We sat in the consultation room again, the patient and I.
His depression was so severe, it had become a voiceless paralysis. The disease that had made a home in his mind had removed any ability to explain how he was feeling, even to himself – let alone to anyone else. There was no eye contact. No reaction. “Poor communicator”, it said in his notes.
All the staff had tried, and failed, many times to find a way in, but there was nothing. As we faced each other, I didn’t have any expectation that this would change. Then he spoke.
“I read a book,” he said. “I never read books, but I read this one.”
He took out the book to show me. He pointed to passages he had circled, writing that had spoken to him with such clarity that he had turned down the corner of the page. Not only had it helped him to understand how he was feeling, he used it to help me to understand, too.
The book was Matt Haig’s Reasons To Stay Alive, and this was the first time the patient had spoken about his depression in 30 years.
This is not a unique event. Many times, patients have used the words of others to make sense of their own emotions. The demand for books exploring mental health is ever-increasing – and so is their appearance on bookshelves. This week, the Bookseller reported this trend as being a reflection of a “cultural shift”, in a time when we are more willing, less afraid, to speak about our personal battles with mental illness. While the idea of self-help books is not a new one, the honest intimacy of accounts like Haig’s should be a fresh touchstone for commissioning editors.
Books help us to make sense of the world, and they shift perspectives. We examine our protagonists for qualities with which we can identify, and send them on a journey to face our uncertainties. At a time when one in four of us are confronted with mental illness, we need more shifts in perspective, more explanations, more heroes to walk through the pages of our books and help us to understand the fragility and strength of human nature.
In my novel The Trouble With Goats and Sheep, I explore the idea that we are all vulnerable to a sense of “unbelonging”: any one of us could easily find ourselves in the consultation room. Stewart Foster’s We Used to Be Kings, Grace McCleen’s The Offering and Nathan Filer’s Costa-winning debut The Shock of the Fall, all tackle psychosis with full force. The power of Filer’s writing has been recognised – and rightly honoured – for raising awareness of mental health issues. To change an opinion, somewhere between the first and last pages of your novel, is really quite an incredible achievement – and it’s often the most valuable reward of reading.
Now we can perhaps applaud ourselves for chipping away at an age-old stigma, and congratulate each other for finding heroes with whom we can all identify. However, this needs to be more than a trend – it needs to be a constant. Not only for me, as a reader and writer, but also for the one in four people who are searching for an understanding, and for that next patient who will sit in front of me and struggle to explain how they feel.
• Joanna Cannon is a psychiatrist and the author of The Trouble With Goats and Sheep, published by Borough Press.
• In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here
