Skin, stomach, vagina: the anatomy of a depression

Maybe it’s because the mind is positioned inside a thick skull, designed never to be penetrated, that we find it hard to talk about. And maybe it’s why we so rarely talk about the physical impact that the mind can have on the body.

But depression and anxiety – and, I presume – other mental health disorders I have no experience of – don’t only manifest in our heads. The relationship between our bodies and minds are deeply and naturally intertwined. In fact, there is evidence that depressed patients feel more physical pain and that depression and pain share nerve pathways in the spinal cord.

We know that the stress hormone, cortisol, when released too much – when our fight or flight reflex is too active – can cause digestive problems. Headaches. Back pain. Weight loss or weight gain. The thyroid, which looks after our mood function as well as metabolism, was once known as the gland of emotion and is still hugely implicated in the disease.

Depression has its own anatomy – or so I found, one summer, two years ago, when I became very depressed.

Spring 2017

It begins as a tickle; a tingle that could, some days, be mistaken for excitement. I convince myself it is the feeling of falling in love – a new relationship is keeping me intrigued for once. Slowly though, the tingles on my skin get more frequent and sharper; every so often, it’s like a wave of tiny shards of ice, starting on my arms, my legs, my arse cheeks. I wonder whether I have MS, I visit the doctor to tell him about my mysterious pins and needles.

The seasons are turning, spring into summer, I feel tingles in frighteningly specific places: my right armpit; just underneath both of my breasts; the tops of my feet and the palms of my hands; fingers, but only the two little ones. There, the skin seems so sensitive the pricking becomes an anxious itch, that I can’t relieve no matter how hard I try. I start to wonder whether people think I have a tic.

A friend tells me that, when she is stressed or anxious, her tongue immediately feels like it’s too big for her mouth. It hasn’t actually changed size, she tells me, although we both think this would be at least pretty novel. A bit of a party-trick. Mine does this when I eat kiwi fruit, I say. We agree it’s not ideal to be allergic to your own mind.

I don’t get the phantom massive tongue, but I do grind my teeth until the front four at the top begin to chip. It’s embarrassing.

The dentist tells me that teeth grinding is a very common side effect of depression – I look at him. ​“And it will absolutely destroy your smile,” he continues.

“Ha, ha, what smile, eh?” I say back, with forced. He doesn’t get the irony and the situation becomes desperately awkward. He prescribes a nightguard I can’t afford.

I have been sleeping on the sofa, and some days I can’t get up long enough to brush my teeth. I worry about that, too.

My tongue goes next. Everything tastes the same, like rubber or dust. Instead of eating I smoke more and more. I drag hard on my cigarette, for longer than I want to, so I know the hot smoke will catch in my throat and linger there. Soon words start to catch too, as the panic tightens its grip. Sally Brampton, in her memoir, Shoot The Damn Dog – written before she died by suicide – describes the feeling as a ​“monster” being at her throat, his ​“claw stuck fast” and I can relate to this. Words seem to be lodged in the grip, too. I hear people talking to me but I’m conscious that each word seems to appear in slow-motion when I try to respond. It’s exhausting so I just keep them to myself.

Summer 2017

The boyfriend isn’t around much. I start to feel desperate for sex – I crave the weight of someone’s body; I want to relinquish control of my own to someone else. Maybe they can fix it, I think to myself. A nice medicinal fuck.

But when it does happen, I want to cry each time because this theory does not work and I realise I can’t feel anything. My clit is numb. I feel less of a woman as much as I feel less of a person.

I am prescribed a high dosage of Prozac and it gets worse. I don’t know precisely whether it’s the painkillers or just me but when I touch myself it feels as though I’ve been administered anaesthetic. It’s just flesh now.

I try that age-old advice ​“fake it till you make it” during sex which is quite obviously fruitless. I hate my body for validating everything I suspected – that I’ve been switched off at the wall, I’m done.

I spend a lot of my time on the sofa pressing two fingers down on my stomach, which is shrinking each week as I feed it less and less.

I know my friends and family are very worried, by now, and when they present meals to me I know I’m already too full. I put the food in my mouth performatively. ​“It’s lovely, I’m sorry,” I tell them when I can’t eat it. I apologise. Depression makes you really fucking rude.

Instead of reading or writing or speaking or fucking or eating, I lie down and watch the sort of TV programmes that just repeat the same narrative over and over and never surprise you. I find the familiarity comforting. When it’s not at my throat, the monster sits on my shoulders and anchors me. I move as little as possible so as not to disturb it. There is a physiological term, ​“shoulder depression”, that describes shoulders being retracted downward which can increase your risk of injury during workouts. Ironically, my own depressed shoulders were permanently flexed upwards.

Everyone feels this, of course – the tension of a day gathered up in our shoulders. We all talk about the knots, when we pretend to know what we’re doing, massaging another body. A wealthy ex-boyfriend said his weekly massage was crucial to fixing his depression. Maybe so. It’s easier to fix anything with money, I thought.

Autumn 2017

The depression begins to break, I do not realise this is happening yet but I do look in the mirror at my unwashed, matted hair decided to take a spontaneous trip to the hairdressers.

In the chair, he lays my head back and exposes my throat – a peculiarly vulnerable position – he places his fingers on my head, rotating them gently and purposefully. I start to cry. It is deeply embarrassing but the intimacy of it all is overwhelming.

He says he sees it all the time.

There is a particular familiarity of being touched on the head that we are drawn to, he tells me – it’s nostalgic of the purest parental care; having our hair brushed or washed or stroked. Touch is so important to our wellbeing, I learn, that we have a nerve function that exists only to recognise this type of comfort. According to science, the perfect stroke is 3 – 5cm per second.

My headaches are beginning to be less frequent. My jaw has ached relentlessly from grinding my teeth (I tell my friends that it feels like being on too much MDMA at the end of a night but without any of the high or the connection to the world) but slowly this starts to lessen.

Depression, I realise, has caused me to resent my body for keeping me alive, but I no longer want to destroy it. When it comes back to me – when I can lift it off the sofa, when I can feel the intense pleasure of orgasm more than a year after it was taken away – I even start to appreciate it.

Now

I listen harder to it now when it tries to tell me I’m unwell. Like today: the rash is back across my chest and uglier than ever and my skin itches too. My jaw is tight – last week I was grinding so hard I chipped the tooth I’ve had fixed twice now for the same reason, again. The disease, perhaps, is rising up to the surface again or trying to at least. But I’ve learned to weaponise my body against it. Before it takes over, I slow down – I take it for walks and immerse my skin in a womb-like bath of warm water. I’m drinking less so that alcohol can’t slip in and malform my thoughts further. I am using my tongue to tell people how I’m feeling before the words catch in my throat and block my airway.

I look at my reflection now – all of my tall, lean body and the rashes and soft pockets of fat on my hips and the freckles over my shoulders and nose – and I no longer despise it. It’s not particularly beautiful, but it is persistent. I respect that. So I will take care of each part. Or I’ll try.