The idea for That Was When People Started to Worry came during my first abortive attempt at starting university. My first book, The Time in Between, exploring my decade-long struggle with eating disorders, had been published in April. By October I was sitting on a hard bed in a noisy accommodation block, wondering why I felt so empty. As I tried to build a life in a new city with new people, mental illness still dictated everything I thought, felt and did. I went to lectures and submitted essays and talked about amorphous ‘problems’ in the past tense, as if the problems were not determinedly, demonstrably present. I was not alone: in internet support groups, within the university and beyond, women were articulating big, black anguish in small, black characters. Often, the posts were anonymous. Often, they ended with, ‘If you know me in real life, please don’t mention this.’ Within the safe confines of cyberspace, the darkness of mental illness was being shared – but sharing was not welcome outside the shadows. It could not be allowed to infiltrate ‘real life’. I began to wonder if I could do anything to shine light on the dingy corners of the mind that all too often go un-illuminated.
That Was When People Started to Worry is the product of interviews I conducted with 70 women aged between 16 and 25, who spoke to me about the various mental illnesses they had experienced or were experiencing. They were from different backgrounds, different cultures, and were at different stages in terms of acute struggle vs recovery. I went into the project with no inclusion or exclusion criteria beyond willingness: if people were keen to talk, I was keen to listen. At times, listening was harrowing; at times it was uplifting. At all times, it was an honour to be allowed into someone else’s internal world.
I did not assimilate the interviews into a book of transcripts, recounting individual stories word for word. Rather, the book’s characters are composites of multiple people: each story an amalgam of various stories. The women who appear are not individual women I interviewed: they are unions of the many women I interviewed. As far as possible, every thought, feeling and experience I have written about is a genuine thought, feeling or experience recounted to me by an interviewee. In this way, I hope to offer authentic impressions of the lived experience of a range of mental health conditions, from depression to bipolar disorder, anxiety to binge-eating disorder.
Sadly, several million young women are affected by mental illness at any one time; it would be impossible to capture every facet of every experience in seven self-contained stories. That Was When… is not the definitive exploration of mental illness: it is a contribution to an ongoing conversation. I hope the book provides valuable insight into how certain psychological disorders feel from the inside: the fear and shame that are usually confined to the shadows. I am the first to admit that there is more to be said, written and learnt about female mental illness – and yet I did learn a great deal from the research and writing that became this book.
I learnt that, while there has been a shift in our willingness and ability to talk about mental illness, there is still a gulf between awareness that these problems exist, and real knowledge of how it feels to be mired in them. Mental illness is not a universal human experience. We all feel sad, but we are not all depressed. We all worry, but we do not all have anxiety. True mental illness is different to ‘normal’ ups and downs in extent, intensity and nature, with the logical implication that those who have not experienced it can never fully understand how it feels. This is true – but then, we can never know how any other person feels, well or unwell. Those with mental illness do not expect to be understood completely: based on past experience, the majority expect to be ostracised or patronised. This is why others hold such power: by making the smallest efforts to learn about the sufferer’s condition, and to respond to what they learn with tolerance and kindness, they can chip away at the loneliness mental illness breeds. The number of people who have not been affected – directly or indirectly – by mental illness is small.
Many of the women I spoke to were leading impressive, successful lives: they held down jobs; they passed exams – things that seemed incompatible with the intense mental torment they described. Often, mental torment was the price paid for maintaining the impressive, successful life. This project confirmed what I had suspected from my own experience: that today’s culture of relentless striving is creating a lucky subset of young people who are happily ambitious – but many more who are phobic about failure, who feel chronically insufficient, who can imagine nothing worse than being average.
Another lesson, related to the above, is that success and sadness – success and madness – are not mutually exclusive. Madness is not a synonym for mental illness, nor justifiable grounds upon which to dismiss the thoughts, feelings and beliefs of those suffering from mental illness. Madness is a subjective state, readily identified by sufferers: a feeling of being off-kilter, topsy-turvy, upside-down, out-of-touch, on-the-edge. It is a dangerous, electric instability that can spill out, uncontained, or bubble beneath the surface. Mental illness conducts much of its activity in secret, such that psychological disorders rarely look as we expect them to look or behave as we expect them to behave.
More than any course of treatment – more even than writing The Time in Between – this book pushed me to reflect on my own story. I am still at the same university. I still make arrangements and cancel them with flimsy excuses. I eat too much or not at all and I train my eyes to the ground when I pass shop windows, afraid of spotting my reflection and being plunged into despair. Sometimes I feel miserably stagnant. But then I read texts or emails or letters I wrote a few years ago, and realise that things are not so bleak as they once were. If my interviews had shed light on how to recover from mental illness, this book would be full of advice, but such tips and tricks were not forthcoming. I cannot identify ‘the answer’, because the answer is not a monolith: it is composed of many small, helpful parts. Time helps. Company helps. Bravery helps, but so does vulnerability, because vulnerability is not weakness but strength. It helps to realise that in order to recover, you have to stop doing the thing you are trying to recover from. It helps to remember that there is no more value in being clever, successful and impressive than in being kind and gentle.
Would I swap my experience for a life that had never involved mental illness? By and large, no. For me and many others, mental illness has brought with it swathes of self-hatred, and often I feel I would like to be a different person. But if I were a different person – a stable, untroubled person – I might lack empathy for those who feel haunted, and I would not want to be that way. If I were a different person, I would not have met such a wide range of brave, vulnerable, interesting women, and I would not have had the privilege of writing this book. That alone is enough to make me glad to be me.
Nancy Tucker is the author of That Was When People Started to Worry: Windows Into Unwell Minds published by Icon books on Thursday, £14.99 hardback.