My ramblings on antidepressants

Last fortnight, after 15 months of waiting for sertraline to kick in, I had a frank discussion with my doctor wherein I admitted to lying.

Since a work-induced near-nervous-breakdown some months ago, I had been put on some little white pills and, under the auspices of five GPs, two work counsellors, one professional mentor, one four-month women’s empowerment course and a CBT therapist, I hoped to feel an improvement in my mood stability. The dose was doubled, later tripled, and month by month, I turned up at the GP surgery and flicked through an array of increasingly well-thumbed magazines awaiting my turn to tell the lie.

‘Yes, I am fine, thank you.’ ‘My moods are much more stable now.’ ‘Life is getting better.’ ‘No nightmares, flashbacks or panic attacks.’ ‘No thoughts of self-harm or being better off dead.’ ‘Yes please, a two months supply.’

What was I doing?

Increasingly, a little voice inside me was tapping at my temples from the outside in, telling me that I was playing the game, and I that knew it. Then an even smaller voice admitted it was only doing so because I was afraid of telling my doctor the truth – these tablets were not helping and I was no different to how I was before I started them. Yes, there was initial euphoria – but that golden (or green) ticket I was first handed several months ago was, in fact, merely symbolic, some sort of placebo, although I hasten to add, a placebo which kicked me firmly up the backside and told me I needed to leave my job to stay sane.

On some level I knew, with steadying clarity, that this was about wanting to keep the conversation open. I didn’t want to be refused more medication. I didn’t want to be denied the right to come in for a monthly appointment to discuss my mental health. I didn’t want to be left to contend with this darkness on my own. If it I meant I had to keep taking these useless, bitter tablets day after day, for fifteen months or so, so be it. But at some point, I had to admit it was no better than taking nothing.

Why do people grin and bear it?

People prevaricate, particularly in a medical context; bright lights, cold hands and the sweet scent of chlorahexadine gluconate are barely a conversation starter, much less about the inner workings of the mind. I can’t speculate for the millions of others with similar mental heath problems, but for myself, I find it all too easy to conflate somethings-not-working with some sort of inner failure, as if in admitting so what I am really communicating is that I haven’t tried hard enough or that it is, after all, my responsibility, and that I deserve to have all forms of support withdrawn.

Anyway, I did it. Last week I began the gut-wrenching and brain-zapping (literally) process of dwindling my daily sertraline intake down to nothing. Then the two day washout period before trying another drug. Then a weekend in tears, violent laughter, anger, irritation, bemusement, and today, in complete silence. I can’t say it’s pleasant but I’m glad I’m getting somewhere.

In the throes of these confusing emotions, I thought I should compile my lessons learned (sorry if they don’t make sense):

  •  Mental health appointments aren’t meant to be a weigh-in. There should not be guilt or shame (nor should there be at weigh-ins, for that matter, but that’s another subject).
  • The fact that something isn’t working doesn’t preclude you from accessing and trying other forms of support.
  • It’s not for want of trying that these things don’t always work. If that’s what’s going on, you can say so. You can be as honest as you need to be.
  • If you can’t put your finger on what’s going wrong (or not right), sound it out with someone you trust – a partner or a best friend. Sometimes having this time to practise your speech can put you at ease and give you a sense of validation.
  • Mental health problems happen to everyone. It’s going to be a while before society gets comfortable with that taboo, but while we all have a brain, a past, confusing emotions and complex relationships, let’s not assume it’s going to go away. Being honest with ourselves and people close to us about the reality and impact of these problems might help pave the way to a more supportive immediate network and a more tolerant society. At least I hope so.

My ramblings on my partner’s anxiety

My partner is, hands down, the most afflicted anxious person I have ever known. Buying a packet of crisps or choosing a satsuma from a market stall are, for him, painstaking decisions. Life comes to an abrupt halt whilst he, daily, struggles against time to deliberate, hesitate and wonder.

Our sofa is a current mish-mash of notebooks, chewed biros, CBT worksheets, half-drunk cups of tea and tousled blankets. As I sit and await his return from an adrenaline-lowering power-walk, prompted by a  phone call, the chance of his having made a firm decision is slim; the compulsion to walk away from an opportunity in favour of the short-term gratification of relief is strong. I feel a ghost of optimism, a shadow of excitement, which is checked by memories and learnt pessimism as soon as it surfaces.

I ask myself how best to support him. Acknowledging his right to delay and his power to walk away when a decision becomes too much is important. Sometimes, though, I feel like our opportunities and chances stand like ghosts in the doorway.

They say you can’t love others until you first love yourself. In order to love and support my partner I have had to retrain my mind and reframe my expectations. I accept that it is challenging, but it is still a surprise. I find myself becoming emotional and worried about the seemingly immaterial. I have tried to become unfeeling about opportunities so that any disappointment slides past me painlessly.

Given my mental health problems, my partner knows where I draw the line on supporting him – I don’t want to have a short fuse with him because his problems are too close to home; it would be wrong for me to support him about something and damage myself, and he knows this.

But where can I draw the line? To be understanding is to know that no decision is easy. To be accepting of the need to walk away because of fear and doubt seems essential but also a kind of martyrdom. Who can say how much accepting I need to do and how much challenging I should be doing?

To be grateful, he is in a place where he recognises the extent of his anxiety and its ripple impact on others. I’ve known individuals to be blind or worse uncaring of the effect on others. He is also my best friend and the kindest man I know. The lows are low, the highs are very high, but we are able to laugh and to truly enjoy the little things in between, and that’s why I don’t give up.

My ramblings on an accidental walk

My foray into lifestyle minimalism was catalysed by a happy memory of an accidental hike in the Lakes with my partner.

On a warm, bright afternoon halfway through our holiday, we stopped in a supermarket, bought lunch, and made plans for a two-hour walk around Derwentwater. We had sandwiches in our backpacks and a rudimentary walking guide in hand. It’s funny, now, how our poor sense of direction meant the walk soon extended to a nine-hour hike through all sorts of weather and terrain, and how, fortuitously, a chance meeting with a seasoned walker atop a rainy hill may have literally been the only thing stopping us walking off the edge of a cliff. But for all we know, we had enlisted on a two-hour stroll and might visit a pub on the way home.

The day was resourcefully simple and memorably beautiful.

Yes, it was dangerous. Yes, we were muddy and, yes, by god I was tired. It was emotional, too – by turns we were groaning in misery as our legs stiffened up, quaking and clambering precariously down rapid descents, laughing hysterically when we had waited at the jetty and realised our state of boatlessness, crying furiously when, as a storm whipped around us in the eighth hour of our walk, my partner wanted to delay our return to take some photos. Not to mention we were assaulted by rain, sun, wind, sleet, mud, cloud, and sunburn.

My partner’s diabetes means we are never far away from the various artefacts of his condition. Armed in public with sweets and small cartons of emergency juice, we live under the rubble of insulin vials, clear plastic tubes, cannula kits, ketosticks, Roche manuals, faded pharmacy bags; the beep and whirr of his insulin pump is a sound I can now practically sing along to. I, myself, have limitations imposed by joint pain and fatigue caused by two long-term conditions and autoimmune disease. I have tendency to rely on taxi rides and hot baths to keep myself sane, and I know I can live over-cautiously.

Today was different. For a few long hours we were living according to the contents of our backpacks and a faded paper map which we still keep for posterity. Sitting halfway up a steep ascent, surrounded by sheep and molested by bleating goats, my sandwich was a reward and a treat. My bottle of water was something I rationed and cherished. My fleecy jumper was my lifeline. I was able to interact far more meaningfully with everything around me. I was liberated from my sense of personal limitations and countless distractions. All we had was each other, the frankly unreliable map, and a mediocre meal-deal sandwich. I had never felt more alive.

We were of course delighted to finally approach the Theatre by the Lake. I remember how, like the creatures which crawled out of the sea, we staggered, desperate and muddy, toward the light and warmth and the jingle of cutlery and murmur of interval discussions. We wolfed down olives and bread and hot tea with gratitude, and felt truly enveloped in privilege and luck and wonder as we stepped inside the warm glow and were able to change our shoes. As, later, we sat and ate a pizza in the torrential rain of Bowness, hair sticking to our faces and clothes covered in mud, I reflected that my nine-hour walk in the woods had been the best day of my life.

My ramblings on friendship

2016 was the year that I started to embrace lifestyle Minimalism, and it was probably because, unhappy in life, I was plucking at any type of straw to stop myself going crazy.

There is currently a plethora (somewhat paradoxically) of information and resources about minimalism: podcasts, websites, YouTube channels, blogs, books, magazines, and currently a documentary on Netflix. My personal (mis)adventure started with KonMari and rapidly evolved into my commitment to try the Minimalists Game. For several days and consecutive weeks, I was selectively downsizing my life, one item at a time, striving to find the magic moment where life felt good and everything just ‘clicked’.

It dawned on me that, for all the current whirlwind of writings about decluttering your cupboards, connecting with your belongings, embracing scarcity and approaching personal and spiritual growth, the paradigm didn’t extend to friendship – at least, not as ostentatiously.

For months, plagued by problematic friendships, I trawled Goodreads and libraries and sought recommendations for books about friendship. There were books about friendships; they were plentiful, but not right. These were the tales of giggly girls and worrisome women, shopping trips and sushi bars and sunshine days and cocktails – nothing practical, nothing useful, to console me that falling into disillusionment with certain friends was perfectly natural or perhaps even ordinary and, dare I say it, useful.

Ever one to blame myself, I used to carry a burden of responsibility on my shoulders that extended to every single friend or acquaintance or person to whom I felt otherwise obliged. At some point I realised how it was depleting me. I found myself promising through grimaces to certain friends that we’d meet for a coffee, responding with false enthusiasm to countless messages which a ballsier me would have ignored, spending time and money and energy and health on social opportunities which didn’t seem to be leading me anywhere I wanted to go.

The obvious thing would have been to realise that those friends wouldn’t have wanted to spend time with me if they had known how little I wanted to spend time with them. The humane thing might have been to be honest about how I was feeling then and there. The prophylactic thing would have been to be far more choosy with my friendships in the first place.

Be that as it may, I have come to realise that life is short and time is scarce. With so many wonderful people surrounding me, I am coming to decide that, if I can be frugal with money or selective with items in my house, it is not a massive stretch to be decisive about those with whom I spend my time and emotional energy. There are so many wonderful and beautiful people I know, and I want to ensure I can be my best self for them, instead of spreading myself too thinly.

My ramblings to my estranged parents

To my biological father,

It’s been very hard for me to grow up realising that it’s not my fault. Whether you meant it or not, I have been overshadowed by a sense that I have hurt you throughout my life and the guilt has followed me from place to place.

It’s only in recent years that I realise that it isn’t my fault and it can’t be. I have grown up feeling my own treachery in the pit of my stomach and tears stinging in the back of my eyes but it’s only now I see that it was mind games. I never did anything to warrant this feeling of guilt and it’s unthinkable anyway that a child could have done.

I am sorry that I had such an adverse response to you in the years following your separation from my biological mother; I remember wrapping the handles of cutlery with tissues (the first I would take would be the second from the box) and holding myself as far away from you as possible to avoid physical contact with your person. I remember the sense of contagion I felt sitting on your sofa and watching your television and if I am perfectly honest I don’t know if I would do any different now. But I am sorry nonetheless because I realise this was a profound statement to make as an 11 year old and I like to think of myself as the type of person to have a regard for the consequences of my actions and their impact on others.

People say that fathers fuck you up and I have been driven to the edge of sanity by you. Even after years and a harassment order I cannot sleep without you interrupting and violating my dreams. I cannot work or socialise the way my peers do because I fear your encroachment in waking hours and the phone calls or even your presence in my city. The feeling of being between sensations, not knowing if my reactions or emotions are right or wrong, haunts me more than any clear-cut recognition of a concrete feeling could. These thoughts have driven me to wondering whether my life should go on. They have undermined my concept of myself as a good honest person and as a person who deserves to live.

I want to tell you that many of the things you have done are unacceptable and that your ability to hurt and to maim people is sociopathic, maniacal and unforgivable. My mother, though I didn’t understand it in my childhood and I have a less than complete grasp of it now, was isolated by you and harassed and threatened and attacked and embarrassed and frightened. I don’t know what you did to your previous wives but I applaud them for escaping you especially in a culture where separation and divorce are unheard of. I have half-memories and confusions of you burning my hand and breaking my arm and invading my private space but I don’t have the capacity to ever understand or rationalise why a child could be deserving of this. The worst thing is that I keep pushing these memories away and trying to convince myself I have invented them.

Are you severely mentally ill? Do you really believe all the things you say about god and angels and my ‘sister’? The more hindsight I have about my childhood, the more I grow in conviction that you are either highly deluded or a manifestation of evil, the likes of which I have not seen in any human being, real or fictional, then or since.

It is hard for me to make a life without you because I have the humility and the respect for human life which does not permit me to draw clear lines of demarcation and gain closure between myself and those who hurt me. I wonder silently whether I am to blame or whether the episodes I encountered were my fault. I try to think of my father the human, as someone who once too had a dad, who went to school, worked hard, cared for family and friends, was endangered, was vulnerable, but I have never seen evidence of this man in my lifetime so it is hard to let those be my prevailing thoughts.

As you are an elderly father it crosses my mind whether you will pass away any time soon: you frequently held myself and my mother, and possibly others, ransom to the fact that you were soon to go ‘up there’. I wonder what kind of despicable person I am who would not communicate with their father, in the full knowledge that he is of old age and might never have the privilege of resting under my forgiveness. But I don’t think you want my forgiveness. I find it hard to imagine that you want anything other than to control me. To blackmail me and those around me, as you did with my ex and his father, my mother and her friends, my friends, to endanger and control and manipulate and violate and observe that to which you should lay no claim. It is my life and I intend to live it without fear and encroachment.

I hope you can fully comprehend what you have done. I hope you can understand that I live in the shadow of a fear so great I wonder if I will ever see a living relative again as long as I live and how hard it is to make it in the world as a traumatised woman. If there is a next life I hope you can get help and learn to live mindful of the fact of the fragility of human life, the vulnerability of children, and your responsibility (and boundaries) toward others.



To my biological mother,

In the contrast to the letter I wrote to my biological father, I am far more pained, I am embittered, and I am still often tearful over the horrendous physical and emotional blackmail and abuse and neglect and terror to which you subjected me.

Up until the age when I considered you my friend at the ripe old age of six, I was attached to you like no other child. Your beautiful face was a ray of sunshine which illuminated my life and your kindness was tangible and huge. I was proud of your beauty and youth and vitality and kindness and I was happy and felt safe in the warmth and comfort of your friendship. I felt protective of you and cried when I was far away from you. I felt happy and blessed to be with you. To this day I cry wondering what I did to deserve you and why it all had to change.

The difficulty of growing up is that my memory of you is a pendulum which swings between two, maybe three versions of you. The first and my favourite is this one which I have described, my beautiful youthful mother in leggings, heels and a baggy shirt at the door of my primary school, raven black hair blow-dried and pushed back against your sunglasses, smelling of leather handbags, peppermint gum and a faint sophisticated perfume.

This lady was soon replaced by a zombie-like mother who spent days and nights, weeks and months and eventually years lying, vegetative on the sofa and paralysed by depression and a never-ending headache. As though lobotomised I remember you lying transfixed by the television under blankets, always in aged greying pyjamas and forever insisting I refrain from conversing with you and go and do my homework.

The final and the longest serving memory I have of you is of the controller and shreiker and bully. I was, to you, from a young age, selfish, hateful, a trap, a punishment, a gift gone horribly wrong. You never allowed me my youth. I’m 26 now and I’m starting to feel youthful but it’s a little too late for me to regain my childhood.

What I did to you to deserve all this must have been my mere existence as an easy target. Not one for argument I was frequently the object of your throws, punches, catalogues, hot cups of tea, insults, threats, and I felt you were trying to squeeze the life out of me. When I was severely sick and I felt, on my deathbed, you ignored my cries for help and chose to glower at me in the doorway as though I were repugnant. When I burned my arm and my skin began to melt and slide off under the pressure of the cold tap you told me to switch the water off and not to go to hospital. When my school called you in to discuss my rapidly descending weight and the visible bones on my chest and the cuts on my arms you blamed my depression on myself and told them there was no compromise. Rather than the desired effect I felt punished for an intervention I had done everything in my power to avert. The names I have been called by you and the mockery still rings loudly in my ears and won’t go away. Did you realise when you said all those things I would carry them to my grave?

For all of the hateful, disgusting things you said and did to me when I was vulnerable in my care, the simple fact of your mockery of me after the day I attended my friend’s wake pulled me to consciousness that I would have to leave forever and there was no boundary you wouldn’t cross. Having lost your mother at a young age, I thought you would find more to ask me than what my friend’s dead body looked like, more comforting words to offer me than insisting I switch the light off and laughing at my evident fear and distress. Here we are today. That was the last day I saw you. I hope you have thought again since about what you said meant to me.

How on earth I survived living with you, I do not know. Every minute was pain. When I returned home from university, depression set in on me like a sickness, and I remember the feeling in the pit of my stomach that I was not wanted there other than as an object of your control and abuse.

I feel sorry for you. I don’t know how you managed to hurt me so much. I forgive you. I know somewhere you are a beautiful person. I hope you know I forgive you. I miss you, but not that version of you. I deserved more but I can’t get closure. I hope you can because I have learned to fear hurting other people more than anything else.

My ramblings on ‘Enduring Love’

I’ve had lots to think about since I sniffled and coughed through Ian McEwan’s Enduring Love, my energy levels ravaged by a particularly violent viral infection this month. It’s years since I first picked it up, but varied life-events and a budding interest in medicine since then have added richness to my understanding of it.

(NB I’m not writing this from the point of view of any well-versed book critic, psychologist or expert in trauma – these are just my underdeveloped musings on a book I have read whilst I’ve been ill.)

The plot unfolds at the point of a middle-aged man called Joe, an academic, and his partner becoming entangled (in his case, literally) in the events of a hot air balloon accident, prompting one of his fellow helpers to misconstrue a cursory glance as a deliberate look of love. This elicits a strange and damaging infatuation which destabilises Joe’s relationships and daily life. The man, Jed Parry, has De Clérambault’s Syndrome, as is both deduced by the protagonist and, later, revealed in a fictitious psychiatric report which forms part of the novel’s makeup.

With an interest in medicine and/in the arts, I was not struck most by the focus on Parry’s erotomaniac tendencies but another potential pathology running prior to this; the language of trauma and distress imbued in Joe’s early narrative. Post traumatic stress disorder is, as the name suggests, triggered by distressing events such as aggression, serious accidents, or warfare. Having experienced PTSD myself, it seems perfectly natural that witnessing a hot air balloon accident resulting in the death of one man and the near-loss of a small child could do the same.

Following a traumatic loss (and surrounding events) I experienced at university, my approach to my final degree examination over a year later was an exploration of trauma and bereavement theories, and I read countless clinical papers concerning the diagnosis and treatment of post traumatic stress disorder in preparation. Particularly useful as I examined my set texts on the Vietnam war, America’s southern states at the early twentieth-century and the psychogeography of New York, these papers also helped me to make sense of what was happening to me as, in that year I experienced one loss after another and was left with a visual torrent of nightmares, hallucinations and exhausting hypervigilance, alleviated through months of EMDR therapy, meditations and the support of countless friends.

The same language of PTSD seems to pervade the novel’s opening chapters, as I read in my final year examination texts and could trace back to my own responses to my own loss. A similar hypervigilance is constructed through recounting highly accurate details of the accident and an untimely knowledge of other characters predating Joe’s possible knowledge, betraying the constant rehearsal of facts pointing both to the indelible mark of the event on his brain and simultaneously the story well-practiced for the inquest following Dr Logan’s death. Later, the chapters demonstrate the well-known coping mechanism of delayed horror, otherwise the ‘denial’ phase of bereavement which allows the human brain to break down a bitter blow and experience its savagery over time, notably in Joe’s dissociation from his viewing of the corpse of Dr Logan, only to realise its full horror later. This, and many other PTSD-invoking choices, seem more than coincidental especially given Joe’s peripheral interest in scientific narrative.

This distressed language dissipates quickly, and by their own admission Joe and Clarissa seek solace in the balm of the quotidian: lecturing, researching, dining with friends etc, and our insight into their upset psychologies is from then on less intensely focussed on the accident. Perhaps the invocations of PTSD come to an end because of Joe’s preoccupation with Parry and his erotic fixation, or perhaps because Joe and Clarissa (unlike Parry) have been privileged with the stability of upbringing which allows them to bounce back psychologically and seek meaning in the mundane after such an event. As a non-psychologist and no expert in literature, I’m not sure which of these is true.

Either way, I found this a great read with psychological plausibility from the outset, or rather, it was meaningful to me. I’d have to think more before asserting with any confidence that this is a tale about trauma and the mind (indeed, I think this only surfaces in the first few chapters) but it’s certainly interesting what my personal experience of loss and my short foray into psychiatric papers did for my reading experience this time.