When Oliver Kamm was overcome by despair, he struggled to cope. Now cured, he has written a book about depression, and warns that many will be suffering during the pandemic
It’s an often overlooked aspect of modern Jewish history: what happened to those who survived the death camps? Or rather, this question is often overlooked in popular discussion of the great moral cause of defeating Nazi Germany. One of the greatest chroniclers of the Holocaust, Primo Levi, wrote in his book The Drowned and the Saved (translated by Raymond Rosenthal): “There is a stereotyped picture, proposed innumerable times, consecrated by literature and poetry and picked up by the cinema: at the end of the storm, when the ‘quiet after the storm’ arrives, all hearts rejoice.”
It was Levi’s last work; shortly afterwards he leapt down the stairwell of his apartment block to his death. And to some commentators, it made no sense that a man who had survived Auschwitz should have taken his own life decades later, while living in a free society and enjoying literary celebrity. The answer to that conundrum is in the quote I’ve given: the quiet after the storm may be deceptive. Levi suffered badly from depression. And another famous author, William Styron wrote in indignation of how Levi’s condition seemed not to attract the popular sympathy it ought to have done.
Nor was Levi alone among victims of Nazi persecution who found the weight of the experience too much to bear. Stefan Zweig, the great Austrian author and an early associate of Theodor Herzl, and his wife Lotte took their own liveswith poison in their exile in Brazil in 1942. It’s often been discussed by Zweig’s biographers why he took this route when the eventual defeat of Nazism seemed already assured. In truth, a state of clinical depression is explanation enough. Levi’s experiences of Auschwitz and Zweig’s of being driven from his homeland were not dispelled by escaping persecution — their mental world had collapsed and they found the habit of living no longer supportable.
In my own experience a few years ago, despite having lived all my life in democratic societies and enjoying the fruits of professional success and a loving family, I suddenly got a sense of complete despair. And I recalled the sufferings of Levi and Zweig, and contrasted my life with close friends of mine who have survived more recent horrors. As Bosnian Muslims, they lived through a ferocious genocidal campaign against their community in the 1990s. They never forget yet have heroically managed to build successful and admirable lives. I saw all this, and felt still more ashamed that I was unable to handle life; and so the vertiginous descent into despair took a further sharp twist downwards.
My condition was diagnosed as severe clinical depression, and it dominated my life for a full year before I managed progressively to restore my rationality. For long stretches of that time, all I could think of was how blissful it would be not to see another day. And the fact that no traumatic event — no experience of persecution or oppression, or even serious setback — had elicited it made my despair still more intense. I was overwhelmed with feelings of shame and guilt, and haunted by the irrevocable conviction that I was evil. The trigger for this state was no more than the vicissitudes of life: romantic disappointments, the death of a father whom I loved yet had — in my estimation — talked to insufficiently in his final illness, and the rigours of single parenthood, for which I felt unskilled and unsuited. I felt I had failed everyone and that the trappings of professional success were a mere artifice.
It was a revelation to me that the state I’d fallen into was a clinical illness, and eventually I made a full recovery. And having experienced the dramatically altered perceptions of the external world that are elicited by mental disorder, I set about finding out all I could on the subject. I talked to leading figures in neuroscience, psychiatry, clinical psychology, neuropharmacology and mental health, in order to understand what had happened to me. And I wrote a book, published this week, to try to illuminate the condition. I hope it will influence public debate by showing that depression is not a “first-world problem” or a medicalisation for the sadnesses that everyone experiences in life, but a real illness like any other, with a variety of causes.
The issue has become especially important because of the public health crisis we find ourselves in. Since March, Britain has been under tight restrictions to stop the spread of Covid-19 infection. It’s been estimated that billions of people throughout the world have been under some form of lockdown, and this is bound to have consequences for mental health. Even in this nation’s greatest peril, under Nazi bombing during the Blitz, the authorities kept open pubs and cinemas in order to keep open the social networks that sustain us in adversity. In the coronavirus crisis, those links are severed. For minorities where communal life is so central, such as British Jewry, the cost is especially heavy — not only for high holy days and the inability to share them, but in the practice of life.
That’s not an argument against lockdown (which I’m convinced is necessary) but an observation about its predictable side-effects. Moreover Covid-19 is itself a multi-system illness that has been found to have neurological impacts. Those who survive the illness are at greater risk of mental disorder. And we have the example of history: the influenza pandemic of 1918-20, which killed around 50 million people worldwide, was followed a by a steep rise in the incidence of psychiatric disorder. It’s quite likely that the same will be true of the current crisis. Policymakers and the public need to be prepared for it.
My researches persuaded me of two essential points: clinical depression is real, and there are effective treatments for it. One of the steepest obstacles to dealing with depression is the widespread suspicion that it’s not a genuine illness. Maladies of the mind carry a stigma that physical injuries and diseases do not. The ethos of the stiff upper lip, and of showing resilience in the face of the difficulties of life, is still very much with us. It causes many who are ill to suffer in silence, for fear of being misunderstood — not least by an employer. That’s an error. Mood disorders have been documented throughout history, and the evidence is that they extend back into prehistory too. Why they happen is mysterious but we can say with confidence that depression is not an imaginary state: it’s a physiological condition, in which the brain malfunctions, brought about by a mix of factors that may be biological or social.
And the treatments work. I don’t mean only that they worked for me: I mean that the randomised controlled trials have been done. Antidepressant medication carries some prejudice: you’ll find numerous tabloid articles claiming that the nation is hooked on antidepressants, whereas they’re actually dispensed carefully and, unlike recreational drugs, don’t give an immediate “buzz”. This class of drug does have side-effects and risks, but it works better than placebos most of the time and for most sufferers. The much-parodied talking therapies have also been given clinical validation in some forms. The practice has moved on from the dubious notions of Sigmund Freud, who placed stress on the role of the unconscious, to genuinely helpful forms of therapy that address current problems. The one that worked for me is cognitive-behavioural therapy (CBT), given by an expert clinical psychologist, who gently but systematically trained me to dispel a cycle of cognitive distortions on which my personality had become broken.
There will be many people in this crisis who find that conventional sadness mutates into the agonies of clinical depression. If you find it hard to cope, don’t blame yourself for weakness or sloth. It’s not you. It may be a condition that has afflicted some of the greatest minds in history too, and there is no shame in seeking help for it. It’s a common view that depression can be cured by fresh air and exercise, and these do indeed have therapeutic effects as well as benefits to physical health. But don’t feel any hesitation in seeking medical and psychological help too. As well as the care and solicitude of those who love you — even if they can’t see you during lockdown — there are medical and other professionals who can show you the route out of a condition that ranges from a persistent low mood to an unfathomable terror and self-loathing. There is always help.
Oliver Kamm is a leader writer and columnist for The Times. His book Mending the Mind: The Art and Science of Overcoming Clinical Depression is published by Weidenfeld and Nicolson (£16.99)
I want to comment, with respect to Oliver Kamm, that psychoanalysis as moved on from Freud & its results are not "dubious".
There is no "one-size-fits-all" but today, when the NHS, even without covid-19, is under funded, people with mental health difficulties, have to wait 18 months & rarely given more than 8 sessions. For "talking therapies", this isn't possible.
If anyone reading this is depressed, please contact me. I am a psychotherapists & no one should feel they are alone. I will try to find you resources you need or point you towards psychotherapy.
It is also worrying that children are also affected by depression and they too need support and help.