Claire Rayner: John Hogan. How could he?

Easily enough. The father, whose leap from a balcony killed his son, suffers from clinical depression. Don't condemn him
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The Independent Online

The majority of people in the UK were pointing fingers in horror last week at a man called John Hogan. He has been labelled wicked, cruel and selfish, because jumped from a hotel balcony with his children Mia, two, and Liam, six. He landed alive, as did his daughter, but his son was killed. Many people find this impossible to understand.

But one family in four in this country does understand why this happened, and that the real problem for John Hogan is not that he is a villain but that he is very, very ill. John Hogan suffers from a psychiatric disorder that is potentially fatal, clinical depression. It is not just a case of being moody or feeling a bit "off-colour". Clinical depression changes people's personalities and pushes them into behaviour that, if they were well, they would never, ever consider.

It is not unusual that he tried to kill his children at the same time as he tried to kill himself, or that he has now tried again to kill himself. There are very ill people with suicidal depression who have children and feel they cannot possibly leave them behind in a wicked, cruel world, which is how they perceive it, to suffer as they have suffered. Their twisted thinking makes them feel they are taking the best possible care of the children by taking them with them.

That's why we read quite often of cases where a mother has drowned herself and her baby or set fire to a car with her children in it, which happened fairly recently. It is indeed a tragic, common - too common - event.

What this man needs is the vital chance to talk about how his own life has been turned upside down by his family history. Two of his brothers committed suicide, and his much-loved father died recently, all of which drove John Hogan further than he felt he could go. A family argument in that Greek hotel was more than enough to push over the edge a man who was already close it and feeling lonely because of the loss of people he cared about.

We don't know whether he was under psychiatric care at the time, although he was apparently taking anti-depressants until seven months ago. A man in so fragile a state should have been receiving such care, but generally people who suffer from depression are likely to keep quiet about it. They suffer from such guilt and anxiety about the state they're in that they are ashamed and frightened to tell their doctor what's going on. They put on a brave face and pretend all is well.

Some become very difficult to live or work with because they turn into what are known as aggressive depressives. They don't burst into tears or curl up in a corner as some do with this disease; they just fight with everyone they meet, shout a great deal and are hell to live with.

One good thing that may come out of this, and I, for one, hope with all my heart that it does, is that people will learn from this one tragic case what a dreadful, potentially fatal illness clinical depression is and will take themselves to their doctor, ignoring the guilt or the feeling they're not worth the trouble to treat (both of which are common feelings in depressed people) and get the help they desperately need.

It may take the form of antidepressant tablets, which are very effective if allowed the time to do their job. They kick in after about seven to 10 days of taking them, during which time, the patient feels much the same, then they begin to feel they are rising up from the bottom of the sea and can see light above their heads; from then on, antidepressants do a very good job for many people in keeping them stable.

"Talking treatments" help many depressed people to understand their illness and its links with past experiences, while others who are very, very ill, may respond well to ECT - electro-convulsive therapy, so-called shock treatment - which has unfortunately suffered a bad press for many years. It is not a damaging treatment; it is done under anaesthetic and, from the patient's point of view, it is painless and undistressing. But, again, after two or three sessions, they begin to feel better, and, after three or four more, they are coming out of the depression and have lost their suicidal thoughts. That's one of the worst things about being clinically depressed; you think constantly about the possibility of killing yourself and people as ill as this can give in suddenly to the impulse.

People who are depressive and working in busy offices or factories or shops should notify somebody there how ill they are feeling because the company too can help. I am speaking of the occupational health section of big organisations. If there is no such department, perhaps a caring and kind colleague who will listen to him or her and persuade the sufferer to go to see a doctor. It can be the first stage to a successful outcome.

We've heard a lot about the children, Liam and Mia, and life is going to be difficult for Mia later when she will be told, or find out for herself, about what happened to her father and brother. The family will need to ensure they get the right psychological help for her - perhaps talking again - which is the other sort of treatment offered to both adults and children with these problems.

And never think children don't get depressed as well. Girls may start showing signs of clinical depression linked with their hormones when they reach puberty. Teenagers are very prone to depression, and what looks like laziness and unwillingness to get a job or study and not even bothering to take a bath and either not eating at all or gorging on junk food are also signs of clinical depression in adolescents. Families need to be alert to this sort of problem. I know what I'm talking about because depression has been part of my family life for 50 years. I realise I was depressed when I was 12 (that is with hindsight) when I had regular monthly attacks of bad temper and general horribleness which made my sisters' lives a misery.

After each of my three babies, I suffered the same problem but, by then, I had my husband, Des, to help me. He was wonderfully supportive and totally understanding, making sure I got my treatment and didn't forget my tablets or visits to a psychologist for "talking treatment".

Then it was my turn to look after him. I had a severe illness in 2003 which nearly killed me and the doctors sent for Des and my children twice to come and say goodbye. But I'm still here, and after I was beginning to be better, Des relaxed for the first time and slid head first into a really severe attack of depression, the worst I think he'd ever had. So we swapped roles and I became the carer for a while. I'm happy to say we're fine now but we do have a great deal of awareness, sympathy and understanding of the disease and what it does to friends when we do try to help.

The fact that so many people shrug away the idea of mental illness and treat it as a stigma means that people who have "nervous breakdowns" and have to go into hospital feel more isolated than ever because, whereas a busy office would have a whip-round to send flowers and fruit to a colleague who had broken a leg, say, or was having an operation, and many would send greeting cards of the "get well soon" kind. Patients suffering from clinical depression or bipolar disorder, which is a closely similar disease (the depression is interleaved with attacks of apparently high-spirited behaviour) rarely get cards, or even flowers. Even in their illness, they are treated differently.

What are my hopes for the future of the Hogan family? First, I hope Mr Hogan will be transferred from Athens as soon as possible to get his treatment here. There's nothing wrong with its doctors, of course; they do excellent work. But there is a problem with mentally ill patients when their doctors come from a different culture and may not fully understand the nuances of what they are told by their patients. In an ideal world, I would hope he can be moved soon, perhaps on compassionate grounds.

After that, I would like everyone to pay a bit of attention to someone who has been almost totally ignored so far and that is John Hogan's mother, Josephine. At 64, she sits beside her sick son's bed (he won't stand trial until next spring, a dreadful wait) trying to cope with her own grief over the death of her husband, two of her sons who committed suicide and a third charged with murder who is a would-be suicide. If anyone is going to be a candidate for clinical depression under such pressure, she's an obviously at-risk person.

But from all reports,she is a caring and kind woman as is Natasha Hogan, John's wife. She has made it clear that he was a good husband and a good father, and it is obvious to me, reading her comments, that she still cares for him. She just couldn't live with him; and many spouses of severely depressed people, I'm afraid, have similar feelings. Depression seeps through a whole family like an invisible gas, and one after another, they become depressed and miserable and need so much help.

It is great to hear that Lord Layard, the "happiness tsar", and the Government are to spend a little more money on this group of people, although not nearly enough. They need to provide better, faster and supportive care for all levels of this illness. It is also good news that a charity, the Charlie Waller Memorial Trust, is backing the appeal for more cognitive behaviour therapy, which helps people to change their thinking. Amazingly, this also has the capacity to alter the levels of brain chemicals which are at the root of depression.

Then everyone would understand that telling people to "pull themselves together" or pointing the finger of disgust and labelling people as "nutcases" or other insalubrious labels is not just stupid, it's downright cruel.

And I, for one, want to see an end to such behaviour, while, at the same, I'm wishing the Hogan family, everyone one of them, all the care and love that they deserve, from all of us.

For more information, contact MIND on 0845-766 0163, or email info@mind.org.uk

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