LOVE more than THERAPY keeps you SANE
She’s a top psychiatrist who suffered severe depression. But after years of treatment she’s finally realised ....
BRITAIN’S mental illness epidemic shows no sign of abating, according to a survey last week, with one in four women now reporting that they have suffered from depression in the past year. It’s a shocking statistic and one, says Dr Linda Gask, which demonstates that, despite Prince Harry’s best efforts, the stigma attached to mental illness needs to be addressed urgently.
Linda, 61, has more reason than most to feel passionately about the subject. As a sufferer of severe depression since her teens and also a professor of psychiatry with 25 years experience, she has viewed the system from both sides. But when I ask what has been most effective — the tablets she’s been taking for years, or her expertise and therapy — her answer is surprising.
‘It’s love. My husband John and the power of our relationship help me more than antidepressants or therapy. It helps that I matter a great deal to him and he does to me. It’s love, care, talking to him.’
Which isn’t to diminish the severity of Linda’s illness — indeed, she has repeatedly contemplated ending her life. ‘sometimes when I’m on the motorway, I can’t get the thought out of my head,’ she writes in her memoir The Other side Of silence. ‘I don’t think I really want to do it, but I can’t stop thinking it.’
Despite years of patching up the psyches of patients, Linda says it’s hard to explain depression to someone who has never had it: ‘It burrows into the soul and damages our sense of who we are and our reason for living, as a worm makes its way to the core of an apple,’ she says.
‘I suffer severe anxiety when I’m depressed; first a terrible tension then a sense of being unable to enjoy anything. I feel flat, exhausted, permanently on the edge of tears. The spark goes out of life and every day is grey. You can be in a beautiful place and feel no pleasure.’
You might imagine that meeting Linda would be gloomy. But she is warm, frank, funny and determined. now semi-retired, she lives with John, 55 — they’ve been together for 30 years — dividing their time between a converted chapel in south Yorkshire and a cottage on Orkney.
As JOHN arrives with coffee and her favourite caramel wafers, she tells me there is always hope. ‘I am well for months; sometimes more than a year. so I know from experience it can be done.’
In addition to drawing strength from her marriage, she adores cats — caring for them has helped her through episodes of deep depression. But she has chosen not to have children.
‘I just don’t think I’d have coped with being a mother,’ she cries. ‘You worry that when you have problems with your mood your kids will too.’
Linda met John after her first marriage to a research scientist had ended. she was 22 and a student at edinburgh University when she married for the first time. Ten years later, the relationship had disintegrated as she struggled with ‘personal demons’ and the fear that her life would revolve around tedious dinner parties with her husband’s academic colleagues.
‘I usually drank too much to cope with the anxiety about my cooking and the interminable conversations about nursery schools and soft furnishings,’ she confesses.
When she announced to her husband that she’d like to study for a PhD — he was working on his own doctorate — and he told her that one was enough for a single household, it confirmed that her career would always be secondary to his.
she began an ‘intense and passionate’ affair with a mental health nurse as an escape. But it ended in ‘utter, painful despair’ when her lover didn’t leave his wife and child for her, as he had promised. she was, she confesses, vulnerable to men who: ‘seduced me with their charm but rejected me when they discovered that beneath my veneer of independence and self-possession there was a less confident and sometimes needy individual, who was often anxious, uncertain of herself and voracious for both love and tenderness.
‘I never went out with anyone who was violent, but I went out with men who used women. If you have low self-esteem, you find men like that who are equally good at detecting women they can dominate.’
I wonder if she is a better psychiatrist because she not only has experience of depression but is also so sharply aware of its emotional toll.
‘I can connect to patients and understand them better,’ she says. ‘some doctors say “you shouldn’t have feelings for patients” but you do. You care about them very much. And if you don’t acknowledge that, you’ll be a very bad doctor. ‘The trick is learning how to deal with it. some doctors can’t cope with people who’ve had terrible trauma and are quite needy, scary and suicidal. I’ve never found it hard. This may be because I know what it feels like.
‘I knew from my own depression that you can’t get out of bed in the morning, but by the evening you feel much better and you start to function again. But in the morning you’re at square one. It’s called diurnal mood variation. My patients have said, “I can tell by the questions you’re asking that you know exactly what this feels like.”
‘I have no problem with people knowing. The danger is that they’ll say “let’s talk about you” when I’m trying to help them. In that respect, it’s not good to be too open.’
Vitally, she has had to be aware of when she was unfit to practise.
‘I’d reach a point when I felt worse than the patients I was trying to help,’ she admits. ‘I couldn’t cope with the effort of working out how they were feeling.’
It would be surprising if Linda did not endure mental health problems. Her parents, both of whom have died, suffered themselves.
Her mother Paula, a factory worker, was perpetually unhappy. Besieged
by anxiety and bitterly resentful of her gifted daughter’s success, she showed Linda no love, gave no encouragement or affection.
‘Before my mother died four years ago I hadn’t really seen her for ten years,’ Linda says. ‘If I tried to get in touch she’d rebuff me. I wonder why people assume all mothers love their children when there is so much evidence in the world to the contrary.’
Linda’s father Raymond, meanwhile, who worked in an amusement park in Skegness, Lincolnshire, had episodes of depression and social phobia. ‘He was incredibly anxious; beyond shy,’ she recalls.
But he recognised his daughter’s intellect and paid for her to go to a private primary school before she won a place at grammar school.
She went on to study medicine at Edinburgh, and was beset by anxiety and insomnia: ‘I was struggling to hold the pieces of my brain together.’
HER GP referred her, for the first time, to a psychiatrist and, with medication, tears and support, she passed her finals.
Afterwards, she realised the area for which she had most aptitude was psychiatry.
She asked her psychiatrist if he thought, with her history of mental illness, she could still train in the discipline. His encouragement set her on a successful career path: that she has such a reputation for her teaching and research into doctor-patient communication is partly thanks to her empathy with those she has treated.
Her memoir, she admits, was an exercise both in therapy and defiance. She says: ‘Mum came home from a parents’ evening to tell me my English teacher had said I’d “never write anything original”.’
Even though she had to wait 50 years, Linda set about proving her wrong. ‘Mum would have been happy if I’d married, lived near her and gone shopping with her every Saturday,’ she says.
As it was, she thwarted her by being successful, clever and by discovering that supportive friends and a loving husband could take the place of the family that failed to care for her.