I’m confident that most women in the English-speaking world will have heard of Marian Keyes: she’s written a large number of very successful and entertaining novels (and one dud, but in the midst of all that excellent writing I think she can be forgiven one sub-par effort). As well as liking her work very much, I can report that she seems to be a lovely woman – I met her at a reading in 2004 and I wrote her a ‘I love your novels, thanks for being awesome’ card a few years ago and received a prompt and very charming reply.

Sadly, she’s had a long history of bouts of depression and, in January last year, she announced in a newsletter on her website that she was suffering very badly; far worse than she had before. While arranging my various Marian Keyes novels during my weeks of unpacking I was prompted to wonder how she was faring, so I visited her website and found that things are still very bleak for her. In her most recent newsletter, which was published in May 2010, she wrote:

I haven’t been at all well, but in the last few weeks I seem to be – mercifully – on the way back to something resembling myself. I’ve been wary about trusting this improvement because in January I rallied for about a week, only to be plunged back into the horrors.

I don’t exactly know what to say because I still don’t really know what happened to me. The medical profession call it ‘a major depressive episode’ but I’ve been knocked sideways by a multitude of feelings, not just depression but agitation, anxiety, terror, panic, grief, desperation, despair and an almost irresistible desire to be dead and it’s gone on for a very long time. Every day for six solid months I’ve had to try really hard to stay alive. I’ve literally got through each day hour by hour, trying to hang on until the sun set and it was time to close the shutters on the windows and then I’d feel, Okay I’ve survived another day. It was such a horrible winter and it felt like it went on forever, but when the clocks went forward I felt even worse because then there was an extra hour of daylight to last through.

I know I’ll be criticised for saying all this, I know it sounds horribly selfish, when life is such a precious gift and many people desperately want to be alive and are denied it, but honestly, I’ve had no control over it.

Wave after wave of black agony has been rolling up from my gut and bursting in my head and I’ve been powerless to stop it. I’ve heard people describe depression as feeling like they’re living behind glass, of being numb and unable to experience anything, but for me, it has been totally different. It has been like being poisoned, it’s felt like my brain is squirting out terrible, black, toxic chemicals that poison any good thoughts. I’m well aware that I have an enviable life and there are bound to be people who think, “What the hell has she got to be depressed about?” But whatever has been wrong with me isn’t fixable by an attitude shift.

Poor woman. Given that she hasn’t written again since then, it seems that her slightly better feelings may not have lasted.

Something that struck me as I read the rest of the newsletter was the way in which her fans – obviously trying to be helpful and wanting the best for her – had taken to suggesting ‘remedies’. Some of them included: acupuncture; cognitive behavioural therapy; cranio-sacral therapy; fish oils; homeopathy; mindfulness and meditation; praying; reiki; vitamins B, C and D; and yoga. She’d also tried (and was continuing with) anti-depressants and psychotherapy – both of which seemed to actually help – and various ‘distracting’ activities, like knitting and baking.

I think it was the mention of fish oils that made me think of John Diamond, journalist and first husband of Nigella Lawson. Diamond died of throat cancer and, during his illness, he wrote an excellent book called Snake Oil, in which he condemned the idea that complementary medicine could help to ‘fight’ cancer.

It seems to me that people who would write to a woman suffering from a crippling depression and suggest homeopathy, or reiki, or any other ‘treatment’ with no medical credibility, must lack some fundamental understanding about this illness. That isn’t to doubt their goodwill, of course, but it’s akin to telling somebody with a broken back that they should just think happy thoughts in order to heal themselves.

I suspect that part of the problem lies with a widespread misuse of the term ‘depression’. It’s not ‘feeling a bit sad for a few days’, or being unhappy (for easily explainable reasons, like bereavement, unemployment, or relationship meltdown). It’s a serious condition and people who are affected by it don’t tend to feel OK some of the time, or find that they can struggle on regardless. And people suffering from depression tend to be completely unable to articulate what is wrong with them – they just feel bleak and terrible, all the time, and there’s no obvious ’cause’.

We seem to have stopped being willing to acknowledge that, sometimes, life is really hard and that we might be unhappy, but that this is part of the human condition and should be endured, with faith that happiness will return. By mistaking unhappiness for depression we attempt to medicalise that which would best be treated with more simple things, like making contact with friends, or making an effort made to help other, more needy people, or indulging in basic things to cheer ourselves up. And it’s important to recognise that being unhappy can provide us with a valuable catalyst for change, by figuring out what is causing the feeling and evaluating whether we can do anything about it. I don’t think that blindly doling out handfuls of anti-depressants is the answer, although it seems to be the first thing that doctors will do, if a patient visits them and complains about feeling down.

Personally, I’ve learned that my unhappy days can best be remedied with serious time on the sofa with Tristan and Tui, and sweets, and a funny DVD. Actually, the most important thing I’ve learned about unhappiness is that it’s perfectly fine to feel down occasionally, particularly if things are going on in one’s life that are difficult. For a long time I would hate to acknowledge that I felt unhappy and would feel guilty about it. Recognising that I have the right to be miserable sometimes has been the best way to increase my own happiness. It’s what Alanis Morissette would call ‘ironic’.

But I digress. Depression is debilitating, and the only proven treatment seems to be exactly what Keyes is following: a combination of drugs and therapy. I worry that, by telling somebody with depression that they will be fine if they just try some unproven complementary treatment, you run the risk of making them feel even more terrible when the treatment doesn’t work. I think that the only thing we can do, when faced with people who are actually depressed, is urge them towards the drug and therapy route and reassure them that they are still loved.

Anyway, I really hope that this lovely woman recovers from her illness. I wouldn’t wish it on my worst enemy.

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