Bloodletting (17 page)

Dr P was the seventh psychiatrist I’d visited, so I didn’t walk into his rooms expecting miracles. Nevertheless, a tiny part of me thought that maybe, just maybe, there was something that everyone else had missed.

Could I just take a pill and make it all go away? Was it that easy? No, no, it wasn’t. I’d been given antipsychotics before and they didn’t stop anything. They just made me very tired—too tired to want to cut myself.That wasn’t a long-term solution. Besides, I wasn’t psychotic. It felt like madness certainly, but I knew it wasn’t.

But what is madness, if not being able to control your own mind?

If there were a cure, then there would be chapters in textbooks, and articles in journals. The medical professional would know about it and I wouldn’t have spent ten years ricocheting around, from doctor to doctor, place to place, trying to escape it.

As I sat in the waiting room and watched the wall clock tick over, I contemplated walking out.The appointment had been scheduled for 10 am, and it was now nearly half-past.What if, like everyone else, he couldn’t do anything and I was condemned? I didn’t know if I could cope with being told that. It was almost easier not to know, and so still be able to hope.

I made an effort to hold back tears.

Finally, Dr P opened the door and asked me to come in. He was tall, with short, prematurely grey hair. Reassuringly, he was wearing ablack suit and T-shirt—perhaps he really wasn’t going to be like the others. Before he even had time to introduce himself, I started to cry. He offered me the box of tissues from the coffee table in the centre of the room, then waited for me to calm down. He wasn’t in any hurry.

After a few minutes, the sobbing subsided and I was able to breathe normally. I looked around the room, which was tastefully decorated in shades of red and green with dark wooden furniture.A large window looked out onto a garden. He was the first psychiatrist I’d visited who actually had a couch. I’d chosen to sit on the edge of an armchair opposite it. I had developed a habit of sitting on the edge of furniture, as though poised for a quick escape. He asked me what I was smiling at.

The couch,I told him.It seemed so,so New York,so Woody Allen.

He told me it had been there when he arrived, and then he changed the subject. He wanted to know about me—and what I was doing there.

I told him. I told him about the images, and the urges, about the hospitals, the bouts of depression, the alcohol, the eating problems, and the moving.As I talked I became more and more despondent,more convinced that he couldn’t help.All psychiatrists were the same: what had I been thinking?

‘Do you actually want to be helped? You don’t seem to want to be here,’ he asked.

That wasn’t fair.‘It’s not that—well it is, in a way. I’ve just seen so many doctors, shrinks, registrars, you name it, and none of them have been able to help. I’ve just had it, and I don’t know what to do anymore.’ I clenched my jaws so I didn’t start crying again.

He nodded and then looked at me over the top of his glasses. ‘I think I can help you but you’ll have to cooperate, otherwise there’s nothing I can do. We’d both be wasting our time.’ He looked at his file notes,‘You’re what,31? And you’ve been having problems,of one sort or another, for at least fifteen years. If you don’t do something now, you’ll suddenly find that you’ve reached 40 and nothing will have changed.’

What he said was true.‘I don’t want that,’ I said quietly.

‘Then we need to work together to ensure that doesn’t happen. There’s an excellent clinic about five minutes from here.’

He made it sound like a restaurant. If I agreed, people would know I wasn’t well, and, as it had happened before, they’d assume it would happen again. And again. I had managed to stay out of mental hospitals for three and a half years now. Besides, I had a job, I paid my bills, I cooked myself dinner. I was functioning well. Psychiatric hospitals were for those suffering from psychiatric problems. Despite sitting in a psychiatrist’s rooms, despite admitting that I couldn’t cope with the images in my head and that I wanted to drive my car into a brick wall, I didn’t see myself as mentally ill.

He tried to reassure me. It wasn’t a public hospital but a private clinic, it had world-class intensive treatment programs, and it was extremely comfortable.Why didn’t I just pop round and have a look at it after our appointment? If I didn’t like it then I didn’t have to stay there. He just thought it would be the best thing for me at the moment—and there was a CBT course they ran that would be good for me.

The referring doctor had mentioned CBT as well. I asked him what it was, and he filled me in.

The theory behind CBT, or cognitive behavioural therapy, is simple: your thinking and your underlying beliefs—which you might not even be aware of—can affect your mental health. They can actually make you sick. CBT is apparently particularly useful for treating eating disorders, depression, anxiety disorders and obsessive-compulsive disorders. A real benefit is that the patient can start making changes immediately, and going over traumatic events or relationships isn’t necessary. Sometimes there is no one thing that makes a person behave in a certain way. I certainly couldn’t think of anything that made me the way I was, and had never been able to. It had always bothered me, and I had somehow felt that discovering the trigger for my behaviour would provide the cure.This was, apparently, a long way from the truth.

Dr P then suggested that I start on a course of antidepressants. The Tegretol wasn’t enough, it only took out the peaks and troughs, and though it probably meant that I wasn’t as bad as I could have been, it wasn’t an antidepressant.

I put my foot down.‘I can’t.’ My medication phobia had returned to the extent that I couldn’t even take the anti-inflammatories prescribed for the pain in my neck. It was ironic: I was thinking about carving up my arms or writing myself off in a car but was nervous about side effects caused by medication.‘Besides,’ I told him,‘I’m not depressed’. And I didn’t believe I was. Unhappy, yes; depressed, no.

He didn’t argue but told me an antidepressant would be useful. There were many different kinds to choose from now, but there was one particular sort, Cipramil, that he thought I’d respond well to. It had very few side effects, though he suggested that I not read the accompanying leaflet.

We reached a compromise. I’d look at the clinic, and, if I didn’t think it was too awful, would check in the next day and start on the CBT program on Monday.The alternative was to stay at home, and at work, and see him once a week. But I knew that it wasn’t a realistic option—besides, an intensive course would kick-start the therapy process. Once in the clinic, he’d start me on a very low dose of Cipramil, which would be gradually increased until I reached what he called a therapeutic dose.

After ensuring that a bed was, in fact, available, he gave me the address of the clinic.

As I was walking out I said to him,‘Do you know what I’m really terrified of? The wrong side winning.It’s as though my mind has split in two and I have no control over it. And the thing is, I’m beginning to get confused about which side is right and which is wrong.’

‘That’s why I think that you really should be in hospital for a bit, and the CBT will really help,’ he said.‘Trust me.You might not feel as though you have any control now, but you have a lot more than you think.’

I’d told my boss that I had ‘women’s problems’ and would be away for a couple of weeks. It wasn’t really a lie, I did have problems and I was a woman after all. It also meant that everyone was too embarrassed to ask any more questions.

Once, I’d been able to use my job—whatever, wherever, it was—as a defence against any intrusive and violent thoughts. I couldn’t any longer, so it was better not to be in the office at all. I’d already spent weeks just staring at my computer screen, or rearranging increasingly large piles of papers. I’d put off as many decisions as possible, not because I didn’t trust my judgment, but because I just couldn’t make them. Everything, even simple things, was too difficult. I’d avoided speaking to my colleagues where possible, and left notes for my assistant. Phone calls and emails had gone unanswered.And it was only a matter of time before someone else noticed that I wasn’t coping—and what then? The thought of people discovering that there was something wrong terrified me. So far, I’d always been able to keep my problems out of my professional life.

Annie and Charles were sympathetic when I told them I was going in to the clinic for a short stay. A couple of weeks, I said. I didn’t tell them what the matter was, only that I wasn’t feeling well. I couldn’t tell them about the thoughts or the urge to hurt myself, as I didn’t want to upset them. They had been so kind to me, and, somehow, it felt like I’d let them down.

Melissa, who was now Archie’s wife and my sister-in-law, was shocked when she heard. ‘I’ll come over,’ she said immediately. ‘This isn’t something you should go through alone.’

‘I’ll be fine,’ I told her. I said she needn’t worry, it was a long way to come.‘I’ll be fine,’ I repeated, as I had so many times before.

‘Vic, you’re not fine,’she said.‘You wouldn’t be being admitted to a psychiatric hospital if you were.’ Her parents lived in Perth, it was a good opportunity to visit them too, she could catch up with friends— it wouldn’t be a problem at all.

Suddenly I did want her to be there. I didn’t want to go through it alone, yet again. It felt uncomfortable, but I struggled against the feeling, and said,‘Actually, that’d be great’.

Melissa had suffered from chronic fatigue syndrome several years earlier: was this why she seemed to understand what I was going through? Perhaps it was a bond, that feeling of being judged by so many as a malingerer, or of not trying. She knew what it was like to suffer from something that others didn’t see, and that some didn’t even believe in.

She said she’d organise a flight and be over in a few days.

After I put down the phone, I realised that this was what I’d been missing for years—a family member who didn’t judge me, who simply wanted to be there. Friends had always been wonderful, but as I’d got older I’d stopped relying on them and increasingly kept silent. It wasn’t fair to lean on them, time and time again—they had their own lives to lead and, now, their own families or partners. Also, there was that niggling feeling that I should have‘this’,whatever ‘this’was,sorted out by now.

I hadn’t acknowledged until that moment how difficult it had been over the last few years, keeping it all to myself. At least, when I’d been openly sick, I could talk about it openly. Pretending to be well had made things so much worse.

‘Comfortable’ was an understatement when it came to describing the clinic.A two-storey red brick building,it had a neat garden at the front with a fountain in the middle. It was what I imagined an exclusive health resort would be like, although, as I quickly discovered, there were no swimming pools, saunas or tennis courts. What I particularly liked was that it didn’t feel like a hospital, and none of the patients were locked in.

My room wasn’t large but had its own bathroom, television and desk under a window looking out over the street.There was an information sheet on the desk with details about the washing machines, the meal times and the video library.

That first night I went to bed at nine, after nervously taking my first dose of antidepressants in some time. I rationalised it: if something went wrong, I was at least in a hospital.

Although the room was quiet and the bed wasn’t too hard, it was difficult to sleep. There was a plastic sheet over the mattress, which meant that it was impossible not to sweat, and the nurse shone a torch in at eleven and asked if I was awake. For the first few days I was indeed awake every time.Wide awake at eleven, and one, and three. I couldn’t sleep but refused to take any sleeping pills—it was difficult enough to agree to the Cipramil, let alone something else. Besides, they weren’t a habit I wanted to get into and there had to be a point at which I’d get so tired that I’d just have to sleep.

After a week I was indeed sleeping soundly but yawning constantly in the morning, at lunchtime, in the afternoon, and even while I was in bed at night. Eventually, I worked out that the yawning wasn’t anything to do with tiredness, but was a side effect of the medication. If this was to be the only one, I thought, then I wasn’t doing too badly.