4
What, Me Depressed?
You’ll want to know when and you’ll want to know why.
When everyday pissiness gave way to ineluctable despair.
Why I tried, repeatedly, to fix it by killing myself.
The answer is I don’t know. Not to any half-satisfactory degree. Certainly not the second question. Not even the first, really. As much as I wind my mind back in time I’m unable to locate the start of a downward spiral. And every well-meaning therapeutic discussion I’ve had attempting to dredge childhood trauma proves futile and guilt-inducing. I’ve never been subject to anything awful enough to warrant this mind-swallowing badness. I have a supportive, loving family, had a happy childhood. I’m a very fortunate person. Only problem is, I hate myself and want to die.
Mental illness, strictly speaking, doesn’t run in my family. Are there people in my family a psychiatrist might diagnose with something like an anxiety disorder, if they got the opportunity? Probably.
And nothing prompts disclosures like one’s own very public, very ugly mental breakdown: One relative admitted to me shortly after my first suicide attempt her own bedridden-paralysis feeling; another told me about her anxiety, which she successfully kept at bay with tiny doses of a common antidepressant I wish worked that magic on me; another took antidepressants for years, although by now he’s taking such a wild combination of meds no one, his physicians included, has any idea what most of them do or how they work together.
But no one in my family has tried to kill herself; no one’s had a psychotic break. No one’s been hospitalized for psychiatric reasons. I’d call us neurotic in the casual, layperson sense but I can’t point to any pathological history that could give clues to my medical misery.
I don’t know where you’d mark my disorder’s germination: When I began to have trouble waking up? (Maybe two years before my first suicide attempt?) When I began to dread going in to work, the thing that gave—gives—my life purpose? (Maybe eighteen months before?) When the smothering sense of failure prompted sporadic suicidal fantasies? (A year?) When those fantasies became insistent, persistent, inescapable?
My mother goes much earlier, to my teenage years. “I don’t think it just came out of the blue,” she said some seven years after that first attempt. She recalls a teen who withdrew and stopped eating, just about, for years. Who wore a back brace for scoliosis that became painfully uncomfortable and made adolescent awkwardness excruciating. “So even though we weren’t maybe aware that what we were dealing with was depression, I think there were indicators. It seemed to me that you were dissatisfied with yourself from the time you were a teenager.”
I’ve never liked myself much, as a person, and what my psychiatrist calls my “negative cognitive bias” probably stretches back to childhood. But when did I lose my capacity for hope?
I know that the attempt, when it came, felt long overdue—an inevitable, necessary step I couldn’t keep putting off.
But I wouldn’t have called myself depressed. Not when I decided I had to die and felt that conviction grow in intensity over the course of a year; not when my failed attempt left me in a psych ward answering awkward questions about my state of mind. The subsuming despondence, the inescapable hopelessness and worthlessness, were matters of fact: I existed without worth or hope.
Months before that first suicide attempt, presciently worried colleagues propelled into action by self-threatening emails had dragged me to the psych emerg and browbeaten me into calling my newspaper’s employee assistance program. Which I did, and set up an appointment with a psychotherapist—for which I arrived, predictably, a half-hour late and which, predictably, I did not reschedule when the receptionist told me I’d arrived too late to see the therapist. I was relieved to have dropped the ball. Of course I couldn’t get treatment. My despair was a pit dug by my own failures, not a remediable medical condition.
I couldn’t believe my problem was extrinsic. I wanted to die because I was an idiot and could never improve, never move forward or do better—not because I was sick and therefore locked in a skewed perception of the world and myself within it.
It’s not just me. Again and again, people I’ve spoken to bring up their sense of isolation, that theirs is a personal flaw unique to themselves, not something faced by others, certainly not something fixable. Debilitation—that inability to get out of bed, to interact with people—fuels self-revulsion. I loathed myself for the endless stasis, projects unrealized and opportunities ungrasped. I felt I was expending all my energy on the most basic level of functioning and had nothing to show for it—just years of going through the motions. And the worse I felt, the less motivated I was to pursue treatments that felt ineffectual.
So I resisted diagnosis. Even when a trained medical professional with decades of clinical psychiatric experience sat across from me informing me I had major depressive disorder, I resisted. “You have depression” did not strike me as a plausible explanation for what I was going through.
5
When Diagnosis Makes You Crazy
At first I resisted diagnosis because being diagnosed as mentally disordered meant more time spent hospitalized against my will. Sitting perched on the short-term psych ward’s consult-room couch I was so close to freedom I could see it in the light sneaking through the hinges of the ward’s weighted grey auto-locking door and I knew I had to be the most well-adjusted, healthy-seeming post-suicide girl you’d ever seen. Of course I rejected diagnosis: in addition to believing my problems were of my own making, I believed that diagnosis would keep me hospitalized indefinitely.
And I resisted because no one wants to be designated crazy and all that comes with it: that litany of off-putting, erratic, socially unacceptable behaviours; to be deemed dangerous, disposed toward violence and harm, to freakish unpredictability. I didn’t want to be considered damaged, unhinged from reality. The patent ass-backwardness of those assumptions doesn’t ease their stranglehold on a society that minimizes the medical toll of mental illness while maximizing its fear of those affected.
But maybe most of all I disdained my diagnosis because depression’s a weak name for a serious disease. (I use “disease” and “illness” and “malady” as a layperson, more or less interchangeably in this book.)
You say “depression” and I think of Marvin the Paranoid Android. That endearing, hyper-intelligent robot from Douglas Adams’ The Hitchhiker’s Guide to the Galaxy boasts the buzzkill tagline, “I think you ought to know I’m feeling very depressed.” Marvin’s a capable, dour, smart-aleck machine who solves foolish human problems even as he rolls his eyes at those humans’ silly fallibility. He isn’t a knot of despair consumed by worthlessness and failure. Beneath my external nope-I’m-totally-fine-please-discharge-me denial, I kept thinking, That’s it? This emotional vacuum, this endless inescapable joyless negation of hope is just depression? Are you joking?
People profess depression all the time. Gloomy weather, inadequate investments in public transit, politically expedient xenophobia, the endangered status of a green-haired turtle that can breathe through its genitals1—they’re all “depressing.” It doesn’t help that it’s entirely possible to experience many of the symptoms of depression without being psychologically unwell: you can be anxious, you can doubt or reproach yourself, you can gain or lose weight, you can have trouble sleeping—and not have depression.
The official-sounding medical term, major depressive disorder, carries little extra gravitas, sounding more like the imaginings of a fanciful hypochondriac, not a genuine illness that does real harm. Surely, if what I had was a real disease and not simply justifiable despair at my own failure, it had to be something more serious.
One of psychiatry’s most persistent bogeymen, dating to the mid-twentieth century and the basis of a still-burgeoning antipsychiatry movement, is the fear of turning normal human emotions into disorders.
But here’s the thing: if the way I feel is just part of being human, for fuck’s sake g
ive me death. I cannot countenance the assertion that this hopeless chasm is simply an extreme on a spectrum of healthy emotion. It has no relation, however distant, to sadness. Sadness is a pain that reminds me I’m alive, that I’m an animal capable of emotion and a sense of loss. Despondence is the flat parched death of the soul. There’s nothing there.
My dad remembers diagnosis differently. Remembers me telling him, while I was in that psych ward, that I’d been told I had depression.
“Hearing you acknowledge that you were sick was a big turning point, a really big moment. Because it wasn’t a doctor telling us, it wasn’t [your mother] or I making that lay conclusion. It was you, I guess, taking ownership of your own health and of your own state. So we weren’t guardians of an unwilling individual anymore.
“By acknowledging you had an illness it was the first step you had to take to begin your process of recovery, I guess….I saw the antifreeze. I saw the empty bottle of sleeping pills. I saw the apartment in disarray. I saw you literally fighting for your life as they tried to get the poisons out of your body. I saw you hot and sweaty and suffering in that ICU bed for a day. I knew you were sick. But I guess I was hoping that a diagnosis would lead to some kind of a cure. There was hope for recovery because we knew what was wrong.”
It’s never been that simple.
If existing definitions are flawed, and diagnostic methods hit and miss, the names we assign mood disorders often feel like a smokescreen masking costly ignorance: we group symptoms and call them an illness because we don’t know how else to define the illness or address the symptoms.
This isn’t rocket science: rocket scientists know how rockets work. The best psychiatrists in the world know astonishingly little about how the brain functions on a good day, let alone how it becomes diseased and how to treat it when it does. They don’t know where depression comes from, or precisely how to map it in the brain, or why some interventions work, on some people, sometimes.
So where does that leave the diagnosed?
6
Killing Yourself Is Tougher Than You’d Think
As I moped in the nunnery-cum–psych ward following my first blue antifreeze–flavoured attempt, I told myself and the psychiatrists deciding whether I was sane enough to be set free that there was no danger of my trying again. That, having failed so blatantly, with such unpleasant (but extraordinarily fortuitous, under the circumstances) after-effects, even similar feelings of despair wouldn’t prompt me to attempt death again. That, effectively, I’d exhausted that option and was ready to move on to another, less lethal one.
I honestly believed this to be true. There’s nothing like marinating in the guilt and self-disgust of one’s botched suicide, wrapped in an ass-displaying blue hospital smock as earnest health workers monitor your blood pressure and probe your emotions, to convince you that you never want to try anything like that again.
But then you’re out and all the awful comes rushing back.
No one tells you that after trying to kill yourself and failing miserably, you don’t necessarily wake up in the ICU feeling awesome. No one tells you that, sometimes, you make it through two and a half weeks in two mental wards and back to the newsroom you love, only to be preoccupied with nothing so much as the wish you’d succeeded. Because everything that made you loathe yourself before is still there. Except now you’re the crazy freak who can’t even kill herself properly, who takes meds every morning that seem to do nothing, who’s been away from work for a month and returns to pitch stories to someone who found her passed out and overdosed in her apartment. Chasing your vocation’s a powerful protective factor. But being thrown back into it after an inpatient stay highlighted the agonizing delta between the person I perceived myself to be and the person I wanted to be.
I believe I wasn’t at an elevated risk of suicide in the immediate aftermath of my first attempt. The weeks and months following, however, were another story.
* * *
—
FOR THE RECORD, I didn’t really try to kill myself again for another year or so. I ducked down, powered through, tried to slough off the torpor that hijacked most days. Then, in the wake of another immobilized morning, steeped in shame at the electoral financing article I hadn’t filed, I tried to smash my bedroom window with my desk chair. My chair is a lovely solid wooden thing. The windows in my apartment don’t open—fruits of a compromise between the building’s developer and the owners of a rubber plant next door who worried about the effect their fumes would have on north-facing residents. But I figured I could shatter that double-paned window and leap out to my death seventeen storeys below.
This did not work. Real-life windows are strong. I am not. Action movies lie. After a few futile swings barely left a scratch, I gave up and swallowed a month’s worth of lithium, which I’d been prescribed at the time as an adjunct to antidepressants. Sat crouched by my bed, waiting for death and ignoring friends’ frenzied phone calls wondering why I’d been incommunicado all day. Similarly ineffectual: fewer than fifteen minutes later my gastrointestinal tract’s gag-reflex peristalsis betrayed me again. I was stuck sitting on my futon-couch, puke flecks studding my jeans, trying and failing to explain myself to my poor beloved friends who’d finally barged in.
I learned very quickly who was safe to confide in. Which friends would judge, flee, insist on calling my parents or the police. Which would listen, tell me they loved me, let me crash on their couch, without getting me in trouble. Maybe it’s unfair—to sometimes need someone to confide in while also needing that person to take no drastic action in response to that confidence. But, again and again, that’s where I found myself.
Then there were the asphyxiation attempts. I mutilated perfectly good plastic bags in my clumsy attempts to seal them airtight around my head with tape or elastic or knots only to realize I’d ripped holes in the motherfuckers. Following one such endeavour I bawled on a friend’s shoulder in the middle of the night on a bench in a bright-lit twenty-four-hour supermarket, picking bits of scotch tape out of my hair to a piped-in generic pop soundtrack.
I was a toxicological ignoramus with an illogical aversion to outright googling “ways to kill yourself at home without a gun or any weight-bearing structure to facilitate strangulatory ligatures.” So I’d do sidelong searches. “Toxic household chemicals.” “Fatal X overdose,” where X was whatever I was being prescribed at the time. I’d look up academic papers for lethal doses of whatever substances seemed easily obtainable and try to reverse-engineer blood concentration measurements to figure out how much of a given substance I’d need to ingest. I spent eternal minutes in the aisles of cavernous hardware stores, peering at warning labels and calculating how much I’d have to swallow, how quickly, how long it would take to work. Wondering if I looked as suspicious as I felt. I once bought a family-size pack of rat poison but couldn’t bring myself to down the piles of pink and blue pellets sealed in clear plastic packets like heteronormative baby-shower loot bags. I tossed a fistful into a glass of water to soak, as though I’d feel better about ingesting them in soggy pablum form. They sat there bloating on the kitchen counter for a couple of days before I dumped them out, washed the glass obsessively, pretended it never happened.
I tried paint thinner. Don’t try paint thinner. I managed to down barely a cup (okay, maybe a cup and a half) before the oily viscosity became too much.
I sat on my bed, looking out the window, trying to read Marjane Satrapi’s graphic memoir Persepolis for more than an hour before I admitted defeat. Wept, went for a walk. It sounds horrible to say this but the conviction that one can’t kill oneself despite wanting desperately to die is infinitely worse than the desire to die and the intention to follow through. Planning suicide at least gives you something to plan: once that’s gone and the inclination remains, you have nothing.
It’s from this abyss that I’d call a friend. Brendan, the first hapless mofo to answer the phone post–paint thinner, was covering a baseball game—could he call back? I wand
ered outside, bathed in evening light, palate coated with solvent. The fresh air reminded me I’d not eaten all day. Devoured whatever junk was in the fridge and the renewed gastric motility was enough to haul all that paint thinner back up. (There’s a lot of puking in this book. I know. I apologize. But, honestly: poisoning’s the leading method of suicide and suicide attempts among North American women. What were you expecting?)
Don’t try paint thinner. Even after expelling everything I could I was burping solvent all night and much of the following morning. Spent hours with sensory memory yanking me back to the wood-stained sea-unworthy rowboat my brother, my dad and I took out on ill-advised Gulf Island fishing expeditions when we were kids. All we ever caught was kelp and, once, a dogfish, but we more than made up for it with Rip-L chip consumption.
I made a point of disclosing all death assays to my psychiatrist—because what’s the point, really, of voluntary psychotherapy if you bullshit your way through it? He in turn was very tolerant of my continued efforts to undermine his Sisyphean work. He did ask, though, that out of courtesy I give him a head’s up when I bought toxic substances at the hardware store, rather than after ingesting and regurgitating them. I’m not sure this was helpful, however:
“Do you still have that jug of antifreeze in your closet?”
“Yeah.”
“After I told you to get rid of it?”
“Yeah.”
“Why?”
“It makes me feel better to have it around. Like, in case I need it.”
“…”
Technically, the paint-thinner incident resulted in my going to hospital but I tell myself it doesn’t count because I went of my own accord, as an outpatient and a horrible liar, after e-mailing my psychiatrist who urged me to call poison control. Which I did, the following morning, traces of solvent lingering at the back of my throat. The voice on the other end freaked me out by demanding my name and contact info, which makes sense if you want poison control to save your life but is terrifying if you just tried to kill yourself and don’t want anyone to find out and lock you up. The person urged me to get checked out in case the vomiting rerouted any solvent to my lungs where it would eat away at my alveoli, causing a fun kind of chemical pneumonia. I acquiesced, reluctantly. Partly because I was scared for my lungs but mostly because the poison control person now had my name and contact details and I was loath to get in trouble. I tried to appear nonchalant in hospital, which is hard to do when you’re waiting in emerg with the non-emerg patients, driven hypochondriac by the sniffles of others.
Hello I Want to Die Please Fix Me Page 5