Reading and anxiety: Proceed with caution

“Then the anxiety set in. If someone told me I had to be depressed for the next month, I would say that as long as I knew it was temporary, I could do it. But if someone told me I had to have acute anxiety for the next month, I would kill myself, because every second of it is intolerably awful. It is the constant feeling of being terrified and not knowing what you’re afraid of. [Anxiety] resembles the sensation you have if you slip or trip, that experience you have when the ground is rushing up at you before you land. That feeling lasts about a second and-a-half. The anxiety phase of my first depression lasted six months. It was incredibly paralyzing.”            – Andrew Solomon

The above passage from a PBS interview with Andrew Solomon, the author of The Noonday Demon: An Atlas of Depression and Far From the Tree, describes the reality of living with anxiety better than any I have heard. I had a bad stretch earlier this year but once it passed I let the memory of this crippling sensation fade. Until now. Anxiety has returned.

Sometimes it helps to get out but that is not an option today. The temperature outside has climbed from the -34C wind chills that settled in late last week to a comparably balmy -7C. But my car sits on the street with a flat tire that cannot be replaced until Friday and a chest cold has left me feeling too ill to walk to the nearby shopping centre to pick up a few necessary items. With my daughter’s 22nd birthday on Wednesday and Christmas on the horizon with no indication that I will even have enough income to pay my bills at the end of the month I can expect to feel a little down. But the anxiety that has coiled its way around my heart is much more devastating.

The worst aspect of anxiety is that it seems to ignite the fears, the loneliness and the paranoia that are already entertaining me during this prolonged mixed hypomanic state. It seems to be impossible to distract myself in any truly functional way – even reading is only a temporary respite.

HungryI have recently emerged from a book, both glorious and heartbreaking, that I would strongly recommend but should come with a warning for the mood sensitive. This book is sad. The book in question is The Hungry Ghosts by Sri Lankan-Canadian author Shyam Selvadurai. This richly sensuous novel begins in Sri Lanka and explores a young man’s complicated and difficult relationship with his grandmother, follows him as he immigrates to Canada with his mother and sister where he struggles to find himself in the gay community of 1980s Toronto. A return to visit his grandmother is marked by a tragedy that will seal his fate, binding him in his own bitterness and pain, to ultimately threaten everything he builds and holds dear in Canada. Buddhist mythology is woven throughout this tale of family, wealth, warfare, race and love. The resulting huge tapestry of life pulls at the very threads of the human heart. But, be warned, this book is sad. Bravely so, something I find missing in much of the Canadian literature I ready today.

The other night I braved the brutal cold, probably the last thing my emerging seasonal illness needed, to attend a reading by the author, the final event of his week-long residency with the University of Calgary’s Distinguished Visiting Writers Program. As positive and rewarding as this opportunity was it served to remind me that my own accomplishments seem to have been stalled by the cards fate (or karma?) has dealt.  I awoke the next morning feeling saddened, empty and anxious.

Adrift in mid-life.

The lonely journey of life

- Copyright JM Schreiber, 2013
– Copyright JM Schreiber, 2013

I had become, with the approach of night, once more aware of loneliness and time  — those two companions without whom no journey can yield us anything.
Lawrence Durrell, Bitter Lemons of Cyprus

Five months have passed since I left my place of employment, deep in the manic vortex of a mental health disorder that had been stable for so long that I failed to recognize the indicators that work stress was taking a critical toll. The first thing I did was hire a psychologist, someone I believed would be able to help me address some of the serious realities that the return of bipolar symptoms threatened to expose. I trusted that her experience would provide a safe space for self exploration and I have not been proved wrong. Mind you I was pretty manic when I arrived at her office, but over the months we have worked together to unspool many of the challenges and concerns that I brought to our very first session.

At the core of our explorations over these past months has been the loneliness I feel and my persistent ability to reinforce the very barriers that maintain this loneliness. When there are people in my life on the superficial, safe level; I cherish being alone. Now that I am making some positive and healthy attempts to connect with others, loneliness seems to follow in the wake of each moment like a hangover.

I don’t know the extent to which my mood disorder has impacted this recurring sense of social isolation. Certainly the up and down waves of manic depression have been marked by episodes of outgoing behaviour, often in conjunction with poor judgement, followed by retreat to safety and protection. There are also temperamental and identity factors that have skewed my experiences. Now my son has shared with me personal concerns that mirror my own in a manner far closer than I ever expected but may help explain the much more severe social anxiety from which he has suffered all his life (and treated with alcohol in recent years). I am not even sure what to make of his situation but I also know that as an adult he has to find his answers on his own because I am weary enough carrying my own baggage.

I accept Durrell’s edict about loneliness and time as necessary for growth, but they can weigh heavily because no matter how much we achieve on our journeys, there always seems to be more open road ahead that, in the end, we can only travel alone.

Manic Implosion: Venturing into the third section of Damon Galgut’s In a Strange Room without warning

About a month ago I had an opportunity to talk briefly with Damon Galgut following his appearance at Wordfest here in Calgary. He published his first novel at 18 and I shared that I had wanted to write when I was younger but wanted to live first, completely unprepared for the messy and complicated path my life would take. So we spoke about the challenge of winnowing out a story that runs close to bone from the detritus of life lived. He pointed to my newly signed copy of In a Strange Room, his 2010 Booker short-listed novel, and admitted that in this, of all his works, he felt that he had most closely captured the essence of his self. And he achieved it, I later learned, by telling three tales which recount actual events from his life and feature a character named Damon from perspectives that often shift from first to third person to a detached observer, sometimes within the same sentence or paragraph.

So far so good.

7199962The first two sections involve travel and more or less unresolved interactions and attractions between the remembered Damon character and people he meets while he frets and wanders through parts of Europe and Africa with a restless inablity to settle himself. The prose is tight and evocative with the open ended reflections and ambiguity that feature in my favourite of his writings. But I was sucker punched by Part Three: The Guardian. Not only is it harrowing in its intensity, but the devastating action centres around a woman in the throws of a full-blown suicidal manic pychosis. I could not help but relate as a caregiver but more critically as someone who has experienced the full impact of manic psychosis from the inside. My blessing, if there is one, is that I have never been especially suicidal or inclined to self-harm, nor do I drink or use drugs. All of those factors are added to the mix in this account.

And it takes place in India.

It is not a secret that his close friend Anna is not in a good way, when Damon agrees to allow her to accompany him on the first part of a trip to India. He has been before and intends to stay and write for several months, but it is thought that the change of scenery might be a positive and healing experience for Anna. Her life is beginning to unravel around her and the creative, vivacious woman he has known for many years is tipping dangerously close to the edge. With a stock of mood stabilizers, tranquilizers and sleeping pills she promises not to drink or indulge in recreational drugs on this excursion – a vow sullenly defied as soon as they take flight. Her mood escalates, and behaviour becomes increasingly frenzied and unpredictable from there, culminating in an intentional overdose while her already weary guardian is close at hand but not paying close attention.

Throughout this process and the weeks that follow, Damon’s concern is stretched beyond affection to annoyance to guilt and back again. While Anna fights for her life in ICU, a British nurse and another couple from the village where they are staying are co-opted into a tag team to provide support and relief for Damon at the hospital where cockroaches and rats scurry about and, although care is free, all supplies from bandages to drugs to all other medical items much be purchased by friends or relatives who trek back and forth to the pharmacy with lists. As Anna begins to recover and relocate to more crowded and unattended wards, she not only becomes increasingly volatile and unpredictable, but her erstwhile crew of attendants have to attend to all her care including propping her over the bedpan and cleaning up the splashing mess afterwards.

Care for her actual mental health concerns is not part of the treatment plan.

To make matters worse, attempted suicide is a criminal offense in India and the police are awaiting Anna’s release so they can detain her. An escape must be planned and executed. Finally she is safely returned to South Africa, but she and her support network are shattered and strained at both ends. Sadly her successful suicide is only delayed, not avoided. And her traumatic spiral leaves those who love her and even those who get caught up in her whirlwind of self destruction, with wounds that will take their own time to heal long after she finally achieves the rest, or self martyrdom, that her illness drives her to desire.

No one wins.

My own manic psychosis was maintained to my home where the refrigerator filled with inedible meals and my children destroyed the yard while I struggled to make it through the days. As my grasp on reality slipped and the long standing issues I had been fighting off for years bubbled and distorted in my mind, a month of growing horror ended in a morning of escalating fear and violence before the ambulance finally arrived. Diagnosis and treatment of my bipolar disorder helped explain much, but in the end the very real issues of identity that had haunted me for most my life still existed. The difficult years that followed would see the end of a long marriage and, the beginning of a new authentic existence for me.

Anna was committed to death in her madness. In mine I found life.

I finished reading this book late this afternoon at a cafe where I frequently go to clear my mind and write. I could not put it down until I reached the final pages. As I stumbled out of the cafe into the biting cold and snow of this premature winter evening, I felt devastated and emotionally wrung out. As painful as it was to read, for those of us who live with manic depression or care for someone who does (and I do both), the third part of In a Strange Room is essential reading.

But consider yourself warned.

Moving fast to slow down

With respect to many fellow bipolar bloggers who are weighed down with depression I am fighting a mixed hypomanic state. This is a more common concern for me and although I have only been fully manic twice in my life, I can run at a heightened level for years. Looking back now I probably was running high over the past few years while I took on increasing responsibilities at work in an increasingly unsupported and dysfunctional environment before landing in full manic mode this past June. I have had access to little psychiatric support since then so between my family doctor and a private psychologist I splurge to see once a month I am trying to stabilize my level of agitation. Hopefully before my disability benefits run out.

At the same time this time has allowed me to unpack a lot of baggage and make some critical reassessments at this point in mid-life. On that level I am making progress. But my brilliant experience volunteering at Wordfest last month, meeting and engaging with so many readers and authors was a high risk experiment with respect to my mood regulation efforts. I barely ate or slept for four days after the event ended.

For all the energy these past weeks have added to my creative efforts, I have trouble concentrating and tend to fall into periods of high energy thought processing without being able to channel the ideas productively. I have been making a point of getting out and spending a few hours writing or reading in coffee shops. Being in public spaces forces me to focus.

However, the word is that winter is truly rolling in tonight with snow and temperatures dropping to the minus double digits celsius. Since I haven’t gotten around to getting my winter tires mounted I am not likely to venture far for a few days. So I decided to spend the last temperate afternoon out, not hunched over a coffee cup but walking off some of my pent up energy.

Typically I walk with my camera and my ipod. It is a slow pace as I find myself regularly stopping to capture scenes or flora. However I hadn’t realized how that actually narrows my experience of some of the locations I regularly visit. When I was working such an activity was a great way to relax and unwind. Since I have been off ill, I have had little enthusiasm for photography and little motivation to visit my favourite natural haunts as if one required the other.

Today when I reached the riverside where I planned to walk I felt momentary regret that I had neither my camera nor my ipod with me. But as I set off on a brisk walk in the late afternoon light of this November day I was surprised to find how freeing and meditative the experience was. The movement helped me slow and focus my thoughts while, freed from the viewfinder of a camera, I was able to take in the fullness of the vista. I watched the changing colours of the slowly fading light reflected in the water and on the glass towers of downtown in the distance. I noted the shifting clouds and birds flying in to roost as the depth of darkness and shadow crept across the fir trees that cover the length of the high embankment across the river.

I returned refreshed, relaxed and calmed.

The path I walked today as it is likely to look in a month or so. Copyright JM Schreiber 2012
The path I walked today as it is likely to look in a month or so.
Copyright JM Schreiber 2012

Reflections on the Day of the Dead

For years a small sugar skull sat on one of the bookcases in our house. Eventually it had yellowed and aged to a point that its value as a keepsake was minimal. One day with a last glance I tossed it out. There were two originally so somewhere in the accumulated detritus of twenty years in this house, another little skull is probably decaying.

Inician la temporada de alfenŽiques2_0The skulls were mementos of a special Members-only preview of an exhibition which passed through our city in November of 2002. ¡Viva Mexico! featured a selection of the glorious huge colourful murals of Diego Rivera, striking photography of Day of the Dead celebrations by Graciela Iturbide and a display of shaft-tomb figures. As a family event, there was also a wide range of hands on creative activities for the kids.

I had been, at the time, a single parent for a year or so, my children would have been coming up on 10 and 13 years of age. It was an era of fundamental change and transition in my own life, but it was also a time when my kids were young enough to really enjoy this type of outing. I had a family pass and the museum was a common weekend destination.

However, until that day I had, somehow been unaware of the importance and spectacle of the Day of the Dead. Hallowe’en was fun of course, and a highly anticipated event for the children in their younger years. But the magic and energy of the the Day of the Dead celebrations captured in the photo gallery left a deep and lasting impression on me.

Many years later it all came back when tackled Malcolm Lowry’s classic Under the Volcano. I read it with The Guardian Reading Group, a three or four week monthly on-line opportunity to tackle a book with fellow readers. It is a challenging work to fully appreciate and before the month was out I found myself reading the text on an e-reader with the paper copy open beside me on the sofa so I could readily flip back and forth to cross reference and the link open on my computer to a brilliant website, The Malcolm Lowry Project, which provides chapter by chapter guidance and assistance to the humble reader along the way. Simultaneously long conversations were unfolding on-line within the Reading Group.

Now I can no longer divorce the Day of the Dead from the tale of Gregory Firmin, the alcoholic British consul in a small Mexican town, and his slow, tragic unraveling and demise throughout the course of one November day. Impending celebrations lurk in the air, but his desperate mental waltz with the push and pull of liquor, the reasoning and rationalizations he plays with himself held my greatest fascination. I have been lucky that alcohol has never held a serious allure for me, and my tastes tend to be above my discretionary budget anyway. Dedicated alcoholics don’t care and my family history has known its share. Especially on the side through which the mood disorder runs.

By the time I sat down with Under the Volcano, my son had been a heavy drinker for several years, although there is a long time before he finds himself in a state of crawling across the lawn toward the vision of a half empty bottle like the poor consul. I should hope. The struggle is a delicate matter for us to balance. He is almost 25, gifted and anxious to an extreme and over the years he has been on his own, on the street and now for the past few years increasingly isolated at home. Over a month ago he had a break of honest self recognition and quit drinking. But for many and complex reasons, especially some particularly horrific experiences in what passes for an adolescent mental health system, he has a complete aversion to any counselling or support.

Today, on the Day of the Dead, he is working a couple of beers back into his routine and I am trying to maintain the boundaries. Our relationship as father and son is complicated, we are close, share many character traits and insecurities. With a history working in social services I am also acutely aware of the limitation of practical services out there. And the cost of living in this city currently precludes even his younger sister who has a profession from moving out. But I know I cannot own his issues.

So with this November 1, I will honour the Dead with hope and ambition for all of us trying to pull together and move forward with Life.

Myself included.

Want to write? Start with reading.

It has taken me over a week to come down after volunteering with and attending events at our recent word festival. I entered into the week slightly down and was spiraling up within a few days. If it was a test of my ability to return to regular work, this is clear evidence that my mixed state is still far from stable. But I would not have missed it for the world.

It was an absolute thrill to mingle with people who are passionate about books and listen to Canadian and international authors talk about their craft. Whenever an author was asked about his or her influences, a love of the magic of books and literature shone through in their responses. If asked about advice for want-to-be writers, the common answer was read, read, read… read widely and drink deep from the wealth that books have to offer.

The stash of books I bought at the event, not including the titles I purchased or read in advance. Volunteering in the bookstore can be expensive!
The stash of books I bought at the event, not including the titles I purchased or read in advance. Volunteering in the bookstore can be expensive!

And so there was this man I crossed paths with at various venues throughout the festival. He told me he was a writer. Patting the breast pocket of his jacket he indicated that he felt he was getting ready to pull together his work. He had a gold pass so I saw him a number of times but always alone, ordering a coffee or buying a glass of wine at the bar. He would acknowledge me and we would exchange a few words on whatever interview or panel we was waiting for. But I never witnessed him engaged in animated discussion with fellow attendees.

The solitary man at a venue where excited discussions about books were regularly erupting between strangers is an anomaly.

On Saturday afternoon I encountered him in the lobby. He was carrying a copy of Sweetland by Michael Crummey. I got the impression he was done with the festival regardless of the major authors still to come. He said, “I have decided, this is the one that impresses me. Let’s see if he writes as well as he talks.” I responded that I had recently obtained a copy of his previous work Galore, the novel Crummey described as the one he feels he was born to write and that I wanted to read that first. He looked at me with surprise and said, “You mean you have heard of him?”

Suddenly it dawned on me that this man, the self-described writer, does not read at all. I suppose he thought he he would be able to absorb all the final inspiration and direction from this one book. If he did not know one of the best known Canadian contemporary authors and poets, even if he had never actually read one of his books, I could not help but wonder how he imagined himself ready to pull his accumulated scratchings into a final product.

With a full evening and day still ahead, he had selected his role model. I never saw him at the theatre again.

Even if it left me swinging up on my attempt to stablize this recovery from my recent manic episode, I was deeply inspired by the talks I attended, delighted by the company of fellow book lovers and especially grateful to a few authors who took a little extra time to encourage me as writer. I was regularly reminded that it is never too late to start.

And I am never lacking for books. In fact they seem to multiply in my life on their own as any truly avid reader knows.

Further reflections on the void left by suicide: deeper appreciation for Miriam Toews

Miriam Toews is one of Canada’s most celebrated novelists. She has drawn heavily on her Mennonite heritage filtered through the ability to explore the messiness of ordinary life with a wonderful sense of humour. Recently I reviewed her Giller nominated All My Puny Sorrows, a novel which is deeply inspired her sister’s suicide. The novel itself, while wicked funny in places, left me wanting more of a connection to Elf, the deeply depressed character. Her “healthy” sister, the narrator, never really seemed to understand but rather struggled with her own reactions – the practical and the reckless.

Tonight I had the good fortune to attend a panel called “Darkness Visible” in which Miriam participated. The theme explored by the three somewhat diverse novelists was focused on looking at whether dark themes, personal or political, can be fully examined in literature. The consensus I suppose was that despite the challenges and limitations, the ambition is valid and important.

swing lowBecause I already own a digital copy of All My Puny Sorrows I purchased a copy of Swing Low: A Life for this event. Written in memory of her father, a well loved teacher and pillar of the community who took his own life about a decade before his daughter followed suit, this slim volume deals more explicitly with manic depression and suicide. I only recently became aware of it. Given my own recovery process I am thinking this is more the story I was looking for with All My Puny Sorrows. Coincidentally, an audience member at the event had grown up in the same Manitoba community as Toews. Her father had been his teacher and he began to cry as he shared his shock when he had learned how much pain and sadness the family was going through. Miriam had to dry her eyes as well.

That is the true impact of suicide and it spreads beyond families.

When I had the pleasure to speak to Miriam after the event I confessed my experience with All My Puny Sorrows, explaining that I was reading it in the aftermath of my own breakdown and, sadly, in the light of Robin William’s suicide. I told her I suspect that the book I was hoping for probably lies in part in this earlier, more serious volume. But then we both admitted that unless we are ourselves are burdened with the desperate desire to let go of this life, we can only ever observe from the outside. We also shared our mutual fears for our children inheriting the same genetic disorder.

I am deeply impressed with Miriam Toews’ desire to speak about mental illness and with her wide appeal in this country, hopefully her message will reach an audience that needs to hear it. I am looking forward to finding out how she explores the bipolar disorder in her family through her father’s story, unaware at the time of course, that the same event would strike her family again.

She told the audience that if writing her most recent book taught her one thing it is to hold tight to the joy in life.

A worthy goal for us all.

Good words and a smile (oh and a good book too)

Wordfest, our annual literary festival is underway. After several months struggling with the fall out from a serious mental health episode this week is my first serious self test, my chance to explore my level of stamina and commitment. It is also an opportunity to spend time with people who love books and listen to great writers talk about their work.

I started with two volunteer shifts and some selected presentations I wanted to see and, as you might suspect, the volunteer commitment portion quickly expanded.

Am I exhausted yet? A little. I will likely sleep for a day when it’s all over but I have so desperately needed to get out in the world. Admittedly I am buffered with medication but the creeping anxiety stays in the car when I get into the venues.

Now if I can find a way for the medical system to prescribe a literary solution I might just be able to live with this bipolar beast. I just have to be able to afford to eat too!

Today has lifted my spirits more than I can remember in months. I had one single volunteer shift as a bookseller at one of the smaller venues, but I was nervous simply because I was expecting a panel discussion featuring one of my favourite authors. When I arrived to discover that the other writer had been forced to cancel at the last minute, the presentation had been redesigned as an hour long one-to-one interview with South African novelist Damon Galgut.

The host was scrambling but I could not have been happier.

American edition of Arctic Summer in case anyone is wondering -a nicer cover than the Canadian/UK I think.
American edition of Arctic Summer in case anyone is wondering -a nicer cover than the Canadian/UK I think.

I have always been apprehensive about meeting my heroes, for fear of disillusion. Nonetheless I had come prepared to have my books signed and hopeful for even a few words with a writer whose works I admire so much. Although we did have books to sell I noticed that I was not the only person who had arrived with their own copies of his latest work, Arctic Summer, already in tow. This novel is an imagined biographical account of the complex personal and emotional factors that led E M Forester through the extended  writer’s block that ultimately produced his greatest work, A Passage to India. As an historical novel it is a departure for Galgut (and one he admitted he would be in no rush to repeat) but rich with a deep affection for India and the driving forces of unrequited desire.

I confess I abandoned my post presentation bookselling duties early to make sure I didn’t miss out on the opportunity to have my copies of In a Strange Room and Arctic Summer signed. To be honest I have yet to see an unpleasant author at any of the events I’ve helped with, but it meant more than I can measure for Damon to take the time to, ask me about myself and encourage me that it is never too late to start writing. I am grateful for his kind words.

This experience, simple and important for me, has lifted my spirits in a way that feels healthier than the meds alone. It feels good to be human again. I have commitments with Wordfest right through until Sunday evening, but for now I am enjoying this warm feeling.

What fresh yellow is this? (With apologies to Dorothy Parker)

Typically I love autumn – the crisper weather, the bright blue skies, the excuse to pull out sweaters. Normally this is the busiest time of the year as new programs and courses start and activities halted for the summer resume. More than New Year’s, this can be the season for resolutions, goal setting and looking forward.

Copyright JM Schreiber 2014
Copyright JM Schreiber 2014

Unless you are depressed.

Without the structure of work I feel lost. And unlike regular unemployment I am in a holding pattern, uncertain what type of work I may be able to return to when I do recover, if I recover, should I even recognize recovered if I meet it in myself.

I feel tired and agitated. Irritable and unfocused. I try to push myself out every day and have an exciting literary festival to look forward to in just over a week. Yet I am terrified that I have taken on more than I will be able to manage and I find myself fighting off regular amorphous panic attacks.

I feel like a wrung out dish towel. I miss having energy and enthusiasm but I have to guard against a reckless flood of these sensations lest they indicate trouble at the opposite end of the bipolar pendulum arc…

Copyright JM Schreiber 2014
Copyright JM Schreiber 2014

For now I am looking toward the brilliant yellows of the moment. Apparently yellow is the colour of the mind and the intellect, it lifts the spirit, stimulates creativity but can also heighten anxiety and emotional instability.

Sounds like a bipolar hue to me.

When even a sibling’s love is not enough – All My Puny Sorrows by Miriam Toews

The title and binding imagery that fuses the latest novel from Canadian author Miriam Toews comes from a poem by Samuel Taylor Coleridge to his friend, the poet Charles Lamb. Both men had their own struggles with mental illness but Lamb’s beloved sister Mary had an especially prolonged and devastating battle. Coleridge commiserates with his friend’s tireless care for his sister, reflecting that he, Coleridge had had a dear sister upon whom he “pour’d forth all his puny sorrows”. Elfreida (Elf) the suicidally depressed character at the centre of this novel drew her signature theme from this line , but it is her sister Yolandi (Yoli) who brings her to life and devotes herself to trying to keep her alive as she narrates this funny, heartbreaking tale. As such, All My Puny Sorrows is well named.

all my puny sorrowsColeridge was the first poet who caught my adolescent attention, much to the shock of my high school English teacher. However I confess it was the rugged adventure of “The Rime of the Ancient Mariner” and “Kubla Khan” that sparked my enthusiasm. The Romantic poets, so many of whom seem to have suffered from mental illnesses seemed kindred spirits ( although this would have been long before my own diagnosis). They loved passionately, often tragically, and became addicted to opiates. For the teenager falling well short of cool, the appeal is not hard to imagine.

SamuelTaylorColeridgeFor Elf and her sister growing up in the confines of a small Mennonite town, the arts were an acceptable outlet. Elfreida channels her energy into the piano eventually taking to concert stages around the world and winning the love of a man so patient he’s surely destined for sainthood. Yolandi opts for a less glamorous route, including a couple of failed marriages, children, meaningless affairs and a career pumping out rodeo themed YA novels.

I was attracted to this book when I heard Toews on the radio explaining that this novel began from a deeply personal space. Her father, a respected teacher despite a lifelong battle with depression, took his own life in 1998. Almost 12 years to the day later, her only sister followed suit in the same very way and location. Having already memorialized her father in non-fiction, Toews felt that fiction would free her up to address this very real and difficult subject more openly. But that is also where it falls apart for this reader.

She is able to make some very astute observations about the failings of the mental health system and sadly demonstrates that, in the end, there is no way that anyone or any system can ever do more than delay the efforts of someone truly committed to stepping off this mortal coil. However I never felt that Elf was more than a tragic figure in a hospital bed. Yoli’s childhood memories and the accounts of her sister’s glorious career rang hollow. The real strength of this book for me lies in the the indomitable spirit of the characters who survive against all the odds and resist the despair that mounts around them.

And maybe that is the point. It is not for us – friends, family, observers or readers to judge. In a few weeks I will be able to see Miriam Toews take part in a panel exploring the ability – or limitations – in being able to make sense of the darkness in life through literature. I will be interested to hear what she has to say.