Voluntary Madness: My Year Lost and Found in the Loony Bin
by Norah Vincent
304pp, Chatto & WIndus, £12.99
Sectioned: A Life Interrupted
by John O'Donoghue
304pp, John Murray, £16.99
Hurry Down Sunshine: A Father's Memoir of Love and Madness
by Michael Greenberg
240pp, Bloomsbury, £12.99
First-hand accounts of breakdown and depression were until recently something of a rarity, for obvious reasons. To own up to mental illness is to invite suspicion, prejudice and discrimination; even the kinder labels - patient and survivor, say, rather than loony or headcase - carry a stigma. The other difficulty is recall: even those eager to describe their experiences may find they have been zapped by medication or lost for lack of a writing implement (the pen is an instrument of self-harm, literally as well as metaphorically, and ballpoints are banned from most psych wards). No wonder mental distress remains a black hole. As Norah Vincent explains it halfway through her book: "You know you felt terrible, and you know you don't want to feel that way again. But you don't really remember the details, the quality of suffering."
Imaginative literature has been resourceful in filling that gap. Frenzy and mania are integral to ancient Greek drama: Dionysus, Medea, Electra, the Furies. There are mad scenes in Shakespeare: Lear, "cut to the brains" as a tempest rages through him, poor Ophelia "divided from herself and her fair judgment". John Clare's asylum poems and Hopkins's "terrible" sonnets (with their "cliffs of fall / Frightful, sheer, no-man-fathomed") are brilliant evocations of the dark and fractured mind. And since the turn of the last century, we've had Sylvia Plath's The Bell Jar, Ken Kesey's One Flew Over the Cuckoo's Nest, Anne Sexton's poems, Tom Stoppard's Every Good Boy Deserves Favour, Peter Shaffer's Equus and Clare Allan's novel Poppy Shakespeare, while Jonathan Franzen's The Corrections has a memorable sequence on a dementia-sufferer hallucinating turds.
Fictional or otherwise, a book such as Dutch novelist J Bernlef's Out of Mind, in which an intelligent man tries to make sense of losing his senses ("Everything happens in jolts and jerks. There is no flowing movement any longer . . . The day is full of cracks and holes"), creates its own kind of truth. The risk with less informed texts - where good intentions stand in for hard knowledge - is that they exoticise and even sanctify mental distress. Of the many modern philosophers and theoreticians of madness (RD Laing, Erving Goffman, Foucault, Lacan, Thomas Szasz, Oliver Sacks), a few run that same risk - for all their rigour or righteous indignation, they remain outsiders looking in. Alongside them, though, there has been an extraordinary surge in personal non-fiction accounts - among them William Styron's "memoir of madness" Darkness Visible, Andrew Solomon's The Noonday Demon, Kay Redfield Jamison's An Unquiet Mind, Susanna Kaysen's Girl, Interrupted, Benedicta Leigh's The Catch of Hands, Elizabeth Wurtzel's Prozac Nation and Tim Lott's The Scent of Dried Roses. In the last two years Elyn R Saks's The Centre Cannot Hold, Martin Townsend's The Father I Had and Stephanie Merritt's The Devil Within have been added to the genre, along with more specialist contributions on (to go no further than the first letter of the alphabet) anorexia, Asperger's syndrome, anomie, autism, agoraphobia and addiction in all its forms.
The authority of such memoirs rests on their claim to authenticity: trust me, they say, I've been there, I'm telling you how it was. Where the narrator appears as a shining light, and every doctor, nurse and shrink as a monster of depravity, the reader won't be convinced. But at best these books take us to places we've never visited or, if we have, never expected to see set down in print. The mind has mountains but memoir may be a way to scale it. And here are three more fascinating logbooks - tales of despair, comedy and catharsis from returning travellers.
For her last outing as an "immersion" journalist, Norah Vincent spent a year in disguise as a man. But can one ever impersonate a mental patient? Isn't it unethical even to attempt to? She gives her answer straight off: this time her mission was for real, not a subterfuge - she has a history of depressive illness, hypomania, panic attacks, paranoia and sexual obsession, and previously suffered a breakdown, in 2004. Though the incarceration she endured in order to write Voluntary Madness lasted far less than a year - just 34 days, in fact - the book is full of alarming detail, thanks to her innate curiosity (aka pushiness and nosiness) and exhaustive note-taking (after her ballpoint was confiscated, she used a Crayola). If the writing is manic, mannered, overblown at times, even that seems apt - a guarantee that she's no mere detached observer.
"When you check yourself in with only a backpack to your name, saying you are suicidally depressed, they take you at your word," she says, and with surprising ease she commits herself to three different institutions: Meriwether, a big-city psych ward; St Luke's, a small private hospital in the Midwest; and Mobius, an experimental therapeutic community. Her findings are pretty much what you'd expect. Meriwether is brutal, dirty and despairing, using drugs and petty rules to control its inmates, who are "chemically infantilised, swathed in institutionalised helplessness, then coughed out the bottom of the system stoned and spiritless to languish on the street until the next arrest". St Luke's is clean, bland, implausibly friendly and no more expensive than Meriwether ($1,400 for 10 days unless you're covered by health insurance). Vincent leaves it feeling better than when she went in, but only because "I learned to pretend that I didn't know all the heavy things that I thought I knew." Mobius, with its holistic emphasis, challenges her prejudices against new age methods and against shrinks ("In my experience, going to a psychiatrist to get at your feelings had always been a bit like going to a gynaecologist expecting to make love"). But by the end she is completely won over, with her life on track for the first time. What does the trick seems banal - long hours spent with a therapist who combats her self-loathing and makes her feel normal - but it works.
Though the focus slowly turns inwards, to Vincent as a patient, the journalist in her never disappears. It's there when she reports how bored she is after a week inside ("I had gotten the material I needed") and how she goes on cigarette breaks "just to overhear things". Her mind works overtime throughout. Is Meriwether a zoo because of the people it houses (poor, homeless, crazed) or does the zoo create the animals? Would the girl who talks a made-up language to imaginary friends feel happier, or more lonely and frightened, for being purged of her delusion? Is depression, despite being portrayed by kindly professionals as a disease, a form of weakness, sloth, resignation, irresponsibility - a "gluttony of sadness"? Her conclusions are impeccably liberal but she asks some awkward questions along the way.
The defining trauma for Vincent was being molested as a child, though she doesn't recount the details. John O'Donoghue was also molested as a child - by a vicar who tried to drive Satan from him by grabbing his genitals - and his book begins with a dramatic, scarcely comprehending account of the episode. What scarred him more, though, was the sudden death of his father: John was 14 at the time and had his mother's grief to cope with as well as his own. The guilt he suffers when she goes off the rails - "I am not a man. I couldn't keep us together. I broke us up" - hastens his journey from a foster home to a psychiatric hospital. At 16 he is given ECT treatment. A year later his mother dies. Over the next decade and a half John is sectioned five times and enters four different mental institutions: Claybury, Friern, Banstead and the psych ward of the Whittington hospital. In a later psychotic episode, he steals a pair of white trousers in preparation for the coming of the Lord and is sent to HMP Pentonville, where the residents seem scarier and crazier than any he's been locked up with before. It's after Pentonville that life and luck begin to turn at last.
"Manic depression?" he asks himself, looking back. "The victim of circumstance? A casualty of Thatcherism?" Rather than answer, Sectioned simply describes what happened, in the style of a picaresque novel, shuffling from one fragmented adventure to the next, with occasional italicised passages to convey hallucinatory states of mind and a constantly changing cast of characters: "This is what life is, I thought. A series of scenes, played out across a stage where the back-cloth and the flats, the props and the lighting rig, are all taken down again and put up again in some other distant place, new performers quickly assembled, old parts recast." The humdrum reality of mental illness has rarely been so well conveyed. It's less a story of locked wards than of hostels, soup kitchens, sheltered housing, drug addicts, well-meaning charity workers and relentless poverty. O'Donoghue is honest about his own failings: misfortune is compounded by his capacity to fuck up. What saves him, in part, is poetry: he begins to write as a teenager and through most of his ordeals he keeps it up. Sectioned is too hard-edged for verse but it's a triumph that it exists at all and a vindication of O'Donoghue's faith: psychosis could easily have killed him, or the liquid cosh stunned him into silence, but here he is, against the odds, speaking loud and plain.
O'Donoghue's mental health problems presented themselves unusually early. The same goes for Michael Greenberg's daughter Sally, who is just 15 when a mental hurricane strikes. Watching two girls in a playground, she has a vision - that we are all born geniuses but have genius drummed out of us as we grow up. Convinced that she has been chosen to deliver this message and thereby save the world, she wanders the streets of New York, collaring anyone who'll listen and many who will not. To her father, her oracular frenzy is like "being in the presence of a rare force of nature, such as a great blizzard or flood: destructive, but in its way astounding too".
Reluctantly discarding the possibility that her mania has been caused by drugs or a glandular imbalance and that a proper meal and good night's sleep will restore her to normality, he swiftly accepts there's only one place for her and signs his consent for her to be "put away". He visits every day but progress is slow and he can't help blaming himself for her condition. If only he and Sally's mother were still married. If only the flat where he, Sally and his second wife Pat live weren't so shabby and precarious. If only the family genes were in better shape - at the very moment Sally is cracking up, Greenberg's vulnerable and dependent brother Steve goes off the rails too. But none of this explains Sally's state, or her Romantic Blakean vision of childhood.
The drama takes place during a long hot summer, during which Greenberg is forced to confront painful truths about his relationships, his work, and his own capacity for violence. (At one point he hits Pat and the police are called.) Sally's mania frightens him - her feral black eyes, with their strange new glitter, like polished coal. But so does her numbed, catatonic state when she's discharged and returns home. To understand what she's going through, he swallows some of her medication - and proves hilariously remote and inept when a visitor calls.
"O heavens," Claudius remarks when Ophelia appears in her cracked state, "is't possible a young maid's wits / Should be as mortal as an old man's life?" The literary precedents Greenberg turns to are Joyce (whose daughter Lucia went mad) and Robert Lowell (who had frequent psychotic episodes). But variations on Claudius's question keep cropping up. There are echoes of Virginia Woolf, too. "Madness is terrific I can assure you," she once wrote. "The six months that I lay in bed taught me a good deal about what is called oneself." Sally feels the same about the truth she saw in her vision and fights to keep the intensity of it alive. "The evil seduction," Sally's psychiatrist calls this: the mind falling in love with its delusions. But Greenberg can understand the impulse, and it's this that gives Hurry Down Sunshine such power. Restrained yet candid, it's a beautifully written book - Greenberg's first, surprisingly, and one that, like O'Donoghue's, has taken many years to write.
All three memoirs have happy endings, as the genre requires: "Look We Have Come Through". By constructing a "diagram of distress" with her Mobius therapist - "molestation> Rage>Alienation>Shame>Guilt> Self- harm>Suicide" - Vincent comes to terms with her past and opens the door to a future "free of, or at least less ruled by, drugs". O'Donoghue is accepted on a writing programme at UEA, marries and has four children: "If sometimes my mood darkens or I buckle under the strain, I have the love of my family to get me through." Greenberg's daughter returns to school in the September after her crack-up and now, 12 years later, is working in her mother's bakery in Vermont: though psychotic episodes have intermittently disrupted her life, she tells her father she's learning to see them coming, "so I can get out of the way or at least drop to the ground like you would when caught in the crossfire of a shootout".
Positive outcomes, then, but only provisional ones. No one's promising a permanent cure or pretending that bad stuff won't happen again. But there's a fortitude in these books - an unceasing mental fight - that makes them redemptive. "Whoever has been restored to health," William Styron writes in Darkness Visible, "has almost always been restored to the capacity for serenity and joy, and this may be indemnity enough for having endured the despair beyond despair."
• Blake Morrison's latest book is South of the River (Vintage). To order Voluntary Madness for £11.99, Sectioned for £15.99 or Hurry Down Sunshine for £11.99, each with free UK p&p, call Guardian book service on 0330 333 6846.
