I first came to therapy in my mid-20s after a particularly melodramatic public fight with my then boyfriend. I have only the haziest recollections of the incident, but apparently I had managed to wallop him in the face as he was attempting to manhandle me homewards. I maintain to this day that it wasn't deliberate, but his split lip the next day was sobering evidence, and when he suggested that I might benefit from professional help, I didn't feel I was in a position to argue. He had a point; over the preceding months I had become increasingly prone to erratic and extreme mood swings, from frenetic, sleepless jags of hyperactivity to grim troughs of despair.
Secretly, I didn't think therapy would be much use, mainly because I was fairly sure I had no buried traumas, and I disliked talking intimately about my feelings. Nevertheless, I was curious about the process. I asked a friend whom I knew saw a "shrink" three times a week, and reasoned that she must be good if my friend kept going back that often. It was not a great success.
Though I had only agreed to keep my boyfriend quiet, I had nurtured a small hope that this therapist might be able to help me. Increasingly, I felt that I was spinning out of control and deep down, I wanted to be told why I behaved as I did, why I seemingly could not control my moods. In reality she barely spoke, leaving me to fill the expensive silence with invented dreams as I heard the minutes ticking by like so many pound coins dropping into a well. I now know that I had stumbled into the kind of Jungian analysis that was viewed by the people among whom I grew up as ridiculously indulgent.
When I asked my therapist how long she thought it would take, she replied that analysis was a lifelong process. After the first few sessions, I decided I could not afford that degree of self-knowledge and gave up. I had also confirmed that I had a very English resistance to talking about myself intimately with strangers.
It was seven years before I gave it another chance. After my son was born in 2002, I sank into a crippling postnatal depression. When I finally asked for help, it was offered in tablet form. Two years later, when the same symptoms returned, I was less keen to accept the medication (I had reacted badly to the drugs), and began to look for alternatives. By then, cognitive behavioural therapy (CBT) was widely discussed in the media as a new, cost-effective form of talking therapy that studies suggested was more effective than antidepressants at getting people back to work and staving off depression for longer. It offered tangible goals and exercises, a fixed-term structure, an emphasis on immediate problems rather than repressed memories. Best of all, it was available on the NHS – in theory.
In practice, I spent 11 months on a waiting list. In the meantime, I took myself off to a private therapist who offered cognitive therapy (only possible because I was writing about it for a magazine). But although this time I warmed to the therapist and found her approach to treatment far more engaging, I still had to overcome my initial resistance to talking about myself. In my daily life I spent so much time trying to hide my depression and convince people that I was just fine, that admitting to it seemed evidence of weakness.
As I began to accept that she was not judging me, I found it a great relief to be able to articulate thoughts that I would not have dreamed of expressing to friends or family, for fear of upsetting or worrying them. This, I think, is one of the greatest advantages of therapy; to be told by someone outside your circumstances that your feelings are not abnormal.
I have never lasted long in therapy, though, and I suspect this may be because I write fiction. When I write, I examine my inner life anyway, even when I don't realise I am doing so.
It was only when I began a course of CBT that I realised that many of the exercises designed to help patients dissect their emotional responses were just variations on the processes I used in writing novels: taking experiences and emotional states, giving them to made-up characters and then examining them from a different perspective. That said, as someone with a recurrent depressive illness, I would choose therapy over drugs if my symptoms were to return severely, and I will continue to support charities and organisations that lobby to make this form of treatment as readily available to those suffering depression as medication is now.
• The Devil Within: A Memoir of Depression by Stephanie Merritt, is published by Vermillion.
