Reasons to Stay Alive

by Matt Haig

  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.

  But.

  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.

  Hypochondria.

  Separation anxiety.

  Agoraphobia.

  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.

  Lost.

  Clammy.

  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.


  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

  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.

  Facts

  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.

  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.