Reasons to Stay Alive summary

Can intense anxiety and depression really strike like a bolt from the blue? Such a bolt seemed to have struck Haig. The abrupt onset of what he describes as his “breakdown” was terrifying. It felt as though a switch had been flipped in his brain, triggering a sudden malfunction. However, in retrospect, he can see that he started feeling anxious long before the panic attacks he experienced in Ibiza.

The key message in this blink is: There were warning signs that could have alerted Haig to the coming breakdown.

Modern medicine has come up with cures for ailments that, just a few decades ago, seemed incurable. HIV is now no longer a death sentence, and childbirth is not an experience that women have to fear. We've become used to finding scientific answers to all our problems.

Unfortunately, the scientific research is much less conclusive when it comes to depression. What causes it? How can we fix it? There is no definitive answer. And there are many conflicting theories.

If you break your leg, you get a cast and crutches. People can immediately see that something has happened to you and will often try to help. Strangers will give up their seat on the bus. Friends will drop off groceries. It’s not easy. But at least people know to treat you with care. 

Depression and anxiety aren’t only hard to handle; they’re invisible. Haig could be in the grip of a terrible panic attack, but from the outside he would just seem a bit slow or distracted. A very observant person might notice that his pupils were dilated, but they'd have no idea what he was really going through.

Imagine you’re trying to explain something to a good friend. You open your mouth; you form the words; but your friend doesn’t understand you. You try and you try, but it’s as though you’re speaking gibberish, and your friend only stares at you uncomprehendingly.

That was how the author felt after his breakdown. He felt utterly unable to explain to family and friends how he was feeling. Their worldview was so different from his that it was like – to use the author’s words – “trying to describe earth to aliens.” What made it worse was that he could barely explain his experience himself. He was so buried in the depression and anxiety that he lost all perspective on his own situation.

A few months after his breakdown, Haig woke up and thought idly about the day ahead. Then he realized with a shock that the thought hadn't been laced with any anxiety. It was just neutral. It was the first time he'd felt calm for months. A few days later, he enjoyed the feeling of sun on his face. This, too, was a novel experience: he hadn't registered feelings of pleasure for a long time. These interludes of calm gave him hope. They seemed like small but promising signs that he could get better.

The key message here is: Haig started to recover by running toward what he most feared.

It may surprise you to hear that Abraham Lincoln struggled with depression. So did Winston Churchill. Both of these men were formidably ambitious and had impressive careers. They also spent large parts of their lives feeling anxious and depressed.

While it's sometimes said that they achieved so much in spite of their depression, you could also formulate it differently. Perhaps they were able to achieve what they did because they had experienced anxiety and depression.

People often think of recovery moving in a straight line. That you'll move slowly upward from mental distress to health, and be “cured.”

The reality is much messier. Fourteen years after having the breakdown in Ibiza, Haig has stopped waiting to completely recover. He's realized that his moods will go up and down, and that he won't always feel good. What he knows now is that anxious states will pass. And that life can be richer and more enjoyable than he ever would have imagined while in the grip of the breakdown.