One of the last things Saul saw before being tipped into his own personal inferno was a photograph of the Turin shroud. It was 1985. He was 15 and still a small boy - "pre-pubertal", as his psychiatric files attest. He had picked the shroud as the topic for a school history project, and now he was wrestling with it over half term.
Newspaper articles painted the dispute over the shroud of Turin as a battle between faith and reason. The Vatican was deciding whether to allow scientists to carbon-date a segment of the cloth. But even if the sceptics were vindicated, and it was shown to have come from medieval Europe, it still wouldn't explain how the shroud had been made. Could a 14th century relic-faker have created a three-dimensional image, in accurate negative, so that the likeness of a crucified man could be best viewed through a camera?
As Saul peered into the shadowy face in the photograph, an idea began to insinuate itself. If this were truly an image of Christ, then he should be looking at the imprint of goodness. But that possibility contained its own negative. If a different man had been crucified - his image being burned into the burial cloth by a freakish chemical reaction - then it was possible that this man had deserved his punishment. Saul began to feel that he might instead be gazing into the face of evil.
His parents had gone out that evening, leaving him at work on his project. They were worried that lately he hadn't seemed himself, but they had no inkling of what they would encounter when they returned home. They found their boy sitting rigidly at the table in his bedroom, paralysed exactly as they had left him, holding his pen over a blank sheet of paper. For three days he couldn't talk.
Saul's original diagnosis betrayed the fact that the first doctors to see him were baffled: "acute anxiety state with borderline psychotic features". Immobilised, blubbering, and soiling himself, he could barely speak except to blurt out panic-stricken ravings about sex or religion. Saul thought he had been possessed by a devil, possibly by Satan himself. Then it occurred to him that he was the devil.
After three months in a teenage psychiatric unit, Saul's condition improved and he went back to school - for the last time. Adolescence caught up with him, and so did the psychosis. He grew with unnatural speed and was seized by a mania so extreme that psychiatrists resorted to injecting him daily with 120mg of the anti-psychotic drug haloperidol. One nurse said it was enough to knock out a horse. (These days, the maximum recommended dose is around 12mg.) But Saul was more like a semi-tranquillised rhino, raging at his jailers through the fog of medication. What worked better were 13 treatments of electro-convulsive therapy.
Manic depression, or bipolar affective disorder, is an affliction of mood that switches the sufferer between extreme highs and lows of emotion, or "affect". In its psychotic form, it is one of the two classical types of insanity - the other being schizophrenia. Although the symptoms of each can overlap, the distinction is roughly one of thought and feeling. The delusions of the schizophrenic seem to belong to an alien system of ideas or perceptions. The manic depressive experience emerges through an excess of energies and passions - rage, sorrow, joy, horror - or their confounding absence.
In the 21 years since his first breakdown Saul has drawn strength from two ways of understanding his illness. First there has been his treatment at the hands of biological psychiatry. To be told that his condition is biochemical in origin has objectified it, allowing him to draw a distinction between his ill self and his well self. It has also allowed him to view medication, for all its inadequacies, as a means of fighting fire with fire. What he has not done is paid any heed to psychotherapeutic attempts to root out childhood causes or find psychological resolutions for his illness. He calls psychoanalysts "moonies" and cognitive therapists "numpties".
Saul's existential fall-back has been religion, and he sees no conflict between faith and biology. In 1988, the Turin shroud was carbon-dated to the middle ages; then the accuracy of the carbon-dating was undermined. The puzzle remains the same. Saul now thinks his childhood vision of the shroud as a Janus-like face of good and evil was "typically bipolar". Yet, like many manic depressives, he has found that only religious language has the capacity to feel like he has felt.
Recently, listening to a sermon by a minister of the Church of Scotland, Saul found himself overwhelmed, and he wrote to the minister about his lifelong struggle with faith and madness. The reply he received said: "Thank you for your truly beautiful letter. Your 20 years of wrestling with the fierce angel of illness have distilled a profound understanding. The Lord bless you and keep you."
· Names and details have been changed
