the serotonin levels in your brain.
However, the serotonin theory of depression looks a bit wobbly.
The problem has been highlighted by the emergence of anti-depressants that have no effect on serotonin, and some that do the exact opposite of an SSRI (namely, selective serotonin reuptake enhancers, such as tianapetine) which have been shown to be as effective at treating depression. Add to this the fact that serotonin in an active living human brain is a hard thing to measure and you have a very inconclusive picture indeed.
Back in 2008, Ben Goldacre in the Guardian was already questioning the serotonin model. ‘Quacks from the $600 billion pharma industry sell the idea that depression is caused by low serotonin levels in the brain, and so you need drugs which raise the serotonin levels in your brain . . . That’s the serotonin hypothesis. It was always shaky, and the evidence is now hugely contradictory.’
So, annoyingly, scientists aren’t all singing from the same hymn sheet. Some don’t even believe there is a hymn sheet. Others have burnt the hymn sheet and written their own songs.
For instance, a professor of behavioural science at Stanford University called Robert Malenka believes that research needs to be carried out in other areas. Like on the bit of the brain right in the centre, the tiny ‘nucleus accumbens’. As this is already known to be responsible for pleasure and addiction, it makes a kind of sense that if it isn’t working properly we’ll feel the opposite of pleasure – anhedonia. That is the complete inability to feel pleasure, a chief symptom of depression.
It also would mean that the fantasy about reaching into our skulls and taking out the part of our brains that is causing us bother is highly improbable, as we would have to go through the entire frontal cortex to reach this tiny central piece of us.
Maybe looking at a specific part or chemical in the brain is only ever going to give a partial answer. Maybe we should be looking at how we live, and how our minds weren’t made for the lives we lead. Human brains – in terms of cognition and emotion and consciousness – are essentially the same as they were at the time of Shakespeare or Jesus or Cleopatra or the Stone Age. They are not evolving with the pace of change. Neolithic humans never had to face emails or breaking news or pop-up ads or Iggy Azalea videos or a self-service checkout at a strip-lit Tesco Metro on a busy Saturday night. Maybe instead of worrying about upgrading technology and slowly allowing ourselves to be cyborgs we should have a little peek at how we could upgrade our ability to cope with all this change.
One thing can be said for sure: we are nowhere near the end of science – especially a baby science like neuroscience. So most of what we know now will be disproved or reassessed in the future. That is how science works, not through blind faith, but continual doubt.

All we can do, for the moment, is really all we need to do – listen to ourselves. When we are trying to get better, the only truth that matters is what works for us. If something works we don’t necessarily care why. Diazepam didn’t work for me. Sleeping pills and St John’s Wort and homeopathy didn’t fix me either. I have never tried Prozac, because even the idea intensified my panic, so I don’t know about that. But then I have never tried cognitive behavioural therapy either. If pills work for you it doesn’t really matter if this is to do with serotonin or another process or anything else – keep taking them. Hell, if licking wallpaper does it for you, do that. I am not anti pill. I am pro anything that works and I know pills do work for a lot of people. There may well come a time in the future where I take pills again. For now, I do what I know keeps me just about level. Exercise definitely helps me, as does yoga and absorbing myself in something or someone I love, so I keep doing these things. I suppose, in the absence of universal certainties, we are our own best laboratory.

The brain is the body – part one
WE TEND TO see the brain and the body as separate things. While in previous epochs the heart was at the centre of our being, or at least on an equal footing with the mind, now we have this strange separation where the mind is operating the rest of us, like a man inside a JCB digger.
The whole idea of ‘mental health’ as something separate to physical health can be misleading, in some ways. So much of what you feel with anxiety and depression happens elsewhere. The heart palpitations, the aching limbs, the sweaty palms, the tingling sensations that often accompany anxiety, for instance. Or the aching limbs and the total-body fatigue that sometimes becomes part of depression.

I SUPPOSE THE first time I really felt my brain was a little bit alien, a bit other, was when I was thirteen. It was a few months after the time I had tried to remove my mole with a toothbrush.
I was in the Peak District, in Derbyshire. School trip. The girls were staying in the hostel. The boys were meant to be staying there too but there had been a double-booking, so eight of us boys stayed in the stables outside, a good distance from the warm hotel.
I hated being away from home. This was another of my big anxieties. I wanted to be back in my own bed looking at my poster of Béatrice Dalle, or reading Stephen King’s Christine.
I lay on a top bunk looking out of the window at the black boggy landscape under a starless sky. I didn’t really have any friends among these boys. They talked only about football, which wasn’t my specialist subject, and wanking, which was slightly more a specialist subject but not one I felt comfortable discussing in public. So I pretended to be asleep.
There was no teacher with us, here in the stables, and there was a kind of Lord of the Flies feeling I didn’t like very much. I was tired. We had walked about ten miles that day, a lot of it through peat bogs. Sleep weighed on me, as thick and dark as the land all around.
I woke, to laughing.
Mad, crazed laughing, as if the funniest thing in the world had just happened.
I had talked in my sleep. Nothing is more hilarious to a thirteen-year-old boy than witnessing an unguarded and embarrassing moment of another thirteen-year-old boy.
I had said something incoherent about cows. And Newark. Newark was my hometown, so that was understandable. The cows thing, well, that was weird. There were no cows in the Peak District. I was told I had said, over and over, ‘Kelham is in Newark.’ (Kelham was a village just outside Newark, where the town council was. My dad worked as an architect there, in the town planning department.) I tried my best to ride the joke. But I was tired, nervous. A school trip was just school, condensed. I had not enjoyed school since I was eleven, when I had been at a village school with a total pupil population of twenty-eight. The school I was at now, Magdalene High School, was a place where I was not very happy. I had spent a lot of the first year faking stomach aches that were rarely believed.
Then I fell asleep again. And when I woke up I was shaking. I was standing up, and I could feel cold air, and there was a considerable amount of blood dripping from my hand. My hand was red and shining with it. There was a shard of glass sticking out of my palm. The window to the stables was smashed in front of me. I felt frightened.
The other boys were all awake, but not laughing now. A teacher was there too. Or was about to be there. My hand had to be bandaged.
I had got out of bed in my sleep. I had shouted out – rather comically – about cows again. (‘The cows are coming! The cows are coming!’) Then I had gone for a piss next to someone’s bed. And then smashed the window. Shortly after, one of the boys shook my arm and I woke up.
It wasn’t the first time I had sleepwalked. Over the previous year I had gone into my sister’s bedroom and taken books off her shelves, thinking I was in a library. But my sleepwalking had never gone public. Until now.

I gained a new nickname. Psycho. I felt like a freak. But it could have been worse. I had loving parents and a few friends and a sister I could chat to for hours. My life was pretty comfortable and ordinary, but sometimes a sense of loneliness would creep over me. I felt lonely. Not depression. Just a version of that wallowy, teenage, no-one-understands-me feeling. Of course, I didn’t understand me either.
I worried about things. Nuclear war. Ethiopia. The prospect of going on a ferry. I worried all the time. The only thing that didn’t worry me was the thing that probably should have: worry itself. It would be eleven years before I had to address that one.

Jenga days
ELEVEN YEARS AFTER smashing a window in my sleep, during those ‘breakdown months’ as I’d later call them, there was a lot of empty time to stare worry in the face.
My parents would get up and leave for work and then me and Andrea would have long days in the house. It’s weird to write about this period. I mean, really there is nothing to write about. It was, from the outside, the least eventful phase of my life by quite a way.
From the outside, it was me talking with Andrea, either in my childhood bedroom or downstairs in the kitchen. Occasionally we would venture outside for a short walk in the afternoon. We would go either to the nearest corner shop, only about two or three hundred metres away, or – on more adventurous days – we would go and walk by the river Trent, which was a little further away, on the other side of the town centre, and involved me walking through streets I knew so well from childhood. (How could they stay the same when I felt so different?) Sometimes we bought a newspaper and a tin of soup and some bread, and we would return and read a bit of the paper and make the soup. Later, we might help prepare the evening meal. And that was about it. Talking and sitting and walking. It was hardly Lawrence of Arabia. Life at the lowest possible volume two twenty-four-year-olds could manage.
And yet, those days were the most intense I have lived. Those days contained thousands of tiny battles. They are filled with memories so painful I can only now, with the distance of fourteen and a half years, look at them head-on. I was a nervous wreck. People say ‘take it one day at a time’. But, I used to think to myself, that is all right for them to say. Days were mountains. A week was a trek across the Himalayas. You see, people say that time is relative, but it really bloody is.
Einstein said the way to understand relativity was to imagine the difference between love and pain. ‘When you are courting a nice girl an hour seems like a second. When you sit on a red-hot cinder a second seems like an hour.’ Every moment was red-hot. And the only real thing I wished for, beyond feeling better, was for time to move quicker. I would want 9 a.m. to be 10 a.m. I would want the morning to be the afternoon. I would want the 22nd of September to be the 23rd of September. I would want the light to be dark and the dark to be light. I still had the toy globe I’d had as a boy in my room. I sometimes used to stand there and spin it, wishing I was spinning the world deep into the next millennium.
I was as obsessed with time as some people are about money. It was the only weapon I had. I would build up hours and minutes like pounds and pence. In my head, amid all the raging waters of anxiety, this knowledge buoyed like hope. It is October 3rd, twenty-two days since it happened.
The longer that time went on, and I was still a) alive and b) not mistaking anyone for a hat, the more I felt like there was a chance I could get through this. But it didn’t always work like that. I stacked the days up like Jenga blocks, imagining I was making progress, and then – crash – along would come a five-hour panic attack or a day of total apocalyptic darkness, and those Jenga days would topple back down again.

Warning signs
WARNING SIGNS ARE very hard with depression.
It’s especially hard for people with no direct experience of depression to know them when they see them. Partly this is because some people are confused about what depression actually is. We use ‘depressed’ as a synonym for ‘sad’, which is fine, as we use ‘starving’ as a synonym for ‘hungry’, though the difference between depression and sadness is the difference between genuine starvation and feeling a bit peckish.
Depression is an illness. Yet it doesn’t come with a rash or a cough. It is hard to see, as it is generally invisible. Even though it is a serious illness it is also surprisingly hard for many sufferers to recognise it at first. Not because it doesn’t feel bad – it does – but because that bad feeling seems unrecognisable, or can be confused with other things. For instance, if you feel worthless you might think ‘I feel worthless because I am worthless’. It might be hard to see it as a symptom of an illness. Or even if it is seen as that, it’s possible that low self-worth, combined with fatigue, might mean there is little will or ability to vocalise it.
But in any case, these are some of the most frequently cited signs that someone is depressed.
Fatigue – if someone is tired all the time, for no real reason.
Low self-esteem – a hard one for others to spot, especially in those people who aren’t that comfortable talking about their feelings. And low self-esteem isn’t exactly conducive with getting out there in the world.
‘Psychomotor retardation’ – in certain cases of depression, slow movements and slow speech may happen.
Loss of appetite (though massive increase in appetite can sometimes be a symptom too).
Irritability (though, to be fair, that can be a sign of anything).
Frequent crying episodes.
Anhedonia – I first knew of this word as Woody Allen’s original title for the film Annie Hall. It means, as I’ve said, the inability to experience pleasure in anything. Even the pleasurable things, like sunsets and nice food, and watching dubious Chevy Chase comedies from the eighties. That sort of stuff.
Sudden introversion – if someone seems quieter, or more introverted than normal, it could mean they are depressed. (I can remember there were times when I couldn’t speak. It felt like I couldn’t move my tongue, and talking seemed so utterly pointless. Just as the things other people talked about seemed to belong to another world.)

THE DEMON SAT next to me in the back of the car.
He was real and false all at once. Not a hallucination exactly, and not transparent like a theme park ghost, but there and not there. There when I closed my eyes. There even when I opened them again, a kind of flickering mind-print transferred over reality, but something imagined rather than seen.
He was short. About three foot. Impish and grey, like a gargoyle on a cathedral, and he was looking up at me, smiling. And then he got up on the seat and started licking my face. He had a long, dry tongue. And he kept on. Lick, lick, lick. He didn’t really scare me. I mean, fear was there, obviously. I was living continually inside fear. But the demon didn’t send me deeper into terror. If anything, he was a comfort. The licks were caring licks, as if I was one big wound and he was trying to make me better.
The car was heading to the Nottingham Theatre Royal. We were off to see Swan Lake. It was the production where all the swans were male. My mother was talking. Andrea was in the front passenger seat, listening with polite patience to my mother. I can’t remember what she was saying but I can remember she was talking, because I kept on thinking This is weird. Mum is talking about Matthew Bourne and her friends who have seen this production and there is a happy demon on the back seat licking my face.
The licking got a bit more annoying. I tried to switch the demon off, or the idea of the demon, but of course that made it worse. Lick, lick, lick, lick. I couldn’t really feel the tongue on my skin, but the idea of the demon licking my face was real enough for my brain to tingle, as if I was being tickled.
The demon laughed. We went into the theatre. Swans danced. I felt my heart speed up. The dark, the confinement, my mother holding my hand, it was all too much. This was it. Everything was over. Except, of course, it wasn’t. I stayed in my seat.
Anxiety and depression, that most common mental health cocktail, fuse together in weird ways. I would often close my eyes and see strange things, but now I feel like sometimes those things were only there because one of the things I was scared of was going mad. And if you are mad, then seeing things that aren’t there is probably a symptom.
If you are scared when there is nothing to be scared of, eventually your brain has to give you things. And so that classic expression – ‘the only thing to fear is fear itself’ – becomes a kind of meaningless taunt. Because fear is enough. It is a monster, in fact.
And, of course –
‘Monsters are real,’ Stephen King said. ‘And ghosts are real too. They live inside us, and sometimes, they win.’
It was dark. The house was silent so we tried to be too.
‘I love you,’ she whispered.
‘I love you,’ I whispered back.
We kissed. I felt demons watching us, gathering around us, as we kissed and held each other. And slowly, in my mind, the demons retreated for a while.

LIFE IS HARD. It may be beautiful and wonderful but it is also hard. The way people seem to cope is by not thinking about it too much. But some people are not going to be able to do that. And besides, it is the human condition. We think therefore we are. We know we are going to grow old, get ill and die. We know that is going to happen to everyone we know, everyone we love. But also, we have to remember, the only reason we have love in the first place is because of this. Humans might well be the only species to feel depression as we do, but that is simply because we are a remarkable species, one that has created remarkable things – civilisation, language, stories, love songs. Chiaroscuro means a contrast of light and shade. In Renaissance paintings of Jesus, for instance, dark shadow was used to accentuate the light bathing Christ. It is a hard thing to accept, that death and decay and everything bad leads to everything good, but I for one believe it. As Emily Dickinson, eternally great poet and occasionally anxious agoraphobe, said: ‘That it will never come again is what makes life so sweet.’


ROY NEARY: Just close your eyes and hold your breath and everything will turn real pretty.
—Steven Spielberg, Close Encounters of the Third Kind

Things you think during your first panic attack
I am going to die.  
I am going to go so mad there will be no coming back.  
This won’t end.  
Everything is going to get worse.  
No one’s heart is meant to beat this fast.  
I am thinking far too fast.  
I am trapped.  
No one has felt this way before. Ever. In the whole of human history.  
Why are my arms numb?  
I will never get over this.  

Things you think during your 1,000th panic attack
Here it comes.  
I’ve been here before.  
But wow, it’s still quite bad.  
I might die.  
I’m not going to die.  
I am trapped.  
This is the worst ever.  
No, it’s not. Remember Spain.  
Why are my arms numb?  
I will get over this.  

The art of walking on your own
WHEN I WAS most severely depressed I had quite a vast collection of related mental illnesses. We humans love to compartmentalise things. We love to divide our education system into separate subjects, just as we love to divide our shared planet into nations, and our books into separate genres. But the reality is that things are blurred. Just as being good at mathematics often means someone is good at physics, so having depression means it probably comes with other things. Anxieties, maybe some phobias, a pinch of OCD. (Compulsive swallowing was a big thing with me.)
I also had agoraphobia and separation anxiety for a while.
A measure of progress I had was how far I could walk on my own.
If I was outside, and I wasn’t with Andrea or one of my parents, I wasn’t able to cope. But rather than avoid these situations, I forced myself into them.

I think this helped. It is quite gruelling, always facing fear and heading into it, but it seemed to work.
On the days when I was feeling very brave, I would say something – ahem – impossibly heroic like ‘I am going to go to the shop to get some milk. And Marmite.’
And Andrea would look at me, and say ‘On your own?’
‘Yes. On my own. I’ll be fine.’
It was 1999. Lots of people didn’t have mobile phones. So on your own still meant on your own. And so I would hurriedly put on my coat and grab some money and leave the house as quickly as I could, trying to outpace the panic.
And by the time I reached the end of Wellington Road, my parents’ street, it would be there, the darkness, whispering at me, and I would turn the corner onto Sleaford Road. Orange-bricked terraces with net curtains. And I would feel a deep level of insecurity, like I was in a shuttle that was leaving the Earth’s orbit. It wasn’t simply a walk to the shop. It was Apollo 13.
‘It’s okay,’ I whispered to myself.
And I would pass a fellow human walking a dog and they would ignore me, or they would frown or – worse – smile, and so I would smile back, and then my head would quickly punish me.

That’s the odd thing about depression and anxiety. It acts like an intense fear of happiness, even as you yourself consciously want that happiness more than anything. So if it catches you smiling, even fake smiling, then – well, that stuff’s just not allowed and you know it, so here comes ten tons of counterbalance.
The weirdness. That feeling of being outside alone, it was as unnatural as being a roof without walls. I would see the shop up ahead. The letters ‘Londis’ still looking small and far away. So much sadness and fear to walk through.
There is no way I can do this.
There is no way I can walk to the shop. On my own. And find milk. And Marmite.
If you go back home you will be weaker still. What are you going to do? Go back and be lost and go mad? If you go back the chances of living for ever in a padded cell with white walls is higher than it is already. Do it. Just walk to the shop. It’s a shop. You’ve been walking to the corner shop on your own since you were ten. One foot in front of the other, shoulders back. Breathe.

Then my heart kicked in.
Ignore it.
But listen – boomboomboomboomboom.
Ignore it.
But listen, but listen, but fucking listen.
And the other things.
The mind images, straight out of unmade horror films. The pins-and-needles sensation at the back of my head, then all through my brain. The numb hands and arms. The sense of being physically empty, of dissolving, of being a ghost whose existence was sourced by electric anxiety. And it became hard to breathe. The air thinned. It took massive concentration just to keep control of my breathing.
Just go to the shop, just carry on, just get there.
I got to the shop.
Shops, by the way, were the places I would panic in most, with or without Andrea. Shops caused me intense anxiety. I was never really sure what it was.

Was it the lighting?
Was it the geometric layout of the aisles?
Was it the CCTV cameras?
Was it that the point of brands was to scream for attention, and when you were deeply in tune with your surroundings maybe those screams got to you? A kind of death by Unilever. This was only Londis, hardly a hypermarket. And the door was open, the street was right there, and that street joined on to my parents’ street, which contained my parents’ house, which contained Andrea, who contained everything. If I was running, I could probably get back there in little over a minute.
I tried to focus. Coco Pops. It was hard. Frosties. Really hard. Crunchy Nut Cornflakes. Sugar Puffs. The honey monster had never looked like an actual monster before. What was I in here for, other than to prove a point to myself?
This is crazy. This is the craziest thing I have ever done.
It’s just a shop.
It’s just a shop you have been in, on your own, five hundred times before. Get a grip. Get a grip. But on what? There is nothing to grip onto. Everything is slippy. Life is so infinitely hard. It involves a thousand tasks all at once. And I am a thousand different people, all fleeing away from the centre.
The thing I hadn’t realised, before I became mentally ill, is the physical aspect of it. I mean, even the stuff that happens inside your head is all sensation. My brain tingled, whirred, fluttered and pumped. Much of this action seemed to happen near the rear of my skull, in my occipital lobe, though there was also some fuzzy, TV-static, white-noise feelings going on in my frontal lobe. If you thought too much, maybe you could feel those thoughts happening.
‘An infinity of passion can be contained in one minute,’ wrote Flaubert, ‘like a crowd in a small space.’
Get the fuck out of this shop. It’s too much. You can’t take this any more. Your brain is going to explode.
Brains don’t explode. Life isn’t a David Cronenberg movie.
But maybe I could fall the same distance again. Maybe the fall that happened in Ibiza had only landed me halfway. Maybe the actual Underworld was much further down in the basement and I was heading there, and I’d end up like a shell-shocked soldier from a poem, dribbling and howling and lost, unable even to kill myself. And maybe being in this shop was going to send me there.
There was a woman behind the counter. I can still picture her. She was about my age. Maybe she had gone to my school, but I didn’t recognise her. She had that kind of dyed red hair that was a bit half-hearted. She was large and pale skinned and was reading a celebrity magazine. She looked calmer than calm. I wanted to jump ship. I wanted to be her. I wanted to be her so much. Does that sound silly? Of course it does. This whole thing sounds silly.
Indiana Jones and the Temple of Marmite.
I found the Marmite. I grabbed it as an old rap from Eric B. & Rakim played at high speed in my head. ‘I’m also a sculpture, born with structure . . .’ I was a sculpture with no structure. A structureless sculpture who still had to get the milk. Rows of milk bottles in a fridge can be as terrifying and unnatural as anything, with the right (wrong) perspective. My parents got semi-skimmed, but the only semi-skimmed here was in pints, not the two-pint ones that they normally got, so I picked up two of the one-pinters, hooking my index finger through the handles and taking them, and the Marmite, to the counter.
The woman I wanted to be was not particularly fast at her job. I think she was the slowest person there had ever been at her job. I think she may well have been the incentive for the later move towards self-service checkouts in many shops. Even as I wanted to be her, I hated her slowness.
Hurry up, I didn’t say. Do you have any idea of what you are doing?
I wanted to go back and start my life again at her pace, and then I would not be feeling like this. I needed a slower run-up.
‘Do you need a bag?’
I sort of did need a bag, but I couldn’t risk slowing her down any more. Standing still was very hard. When every bit of you is panicking, then walking is better than standing.
Something flooded my brain. I closed my eyes. I saw dwarf demons having fun, laughing at me as if my madness was an act at a carnival.
‘No. It’s okay. I only live around the corner.’
Around the bend.
I paid with a five-pound note. ‘Keep the change.’
And she started to realise I was a bit weird and I left the shop and I was out, back into the vast and open world, and I kept walking as fast as I could walk (to break into a run would be a kind of defeat), feeling like a fish on the deck of a boat, needing the water again.
‘It’s okay, it’s okay, it’s okay . . .’
I turned the corner and I prayed more than anything not to see someone I knew on Wellington Road. No one. Just emptiness and suburban, semi-detached, late Victorian houses, lined up and staring at each other.
And I got back to number 33, my parents’ house, and I rang the bell and Andrea answered and I was inside and there was no relief, because my mind was quick to point out that being relieved about surviving a trip to the corner shop was another confirmation of sickness, not wellness. But maybe, mind, there would come a day when you could be as slow as the girl in the shop at pointing out such things.
‘You’re getting there,’ said Andrea.
‘Yeah,’ I said, and tried so hard to believe it.
‘We’re going to get you better.’
It’s not easy, being there for a depressive.

A conversation across time – part two
THEN ME: I can’t do this.
NOW ME: You think you can’t, but you can. You do. You will.
THEN ME: This pain, though. You must have forgotten what it was like. I went on an escalator today, in a shop, and I felt myself disintegrating. It was like the whole universe was pulling me apart. Right there, in John Lewis.
NOW ME: I probably have forgotten, a little bit. But listen, look, I’m here. I’m here now. And I made it. We made it. You just have to hold on.
THEN ME: I so want to believe that you exist. That I don’t kill you off.
NOW ME: You didn’t. You don’t. You won’t.
THEN ME: Why would I stay alive? Wouldn’t it be better to feel nothing than to feel such pain? Isn’t zero worth more than minus one thousand?
NOW ME: Listen, just listen, just get this through your head, okay – you make it, and on the other side of this there is life. L-I-F-E. You understand? And there will be stuff you enjoy. And just stop worrying about worrying. Just worry – you can’t help that – but don’t meta-worry.
THEN ME: You look old. You have crow’s feet. Are you starting to lose your hair?
NOW ME: Yes. But remember, we’ve always worried about this stuff. Can you remember that holiday to the Dordogne when we were ten? We leaned forward into the mirror and started to worry about the lines in our forehead. We were worrying about the visible effects of ageing back then. Because we have always been scared of dying.
THEN ME: Are you still scared of dying?
NOW ME: Yes.
THEN ME: I need a reason to stay alive. I need something strong that will keep me here.
NOW ME: Okay, okay, give me a minute . . .

Reasons to stay alive
You are on another planet. No one understands what you are going through. But actually, they do. You don’t think they do because the only reference point is yourself. You have never felt this way before, and the shock of the descent is traumatising you, but others have been here. You are in a dark, dark land with a population of millions.  
Things aren’t going to get worse. You want to kill yourself. That is as low as it gets. There is only upwards from here.  
You hate yourself. That is because you are sensitive. Pretty much every human could find a reason to hate themselves if they thought about it as much as you did. We’re all total bastards, us humans, but also totally wonderful.  
So what, you have a label? ‘Depressive’. Everyone would have a label if they asked the right professional.  
That feeling you have, that everything is going to get worse, is just a symptom.  
Minds have their own weather systems. You are in a hurricane. Hurricanes run out of energy eventually. Hold on.  
Ignore stigma. Every illness had stigma once. We fear getting ill, and fear tends to lead to prejudice before information. Polio used to be erroneously blamed on poor people, for instance. And depression is often seen as a ‘weakness’ or personality failing.  
Nothing lasts for ever. This pain won’t last. The pain tells you it will last. Pain lies. Ignore it. Pain is a debt paid off with time.  
Minds move. Personalities shift. To quote myself, from The Humans: ‘Your mind is a galaxy. More dark than light. But the light makes it worthwhile. Which is to say, don’t kill yourself. Even when the darkness is total. Always know that life is not still. Time is space. You are moving through that galaxy. Wait for the stars.’  
You will one day experience joy that matches this pain. You will cry euphoric tears at the Beach Boys, you will stare down at a baby’s face as she lies asleep in your lap, you will make great friends, you will eat delicious foods you haven’t tried yet, you will be able to look at a view from a high place and not assess the likelihood of dying from falling. There are books you haven’t read yet that will enrich you, films you will watch while eating extra-large buckets of popcorn, and you will dance and laugh and have sex and go for runs by the river and have late-night conversations and laugh until it hurts. Life is waiting for you. You might be stuck here for a while, but the world isn’t going anywhere. Hang on in there if you can. Life is always worth it.  

WE ARE ESSENTIALLY alone. There is no getting around this fact, even if we try and forget it a lot of the time. When we are ill, there is no escape from this truth. Pain, of any kind, is a very isolating experience. My back is playing up right now. I am writing this with my legs up against a wall, and my back lying flat on a sofa. If I sit up normally, hunched over a notepad or a laptop in the classic writer position, my lower back begins to hurt. It doesn’t really help me to know, when the pain flares up again, that millions of other people also suffer from back problems.
So why do we bother with love? No matter how much we love someone we are never going to make them, or ourselves, free of pain.
Well, let me tell you something. Something that sounds bland and drippy to the untrained eye, but which – I assure you – is something I believe entirely. Love saved me. Andrea. She saved me. Her love for me and my love for her. Not just once, either. Repeatedly. Over and over.
We had been together five years by the time I fell ill. What had Andrea gained in that time, since the night before her nineteenth birthday? A continued sense of financial insecurity? An inadequate, alcohol-impaired sex life?
At university our friends always considered us to be a happy couple. And we were, except for the other half of the time when we were an unhappy couple.
The interesting thing was that we were fundamentally different people. Andrea liked lie-ins and early nights, while I was a bad sleeper and a night owl. She had a strong work ethic, and I didn’t (not then, though depression strangely has given me one). She liked organisation and I was the most disorganised person she had met. Mixing us together was, in some ways, like mixing chlorine with ammonia. It simply was not a good idea.
But I made her laugh, she said. I was ‘fun’. We liked to talk. Both of us, I suppose, were quite shy and private people in our own way. Andrea, particularly, was a social chameleon. This was a kind of kindness. She never could cope if someone felt awkward, and so always bent to meet them as much as she could. I think – if I offered her anything – it was the chance to be herself.

If, as Schopenhauer said, ‘we forfeit three-fourths of ourselves in order to be like other people’, then love – at its best – is a way to reclaim those lost parts of ourselves. That freedom we lost somewhere quite early in childhood. Maybe love is just about finding the person you can be your weird self with.
I helped her be her, and she helped me be me. We did this through talking. In our first year together we would very often stay up all night talking. The night would start with us going to the wine shop at the bottom of Sharp Street in Hull (the street my student house was on) and buying a bottle of wine we couldn’t afford, and would very often end with us watching breakfast TV on my old Hitachi, which required constant manoeuvring of the aerial to see the picture.
Then a year later we had fun playing grown-ups, buying The River Café Cookbook and holding dinner parties at which we would serve up panzanella salads and expensive wines in our damp-infested student flat.
Please do not think this was a perfect relationship. It wasn’t. It still isn’t. The time we spent living in Ibiza, particularly, now seems to be one long argument.
Just listen to this:

‘Matt, wake up.’
‘Wake up. It’s half-nine.’
‘I’ve got to be at the office at ten. It’s a forty-five-minute drive.’
‘So, no one will know. It’s Ibiza.’
‘You’re being selfish.’
‘I’m being tired.’
‘You’re hungover. You were drinking vodka lemon all night.’
‘Sorry for having a good time. You should try it.’
‘Fuck off. I’m getting in the car.’
‘What? You can’t leave me in the villa all day. I’ll be stranded in the middle of nowhere. There’s no food. Just wait ten minutes!’
‘I’m going. I’m just so fed up with you.’
‘You’re the one who wants to be here. My job is what keeps us here. It’s why we’re in this villa.’
‘You work six days a week. Twelve hours a day. They’re exploiting you. They’re still out clubbing. And no one’s in the office till after twelve. They value you because you are a maniac. You bend over backwards for them and treat me like crap.’
‘Bye, Matt.’
‘Oh fuck off, you’re not really going, are you?’
‘You selfish cunt.’
‘Okay, I’m getting ready . . . fuck.’
But the arguments were surface stuff. If you go deep enough under a tidal wave the water is still. That is what we were like. In a way we argued because we knew it would have no fundamental impact. When you can be yourself around someone, you project your dissatisfied self outwards. And in Ibiza, I was that. I was not happy. And part of my personality was this: when I was unhappy, I tried to drown myself in pleasure.
I was – to use the most therapy of terms – in denial. I was denying my unhappiness, even as I was being a tetchy, hungover boyfriend.
There was never a single moment, though, where I would have said – or felt – that I didn’t love her. I loved her totally. Friendship-love and love-love. Philia and eros. I always had done. Though, of the two, that deep and total friendship-love turns out to be the most important. When the depression hit, Andrea was there for me. She’d be kind to me and cross with me in all the right ways.
She was someone I could talk to, someone I could say anything to. Being with her was basically being with an outer version of myself.
The force and fury she’d once only displayed in arguments she now used to steer me better. She accompanied me on trips to doctors. She encouraged me to ring the right helplines. She got us to move into our own place. She encouraged me to read, to write. She earned us money. She gave us time. She handled all the organisational side of my life, the stuff you need to do to tick over.
She filled in the blanks that worry and darkness had left in its wake. She was my mind-double. My life-sitter. My literal other half when half of me had gone. She covered for me, waiting patiently like a war wife, during my absence from myself.

How to be there for someone with depression or anxiety
Know that you are needed, and appreciated, even if it seems you are not.  
Never say ‘pull yourself together’ or ‘cheer up’ unless you’re also going to provide detailed, foolproof instructions. (Tough love doesn’t work. Turns out that just good old ‘love’ is enough.)  
Appreciate that it is an illness. Things will be said that aren’t meant.  
Educate yourself. Understand, above all, that what might seem easy to you – going to a shop, for instance – might be an impossible challenge for a depressive.  
Don’t take anything personally, any more than you would take someone suffering with the flu or chronic fatigue syndrome or arthritis personally. None of this is your fault.  
Be patient. Understand it isn’t going to be easy. Depression ebbs and flows and moves up and down. It doesn’t stay still. Do not take one happy/bad moment as proof of recovery/relapse. Play the long game.  
Meet them where they are. Ask what you can do. The main thing you can do is just be there.  
Relieve any work/life pressure if that is doable.  
Where possible, don’t make the depressive feel weirder than they already feel. Three days on the sofa? Haven’t opened the curtains? Crying over difficult decisions like which pair of socks to wear? So what. No biggie. There is no standard normal. Normal is subjective. There are seven billion versions of normal on this planet.  

An inconsequential moment
IT CAME. THE moment I was waiting for. Some time in April 2000. It was totally inconsequential. In fact, there is not much to write about. That was the whole point. It was a moment of nothingness, of absent-mindedn