One in four people have some form of mental illness, and Ruby Wax wants to talk about it. Watch her TEDTalk, posted today and inspired by her show Losing It, to start the conversation. One project she didn’t get to mention onstage at TEDGlobal: This winter, Wax started up the Black Dog Tribe, an online network for people with mental illness to connect to each other. So the TED Blog asked Ruby for more about the Black Dog, her next show, performing in mental institutions, and the big questions that we still can’t talk about.

Who’s the Black Dog?

The Black Dog is familiar because Churchill used to say it. I guess he was hiding the fact that he had depression at the time. People thought it was a mood swing, but he had serious depression. He used to say he didn’t want to go near train platforms; luckily not common knowledge at the time.

Because Churchill himself was depressed, do you find that it’s a more accepted condition in the UK?

No. The stigma is unbelievable. Over here, if you’re a managing director and you take time off, take six months off, and they find out you’re off for depression, you’re out. They can sack you. That’s the law as it stands. You cannot put it on your cv, especially if you’re a nurse or a doctor. You can’t talk about it because your job is in jeopardy.

What I found when I was doing my show was, when people can talk about mental illness, they’re so relieved. In the second half of my show, I’d let the audience talk, people fought for the microphone; mothers who were afraid they passed their depression to their kids, people in despair who didn’t know where to get help. One guy said he’d been on anti-depressants for 20 years and he never told anyone. His wife was open-jawed next to him.

There’s no AA for depression. I wish we had those. I tried AA, but when they found out I wasn’t an alcoholic, they took my cookie and said: “Get out!”

We can tell our own. You can see it in the way we walk. When I meet other depressive people, I can see they have the same look in their eyes as in mine. There’s a difference between someone who’s just having a bad day and someone who’s depressed. We should train teachers to look for these signs, people who work with teenagers. If you look in their eyes and they look like a dead shark — it’s not just a bad mood.

Really, if it’s 1 in 4 people, they should have a checklist.

The difficult thing is, your brain can’t tell there’s something wrong with your brain. If you have a rash on your leg, you can look down and see it. But you don’t have a spare brain to make an assessment of your own brain. You’re always the last to know — that’s the bitch.

What do we all want to know: How far are we off the scale of normal? It’s why it’s important to have someone to talk to. My dream for the Black Dog Tribe or any mental illness website is to create walk-in centers so that somehow, some way, people will meet up in real life. Because meeting your own people is half the cure. You can compare symptoms and know you’re not making it up. Say you’re a hairdresser in Detroit, and you say, every Monday night, come and meet at my hair salon and talk. I imagine forums all over the US and UK, at Woolworth’s or whatever, where people can meet and have these conversations. You won’t meet a single person who’ll tell you to “perk up.”

And let’s end the stigma. At TED, I was talking to Vikram Patel about depression, and he said that in some other languages, the word that means depression isn’t an emotional word but describes a physical sensation. Again proving this isn’t something you made up.

In my lifetime, the gay movement went from something to be shunned to acceptance. How can you break a stigma like that and this one is dragging on? They’re a lot fewer than 1 in 4. Couldn’t we just get whoever their PR was? Can we use their high heels and their banners with the rainbow — it’s in a warehouse somewhere. We can have a rally. People can come in their pajamas waving pitchforks.

What led you to feel you were finally ready speak out?

Comic Relief put my face on a poster. I was in the Tube, and there was a poster of my face with the word DEPRESSED stamped across it. When I saw it, I almost lost my organs out of my nose. I tried to stand in front of the first poster and block the view. And then, down the escalator, there was another poster, and another. You know how they do that? And by the time I got down to the platform I thought, OK, well, I’ll write a show and pretend this was my publicity. I’ve always said to myself, if you’ve got a disability, use it.

You know, I entertained for a year and a half in mental health wards, and I was sensational, though they weren’t always facing in my direction. The bipolars — they laughed, they cried. The smoking room of a mental institution — it is the greatest theater. Brilliant stories. And no one can see each other through the smoke. You’ll never watch television again.

I did a documentary on the Priory, and I said: “Smell these walls.” It smells of security to me. It’s the mother I never had. And there’s a different culture on each floor. We’d steal food from the anorexics; they didn’t mind!

So tell me about your new show.

My new show is about the brain, and about the glitches that we all have. It’s comedic, and it’s about how we have more capability than we know of, because of what’s up there. And why we’re fucked because of evolution. It’s pretty simple, but I drag it out for an hour. (My other show goes to LA on January 20.)

This is for the 4 in 4, not just the 1 in 4 with a mental illness. We assume that we’re all evolved, we’re homo perfectus, but we don’t really know how to run our own machinery. We don’t know enough about our brains. We don’t know how to tune the dials. We get overloaded.

I want an answer to these questions: How much are we supposed to know — where’s our limit? I’d like to get a consensus on that. Am I supposed to know everything in each day’s newspaper, just so I can have opinions on it at dinner parties? I do want to know if my next-door neighbor was shot, but I don’t know if I care about three doors down. How much do I need to know? There’s no answer, and then you’re caught in the stream of self-loathing for not knowing what color was Bismarck’s mustache.

But there is a braking system. It doesn’t matter how you do it but you have to learn to intentionally be able to focus your attention away from all that ruminating. I do mindfulness, and not in a guru Buddha let’s-eat-a-cauliflower way. I throw my attention to a physical sensation, to a sound, focus on my feet on the ground, as opposed to this … endless mental loop tape … because the mind can’t be in two modes at once. It can’t think and also sense something at the same time. It’s a trick you’re playing on yourself, on your thinking. If I throw focus from my rumination to one of my senses, it brings the cortisol down. Other people might say, “I’m going to focus my attention on my cat or put Vivaldi on.” I don’t care how you learn to flip your dial when you need to.

But don’t confuse the braking system with distractions. People with stressful jobs who spend their weekend jumping off buildings to relax, or helicopter-skiing because the double black diamond trail isn’t enough, we should simply hold up a sign behind them that says “Psychopath.” That’s not what you do to relax. Actually, that should be a way to judge whether you invest in a company: if you ask what they do on the weekends and they all helicopter-ski, congratulations, you’ve found the next Enron.

Why don’t we talk about the big questions? The idea that we are superior beings — we are superior to an ape, but big deal! I want to know, how does memory work? How is the world created outside of you?

But we’re still living in a world where people ask your star sign. That’s why we’re not able to talk about it. We need better words. “Mindfulness” sounds like something Martha Stewart says: “Be mindful when you serve the chicken at a dinner party.”

Can you define mindfulness?

Mindfulness is actually being aware of what you’re thinking and what you’re doing in the present moment. It’s attention on attention. When you focus on the touch of your feet on the ground or the physical sensations when breathing. And the bitch of it is, you have to do it every day. Feel your breathing, feel your feet on the ground. It’s attention on attention. When you do it regularly, your neurons are rewiring. It builds up something like a muscle in your insula, giving you metacognition. That way, when your thinking becomes dysfunctional, you’re the first to know it. So you can track what’s going on in your head, rather than denying it or running away. If you really are tuned into your own channel, if it starts becoming dysfunctional, you’ll really know how to dodge from the oncoming bullets.

Your memory goes down when stress goes up, then your cortisol goes up. So when you feel it, take a break. Hold up a white flag saying “meetings over, I’m nuts right now, let’s do this later.” The higher your cortisol goes, the worse your memory gets — and if you know that, you’re ahead of the game. If people only knew: you’re poisoning yourself.

I’m getting my masters now from Oxford in mindfulness-based cognitive therapy. I focus a couple of minutes a day. People say, Oh, she’s a Buddhist now. But I don’t really follow the fat guy. For me, it wasn’t a religion, it was a psychology. I got into mindfulness because I didn’t want to pay for shrinks anymore. My last shrink was an analyst, and he tried to convince me all my troubles came from the fact that my father made sausages. He wouldn’t let it alone. I wanted to tell him, sometimes a cigar is just a cigar.

In my view, if someone says everything’s fine, it signals you have a big problem.

Ruby Wax bounds onto the stage with a beaming smile and a glint in her eye. Then she says firmly, “One in four people have mental illness.” She looks down at the audience mischievously. She counts out. “You, sir, with the weird teeth. It’s you.” She points behind him. “That whole row isn’t right. Hi. Don’t even look at me.”

Wax is here to tell us her story. As she puts it, she’s one of one in four, and while she’d imagined that her nervous breakdown would be the result of some deep Kafkaesque revolution, with Cate Blanchett playing her in the movie version, the reality was rather more pedestrian. Her breakdown took place at her daughter’s sports day, after which she found that she had been institutionalized. When she woke up a month later, she noticed that on the rare occasion her old friends contacted her, they generally concluded by telling her to perk up. “Perk up. Because I didn’t think of that.” She pouts. The audience laughs.

The thing is, this isn’t really a laughing matter. Depression and mental illness may not be visible, but they are real — and they come with a sense of shame built in. Why? Abuse a baby, Wax tells us, and its brain will send out chemicals that are so destructive that the part that tells good from bad won’t grow. If a soldier sees a friend blown up, his brain goes into such high alarm he can’t experience words; he feels the horror over and over again. “So how come when people have mental damage, it’s an act of mental imagination?” Wax asks. “How come every organ gets sick and you get sympathy except for the brain?”

Now is the science part of Wax’s presentation. As such, she dons a white lab coat and brings out her flip chart, adorned with her own daubings (she’s clearly from the Outsider school of art). The good news is that we’ve come a long way since we evolved from one-cell amoeba. But the bad news is that we’re not well equipped for the 21st century. “People saying they’re having a lovely day are more insane than the rest of us,” she says.

There’s a reason for this. When ancient man felt threatened by a predator, he would fill up with adrenaline, kill or be killed, eat or be eaten. Then he’d defuel and go back to normal. Nowadays, modern man still fills up with chemicals when he feels threatened, “but because we can’t kill traffic wardens or eat estate agents, the fuel stays in our bodies. We’re in a constant state of alarm,” Wax says.

Living in this constant state of emergency is unhelpful. That which once made us safe now makes us insane. Let’s face it: “Your pets are happier than you are,” she says, to huge laughs. “Cats: happy happy happy. Human beings: screwed.”

Yet amidst the colorful drawings and exuberant presentation, we should be clear that Wax is deadly serious. “My point is, if we don’t learn to deal with this it won’t be one in four, it will be four in four who are really going to get ill in the upstairs department,” she concludes. “And while I’m at it, can we stop the stigma? Thank you.”

Photos: James Duncan Davidson