'I was told English publishers don't like this kind of story' - Mary Cregan on writing about major depression
Mary Cregan first had to overcome her fear of destabilising vulnerable readers in order to write honestly about her experience with major depression, writes Maggie Armstrong
Who would want to read a book about depression? It's a question Mary Cregan asked herself a lot as she came to write her first book, The Scar: A Personal History of Depression and Recovery.
"A book on depression, how depressing," says Cregan with a wry laugh. "Depression, like, it's a bummer. Well, that's the reason I never wrote the book before now."
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Early on, her publisher had similar reservations, telling Cregan it was "a difficult story". Her agent was not successful in finding a publisher for the book in England: "I was told that English publishers do not like this kind of story."
This "kind of story" is actually one of a kind, you won't have read another like it. Cregan explores the suicidal illness she suffered and frames the memoir within a much broader history of depression, its treatments, and the asylum. "My husband calls me the Forrest Gump of psychiatry, in that my story intersects with many pieces in the history of mental illness."
Cregan's scholarly book takes in science, medical history, literature and poetry, quoting a range of sources from films and song lyrics to ancient Greek texts. One might be a little nervous meeting this brainbox.
Cregan is warm and open with that American ability to talk. She is both quick-witted and intense. She is nicely dressed and stylish.
Her life - a post at Barnard College, with Colm Tóibín and Paul Muldoon among her friends, her husband James Shapiro, the eminent Shakespeare scholar - conjures an image of Manhattan glamour. But she is compassionate and aware - depression is a class problem, and she mentions twice the added danger for people without adequate finances to cover the medical bills. Her thesis can be boiled down (crudely) to this: recovery begins with talking.
"People need to be able to admit to their depression in order to be helped. Because we can get really good at hiding it, and performing the usual social self.
"No one wants to talk about this. And for that reason, I feel it's very important to talk about it."
Cregan was born in Philadelphia into an Irish-American Catholic family, one of six children, with Mass a regular feature. "I was a popular girl. I had a boyfriend on the football team, and that really means a lot, you know."
When she was 16, something changed and she retreated into herself. "I realised nothing was satisfying. I started spending more time alone. It all kind of fell apart.
"I felt this revving or charging of anxiety, which was completely new. I couldn't concentrate, I would read the same page over and over again."
It was never diagnosed, but it would be the first of a number of depressive episodes that would take years to recover from.
When Cregan was 27, she gave birth to a daughter, Anna, who died just two days old from a heart defect. This loss left Cregan in total despair. Her grief was left to play out in the isolation of the suburbs, while her husband was at work. "There was no support."
What frame of mind was she in before the first of two suicide attempts?
"Things became increasingly strange, I felt kind of haunted. I'd see a baby's bottle on a window ledge, or a baby's shoe dropped on the street. Things began to take on an ominous quality, a distortion."
After she self-harmed, her husband brought her to a psychiatric hospital. (They divorced and she has since remarried). She was diagnosed with major depression, with melancholia to top it off.
Then, while in hospital, she attempted suicide.
It was nearly fatal, and she was put on 24-hour watch. "I remember going into that room and doing what I did with great determination. It's horrible to talk about."
It was also horrible to write about, as aside from having to return to her own suffering in precise detail, she feared she would shock and destabilise people. "I worried about whether the description of what I did was too graphic, that it was too much information for people. I gradually overcame my reluctance to impose upon the reader anything that was 'too disturbing'. I thought to myself, 'Yeah it's disturbing, this really happens people.'"
Her recovery involved a programme of electroconvulsive therapy (ECT) - which she doesn't discount when administered humanely - antidepressants that gave her hives, improved antidepressants, group therapy. She now takes medication and has faith in therapy, in the therapeutic bond: "Faith sometimes has to come from someone else, somewhere else."
The "invisibility problem", as she calls it, of her illness was of a part with being raised by "very, very Irish people". Her four grandparents had emigrated from rural Ireland. Her family was steeped in a culture of (she writes) "self-suppression, stoicism and silence".
"We never used to talk about trauma in those days. To use words like trauma for a very private small-scale event seemed like overblowing it. Now, I know about trauma, the way it imprints itself on the brain and you fear it returning. I realise that was a trauma."
What can explain the silence we reserve for mental illness? For Cregan, "part of the silence and stigma is that there is a problem with finding the physiological evidence for these illnesses. They're called 'mental' illnesses, when clearly they're much in the body as much as diabetes or cancer. They happen in the brain, in the wiring, in the hormones."
What would Cregan say to someone who didn't see the point in living, or getting immediate help? Cautiously, she replies: "I would say to them that they are valuable. Their life is valuable."
She quotes Rilke - "just keep going, no feeling is final."
Cregan went from living in an asylum to writing a doctorate on Virginia Woolf and finding love. At 40, she had a son, Luke.
"In a state of wellness, I'm a really sociable person. I don't think anyone would perceive me a depressed person."
Coping, these days, is second nature to her. She reads the writers and poets who were "company along the way", who gave meaning when life was meaningless. She takes exercise.
"Exercise is the first thing a psychologist will suggest, before medication. It gives you energy, and depression is a depletion of energy."
She looks at art in galleries. "Looking at paintings is kind of just switching the channels in your brain."
As it happens, Cregan has not written a "depressing" book about depression. It is an interesting book, crafted by a deep and investigative mind, myth-debunking and revelatory, if difficult in parts.
Who would want to read a book about overcoming, healing, living a full life with depression? That's a question we could ask ourselves.
Samaritans' 24-hour freephone helpline is at 116-123 or email email@example.com
'The Scar: A Personal History of Depression and Recovery' is published by Lilliput Press