Depression

‘If life is a race, I feel that I’m not even at the starting line,’ I said to the doctor in French. (I’d composed, polished and rehearsed the sentence in the waiting room beforehand.) She was a sexy piece in her early fifties with a husky voice. She listened to my halting effort to describe my depression with a smile playing lightly over her scarlet lips as though I were relating an amusing anecdote with a witty punchline lurking just around the corner. I further explained in French that I had been properly but briefly depressed once before, about 15 years ago.

Still depressed, or, as Matthew Arnold put it, ‘the foot less prompt to meet the morning dew’, I got out of bed one afternoon and exchanged the soggy Devon hills for the tower blocks of Canary Wharf. I went at the invitation of Dr Ivan Mindlin, orthopaedic surgeon, Las Vegas casino house doctor during the mob-run era of ‘Lefty’ Rosenthal and Tony ‘the Ant’ Spilotro, and one of the most successful sports bettors in US history. He kindly put me up in an ‘executive’ room at a hotel round the corner from his 18th-floor apartment. The first night we went for dinner at a Chinese restaurant. We went there on foot. It was like going for a walk in a multicultural concrete-and-glass future.

On the Monday before Christmas, the black dog came around again and I couldn’t get out of bed. I lay all day staring at the wall. Depression has little to do with sadness, I think. It’s blankness. The same thing happened to me about 15 years ago. I was like a prize gonk for the four or five weeks it took for the Prozac to work, which it did, and since then I’ve managed to foster and sustain all the illusions I need to keep me buoyant. I couldn’t get out of bed on the Tuesday either. I was adrift in outer space. But I knew I must pick up the phone and make an appointment to see someone with a prescribing pad. It’s easier said than done, though, getting an appointment to see a doctor during the festive period.

In 1999 I went to the doctor about the impotence. Don’t worry, he said. I have good news for you. He prescribed a new drug called Viagra to get me over the psychological hump. It worked; spectacularly. In 2001 I went to the doctor mumbling about depression. Don’t worry, he said. I have good news for you. He prescribed a new drug called Prozac to lift me out of it. Within three months I was back on the poop deck of this ship of fools with the wind in my hair and salt spray on my face. In 2013 I went to the doctor because I couldn’t pee. A blood test showed I had cancer. Don’t worry, he said. I have good news for you. These days we have so many effective new drugs against cancer, it might not kill you. Three years later it still hasn’t.

Monty Don, the television gardening presenter, always comes across on screen as irrepressibly cheerful and enthusiastic, but this is a misleading impression. In fact, he gets black moods. ‘It’s no secret that for many years I’ve suffered from depression,’ he said last week at the Cheltenham Literary Festival. He had tried Prozac and cognitive behavioural therapy, but the only treatment that had worked for him was provided by his dog. ‘If you are unwell, physically or mentally, a dog is a huge comfort,’ he said. ‘Dogs heal. There is plenty of evidence to show that.’ I was glad to hear this praise at a time when the word dog is more famously being used as a term of disparagement.

Baby George was born into a happy family. His mother and father love him dearly. He lives in a cottage in a pretty village, with a six-year-old sister who adores him, and his grandmother lives nearby. His parents both have good jobs and his nursery is filled with toys. By most measures, George has had a good start in life. It was only when his mother was diagnosed with post-natal depression that George’s prospects looked bleaker. Not because his caring mother was feeling blue, but because in this, paranoid, post-Baby P era, the authorities take no chances. The slightest whiff of a mother unable to cope, and they swoop down, ready to whisk the baby away. When Rosie first realised she was depressed, she assumed the doctor would be able to offer her advice about how to cope.

Because, it says, of its ‘liberal values and respect for human dignity’, the Economist has put out a film about Emily, a 24-year-old Belgian woman, who wants assisted dying. She is physically healthy, and comes, the film assures us, from a happy family. She has suffered from severe depression since childhood, however. By her own account, her self-made video (two years ago), in which she says ‘I don’t want to live a lie’ and ‘It keeps feeling empty whatever I do’, made her feel empowered. It inspired her to seek death at the hands of doctors. Belgium is one of two countries in the world which permits assisted dying for psychiatric reasons.

The smart phone is a wonderful thing. We are never out of touch anymore, neither with friends nor with the world at large. But increasingly we read of the harm that it is doing us. We are no longer its masters but its victims. It makes us tense, anxious and insecure. We respond with unnatural haste to every noise it emits; and even when it isn’t peeping or squeaking at us, we neurotically check it all the time for messages that might have crept in surreptitiously. Psychologists and sociologists are having a field day warning us of its dangers. Our obsessive phone checking is affecting our brains, they say. It blights our relationships and stops us concentrating on anything.

I was signed off work five years ago. I had lost my job and was, unsurprisingly, feeling low; I went to see my GP, as I was having difficulty sleeping. Rather than dishing out a few sleeping pills, as I had hoped, my doctor googled the letters PHQ-9 on his computer and quickly went through the multiple-choice test for depression he found. Within a few minutes, I walked out of the surgery with a diagnosis of depression and a sick note stating that I was, in his medical judgment, unfit for work. Looking at the Patient Health Questionnaire now, one thing immediately stands out: the copyright notice.

There was much discussion recently about the rise in male suicide rates, after official figures published last week showed they were at their highest level since 2001. But one aspect of this has attracted little attention: the lack of support for men abused by their partners. In a poll of 130 Citizens Advice Bureaux workers, 63 per cent said it was easy to get help for women reporting domestic abuse, compared to 13 per cent for men. It’s bad enough that men struggle to find help once they pluck up the courage to ask for it. But they are also less likely than women to look for support in the first place - and more likely to be disbelieved.