Sometimes it begins with a pimple. A large shiny
spot appears on my forehead. Or it begins with a
feeling of heaviness, and I long to wear only
loose-fitting clothes. Then my mood plunges, my
lower back aches, my insides turn liquid. Stomach
cramps come in spasms so painful I sometimes
cry out. I lose interest in the things I care about.
My family become unbearable, my friends
become strangers with dark intentions, and
cashiers and waiters seem unforgivably rude.
A furious, righteous paranoia shrouds me: every
human being with whom I interact is wrong, either
insensitive or ill-willed. I eat mounds of food – I
crave greasy stews and fried yams and dense
chocolate truffles – or I have no appetite at all,
both unusual for a careful, picky eater. My breasts
are swollen and taut. Because they hurt, I wear
my softest bras – “tender” seems a wrong word
for the sharp discomfort. Sometimes they horrify
me, so suddenly round, as though from science
fiction, and sometimes their round perkiness
pleases my vanity. At night, I lie sleepless,
drenched in strange sweat; I can touch the
wetness on my skin.
I am sitting in a doctor’s office in Maryland and
reciting these symptoms. On the wall of the bright
room, there is a diagram of a lean female, her
ovaries and uterus illustrated in curling lines; it
reminds me of old pictures of Eve in the garden
with Adam. The doctor is a kind and blunt woman,
bespectacled, but reading over her lenses the
forms I have filled out. When she first asks why I
have come to see her, I say, “Because my family
thinks I need help.” Her reply is, “You must agree
with them or you wouldn’t be here.” Later, it will
strike me that this is a quality I admire most in
women: a blunt kindness, a kind bluntness.
When she asks questions, I embellish my answers
with careful detail – the bigger-sized bra I wear for
a few days, the old frost-bitten ice cream I eat
because I will eat anything. I make sure to link
everything to my monthly cycle, to repeat that I
always feel better when my period starts. I make
fun of my irritability: everyone I meet is annoying
until I suddenly realise that I am the only constant
and the problem has to be me! It is, I tell her, as
though a strangeness swoops down on me every
month, better on some and worse on others.
Nothing I say is untrue. But there are things I
leave out. I am silent about the other strangeness
that comes when it will and flattens my soul.
“It sounds like you have premenstrual dysphoric
disorder,” she says.
It is what I want to hear. I am grateful because she
has given me a name I find tolerable, an
explanation I can hide behind: my body is a vat of
capricious hormones and I am at their mercy.
But the doctor is not done. Her eyes are still and
certain as she says, “But the more important thing
is that you have underlying depression.” She
speaks quietly, and I feel the room hold its breath.
She speaks as if she knows that I already know
In truth, I am sitting opposite her in this
examining room because my family is worried
about the days and weeks when I am, as they say,
“not myself”. For a long time, I have told them that
I just happen to have hormonal issues, victim to
those incomplete tortures that Nature saves for
femaleness. “It can’t be just hormonal,” they say.
“It just can’t.” Mine is a family full of sensible
scientists – a statistician father, an engineer
brother, a doctor sister. I am the different one, the
one for whom books always were magical things. I
have been writing stories since I was a child; I left
medical school because I was writing poems in
biology class. When my family says it is “not just
hormonal”, I suspect they are saying that this
malaise that makes me “not myself” has
something to do with my being a writer.
Now, the doctor asks me, “What kind of writing do
I tell her I write fiction.
“There is a high incidence of depression in
creative people,” she says.
I remember a writers’ conference I attended in
Maine one summer years ago, before my first
novel was published. I liked the other writers, and
we sat in the sun and drank cranberry juice and
talked about stories. But a few days in, I felt that
other strangeness creeping up on me, almost
suffocating me. I drew away from my new circle
of friends. One of them finally cornered me in the
dormitory and asked, “You’re depressive, aren’t
you?” In his eyes and his voice was something like
admiration, because he believed that there is, in a
twisted way, a certain literary glamour in
depression. He tells me that Ernest Hemingway
had depression. Virginia Woolf and Winston
Churchill had depression. Graham Greene had
depression. Oh, and it wasn’t just writers. Did I
know Van Gogh had wandered into the field he
was painting and shot himself? I remember
feeling enraged, wanting to tell him that
depression has no grandeur, it is opaque, it
wastes too much and nurtures too little. But to say
so would be to agree that I indeed had
depression. I said nothing. I did not have
depression. I did not want to have depression.
And now, in the doctor’s office, I want to resist. I
want to say no thank you, I’ll take only
premenstrual dysphoric disorder please. It fits
elegantly in my arsenal of feminism after all, this
severe form of premenstrual syndrome, suffered
by only 3% of women, and with no known
treatment, only different suggestions for
management. It gives me a new language. I can
help other women who grew up as I did in
Nigeria, where nobody told us girls why we
sometimes felt bloated and moody. If we ever
talked about what happened to our bodies, then it
was behind closed doors, away from the boys and
men, in tones muted with abashment. Aunts and
mothers and sisters, a band of females
surrounded in mystery, the older whispering to
the younger about what periods meant: staying
away from boys, washing yourself well. They
spoke in stilted sentences, gestured vaguely, gave
no details. Even then I felt resentful to have to feel
shame about what was natural. And now here I
was, burnished with a new language to prod and
push at this damaging silence.
But depression is different. To accept that I have it
is to be reduced to a common cliche: I become yet
another writer who has depression. To accept that
I have it is to give up the uniqueness of my own
experience, the way I start, in the middle of
breathing, to sense on the margins the threat of
emptiness. Time blurs. Days pass in a fog. It is
morning and then suddenly it is evening and there
is nothing in between. I am frightened of
contemplating time itself: the thought of
tomorrow and the day after tomorrow, the
endless emptiness of time. I long to sleep and
forget. Yet I am afraid of waking up, in terror of a
new day. Mornings are dark, and I lie in bed,
wrapped in fatigue. I cry often. My crying
puzzles me, surprises me, because there is no
cause. I open a book but the words form no
meaning. Writing is impossible. My limbs are
heavy, my brain is slow. Everything requires
effort. To consider eating, showering, talking
brings to me a great and listless fatigue. Why
bother? What’s the point of it all? And why, by the
way, are we here? What is it I know of myself? I
mourn the days that have passed, the wasted
days, and yet more days are wasted.
The doctor calls these symptoms but they do not
feel like symptoms. They feel like personal
failures, like defects. I am normally full of
mischievous humour, full of passion, whether in
joy or in rage, capable of an active, crackling
energy, quick to respond and rebuke, but with this
strangeness, I do not even remember what it
means to feel. My mind is in mute. I normally like
people, I am deeply curious about the lives of
others, but with this strangeness comes
misanthropy. A cold misanthropy. I am normally
the nurturer, worrying about everyone I love, but
suddenly I am detached. It frightens me, this
sense of slipping out of my normal self. It cannot
be an illness. It feels like a metaphysical failure,
which I cannot explain but for which I am still
There is an overwhelming reluctance to move. A
stolidness of spirit. I want to stay, to be, and if I
must then only small movements are bearable. I
switch off my phone, draw the shades, burrow in
the dim stillness. I shy away from light and from
love, and I am ashamed of this. I feel guilty about
what I feel. I am unworthy of the people who care
about me. I stew in self-recrimination. I am alone.
Stop it, I say to myself. What is wrong with you?
But I don’t know how to stop it. I feel as if I am
asking myself to return a stolen good that I have
not in fact stolen.
In some of my family and friends, I sense
confusion, and sometimes, suspicion. I am known
to nurse a number of small eccentricities, and
perhaps this is one. I avoid them, partly not to
burden them with what I do not understand, and
partly to shield myself from their bewilderment,
while all the time, a terrible guilt chews me whole.
I hear their unasked question: Why can’t she just
snap out of it? There is, in their reactions, an
undertone of “choice”. I might not choose to be
this way, but I can choose not to be this way. I
understand their thinking because I, too, often
think like them. Is this self-indulgence? Surely it
cannot be so crippling if I am sentient enough to
question it? Does the market woman in Nsukka
have depression? When I cannot get out of bed in
the morning, would she be able to, since she
earns her living day by day?
The doctor says, about the high incidence of
depression in creative people, “we don’t know why
that is”. Her tone is flat, matter-of-fact, and I am
grateful that it is free of fascination.
“Do you think anybody else in your family might
have depression?” she asks.
Nobody else does. I tell her, a little defensively,
about growing up in Nsukka, the small university
campus, the tree-lined streets where I rode my
bicycle. It is as if I want to exculpate my past. My
childhood was happy. My family was close-knit. I
was voted most popular girl in secondary school.
Yet I have memories of slow empty days, of
melancholy silence, of perplexed people asking
what was wrong, and of feeling guilty and
confused, because I had no reason. Everything
was wrong and yet nothing was wrong.
I remember a gardener we had when I was a
child. A wiry ex-soldier called Jomo. A man full of
stories for little children. My brother and I
followed him around as he watered the plants,
asking him questions about plants and life,
basking in his patience. But sometimes, he
changed, became blank, barely spoke to anybody.
Perhaps he had depression. Later, I will wonder
about African writers, how many could be listed
as well in this Roll of Depression, and if perhaps
they, too, refuse to accept the name.
The doctor says, “I’d recommend therapy, and
that you try anti-depressants. I know a good
A therapist. I want to joke about it. I want to say
that I am a strong Igbo woman, a strong Nigerian
woman, a strong African woman, and we don’t do
depression. We don’t tell strangers our personal
business. But the joke lies still and stale on my
tongue. I feel defensive about the suggestion of a
therapist, because it suggests a cause that I do not
know, a cause I need a stranger to reveal to me.
I remember the first book I read about
depression, how I clung to parts that I could use
to convince myself that I did not have depression.
Depressives are terrified of being alone. But I
enjoy being alone, so it cannot be depression. I
don’t have drama, I have not ever felt the need to
rant, to tear off clothes, to do something crazy. So
it cannot be depression, this strangeness. It
cannot be the same kind of thing that made
Virginia Woolf fill her pockets with stones and
walk into a river. I stopped reading books about
depression because their contradictions unsettled
me. I was comforted by them, but I was also made
anxious by them.
I am in denial about having depression, and it is a
denial that I am not in denial about.
“I don’t want to see a therapist,” I say.
She looks at me, as if she is not surprised. “You
won’t get better if you do nothing. Depression is
It is impossible for me to think of this as I would
any other illness. I want to impose it my own
ideas of what an illness should be. In its lack of a
complete explanation, it disappoints. No ebb and
flow of hormones.
“I don’t want to take medicine either. I’m worried
about what it will do to my writing. I heard people
turn into zombies.”
“If you had diabetes would you resist taking
Suddenly I am angry with her. My prejudices
about American healthcare system emerge:
perhaps she just wants to bill more for my visit,
or she has been bribed by a drug rep who
markets antidepressants. Besides, American
“How can I possibly have PMDD and depression?
So how am I supposed to know where one starts
and the other stops?” I ask her, my tone heavy
with blame. But even as I ask her, I feel dishonest,
because I know. I know the difference between the
mood swings that come with stomach cramps and
the flatness that comes with nothing.
I am strong. Everyone who knows me thinks so.
So why can’t I just brush that feeling aside? I can’t.
And it is this, the “cantness”, the starkness of my
inability to control it, that clarifies for me my own
condition. I look at the doctor and I accept the
name of a condition that has been familiar to me
for as long as I can remember. Depression.
Depression is not sadness. It is powerlessness. It
is helplessness. It is both to suffer and to be
unable to console yourself.
This is not the real you, my family say. And I have
found in that sentiment, a source of denial. But
what if it is the real me? What if it is as much a
part of me as the other with which they are more
at ease? A friend once told me, about depression,
that perhaps the ancestors have given me what I
need to do the work I am called to do. A lofty way
of thinking of it, but perhaps another way of
saying: What if depression is an integral but
fleeting part of me?
A fellow writer, who himself has had bouts of
depression, once wrote me to say: remember that
it is the nature of depression to pass. A
comforting thought. It is also the nature of
depression to make it difficult to remember this.
But it is no less true. That strangeness, when it
comes, can lasts days, weeks, sometimes months.
And then, one day, it lifts. I am again able to see
clearly the people I love. I am again back to a self I
do not question.
A few days after my doctor visit, I see a therapist,
a woman who asks me if my depression sits in my
stomach. I say little, watching her, imagining
creating a character based on her. On the day of
my second appointment, I call and cancel. I know I
will not go again. The doctor tells me to try anti-
depressants. She says in her kind and blunt way:
“If they don’t work, they don’t work, and your
body gets rid of them.”
I agree. I will try antidepressants, but first, I want
to finish my novel.