Tristimania

by Jay Griffiths

  My cats were also acutely important when I was ill. The poet Christopher Smart, who was manic depressive, spent seven years in a mental asylum. He was allowed to keep a cat, and wrote the loveliest ode ever dedicated to a cat, writing of his cat, Jeoffry:

  For there is nothing sweeter than his peace when at rest.

  For there is nothing brisker than his life when in motion.

  Now, as I write, my cat Tom is asleep on my study floor. He is using two of my small black notebooks from that year of illness as a pillow for his head. He is a feral cat but has been with me since kittenhood and is more attached to me than any cat I’ve known. What do they do, these pets, for our savaged psyches? They are company; they breathe near us, and that in itself is consolation. They are more than happy to wake in the middle of the night and pad downstairs to sit with us in the kitchen. ‘For he keeps the Lord’s watch in the night against the adversary,’ wrote Smart. They need us to feed them and, at my worst, this responsibility was more pressing than the need to feed myself but knowing that I could at least perform this task was helpful. They offer affection without analysis. They are an exercise in instant mindfulness: wholly purring, wholly stretching, wholly sunbasking, wholly catnip-toy-mouse-chasing. They cannot but live in an eternal present and do so beguilingly, drawing us, too, towards the glow at the heart of now.

  Though my sleep was short, the medication made me sleep furiously – that phrase which Gideon Koppel used to title his exquisite film, precisely because Chomsky had said it had no meaning. If I slept furiously, I also felt a life force furious within, of green life in a green flame flowing, and it seemed both to conjure and confound the suicidal thoughts which devilled me. Mania was like a Faust in my mind, paradoxically both calling up the demon suicide and at the same time driving it off in rage: when suicide seemed to tinge the edge of my vision, mania roared at it: Stand Where I Can See You. And FUCK OFF.

  Maybe the sleep of depression protects you, through its anaesthesia, from something worse, from the pain that would drive you to suicide. Perhaps, further, that’s part of the reason why mixed-state hypomania is so dangerous; because its depressions are sleepless, and that sleeplessness feeds on itself, self-cannibalizing. In sleepless mania, the mind is yellow-dizzy with a turbulence of colour, the air licks it with tongues of fire, flowers bow their petals like violinists and are bent to the applause of a rapturous wind while even the shadows of things are brilliant and burning. (Van Gogh knew.)

  The ferocity of life sought the idea of death like an artist might: a painter demanding chiaroscuro – dark light shining. Vitality connected me with every living thing and filled me with an acute love for the world’s life forms, for every bird, every tree, every mountain. Nothing seemed to have its normal surface; everything and everyone seemed semi-permeable. This, too, is the over-connected aspect of mania, and one of its most profound experiences is the feeling of being able to step over the threshold of ‘Other’ without quibbling about species difference, or language, or the expectation of either boundary-mind or barrier-body. This contains the blunt psychiatric concept of the manic ‘disinhibition’ but goes far beyond its crude enactions (taking one’s clothes off in public; being wholly inappropriate) into the precious experience of finding oneself porous to the world. It can thus be a spiritual experience and an artistic one. Keats’s famous ‘negative capability’ comes close to explaining this feeling that the psyche’s skin is transparent, and the psyche of others can seem so. It is a glorious trespass, weirdly observant, and often correctly intuitive, steeped in deep empathy, a fellow-feeling. Empathy, incidentally, is one of the key markers of manic depression identified by Darian Leader. No wonder so many people feeling manic and hypomanic want to have sex with loads of people, but that is so literal and therefore not as interesting as this extensive, metaphysical love, not crudely ‘making love’ but rather noticing the love surrounding every human, every animal, the transcendent betweenness.

  A friend was ill, with a breast cancer scare, and wanted me with her for some of the treatment, and we choreographed a dance of mutual care. I went to see her in London. But on the train I found myself desperately trying not to scream. I wanted to get off the train and do – what, exactly? Bizarrely, of all things, I wanted to find a policeman and ask for help. As if I needed someone else’s power, and my mind suddenly read ‘power’ literally. I had no idea what I would have asked them to do – call a doctor? Take me home? Hold my hand? Tell me a joke? What? I do not know. All of the above would have been helpful, but I was scared of their reaction. Transport police are in fact accustomed to coping with people who are experiencing psychiatric problems, and are trained to deal with them. Sorry, Officer, it’s a bit of an emergency . . . I need you to tell me a good joke. Yes, I know how absurd that sounds, but it felt as if a joke could create a sane link between my mind and someone else’s more quickly than anything else.

  Once I’d got to London, I had a soaring moment when I wanted to take my shoes off and run across the city, barefoot and naked, as if by doing so I could join myself to the roaring and jubilant pandemonium of cityness. My voice of reason stepped in firmly, quoting that familiar line: ‘The thing about inviting trouble is that trouble usually accepts.’ But I wanted to hold on to the spirit of that wish, the racing of naked flame without the embarrassment (and dangerous stupidity) of its actualization. On a bus going to my friend’s house, I watched a father with his three young children, and I felt a wave of utter love for them all, creatures as we all are of fire and love and need and hope. This sensual fire connects – one’s ardour easily sets another’s alight – but I wanted to let it run to the ethereal rather than the corporeal until I could cry out to the sky itself that I loved it.

  I was with my friend at a hospital appointment post-surgery. I was meant to be there as her Sensible Friend. (Ahem.) Trying with all my might to stay engaged, I managed to jot down the right questions we needed to ask and even get the answers. We came to the crucial appointment when she was told she was in the clear. She went into a shocked state of vertiginous relief. In the moment of delight and love, I slipped on a mental banana skin and fell into cartoon: Desperate Dan unleashed in Vizland. Hullabaloo – like a rubber boomerang made of chewing gum and powered by farts – exploded in my mind, and I started giggling terribly. One of the nurses was looking at me uneasily. ‘I’m so sorry,’ I gasped, ‘my friend’s just had breast cancer and I’m hypomanic, so we’re both off our tits.’

  Then my friend lost her umbrella and I lost her. It only lasted a few minutes, but it was as disturbing as a dream where everything is almost exactly as you know it to be, but with the crucial bit (my friend) entirely missing. When we found each other, we went out for lunch to celebrate her results and, although she was pleased, she was still weak and shaky. And there, as she sat opposite me, I could see her wings. Black and shining, her wingtips were tilted to hope, curious for sky, quizzically trying for a fledgling happiness. It was so right for her situation after the flightless and frightening cancer weeks, and I told her what I could see. Once again, I didn’t think they really existed, but it was like seeing an actualized metaphor, and I sketched her, and both of us hummed the Beatles’ ‘Blackbird singing’.

  The Christmas lights along Regent Street were like reindeer horns and made me feel trippy, the shoots and offshoots and offshoots of the offshoots, all curling and dendritic, like a visible and outward design of invisible and inward mind-lines, how one thought shoots off to another and another. My mind lit up and my heart felt full of love for my friend, and we passed a shop selling mugs and bought one for her saying ‘JOY’.

  It is ravenous, this hypomanic state; all-consuming and auto-consuming, and I could feel it yearning towards mania, wanting a higher reach. But aces in this bipolar game are both high and low, and after eventually managing to sleep that night, I woke with my face in spasm, muscles leaping through reflex of emotions unbidden. In this crash, London was a terrifying place to be, and I wondered how I could manage to
get home. I needed to be near my doctor.

  Technically, he was a GP, but more truly he was a mind doctor, a psyche-iatros, as the root of the word ‘psychiatrist’ attests, the most gifted doctor I’d ever met. He was also, in the deepest sense of the word, a healer. I had told him that in one early appointment, and he had gently turned the compliment aside, in a self-deprecating only-doing-my-job kind of gesture.

  I held on to these appointments as if my life depended on them, and this is no exaggeration. I felt at the time, and still feel now, that my doctor saved my life. In the course of the crisis, which lasted into weeks and months, I saw him dozens of times and, partway through, I began to wonder what it felt like to listen to a mad person so desperate to talk, so much and so often. Madness forces you to concentrate on it. It is attention-seeking because it wants an audience. Madness wants to paint its vision so the world can see what the human mind is capable of seeing. It wants to play its passions so the world can hear the song. It wants to write and speak because it seeks to be understood and to understand itself. It wants to utter – to outer – its inner knowledge. It is as if the human mind, on its continuum from normal middle C to the upper reaches and lower depths, needs some people to play the highest Cs and to be played by the cavernous bass, so that everyone may know of those realms, even if they themselves are never dwellers there.

  It is troubling to find oneself in mid-flight and uninterruptable, hijacking people’s attention. I suddenly remembered that joke about the egotist at a party: Is it solipsistic in here, or is it just me?; and told my doctor, who laughed. After that, I tried to save up any joke I heard or remembered, and take it to appointments to lighten his load of listening.

  I feel sorry for doctors: we take our dodgy psyches, our warts and bad breath, our boring aches and nondescript pains, our malfunctions and mishumours and moods, our putrid life experiences and biliousness and vaginal discharges and itchy foreskins and diarrhoea, and our bums-with-grapes and our leaking noses and eyes, and our swellings and protuberances and our history-ofs and our tears and our sleeplessness, and our skinninesses and our obesities and our corns and earwax and ingrowths and outgrowths and groins and acne: and we stick it all in front of the doctor, all this dirt and ugliness. Good doctors leave me in awe.

  Several people – particularly those in the caring professions – have asked me what exactly my doctor did that was so helpful. It seems important, particularly because so many people in manic-depressive crisis feel acutely aware of what goes wrong with their medical care. So: what did he do right?

  He listened, deeply. I felt as if he let my words into his mind, so that he could re-hear my words right inside himself and re-listen if necessary. There was a musicality to his empathy. He heard in resonances, making of himself the sympathetic string. I felt utterly – unbelievably – understood. Because he listened to my metaphors, I felt he was willing to walk with me in the landscapes of my mind. When I was stranded up a mountain, the one thing that kept me safe was a slender but strong rope which he held, and I trusted him not to let it go. It seems significant that many people in manic-depressive crisis, including me, speak of ropes, lifelines, threads and linking things, because this madness is sharply focused on connection and disconnection, from the neural pathways of the mind to the Trickster paths and the relational pathways between people. In the weirdscape I walked in, he was my lead climber, guiding in line with the etymological heart of doctoring. He told me the etymology of ‘doctor’, from docere : to lead, guide or teach; to hold someone’s hand and guide them through an illness. I was moved that this quintessential doctor should be the person who told me the quintessential meaning of his gift.

  Hermes’ staff, the caduceus, is the symbol of Western medicine, and the gifts of Hermes are related to medicine, including, as Zoë Playdon writes in Medicine’s Original Psychodrama: ‘the exercise of professional judgement, living with uncertainty, minute by minute, hour by hour, staying open to sudden changes, coping with twists and turns, and still finding the best route to health and wholeness for each individual patient. It is Hermes the compassionate Imagination who is the guide within the clinical encounter, drawing out the patient narratives and the doctor’s responses.’

  Manic depression is a tricky illness and people feel (and are) in a place of danger. My doctor gave me a sense of utter safety and protection, of being, in that tender phrase, ‘under his care’. I had a kind of fantasy sometimes that he’d just wrap me up in a tartan blanket and put me in his pocket for a few months and then, in time, I’d be okay, with the osmosis of a kind, sane mind.

  There was him, there was me, and there was a third place, the place between, where I could take my helplessly fluttering mind and huddle, safe, holding tight to the rope. He was ‘there for me’ in that simple phrase of pure gold. He made himself available, reachable. A couple of times, I felt I couldn’t wait for an appointment and wrote scrawled messages for him which I left at reception. A couple of times I phoned. Each time, he responded, and fast. He didn’t shunt me off to the circus of serial strangers which so many psychiatric patients experience, and I was grateful for that to the bottom of my heart. He was the NHS at its best.

  ‘We ought to take pride in the fact that, despite our financial and economic anxieties, we are still able to do the most civilised thing in the world – put the welfare of the sick before every other consideration,’ said Aneurin Bevan, father of the NHS. Meanwhile, during that awful year, when I saw my doctor for dozens of appointments, the Tory prime minister was suggesting that people should have just one free doctor’s appointment per year. ‘If the Tories get in again,’ my doctor said with real feeling, ‘there’ll be no NHS.’

  The mind, in manic-depressive breakdown, is precarious, fallible and mutable. It swoops, soars and slips. Flight collides with fall and the falls are brutal, breaking, bruising. But even the falls do not stay still. Cadences glitter in false certainty – ‘all that is solid melts into air’ – and the upswings run glissando arpeggios through you. Wherever I was, he positioned himself as a counterweight. When storm clouds overhead transformed to skylarks and I was flying, he gave me a sense of earthedness, holding a cautioning steadiness against mania. When firm ground turned to water under my feet and I was drowning, then he was buoyant and firm with gentle positivity. Both the drowning and the flying could reverse in minutes; flying fish and diving birds flickered from form to form, Escheresque, gold and blue, an amphibious either-air, an aether-ore.

  Madness is frightening but, into the chasms of fear, he threw ropes of reassurance which I remember, even though I know I have forgotten much that happened in the first weeks. ‘You will be okay,’ was one of the few things I can remember my doctor saying in the early appointments. I felt as if I were hauling a memory of reason within me to try to hear this, because it took enormous discipline and willpower not to lose myself into the chaos unleashed in me. He repeated his reassurance hundreds of times over the numerous appointments I had with him, and he seemed to believe it so completely that I held to it like a lifeline. The confidence (or lack of) which a doctor feels about a patient’s recovery can affect the outcome of their illness, probably never more so than when it is psychiatric in origin. ‘You’re going to be okay, you’re going to be okay,’ was unforgettable as a spell. It engendered belief in me and that belief went a long way to working its own cure.

  In the week when Robin Williams, himself manic depressive, committed suicide, the media re-told the story of a young man, Jonny Benjamin, who was deeply depressed and about to jump from Waterloo Bridge. He was talked down by a passer-by. The point the passer-by made was simple and powerful: ‘You will get through this.’ No one, Jonny said later, had ever told him this before.

  I held on to my doctor’s confidence like a saint’s relic and when I was alone I repeated to myself over and over his reassurance that I would get well. If he lost his confidence in himself or in the medication or in my recovery, he never let it show. I trusted him so I believed in his judg
ement; he said what he meant and meant what he said. I trusted him in another way, too: I confided in him, and felt that I could give him my hurt and secret things.

  I had trusted him from the very first appointment I’d had with him, several years previously, not in a state of hypomania but of severe depression. During the three months prior to that very first meeting, I had spent weeks intolerably isolated, mainly sitting on the stairs, en route to the unreachable kitchen or the equally unreachable bed. I eventually made an appointment, walking into his office with some almost-but-not-quite-fictitious ailment, unable to say anything about depression. He dealt swiftly with this semi-fiction. Then he slowed right down, and I felt him searching my face. He asked what I did for a living.

  – I’m a writer.

  There was a pause.

  – That must be very lonely.

  Five words.

  I wept and wept. The loneliness of my writing life, which fed the shrieking isolation I felt in depression, was named aloud. In five words, it was spelled and dispelled. Five words which began to link me back to the unlonely world. Five words which released me into being able to talk to a doctor about depression for the first time in my life, although I’d suffered from it since I was twelve.

  In the intervening years, I’d seen him several times, and I felt he knew me in wellness as well as in illness. He had a yardstick to measure both the heights and depths of this current episode. Without that prior knowing, what does a patient face? What can a doctor do? A patient may need to explain who they’ve become, in depression, just when they are sinking to silence. They may want to portray who they truly are when they are well, just when that seems an unrecoverable state of grace. A doctor, meanwhile, attempting in ten minutes to diagnose someone they’ve never met, is working blindfold, sticking the tail on the donkey. Both of them often end up meeting in the no-man’s-land of typical symptoms and the prescription du jour.