Depression Posts

Sarah Moon’s “Sparrow”

And then there it is, our new, terrible silent routine. And to top it off, I have no birds and the world feels like a different kind of dark than it felt before. Mom isn’t perfect, but I miss her. I miss her picky neatness, I miss her bothering me about taking my nose out of a book and making a friend for once, I miss her getting on my case about my hair. I miss telling her about what I’m reading, what I’m thinking, asking her about work, listening to her carry on about Aunt Joan and whatever drama she’s gotten into. I miss her. There is a sadness I can’t shake, that’s not just from breakfast. There are no birds by the feeder. There aren’t pigeons cluttering the sidewalk as I go to school. I know, now, that last night’s dream was the last flight I’ll take. 

Sarah Moon‘s debut novel for young adults Sparrow is about a teenager of the same name who has a nervous breakdown. Sparrow is fourteen. She was whisked away to hospital from school after being discovered on the roof. Sparrow maintains she was bird watching as she has always been fascinated them fly. Sparrow lives with her mother, who is a single parent. Sparrow is named after the bird by her mother because she was “so small and brown, almost breakable, but so strong. Tiny but mighty…”. Few weeks later Sparrow is released in her mother’s care with the stipulation she takes her prescribed medication and visits a therapist regularly. So it is fixed that Sparrow attends regular sessions with Dr. Katz which are protected by doctor-patient confidentiality and even Sparrow’s mother cannot sit in upon the hour-long meetings. At first Sparrow refuses to speak to Dr. Katz but after weeks of therapy Sparrow begins to come around. It is probably listening to Dr. Katz playlist which begins to break the barriers for Sparrow. So much so she orders the very same songs/bands she heard during therapy for her listening pleasure at home. All through months of treatment and close questioning by her mother Sparrow is adamant that she was not trying to kill herself but just wanted to be with the birds. Probable reason for her being found alone on the roof ledge was she was devastated upon hearing of the tragic death of her favourite librarian, Mrs Wexler, in a traffic accident. Mrs. Wexler had been warm and welcoming to the shy and reserved Sparrow, encouraging the little girl to sit in the library any time she felt like it, read, participate in the book club etc. Mrs. Wexler offered the fragile little Sparrow a refuge from a world which constantly overwhelmed her.

Sparrow begins from the moment Sparrow is released from the hospital. She is portrayed as a very lonely girl who slowly opens out under Dr Katz’s patient guidance. By the end of the novel Sparrow finds the smallest steps like conversing with other girls of her age still a daunting task but at least she is doing it! It suddenly dawns upon her during the finale when she is running away from her responsibility that the feeling of being ready will never come. She has to muster courage. “I am not going to be ready. I’m going  to have to do this without being ready.” The ultimate epiphany is that the very same music that helped her in therapy is where she finally gets what she has been craving for — to fly away, for her limbs to go light. In fact Sarah Moon created her playlist for Sparrow on Spotify. In it are listed all the pieces of music referenced in the story.

Depression comes in many shades. With the recent suicides of two prominent people Kate Spade and Anthony Bourdain within a week of each other has suddenly put the spotlight on mental health. These issues were always there and always discussed but the magnitude of this problem is unthinkable. To quote Dr Anirudh Kala, Clinical Director, Mind Plus:

Clinical depression is the commonest mental illness and it is true that life time prevalence of depression(which means how many people at one time or the other during their life time will suffer from it) is about 18-20% and many times it just comes out of the blue without any stress like any medical illness which Clinical Depression  actually is a medical illness. Both drugs and psychological treatment methods help and these help the best when used together.
However many well meaning but ill informed persons and some pop psychologists keep telling the person that the key to getting matter is to feel positive implying that the patient can if he willed to feel positive and get better, which is not true. You cannot will away your depression like you cannot will away your fever or your thyroid problem. And it makes the person worse because because he is told he can and he cant’. That is why the quip,’ Positivity is a scam.’
( In fact Dr Kala is also a debut author with his forthcoming collection of short stories The Unsafe Asylum: Stories of Partition and Madness)

In Longreads essay “Surviving Depression” by Danielle Tcholakian written after the deaths of the Bourdain and Spade one of the sanest pieces of advice shared for those who battle depression every day as well as those around them is:

…the biggest lesson I’ve learned in wrestling with this illness for nearly 20 years. You can’t get out of it alone. It is also, confusingly, true that no one can save you — you’re always the one who has to do the work, who has to slog through the muddy darkness — but the eminently human kindnesses of friends and family along the way are what make the slog even remotely possible. And the truth is, you don’t have to do much of anything most of the time. Just be there. . . . Depression is a beast that swallows you whole and forces you to live inside it until you fight your way out — always with help, always with the others safely outside the beast who can pull you back. 

Writing about a teenager whose mental health is being questioned by everyone around her even though the teenager herself is under the impression that her reality makes perfect sense is probably not easy. Yet Sarah Moon’s undeniable wizardry is evident in her sensitive storytelling. Sparrow can be challenging even for an experienced author to create as it is a potential minefield if not handled well. It can fall apart easily. After Nathan Filer’s The Shock of Fall this is another great young adult novel to add to a school reading list. Perhaps to be read in conjunction with Matt Haig’s Reasons to Stay Alive which is not a young adult novel, nevertheless an excellent memoir about coming-to-terms with depression and easily accessible to readers of all ages.

Do read Sparrow. It is not always easy to read for it can be a challenge to read but it is time well spent.

Sarah Moon Sparrow Arthur A. Levine Books, An imprint of Scholastic Inc., New York, 2017. Hb. pp. 270 

21 June 2018

 

 

 

A.J. Finn’s “The Woman in the Window”

[bwwpp_book sku=’97800626784160000000′]  A. J. Finn’s debut psychological thriller The Woman in the Window is about child psychologist Anna Fox who has a bad case of agoraphobia. Confined to her refurbished brownstone in Harlem she uses her Nikon to take photographs of her neighbours. It is very reminiscent of Alfred Hitchcock’s storytelling particularly Rear Window. The resemblance is probably intentional as Dr Fox is addicted to watching black and white films of the past, many of the classic Hitchcock films are her perennial favourites. She suffers from depression as well so is constantly on a cocktail of prescription chemicals that are constantly being titrated by her doctor. He has to constantly advise her not take alcohol as she is fond of drinking Merlot. ( To her delight she has discovered that for an agoraphobic person like her it is convenient to order cartons of Merlot online and it will be delivered at home.) Otherwise she whiles away her time participating in online group chats with other agarophobic patients and playing chess.

The Woman in the Window is about Anna Fox who is confined at home out of choice and the supposed murder she witnesses across the street. Unfortunately she has a hard time persuading neighbours and the police that it is true and not a hallucination under the deadly influence of medicines and alcohol. The story takes a while to build up though the details are fascinating. It is only about 100 pages into the story that it zips along. It is being promoted to be a thriller in the same vein as Gone Girl and Girl on the Train. The chapters are short, sometimes only a few paragraphs, a form of writing apparently influenced by James Patterson’s writing.

A. J. Finn’s debut is being much talked about as it was sold in a hotly contested auction only to be won by William Morrow in a deal worth seven figures. The movie rights have been sold to Fox 2000 to Hollywood producer Scott Rudin who won an Oscar in 2008 for the adaptation of Tom McCarthy’s No Country for Old Men. It is rumoured that Kate Winslet is in the running for the lead role. So far the book has already been sold in 38 book markets. A.J. Finn is the nom de plume for publishing executive Daniel Mallory who used to work at William Morrow but after the runaway success of his manuscript he has quit his day job. Instead he is focussing on writing his next novel. he is being represented by Felicity Blunt, Curtis Brown Literary Agency, sister to actress Emily Blunt who acted in the film version of Girl on a Train.

The Woman in the Window is also the first debut novel to have made it immediately to the NYT Bestseller List in nearly 12 years. Undoubtedly the influence of Hitchcock exists in the story not necessarily due to the constant references to his films. Though the story is a story that has been told many times before and there are sufficient hints in this novel itself to old films to how the plot is going to develop, yet there it rings true for the character sketch of Anna Fox. Apparently Daniel Mallory suffers from bipolar disorder and had been misdiagnosed for a very long time. So the descriptions of Anna and her breakdown are to a large extent “authentic”. Otherwise the plot itself is very thin and relies heavily on many details being shielded from the reader until the explosive conclusion. A very old fashioned trick. Be that as it may it is a book that will be read, watched on screen and talked about for a long time for the richness of detail and the pitch perfect suspense.

A. J. Finn The Woman in the Window HarperCollins Publishers, London, 2018. Pb. pp. 430 Rs 399 

12 March 2018 

Cathy Rentzenbrink

Reading Cathy Rentzenbrink’s memoir The Last Act of Love and the companion to it A Manual for Heartache is a gut wrenching experience. The Last Act of Love was shortlisted for the Wellcome Prize 2016   for its an account of how Cathy Rentzenbrink’s younger brother Matt had a head injury and was for eight long years in a coma. The medical term for it is PVS or “permanent vegetative state” or as their mother says of Matt “living corpse”. Matt was a teenager in his prime when he met with an accident that left him in this horrific state. The Last Act of Love is a compassionate account of a sister trying to understand what her brother must be going through if he can feel anything. More importantly it is an account of how much of themselves caregivers have to give to ensure that a patient is cared for well.

Caregiving can be a thankless task since it is repititive with no breaks whatsoever. After a while the sympathetic circle of friends and relatives return to their lives but the immediate family of the patient is responsible for the daily courageous and relentless task of caregiving. At times it can become exceedingly lonely, stressful and mentally debilitating. For Cathy Rentzenbrick her escape mechanism was reading.

Reading was still my friend, though. I read continuously and compulsively, drowning out sounds of my own thoughts with the noise of other people’s stories. I no longer turned out the light before going to sleep — I had to read until the moment my eyes closed. There could be no gap for the demons to jump into. 

Most caregivers are caught in a cycle of maintaining systems that they forget to take care of themselves or share experiences about the roles they inhabit. These involve a bunch of questions about the quality of life the patient has to how effective are advancements in medical technology.

The Last Act of Love written  many years after her brother passed away takes its title from a phrase the author’s mother used in her sworn affidavit to the court seeking legal permission to discontinue nutrition and hydration given how poorly Matt was with a chest infection and recurring epileptic fits.

I have known for some time that there is nothing I can do for Matthew to enrich his life in any way. He needs to die. We had hoped it would happen with an infection and without the need to approach the court. But the sad irony is that his poor body, unable to do anything else, seems capable of fighting infection. So we are asking the court’s permission to cease nutrition and hydration so that Matthew can be released from his hopeless state. It is our last act of love for him. 

Writing The Last Act of Love may have been thereapeutic for Cathy Rentzenbrick but it certainly provides a much needed account of hope and a way of managing caregiving at home, many times the dilemma it presents. Sharing of stories is a relief for many in a similar situation but few have time to do so. Reading an account is possible.

Within months of the successful publishing of The Last Act of Love, Cathy Rentzenbrick wrote A Manual for Heartache which can be viewed as a sequel to her memoir but works very well as a manual for managing grief and loss. It is full of wisdom and gently with big dollops of kindness shares wisdom garnered over the years of caregiving for Matt.

 

Here are some invaluable excerpts from the book

On grief

What I now wish someone had told me is this: life will never be the same again. The old one is gone and you can’t have it back. What you might at some point be able to encourage yourself to do, and time will be an ally in this, is work out how to adjust to your new world. You can patch up your raggedy heart and start thinking and feeling your way towards how you want to live. That’s what I wish someone had told me and that’s what I want to tell you. I think I’m finally doing it.

On etiquette of bad news

It seems ridiculous that in the face of someone else’s misfortune we spend time worrying about our own behavious, but it’s only human and is particularly true when it comes to death and grief. I’m sure it was easier in Victorian times when there were prescribed rules, when society and the Church provided a framework. There was guidance on what to wear, how to communicate with people, how much time should elapse before everyone rejoined the business of life. Visible signs such as black crepe and mourning brooches made of jet acted as clues to the rest of the world. Like a version of the “Baby on Board” sign stuck in the back windscreen of a car, the blackness served as a warning that an individual needed to be treated kindly. All cultures have rituals around death and mourning but, in our increasingly secular society, it’s easy find ourselves unsure of what to do. 

….

I have come to see there is a beauty in simply being present for someone who is struggling wiht a heavy burden. The best thing you can offer is unlimited kindness. People to whom the worst has happened can be out-of-control sad and unable to obey the normal rules of life. It mught be all they can do to hold on. If they are mean or cruel or temporarily incapable of good manners, we need to suspend our expectations around them and give them space and compassion as they splinter and behave badly and say the wrong thing. If they are behaving perfectly and holding themselves together, then that’s OK, too. 

Reading both the books together is highly recommended. Share, share, share these books.

Update ( 5 Sept 2017)

The Guardian Longreads published a fascinating account of “How science found a way to help coma patients communicate“. It is worth reading!

Cathy Rentzenbrick The Last Act of Love Picador, an imprint of Pan Macmillan, London, 2015. Pb. pp.248 Rs 450

Cathy Rentzenbrick A Manual for Heartache Picador, an imprint of Pan Macmillan, London, 2017. Hb. pp. 150 Rs 499 

31 August 2017 

 

Literature on mental health

Jerry PintoThis past month I have spent a while reading literature about mental health. It was sparked off by the publication of the maginificent collection of essays edited by award-winning author, Jerry Pinto. A Book of Light: When a Loved One has a Different Mind consists of essays written by caregivers to mentally-challenged patients. These could be daughter, mother, son, father or even a close friend. All the essays are written by a caregiver who is also part of the immediate family so has witnessed the painful deterioration of the loved one. Some of the essays like Nirpuma Dutt on her adopted daughter though written using the literary device of an omniscient narrator is one of the most chilling and moving contributions. Every single essay stands out for the grief caused but also for the time and effort required in the caregiving which was mostly offered uncomplaingly and with total dedication. Amandeep Sandhu’s essay about his mother which I first read in draft many years ago continues to be powerful once published years later. As if this caregiving was meant to be. This was the truth. Jerry Pinto who won the Windham-Campbell prize in 2016 has been writing for years made his mark as a literary fiction writer with the splendid novel, Em and Hoom. A thinly disguised fictional account about his mother who remained in poor mental health for most of her life. It was twenty-six years in the making. Despite the vast variety of literature across genres and now his forays into translations, Jerry Pinto is at his best when writing about mental afflictions. There is a certain tenderness and sensitive understanding that seeps through his essays as it does in the introduction to this book and his curation of the essays.

Having read this splendid volume in one sitting I found some more books to read. For instance, Matt Haig’s powerful autobiography Reasons to Stay Alive. It is about his leading a perfectly normal life except to develop acute depression and have a nervous breakdown in his early twenties. He even attempted suicide but then slowly recovered with the help of his then-girlfriend and now wife, Andrea, and his parents. Today, he is a successful author for children and adults and is a social media influencer ( @matthaig1) .

When you are trapped inside something that feels so unreal, you look for anything that gives you a sense of your bearings. I craved knowledge. I craved facts. I searched for them like lifebuoys in the sea. …Things that occur in the mind can often be hidden. Indeed when I first became ill I spent a lot of energy on looking normal. People often only know someone is suffering if they tell them, and with depression that doesn’t always happen, especially if you are male ( more on that later). 

Then I discovered bestselling author Jenny Lawson’s Furiously Happy that explores her lifelong battle with mental illness. It is written at a pitch that can get disconcertingly high, it is not easy trying to keep pace with the ups and lows in her life which are surpringly palpable in the text as well. But what truly shines through is the struggle of managing daily life and yet how determined she is.  Simple things are daunting but the unimaginable fear she experienced when recording her audiobook turned her into a nervous wreck. So she finally turned to her friend, Neil Gaiman, for advice and this is what he texted her: “Pretend you’re good at it.” She took his advice to heart and shone.

Reasons to Stay Alive and Furiously Happy are two books written from the perspective of people who struggle with mental ill-health but have had the courage to write about it too. Offer an opinion that does not consider them over sensitive, peculiar and odd.

And then I read Oliver Sacks absolutely stupendous memoir On the Move. It was first published in April 2015 a few51JcHq846GL._SX328_BO1,204,203,200_ weeks before he succumbed to cancer on 30 August 2015, exactly a year ago today. In fine literary form it reflects upon a richly memorable life that spans eight decades focusing on his fascination with neurology, science, music, literature and his strong links with his family. Oliver Sacks came from a family of doctors where even his mother was a renowned surgeon. His father and two elder brothers were general practitioners but Oliver Sacks decided to become a neurologist. What is extraordinary is his recognition that when he began medical school in the mid-1950s there seemed to be an unbridgeable gap between neurophysiology and the actualities of how patients experienced neurological disorders. Neurology continued to follow the clinico-anatomical method set by Broca a century earlier, locating areas of damage in the brain and correlating these with symptoms; thus speech disturbances were correlated with damage to Broca’s speech area, paralysis with damage to motor areas, and so on. But by the mid-1980s scientists like Gerald M. Edelman were stating boldly that “We are at the beginning of the neuroscience revolution.” Having witnessed, documented and analysed significant neurological milestones writing about them in medical journals and popular magazines made him famous. It probably also helped recognise to some degree that mental ailments need to be discussed. Mentally ill patients are not pariah. Having firsthand experience of looking after a schizophrenic brother and extremely fond of a simple-minded aunt, a treasured member of their household he had a warm and sensitive generosity evident in the way he dealt with his patients too. More importantly he had a sense of history and an understanding to document what he experienced and analyse it. A rich and influential legacy he left on the way mentally-ill patients are perceived and how they can also learn to manage themselves. But at least he with his passion for neurological science made it possible for mental health to be made visible in public discourse. Otherwise how else would a well-known scientist and Pulitzer-award winner Siddhartha Mukherjee begin his fascinating account of the gene with a very personal account of his schizophrenic uncle?

Jerry Pinto ( Ed.) A Book of Light: When a Loved One Has a Different Mind Speaking Tiger, Delhi, 2016. Hb. Pp.180. Rs. 399

Matt Haig Reasons to Stay Alive Canongate, London, 2016. Pb. Pp. 270 Rs 499

Jenny Lawson Furiously Happy: A Funny Book About Horrible Things Picador, an imprint of Pan Macmillan, London, 2016. Pb. Pp. 330 Rs 450

Oliver Sacks On the Move: A Life Picador, London, 2015. Pb. Pp. Rs 499

30 August 2016 

Buddha in the Attic, Julie Otsuka

Buddha in the Attic, Julie Otsuka

I read The Buddha in the Attic by Julie Otsuka last night. I could not put the book down. A brilliant example of historical fiction from contemporary writing. It is about the Japanese immigrants chasing the American dream in the early 1900s. Told from the perspective of a collective group of Japanese women, who remain nameless. But it tracks them from the time they board the ship in Japan as the modern day equivalent of mail order brides to land on the hallowed shores of America, the birth of their children, the various menial jobs they hold or travel in search of better jobs till the time of WWII when the “Japs” are looked upon askance. These women are caught in a terribly painful situation of being ostracized by society, treated like worse than filth by their patriarchal husbands and what is worse, distanced by their own kids who do not want to really have anything to do with their parents, who are so obviously alien to the American culture, modes of lifestyle and language. Julie has written this slim (it is only 117 pages) novel after loads of research. She lists some of the books that were consulted for her writing. It is the perfect little gem of historical fiction. Brings you immediately into the story (the hallmark of a good storyteller) and creating a moment in history evocatively, putting in sufficient background details to place it in a period setting, but without crowding the text or obstructing the narrative/story/plot. Read it, if you can.