Shoot the Damn Dog: A Memoir of Depression (19 page)

I felt no respite.

One day, without intending to, I stopped therapy.

I had been in the room for only a few minutes.

‘How are you feeling?’ Margaret asked.

‘Terrible.’

‘Why do you think that is?’

I told her that my period was due, so I was hormonal, irritable and physically tired. I had also stopped drinking having become aware that my alcohol consumption was reaching danger levels. I was detoxing, or going through alcohol withdrawal, and, given the amounts I had been drinking, I was feeling very bad.

‘But what’s underneath all that?’ she said.

‘There’s nothing underneath it,’ I said irritably. ‘I’ve just told you that I’m hormonal and detoxing. I feel like shit. That’s all.’

‘But what’s underneath it?’ she asked again.

At first, I thought she was joking. And then I realised that she was serious. According to her training in psychoanalysis, nothing could, or should, be accepted at face or even reasonable value. And I knew that I couldn’t stay in that room a moment longer. That, if I was mad, ignoring two perfectly rational physiological reasons was madder still. And so I got up and said, ‘I’m sorry, I can’t do this any longer.’ And I walked out of the room.

Her voice followed me down the stairs. ‘Sally? Sally!? Where are you going?’

I didn’t reply. I just kept walking. I felt free, in control, for the first time since I had become depressed.

She called me later. ‘What was all that about?’

I couldn’t be bothered to give excuses so I said what I knew to be true. ‘I hate it. I don’t want to do it a minute longer.’

‘Then don’t,’ she said.

I abandoned therapy for a year after that. Not only did I abandon it, I was hostile to the very idea of it. I loathed it, thought it was the preserve of middle-aged, middle-class, middle-brow do-gooders, most of whom had been through a personal crisis of their own which, with a little training, became a qualification for fixing other people’s pain.

I still believe that some of that is true. Anyone can set up as a therapist and, often, anyone does. Therapy should be far more widely regulated. Its lack of regulation is both dangerous and symptomatic of the myopia we, as a society, have around mental illness. We know so little about the workings of the mind that we assume that anybody who has studied it, however passingly, has all the answers. This is simply not so.

Good therapy is about connection—helping somebody to connect back into life. That’s a rare enough commodity in the human race so there’s absolutely no reason why we should believe that therapists have the monopoly on it. A great therapist is both a great teacher and a healer—someone with wisdom and perspective. They also need to be a great role model. In order to trust them and to learn, you have to want at least some of what they have. A course in therapy doesn’t give someone that. Life does, or a great gene pool. Who knows?

What most of us do know is that we sense when it is not present. Unfortunately, confused as we are about therapy and the mystery in which it is shrouded, we ignore those very instincts.

It is something I still regret. The failure of my initial attempts at therapy drove me even deeper into depression. I thought that I was beyond help and beyond hope, that I was incurable. At the same time, I was struggling with my medication, which seemed to have no discernible effect on the blackness in my head but, instead, made me so physically ill that I could scarcely function.

I finally found a therapist, Elizabeth, who gave me enough strength and hope to believe that there was life after depression and that, one day, I might experience happiness again. She turned up at a retreat, in the depths of the country, where I had gone in a desperate effort to soothe my still violent depression with meditation, acupuncture and yoga. With everything and anything except therapy. When we met I was belligerent and hostile to all and every form of it.

The first thing she did was to make me laugh. She talked back. She was irreverent, cynical, funny, warm and, above all, human. She did not practise psychoanalytical therapy, but a combination of different forms including person-centred therapy, transactional analysis and relationship therapy. Many therapists train in more than one form of therapy, slowly adding to their knowledge of the field (which is constantly changing) over the years.

Now that I know a little more about therapy, I realise that I have no personal favourite form. I have only favourite therapists, practitioners who combine the disciplines of therapy with a wisdom and humanity that I might want to own.

Such was the case with Elizabeth. On the retreat, I discovered that she lived and worked in London. I asked if I could see her, once a week, for a two-hour session. I like my therapy in large uninterrupted chunks, although some people find that too gruelling and prefer the usual fifty-minute session. All I know is that two hours works for me.

And so I embarked on the final phase of therapy, which lasted for nearly two years. In the end, Elizabeth sacked me. ‘I don’t think I should take your money any more,’ she said.

‘Don’t you like it?’

‘I love it! It buys me great shoes but I think that you’re emotionally healthy enough to go out there, on your own. Try it, see how it feels without a safety net. Life is for living, Sally. There’s no other way of doing it.’

It is one of the marks of a great therapist, to know when to stop.

‘You can always come back, if you need to.’

I did. Once.

I left the second hospital as precipitously as I had the first, and for the same reason: lack of insurance. This time, I was in tears.

‘We can’t let something as stupid as money stop you from getting better,’ Sarah said. ‘If we find you some, do you want to stay?’

‘No, because I’ll have to pay it back later and I can’t work. And if I can’t work, how can I pay it back? Then I’ll spend the whole time worrying about it and trying to work and beating myself up because I can’t even read at the moment, let alone write. I can’t make sense of the patterns on the page.’

‘You don’t have to pay us back.’

‘I do. I could never be happy until I did. You know I hate feeling beholden to anyone.’

Sarah laughed ruefully. ‘Yes.’

‘But thank you.’

There was a silence. ‘What are you going to do?’

‘I’ll go home.’

‘I don’t think you should be by yourself at the moment. Come and stay with us.’

‘No, but thank you. I’d rather be at home. It’s the only place I feel safe.’

‘Will you be all right?’

‘I’ll be fine.’

A long sigh. ‘OK. But call me.’

‘Yes, of course.’

I was not fine. I was, if anything, worse. But I had people now, who understood. The only time I left my flat was to see my therapist or my psychiatrist or if Kate or Andy or Susie or Nigel, all of whom left hospital soon after I did, dragged me out. The medication I was taking was so strong it made me shake constantly, but when you’re among friends who are also shaking from their medication, it comes to seem almost normal.

‘Oh, that,’ Nigel said, as I spilled my drink. ‘That’s nothing. I have to lower my head to my glass and lap it up, like a dog.’

We were in a bar, somewhere in the East End of London. Me, Nigel, Andy, Susie and Kate. It was our first, and only, night out.

It was so dark, none of us could see.

‘Fuck,’ Kate said, tripping over a stool. ‘I haven’t got my glasses on.’

‘Where’s Susie?’

‘I think she got lost on the way back from the loo.’

‘Oh, well,’ somebody said.

‘She’ll turn up,’ said somebody else.

‘I couldn’t get out of the loo,’ Susie said, when eventually she turned up. ‘The door didn’t make any sense. And the loo kept flushing, all by itself. Nearly gave me a fucking heart attack.’

Nigel laughed. ‘Poor you. Just the thing for panic disorder.’

The music was so loud that none of us could hear each other, and we all got headaches, so quite soon we had to go home.

My feet hurt so much from wearing high heels for the first time in months that I had to take off my shoes and walk barefoot through the dark, frozen streets. ‘At least you’re not wearing flip-flops,’ Nigel said.

We had a party, The Loonies Work Christmas Party, as it was known. None of us was working, because none of us could. Nigel and Andy both owned their own companies (‘or what’s left of them,’ as Nigel said), and the others were on sick leave. Jonathan and I had sold the family house, so I had enough money put away to live off, if I was careful.

‘Everyone else has a work party,’ Kate said. ‘So why shouldn’t we? We’re working hard at not being mad.’

I cooked chicken, with all the trimmings. I delved into my fashion past, and my wardrobe, and produced a black Jasper Conran jersey top, a black Betty Jackson satin skirt and Helmut Lang leather boots. There, I thought, I’ve got dressed. I’m normal. Then I went and spoiled it all by putting on so much mascara that my eyes stuck together from the heat of the oven and the potatoes were burned beyond repair. Nigel told me my eyes looked like demented spiders.

Susie turned up three hours late, because she’d got lost. I kept her lunch warm, in the oven.

‘Lovely,’ she said, eyeing the plate of sticky, congealed food and lighting a cigarette. We all got completely drunk, even Kate who didn’t normally drink and Susie, who only seemed to be drinking tea. There were presents, of course. Nigel gave me a book, a 1950s hardback edition of Angela Brazil’s
The Naughtiest Girl In School
.

Kate had a row with Andy, Susie kept shouting at herself for being such a loser and getting lost on the Tube and I had a row with Nigel because, as I said, he was always laughing at me.

‘He laughs at everybody,’ Kate pointed out.

‘You should watch that,’ Andy said. ‘Humour is denial.’

‘Oh, fuck off,’ everyone chorused and Susie fell asleep, curled around Bert the cat.

We all agreed that it had been a very good Christmas party.

Tom came, and Tom went. He was living in a rented flat, which he hated, but it was all he could afford. It was next to a railway line and square, like a box, with three tiny bedrooms. He was fighting for the right to see his children. It took all of his money, and most of his sanity.

‘When I was twenty,’ he said, ‘I owned my own house. I seem to be doing life the wrong way around.’

‘We both do,’ I said, thinking of the first days of our affair and the pubs and street corners, where we had kissed and fumbled like teenagers. I missed them. Now, I just felt old.

We kept our relationship a secret, because of his children. Or, he kept it a secret and so, by default, did I. When he was with them, he wouldn’t answer the phone or speak to me. It was as if I didn’t exist, which only added to my already pronounced sense of unreality. We never discussed his refusal to acknowledge our relationship, or the kids, or his situation or mine, or the future.

‘I can’t see a future,’ he said. ‘My position is completely precarious. What is there to discuss?’

‘We could make a plan.’

‘The kids are in pieces.’

We couldn’t make a plan.

He always came to see me at my flat. We always went straight to bed. We were as passionate about each other as we had been when we first met. We lived in separate bubbles; our time together, our lives apart.

After a while, I began to feel like a hooker.

‘We should go out sometimes,’ I said, knowing why we didn’t. If we went out, we would have to acknowledge reality. ‘We always stay in.’

‘I like it here.’ He put his arms around me. ‘We have everything we need.’

Everything, except the truth. It drove me mad.

The shaking grew worse. It started, every morning, an hour after I took my medication, Venlafaxine, also known by the brand name of Effexor. Prescribed dosages are typically in the range of 75–225 mgs per day, but higher dosages are sometimes used for the treatment of severe or treatment-resistant depression. I was taking 300 mgs and felt so physically ill that some days, I could not leave my flat. My vision was blurred so I found it hard to judge distances. I also shook so badly that crossing a road became an act of fierce concentration as I tried to factor in how far away a car was with how fast I could walk, shakily, to the pavement on the far side. It seemed to take an eternity and my heart pounded so badly, I was sure that it would leap out of my chest.

I stopped drinking, again. Alcohol made the shaking worse and I was determined to at least try to give the medication a chance. Going to see my psychiatrist or my therapist, who both worked out of the same building a short Tube ride away, took all of my energy. The Tube station, which also served as a mainline national train station, was filled with people who shoved past me as I stood, stock-still and shaking, willing myself to take another step. The escalator, one of the deepest in London, seemed to drop like a precipice beneath my feet. I clung on to the handrail, dizzy with vertigo, convinced that I would fall, as people clattered past me down the sharp, corrugated metal steps. There was a time when I used to run down those steps, two at a time, or casually push past tourists. It seemed to me then that it belonged to another life, another Sally.

‘I think I’m being poisoned,’ I said to my psychiatrist. ‘My body can’t handle these drugs. I shake all the time. I get dizzy. I can’t see properly. Sometimes, it’s so bad I think I’m going to go into convulsions.’

My psychiatrist frowned. ‘Venlafaxine is the best antidepressant for resistant depression. We’ve tried three others and none of them seemed to agree with you.’

‘I hate it. Perhaps I should stop taking it.’

‘I’m concerned that you may experience a drop in mood.’

‘I’m not sure that I could go any lower.’

‘It’s not advisable.’

I had grown to hate my psychiatrist. Or, ‘that cunt’ as Nigel pointed out he had come to be known. I swore a lot when I was very ill. I have no idea why. Anger was a strong and constant feature of my depression. I was, literally, in a bad mood. I felt my psychiatrist never listened to me, that he pumped me full of drugs according to whatever new research he had read. I felt like I was a guinea pig, not a human being. He had a habit too, of answering his phone when he was with another patient. ‘This will have to be brief, I’m with somebody,’ is what he always said.

Finally, I could stand it no longer. ‘If you’re with somebody, why are you answering the phone?’

Long pause. ‘I’m a busy man.’

Yes, busy pissing off two depressives, instead of just one.

My psychiatrist was speaking. ‘If we try another SSRI, it means you have to withdraw from the present one, and wait while the new one takes effect, which is usually anything up to six weeks. Do you think you can handle that?’

I buried my face in my hands. ‘No.’

‘How about ECT. Have you thought about that any more?’

‘No and no.’

I was still not sleeping, at least not past four hours a night. I had not had a full night’s sleep for nearly two years.

‘Let’s try you on rohypnol, which is also known as the date rape drug. Be careful. It’s very strong. It can also be associated with short-term memory loss, if used in combination with alcohol.’

I remember being excited, the first night I took the drug. I thought, if I can sleep, perhaps my mind will get back into order.

It kept me awake.

I felt worse. The treatment seemed more violent than the illness.

My hands shook so badly, I could barely hold a pen. For a week, I practised writing a signature, but could manage nothing that looked even vaguely like my own. I had bills I needed to pay, cheques I had to write.

I called Jonathan. ‘I need your help.’

‘What’s happened?’

‘I can’t pay my bills.’

‘I’ll lend you some money.’

‘No, I have money but I can’t write a cheque. My hands shake too much. Can you come over and pay my bills for me?’

‘Sure,’ he said, sounding baffled.

‘Oh dear,’ he said, when he arrived. I was deathly pale and my teeth were chattering uncontrollably. I was in my dressing gown but kept my arms wrapped tightly around myself to stop the shaking. If it got too bad, I fell over. I didn’t want anybody to see that. ‘What’s wrong with you?’

‘I think it’s the drugs.’

‘Perhaps you should change them.’

‘There’s nothing left to change them to.’

‘There must be.’

‘There isn’t.’ I was too tired to explain the intricacies of psychopharmacology. Besides, if you haven’t been there yourself, it is impossible to understand.

‘There must be,’ he said again.

‘If you could pay all these,’ I said, showing him the bills laid out on the table, ‘and tell me how much I owe you, I’ll give you a cheque. I think I can manage to sign one.’

It was after he left that despair began to set in. True despair. I sat alone in my flat, unable to control the shakiness in either my body or my mind and I thought, I can’t go on like this. I can’t go on.

Then I thought, I have to. I have to find out about these drugs I’m taking. I turned on my dusty computer and went on to the Internet. This is what I found.