Tristimania (3 page)

There was no available appointment for days. I took a deep breath and said very quietly and slowly and urgently:

– I–need–to–see–him.

My thought processes had been kidnapped. Each word was like a hostage of meaning smuggled out under the kidnapper's nose.

– You can see another doctor, the receptionist said gently.

I took a deep breath.

– He–told–me–to–get–a–message–to–him–if–I–needed–to.

If I couldn't see him, I knew I was at the end of something. I thought I might convulse like a fish out of water, a hideous grotesquerie of a physical performance of this mental floundering, drowning in air.

– He's doing an emergency surgery this afternoon. You could come back at four.

Saved.

Then it was a matter of holding the molecules of the self together for four hours. A friend had planned to come by. He took me for a short drive, just for something to do other than sit on the sofa trying not to jabber. But though he drove carefully and slowly, the motion
and speed of the car made me vertiginously anxious, like a shriek of sawn nerves, and we had to turn back.

Four o'clock came. I nearly fell into the doctor's office. He was shocked that in a week the mental health team had failed to give me an appointment. He would, he said, have felt happier with a psychiatrist's diagnosis, but he would have to make decisions on his own. To him, it looked like mixed-state hypomania, and slipping worse: hallucinations mean you're entering psychotic territory. He said he'd phone the psychiatrist so at the very least he could get confirmation of the antipsychotic medication he was proposing.

– Whatever it is, I want a low dose, I managed to say.

I felt as if I were not speaking my thoughts but rather dredging up a memory of what ‘I', the un-mad person, would have wanted to say. I was frightened of the idea of antipsychotic medication, particularly as I'd seen a brilliant friend of mine sectioned for a manic episode and given so much lithium that he became a slur-mountain of shambling zombieness. There was little left of him, and it took him years to recover from the medication. It was as if I were appealing to the slip of logic that threaded my mind, as if I were asking my memory of myself to take power of attorney over my current threadbare, madswept self.

The doctor told me to go home and wait by the phone, and he'd call me when he had spoken to the psychiatrist.

– Can I check we have the right phone number for you? he asked.

I said nothing.

– What's your phone number?

This was it.

I could not remember it.

Chasm.

This was the hardest question I'd ever been asked in my life. My mind shut down every other activity in order to focus on it, because of what the inability to answer would mean. Gone. Sunk. Drowned. Sanity is to the psyche what oxygen is to the body; its loss, even momentary, hits the mind shockingly because it is speaking the language of ultimates: life and death. My mind was losing its oxygenating sanity. It was as if Dr Leslie had asked the question from miles away, from a shore whose safety I could not reach. I wanted to say ‘Help', but even that word was a luxury in the drowning mind's innerness, its internal compression of need to an absolute imperative, beyond help, beyond calling.

How brief a moment it probably was in real-time but how long a moment in psyche-time. How invisible to an observer this moment would have been and yet the enormity of the drama within me. My fear muted me into unobservable panic, a shut-down, a white-out. I can remember this now, as if it happened an hour ago. The psyche will fight for its life, reckless of anything beyond itself. I felt the ferocity of the need, the almost physical sense of raging emergency, and I knew I would ruthlessly fight, struggle or latch on to anything in order not to drown.

And then I felt as if my mind split into two: the drowning mind which simply couldn't remember and the watching mind which saw truly the gravity of the situation. I was down to the fundamentals of the psyche. Everything else had spooled away, the lovely skeins of linking things; thoughts, words, feelings, selfhood or relationships were not in fact the centre. At the real centre was an instinct to survive. Something I'd call core mind. Ferocious. Adamantine. In the bitten vehemence of the violent need to survive, I was at the cold, hard kernel of implacable willpower. My psyche was down to its bones, down to the bleached calcium of a revenant star, the
obdurate bones of the psyche, which are harder than iron or steel, harder than the hexagonal diamond, the hardest mineral on earth.

I never did answer the question. Instead my doctor read out to me the phone number he had and asked me if I recognized it. I didn't. He read it out more slowly, and I did.

He moved fast, sending me home, getting hold of the psychiatrist, confirming the medication, calling me back in, all in minutes. He agreed to start on a low dose and had one of the pills in his hand to show me how to halve it. I wanted to take the one he was holding in his fingers, in a kind of sympathetic magic. I have always loved the placebo effect, and I thought the medication would work better if I had this particular pill. It combined magical thinking with the logic of placebo studies. I have never taken a pill so quickly. Thanks to that, things were about to get better. And worse.

The pill was fast-acting. My friend took me out to a place where he could have dinner and I could try to. Three hours after I'd taken the pill I could swallow, and I ate half a veggie burger and some chips; more than I'd eaten in days. That night, I slept for six hours, twice the amount I had been sleeping for some time. When I woke, I went downstairs to where my friend was sleeping on the sofa and I sat near him and held his hand for hours.

The next day, I got the psychiatrist's appointment. While I was in the waiting room, the social worker asked if she could come along into the appointment.
I'm not a fucking sideshow,
I thought and bit back. Do these people not realize how hard it is to deal with even
one
stranger when you've gone mad? The psychiatrist was late back from his lunch and seemed flippant about it. I followed him into his office, watching his feet. He wore winklepickers, which I disliked intensely. My initial loathing was confirmed in seconds. His questions sounded to me like something you'd find in a
pop-psychology quiz in
Cosmo.
I felt he was trying to catch me out in self-contradictions, and it was like being interrogated by PC Plod, oafishly trying to outwit someone who has committed no crime. He sat trapping my words in lumping handwriting. I made myself unapproachable: I think he wrote that I had a problem with authority. He seemed to think of psychiatric illness purely as a brain malfunction, a mechanical problem. To me, the psyche is also a matter of the soul.

But knowing I was mad, and not feeling any trust in the psychiatrist, I felt I must tread a delicate path, giving him enough information so that he could give an accurate diagnosis but without providing any reason for high-dose medication or any excuse to section me. I was judging how little I could get away with saying, while ensuring that I said enough. I was concentrating all my attention on this, like taking an exam on which my life depended. This was made worse because part of my mind knew I'd gone mad, so I was in a logical predicament: I knew my judgement was untrustworthy and yet I knew I had to trust my instinct for who could help me and who couldn't. He may well have been trustworthy – indeed, he may well have been a perfectly good psychiatrist – but the point was whether or not I could find it in myself to trust. And I could not. My intuition would have to compensate for my lack of judgement.

There were also things I didn't feel like saying, out of a sense of privacy, almost of decorum. The previous time I'd had an episode of hypomania, thirteen years earlier, I had slept with eight different men over a couple of weeks. It was a kind of sexual larceny against my usual monogamous instinct. The emotional aftershocks of that particular self-spending spree were, well,
rather awkward.
But when the psychiatrist asked about previous episodes, specifically angling for answers to do with unwise and intemperate sexual encounters,
although I knew that was one of the tell-tale signs of mania and hypomania, I refused to answer.

In any case, for me, the acting out of hypomania was uninteresting; it was a way of literalizing a profoundly metaphoric experience, and this time around I wanted to explore the manic world for its metaphors. I certainly felt that lovely hot purring of sexuality from time to time – especially when one of my friends, playing Nogood Boyo, was flirting with me outrageously – but actually having sex seemed both too dangerous and far too literal. If I physically acted out these invitations, it would have felt crude, the mind miming its metaphors in the clowning body; rather, I wanted to let my psyche explore its non-literal and far subtler landscapes.

Shakespeare's clown, Will Kemp, in what he called his ‘nine days wonder', morris-danced from London to Norwich, and that seems to me something which could appeal only to the manic-minded, for the flaring energy of mania craves expenditure. While the need to spend your entire body's energy is acknowledged in the literature, it seems unlikely to be a priority in diagnostic questioning. Manic ‘spending' is often enacted in the form of money, and this seems to be a narrow focus of psychiatric questions. Those enquiries also lean heavily on whether a patient has been ‘spending' themselves sexually, perhaps because our society is obsessed with the crudely countable: it is easier to ask patients how much money they've spent or how many people they've slept with than to ask if they've skipped with the electric jubilation of a six-year-old or to attempt to measure the vastness of their love for the universe.

When my doctor saw the report from the psychiatrist, he was glad his diagnosis had been seconded and told me that, reading between the lines, the appointment had not been wholly successful.

– It's okay. We'll look after you here, I remember him saying.

I wanted to weep with relief.

Memory goes odd in madness: some conversations, events and mental happenings are etched unforgettably in my mind. Other moments, though, are wholly void: blanks of memory which I know are blanks only because my friends have sometimes asked me if I remember a certain thing, and the occasional total memory failure makes me poignantly embarrassed. A friend had phoned me in the epicentre of this madness and asked how I was. I apparently answered with a kind of gleeful clarity, ‘I am in the middle of a spec-TAC-ular breakdown,' and started giggling manically. I had forgotten that completely until he reminded me, months later.

A few things, meanwhile, are self-evidently misremembered. I was half convinced that an early appointment with my doctor had been in the corridor of the surgery, because I was then putatively halfway between being in his care and in the care of the psychiatrist. My mind was waywardly transposing emotional truth to actual fact, and I found myself imploring my trust in my own logic and in my doctor. Number one: I knew he wouldn't have fixed an appointment in the corridor. Number two: I knew I was mad. Therefore this was not a real memory but a hallucinatory one. How precious reason is, when one is losing one's mind. This was the first of many times when I had an implacable, ferocious sense of clinging to logic – pure, almost mathematically logical steps of thinking – in order not to drown in the mind's expansive, oceanic imaginings, although the siren voices cried to me to lose myself in the wildest waters.

And I – drowning.

My mind couldn't hold itself together; it couldn't carry its own weight. I tried to hold on to anything that could give me comprehension and coherence. I read the leaflets about my medication
obsessively, as if the words spelling out their curative power were also healing spells. I sometimes sought in the language of science the descriptions of the structures of the mind, though I could barely concentrate for more than a few sentences. Often, I found that when I turned the dial in my mind, there was nothing except static hum, the sound of furry electricity, but if I could tune into someone else, I could borrow their sense and sensibleness. I often phoned friends briefly, just to hear language being broadcast on the frequency of sanity.

I began trying to write down what I felt in the moments when I was collected enough, because the written words anchored me and gave me a sense of safety, as if a line of words across the page were a lifeline. Words were a slender thread to logic, which was a stronger rope to lucidity. I was desperate for something of
logos
which the sick and careering drowner in the illogical, hallucinatory, voluptuously mad psyche could hold to. Tough. Taut. Rope. Often I wrote down the same thing many times, forgetting I'd remembered it already. These shards I took to friends and to doctor's appointments in case, otherwise, I would turn up, sit down and be speechless. With these shards, I could give them fragments of sense about the madness which engulfed me.

I never lost my insight, according to my doctor; never lost the overseeing part of the mind which charts the craziness of the other parts. Sometimes I had to use all my willpower and all the sternness of logic to support this insight. I wanted neither to overstate nor understate my psychological condition, and this accuracy seemed vital for two reasons. The first was medical, so that my doctor could assess medication and dosage, because the fluctuating nature of these episodes means that medication must also be fluctuating; alterations must be tailored as closely as possible to needs and moods which
are ever-changing. The second was a strong sense of the abstract relationship between truth and wellness. The truth will heal; lies will kill.

My notebooks have always been very precious to me and I travel with them wrapped, waterproofed, closer to me than my passport or money. They are footprints of my thoughts, tracks of journeys, curiosity-paths and desire-lines. I have never surrendered my notebooks to anyone to hold except once, in the Amazon, crossing difficult rivers on rickety bridges, when there was a real risk I'd lose my footing, so I gave my notebooks to my guides for safekeeping because their balance was surer than mine. Now, I felt I was giving not my notebooks but my psyche itself to my doctor for safekeeping
–please can you carry my mind for a while?
– because I'd lost my mental balance. I was scared I'd drop my psyche in this torrent, frightened I'd lose my mind downstream, but I knew he could hold it safe and give it back to me when I was able to look after it myself again.