A personal memoir of mental health, by Paula Harris.
Content warning: this essay discusses severe mental health issues, including suicidal ideation.
On Tuesdays I go to the pharmacy. That’s the day when I pick up that week’s worth of antidepressants. Someone somewhere thought it’d be fine to manufacture an antidepressant that people can overdose on. And since I’m At Risk, my doctors don’t take chances. I’m only allowed a week of meds at a time.
So every Tuesday I go to the pharmacy, right after I’ve taught a lunchtime Pilates group class. This routine is the only way I can remember to get the next lot.
It used to be I only went to the pharmacy once every few months, when I needed something fairly boring and pedestrian, like painkillers or nail files. Then I started on these antidepressants and here I am, once a week, going in.
Most of the staff now recognise me when I arrive, calling out “Hi Paula, are you here to pick up your meds?” as they turn towards the shelf where my small paper bag has again gotten lost under all the bigger paper bags of other people’s health problems. The experience catches me awkwardly: I like to feel part of a community, for people to know my name, for that look of recognition in their eyes, which is what I get on Tuesdays. But at the same time I’m aware that they all know what I’m picking up and why I have to come in every week for it, that they can see a little glowing sign above my head saying At Risk.
I was first diagnosed with depression when I was 26. I’d just come through a turbulent month in hospital from Crohn’s Disease, during which I’d been told twice that I was dying and had undergone two emergency surgeries. I left hospital with an ileostomy, pain, painkillers and fresh wounds. My then-GP rang to say he wanted to see me, having received my surgery notes. When I arrived for my appointment he asked how I was doing and I began crying. I cried and cried, in front of a man who I’d known since I was small. He handed me tissues and said “You’re depressed.” He’d never been a particularly comforting doctor, but now he looked at me with soft eyes and worried eyebrows.
With a prescription for antidepressants in my hand, I started seeing a counsellor at the hospital. Anne talked me through what depression was; I remember sitting there thinking “That’s depression?? Oh, I’ve felt like this for years. Is this not normal?”
When I was young, I used to sit as close to the TV as possible. Sprawled on my belly, resting on my elbows, I would look straight up at the screen. My mother would grab my ankles and drag me back towards the couch, telling me I didn’t need to sit that close. I’d quietly inch back forward; she’d drag me back…. This was our nightly tug-of-war. When I was 11 she got sick of it and brought me to the optometrist, to prove that she was right. I still remember the optometrist getting me to sit in that big awkward chair and, after he’d raised its height, saying to me “You can read the top line, can’t you.” It wasn’t a question, it was a statement. Surely everyone could read the top line! I looked in the direction he was pointing and said “What top line?” All I could see in front of me was a white blur. Because blurs were my normal.
When I went back a month later to get my new glasses (brown plastic frames that were square with rounded corners; the 80s were indeed a terrible time), a whole new world was there. There was a top line! And the calendar behind the reception desk had numbers on it. Numbers! I didn’t know that calendars were anything beyond pretty coloured blurs. Because all I knew was blurs. I couldn’t see out of anyone else’s eyes to know that what my eyes showed me wasn’t normal. It was the only normal I’d ever known. Now though, the way my school friends knew what was written on the blackboard ceased being some magic I’d never been able to understand. Now I had magic eyes too.
My brain is the same. I couldn’t see the world through someone else’s brain to know that mine wasn’t seeing things quite right. I thought everyone felt the way I did, saw things the way that I did, thought how I thought. It was only when Anne told me that this and this and this were signs of depression that I started to realise my brain was playing tricks on me, and had been since I was 10, at least. That’s how far back I can remember feeling these things, thinking these thoughts, seeing the world this way. With or without glasses, I see the world a bit wonky.
After my surgeries, I spent three and a half years on antidepressants, and the same length of time in counselling, although I moved on to a new hospital counsellor, Erica, after a while. Antidepressants allowed me to get out of bed in the morning, to get showered and dressed and eat. And I was even happy – sometimes, of a sort. Mainly I wasn’t as sad and suicidal. But they also took away my desire to write anything, and so I felt like a Fake Me. I stopped taking them when they didn’t feel like they were working the same anymore. Without them I was still getting out of bed and showering and dressing and eating, so I didn’t want to face starting something new. I stopped seeing Erica a little later, after her job changed and she was no longer able to see patients for counselling. Erica had sat there through sessions where all I did was cry, she’d helped me take on studying, she’d started the process of helping me to undo some of the mess my childhood had done to my head, she’d helped me see myself as someone who wasn’t just a bunch of scars but someone who could still be attractive to others. I just couldn’t bring myself to start the process over again with someone new.
Since then I’ve wavered up and down, sometimes going through a bad episode of depression, managing it with herbs and supplements because I didn’t want to go back on antidepressants and feel like a Fake Me. The longest of those antidepressant-free episodes was nine months, which felt like forever.
It’s been a little over two years since this episode started. It took a year before I gave in and went looking for help. My new GP is fantastic, an old school doctor who looks vaguely saddened at my monitoring sessions that I haven’t made a major improvement after a year on various antidepressants. Earlier this year he openly admitted that he was at the end of his comfort zone, both in knowledge of remaining medications for depression and in how bad my depression is, and referred me to Community Mental Health Services for them to provide additional support for both me and him.
In his reports my psychiatrist writes that I have a 30+ year history of Dysthymia, with Major Depressive Disorder currently in full swing. He tells me that I’m about the middle of the scale for Major Depressive Disorder, that if I was closer towards the top end of the scale I wouldn’t be getting out of bed and dressed. Some days I don’t, but generally I can. I find it harder and harder to leave the house these days, especially if I have to go somewhere with lots of people or noise. It makes for a very lonely life.
Just because I’m depressed doesn’t mean I can’t experience happiness; it’s just harder. A psychologist I was seeing last year explained that while everyone experiences highs and lows, mine are more extreme: I experience good things incredibly intensely and they have a massive emotional impact on me, while my lows are sudden and fast and very very low. There’s nothing wrong with that, she reassured me, it’s who I am and it’s part of what makes me Me. It’s a matter of figuring out how to cope with the lows so that they don’t sink me.
Figuring out how to cope with the lows is easier said than done.
There were three weeks last December when I felt great. Every day, I felt great. I didn’t think about suicide once, which startled me, because I couldn’t remember the last time I went more than a day or two without thinking about it. I hit a magic spot where I was genuinely not depressed: I was doing a poetry paper at university and so was writing and talking about words every week, I was staying with my closest friend, Mike, every Sunday night and felt relaxed and calm from my time with him, and yes, the antidepressants were doing their job.
It was a strangely unfamiliar feeling. I kind of liked it, even though I felt a bit weirded out and lost, like when I first got glasses and found the ground rushing up towards me. It’s like suicide has become my security blanket, the thing I curl into when things are really bad, knowing that there’s a way out. Suddenly it wasn’t there and even though I should’ve felt relief, it was also confusing. I found myself thinking “is this what it’s like for other people?” and trying to adjust to my new view. Then, just as I was settling into it, it slipped away. I finished uni for the semester – now I wasn’t staying with Mike every week or feeling the rush of words – and the anniversary dates of my surgeries were coming up fast. I dropped low and fast.
It was hard for everyone. My GP was a bit crushed to have me back to being unable to control my crying. My psychologist returned from holiday to find me a wreck and we never managed to get our sessions back to a helpful place. Mike got worn out from having to help carry the weight of my depression and our friendship exploded. I no longer heard from the two other people I’d been closest with. Depression can be an incredibly destructive weight to bear.
On Tuesdays I go to the pharmacy. My new antidepressant, which I’ve been on for two months, makes my brain a bit foggy, and causes nausea and weight gain and achy dry eyes. I’m still depressed; I can usually get up and get dressed, but I’m anticipating that my psychiatrist will increase my dose when I see him next. I’m finding it harder to write and I worry about becoming a Fake Me again. My GP understands this and asks me to just give it a bit of time, and if the writing doesn’t come back easily, there’ll be another med to try. I try not to think about stockpiling this med and using that as my security blanket.
Antidepressants are not an easy choice. I’ve lost track of how many I’ve been on in the last year. They’ve made me nauseous enough to be gagging in front of clients, caused me to develop horrendous bruises from small knocks, given me massive palpitations that make me think I’m having a heart attack, and added 10 kilos to my body. Sometimes I’ll be so tired I’ll sleep for at least 12 hours a day and still hardly be able to stay awake when I was meant to be working. Then there’s acne, hallucinations, mood swings, impaired brain function, nightmares, headaches, acid reflux, the inability to regulate my body temperature (mainly on the side of feeling overly hot and sweaty), and the simple fact that my guts just really don’t cope well with the meds. Plus there was the month when I was pretty much a zombie and moved through life with nearly zero brain function. My GP tells me I’m in the hard place, where I get all of the side effects without the benefit of, well, not being depressed, so he understands why it’s so hard to keep taking my meds. I know that if I stop taking them right now, I won’t be alive in six months time.
I cry whenever the loneliness hits me. It’s hitting me as I write this. But on Tuesday I will go to the pharmacy, try to smile at the woman behind the counter whose name I can never remember, and get my next week of pills.
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