The Electric Slide

When the antidepressants haven't worked yet, and you haven't killed yourself yet, the options start to narrow. I mean, what's a guy to do when he has crossed the border into breakdown territory, when a wife's departure is the straw that broke the camel's back, when the cumulative weight of a lifetime has become more than he can bear? Electroconvulsive therapy, of course. ECT. The measure that some consider draconian. The undoing of Randle Patrick McMurphy.
It really is a measure of last resort because, well, it's pretty fucking inconvenient. Expensive, too. So I guess I should be thankful that I was able to afford it. It also fucks up your memory, so my reconstruction is necessarily somewhat patchy, but it's mine, and at no time have I ever felt as alone as when the wires were attached to my head and the anesthesia was injected. Counting down from 100, I considered that those might be my last utterances, and I could see them informing my mother, "We're sorry, but his last words were '100, 99, 98, 97...."
Now, if I remember correctly, there were seven treatments over two weeks. I remember the gurney, and the institutionally white walls. I had an invasive physical exam. I was treated like a child. I was accused of being a drug user because of my perforated septum. I was more exposed and vulnerable than at any other time, a denuded, lightning-struck tree buffeted by the elements and whose roots held only a tenuous grip on the ground. I stood outside and smoked, in the middle of March. The ides of march, when spring hadn't arrived and winter hadn't departed. A brackish season of windy transition that left me feeling even more desolate and bereft of any justification for existing. The translucent and twisting cigarette smoke floated ethereally until dispersed by the chilly breeze.
When one has to resort to being strapped down, anesthetized and electrified, the bright side of life, a locale I never inhabited, becomes that much more dim. It might be lonely at the top, but it's pretty lonely at the bottom, also.
I attended group-therapy sessions that seemed to be a way for them to soak me for more money, though perhaps I'm being too cynical. Mostly I sat with drug addicts. I played the piano and played ping-pong. I received visitors and cried. I looked at my comatose roommate, also in for some ECT, and thought, 'Well, I guess I'm not as bad off as that motherfucker.' I drank the institutional fruit drink and ate the institutional food and conversed with an elderly lady who was in for her maintenance ECT. Every five years. She highly recommended it. I read a book and later had to read it again, because I remembered nary a detail.
And I wrestled with the aftermath. Someone showed up at the hospital whom I didn't recognize, even though I had known him for years. Flashes of recollection peeked out from behind the shadows on my brain. I would think I knew someone at the 7-11 and then doubt that I did. But I thought that they knew me, that they saw through me for who I was. I needed about a year for my memory to recover. A sharp memory is both a blessing and a curse, but I was accustomed to retaining information easily.
ECT, nevertheless, perhaps saved my life, a stopgap measure that helped to provide a bridge to a more effective treatment regimen.
I swore I wouldn't do it again and, to date, I haven't. The trauma leaves a lasting impression, even 15 years later, and the medication has been enough to stave off the most imposing demons. They lurk, though, in pursuit of a crack through which to slip, reassuring me that there's no escape from my own charged brain.

Therapy

There exists what some people consider an alternative to antidepressants, and what other people would call an adjunct. I fall into the adjunct camp, because cognitive therapy alone didn't cut it, with any of the multiple therapists. I could have spent much less, but more productive, time in therapy had medication existed when I first started.
That was in high school. The school I attended had a psychiatrist from an Ivy League school come once a week. Now, I recognize that there's a difference between a psychiatrist and a psychologist, with the former primarily being concerned with the underlying physiology and drug dispensing and the latter with your thought process. The lines then, however, were more blurred then, since Prozac hadn't yet revolutionized treatment and made it easier on psychiatrists.
This guy had no empathy whatsoever. It was like I was speaking Greek. I was ready to jump off the library roof, and this guy was like, "Why would that bother you?" after I expressed a particular concern. If my thinking was in fact misguided, I thought that it should have been incumbent upon him to offer insight and perhaps remedial steps. No chance.
The next guy I saw was while I was in college. He was into diagrams.
Because you grew up without a father, your mother assumed this responsibility (circle overlapping circle). Because your mother had no husband, she turned to her sons to fulfill his responsibilities (more circles overlapping).
I felt like I was in math class. And understanding the situation didn't necessarily help with coping. Perhaps we would have gotten to that point, but my mother, who controlled the purse strings, called him up and told him I was behaving worse. To his credit, he wouldn't tell her anything, since he was treating me, not her, but she badgered me to such an extent that it was easier for me to stop going.
The next guy, whom I saw when I was out of college for a few years and in the working world, liked to talk a lot about himself. Not that I mind a therapist relating his own experiences to demonstrate similarities between those situations and my own, and also perhaps to offer potential coping mechanisms, but he ran on too long, and I was paying him. Toward the end of my time with this guy, I started to be more honest, since I hadn't really been candid with a therapist following the response I got to my candor from the guy in high school. It isn't easy to be honest when what you are conveying cast you (or so you think) in a negative light. Anyway, it was at this point that he told me that smart people sometimes don't do well in therapy because they can outsmart themselves. That is, they convince themselves, in a highly reasoned way, that A is the cause of B. But it might not be the case. So, to make any progress, you have to be honest and willing to accept that your perceptions might have been wrong all along. You probably wouldn't be in therapy in the first place if you didn't have a problem with those perceptions.
The next person, about five years later, became my enduring relationship. We were together about 10 years before she moved to a distant state. It took me about five years to decide I had the energy and could summon the candor to re-enter therapy. And sometimes I would go see her and tell her right off the bat that I didn't want to be there. There were, in fact, times that I didn't have the energy. Maybe that was my way of pushing her away. I had decided that I wanted a female perspective, but then I didn't want any perspective at all. But I persisted, and the medicine helped, and out of our honest exchanges arose a turning point. It was as simple as her telling me that she agreed with my assessment of a situation, when I had been so conditioned to think I was wrong. This was a woman telling me I was right. This was an entirely new situation. It may seem hard to believe that that was a turning point, but when you're conditioned from childhood to have no opinion other than your mother's opinion, it's only natural to fall into the same trap over and over. My mother didn't encourage independent thought. This therapist and I had our peaks and valleys. We tried EMDR, or Eye Movement Desensitization and Reprocessing, which involves watching dots of light move across a panel. The eye movement is supposed to facilitate the release of bad thoughts, as in you're letting them go. We did it here and there but I suspect never gave it enough attention. We did make some significant progress, the most pivotal being the adjustment of my thought process so that I didn't translate everything as potentially catastrophic. Self-talk. I talk to myself too much, and it's a constant struggle to overcome myself, so to obtain a tool that would help me toward that end was invaluable. It was worth the 10 years, but we eventually broke up. We were getting stale, anyway, familiar with one another, comfortable, but not making any real progress.
She left me in the care of a colleague, who I like but don't see anymore. She was pleasant to talk to, supportive, but maybe not tough enough on me. She's the one who referred me to the holistic-medicine practitioner and some Buddhist-like schools of thought, though she didn't try to push an agenda. To their credit, neither of my latter two therapists were opposed to medication. The two earliest probably wouldn't have been, either, but the pharmaceuticals then just weren't what they are now. And I probably wasn't conveying forcefully enough to them the distressI felt, anyway. The middle psychotherapist, the one who talked too much about himself, didn't seem to have a problem with drugs.
When I think about it now, there were earlier therapists of sorts, as well. Priests, I guess, who were the people to whom people like my mother turned. Ok, so that was misguided. And there were friends and friends' parents, and I cringe to think about how I must have come across as groping for something to fill a void, even though I was. All in all, therapy has been a good thing. It takes time and persistence to find the right match, though. And it takes energy and commitment and a willingness to feel vulnerable. Not an easy recipe for success. And sometimes it all seems so pretentious. Why should it matter if I'm depressed? There's a lot worse stuff going on in the world. There are people who say you shoudn't take medicine because when you hurt, that's when you're really feeling and really living. If that's living, then I don't want it. In the end, I have to live in my own head, and I'd rather make it tolerable. To that end, therapy helps, but the drugs are good, too.

Parakeet

If you go to Google, at least today, and start typing in why won, the autofill function that gives you possible search terms in the dropdown window, as your first choice, offers why wont my parakeet eat my diarrhea. So, let's speculate as to why, at the risk of sounding like a less-than-top-10 list:

Because he's full after draining your boil.
He's too preoccupied with his own diarrhea.
The dog beat him to it.
E. coli.
He's just starting to feel better since the last time he ate your diarrhea.
He wouldn't dream of depriving you.
Because you don't eat diarrhea, you drink it.

Courtship

Finding the appropriate antidepressant is like a courtship, you know, playing the field before you settle on one that works, looking for your pharmaceutical soul mate. You flirt with one, it seems great at the beginning, your heart races when you see that little amber bottle, you get that thrill when pop off the lid, you drink in the shape, you taste it as it settles on your tongue, bitter and foreign at first and then bitter and familiar, and you swallow, visualizing the path that medication traverses before it settles and starts to disseminate throughout your system. It infiltrates your pores. A chemical caress. You feel a warm glow. You feel safe. You start to look at the world in a novel way. You start to understand how people can make small talk. You wonder if that's how you're meant to feel, even though you're different from everything you've ever thought you were. But maybe who you have been hasn't been who you have been meant to be. Then the honeymoon ends, and your dance partner turns out to be different from how you thought it was. Imperfections arise, cracks in the facade. But you stick with it. It's what you know. You dabble with others, lured by the promise of something new, but you return to it. You can't escape its orbit. It's imperfect but nevertheless a balm of sorts.
Some of these relationships are bad from the start, and they make you wonder how you ever came to be involved in them in the first place. What was I thinking? You notice, but ignore, troublesome signs right from the beginning. You give it time. You persist even after you've overcome the illusion that it will work out. But eventually you come to your senses and return to the familiar, sometimes begrudgingly.
Other times, when the routine grows tired, you invite another pill to join in. A threesome, if you will. Then you open the door to your other mistress, a bottle of a different type, to further spice up the interaction. No jealousy. No obligations the next day. Kick any one of the components out at will. Not so simple, though, really. They're all demanding in their own right, not to be abused or regarded casually. Alas, there's no easy solution, but the magic bullet could be lurking right around the corner.