“I wept not, so to stone within I grew”

Io non piangea, si` dentro impetrai.
-Inferno, Canto 33

It is 3:40 AM, the witching hour, and my being awake cannot be a good sign.

Of course, I have been awake at this hour every day for quite some time now. Maybe wanting to get up and write is a good sign.

Things here are, well, empty. I suppose it is a depression of sorts, though fortunately like the ones I suffered as a child and teenager, before the “manic” part was added to the title. It is much more bearable, at least on the surface, than the episodes I have suffered in the last few years, because I am just quiet and still and numb. No racing mind or body torturing me with horrible thoughts that come faster than any human was meant to think. If I didn’t have the practicalities of running a life to worry about and could just crawl into bed until it goes away, it wouldn’t be bad at all.

It is strange how it has come full circle, taken me right back to where I started. It does remind me of that time when I was 12 and my mind broke for the first time, for seemingly no reason. It is familiar, if not comfortably so, ha ha. It makes me a little nostalgic for that time, when I thought that the worst that could happen, crazy-wise, was the need to crawl into bed for months. Before I knew what could really happen, all the ways a mind can burn and break that I know now.

It does get better throughout the day, and by evening I am almost normal. Unfortunately, 9 PM is not the best time to apply for jobs or deal with the mundane details of life. Every night I go to bed thinking of what I will do first thing in the morning, the interview I will schedule, the tax papers I have been avoiding (two forms, that’s it, two forms!) for months.

And then morning rolls around at 3:30, and I am numb and frozen and terrified again and nothing gets done.

I have not worked in four months. All solid job offers are shift work, night work, in busy, miserable emergencies for minimal pay. Seeing as that is what made me so crazy over the last few years, I have not accepted any of them. I don’t want the responsibility of not missing a heart attack for $5 of pay. It makes me physically ill to think about going back to medicine.

I wrote before that it wouldn’t be so bad if I weren’t trying to keep up with life, but I am not sure that that is entirely accurate. I woke at this atramental hour, and beyond the dampened terror of my bank balance, the horror at the thought of returning to the repugnant job that is the only one I am qualified for, a little voice dared to run through my head and say the one thing that I have not allowed myself to think: “Your hope is all gone,” the voice intonated. “Your mind will not work again. This is what you are now.”

I miss very much the streams of words that used to race through my mind, needing to be caught on paper before they got away. I miss writing, which used to be an automatic and unconscious activity. Whatever force I used to channel, whatever it was in the universe that fed me the words, has left. I have been alone, without even the words that I could always count on to come, unbidden. I try to force myself now to write, but I sit and try to think of words. I have to choose them, and they are never quite as right as the ones that come from without. I never used to “have to” make myself write. The words used to just come, words and phrases and alliterations and allusions would streak through my head, unannounced and at odd times, often surprising me and making me laugh or smile at their unexpectedness. All I ever had to do was appreciate them, and transcribe them, and be thankful for the electricity that ran through me when they were flowing, the sense of pure purpose, that this is what I had been put on this planet to do.

But whatever consciousness it was in the universe must have moved on, found another emissary or oracle.

Not only the words are gone. The more primal, wordless passions, the pathos and exultations of life, are muted into nonexistence. For months now, I have been walking around on the verge of weeping, with tears in my eyes that obstinately refuse to fall. I think that if I could weep, something might shift, maybe for the better, maybe not, but at least there would be motion.

I don’t understand where those tears are coming from, why they are so firmly fixed behind my eyes. Maybe when my muse left, someone else’s tragedy mistakenly got into the void left in my eyes, and I, having picked up the narrative in the middle, cannot identify the nature of the misfortune, and thus, cannot weep for it. I have no reason to be sad now (unless I think of the countless broken bodies and broken lives that surrounded me and sometimes touched me over the last years). So I am not sad. Just numb.

The lack of hope – another entity that has left me: something in my head keeps whispering, maybe this is it…this is the best you will ever be. Sometimes I wish that the “maybe” would disappear. If I were to be sure, I could figure out how to arrange some kind of half-existence around what is left. But as long as there is still a memory of how I used to be (abstractly, anyway – I cannot channel how I felt when I was alive and ready to do anything and conquer the world, but I can picture my younger self smiling and full of energy, doing things, doing everything), there is that little last bit that keeps me waiting, as the song says,  busco un mejor momento. In some ways, this keeps me from playing the hand I have been dealt. I am always waiting for the next deal.

For my own record, since I do record this shit, I just saw a new shrink. It was horrific and humiliating, as usual, but no worse than most new shrink appointments. The decision was to raise the bupropion, give that two weeks, and if it isn’t enough, add valproate. I have a hard time seeing much logic in this; it seems to me that the last thing I need now is a drug that will slow me down or make me stupider. But I suppose I have nothing to lose (except my hair and my hormonal balance and my lack of diabetes and any potentially normal fetus I may someday conceive), so I’ll try. Mostly because I don’t want to be that patient on the very first meeting with a new shrink.

And things have undoubtedly improved ever since getting out of the miasma that was the previous shrink. I miss him, maybe, as a person, and on some level I think I like him more than this new one, but I cannot ignore the overwhelming experiential evidence that it was bad for me, and there were too many lapses in professionalism to ignore (see “refusing to release records”).

Sometimes, though, in these tenebrous hours, his words still haunt me: accusations he made, (mis)interpretations of things I did or said that nonetheless were hurtful. The insinuations from someone I trusted that something is so wrong with me that it is a miracle I function, and that I will never be “normal” without serious interventions, which apparently have not yet been invented.

For these reasons, even though it is all I think about almost every day, I am trying to avoid anything psychological or mental health related. When I am away from the whole paradigm, I’m just a flawed person, no more or less than anybody else. When I let them near me, I become an amalgam of pathologies and brokenness. Sometimes I wish I never had gone to any doctor. Then, I would have just been eccentric, or emotional, or melancholic, or even just plain crazy.

I have to remind myself that I don’t even believe in their system of belief, that people lived for thousands of years without shrinks, that 99% of the world’s population has never even heard of their concepts. I try to remember who I was before I ended up so entangled with this bullshit system. I was a person. I wasn’t perfect but I was alive and I did things and knew people and sometimes felt something.

Somehow, all of that has disappeared, and all I can think about are all of the words that have been used by the priests of this odd religion to judge my essential being. I do not believe in their religion, yet somehow, their damnation of my many sins, that they delineate in the clinical terminology of their liturgy (affective instability, noncompliance, Melancholia, Mania, narcissism, Cyparissusism, Axis I, II, III, x, y, z, the asymptote of mood-personality-behavior), haunts me.

I don’t know why I cannot break the hold this farcical cult and its practitioners have on me. I suppose it is my version of the person who doesn’t really believe in God anymore, yet somewhere deep down, is too frightened by the spectacle and rhetoric of the fundamentalist hellfire to actually get up and leave the pew.

And so…back to the title quotation. I feel that underneath the conspicous anodynia, there is a well of misery hiding. Hell, it keeps trying to creep out through my eyes. I can’t help suspecting that the underlying pain is for all that I have seen over the last few years and all the people I have lost. I would drain the well, cry profusely and feel deeply, if I only knew how to reach the stygian waters.

But it is too late. So many years of having wept not, I both created and became the adamantine stone.

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On Chronic Depression and Myth

One of the things that occurs a lot in the mentally ill, especially, thought not exclusively, in the mood disordered, is that a mood episode is treated with medication, and the cycling of moods is stopped, yet the person remains miserable, suicidal, even, and suffers a lingering handicap. In the world of psychiatry, this is the stage in which the doctor says, “There are personality factors at work,” which is code for, “This person is nuts and I have no fucking idea what to do.” The patient is then referred for long-term therapy, which rarely helps.

I know because I experienced this recently.  My acute episode ended – the heavy cardinal signs of depression and mania were gone, yet I remained miserable. The same pattern is readily apparent on many of the blogs on my sidebar (Exact Science, Coloured Mind, PWH). The thing that is last to fade, it seems, is the temptation of suicide.

The doctors never seem to understand this. “We fixed the chemical symptoms, why are you still fucked up? Why can’t you just go back to doing whatever it is that you were doing before you flipped out?”

My partner has been traveling to the Far East a lot lately, and has become interested in Buddhism. I got him a copy of Siddhartha, which I only read in high school and remember not liking that much. I thumbed through some of the coffee table books on Buddhism that he brought back, and one detail of the life of the Buddha struck me: that the hardest part of his journey was not leaving home to seek out new knowledge; it was not the reaching Nirvana, complete insight into the order of the universe, and not spreading his teachings to his disciples.

The hardest part was, after reaching Nirvana, reintegrating into the stream of life, caring about other living beings. He was presented the choice, upon seeing Nirvana, to either remain there for eternity, or to stay and spread his teaching on earth. The Brahma itself (God) had to come and convince him to continue on the path.

This struck me as the crux of the matter, as the reason I continued to be suicidal well after the depression had lifted. It is not the descent into symbolic death that is difficult, nor the ascent out of the underworld. Rather, the most painful and difficult part of the narrative journey is the return to the flow of everyday life after the threshold experience.

Myth studies and Jungian psychology are the types that most move me, interpretation through metaphor, myth, and poetry, seeing each individual as a Hero. It gives strength to people to realize that what they are facing is not mundane, not a result of skewed object relations or personality flaws, or dysfunctional families, but rather a part of what humans have faced since the dawn of time, and helps awaken them to the fact that they will have to call on their own mythic strength to prevail.

Mental illness in its life-threatening forms – suicidality, depression, mania, psychosis – is a liminal experience, one in which, unrequested, people are forced to face the boundaries of normal human experience. Symbolically, suicidal depression is a descent into the underworld, in which all of the trivia of normal life is stripped away.

During my last illness, I considered whether I would live or die, nearly each moment of each day. I made preparations for my death, and saw the world differently, knowing that I might not reside in it much longer. Trivia fell away; the world seemed quieter. Preoccupied with thoughts of high cliffs and nooses, the overwhelming unbearableness of life, other things seemed to fade.

When the episode was treated, under control even, I stayed on the edge of suicidal thoughts. They didn’t go away, even though the misery that had led to them did. And the shrinks never understand why.

But myth does. A classic stage in the monomyth is “the return threshold.” Dying is one threshold, and every hero has to face a symbolic death and descent. The hero is then saved and brought back to life with new understanding, either by his own prescience or a force from without. Though it seems like that should be a central plot moment, it is very short, albeit dramatic.

The true struggle comes after. It is not easy, once one has seen the void and been swallowed by it, to return. Everyday life seems trivial, bland, meaningless. When one has faced the pit, how is one supposed to return to preparing dinner, to cuddling in bed, to laughing? To getting up and going to work, to petting the cat, to doing the million small and seemingly meaningless things that make up life?

The road back is long and not terribly exciting. It is nothing like the symbolic death or the symbolic rebirth. It is arduous, in many ways more painful, and its outcome less certain than the simple death or rebirth. It is natural, easy even, to be faced with this journey and to wish to return to the underworld, where things appeared more certain, if darker, more essential, more stripped down to meaning-and-unmeaning. It may be a horrible place, but it least it is a final one, unlike the slow journey up the mountain to a destination – life – that one hardly remembers, that does not promise to be less frightening than the life that led one to the threshold of death in the first place.

And so we stay suicidal long after the depression has faded. We frustrate our doctors by continuing to talk about death and pain and our wish to be freed long after we have stopped waking up at 3 AM and being restless and wrestling with God.

This part of the journey is much longer and more arduous than crawling out of the grave. We, and our doctors, deceive ourselves by thinking that the gateway out of hell is the end of the struggle, the hardest part, when in fact it is the easiest and shortest part. The only way back, as the Buddha knew, is to immerse oneself in the river of life, and forget the rest, let the questions of life and death fade away, at least until they are back for good.

Yet another Shrink’s Line of the Day

Yesterday I decide that I feel bad about quitting the shrink all abruptly and in a rage. That I didn’t want to end like that, if just out of politeness. I really wanted to call and leave a message apologizing, and wishing him a happy holiday. I said that I was going to be the bigger man here, be the one to let my ego come down off the high horse first. Because, true, he shouldn’t have gotten sucked into the whole yelling and power struggle, but I participated too. I felt bad. I decided that, for the sake of my own dignity, that no matter what he said or did, that I wasn’t going to get into another knock-down-drag-out. I was going to be mature and in control, like my first therapist taught me.

Unfortunately, he answered the phone, despite my best attempts at timing to get voicemail.

“Hi, this is Sara. I just wanted to say that I’m sorry for losing my temper, and I didn’t want to end on that note. So…I’m sorry for anything I said or did that was inappropriate – ”

At this point he cut me off and said ominously, “Well, I’m sorry too that you’ve chosen to be like this and end things this way.”

My blood pressure immediately rose and all of a sudden I was almost ready for a fight again. I mean, even if I and my personality flaws are 90% at fault, there was at least some unprofessionalism on his part.

I took a deep, deep breath, and said, “Let’s not go into this again. I really just wanted to apologize for yelling, and wish you a happy holiday.”

He could hardly control his anger and snapped back at me, “Happy Holiday!” and hung up.

* * *

I promise, soon to get to the post on recurrent/long-standing mental illness and what the Buddha has to teach us. You know, something that might be of use to someone.

But since this is my journal, I can use it to think in writing. This incident raised so many questions for me.

Am I so crazy that I am imagining the anger/stubbornness/power struggles coming from him? Is that projection or some other psychological bullshit I am doing because I’m really as fucked up as he says?

Is there a legitimate therapeutic reason ever for being obscure or concealing the therapeutic mechanism? Is it ever right to say to a patient: I don’t think we can discuss your condition, how we are going to go about treating it? Is it ever ok to refuse to discuss the kind of therapy you do? Is it ok to say, “You just have to trust me” – and not at a given moment, but as a guiding policy? Especially when the patient is going through considerable distress as a result of the treatment? I mean, if I give a patient steroids for a serious disease, and they complain of side effects, I feel obligated to explain why I think that the benefit of the drug outweighs the side effects, what it is doing to them. Is psychiatry really so different?

Is it ever ok to refuse a patient their record, especially while refusing to give a reason? (Thanks to Jay for some perspective on this one.)

Is honesty on the part of the therapist always an important part of therapy? I mean, to me, it seems like that’s exactly what I’m paying for – someone else’s honest and trained opinion. But maybe I am understanding wrong – maybe I am supposed to just let him do whatever it is he is doing?

Is there a rule that therapists should never apologize? I mean, this whole thing would have been avoided (in retrospect), if he could have just said something like, “I’m sorry you feel hurt.” I wouldn’t even expect an apology for the content of what he said or anything – just some sort of acknowledgment that I was upset. Is there a rule in therapy that it undermines authority/transference/focus on the patient to apologize? I mean, my natural instinct in a similar situation with a patient – no matter how nuts they are – is always to say something like, “I’m sorry you’re so upset.” And when I’ve lost my temper or gotten annoyed with a patient, I always apologize – but maybe out of my own sense of guilt and remorse rather than concern for them?

The reaction I got was, “Why are you upset? There’s no reason for this to be upsetting to you. Why should this (being called both narcissistic and borderline in two sentences, one after the other) be a cause for concern?” This seemed so invalidating after I had said it was worrying to me to think that that might be the problem and asked what the treatment would be, what to do about it. I think I would have been ok if he had said something like, “Yeah, it’s hard to hear.” But a total failure to understand why I was upset – and then to tell me to “not be upset” was incredibly invalidating. It’s ok to tell a patient, I think, that their feelings are colored by their past experience or knowledge, that maybe they are taking offense or being hurt excessively – that, after all, might be part of what brings them to therapy. But to flat-out say that someone has “no right/reason to be upset” seems sort of anti-therapeutic to me – I mean, isn’t part of the idea of therapy recognizing and acknowledging feelings (even if one wishes to change them)?

Is any problem always the patient’s pathology?

And most importantly: Why do I keep seeking validation and understanding in a place where I so obviously am not going to get it? Why am I seemingly endlessly attracted to going back to someone who repeatedly hurts me, hoping for a different outcome the next time? What buttons is he pushing in me, or what screwed up need do I have that I keep running right back in for another round?

* * *

I’d like anyone, but especially therapists working in various schools, to respond to any question that catches your eye.

Anyway, if anything, that phone conversation should have cemented my position. From time to time, the situation catches me and I feel kind of bad. Not abandoned or whatever – I mean, I know if I’d just give in and stroke his ego a little, I’d be welcomed back and “forgiven.” It’s not like he’s kicking me out. I am, as he said, “choosing to end this way.” I think the choice is being made rationally, for sound reasons. I mean, I have to trust my own intuition and logic – it’s the only source I have. The real question is why I’ve been ignoring the signs for so long.

But still, I think it’s ok to feel a little sad. After all, even if he never did offer me much in the way of comfort, even if I’ve gone downhill under his care and felt worse for it…it still is, as Tony White would put it, an attachment, even if not the healthiest one in the world. I did like the guy as a person, if not as a therapist. And we’ve known each other a long time. And he did try to help me. Maybe I’m just unhelpable or unreasonable. So I think it’s ok to feel kind of bad, knowing that in the long run I’ll be better off. And I think I really do need to examine why, after so long and so much of my gut and brain telling me otherwise, I kept being pulled back.

Is a big part of it hope and regression? That he promised that, as deeply flawed as I am, that there was hope of a “cure” if I’d just keep coming and talking to him? (A lot of my frustration that brought up the conflict was that this therapy seemed to be going nowhere – that it was just like chitchat…with no change in anything.)

* * *

About the comment on the last post about the colors and design of the blog being dark and depressing, well, true. But I rarely see them anyway – I just see the compose window and get the comments by email. I almost never look at the finished blog, so I forget the dark colors and photograph. I feel sort of like I do want to leave it, just because this is the place I can let the darkness out, my place to be the goth teenager I secretly always wanted to be. My other blog, the one about my real life and not my mental patient life looks nothing like this at all. Though it is a good point. I do take a lot of these kind of suggestions in real life – exposing myself to sun, to sunny people, exercising, keeping the Dali posters off my walls in favor of something warmer – definitely a good point.

Still alive, beyond comfort of man or spirit

Thank you to everyone who left me comments or emails or anything. All much appreciated. Sorry I haven’t written back.

I am, indeed, still alive. In fact, the longer days are making some things easier. But I don’t feel better, am not getting better, am just biding time, this version of bardo, laced with apathy and terror. I started Wellbutrin intermittently again. The shrink has pretty much given up on me – tells me to just prescribe for myself and take whatever I want, because that’s what I’m going to do anyway. Not true, but it is very difficult to argue with a shrink.

Except when it isn’t, like the last time I was there, and ended up yelling at him for an hour straight. I feel bad, couldn’t have been very pleasant, but still, throwing psychodynamic interpretation shit at someone in my condition…well, seems like that’s asking for yelling. “Why are you so angry?”

Well, I guess I’m still angry about the borderline comment.

I wish my shrink weren’t so complicit with my self-punishment.

* * *

I woke up after a weekend of physical pain; unfortunately my GP is out until next week. I called the shrink  but then hung up on the answering machine.

Maybe, since I obviously am not going to work today, I should try writing something. I’ve thought of what I need to write, but haven’t been able to care enough, to drag up the energy, to do it. Which, in and of itself, is probably loaded with unconscious meaning that I also can’t quite seem to bring myself to care about.

* * *
Also, I have about 6 more weeks before finishing a certain stage in my training, after which I will have vacation. I have decided to try my hardest to avoid suicide until after that point, so that they can’t say that it was the pressure of the job or that I couldn’t take it or anything like that. Because, God knows, it isn’t that. It is me, all me.

Thanks for continuing to read

When a poster on a blog like this stops posting, usually one of two things has happened: either they’ve hit a significant remission and have somewhat lost interest in all things mental-health-related, or they have taken ill in a way that keeps them from writing, usually either a severe depression, hospitalization, apathy, or the black hole, in which there is nothing to say. And, I guess, sometimes they die.

Usually they come back to writing sooner or later, good for the second group, not so good for the first. As far as I know, there are no reports from anyone from the third group hasn’t returning to blogging.

I, unfortunately, belong to the second group, have had a tremendous crash-and-burn. I’m not sure why I’m writing now, and I apologize for the quality; it is written through a haze of legal psychiatric drugs that makes it difficult to stay conscious, let alone coherent or eloquent.

I just wanted to say that the other night, I went outside in a miserable state, where there was no peace to be found – not in drugs, not in music or poetry or adventure novels, not in trashy magazines, and not in sleep, which, anymore, is haunted by nightmares. I sat under the stars and smoked a cigarette. The moon was half full; soon, it will be full, and then, after that, the next time it will be full, it will be Passover.

And I thought: I really would have liked to see another Passover, that holiday I love so much, when I really do feel the holiness in the air, the meanings, the social and the mystical. The elision of time, when it is that same night as it was so long ago, in which we start out bound and by the end, hopefully, will be freed. And the merging of the physical and spiritual – the tastes of the bitter and the sweet.

I always loved Passover, the one time when my skepticism and atheism faded into a sentimental belief in magic. I would have liked to see this one. One more. One more full Nisan moon, one more race to bed before midnight. One more hope for Eliyahu to come and save us from this sorry world. To save me, on the wings of the Shechinah.

But I just know that it isn’t going to happen. That I won’t have one more Spring. I think it’s too late now. I’m too far lost, beyond a way back, beyond where I can even want one.

And finally, after all this time of numbness and dead souls, I sobbed. I could imagine something, anything, that I did want to see, would have liked to see, to be there for. Knowing that, I could sob. Not for missing the rest of my life and not for the gruesomeness of death or hopelessness or suffering, but for the simple, plain, yet cosmically significant idea that  I really would have liked to make it to Passover. One more time, I would have liked to feel that. And I most likely won’t.

Just that. I am beyond missing future adventures, past beauty, beloved books and books to come, future love, past love, present people and the spectacular world around me. I’m far beyond mourning any of that. Those things all have lost the hold they once had on me. I don’t love the things that I used to love anymore.

But I would have liked to see the Seder table, one more time, the poetry and ritual of it, the full moon, the sense of blurring of boundaries between present and past, the individual and the symbol, the present reality and the hope for a better day. I would have liked…to just be there this Passover. And oddly enough, when nothing else could, that was enough to make me cry. I was sort of surprised I still could.

I did not see this coming

The latest in my escapades – no essays or deep thoughts or medical stuff here, just my personal update.

The anxious racing episode, naturally, crashed into a depression that hit hard and fast. Or maybe not so fast, but I didn’t feel it until it was out of control.

I think I am more and more becoming a burden. I haven’t had many normal conversations with any of my friends lately, it all revolves around my condition. I feel like a burden, and though they’d never say it, we are all doctors in training and under so much pressure that we are very limited in how much we can give to each other. It’s sad, but it is how things are. I also just sort of want everyone to go away and leave me alone, so they won’t see all this, and I can return to my life after I’m better without having done too much damage.

It is very hard for me to accept help, and I just want my partner and everyone else, well, I want them to help me and care for me, but I don’t want them to see me like this.

Since the depression got worse and worse, I went to my GP, who is very sympathetic to these kinds of problems, having had a son commit suicide, so he treats people with mental illness like people, not diseases. Actually, I didn’t want to go, but the psychiatrist wouldn’t treat me further unless I did because he wanted to be sure I wasn’t physically ill. I had attributed a lot of the physical symptoms to medication side effects and the depression effects.

I went to the GP and told him to just sign off, send some basic blood tests etc, and to give the shrink a green light to continue treating me. I told him I was not alright, but I couldn’t tell him about the suicidal thoughts. He knows about the depression, not sure how much about the whole bipolar story. He said I looked bad, and asked if I had ever been this bad before – I had, twice.

He started to do a brief physical exam, like, put a stethoscope on me while I was just sitting in the chair, but once he heard my heart, he told me to get up on the table, and did a full exam. He started yelling at me (well, not “yelling at me” but he got surprised and upset) that I was in horrible physical condition – apparently malnourished and dehydrated almost to the point of shock – racing pulse, minimal blood pressure, gray, the whole textbook version.

I had been feeling dizzy and horrible, but thought it was some central effect of some drug so I didn’t really pay attention. I was surprised because I’d been working as usual. I knew I hadn’t been eating because the depression sort of took away my appetite and one of the medications or another was making me either unable to eat or throw up often. But I didn’t think it was so much. I had been trying to eat a lot of calories in whatever I did eat – adding butter and honey and always juice with lots of sugar. It’s my “depression diet” because I know that sometimes I lose a lot of weight fast when I get like this, so I try to pack as many calories as possible into what I do eat. I guess I didn’t start early enough this time.

He called the psychiatrist from the office right then and there. This felt really bad, like I was this wayward child who needed to be taken care of – all of the sudden I was the ward of these two doctors, playing ping-pong about what to “do with me.” I only heard the GP’s side of the conversation, but he said at the end, “Look, I really think we’re getting to the limits of what can be treated outpatient.” No idea if he was referring to mental or physical state.

He sort of vaguely asked me about suicide, asked if I could or would talk to the psychiatrist about that. I said, “Probably not.” But it got the idea in my mind that maybe I should say something.

I walked out of his office and I remember sitting down at a bus stop just to rest and catch my breath for a few minutes before going to the car. It was freezing. But I was so tired, two hours passed while I sat there, watching people and buses come and go, waiting for the energy to get up and leave.

I did the blood test and the H. pylori test, and then went to meet a close friend (also a doctor), and told him how scary facing hospitalization was (for either the medical or mental stuff, I wasn’t even sure which anymore). He told me, “You look terrible. I’m a friend, not your doctor, so I’m not going to tell you what to do, but maybe you should go to the fucking hospital.”

The next day, I went to the shrink and confessed the suicide stuff, even though it was hard. It seemed like the responsible thing to do. I think I was actually looking a little less depressed by then because going to his office makes me so nervous that it gives me a little energy. He basically didn’t react. Nothing. I asked what to do. Nothing. I felt ridiculous, like some drama queen. He didn’t ask any of the suicide questions that even I know to ask (Do you have a method? Plans? What do you think will happen if you do? What stops you?).

Finally I asked, “Do you think this is some sort of manipulative thing, just to get attention, or something?”

His answer was, “It would only be manipulative if you were doing it consciously.” (I guess that qualifies as a Shrink’s Line of the Day.)

Then he said he wanted to give me Zyprexa “as it recently got approval as a mood stabilizer.” He sounded like a fucking Lilly commercial. I absolutely refused. Then he got angry at me. “You just can’t work with you! You say you want help, but then you refuse the help anyone offers!”

I asked him if he would take a pill of that. He said that that wasn’t a fair question. I said I ask myself that every time I prescribe something for someone (true). At the same time, he told me to stop the antidepressant that he started a week ago – just as I had started to get over the nausea from it, way before anyone has any idea as to if it will work or not.

As usual, I left there feeling worse than when I went in. Maybe he was right, who knows? Maybe not reacting will discourage me from threatening suicide again. He’s a nice guy. He did call today to suggest maybe somehow finding some derm specialist who can solve the side effect problem of the old drug (or possibly that was the subtext for calling to make sure that he didn’t kill me after all), that he had searched around the area and there was some guy a few towns away who specializes in drug reactions in the skin.

I said I was sorry for being such a horrible patient.

The next morning I went back to the GP for the test results and because he had said he wanted to see me again the next day. To make sure I was still alive, I guess. I told him what happened. I asked him if he thought I was being unreasonable to refuse the Zyprexa. He did the screening for psychosis (of which I have never had any symptoms). Then he said that Zyprexa seemed a little excessive (“an atomic bomb drug”), but that he didn’t know why a psychiatrist would suggest that or what psychiatrists consider.

You see so many psych patients who come in with lists of maybe 5 or 7 psych meds, from all different categories, and they look horrible, like zombies, and you have to think that whatever their illness, it can’t be as bad as that, and that there is no rhyme or reason to treatment, they just keep throwing more drugs at them, one on top of the other. That poor girl I wrote about was on something like two antidepressants, and old and a new antipsychotic, a benzo, valproate, and a sleep aid. No wonder she could hardly speak.

I felt like I was slowly turning into that. I was on a lot of peripheral shit at the time. The psychiatrists, including mine, mean well, but it’s such a strange field, no one knows anything, and they just keep throwing more and more drugs on people until they are just shells. I feel bad, so he gives me a med, and I still feel bad, so he gives me another – it’s all well-intentioned, trying to relieve my misery. But I got the feeling that that was what was happening to me – I was being made sicker.

So a few days before, I had also stopped taking all kinds of benzos and sedatives and phenergan and shit that the shrink had put me on, and only left the antidepressants, so I think I had a little more affect when I walked in to the GP, looked a little better, even if I didn’t feel better. I wasn’t like the walking dead.

The clinic was very busy so I didn’t want to take up a lot of his time. But it took me a minute or two while I asked him to wait so I could get up the courage to tell him that I had been checking my life insurances, making sure everything was in order. I didn’t tell him the rest. But he took me seriously, told me to go home, go to sleep, and come back in the morning again.

I was supposed to go with my partner to his parents’ for a few days, but when he got home from work it was late, and I had showered for hours and gotten minimally dressed to leave. But I was so weak and lying in bed, thirsty, sort of hungry. I couldn’t move (as had happened most of the week, lying down with no willpower to physically move my muscles). I just couldn’t get up and pack a bag and get in the car. The wind was howling outside, and the bed was warm and soft, and I was so tired, and thought of the uncomfortable bed at his parents’, and their yapping dog and the noise there…when I finally felt sleepy and warm and safe at home. I just told him to leave me a glass of water and go without me.

The prospect of a silent weekend alone was so tempting. I slept. Woke at 3 AM again, but not as restless as usual. Just relaxed in bed and listened to the wind until I fell asleep again at dawn. I got up in the morning at 9. I wanted to go back to sleep, but I figured that since the GP had been so decent, the least I could do was show up. (Friday is a half day for him at that clinic.) So I went in there, and sat down to wait, and started to feel faint so I went and bought some juice. I didn’t want to pass out and make a scene, or worse, be sent to the emergency room of my own hospital.

I told him that I thought all the drugs had really knocked me down and out, taken away the last bit of energy I had to cope with anything, including the depression, that they were slowly working their way out of my system. I kept taking the antidepressants but stopped all the heavy shit. And suddenly I could move again.

He asked me about my plans for the weekend, and I told him honestly…that I just really wanted to be alone at home. He said I deserved some rest. I was glad he didn’t try to insist I be around someone, that my partner be home or that I go with him. I thanked him and apologized for making such a mess and scaring him, and he hugged me and told me to come back sometime next week.

Then I went across the street and bought a newspaper and some bread and light food and went home and, for once, instead of dropping it all on the floor to deal with later, put the things away. I took out the garbage and minimally cleaned the floor. I drank and ate a little bit, then went back to sleep until the afternoon. Then I moved to the sofa and watched bad 80s movies. The quiet day, no one at home but me, the big bed all to myself…the sleep, for God’s sake. It was all so sweet.

I hate to say I’m getting better because every time I say that something horrible happens, but I wish this quiet could never end. I am just going to try to enjoy the rest of the evening, watch bad sitcoms. Try to sleep off the rest of these drugs. Not to worry about all the things that got me to this point or when I will go down again. Not to fantasize about suicide. To eat long enough before taking the meds that I will gain some calories from it. To drink. To try to orally fix the electrolyte mess that came back in the bloodwork.

* * *

I’m not sure if I learned anything from all of this or what the point of writing it down was. No profound insights. I didn’t suddenly find purpose in life, and I don’t know how long I will remain ok. I have to go back to the race shortly and I am terrified and still exhausted. It’s not a big happy ending. I don’t “know that I have more of a safety net than I thought” or that “people really care about me” (they do, but I already knew that and it doesn’t really matter when I’m in that place). And it seems like I have made a real mess of my body that will need some straightening out. I guess that there are probably some readers who read for the personal stuff, the same kind of stories as they go through. So that is why I am trying to be honest here for you.

I may go back and remove or edit this. It feels very raw and exposed. But for now, this is my story.

Here we go again

New appointment.

New level of truth telling by me.

New drug.

One (low) dose of fluvoxamine down.

Hours later: paralytic sleep, the kind where you know you are asleep but can’t move and can’t wake up.

Woken up by nausea. At the same time, phone call from work.

Vomit for 15 minutes, not very successfully. Do not feel better. (It’s central nausea, of course not.) Wonder vaguely how the eating disordered do it.

God, will this ever stop? I just don’t know how much longer I can do it.