How did we get to this point? Is life a crap shoot? Who is in charge? Do we get any smarter as we get older? Does anyone know what they are doing?
Ruby Wax is addressing some serious questions in her new show, Losing It. An odd move, possibly, for someone best known as a wise-cracking comedian, but these days Wax is more interested in serious matters, particularly concerning mental health, than easy laughs.
There was a breakdown, you see. It led to four stints in the Priory, the clinic that gained its reputation by saving many a celebrity from themselves. The experience led to Wax pairing up with singer-songwriter Judith Owen, and creating Losing It, in which Owen provides the poignant music and Wax the words. Most importantly, the show attempts to de-stigmatise mental illness.
As the comedian points out mental illness is taboo. Which is strange when you think that the particular condition for which Wax was admitted to the Priory - depression - has the reputation of being one of those most often faked by people who are looking for anything from sympathy to time off work.
One day, not too far away, there will be a test for depression, she suggests. Apparently, there are certain signifiers that will one day be visible on brain scans. Doctors will at last be able to tell the difference between depression and the much more boring disappointment, which is what many people who claim they are depressed actually have.
There's a long legacy of Jewish shrinks, of course
"That's a few years away," says Wax, and then adds, with a laugh, "they'll be able to scan you at airports - 'Sorry, you're too depressed'."
We are sitting in the cushioned comfort of a posh Holland Park restaurant. This is Wax's local. After marrying her TV producer husband, Ed Bye, with whom she had three children, this was where they had the wedding party.
Her tipple this morning is weak lemon tea. She does not drink alcohol. She used to, more than was good for her. She even tried joining Alcoholics Anonymous, but they would not have her. Her problems seemed a tad trivial compared to others in the meetings, she says.
"They were telling really awful stories like how they'd be so drunk, they'd eat their pets, and all I could tell them was how when I'd been drinking I started to repeat myself. I really wanted to be cosy and have all those friends. And I liked the cookies."
Wax cannot help but be funny, even when she is being serious. And it does not get much more serious than being addicted to alcohol or finding that in the days that she was making her hit celebrity talk show in the '90s that she was addicted to something else that made her ill - adrenalin. Then there were the cigarettes, also now ditched.
Losing It is different from her stand-up show, Stressed, of a decade ago. In that one she laid bare the psychoses passed down to her like an heirloom by her Austrian Holocaust survivor father, Edward Wachs, and her carpet-obsessed mother, Berta. They are a subject of every Wax interview. I tell Wax I am reluctant to bring them up, and she is relieved.
"Oh, man. I am so sick of it. I really don't want to talk about them. I mean, there is a point where it's over. You know? You don't go at my age, 'poor me'."
And then she adds revealingly: "I've cut the shtick out which hurt me so much. Because comedians are really tempted, when they're getting laughs, to keep going."
So the painful stuff is the funniest. But do not worry. There is enough pain in Losing It for it to be funny.
After the interval the audience is encouraged to talk too, she says. "They want to talk. You get someone in the balcony asking someone in the stalls, why their mother hasn't left the house in 200 years. 'What do you think the problem is?'"
At 57 - she could easily pass for 10 years younger - the new Wax is all about cure, not complaint. And to that end, about five years ago the former University of California student decided to go back to school and study psychotherapy.
"I was never going to be a psychotherapist," she says. "I was just interested, so I went to school to learn about it. It doesn't mean I am one." Still, in order to complete her postgraduate diploma, she did her 200 hours of listening to other people's problems - much of it with mental health charities Woman's Trust and Mind.
"They were not really interviews," she explains. "You shut up and get out of the way. That's a really good discipline for someone like me - to shut up and just get incoming."
But was it not strange for her patients to walk into a room for a therapy session and see one of the country's most famous comedians sitting there with a welcoming smile?
"They forget about it. If you don't present a front, they don't react to it. So I'm looking right into their eyes and if I'm good they are very appreciative."
Wax must be very good because she has moved on to doing a Masters at Oxford. "It's partly neuroscience and partly cognitive therapy. I'm the only Jew in my class," she says.
Depression, she reckons, is not a particularly Jewish disease. "But there is a long legacy of Jewish shrinks, of course," she says, as if that is the next best thing.
Just like those shrinks, Wax is becoming an expert on the subject of therapy, but there is one question, she admits, she does not know the answer to - why is the Priory so expensive.
"I had insurance," she shrugs. "And the tragedy is when the insurance runs out, you're out. I don't know why it's so expensive. How can you pay that kind of money and not be able to tell the chicken from the fish. It's a disgrace. I wouldn't pay it, because that would drive me more mentally ill."