Five months later, Maud had finally recovered, though a combination of “time, therapy, medication and a strong-willed personality,” her sister says. Soon afterward, Taije Silverman, an editor at William Morrow, was looking for a young editor to work on a low-budget project, a collection of mostly original essays on depression. She asked Nell, a books editor at Self magazine. “It was such a strange and good coincidence because it seemed wonderful to be asked to write about something that had been so harrowing,” Casey says. Nell asked Maud, also a writer, if she would participate, and she agreed. Other authors followed.
In the result, “Unholy Ghost: Writers on Depression,” 22 authors give their personal takes on this all-too-common illness. An excerpt from “Lie Down in Darkness,” William Styron’s exploration of his own state of mind, is further enlightened by his wife Rose’s own account. Russell Banks questions his mental health after dealing with his depressed wife, the poet Chase Twichell, while Larry McMurtry, Susanna Kaysen, Virginia Heffernan and others detail their own varied experiences. NEWSWEEK’s Laura Fording asked both Nell and Maud Casey about the illness and the book.
NEWSWEEK: How did you feel writing about Maud, knowing that she would see and react to it?
Nell Casey: It’s very hard to write something so frank about someone you love. You want to be honest and to strike a tone that is frank and helpful, as well as literary and eloquent. But at the same time, this distant voice in your head is saying, “Well what is Maud going to think?” I had to go on the faith that I was being very fair and that my overall feeling was of great generosity and love. To my surprise-although of course my heart was pounding when I gave it to her-I think Maud felt relief after she read it. I think when you come back to your life as she did, you imagine what your family has been through on the other side. I think she needed to have an honest account.
Would you notice when your sister was going through a manic phase?
Her mania was mainly in the hospital, so yes, I noticed it. It seems like a different person, someone with heightened anxiety. But it’s also a very creative moment-not to romanticize it-but it is intriguing in the sense that there are all kinds of way-out but very creative and intelligent theories and ideas and fantasies just flowing out of the person. A lot of people experience mania in such a light form that it’s just like extra energy. But Maud’s case was more severe. She was aware of who people were, but everything was attached to a theory or a suspicion.
Your description of Maud and her “hungry medicated pupils” after she is released from the hospital and comes to visit you hit me hard-how she was able to hold her own in the real world, but she wasn’t really there.
That’s the scariest part, because the person is gone. The medication is great when you have the right medication at the right level. In many ways, it’s a miracle for people with bipolar disorders. Along with Maud’s own strength and courage, it has brought her back to her life. But at that point when she came over, I don’t think the levels were right, she was on too much. She had something like 18 different drugs by the time they got it right.
William Styron describes depression as a “veritable howling tempest in the brain.” David Karp says “the volume of my personal agony reached a deafening pitch.” Why the references to noise? I always think of depression as muffled, numb.
I think that’s the outward appearance of it. On the inside, it reaches a deafening pitch, but on the outside it does seem muffled. I think when people are depressed, they don’t feel capable of communicating their agony to the world. So they just give up. But I want to be careful because every depression seems very different.
What are some other examples of how people describe depression?
Virginia Heffernan has an amazing essay-they are all amazing-and she describes it as work…. Chase Twichell talks about inhabiting subtly different personas based on the medication. I think Maud’s description is also unbelievably scary, about being in a gray world of nonexistence and the inability to make decisions. The metaphors for depression are really interesting. Work and drunkenness.
In his essay, Russell Banks talks about how his wife’s illness caused him to think that he was depressed. Does this often happen?
I think it does. I think informal caregivers have to defend themselves against the feeling of contagiousness. They definitely begin to feel like they could take it on themselves. Part of that is from overempathizing and part of it is that the situation does feel contagious: the person is so deep in it and you’re trying to understand it and that’s a scary road to go down. When Maud was in the hospital and when she was depressed, I had the taste of it on the tip of my tongue. I just could imagine myself into it far too easily.
People also talk lot about their struggle with the medication. What are some of the reasons they want to go off?
For one, there are side effects. Some make you feel tired, some make you gain weight, some make you feel logy, some make you have memory loss. Chase Twichell goes through a whole list of things they can make you feel. And sometimes people just have to decide that the trade-off is worth it. There are enough medications that you can try to find ones that don’t make you feel as bad. And then there are existential reasons, feeling like you haven’t felt a real emotion or that somehow you are a personality made up of medication, and who are you, really? And those are valid and deep questions.
What do you hope people will get from this book?
One of my biggest hopes is that it can be helpful to informal caregivers, people in families who are helping those who are depressed or who have mental illness. I hope that it helps to put words to this incredibly elusive illness. I found that as I went along the project took on such deeper meaning. It is about depression, but it’s also about vulnerability, isolation, loneliness, alienation and death, things that we all think about.
[To Maud:] Can you describe how manic depression, or bipolar disorder, feels?
Maud Casey: Depression and mania are both awful but in different ways. Just before it gets awful, mania feels kind of nice, kind of electrifying. Suddenly you’re having all these thoughts that seem really brilliant, as if you are finally making sense of your life and the world. But I actually tipped over into psychosis, which is not as fun, mainly because you are hearing voices and you can’t distinguish reality [from fantasy]. Depression is the opposite of electrifying. It’s deadening. It felt like emotional paralysis. The mania can be pretty terrifying to the people who have to witness it. But the depression was much harder for me because it wasn’t craziness, it wasn’t psychosis, which people see and recognize as bizarre behavior. With depression it’s more, “Get over it already, let’s get on with it.” It’s a little bit more invisible.
Does your upcoming novel, “The Shape of Things to Come,” come from your personal experience?
It’s not an autobiographical novel. It’s the story of a woman in her thirties who has left the suburbs and has gone to San Francisco. She fails in life, love and career and gets fired from a not-so-great job with the phone company for Xeroxing her naked body when she has a little bit of a breakdown. She goes back to live with her mother, who was abandoned many years before by the narrator’s father, and discovers what I call the fluidity of identity through this kooky temp job she gets which requires her to take on many different disguises….
Has your experience affected your writing?
Absolutely. When Nell started to do the book, at first the prospect of writing about what happened seemed terrifying. But when I began to write the essay, it was really helpful to me to look at it head-on. It was a private way for me to say things that might not be possible to say out loud. But there was also a public aspect: so many people were involved in helping me recover and helping me live that I felt the essay was an opportunity for me to thank them.
What was it like reading your sister’s essay?
It was tough but the anticipation of reading it was tougher. I was a little scared of what she had to say. When you are depressed or manic, your memory isn’t so great. I was horrified at the thought that I was going to read something that was so damning that I would have to leave the country [laughs]. But we exchanged essays, and it was a chance to have a private conversation on the page that probably would have been completely impossible out loud. It would have been too much to say those things to each other in any other way.
Why did you want to stop your medication?
I was feeling cloudy, forgetful. But I would hesitate to blame it entirely on the medication. It’s impossible to untangle the difficulty I was having with life from how the medication made me feel. As someone who has been on medication a long time, I struggle with the feeling of “is this me, or is it the medication?” That’s a natural struggle, I think, for people who are on medication. And while I’ll always feel conflicted about it, I think the thing I’ve absolutely learned from the second episode is to stay on it. I feel really lucky now because I feel as though my psychiatrist has achieved a perfect balance. And any time I have that conflicted feeling and say to him, “Maybe I don’t have to be on two different antidepressants,” he says, “You were like the Titanic. You were going down fast. Please remember that.”
