Rhapsody on a Theme (15 page)

“I am in a difficult position here,” the doctor said after a little while. “Given Darren’s medical history—and especially the suicidal history—I am not particularly happy about starting a course of anti-depressants without some kind of observation set in place…”

“No,” Darren said flatly.

The doctor nodded once and continued. “On the other hand, his depression has clearly worsened over the last few years, and I am equally unhappy leaving a patient with depression of this severity without a firm treatment plan.”

“So…?” Jayden prompted.

“I am going to start him on a low dose of fluoxetine,” Dr. Zielinski said eventually, sitting forward to type. “Prozac. It will be a
very
low dose, however. His reaction to the citalopram last time a course was attempted suggests this is not going to be particularly pleasant at first. I do think in the long run it will help stabilise his mental condition and give him back full functionality, but it may be that like the citalopram, getting past the short-term impact is the struggle. A lot of people experience some nasty side effects, but they do wear off over the first six weeks.”

Darren’s face tightened, but he said nothing. Jayden squeezed his hand anxiously, but anything was better than nothing right now, he figured.

“The citalopram…” He licked his lips. “That was bad. That was really bad, and he was ill for weeks and…”

“I have seen several patients with similar symptoms to Darren’s, and fluoxetine—in my experience—is likely to be more suitable than citalopram. I would prefer to try our luck with the SSRIs for the moment, for two reasons: firstly, the side-effects are generally less severe than other types of anti-depressant, and secondly, an overdose is far less dangerous.”

Jayden’s chest seized for a half second.

“He’s not going to overdose,” he said sharply, instantly deciding to invest in a second lock for the kitchen cupboard.
As if
he was going to leave packets of anti-depressants lying around.

“Fluoxetine is similar to citalopram in that it can cause a rise in suicidal behaviour,” the doctor warned, printing off a sheet of paper and handing it to Jayden. “These are the known side-effects, separated by commonality. I would suggest that generally Darren will experience similar side effects to those he had on citalopram, but hopefully with much less severity. I would certainly expect to see a similar mixture of drowsiness and insomnia, so be aware that he may move around at night or have low energy for a while.”

Jayden clutched the sheet, various words jumping out at him as if mocking him.
Drowsiness. Insomnia. Suicidal thoughts. Sexual dysfunction. Dry mouth. Self-harm.
He felt vaguely sick all of a sudden.

“I will be insisting on a check-up every two weeks, and I suggest you book those in at reception for the next ten weeks in advance,” the doctor continued gently. “It will take two to four weeks to see any effect, and three to six weeks generally to see an improvement.” The printer spat out a prescription sheet, and that, too, was handed to Jayden. “I’m going to start Darren on the lowest dose possible. If you are particularly concerned about his symptoms, do give me a call at any time, but also keep him taking the medication. He will get worse if the medication suddenly stops as opposed to being eased off, and that sharp cessation in taking the drugs is often a cause of suicide attempts.”

Jayden rubbed at Darren’s hand again, hard, and Darren shifted. He should have been restless by now. He should have been angry, even, because he hated being talked about like he wasn’t there, but he simply stared at his boots and said nothing at all. Jayden clutched the prescription and side-effects sheet to his chest, and felt his heart beating anxiously.

“Okay,” he said lowly. “Um, so…see you in two weeks?”

“It may be prudent,” the doctor said quietly, “to wait until this episode has passed before starting him on the drugs. It won’t make any difference to Darren, but it might help some of
your
concerns.”

Jayden nodded, looking to Darren for some kind of guidance on which option to go with. When coaxed, Darren simply shrugged.

“Maybe start next Monday?” Jayden tried. He’d be out of the other side of it in a week, right? They rarely lasted more than four or five days, and it had started on Sunday, so…“We’ll start next Monday.”

The doctor made a note. “In which case, I’ll see you again two weeks from then. Any concerns, do call me. And please avoid the NHS online symptoms checker?” he added, in a flash of humour. “Otherwise you’ll have convinced yourself that you both have a rare form of cancer or something equally extreme before the first week of treatment is out.”

Jayden smiled thinly, but the joke didn’t dispel his anxiety. He felt sick and stressed, and a headache was beginning to form around his temples. They were really doing this again. Really going back to drugs, and that night Rachel had called him down from Bristol because Darren was having some kind of manic fit or something, and…

He shook off the gnawing worry as much as he could, and rose from his chair, thanking the doctor and guiding Darren out of the office, new prescription in one hand and the horrible list in the other.

He didn’t want to do this—but they had no choice.

On Monday morning, Jayden put out a glass of orange juice and a single pill. Darren eyed both dubiously, then sighed and knocked them back like a professional drug addict.

The episode had lifted on Friday morning, but Darren had been subdued and preoccupied anyway. Jayden suspected he was angry with himself over the pills, and tried to derail any negative thoughts, but it was hard when Jayden was upset too. He hated having to do this. He hated having to rely on drugs to keep Darren safe and stable—and even worse—relying on drugs that weren’t reliable. He hated the whole bloody mess, and he hated having to insist on treatment when Darren didn’t like it, but he hated even more the potential, without any treatment at all, for Darren to…

Jayden had been at university in Bristol when Darren had last tried medication—citalopram, in theory for six months, but it had only lasted three before he’d had a major suicidal fit. He had locked himself in his flat in the middle of some weird episode, and had scratched at his wrist until he split it open, digging almost down to the bone. By the time Jayden had reached Southampton, Rachel had managed to break in and had had Darren taken to hospital. Darren had been irrational, furious, panicky, and hurt; he had clung to Jayden, removing himself from the hospital the minute his wrist was wrapped, but had rejected Rachel outright until the drugs wore off and his rationality caught up to him again.

It had been
horrific
, the sight of his blood-splattered room, and Jayden hated even the memory of it.

But he’d not been there all day and every day, not like this time. He hadn’t seen every minute of Darren on citalopram, or the earliest responses to it. He hadn’t seen most of the build-up, just weekends of increasing illness until that midnight phone call, and…

And this time, with the fluoxetine, Jayden was struck by the
nothingness
.

That first morning, Darren knocked back his pill, had a shower, and kissed Jayden goodbye at the door. He texted a couple of times during the morning until he went to work for the two-to-ten shift, and Jayden was woken briefly at quarter to two by that warm, heavy body sliding into bed and curling around his back in comfortable silence.

And the second morning, they did it again. And the third, and the fourth, and the fifth. And on Saturday morning, Jayden woke Darren up with honeyed-porridge-in-bed (he wasn’t stretching to a fry-up, because Rachel’s cat would be all over him for the rest of the day if he did that) and yet another pill, and Darren knocked that back too, and nothing happened.

“Do you feel any different?” he asked on the Saturday, and Darren snorted.

“Not yet.”

“Well…that’s good, right? I mean, if…”

“It means nothing, Jayden. The citalopram didn’t kick in until week three either.”

It didn’t last quite that long. By the following Tuesday, Darren had lost his appetite completely, to the point where he was even refusing soups. Which he usually
inhaled
in the winter. By Wednesday morning, he wanted water instead of juice, complaining of feeling sick, and when Jayden texted at the end of his day at the office, Darren’s only reply was
still feel sick and its nowt 2 do w/ this scene :(
.

On Thursday, Darren got out of bed, and promptly fell right back into it. “Fuck,” he breathed, clutching his head and physically swaying. Jayden caught his shoulders.

“Dizzy?”

“Yes.”

Jayden kissed his hair. “Okay?”

“Mm.”

“You going to be all right on the stairs?”

“Should be. Think I might puke, though.”

He didn’t, in the end, but he sat shivery and swaying at the kitchen table while Jayden forced another pill and a glass of weak squash down him. He refused food, even when Jayden pointed out he’d start losing weight he couldn’t afford.

“Well, if I eat, I’ll hurl,” Darren said grimly. “So what’s the point?”

Jayden kissed his hair and went to work worried.

On Friday, they saw Dr. Zielinski again, who made a load of notes but said it was all perfectly normal and fit with Darren’s recorded reaction to citalopram, but milder. (Jayden was stunned by the appetite loss being
milder
, but fine.) And milder was a good sign. Apparently.

Jayden didn’t quite believe him, because Darren had
eaten
on citalopram, although he did have to admit that it hadn’t been much. He continued with the small-and-frequent diet, and tried not to snap at him whenever he refused it. Physical side effects were fine. They could cope with those. They weren’t
dangerous
, not like the mental ones on the list. Not like
suicidal thoughts
and
self-injury
and
irrational behaviour
. Physical was manageable.

And then the drug
really
hit.

The mental side effects arrived in force on Sunday morning, like a party of unwelcome guests traipsing mud all over the carpets and eating everything out of the fridge. Darren was quite suddenly drowsy—stupidly so, given he was on normal weekends off for a good few months while the force trained up some new crime scene officers—and listless. The apathy returned in full-force, and Rachel’s piano lessons were promptly dropped. He started rubbing his hands on everything, and when the sporadic snapping started in the evening, Jayden wanted to cry.

“Are you feeling funny?” he asked lowly at dinner, while Rachel was on the phone in the living room.

“Don’t feel anything,” came the dulled reply, and Darren sighed heavily, head propped wearily on his hand. “I’m really not up for food, Jayden.”

“You’re still feeling sick?”

“No, I just…I don’t want any.”

Jayden made him a small plate anyway, but most of it was left, and Darren went back up to bed by seven. Jayden put it in the microwave, but had no real hope it would ever be eaten. Not now.

“He’s getting weird again,” Rachel said bluntly after he’d gone. “What’s his schedule for the next few weeks?”

Jayden dug it out—he kept a diary, to align his time off with Darren’s—and handed it over. She scrutinised it carefully, muttering to herself in places, then began to write it down in her own diary.

“Time to set up a watch for him?” Jayden asked, folding his arms and hunching in on himself. He felt cold and sick. He felt horrible for having to say that, like Darren was an unruly child or a…

Or a mental patient.

“Yeah,” Rachel agreed.

Jayden double-checked the locks on the kitchen cupboard doors that night.

* * * *

The phone was ringing when Jayden let himself into the house, and he caught it just as the answering machine light came on.

“Hello?” he said, fumbling with the front door and his jacket, almost throwing one arm out of its sleeve clumsily. The cat regarded him sceptically from the sofa.

“Hello, darling!”

“Mum!”

“Of course, darling,” Mum said cheerfully. “How are you both?”

There
was a question. “Um, we’re, you know, us.”

“Mm,” Mum said. “Are you free on Saturday afternoon? There’s some combat-ship…”

“Battleship, Mum.”

“Oh, whatever,” she said. “There’s some big boat owned by the Royal Navy that’s parked up…”

“Moored.”

“
Parked up
—stop arguing with me, you might be twenty-three but I’m still your mother—in Portsmouth that’s letting the public have a poke about, and your father’s decided to take Rosie on Saturday. I’m going to do some shopping,” she added snottily, and Jayden laughed. “But we’ll be having lunch after Rosie’s tired herself out and we can’t come all the way down there and not see you.”

‘All the way’ was about fifty or so miles, but Jayden supposed it was a long way if Rosie was in the car too.

Then he winced.

“Um, well, we’re not
busy
…”

“But?” Mum said sharply.

“Well, um…Darren’s…” he fumbled.

Her voice softened. “Is everything all right, darling?”

“…Darren’s started some new antidepressants,” he said lowly. “And he’s not very well. He doesn’t do drugs…”

“Oh, I know, I remember your insisting on having him over all the time after he was attacked,” Mum said dryly, and Jayden grimaced. The hospital had put him on codeine to get him through the first few weeks of physiotherapy for his shoulder, because cocodamol hadn’t
touched
the pain, and he’d spectacularly thrown up on Mum’s old coffee table after Dad had clapped him on the back in greeting one evening that summer. Even painkillers made him sick and sleepy.

“Yeah, well,” Jayden said weakly. “He’s, um…well, the side effects just kicked in, and he’s not…he’s not good.”

“How bad is not good?” Mum asked gently. “He’s not hurting himself again, is he, darling?”