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| Life in my sauce |
I first thought about killing myself when I was thirteen years old. Forced to attend a school I loathed, I repeatedly ran away or refused to get into the car in the morning and had to be dragged, literally kicking and screaming. My father’s solution was ruthless but effective. Having initially acquiesced to my demand to be a 'day boy' in an all-boarding school, he made me return in my second term as a boarder. Life in an English boarding school in the 1980s was far less brutal than it had been even a decade earlier. Older boys were still, however, given the authority to order younger children to take ice cold baths at seven o’clock in the morning for minor breaches of school rules and, until the end of my second year, 'fagging' was still de rigeur (the Wikipedia article on this subject is an adequate introduction, if you are not familiar with the practice, now largely extinct).
"It never did me any harm.” Was the refrain of adults who had been broken by the system or naïve men like my father, whose parents had been unable to afford an independent education for him, and who was determined that his children would enjoy that privilege. Of course, it did immense harm, as the few friends I retain from those days will universally attest. The theory of evolution saved my life. I had few talents but I excelled as a biologist, a subject I had loved since before I knew the word. Biology wasn’t taught in the first year at Sherborne, so when I graduated to the fourth form my pent-up enthusiasm was unleashed. In a rare stroke of luck I found myself assigned a teacher, Byron Henry, who responded to and nurtured my undisciplined fascination with nature through the rest of my school career. He taught me how to be a scientist, a gift beyond price. I don’t think I’ve ever recorded in writing the debt I owe him, an omission I am glad to rectify now.
I have been thinking about suicide on-and-off ever since that early-adolescence crisis. Generally these thoughts take the form of fantasies. I imagine myself, post-suicide, thumbing my nose at the world I have left behind. I cannot imagine being dead because it is impossible to get into the subjective perspective about the objective fact of being extinct, so my brain conjures up a sort of avatar that comments on the situation as my body dies. So far, I have remained sufficiently tethered to reality to grasp that death and, more pertinently, dying wouldn’t be that way. As the wheels of the train rolled over my brain, whatever memories, ideas and wisdom those cells had accumulated would be forever and instantly extinguished. So far, the idea of having my essence smeared across a few metres of the Chippenham to Paddington tracks has been less attractive than the alternative.
But not much. I have actually attempted suicide only once, as recorded elsewhere on this blog. It was a pretty feeble attempt, if truth be told. I have enough pills in my medicine bag to kill a rhinoceros and I took only sufficient to ensure that I slept soundly for a very long time. I was playing a coward’s version of Russian roulette. The only other occasion when I came close occurred a few days before my precipitous departure from the City. Driven mad by the monotony of the commute to a job that I hated with a passion so profound that words have not been coined to describe it, I went to a bar with the explicit intention of screwing up my courage to jump in front of a train. By the end of the first bottle, I reckoned that another bottle would do the trick. By the end of the second bottle, I found that the idea of a third seemed attractive and by the time that was empty, I had lost the will to die. In a way, therefore, booze saved my life. At least, it postponed the inevitable.
So here I am, more-or-less alive, thanks to Charles Darwin and ethanol. I’ve been reading a short book, How Sadness Survived by Paul Keedwell. It is a brave attempt to argue the positive case for depression. This isn’t anything like as crazy as it sounds. Life consists in a series of trade-offs among various awful alternatives and natural selection takes no account of human values when wielding her scythe. Sickle-cell anaemia is common in some parts of Africa because carriers of a single copy of the relevant gene are resistant to malaria. Unfortunate carriers of two copies die young but natural selection will keep the gene in circulation until malaria is eradicated. I once engaged in an online discussion with a Christian who could not understand how a gene detrimental to its carrier could spread (1). I gave the example of the gene(s) responsible for making beef taste delicious to humans. These genes are now more numerous than almost any other in mammals but that fact is presumably of scant comfort to the cow in the queue at the abattoir.
Keedwell produces evidence to suggest that depression is both ancient and a human universal, contrary to the stereotype that only the current, enfeebled generation of adults in the West is susceptible. If true, and if mood is influenced by genes, for which there is abundant evidence, this implies that some benefit associated with depression may be causing the relevant alleles to persist in human populations.
In a section with the Pythonesque title 'What has depression ever done for us?' the book proposes two main benefits and a host of positive side effects.
1. Depressive realism.
In a recent article in New Scientist (The Grand Delusion. 2011. 210: 2812, pp 35-41), Graham Lawton reviews some of the many ways in which most people deceive themselves.
"One study found that 74% of drivers believed themselves to be better than average behind the wheel [not statistically impossible but highly unlikely to be true]...if you ask most people to rate themselves on almost any positive trait - competence, intelligence, honesty, originality...most put themselves in the better-than-average category. Ask them similar questions about negative traits and they will rate themselves as less likely than average to possess them...We also inflate our opinions of loved ones. Around 95% of people rate their partner as smarter, more attractive, warmer and funnier than average...optimism bias [is] a well-established effect characterised by unrealistic expectations about the future. Most people expect to live longer, healthier and more successful lives than average while underestimating their chances of getting divorced, falling ill or having an accident...The fawning doesn't stop there...In an ironic twist, most people believe themselves to be more resistant than average to having an inflated opinion of themselves."
I love that last sentence. What a deliciously succinct put-down of the cup-half-full crowd.
It turns out that patients diagnosed with clinical depression do not suffer from these biases. We rate ourselves, the way we are perceived and the likely outcomes in our lives more accurately than non-sufferers. It is plausible (but remains to be rigorously tested) that depressive realism could confer real benefits in certain conditions, perhaps more so in the very dangerous ancestral environments in which the structure of our brains largely evolved. Keedwell quotes one of my favourite psychologists, Daniel Gilbert: "Depression stops us chasing rainbows." And possibly also saber-toothed tigers.
2. Reflection.
Several of the symptoms experienced during an episode of depression - social withdrawal, intense introspection, feelings of worthlessness - are conducive to encouraging reflection upon the sufferer's life, goals and ideals. "Ah, but a man's reach should exceed his grasp,..." said Robert Browning before spoiling this brilliant observation by adding "or what's a heaven for?" In less poetic language, we aspire too much. Almost none of us will achieve all that he (mistakenly) thinks he is capable of. Most depressions resolve spontaneously within a few weeks or months and there is plenty of case evidence that many people emerge from such periods having abandoned unrealistic goals, redefined their aims in life or having had some kind of epiphany regarding the mistakes they had been making.
Keedwell thinks that the similarity of the symptoms and typical duration of grief and depression is not an accident. The main 'goal' of grief, in an evolutionary sense, is acceptance. If we were not overcome with sadness on the death of a parent, child or lover, our feelings for them could not have been very intense. But unless we 'move on' fairly swiftly our own lives would soon be forfeit too. Enabling us to move on is the function of grief and the reason natural selection gave it to us.
Perhaps an analagous function exists for depression, at least in its commonest manifestations which, as noted, resolve quickly. Perhaps it is an evolved mechanism that allows us natural born losers eventually to let go of unrealistic but cherished plans and dreams and to accept our limitations.
3. Ancillary benefits.
A miscellany of hypothesised benefits is discussed, without much analysis, towards the end of How Sadness Survived. Keedwell argues that depression actually aids coping with suffering, enhances your ability to feel empathy and compassion, induces humility (by prompting feelings of worthlessness) and encourages creative thinking. He quotes another great poet with the first name Robert.
Speaking from my own experience, I find these claimed benefits only somewhat plausible (I am attracted for obvious reasons to the idea that clinically depressed persons are creative geniuses but, being a depressive realist, I immediately dismiss it). They do, however, suggest a research program.
Keedwell produces evidence to suggest that depression is both ancient and a human universal, contrary to the stereotype that only the current, enfeebled generation of adults in the West is susceptible. If true, and if mood is influenced by genes, for which there is abundant evidence, this implies that some benefit associated with depression may be causing the relevant alleles to persist in human populations.
In a section with the Pythonesque title 'What has depression ever done for us?' the book proposes two main benefits and a host of positive side effects.
1. Depressive realism.
In a recent article in New Scientist (The Grand Delusion. 2011. 210: 2812, pp 35-41), Graham Lawton reviews some of the many ways in which most people deceive themselves.
"One study found that 74% of drivers believed themselves to be better than average behind the wheel [not statistically impossible but highly unlikely to be true]...if you ask most people to rate themselves on almost any positive trait - competence, intelligence, honesty, originality...most put themselves in the better-than-average category. Ask them similar questions about negative traits and they will rate themselves as less likely than average to possess them...We also inflate our opinions of loved ones. Around 95% of people rate their partner as smarter, more attractive, warmer and funnier than average...optimism bias [is] a well-established effect characterised by unrealistic expectations about the future. Most people expect to live longer, healthier and more successful lives than average while underestimating their chances of getting divorced, falling ill or having an accident...The fawning doesn't stop there...In an ironic twist, most people believe themselves to be more resistant than average to having an inflated opinion of themselves."
I love that last sentence. What a deliciously succinct put-down of the cup-half-full crowd.
It turns out that patients diagnosed with clinical depression do not suffer from these biases. We rate ourselves, the way we are perceived and the likely outcomes in our lives more accurately than non-sufferers. It is plausible (but remains to be rigorously tested) that depressive realism could confer real benefits in certain conditions, perhaps more so in the very dangerous ancestral environments in which the structure of our brains largely evolved. Keedwell quotes one of my favourite psychologists, Daniel Gilbert: "Depression stops us chasing rainbows." And possibly also saber-toothed tigers.
2. Reflection.
Several of the symptoms experienced during an episode of depression - social withdrawal, intense introspection, feelings of worthlessness - are conducive to encouraging reflection upon the sufferer's life, goals and ideals. "Ah, but a man's reach should exceed his grasp,..." said Robert Browning before spoiling this brilliant observation by adding "or what's a heaven for?" In less poetic language, we aspire too much. Almost none of us will achieve all that he (mistakenly) thinks he is capable of. Most depressions resolve spontaneously within a few weeks or months and there is plenty of case evidence that many people emerge from such periods having abandoned unrealistic goals, redefined their aims in life or having had some kind of epiphany regarding the mistakes they had been making.
Keedwell thinks that the similarity of the symptoms and typical duration of grief and depression is not an accident. The main 'goal' of grief, in an evolutionary sense, is acceptance. If we were not overcome with sadness on the death of a parent, child or lover, our feelings for them could not have been very intense. But unless we 'move on' fairly swiftly our own lives would soon be forfeit too. Enabling us to move on is the function of grief and the reason natural selection gave it to us.
Perhaps an analagous function exists for depression, at least in its commonest manifestations which, as noted, resolve quickly. Perhaps it is an evolved mechanism that allows us natural born losers eventually to let go of unrealistic but cherished plans and dreams and to accept our limitations.
3. Ancillary benefits.
A miscellany of hypothesised benefits is discussed, without much analysis, towards the end of How Sadness Survived. Keedwell argues that depression actually aids coping with suffering, enhances your ability to feel empathy and compassion, induces humility (by prompting feelings of worthlessness) and encourages creative thinking. He quotes another great poet with the first name Robert.
Two roads diverged in a wood, and I -
I took the one less travelled by,
And that has made all the difference.
Robert Frost
Speaking from my own experience, I find these claimed benefits only somewhat plausible (I am attracted for obvious reasons to the idea that clinically depressed persons are creative geniuses but, being a depressive realist, I immediately dismiss it). They do, however, suggest a research program.
There are weaknesses in Keedwell's analysis. He is a clinician and is clearly biased by his compassion for patients. He argues, for example, that genes predisposing an individual to suicide could not spread because suicide is rare. This is, of course, nonsense. If a gene predisposing its carrier to take his own life is manifested sufficiently late in life then it will certainly spread in human societies living in marginal environments, where the sudden removal of a mouth to feed could tip the balance between the death or survival of that mouth's relatives. It is a good start, however, and should be seized upon by population geneticists and neuroscientists, who have the tools and skills necessary to identify the genes involved in mood control, track their distribution within and between populations and begin to understand how they affect the development and functioning of the brain.
Sadly, vested interests in the pharmaceutical and psychotherapy industries will probably kill any such research stone dead. The reason for this, if it not already obvious, is that typical depressions should probably not be treated, either with anti-depressants or psychotherapy (which is largely bunkum anyway). You would not 'treat' grief because it is not an illness. Rather it is a perfectly normal and helpful reaction to a deep loss. Why then would you treat depression, if Keedwell is on the right track?
Part II - Malignant sadness
Lewis Wolpert wrote a brave book, Malignant Sadness, about his own experience of depression. Wolpert is a physiologist and understands how anti-depressants work on a level that I can't reach. He's an enthusiast and attributes to their influence his survival of the experience of depression. Wolpert contrasts ordinary sadness - a normal, perhaps everyday experience for everyone - with depression, which he regards as a disease, a pathological variant of sadness.
Keedwell draws a distinction right at the beginning of his book between typical (he might say 'heatlhy' depression) and persistent or recalcitrant depression. His analysis addresses the former. I think he is right when he implies that lifelong or suicidal depressions are generally pathological and it is then appropriate to regard sufferers as having a disease and attempt to cure it, if the patient wishes to be cured. Like the ex-leper in The Life of Brian, not everyone wants to get better (see clip).
Based solely in my own experience, I think that Keedwell is closer to the mark here than Wolpert in where he draws the line. I'd wager a case of Champagne to a pint in the King's Arms that Keedwell's thesis is essentially correct. I also suspect (but cannot begin to prove) that there exist unlucky individuals who have inherited too many allelles of too many genes that predispose them to experience depression. These individuals - people like me - really are 'marked for death'.
Last night, as a result of a recommendation from my plumber (who else), I watched on iPlayer Choosing to Die, a documentary made by Terry Pratchett about assisted suicide. This subject is much on (what is left of) his mind because he has early stage Alzheimer's and will soon be unable to make for himself the decision to go to the Dignitas clinic in Switzerland and be given permission to die. He is clearly in turmoil as he wrestles with the terrible dilemma: die legally, before I want to or die at the right moment, when someone else will have to help, rendering them likely to be prosecuted for murder.
I think this is the most moving piece of television that I have ever watched (see it here). I was in floods of tears at the end, not for the two courageous men who's deaths were documented, but out of a strong feeling of solidarity with the family members and lovers who accompanied them to their bitter ends (apparently the killing drug tastes foul). In one case, a young, terminally ill man's mother accompanied him to Switzerland, so that he would not die alone. In the other, a wife of 40 years squeezed the hand of her husband as she watched him die.
Part III - Me
As I look back on my life, I see that it is a story full of loathing. Perhaps contempt is a better word. Contempt for my teachers and the arbitrary rules they unthinkingly enforced; contempt for my peers and their pathetic enthusiasms for sport, fashion and popular music; contempt for anyone less able intellectually; contempt for the adults too stupid to understand that the world was on the brink of environmental catastrophe and, later, contempt for the single-issue environmentalists too stupid to see that their obsessions aren't very useful. I am contemptuous of laws, lawmakers and law enforcers, of bureaucrats and the wage slaves who do their bidding. I despise the commuters who herd themselves like semi-autonomous sheep to and from contemptible jobs. I despise the system and also the spongers, like me, who parasitise it. I detest organised religion viscerally and feel physically sick when I contemplate the fact that my children are growing up immersed in its influence. I hate psychoanalysts and Supernanny and well-meaning friends who offer to pray for me.
Of course, above all, I loathe myself. The handful of people who read this blog are all kind enough to deny that I am a worthless sack of cells, with a decaying brain, a rotten heart and a rotting liver. I'm afraid, my friends, that I know better. I am, after all, a depressed realist.
Whatever happens next, it wasn't your fault.
1. Richard Dawkins, in one of the finest phrases he has ever coined, describes this sort of thinking as 'the argument from personal incredulity'.
Sadly, vested interests in the pharmaceutical and psychotherapy industries will probably kill any such research stone dead. The reason for this, if it not already obvious, is that typical depressions should probably not be treated, either with anti-depressants or psychotherapy (which is largely bunkum anyway). You would not 'treat' grief because it is not an illness. Rather it is a perfectly normal and helpful reaction to a deep loss. Why then would you treat depression, if Keedwell is on the right track?
Part II - Malignant sadness
Lewis Wolpert wrote a brave book, Malignant Sadness, about his own experience of depression. Wolpert is a physiologist and understands how anti-depressants work on a level that I can't reach. He's an enthusiast and attributes to their influence his survival of the experience of depression. Wolpert contrasts ordinary sadness - a normal, perhaps everyday experience for everyone - with depression, which he regards as a disease, a pathological variant of sadness.
Keedwell draws a distinction right at the beginning of his book between typical (he might say 'heatlhy' depression) and persistent or recalcitrant depression. His analysis addresses the former. I think he is right when he implies that lifelong or suicidal depressions are generally pathological and it is then appropriate to regard sufferers as having a disease and attempt to cure it, if the patient wishes to be cured. Like the ex-leper in The Life of Brian, not everyone wants to get better (see clip).
Based solely in my own experience, I think that Keedwell is closer to the mark here than Wolpert in where he draws the line. I'd wager a case of Champagne to a pint in the King's Arms that Keedwell's thesis is essentially correct. I also suspect (but cannot begin to prove) that there exist unlucky individuals who have inherited too many allelles of too many genes that predispose them to experience depression. These individuals - people like me - really are 'marked for death'.
Last night, as a result of a recommendation from my plumber (who else), I watched on iPlayer Choosing to Die, a documentary made by Terry Pratchett about assisted suicide. This subject is much on (what is left of) his mind because he has early stage Alzheimer's and will soon be unable to make for himself the decision to go to the Dignitas clinic in Switzerland and be given permission to die. He is clearly in turmoil as he wrestles with the terrible dilemma: die legally, before I want to or die at the right moment, when someone else will have to help, rendering them likely to be prosecuted for murder.
I think this is the most moving piece of television that I have ever watched (see it here). I was in floods of tears at the end, not for the two courageous men who's deaths were documented, but out of a strong feeling of solidarity with the family members and lovers who accompanied them to their bitter ends (apparently the killing drug tastes foul). In one case, a young, terminally ill man's mother accompanied him to Switzerland, so that he would not die alone. In the other, a wife of 40 years squeezed the hand of her husband as she watched him die.
Part III - Me
As I look back on my life, I see that it is a story full of loathing. Perhaps contempt is a better word. Contempt for my teachers and the arbitrary rules they unthinkingly enforced; contempt for my peers and their pathetic enthusiasms for sport, fashion and popular music; contempt for anyone less able intellectually; contempt for the adults too stupid to understand that the world was on the brink of environmental catastrophe and, later, contempt for the single-issue environmentalists too stupid to see that their obsessions aren't very useful. I am contemptuous of laws, lawmakers and law enforcers, of bureaucrats and the wage slaves who do their bidding. I despise the commuters who herd themselves like semi-autonomous sheep to and from contemptible jobs. I despise the system and also the spongers, like me, who parasitise it. I detest organised religion viscerally and feel physically sick when I contemplate the fact that my children are growing up immersed in its influence. I hate psychoanalysts and Supernanny and well-meaning friends who offer to pray for me.
Of course, above all, I loathe myself. The handful of people who read this blog are all kind enough to deny that I am a worthless sack of cells, with a decaying brain, a rotten heart and a rotting liver. I'm afraid, my friends, that I know better. I am, after all, a depressed realist.
Whatever happens next, it wasn't your fault.
1. Richard Dawkins, in one of the finest phrases he has ever coined, describes this sort of thinking as 'the argument from personal incredulity'.
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