by Ned Vizzini
“Great, excellent,” the guy had said. “You other people are out of a job! Heh heh. Learn comp sci.”
Please die right now, I mumbled in my head, where more and more activity was taking place. The Cycling had begun to develop, although it hadn’t hit hard, and I didn’t know quite what it was yet.
“Wall Street is fine,” I told Dad across the table. The restaurant we were at was one of the ones in Brooklyn that was featured in a Times article I had yet to read for current events. I didn’t think we could really afford it, so I didn’t get an appetizer.
The spinach and tuna mulled in my stomach. My whole body was tight. Why was I here? Why wasn’t I off somewhere studying?
Soldier, what is the problem?
I can’t eat this. I know I should be able to.
Get over it. Eat it.
I can’t.
You know why that is?
Why?
Because you’re wasting your time, soldier! There’s a reason the U.S. Army isn’t made up of potheads! You’re spending all your time at your little horn-dog friend’s house and when you get home you can’t do what you have to do!
I know. I don’t know how I can be so ambitious and so lazy at the same time.
I’ll tell you how, soldier. It’s because you’re not ambitious. You’re just lazy.
“I’ve got to be excused,” I told my parents, and I walked through the restaurant with that fast-walking gonna-throw-up gait—a run aching to get out—that I learned to perfect over the next year. I came to the chrome bathroom and let it go in the toilet. Afterward I sat, turned the light off, and pissed. I didn’t want to get up. What was wrong with me? Where did I lose it? I had to stop smoking pot. I had to stop hanging out with Aaron. I had to be a machine.
I didn’t get out of the bathroom until someone came and knocked.
When I went back to my parents, I told them: “I think I might be, y’know, depressed.”
twelve
The first doctor was Dr. Barney. He was fat and short and had a puckered and expressionless face like a very serious gnome.
“What’s the problem?” He leaned back in his small gray chair. It sounded like a callous way to put things, but the way he phrased it, so soft and concerned, I liked him.
“I think I have a serious depression.”
“Uh-huh.”
“It started last fall.”
“All right,” he took shorthand on the pad on his desk. Next to the pad was a cup that read Zyprexa, which I thought was the craziest-sounding medical name I’d ever heard. (It turned out to be a drug for psychotics, I wondered if maybe a psychotic person had called a doctor a “zyprexa” and that’s how they came up with the name.) Everything in Dr. Barney’s office was branded—the Post-it notes said Paxil on them; his pens were all for Prozac; the desk calendar had Zoloft on each page.
“I got into this high school, and I had every reason to be the happiest guy in the world,” I continued. “But I just started freaking out and feeling worse and worse.”
“Uh-huh. You completed your sheet, I see.”
“Yes.” I held up the sheet that they had given me in the waiting room. It was a standard sheet, apparently, that they gave all the new recruits at the Anthem Mental Health Center, the building in downtown Brooklyn where this brain evaluation was taking place. The sheet had a bunch of questions about emotions you had felt over the past two weeks and four checkboxes for each one. For example, Feelings of hopelessness and failure. Feeling difficulty with your appetite. Feeling that you are unable to cope with daily life. For each one, you could check 1) Never, 2) Some days, 3) Nearly every day, or 4) All the time.
I had run down the list, checking mostly threes and fours.
“They like to collect these sheets every time you come in, to see how you’re doing,” Dr. Barney con tinued, “but on yours right now there’s one item of concern that we should discuss.”
“Uh-huh?”
“ ‘Feeling suicidal or that you want to hurt yourself.’You checked ‘3) Nearly every day.’”
“Right, well, not trying to hurt myself. I wouldn’t cut myself or anything stupid. If I wanted to do it, I would just do it.”
“Suicide.”
It felt strange to hear. “Right.”
“Do you have a plan?”
“Brooklyn Bridge.”
“You’d jump off the Brooklyn Bridge.”
I nodded. “I’m familiar with it.”
“How long have you had feelings like that, Craig?”
“Since last year, mostly.”
“What about before then?”
“Well . . . I’ve had them for years. Just less intense. I thought they were, you know, just part of growing up.”
“Suicidal feelings.”
I nodded.
Dr. Barney stared at me, his lips puckered. What was he so serious about? Who hasn’t thought about killing themselves, as a kid? How can you grow up in this world and not think about it? It’s an option taken by a lot of successful people: Ernest Hemingway, Socrates, Jesus. Even before high school, I thought that it would be a cool thing to do if I ever got really famous. If I kept making my maps, for instance, and some art collector came across them and decided to make them worth hundreds of thousands of dollars, if I killed myself at the height of that, they’d be worth millions of dollars, and I wouldn’t be responsible for them anymore. I’d have left behind something that spoke for itself, like the Brooklyn Bridge.
“I thought . . . you haven’t really lived until you’ve contemplated suicide,” I said. “I thought like it would be good to have a reset switch, like on the video games, to start again and see if you could go a different way.”
Dr. Barney said, “It sounds as if you’ve been battling this depression for a long time.”
I stopped. No I hadn’t. . .Yes I had.
Dr. Barney said nothing.
Then he said, “You have a flat affect.”
“What’s that?”
“You’re not expressing a lot of emotion about these things.”
“Oh. Well. They’re too big.”
“I see. Let’s talk a little about your family.”
“Mom designs postcards; Dad works in health insurance,” I said.
“They’re together?”
“Yes.”
“Any brothers or sisters?”
“One sister. Younger. Sarah. She’s worried about me.”
“How so?”
“She’s always asking me whether I’m good or bad, and when I tell her I’m bad she says, ‘Craig, please get better, everyone is trying.’Things like that. It breaks my heart.”
“But she cares.”
“Yeah.”
“Your family supports you coming here?”
“When I told them about it they didn’t waste any time. They say it’s a chemical imbalance, and if I get the right drugs for it, I’ll be fine.” I looked around the office at the names of the right drugs. If I got prescribed every drug that Dr. Barney repped, I’d be like an old man counting out pills every morning.
“You’re in high school, correct?”
“Yes.”
“And your sister?”
“Fourth grade.”
“You realize there are a lot of parental consent forms that need to be filled out for us to help you—”
“They’ll sign everything. They want me to get better.”
“Supportive family environment,” Dr. Booth scratched on his pad. He turned and gave his version of a smile, which was a slight affirmative, the lips barely curled, the lower lip out in front.
“We’re going to get through this, Craig. Now, from a personal standpoint, why do you think you have this depression?”
“I can’t compete at school,” I said. “All the other kids are too much smarter.”
“What’s the name of your high school?”
“Executive Pre-Professional High School.”
“Right. I’ve heard of it. Lots of homework.”
“Yeah. When I come home from school, I know I have all this work to do, but then my head starts the Cycling.”
“The Cycling.’”
“Going over the same thoughts over and over. When my thoughts race against each other in a circle.”
“Suicidal thoughts?”
“No, just thoughts of what I have to do. Homework. And it comes up to my brain and I look at it and think ‘I’m not going to be able to do that’and then it cycles back down and the next one comes up. And then things come up like ‘You should be doing more extracurricular activities’because I should, I don’t do near enough, and that gets pushed down and it’s replaced with the big one: ‘What college are you going to, Craig?’which is like the doomsday question because I’m not going to get into a good one.”
“What would a good one be?”
“Harvard. Yale. Duh.”
“Uh-huh.”
“And then the thoughts keep turning and I lie down on my bed and think them. And I used to not be able to lie down anywhere; I used to always be up doing something, but once the Cycling starts I can waste hours, just lying and looking at the ceiling, and time goes slowly and really fast at the same time—and then it’s midnight and I have to go to sleep because no matter what I do, I have to be at school the next day. I can’t let them know what’s happening to me.”
“Do you have difficulty sleeping?”
“Sometimes not. When I do it’s bad, though. I lie there thinking about how everything I’ve done is a failure, death and failure, and there’s no hope for me except being homeless, because I’m never going to be able to hold a job because everyone else is so much smarter.”
“But they’re not all, are they, Craig? Some of them have to be not as smart as you.”
“Well, those are the ones who I don’t have to worry about! But plenty of people are, and they’re going to kick my ass everywhere. Like my friend Aaron—”
“Who’s that?”
“My best friend. He has a girlfriend too, who I’m friends with.”
“How do you feel about her?”
“Not so much . . . one way or the other.”
“Uh-huh.” Dr. Barney wrote on his pad.
“Anyway . . ."I tried to sum up. I was lying to this guy; that meant we really knew each other. “It’s all about living a sustainable life. I don’t think I’m going to be able to have one.”
“A sustainable life.”
“That’s right, with a real job and a real house and everything.”
“And a family?”
“Of course! You have to have that. What kind of success are you if you don’t have that?”
“Uh-huh.”
“So to have that I have to start shaping up now, but I can’t because of this crap that’s going on in my head. And I know that these things I’m thinking don’t make sense and I think ‘Stop!’”
“But you can’t stop.”
“I can’t stop.”
“Well.” He tapped his Prozac pen. “You know that your thoughts aren’t thoughts you want to have. That’s a good thing.”
“Yeah.”
“Do you ever hear voices?”
Uh-oh. Now we were getting into the real meat. Dr. Barney was cuddly enough, but I was sure that if you gave him a straitjacket he’d be able to handle it just fine, coaxing you into it and leading you to a very comfortable room with soft walls and a bench where you could sit looking at a one-way mirror and telling people you were Scrooge McDuck. (How did they make one-way mirrors, anyway?) I knew I had problems, but I also knew I wasn’t crazy. I wasn’t schizo. I didn’t hear voices. Well, I heard that one voice, the army guy, but that was my voice, just me trying to motivate myself. I was not going to get thrown in the loony bin.
“No voices,” I said. Lied, technically. Lied again.
“Craig, do you know about brain chemistry?”
I nodded. I’d skipped ahead in the bio textbook.
“Do you know how depression works?”
“Yeah.” It was a simple explanation. “You have these chemicals in your brain that carry messages from each brain cell to the next brain cell. They’re called neurotransmitters. And one of them is serotonin.”
“Excellent.”
“Which scientists think is the neurotransmitter related to depression … If you have a lack of this chemical in your system, you can start to get depressed.”
Dr. Barney nodded.
“Now,” I kept on, “after the serotonin passes a message from one brain cell to the next, it gets sucked back into the first brain cell to be used again. But the problem is sometimes your brain cells do too much sucking"—I chuckled—"and they don’t leave enough serotonin in your system to carry the messages. So they have these drugs called selective serotonin reuptake inhibitors that keep your brain from taking too much serotonin back to get more of it in your system. So you feel better.”
“Craig, excellent! You know a lot. We’re going to put you on medication that is going to do just that.”
“Great.”
“Before I write a prescription, do you have any questions for me?”
Sure I did. Dr. Barney looked happy. He had a nice gold ring and shiny glasses.
“How’d you get started in this?” I asked. “I’m always interested to know how people got started.”
He leaned forward, his paunch disappearing in his shadow. He had huge gray eyebrows and a somber face.
“After college, I went through my own shit and decided that all the physical suffering in the world couldn’t compare to mental anguish,” he said. “And when I got myself cleared up, I decided to help other people.”
“You got yours cleared up?”
“I did.”
“What did you have?”
He sighed. “What you have.”
“Yeah?”
“To a tee.”
I leaned forward—our faces were two feet away from one another. “How did you fix it?” I begged.
He tilted the side of his mouth up. “Same way you will. On my own.”
What? What kind of answer was that? I scowled at him. I was here for help; I wasn’t here to figure this out on my own; if I wanted to figure it out on my own I’d be taking a bus tour of Mexico—
“We’re going to start you on Zoloft,” Dr. Barney said.
O-ho?
“It’s a great medication; helps a lot of people. It’s an SSRI, it’s going to affect the serotonin in your brain like you said, but you can’t expect an instant effect because it takes weeks to get into your system.”
“Weeks?”
“Three to four weeks.”
“Isn’t there a fast-acting version?”
“You take the Zoloft with food, once a day. We’ll start you on fifty milligrams. The pills make you feel dizzy, but that’s the only side effect, except for sexual side effects.” Dr. Barney looked up from his pad. “Are you sexually active?”
Ha ha ha ha ha ha ha. “No.”
“All right. Also, Craig: I think that you would benefit from seeing someone.”
“I know! Don’t think I haven’t tried. I’m not really good at talking to girls.”
“Girls? No. I meant therapists. You should start seeing a therapist.”
“What about you?”
“I’m a psychopharmacologist. I refer you to the therapists.”
What a racket. “Okay.”
“Let’s take a look for one.” He opened up what looked like the white pages on his desk and started rattling off names and addresses to me as if they made a difference. Dr. Abrams in Brooklyn, Dr. Fieldstone in Manhattan, Dr. Bok in Manhattan … I thought Dr. Bok was a cool name, so we set up an appointment with him—I missed it, though, because later in the week I was doing a history assignment, and I was so embarrassed that I didn’t call to cancel with Dr. Bok that I never went to see him again. The next time with Dr. Barney we had to pick another shrink, and then another, and then another, among them the little old lady who asked if I had been sexuall
y abused and the beautiful redhead who asked why I had so many problems with women and the man with the handlebar mustache who suggested hypnosis. It was like I was dating, except I didn’t get to make out with any of the girls—and I was also bi because I met up with guys.
“I like talking to you,” I told Dr. Barney.
“Well, you’ll be seeing me in a month, to check up on how the medication is treating you.”
“You don’t do therapy?”
“The other doctors are great, Craig; they’ll help.”
Dr. Barney stood up—he was about five-foot-five—and shook my hand with a soft, meaty grip. He handed me the Zoloft prescription and instructed me to get it right away, which I did, even before taking the subway home.
thirteen
The Zoloft worked, and it didn’t take weeks—it worked as soon as I took it that first day. I don’t know how, but suddenly I felt good about my life— what the hell? I was a kid; I had plenty more to do; I’d been through some crap but I was learning from it. These pills were going to bring me back to my old self, able to tackle everything, functional and efficient. I’d be talking to girls in school and telling them that I was messed up, that I had had problems but that I’d dealt with them, and they’d think I was brave and sexy and ask me to call them.
It must have been a placebo effect, but it was a great placebo effect. If placebo effects were this good, they should just make placebos the way to treat depression—maybe that’s what they did; maybe Zoloft was cornstarch. My brain said yes I am back and I thought the whole thing was over.
This was my first experience with a Fake Shift. Dastardly stuff—you do well on a test; you make a girl laugh; you have a particularly lower-body-simmering experience after talking online and rushing to the bathroom; you think it’s all over. That just makes it worse when you wake up the next day and it’s back with a vengeance to show you who’s boss.
“I feel great!” I told Mom when I got home.
“What did the doctor say?”
“I’m on Zoloft!” I showed her the bottle.
“Huh. A lot of people at my office take this.”
“I think it’s working!”
“It can’t be working already, honey. Calm down.”