During a career spanning more than 30 years, BBC special correspondent Fergal Keane has covered brutal conflicts in South Africa, Rwanda and Bosnia. It’s taken a lasting toll on his mental health, and in 2020 he stepped back from frontline reporting, revealing that he’s suffering from acute PTSD. In his memoir The Madness, newly published in paperback, he goes into greater detail, powerfully describing multiple breakdowns, alcoholism, and the inherited trauma that shaped his Irish childhood, as well as the resilience he’s found in himself. He will be talking at the Edinburgh International book festival on 17 August.

What part of The Madness was hardest to write?
Most difficult was what it was like to be in a psychiatric hospital. People talk about going mad and it conjures up all kinds of stereotypical images, but it’s terrifying, it’s this implosion. I’ve never been so afraid in my life.

How have readers responded?
The most interesting feedback is from other foreign correspondents, who’ll say: “I’ve gone through this.” There is a lot of talk about PTSD across the news industry, but when you’re in the middle of it, it’s a damn lonely place. It would be really beneficial if more foreign correspondents had tough but compassionate conversations with themselves and others who are going through the same thing. What I didn’t want the book to be was an elegy for the walking wounded. I’m also not comfortable with people saying “Well done for speaking out”, because I didn’t do it as an act of charity, I did it for my own sanity.

Has the book taught you anything?
Quite a few people have said to me: “You’re really hard on yourself.” It’s a self-protective mechanism – if I’m really tough with myself, then nobody else can be as tough on me. It’s been a habit all my life and goes hand in hand with shame, beating myself up; but it isn’t healthy, and that’s something I learned from writing the book, and the reaction to it.

Do you think personal change is possible, or is self-awareness a more realistic goal?
Change is really possible. Since the book came out, I’ve had another breakdown, and as a consequence, I’ve been working hard on not just therapy but the day-to-day, meditating in the morning, journalling, exercise. I’m a lazy bastard, but I realise that if I don’t do this, I’m in trouble. The breakdowns get harder to recover from each time.

How has war reporting changed?
The drinking culture has gone. It was romanticised, along with the broken soul, but there’s no tolerance for it now. The other good thing is it’s no longer possible for foreign correspondents to drop into people’s countries, write whatever they want, go away, and not get called on it if it’s bullshit. It was an almost neo-colonial form of journalism. But the shrinking of foreign coverage and foreign bureaux is worrying.

How do you see the war in Ukraine developing?
I think there may be a Ukrainian breakthrough sooner rather than later, but when a society has been so militarised in a relatively short space of time, what are the consequences of that in peacetime? You know that line in Apocalypse Now, “Someday this war’s gonna end” – it’s true, and it needs to end in such a way that it doesn’t become the seed of future conflicts.

How do you cope with PTSD in your daily life?
It’s never over – I can always tell how wound up I am by how quick my reflexes are if there’s a bang nearby. It’s manageable if I don’t let myself get too strung out by things, and I also take antidepressant medication. The other thing that I do every day is I remember the things I should be grateful for.

What were you grateful for yesterday?
I’m in Italy with my family and we were on a ferry on Lake Garda as a storm chased across the water. The lightning was forking down and then the rain hit us, bam! I thought of Shelley on the Gulf of Spezia and how quickly the storm got him, and I was grateful to be alive.

Is poetry important to you?
I read an awful lot of poetry – Sharon Olds, Anna Akhmatova, Michael Longley, Derek Mahon. Raymond Carver has written some moving poetry, and he’s got this line that really speaks to me: “All of us, all of us, all of us trying to save our immortal souls, some ways seemingly more round about and mysterious than others”. That’s it.

You were once in a rhythm and blues band. Do you still play guitar?
I was not a good musician but I still play at family gatherings. I love folk music. If you look at how ordinary people remember the past, the people who didn’t get to write their own history, it’s in the ballads.

Your father was an alcoholic. How did that complicate becoming a father yourself?
You want to be different, and in that sense what happened to my father, his example, pushed me towards being someone who will always want to be open to his kids. I don’t look back on growing up as something from Angela’s Ashes – I was very fortunate in many ways, and lucky to grow up with people who loved books, who loved words.

War became another addiction for you. Now that you’re no longer going to the frontline, has that addictive side of your personality found other outlets?
I got very close to being diabetic and was told I had to lose weight. I went at it and got one of those calorie-counting apps, and I think it got slightly obsessive. I lost a lot of weight, but I now feeling guilty if eat French fries.

Are you working on another book?
Yes, it’s about the conquest of Ireland by the Elizabethans – basically the beginning of Empire. So much of history, to me, is about people who don’t see the ground shifting under their feet, and this new book is very much about that. It’s called The Golden World, from The Faerie Queene by Edmund Spenser.

Is there a conflict from history that you’d hop in a time machine to cover?
I’m fascinated by the Napoleonic wars because they changed Europe and the world, but the idea of being on the field of Waterloo with a telescope fills me with horror.

Was fear always present for you on the frontline?
I used to be able to deny it to myself, but it got much worse. By the 2006 Lebanon war I was petrified.

How do you define heroism these days?
Heroism is the daily grind, and I’m not talking about myself, I’m talking about the people who don’t have the privilege of being able to pay for therapy, who are getting by and taking care of kids on extremely limited means, but who keep doing the best they can. That to me is heroism.

Name your ultimate war reporter.
Martha Gellhorn. There’s a sense of empathy and of being present with people that really moves me. I was going to say Ryszard Kapuściński, but though he writes magnificently, I’m not sure how much of it I can believe.

• The Madness is published in paperback by HarperCollins (£10.99). To support the Guardian and Observer order your copy at guardianbookshop.com. Delivery charges may apply