The New Black: Mourning, Melancholia and Depression, by Darian Leader (223pp, Hamish Hamilton, £17.99)
Shoot the Damn Dog: A Memoir of Depression, by Sally Brampton (326pp, Bloomsbury, £15.99)
What have you done for the economy today? Have you produced? Have you consumed? Probably not enough of either activity to make yourself a useful citizen, if you have the misfortune to be ensnared in depression, misery, mourning, melancholia, malignant sadness or whatever you care to term it. Unhappy people don't want much, which puts them at odds with the rest of society. The least they can do - or so says the dominant school of thought - is to swallow some prescribed pills, do their bit for the profits of the pharmaceutical industry and return themselves smartly to the workforce and normal 21st-century patterns of ambition and greed. If pills don't pull you out from under the duvet, try a course of cognitive behavioural therapy, which health insurers and the NHS like because it is quick and cheap. It will show you that your symptoms are learning errors, mistakes to be avoided rather than pointers to the truth, and will recondition you back to efficiency within weeks. And if another symptom presents later, you can always try another pill.
Darian Leader's short, provocative and fascinating book casts doubt on the very term "depression". It is too flat, too ubiquitous, and it is the invention, he says, of the modern drugs industry, which has both described the problem and prescribed the solution. Modern "depression" is like sin in the medieval church, a self-validating money-spinner. Leader prefers the older, more complex ideas of mourning and melancholia, and his book is a Freud-inflected study of human loss and how we incorporate it, how we shape ourselves around it. The person who is in mourning knows, more or less, what he has lost: his wife, his job, the argument he's been conducting all his life. The melancholic cannot easily name what's missing. When we are bereaved we lose ourselves, forfeit our identities, as it may be, as wife or daughter or sister. It is a simple point, but one often forgotten in dealing with those whom loss has invaded and deformed. The melancholic person has lost self-regard; he can no longer see his own shape.
Leader's distinction between melancholia and protracted and difficult mourning may not be entirely convincing, but his book is worth an armful of vapid self-help tracts, and goes beyond the realm of psychology into sharp social critique. How do we live with loss? How do we remember the past without giving it power over us? Is mourning ever finished? Currently favoured treatments are aimed at curtailing it. They are framed to change the patient's behaviour, not address his mental state, and aimed at suppressing symptoms rather than removing the need for them. Leader employs a brutal analogy: quick-fix remedies work in the same way as a missile strike works on a terrorist base. In the short term it looks successful, but it does nothing to alter the terrorist mindset. When loss and misery enter our lives, we are impatient to condense a process that, by nature or through talking therapies, can only be worked out over years. We want a name for our condition, and we want a timetable. Even mourning has become target-driven; we are supposed to move through loss in key stages, like schoolchildren, and to lag behind is to demonstrate a pathology.
So what's to be done? Mass psychotherapy is by the nature of the process impossible. The problem can be reframed, though: taken away from the medics, and given back to the humanities, to the artists. The artist's work is a protest against loss. He makes something, where nothing was there before, and often makes it out of the mourning garments of his own life, patches it together from his own losses and deficits. The "work of mourning" is about communication, Leader says, and it is about creativity. "Freud names not psychoanalysis but culture as the only possible panacea for the terrible demands that civilised life places on us. In other words, he is saying that it is the arts that can save us."
Practically speaking, though, how do we address the immediate needs of a patient who is dazed and mute, who is unable to sleep or eat or think straight, who cries all the time? Are pills ever helpful, as a way in to the problem? They didn't help Sally Brampton, the fashion journalist and former magazine editor. She suffered malign reactions to her prescribed drugs, which were pushed up to higher and higher dosages in an attempt to elicit some response. At one stage, anti-depressants, tranquillisers and sleeping pills, combined with her two daily bottles of wine, had trapped her into a cycle of wretchedness. Suicide seemed the only way of breaking out.
Though there are times when she seems to flaunt her bad-girl credentials, Brampton protests against the stigma still attached to melancholy, saying that for her depression is "an illness like any other". But which illness is like any other? She has "read every book on depression I could lay my hands on", which may be why her own book is muddled, pretentious and trite. Her excursion to her early life is ill-judged; there is more to reclaiming a child's voice than the use of short words and the present tense. Her parents were expatriates - "ex-patriots", as she calls them - and she was unhappy at boarding school. Though unsettled, her upbringing doesn't seem to account for her plunge into misery. When she became ill and drunk, she was badly advised by her doctors and, one feels, by her friends. At one point a profound but easily remedied physical problem was detected - a thyroid deficiency - but she was unlucky enough to run into an idiot GP who thought that a properly functioning thyroid was like a designer bag, nice to have but not totally necessary. It's a grim thought, that doctors are so keen to find a biological basis for depression, but fail to recognise and treat a hormone deficiency known to cloud the thoughts and cause low mood and unshakable fatigue. Though the thyroid condition can't account for the whole of Brampton's ordeal, she could have been spared at least some of her suffering. As anti-depressants didn't work for her, and made her physically ill, she tried talking therapies, but she wanted a therapist who talked back, and it took her a long time to work out that there were techniques other than the Freudian. Besides, the therapists she met offended her by their lack of fashion sense. My dear, shawls! Unnecessary scarves! Cheesecloth, even, and at one low point a purple smock.
Her memoir comes studded with gems from great philosophers, including Kierkegaard (died 1855) whom she believes lived "a few hundred years ago". Among his sayings she picks out "Don't forget to love yourself", for which, she says, "I rather love him". She mentions him so often it seems she must, though not quite enough to check his dates.
· Hilary Mantel's most recent novel is Beyond Black (Harper Perennial)
