This isn’t a book review in the usual sense. It can’t be—the subject matter is just too personal. I’m an emotional reader anyway—the kind who projects herself into books and uses books to understand herself—but I’m not sure I’ve ever read anything where the identification was so immediate. This wasn’t reading a story I could empathize with; this was reading my own story.
Mental illness is strange, because it’s both completely subjective and (in my experience) totally predictable. Mental illness typically doesn’t leave physical traces that can be measured or examined; its only symptoms are thoughts, feelings, and (sometimes) odd behavior—the kinds of things patients themselves have to identify and report. Which is tricky, because you may or may not recognize yourself in the official psychological lexicon. And when you don’t, it just exacerbates what is already an isolating experience—being trapped inside a mind that’s already screaming at you that you’re different, freakish, and bad.
That, at least, is what depression has been like for me. I was no stranger to mental illness before this year—I’ve had waxing and waning OCD since my early teens, as well as what I now recognize as a few bouts of mild depression in the past—but I was entirely unprepared for how painful more severe depression would be. I knew that depression made people tired and sad, so I think I imagined that it might feel a bit like ennui. So while I probably spent much of the last year sliding into depression, I didn’t recognize it for what it was until very recently; the feelings had been kick-started by a relapse of anxiety, so I assumed that everything I was feeling was OCD, even though what I was feeling was increasingly less like worry and more like despair.
I’m sure that sounds self-dramatizing, but believe me when I say that I’m not throwing the word “despair” around casually. Depression is qualitatively different from sadness; it’s more like grief, but grief untethered from any concrete loss and (in my experience) coupled with generous side helpings of guilt and dread.
In any case, I say all this because as it turns out, someone else has felt the same things that I have—right down to the feeling that no one else has ever felt the same way:
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 traumatizing you, but other have been here. You are in a dark, dark land with a population of millions.
So, yes, in spite of how strange an illness like depression can feel, it’s actually totally predictable; someone, somewhere is virtually guaranteed to have suffered in precisely the same way as you. For me, that person is Matt Haig. Here are a few of the reasons why:
You can be a depressive and be happy, just as you can be a sober alcoholic.
True, and something that prevented me from describing what I felt as depression for a long, long time. If I could be momentarily cheered up, it hardly seemed fair to call it “depression.” Perversely, this sometimes makes me feel the need to resist being cheered up, for fear that that would somehow disprove the seriousness of what I feel in bleaker, more solitary moments.
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.
To be fair, I would also like to be happy, but Haig has certainly captured the essence of the desperate and impossible fight-or-flight that kicks in when you’re trapped inside your own mind.
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.
This was a bit of a revelation to me. Unlike Haig, I had my first brushes with “real” mental illness as a young teenager, but in retrospect, I think the signs were there even earlier. I wasn’t, perhaps, as anxious a child as Haig describes, but I was hypersensitive to both the good and the bad. And it’s a trait that’s never really gone away, even during periods of my life when I was relatively untouched by “symptoms”—the childhood nights I spent awake, uncomfortably keyed up by a day out with friends (think excitement, but with a painful, out-of-control edge to it); the summer in high school when reading a book tripped me into several months of existential despair (not depression, I thought at the time, because hello, who wouldn’t cry about the meaninglessness of everything?); the seminar presentation where I began to black out from nerves (the only upside: my physical distress was so obvious that I think everyone assumed I had come down with the flu). I’d like to think that someday we’ll be able to spot warning signs like these in time to nip the full-blown disorders in the bud.
When I was most severely depressed I had quite a vast collection of related mental illnesses. We humans love to compartmentalize 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…I also had agoraphobia and separation anxiety for a while.
Mental illness is predictable, but it is also individual. My depression happens to feel a lot like Haig’s (perhaps because it’s comorbid with anxiety), but not everyone will have the same experience. It’s important not to get too hung up on the dictionary definition, because different disorders interact with and shade into one another. Besides, disorders are just clusters of common but ultimately somewhat arbitrary symptoms; in the absence of any real understanding of exactly how and why the brain goes astray, we’re not in much of a position to police what “counts” as an illness. If you’re suffering, something is wrong—get help, and worry about the labels later.
The main thing is the intensity of [depression]. It does not fit within the normal spectrum of emotions. When you are in it, you are really in it…Every single thing you experience is filtered through it. Consequently, it magnifies everything. At its most extreme, things that an everyday person would hardly notice have overwhelming effects. The sun sinks behind a cloud, and you feel that slight change in weather as if a friend has died. You feel the difference between inside and outside as a baby feels the difference between womb and world…
Depression, for me, wasn’t a dulling but a sharpening, and intensifying, as though I had been living my life in a shell and now the shell wasn’t there. It was total exposure. A red-raw, naked mind. A skinned personality. A brain in a jar full of the acid that is experience.
Oh, look at that—a passage I unknowingly paraphrased above. But in all seriousness, this was one of my favorite passages from Haig’s book. My own experience of depression has not been as severe as Haig’s, but as I said, I was bowled over by the painfulness of it—not to mention the ability of that pain to feel like the most intensely real thing in the universe. In this excerpt, Haig describes that reality in much more eloquent terms than I ever could.
There is this idea that you either read to escape or you read to find yourself. I don’t really see the difference. We find ourselves through the process of escaping…If there is a way out [of the mind], a way that isn’t death itself, then the exit route is through words. But rather than leave the mind entirely, words help us leave a mind, and give us the building blocks to build another one, similar but better, nearby to the old one but with firmer foundations, and very often a better view.
I can remember during a short depressive episode watching Martin Scorsese’s Howard Hughes’ biopic The Aviator. There is a scene in it where Katharine Hepburn, played rather brilliantly by Cate Blanchett, turns to Hughes (Leonardo DiCaprio) and says: “There’s too much Howard Hughes in Howard Hughes.” It was this intensity of the self that, in the film version of his life at least, was shown to contribute to the obsessive-compulsive disorder that would eventually imprison Hughes in a hotel room in Las Vegas.
Andrea told me after that film that there was too much Matt Haig in Matt Haig. She was kind of joking, but also kind of on to something. So for me, anything that lessens that extreme sense of self, that makes me feel me but at a lower volume, is very welcome
It’s a weird thing, depression. Even now, writing this with a good distance of fourteen years from my lowest point, I haven’t fully escaped…I woke up with it a few days ago, in fact. I felt its dark wisps around my head, that ominous life-is-fear feeling. But then, after a a morning with the best five- and six-year-olds in the world, it subsided. It is now an aside. Something to put brackets around. Life lesson: the way out is never through yourself.
Yes, to all three excerpts. The only time I have felt even remotely normal during my latest depressive episode has been when I’ve managed to force my attention outwards. Admittedly, being around other people can be a double-edged sword; in my worse moods, it’s a reminder of how hopelessly strange and other I am—or, at least, feel. But it’s also the only way to satisfy, even fleetingly, that desire that Haig nails in these passages—the desire to live somewhere outside your own mind.
And that, perhaps, is the biggest gift Haig’s book has given me. I realize now that I’ve written this review as if my depression were in a thing of the past, but that’s not the case; fingers crossed, the worst may be over, but I’d hesitate to say I’ve recovered from even this bout of depression, let alone the illness as a whole. Reasons to Stay Alive, though, is a way out of myself. Yes, it’s an escape into a mind that is all-too familiar to me, but maybe that’s a necessary step. Depression is not the same as wallowing in your misery, but for a variety of reasons, it does encourage you to hold your misery tightly to yourself. So by allowing me to experience, for once, a pain outside my own mind, Haig has opened a window for me.
Maybe even a door.
PSA: If you are struggling with depression or suicidal thoughts, I recommend https://www.imalive.org/ as a short term solution; I’ve contacted them before when my levels of despair were approaching the stratosphere, and they calmed me down significantly. If you’re in the US, you can also call the national suicidal hotline at 1-800-273-8255.
If you’re not sure whether what you’re feeling is depression or not, I highly recommend perusing the internet—particularly McMan’s Depression and Bipolar Web. Figuring Out Depression would be a good start, if you know you feel terrible but can’t relate to the conventional description of depression as numbness; as McMan explains, what we call “depression” is probably a number of different conditions—some that look “agitated,” some that look “vegetative,” some that look “mixed,” etc. I personally tend more toward the agitated side of things, but it can vary from day to day. Bottom line: if you’re feeling everything way too intensely rather than not at all, know that that can be depression too.