Matt Haig

Reasons to Stay Alive


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      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.

      Insomnia.

      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.

      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.

      HEY, SAD-SACK!

      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 FACTS

      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.

      DEPRESSION FACTS

      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.

      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