World Mental Health Day

Guy steps back and allows more sensible voices to be broadcast.

Transcript

Welcome to the one-hundred-and-thirty-ninth episode of The Undercover Intern podcast I'm your host, Guy Snapdragon, and today is Monday the 6th of October 2025.

Our first quote this week is from the neurosurgeon and author Henry Marsh. Open. I learned a long time ago to make no distinction between ‘real’ and ‘psychological’ pain. All pain is produced in the brain, and the only way pain can vary, other than in its intensity, is how it is best treated. End.

On Friday, it will be World Mental Health Day. Certain activities in my past preclude me from talking with authority about this subject. So, for this episode only, I think it’s best that I become a Cover Book Narrator, and read some passages about mental health, specifically depression, written by experts.

Rose Cartwright writes about her initial need to label her own mental illness. Quote. We are all searching for a story, an orienting narrative that shows us our place in the world. We use tools of storytelling to make sense of ourselves. We keep a lookout for throughlines and patterns, recurring themes and the opening and closing chapters. Because I’d been searching for a story, official-sounding terms like generalized anxiety disorder and depression feel like a life raft in the fog – the only thing for miles with any structure. So I grew up as someone with mental illness. End quote.

Rose goes on to explore how, over the years, this label of mental illness became unsatisfactory, how she felt like a fool for believing for most of her life that she had a disease in her brain. One problem is that there are strong financial incentives to maintain the myth of brain disease, treated by drugs. She found that, quote, Western psychiatry, with its deficit model of healing as a reduction in symptoms, a negation of a bad thing rather than an emergence of a good thing, failed, in its lack of imagination … The one thing that all definitions of healing have in common is connection, and another way of thinking about connection is closing the gap between things. End quote. Rose’s book describes her journey to understanding the multiple factors of mental health, not only biological, but also psychological and social.

Andrew Soloman says, quote: Depression is the flaw in love. To be creatures who love, we must be creatures who can despair at what we lose, and depression is the mechanism of that despair. When it comes, it degrades one’s self and ultimately eclipses the capacity to give or receive affection. It is the aloneness within us made manifest, and it destroys not only connection to others but also the ability to be peacefully alone with oneself. End quote. In a sense, those inner connections no longer exist when depression is at its worst, and being peacefully alone is impossible.

At its worst, Andrew’s own depression was almost entirely debilitating. Quote. Killing myself, like dressing myself, was much too elaborate an agenda to enter my mind; I did not spend hours imagining how I would do such a thing. All I wanted was for “it” to stop; I could not have managed even to be so specific as to say what “it” was. I could not manage to say much; words, with which I have always been intimate, seemed suddenly every elaborate, difficult metaphors the use of which entailed much more energy than I could possibly muster… I can remember lying frozen in bed, crying because I was too frightened to take a shower, and at the same time knowing that showers are not scary. I kept running through the individual steps in my mind: you turn and put your feet on the floor; you stand; you walk from here to the bathroom; you open the bathroom door; you walk to the edge of the tub; you turn on the water; you step under the water; you rub yourself with soap; you rinse; you step out; you dry yourself; you walk back to the bed… All over the world people were taking showers. Why, oh why, could I not be one of them? And sometimes in some quiet part of me there was a little bit of laughter at that ridiculousness, and my ability to see that, is, I think, what got me through. Always at the back of my mind there was a voice, calm and clear, that said, don’t be so maudlin; don’t do anything melodramatic. End quote. I’ve been there too, Andrew.

Recourse to metaphor is inevitable when discussing depression. Here’s Al Alvarez describing the weather in the weeks leading up to the suicide of his friend, Sylvia Plath, in 1963. Quote. The snow began just after Christmas and would not let up. By New Year the whole country had ground to a halt. The trains froze on the tracks, the abandoned trucks froze on the roads. The power stations, overloaded by million upon pathetic million of hopeless electric fires, broke down continually; not that the fires mattered, since the electricians were mostly out on strike. Water pipes froze solid; for a bath you had to scheme and cajole those rare friends with centrally heated houses, who became rarer and less friendly as the weeks dragged on. Doing the dishes became a major operation. The gastric rumble of water in outdated plumbing was sweeter than the sound of mandolins. Weight for weight, plumbers were as expensive as smoked salmon and harder to find. The gas failed and Sunday joints were raw. The lights failed and candles, of course, were unobtainable. Nerves failed and marriages crumbled. Finally, the heart failed. It seemed the cold would never end. Nag, nag, nag. End quote. In fact, though, suicides peak in the spring, perhaps because, quote: A suicidal depression is a kind of spiritual winter, frozen, sterile, unmoving. The richer, softer and more delectable nature becomes, the deeper that internal winter seems, and the wider and more intolerable the abyss which separates the inner world from the outer. End quote.

Al Alvarez had an epiphany months after his own suicide attempt. Quote. The despair that had led me to try to kill myself had been pure and unadulterated, like the final, unanswerable despair a child feels, with no before or after. And, childishly, I had expected death not merely to end it but also to explain it. Then, when death let me down, I gradually saw that I had been using the wrong language; I had translated the thing into Americanese. Too many movies, too many novels, too many trips to the States had switched my understanding into a hopeful, alien tongue. I no longer thought of myself as unhappy; instead, I had ‘problems’. Which is an optimistic way of putting it, since problems imply solutions, whereas unhappiness is merely a condition of life which you must live with, like the weather. Once I had accepted that there weren’t ever going to be any answers, even in death, I found to my surprise that I didn’t much care whether I was happy or unhappy; ‘problems’ and ‘the problem of problems’ no longer existed. And that in itself is already the beginning of happiness. End quote. 

I think Alvarez’s following conclusion about suicide is beautifully clarifying. Quote: The sociologists and psychologists who talk of it as a disease puzzle me now as much as the Catholics and Muslims who call it the most deadly of mortal sins. It seems to me to be somehow as much social or psychic prophylaxis as it is beyond morality, a terrible but utterly natural reaction to the strained, narrow, unnatural necessities we sometimes create for ourselves. And it is not for me. Perhaps I am no longer optimistic enough. I assume now that death, when it finally comes, will probably be nastier than suicide, and certainly a great deal less convenient. End quote. There’s no need to romanticize or condemn suicide or suicidal thoughts; it is the most normal, human thing. I’m particularly taken by the metaphor of suicide being a ‘social prophylaxis’ in response to social factors that can make life intolerable, whether loneliness, alienation or poverty, and this goes back to Rose Cartwright’s explorations.

In her memoir, Sloane Crosley describes the final moments of her close friend. Quote. He takes the dogs for an evening walk while his partner reads on the porch. He lets the dogs back into the house, through a screen door I can hear banging if I really want to. Then he turns on the television in the living room and leaves once more, moving across the yard. At eye level are his beloved chickens, asleep in their coop. They are named after a mix of former coworkers and dead celebrities (Lana Turner almost pecked your eyes out this weekend). Down the slope is the garden with the rhubarb no one eats. Buried in the ground are the rows of garlic he plants every year. Then he walks into the barn and hangs himself from a rafter. End quote. There was no prior depression or self-harm and Sloane comforts herself with the thought that, quote, I don’t believe Russell thought he’d lost his argument with life; I believe he thought he’d won it. He no longer saw a place for himself in the world and this was the same as terminal illness. The illness of aging. The illness of aging as a gay man. The threat of irrelevance, the loss of power, the expansion of indignities, the condition of being alive. All to be nipped in the bud before the symptoms got too gnarly, all to be addressed while he still had a choice. End quote.

What I will say is that depression remains something of a mystery, even to those who suffer from and / or treat it. The best practical advice, I think, comes from David Brooks, in an article he wrote in response to his friend's suicide. Quote. I learned, very gradually, that a friend’s job in these circumstances is not to cheer the person up. It’s to acknowledge the reality of the situation; it’s to hear, respect and love the person; it’s to show that you haven’t given up on him or her, that you haven’t walked away. If I’m ever in a similar situation again, I’ll know that you don’t have to try to coax somebody out of depression. It’s enough to show that you are trying to understand what this troubled soul is enduring. It’s enough to create an atmosphere in which the sufferer can share her experience. It’s enough to offer him or her the comfort of being seen. End quote.

May you be seen in your times of need.