Suicidal Feelings – Still a Taboo Subject?

If you’re feeling suicidal right now, this is a good guide for avoiding acting on  those feelings. Above all please talk to a friend or family member, or call a crisis line in your area – here’s a list.

In an attempt to reduce the shocking suicide statistics, we’re encouraged to talk about suicide, especially during Mental Health Week. There are 24-hour suicide lines and guidelines for reporting of suicide, especially the sudden deaths of the uber famous like Robin Williams. There are support groups for survivors – those who lose loved ones to suicide.

But suicidal feelings? Not so much. They are buried in the mush of the word ‘depression’, which is so vague it refers to any kind of low mood. Suicide is caused by depression, apparently, and therefore depression is Bad, and so is mental illness. At least these assumptions signal the community struggling to acknowledge that mental suffering can be as tortuous as physical suffering. But how can we expect the public to have the first understanding of mental illness when the sector itself is in crisis, by lack of funding on the one hand and the clash of competing paradigms on the other?

There may be support groups of survivors but there are no bricks-and-mortar self-help groups (that I’m aware of) for those afflicted with suicidal thoughts (if anyone knows of one, please let me know and I’ll mention it. There is an online forum for people who feel suicidal, Suicide Forum). There are plenty of other self-help groups, of course, for the kind of problems that can lead to suicidal thoughts. As soon as you voice a suicidal thought in such a group, a protocol comes into play. This is a good thing – it is evidenced based and its one aim is to stop the person in question suiciding, to keep them safe during the crisis. Suicidal feelings can result in death so must always be taken seriously. But it speaks to the problem of suicide – that it’s difficult for the person afflicted with the thoughts to speak about them. Once you do, the direction of the discussion must change immediately, if not come to a halt. There’s still a taboo.

Part of the problem is that suicidal feelings can actually mean many different things and arise for many different reasons. Lumping them all together could be as harmful as not dealing with their disparate causes.  I’d suggest the following categories of suicidal thoughts arising from mental suffering (I’m not an expert – feel free to offer opposing opinions or some additional categories).

Also, these categories are fluid – some may suffer from a combination of these things.

― Fleeting thoughts that everyone has. The only problem with these thoughts is that the person who has them might decide they were abnormal. I guess the internet makes that fear obsolete. 

Fleeting thoughts of self-harm during a low period are pretty normal as far as I can tell.

― OCD thoughts. The sufferer here doesn’t actually have the desire to commit suicide at all but  afflicted with persistent, disturbing thoughts and images of self-harm – a form of pure OCD known as suicidal OCD. The sufferer is not in danger of committing suicide, but needs treatment for the OCD.

― Suicidal thoughts during periods of an acute mental illness. This would include particular kinds of depression, including bipolar, that push sufferers into extremely desperate states. It might also include a psychotic episode for someone with schizophrenia. Such people might actually realise they are a danger to themselves and ring up a suicide line or admit themselves to hospital. That is, they may know that as a life choice suicide is not what they want – but they fear the illness will take over and make a terrible decision. Anyone suffering from an untreated mental illness could be at risk simply because their mental suffering is severe and they  don’t know how to reduce it.

― Suicidal thoughts provoked by unbearable grief. This can afflict all genders but males are particularly vulnerable because society teaches males to cover up and repress their feelings when they experience loss, for example the loss of the family farm or the breakup of a relationship. Some may find the feelings of grief unbearable or fear that the feelings will never change.

What these people desperately need is help to process their feelings. Often these feelings may be accompanied by unhelpful, unrealistic ideas about gender expectations, so these people may also need help in being compassionate with themselves and letting go of outdated ideas. The latest DSM has been criticised for pathologising grief, but this is perhaps because the idea of a drug for grief is so counterproductive. Perhaps it’s not that the grief itself is pathological, but that sufferers of pathological grief don’t have the tools they need to process and get through it. Help with doing that – if the therapist is willing to ‘suffer with’ the patient – can only be a good thing.

―The suicidal thoughts of someone with mental illness when they have insight. These thoughts are based on the overall quality of life, and the reality of continuing mental suffering. These thoughts could be equally applicable to someone with chronic physical illness or disability, and also their carers.

In particular this reason may merge with the previous one because any kind of illness or disability involves an element of ongoing grief as to the limitations that the illness places on the sufferer (even if some of those limitations are caused by social attitudes). So feelings of quality of life must be dealt with separately from the grief-work that is part of having a chronic condition or caring for someone who has.

What this shows is that there is not just one remedy for suicidal thoughts and impulses. However, if someone feels acutely suicidal then there are urgent things that need to be done regardless of the causes. The appropriate treatment comes later.

Giving in to the Madness of Christmas

I didn’t want to wish anyone on Twitter Happy Christmas (or happy holidays) this year. I had to force myself.

It’ s not that I don’t want them to be cheery. It’s just not how I’m feeling, politically speaking any way.

Christmas is always a strange time for the sanest of us, let alone those with an anxiety disorder or other condition.

As my doppelganger FCM I’ve had a Twitter account for a few months now. It consists mainly of links to articles about the terrible things going on in the world, with some interesting literary snippets thrown in.

In the lead-up to Christmas this year I felt such a strong need to stop the political hectoring, the calling out of bad behaviour, the keeping up to date with it all. Such an overwhelming desire to withdraw and to give in to the madness of Christmas.

Yet the world didn’t stop being messy and tragic. New tragedies kept happening. Some were human made, others less obviously so.

The unpredictably bizarre injustices of the Abbott government have had an effect on so many Australians this year. No-one likes Tony Abbott much, not even Liberal voters, and these days his Treasurer, Joe Hockey, is just as reviled.

On 22 December, just days before Christmas, Abbott announced that Scott Morrison, who as immigration minister removed the obligation that Australia follow the refugee convention, and set off a scale of death, torture and misery in the gulags  detention camps that put Australia to shame, will now be our Minister for Social Services.

To paranoid lefties like me this seemed a cruel joke, both in its substance and its timing.

Tragedy continued internationally. In Missouri yet another black teenager was shot by police. Hundreds of thousands of people were evacuated from their homes, and at least 24 killed, following massive flooding in Malaysia. A plane carrying 162 passengers from Indonesia to Singapore went missing mid-flight, and the wreckage has since been found with all passengers presumed dead. The international community has continued to ignore the plight of the more than 1 million refugees fleeing the conflict in Syria.

Yet the need to withdraw from the fray, at least partially, has continued. My Christmas depression this year was partly just a response to the hullabaloo of Christmas itself, which seems to be a little more disconnected from reality, a little more surreal, every year.

There is such a yawning gulf between the hectoring cheerfulness of the relentless carols and the mad spending of the crowds on the one hand and my own state of mind on the other that it produces an odd lurch into alienation.

But like birthday depression, I suspect much of what passes for Christmas depression is unacknowledged grief, which is rampant in our society. In A Life at Work, Thomas Moore talks about the difference between the human soul and the human spirit. The soul seeks the past, the familiar, and is rooted in the earth. The spirit seeks out the new, the unknown, creativity and challenge.

Christmas is a time in which the soul demands to be heard above the din. At Christmas, even more so than at birthdays in my experience, the soul longs for the certainties of the past. Over the last few weeks I’ve found myself driving past my old place, which I moved out of in May, several times. I realised that it was the first Christmas I’d spent away from the place for ten years, and my first Christmas at my current flat. My soul was yearning for that connection with past Christmases.

But perhaps notions of unacknowledged grief are just scratching the surface when it comes to the kinds of funk people experience on holidays, birthdays and anniversaries. I’m reading Horse Boy, an inspiring book about how an autistic boy was healed of many of his worst behaviours by a combination of horse riding and a series of gruelling healing rituals by Mongolian shamans.

This book has made me wonder whether my understanding of spirituality and its repression in the West has been incredibly shallow. The spirituality of the Mongolian shamans seems to allow them to harness powerful forces for healing that put our Western alternative healers to shame. The scale of what we have lost in modern life suddenly seems so much larger, and is perhaps the reason for all the mental illness we are experiencing.

Yet there’s no need to ditch the scientific method that has created such leaps and bounds. If science had an open enough mind to explore what was going on when the shamans healed Rowan Isaacson, whole new areas of study could be established.

They might include an expansion of human psychology. Maslow’s hierarchy of human needs was an important milestone but perhaps it should also include the need to connect with the forces of the Earth and to balance them within ourselves. No wonder even the sanest of us goes a bit mad at Christmas. (In fact there have been studies of shamanism in relation to Western notions of mental illness. However, my sense is that interest in shamanism is still considered flaky within the mainstream psychiatric community.)

But as usual I’m getting ahead of myself. My challenge for Christmas this year was just to let go. Not try to change my rellies, or escape the boring bits, or get angry because our family never – I repeat never – gets around to eating lunch before 3 pm by which time my blood sugar is lower than Scott Morrison’s ethical standards. What else was there to do but play that daggy Christmas carols CD, break open the Christmas crackers, put on the tissue-paper hat that never fits properly and read out the dumb joke? I just let the whole circus roll.

Okay, so there was one conflict towards the end of the night but it arose from another family member’s angst, not mine. I’m not wearing it!

Happy new year to everyone out there in blog land.

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The Familiar from a Different Angle - Renting, Moving and Disorientation

Last week I was planning to go to a yoga class at a neighbourhood house in the adjacent suburb of Elwood. It's a place of picture-book picturesqueness with narrow winding streets and rows of art deco apartments and intimate shopping centres with independent boutiques and an oversupply of cafes (there's also a flashy, beachy aspect that we won't go into). It is heavily freighted for me because I lived at the Elwood end of (then ultra-hip) St Kilda for one year back in 1988. Nowadays both suburbs are just ultra-expensive, but they still carry for me the weight of the bohemian romanticism that blinded me to the necessity of home ownership for so many years. Much of the charm that attracted the young to these suburbs in the seventies and eighties came from the strong presence of Jewish people from Eastern Europe who had settled there after the Second World War, bringing their rich artistic and culinary cultures with them.

I mapped out the route I would take to the yoga class using Google maps. It was a trip of only seven or eight minutes, but I have lived in Melbourne all my life and although I am not really familiar with Elwood's mish-mash of streets it is not as if they are foreign either.

Yet I could not find the place in time for the class. I drove up the wrong street and then I was in the right street but with not a clue which section of it the neighbourhood house was in. The class started at 6.30 pm. At 6.45 I turned for home feeling cheated, my attempts to reforge my life in this new place stymied. Yet there was a deeper problem. I couldn't really imagine myself at the yoga class. There was something fairytale for me in my mental image of it. As if I was fated not to make it there, because it wasn't quite real.

This raises a mild mental problem that I don’t think or talk about that much because it usually doesn’t involve suffering. It's the place in my experience where dysthymia (mild clinical depression) meets depersonalisation.

I managed to get to the yoga class the following week – I had done the trip in daylight the Saturday before, determined to know in advance exactly where the centre was. And as I waited to give my money to the short, sweet-looking female yoga teacher with the kind, lived-in face and the Eastern European features – the sort of person I associate with my traditional idea of Elwood – I started to feel slightly removed from the situation. For a few seconds I felt as if I was experiencing a memory of this event – but not in the sense of deja vu; rather, in the sense that the emotional content was simply not strong enough for the episode to be taking place in the present. It had a recycled quality. I mentally shook myself and was back in the present again, but a little unnerved. It was as if I could not take in the reality of having managed to join the class.

These feelings are not acute or frightening. They hark back to my nervous breakdown at the age of 21, when they were infinitely stronger and more threatening because I fought them ceaselessly, scared shitless as to what they indicated about my mental state. They were accompanied some of that time by the distorted sense that everything around me was contaminated by being a manifestation of capitalism. Not contaminated in the OCD sense, just completely engulfed by this overarching political reality.

I wonder now whether the content of that distortion was less significant than it seemed to be at the time. Perhaps I have a constitutional inability to fully come to terms with life as it is without experiencing it as some sort of system that represents a threat to me. I wonder whether my ingestion of the bizarre worldview of Irish Catholicism at such a young age has forged this inability. Because now the distortion has a different theme. It’s been there for a few years but has grown stronger since my move – I see everything in terms of Melbourne’s stratospheric property prices.

The social and economic aspects of depersonalisation

The homes around me don’t seem quite real, because they are unattainable – completely so in my case, but also increasingly to people of the younger generation. The houses and old-style flats in Elwood seem to have regressed to the fairytale world of my childhood that I never really left. They are, in fact, fairytales because they look and sound like real homes while being the residences and future homes of millionaires, or the playthings of rich investors. (Mansions don’t have that effect on me, probably because they represent a class that has always been there and whose wealth has always been unattainable to most.) My continued romanticisation of places like Elwood is both a defence against the realities of Melbourne real estate and an acknowledgement of how surreal house values have become in relation to daily life.

It’s confusing because the architecture of where I live has very distinct delineations depending on the area. My suburb, Gardenvale, is more ‘comfortable’ and established than East Malvern, the suburb I left, yet it’s also much less showy (a large Jewish population; people who have bought there simply because they like the beach). But Gardenvale also has elements (architectural as much as anything) of Brighton, the posher suburb over North Road, which is different again (old money and cricket stars). Then there’s Elwood, to which yet other kinds of money are attracted (rock stars, rich new agers, young professionals who love the outdoors, wealthier young families).

Yet Gardenvale itself has felt fresh so far, a place in relation to which I have no emotional baggage. I have commented on the strange foreignness of this suburb, the sense that I have moved to another country rather than an area that is 15 minutes drive from my folks' place. This has also been profoundly disorientating, but not in a bad way.

There is a further complicating factor. When I lived in inner city Carlton for five years in the nineties I was always bumping into people I knew (I’m sure this still happens to younger people who are willing to pay inner city rents). I’ve long moved from Carlton but on my fairly regular visits there I rarely bump into people I know. So there’s a feeling that I have lost my peers, and a sense that they have all moved to the inner north and left me alone (Coburg, Preston and Reservoir, inner northern suburbs which were affordable in the nineties but a long way north of Carlton, spring to mind). I think this loss of community strengthens my feelings of confusion and disorientation when I go back to old stamping grounds like Elwood. Perhaps there’s an age factor also – does depersonalisation get more acute with age, as the brain tries to process an increasing bank of memories while also taking in the present?

Perhaps my dysthymia and depersonalisation are also due to my precarious place in the social fabric. For a while I seemed to be experiencing them less often since joining Grow, but since moving house they've come back. Perhaps they are the way my mental weakness expresses the fundamental puzzle of where I fit in now. Is there any of the old St Kilda and Elwood left? Even if there is, is it actually relevant to me? What am I doing here? What does it actually mean for me to live in a particular location as a childless single woman in her fifties, who’s on a low income?

But I shouldn't talk only of my disorientation and failures to arrive. I now live about five minutes closer by car to the centre where my weekly Grow meeting is held. And only one or two weeks after I arrived in Gardenvale I managed to find my way on foot to a local Buddhist temple that I'd found on Google Maps. That first walk there was taken with the near-certainty I'd get lost but luckily as I approached the temple, a white neoclassical mansion with a park behind it, other people were converging on the property. So there was a feeling of mastery, triumph almost, at having made it to the temple – a sense that I still had it in me to settle in a new place and find new places to go.

But the sense of formlessness still returns, especially on these winter nights that fall so quickly, so early. Who is this new version of me who lives in this in-between suburb yet rushes off to Elwood? How can she relate to anyone living in either area when most of her peers will have kids and own their places? Is she ever going to stop romanticising suburbs over which real estate agents have been greedily rubbing their hands for decades, or is it possible for a suburb to retain some kind of identity beyond real estate values, a retention some Elwood and St Kilda residents seem determined to achieve?

Ah what the hell. I'm going to give up analysing and join the artists.

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Heatwave Hell in Melbourne - And Afterwards

Pic: Koshy Koshy

Last week, Melbourne endured four days of temperatures over 40 degrees Celsius, including three days over 42, and two days at virtually 44 degrees.

Adelaide fared even worse: 42.1 on Monday, 45.1 on Tuesday, 43.7 on Wednesday and 44.2 on the Thursday. On that day Roseworthy, north of Adelaide, was the hottest place in South Australia, with the maximum temperature reaching 46.4.

I wasn’t expecting to write a blog entry primly entitled ‘How I felt after the heat wave’, especially as I’ve just had a whinge about the difficulties of being green and anxious. But then a couple of friends talked about being depressed and tired once the weather had changed so I decided to make a few speculations about it.

It was a week when things got a bit too sci-fi for my liking. The level of heat was something I felt I hadn’t experienced before, but apparently things got this bad back in February 2009, culminating in Black Saturday, when the temperature reached 46.4 in Melbourne. (As you can see these extremes are turning me into a climate nerd!)

It seems there is something we lack when we think and talk about temperature. We don’t have the words to describe the spiritual and emotional effects of extended heat. We know that the very young and the elderly die in heatwaves, as do numerous small animals – bats, possums, birds – and in the worst hours we fancy we experience something of what they must have gone through, but we can’t possibly.

Nor are we able, as a society, to communally memorialise the heat. We commemorate the bushfires of course, and the terrible loss of life and home, as we should. But somehow the communal bruising of extended extreme weather doesn’t get memorialised.

Perhaps we should have some kind of public art work that can be added to over the years, recording the highest temperatures for each summer with accompanying statistics and stories. Some of those stories would be funny but some of them would be tragic – losing grandparents and young babies to heat stroke for example. More than double the number of people died of the heat in the week before Black Saturday (374) than died in the fires (173).

Maybe the lack of a vocabulary for this type of stress is why some people try to go on as if nothing has changed – there were still joggers on my street early in the the mornings of the hottest days. Routines are comforting touchstones in uncertain times, but it's important to adapt and bend. A friend of mine rode his bike to the local shopping centre for breakfast, but he rode slowly, and found it less tiring than walking would have been.  

Suffering the heat

With extreme heat and cold, it’s not, in a first world country, just about the temperature. It’s what battling the temperature, and the practical effects of the extreme weather, takes out of you physically and emotionally.

If your body is overheated for a long period of time, it’s a low-key, extended suffering. It’s exhausting in a way that is difficult to describe. I imagine that battling with extreme cold has similarly debilitating effects.

But why the mental effects, the lingering ennui and depression? Although there is a robust public discussion about the heat, with plenty of warnings and advice about how to cope with it, there is no advice on how to cope with the fears it engenders. Perhaps being very hot for a long period provokes ancient, preverbal terrors. There’s also the strange sense of anticlimax that we experience when the temperature drops suddenly, and we are expected to go back to normal straight away.

Yet it’s fundamentally wrong for the body to be this overheated and it feels that way. It took me three days to get over the physical effects of the heat. In those days I paced myself well and got everything done that I needed to. And there were small breaks, too, during the ordeal, like the Wednesday morning at quarter to six when I opened the front door and the morning air was cool and welcoming so I walked a couple of blocks and it was the most beautiful reprieve. To feel alive in the world and able to move freely without being overheated.

But by the last day I’d had it. I escaped the house at about 3, drove myself to Camberwell library, picturing the waiting beanbags, which no one usually uses – imagining myself on one of them. And when I got there, sure enough there were a couple of empty beanbags. On one side of me, a young man had fallen asleep. On the other, a young couple sat close and chatting quietly. An almost full bottle of spring water on the ground beside them. Forgot. The. Water. Damn. At Ashburton library two days earlier, the staff had put out a jug of water and plastic cups – a great idea. Camberwell library hadn’t done that so the utter joy of the beanbag was marred a bit by thirst, but it was manageable.

Anyway, the end of the ordeal was in sight, and came earlier than expected. On the way home from the library the temperature started to drop – by about 10 degrees Celsius in an hour. That was enough to provide immediate relief and then the full cooling came a few hours later.

It was a sobering glimpse into a future dominated by catastrophic climate change. When I was growing up, it was a big deal (and kind of exciting) for the temperature to reach 100 degreees Fahrenheit, which is ‘only’ 37.7 degrees Celsius. A few months ago the Bureau of Meteorology made an announcement – that the climate of Australia had changed, and that there was no point in looking at climate records to forecast the future. I try to imagine what would have happened if those four days had stretched to five, or six, or more.

In the future, will there be a number of days every year when certain places will be simply uninhabitable? I imagine there could be evacuations. Or instead will there be public places set aside with airconditioning for people to huddle in?

When it came to bushfires – which usually get worse when the cold change hits because the winds fan the flames – my state got off lightly. There was no repeat of Black Saturday. This was a huge relief, although in Victoria alone, the Grampians blaze burned for 52,000 hectares, one person was killed, about 4000 sheep lost their lives, and 27 houses and about 60 other buildings were lost. Terrible, but it could have been so much worse.

So – a huge impost on the body and spirit that probably translates into a huge dive in productivity across the state. I feel as if I’ve gone through some ritual ordeal. And yet in twenty years' time I won’t be boasting to my great-nieces and nephews about how I lived through the Great Heatwave of 2014 – what they will have to put up with in future heatwaves will make last week look like a pleasant spring interlude!

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Silver Linings Not All They're Cracked Up to Be

I finally got around to watching the comedy-drama Silver Linings Playbook the other night. The film’s hero, Patrick Solitano, is a sufferer of bipolar whose problems stem from his initial refusal to take medication. I’m not exactly the first person to watch it through the lens of mental illness, and to be judging it poorly on its portrayal. Yet it’s been critically acclaimed and has received a huge number of accolades, won Jennifer Lawrence an Oscar for Best Actress and and has a 92 per cent critics rating on Rotten Tomatoes.

Actually, the parts of the film that did deal with mental illness weren’t uniformly terrible. If the humour is done in the right way (ie laughing with, not laughing at) the travails of trying different drugs and putting up with the side effects until the right drug is found can have a funny side. The ability to laugh at difficulties is an essential tool for getting through any chronic illness, and also a way of educating non-sufferers.

However, while Patrick and his potential romantic partner, Tiffany, initially toss drug names and their side effects at each other in a humorous way, once Patrick is resigned to taking his meds the film as a whole simply forgets that both of them are on drugs. There are no more side effects, no having to get off one drug and try another, just two people trying to be human. Which is fair enough, but the loss of drugs from the narrative, which implied that both characters were on stable regimes that enabled them to enjoy complete sanity, made me wonder whether the film had been funded by a drug company.

But I don’t want to give the impression that this was the sole thing wrong with Silver Linings. I wish. No, it was the script and the characters. There is a certain kind of Hollywood humour that consists of people starting off on a high register of emotional conflict, and staying there. Part of the humour in these films consists of people being rude and abusive to each other. This is the style of Judd Apatow, who directed and cowrote films like The 40-Year-Old Virgin and Knocked Up. It has been hugely successful, so much so that other writers have adopted it (traces of this style can also be found in The United States of Tara).

This, sadly, is the style that dominates Silver Linings Playbook, courtesy of writer-director David O. Russell. Robbie Collin of the Daily Telegraph said there was ‘a tiring fruitlessness to the mayhem’ of the film, and I couldn’t agree more.

I didn’t entirely dislike the characters – there is something brooding and interesting behind Jennifer Lawrence’s Tiffany and she’s such a good actress she gives every character resonance – but the script makes her a lonely bad girl in a way that is cliched and boring.

But no movie experience is a complete waste of time. It was actually quite timely – well, spookily timely – sitting there and watching the hero deny his need for meds. I have just been going through the same thing – coming off Luvox because it had stopped working, trying to exercise to compensate. Then my back gave in on me and my mean sister told me that she had noticed I wouldn’t look at her.

So I did some googling and found an SSRI called Lexapro that seems to have fewer side effects than other SSRIs. I am seeing my doctor and hopefully getting a prescription when the surgery gets back from holidays next week. (Art imitates life, or is it the other way around?) I wish I could be confident of ending up as functional as Patrick is by the end of the film, but I fear that my experience with Luvox will be repeated with Lexapro and I’ll have to switch again. Watch this space ...

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’Tis the Season to Be Melancholy – Enduring a Bout of Christmas Depression

Pic: Mike McCune

I have been suffering Christmas depression since I first became an adult. It was a long time coming because if truth be told my parents were as reluctant as I and my four sisters to give up the old rituals – we still put out our Santa sacks even in our late teens, although by that stage they were thankfully left under the tree rather than at the end of our beds. Perhaps it was after the last year of the Santa sacks that the Christmas depression first showed itself?

Here, for the record, are the symptoms: weeping uncontrollably at one’s desk; regretting the entire life course one has taken; and a pall covering everything as if one is living in a fake, Truman-style world that can offer nothing that is authentic or remotely interesting.

And perhaps the most clichéd of all, wishing fervently that Christmas could take place every second year instead of annually. Wouldn’t that be more sensible?

These kinds of seasonal depressions follow their sufferers around like drones. They seem to find us. We do not choose them. Anyone who, like me, suffers anxiety and depression throughout the year is a prime candidate.

Each year the scale of the attack is completely unpredictable. One year, swept up in a pre-Christmas deadline frenzy, the whole shemozzle completely passes me by; another year there might be faint twinges a few days before Christmas, while the following year I will be swamped by dark ruminations as soon as December hits its stride.

More than anything, their weapon of choice is the past. Reels and reels of negatives (the word having two meanings here) of all that is irretrievably lost. By a certain age we have all sustained many losses and regrets, but at Christmas some regrets seem to be more equal than others.

Namely not having a family of one’s own. Reading stories about families is a big no-no for me at this time. In fact you would think Monica Dux’s Things I Didn’t Expect (When I Was Expecting) would be a fine book for a single, child-free woman to read around Christmas, with its tales of collapsing vaginas, stigmatic nipples and psychopathic mothers’ groups. You’d expect someone like me to be sighing with relief and thanking Fortune I’d somehow wiggled my way out of that. And on one level I am. As a feminist, I certainly don’t feel a woman’s worth and identity depend on her status as a mother. It is the whole family orientation of Christmas that sinks the (Santa) boot in. When I found myself envying Dux despite (or perhaps because of) what she’d been through, I knew it was going to be a bad bout this year.

You’d also think getting into the thick of the shopping scrum would help, and it can for short periods. But if you stay too long you’ll be hit by a percolation of hissing irritation that threatens to bubble over into a bad case of mall rage. All these people with lines of children attached to them like charm bracelets, throwing money around like they’ve just had a big win at the races, are not fun or edifying for a single person to witness for long periods.

And if you’ve made a decision not to buy a lot of presents at Christmas, as I have this year, that leaves you without an important compensation for the Christmas frenzy – spending money on other people. Research suggests that no matter how much or how little you spend, it actually feels better to buy for others than to buy for yourself. As someone with ten nephews and nieces I’ve given up trying to pick a present for each one of them at Christmas; and while that saves me time and effort and helps the planet a tiny bit, it also robs me of a chance to leaven my Christmas depression with a dose of therapeutic giving.

Just because other people go through similar torment doesn’t mean you get to join a fellowship of sufferers. This is because there is something deeply personal about how we celebrate (or don’t celebrate) Christmas, demonstrating how individualistic our society has become. At this time, whether or not we are Christian, we are forced to withdraw from the social world and into the bosom of our family networks. And whether those connections are firm, fragile or merely frazzled, we are stuck with them like never before. ‘What are you doing for Christmas?’ we ask each other. We rarely say, for example, ‘Can I catch up with you on Christmas Day?’

This Christmas, I will play my usual role as black sheep in the Christmas nativity of my birth family. And I will be grateful to do so. I know a friend who is spending Christmas Day alone, and another friend who hosts a small gathering of fellow Christmas ‘orphans’ each year. I have decided not to extend an invitation to these friends, simply because I don’t want to impose the tricky-at-best family dynamics on them.

This reluctance to meddle with tradition also suggests that my own Christmas depression has become for me an inextricable part of the annual ritual, along with feeling left out because I can’t join my champagne-quaffing sisters on Christmas morning (dietary reasons), eating a kilo of roasted cashews before lunch to compensate, goading my father into political  arguments by making extreme left-wing comments while he tries to eat his Christmas pudding, and falling asleep in the spare bedroom at 5 pm precisely.

Despite the above, wishing all my blog readers a safe, peaceful and stress-free festive season.

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Book News

Here’s an update of my publishing adventures ...

I’ve now published a book about Birthday Depression! It makes no claims to cure it, doesn’t tell readers to just get over it. Instead it offers some keys to understanding, and perhaps even benefiting from it – looking beyond the balloons and streamers of the ‘celebration’ to what’s really going on underneath.

The book is available to US readers,  UK readers and now there is a separate Amazon Australia site.  (There are also several other country sites but too many to list.) 

Unfortunately at the moment if you’re buying in Australia, you can’t click to see the book on the Australian site – have a look inside on the US or the UK sites.

My memoir now has a review! The reviewer gave it five stars which is extremely gratifying.

Of course this is exciting but I want to reiterate that I am interested in getting a wide range of feedback about the book. I do not expect every reader to have the same reaction to it.

I’ve also updated the memoir – it now has a new title and blurb.

If you don’t have an ereader, don’t despair. You can download free Kindle apps for your tablet, smart phone or computer (PC or Mac).

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Memoirs of Madness: Five of the Best

The memoir of madness has been with us far longer than Sylvia Plath’s Bell Jar or William Styron’s Darkness Visible. Firsthand accounts of life beyond the limits of sanity have been around from at least the early nineteenth century, as this alluring bibliography attests. 

Below I’ve picked five of my favourites, all dealing with illness that includes elements of psychosis. I’ve chosen these memoirs because they are all vividly written and because they provide vital insights into the treatment and lifestyle needs of people with mental illness. Each and every one of these memoirs makes the loud and clear declaration that it is never more important to view the mentally ill person as a complete human being with human needs and emotions than when they are most acutely ill.

Madness: A Bipolar Life by Marya Hornbacher

Already a classic in the field, Hornbacher’s riveting immediacy, hold-onto-your-hat style and liquid prose make this memoir un-put-down-able, even as the reader squirms. She ignores her bipolar diagnosis, ditches her medication and descends into alcoholism, destructive relationships and psychosis before colliding with the consequences of her illness and making a slow journey back to sanity. Meeting her husband Jeff, finding meaningful work and suffering extended stays in a psychiatric ward are all part of the fabric of this painful and visceral but ultimately uplifting memoir.

Madness: A Memoir by Kate Richards

This memoir is written in the tradition of Hornbacher’s but Richards has a talent and voice that are hers alone. Richards’s seductive prose demonstrates that great pain and suffering can actually amplify the sensory perceptions that make life rich and meaningful. At the start of the memoir the narrator’s psychotic depression has left her an emotional adolescent, addicted to sleeping pills, dependent on alcohol and lacking in life skills. But sustained by music, literature, philosophy and the outdoors, meaningful work as a medical researcher, strong friendships and the support of a wise psychologist, Kate and the reader emerge into the daylight – with all the down sides as well as the joys and possibilities that stem from coming to terms with life and chronic illness.

One of the key strengths of this memoir is the passages written while the narrator is in psychosis, seemingly drawn from Richards’s diaries. They explore the limits of meaning, collapsing the difference between subject and object and demonstrating the dangers and lure of madness. At the same time the memoir encompasses vivid accounts of episodes in psychiatric hospitals and a grounded critique of Australia’s mental health system.

Flying with Paper Wings: Reflections on Living with Madness by Sandy Jeffs

Sandy Jeffs is a popular Melbourne poet and an acclaimed community educator on mental illness (in her own words ‘professional lunatic’). In this honest and moving memoir she reflects on a life lived with the chronic illness of schizophrenia following a semi-rural childhood riven by constant battles between her alcoholic mother and violent, controlling father.

Jeffs’s experiences in Melbourne mental hospitals from the 70s onwards, mostly harrowing but occasionally affirming, the stubborn viciousness of her inner voices, the sustaining support of her alternative family, and the world of literature and philosophy that feed her intellect and spirit all enrich this narrative. Entirely lacking in self-pity, this is a document imbued with the wisdom and clarity of a well-lived and nurturing life despite mental health that is at times precarious, with plenty of useful lessons for carers, professionals, policy makers and the general reader.

Hurry Down Sunshine: A Father’s Story of Love and Madness by Michael Greenberg

Photograph: Marion Ettlinger

This is a poignant and beautifully written memoir about bipolar disorder from the perspective of fatherhood. Greenberg narrates the horror of watching his beloved daughter Sally switch suddenly into bipolar psychosis at the age of 15 and eke out a slow, shaky recovery in a no-frills Manhattan psychiatric hospital during a sweltering summer. It is meticulously and delicately written in a realist style that conveys the heaviness and various losses that result from watching a loved child disintegrate, as well as the financial stresses of living in New York, and of dealing with an inflexible, privatised health care system.

Greenberg describes madness as something that takes his daughter far away from him, and vividly conveys his fears that she will never return. The awkward encounters between his current and his ex-wife, the eccentricities of the other patients, as well as the burden he already bears of supporting a mentally ill brother, ground this memoir in a complex and challenging context.

The Center Cannot Hold: My Journey through Madness by Elyn Saks

Elyn Saks is a tenured professor of law and psychiatry at the University of Southern California with degrees from Oxford, Yale and Vanderbilt, and an expert in mental health law. She has also had the experience of being forcibly restrained for hours on end in psychiatric wards and forcefed medication while suffering acute psychosis. This memoir describes Saks’s struggle to accept and manage a diagnosis of schizophrenia, while forging a stellar academic career.

Saks first experienced full-blown psychosis as a young postgraduate on a philosophy scholarship at Oxford. In The Center Cannot Hold she documents her torturous journey towards accepting the severity of her illness and the need to take medication. During this period she was able to avail herself of skilled psychoanalysts who understood the emotional content of her delusions and enabled her to maintain some degree of equilibrium.

Saks gives important insights into her state of mind during her most acute episodes and how traumatised she was by the dehumanising treatment she experienced after suffering a breakdown at Yale. Key here are the human aspects of the illness – the way it is affected by stress, Saks’s struggles to maintain her academic career, and the shocking attitudes of psychiatric staff who valued compliance over healing. ‘While medication had kept me alive, it had been psychoanalysis that had helped me find a life worth living’, Saks asserts. The support and intellectual engagement that her career and her academic colleagues provide, her ultimate acceptance of the need for ongoing medication and her fulfilling marriage in her mid-forties together enable a life that is ‘rich and satisfying’.

Narratives of madness

These memoirs are riveting yet educational reads for the general public, as well as important guideposts for sufferers. But they are also vital documents for mental health practitioners, akin to qualitative research about the experiences of users of mental health services.

Three of them, Madness: A Bipolar Life, Madness: A Memoir and The Center Cannot Hold, contain a similar trajectory – after experiencing the extremes of the illness, sometimes worsened by addiction, the sufferer eventually comes to accept the need to take medication and to manage addictions and stresses, and learns how to maintain a balanced, fulfilling life. 

This trajectory suggests that if the right level of support and skill were offered early enough, sufferers might be able achieve recovery without the self-destruction and descent into addiction that are so commonly represented as necessary stages on the journey.

All five of them reflect on the human elements that make the long-term management of illness – and just as important a fulfilling life – possible.

In The Center Cannot Hold and Madness: A Memoir, what makes this journey possible is the loving, sustained attention of therapists who provide a safe psychic space in which the patient can explore emotional defences and gradually embrace maturity.

In Hornbacher’s case it is her ever-patient psychiatrist, the hospital she lives in for months on end, where staff are unendingly accepting and supportive, and the unconditional love and fortitude of her husband that together create a safety net in which she is harboured until the illness is tamed.

In Flying with Paper Wings, it is Jeffs’s ‘two Demeters’ – the female friends with whom she has lived in a peaceful setting on the rural fringes of Melbourne for 30 years.

In Hurry Down Sunshine, it is the sustained love and attention of Sally’s family, including the father–narrator, that eases Sally's transition to precarious sanity.

Creativity, purposeful work and strong friendships also play vital roles. Secure housing is vital and the fact that most of the stories feature middle class sufferers is no accident. Kate Richards expresses how lucky she is to be able to afford to choose her own therapist, and to buy a home that offers not just long-term security but a haven.

One of the reasons for the importance of these memoirs is their various critiques of the psychiatric profession and the mental health sector.

The memoir of Richards, a medical researcher, has not one decent psychiatrist throughout its 200-plus pages. Not one. They are helpful in dispensing medication, but the healing she receives comes from a psychologist. The implication is that the problem is systemic, due to faulty training – Richards is ‘sacked’ by one psychiatrist, while others demonstrate various levels of boredom and disengagement.

Sandy Jeffs also questions psychiatry, having left her long-term therapist, Dr Y, after 27 years. She is critical of what she calls ‘Fastpsychiatry’ and ponders the dangers and possibilities of investigating the psychic content of her delusions with a new therapist, Dr K, who is willing to explore with her the darkest underpinnings of her hostile voices: ‘If I could heal that little girl, would the persecutory content of my delusions and voices diminish, and allow me to embrace her?’

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