The drugs don’t work

Zoloft for depression

Three decades ago, in the mid-90s, my friend and I managed to get our hands on a prescription for Prozac. A single box, I don’t remember how. We were giddy with excitement, sweaty-palmed and flushed-faced, and trying to arrange our features in a suitably sombre/casual expression as we handed the script over to the pharmacist; we had a whole elaborate backstory ready to deliver if challenged – but nobody paid us any attention. The reason being – apart from a slightly liberal attitude to the dispensing of drugs – that a single box of Prozac, even in the hands of impressionable and rebellious teenagers, could do no harm. No harm and equally no good. It was the stuff of legends, pain-ridden songs and cult movies and cutting-edge literature; it was the wonderdrug that defined our generation – Generation X, generation Prozac Nation – but it wasn’t a drug in the sense that we imagined, and a single box of Prozac, especially split two ways, could have absolutely no discernible effect on our psyche. We split it, regardless, and swallowed a couple of pills.
    Perhaps we thought we were depressed, perhaps we aspired to be: depressed was synonymous to interesting, in those days, and a happy disposition clearly meant you hadn’t understood how heavy a burden this life truly was. We idolised the troubled souls of the grunge and indie rock music scene, and our own souls were reared on complicated emotions that we weren’t yet ready to understand, but we knew all the lyrics by heart, anyway, and the pain we felt was real enough as we sang them, as we swayed clumsily in damp, sticky nightclubs. When Kurt Cobain killed himself, we mourned him as a hero; nevermind the example he set, nevermind the wife and daughter he left behind: that devastated, heroin-chic look was made for Courtney Love. She was a style icon to many of us, nevermind that she was actually a junkie. There was glamour in that, the dark lure of really terrible lifestyle choices, scary-attractive, because the world was fucked up anyway and, as Cobain put it in his suicide note: “it’s better to burn out than to fade away”. Also: Trainspotting. Also: Pulp Fiction. I mean, come on.
    While all this was taking place in LA and Seattle and the mean streets of Manchester, in middle class Athens we had to make do with warm vodka and orange, cans of Heineken, and rumours of ecstasy tabs with the original smiley face stamped on. We gathered in parks and smoked Marlboro Reds and bad weed that made us throw up in the bushes. While teenagers in the enlightened land of America had therapy to deal with their existential angst, we had curfews. While they bravely bared their souls and got prescribed antidepressants, we got a slap around the face and told it was our hormones. Nobody understood and it was all so unfair. So to get our hands on an actual box of Prozac was really something. It would have been better, of course, to be prescribed the thing, to have a professional acknowledge our pain, legitimise it with his signature, but failing that, fuck it, we would self-medicate. So we took a couple of pills each, and told each other we felt changed. And, being slightly nerdy rebels, we had studied the enclosed leaflet of side effects, and reported a few of those, too. Our serotonin levels, I am certain, remained blissfully unaware.
    The point is, as The Verve sang over and over again and nobody listened, the drugs don’t work. Not the way we imagine. Not the way popping an ecstasy tab works, or even drinking a cup of coffee. They do work, but in their own, slow time, and there is nothing you can do to rush them. What I found out, three decades after swallowing 40 mg of fluoxetine and expecting it to change my life, is that when you’re prescribed antidepressants, you are also prescribed patience. And if you’ve ever been depressed, you know that patience is one of those virtues you don’t have a lot of. When you come to a psychiatrist begging to be saved, when you submit to taking a pill to make you feel like yourself again, even though that sounds inherently, fundamentally wrong, you do not want to wait. It’s a fucker. But then again, no one – except teenagers in the 90s – said depression would be fun.
    My teenage self would be delighted: she’s finally had her wish. Three decades on, I have been prescribed antidepressants; I have been found, legitimately, in need of medication. Funny that I don’t share her joy. Not funny, no: I can’t find joy in anything, hence the drugs. But I’ll admit, there was an echo of her when the doctor told me I’d be taking Zoloft, and I felt a tinge of disappointment that it wasn’t Prozac. I allowed myself a small, ironic smile at the thought, before it fluttered away to be replaced by the thump of gravity: this is serious. But I am grateful, really – or I would be, if I could access that function (time; patience). I am grateful that it isn’t more serious, and that Prozac – shimmering magical wonderdrug – isn’t called for, because Prozac is a much stronger medication, whereas Zoloft, I am assured, is just like taking painkillers for a headache.
    If the headache were a black, swirling void that kept growing until it swallowed you whole. And the painkillers took two weeks to work.
    I have been prescribed patience, and 50 mg of sertraline daily. This is day seven, and it’s clearly a case of things getting worse before they get better. I didn’t read the side effects this time. Being depression’s plaything is hard enough; I have no interest in adding hypochondria to the mix. My survival instincts may be dulled, but they are still capable of sidestepping a trap as giant as that one. But experience quickly makes up for lack of knowledge, and it seems depression is just as eager to survive, if not more. It’s come under attack, and it is fucking angry. It would amuse me, if that function were available to me, to imagine the battle taking place inside my brain, depression growing darker and thicker and more monstrous and roaring with rage as the noble (if unsung) Zoloft builds its army of sertraline soldiers, one 50 mg dose at a time. It would amuse me, if it weren’t for the devastation it causes. But the landscape of depression is actually very mundane, and I won’t bother describing it. Suffice to say, yesterday I congratulated myself for putting on clothes.
    The drugs don’t work – until they do. And it is slow, it is relentlessly slow, when you’re desperate to be saved, when you’ve just about accepted, so reluctantly, that you need to be. But I have to hope – though hope is another thing depression doesn’t hold with – that they will. That by day twelve, thirteen, fourteen, my sertraline army will be strong enough to make its presence felt, and the black, swirling void will subside, and I’ll be able to see my way to getting better. And that I’ll know, once again, that smudged mascara might look good on some people, but there is nothing heroic about choosing to die, and that, actually, Kurt Cobain’s iconic last words make no sense, because both options are just as bad and living is the only possible choice; once I know that for a fact, only then will I begin to contemplate the implications. Of balancing my brain’s chemistry from the outside, of needing a pill to bring me back to who I am. The fundamental wrongness of it, and why, at times, it may be right.
    I have to hope.

P.S. For the sake of clarity, and so my parents don’t get blamed, retroactively, for neglect: my teenage self was not depressed. She was a teenager. And she grew up to be an adult of a (mostly) happy disposition, despite being aware of the heavy burden of this life.

Bring it on

ohi day

Depression came. She came to tell me to go my bed. She came with the storm but, like the storm, I had felt her rumbling approach long before that. She likes to give warning, build up the anticipation, set you up for the plunge into her horrible anticlimax, the flatness she brings that neutralises everything into nothing.
    The day before, the Tuesday, was symbolic, and there were signs of her already. It was a national holiday, ohi day, the day of no, and it completely passed me by. On the 28th of October 1940, Benito Mussolini delivered an ultimatum to the Greek Prime Minister, Ioannis Metaxas: allow the Italian forces free passage into Greece, to occupy certain strategic locations, or there will be war. Metaxas refused but, contrary to popular misconception, he did not just say “no”; he responded in French, the diplomatic language of the day, and said: ‘Alors, c’est la guerre’. Then, it is war. But the Greeks love slogans and battle cries and, in contrast to their everyday conversation, they like them punchy and to the point. And they couldn’t very well take to the streets shouting stuff in French; they had their national pride to consider, especially on a day like this. So Alors, c’est la guerre became a resounding Greek No!, ohi, a short, two syllable word of pure defiance, and that’s the word they chanted, in their thousands, when they spilled out on the streets of Athens, until their throats were raw. And then, there was war.
    There are parades on ohi day, and marching bands, and bunting, and the Greek flag flies everywhere. The children gather in the village square, dressed in white shirts and navy blue skirts and trousers, and march proudly through town, and the officials make moving speeches about the courage and integrity of the noble race of the Greeks. All this took place on Tuesday, and I missed it, cooped up in my house on top of the hill, typing away on my computer. When I passed through town in the evening, all that remained was the bunting, a long row of blue and white flags flapping about in the breeze over the empty benches in the square.
    I felt her approach in the late afternoon, after the celebration that had gone ahead without me. Nothing too obvious, but there was a restlessness that often preludes her arrival. I dressed myself in several layers and stepped out into the final vestiges of the gloomy day. I would walk, I decided, down to the ring road and follow it round in a big circle, all the way to the supermarket, past the playground and back home; it would take about an hour. This was not a road I’d walked before. You wouldn’t do it in the summer: it’s too busy with cars using it to bypass the traffic at the centre of town and, like most of these island roads, it makes no provision for pedestrians.
    I should have known better than to expose myself to all that nothingness; I should have known I was making it too easy for her to find me. I had counted on quiet roads, a peaceful, contemplative walk to settle me down, but I’d forgotten about ohi day, and I got more than I bargained for. There was nobody around, only stillness and, every now and then, the parked up vehicles of everyday labour, abandoned only for this one short day of celebration that seemed to stretch, infinite, into the future and the past. This is a small island, but the emptiness made it seem vast, and it was exciting at first, like a child suddenly free to explore all the secret places that adults usually guard, but then I became acutely aware of my own smallness in comparison, and the feeling turned to awe.
    It wasn’t loneliness, but the actual, physical fact of being completely alone. I let myself think about it and it frightened me. A donkey stuck his head over the fence as I was passing by, and I jumped so far that I found myself on the opposite side of the road before I realised what had happened, felt immensely silly and crossed over again to pat his muzzle and apologise. I walked on, and I could hear my footsteps on the tarmac, a dog barking, echoey, in the distance, a birdcall, the dry rustle of creatures low in the grass. Nothing else, no other sounds: nothing mechanical, nothing human. An eagle circled overhead. The shadows grew deeper. A single motorbike drove past, and the noise it made seemed completely absurd in the ever-expanding stillness.
    It was a good walk, despite the fear; it made me feel alert and alive. But I should have known better than to walk alone, when she had warned me she was coming; I was too easy to find. And she came to me, like a bad fairy, and sprinkled me with her flattening dust. I took the emptiness home with me, and into town, later that evening, when I met Christina on one of her flying working trips, for a bite and a glass of wine. The process had been set in motion, and all the warmth and the unexpected company could do was stave off its inevitable conclusion for a time. I had exposed myself, and I was infected.
    And so the day of ohi passed me by, and then came Wednesday, and depression. She came with the storm, and I surrendered without a word. As the rain began to fall, I felt her twisting me up inside, turning me inside out, and then she was there, with her soothing, hypnotic voice. ‘Just lie down,’ she said. ‘Just give in, and lie down. There is nothing else to do.’ I surrendered and took to my bed, and she came to tuck me in, full of tenderness and gentle words, like a nurse for the terminally ill. Palliative care, with no hope for recovery. Just give in to it. There is nothing else. I closed my eyes, and went to sleep.
    When I woke up, the storm had been and gone but depression lingered, her heavy flatness making it hard for me to move, like a stiff old blanket that she’d laid over me while I slept. I kicked it off, and shook some life back into my limbs, enough to carry me listlessly around the house, pretending activity by making tea. Depression lingered, and whispered desolation.

The Greeks are always being defiant; we’re always looking for things to be defiant about. And when it comes to inventing battle cries, we are truly undefeated, the most notable of all being the immortal two words uttered by Leonidas of Sparta in response to the Persian King Xerxes’ demand that they lay down their arms and surrender: molon labe. Come and get them. The man had balls.
    I had mislaid mine for a day, the day of defiance: I’d been a bad Greek, and let it pass me by. But then I found them again, a day late. I found my defiance, but not as I expected. I found the saddest, most embarrassing, most heartbreaking Greek songs I could think of, and played them loudly, standing up in the middle of the room, and cried, for no reason whatsoever: for nothing. And I surrendered in defiance, and I said no, a day late, but just on time. It wasn’t war, it was guerrilla warfare; dirty tactics and sad Greek songs and Leonidas’ words, paraphrased for the 21st century: bring it. Bring it the fuck on.
    There were no flags and no fanfare, but it was a celebration, nonetheless, because as I cried over nothing, I realised I had nothing to cry about, and that made me laugh. Depression slunk off, taking her blanket with her, and I turned the music off and drank my tea, and painted my toenails red. Leonidas winked, and the Greek Prime Minister said some stuff in French that I didn’t understand. And the day ended, and Thursday came.

This is Day 51 from 100 days of solitude, written on October 29, 2014.

Your soul is always where it needs to be

I’ve said it before, that you can’t be depressed in a place like this. I’ve said it many times, but it’s a lie. It’s a line I feed myself when I feel it coming on and I’m hungry for nothing; deplete of everything and wanting nothing. It’s a line for when I sense it circling and I’m frozen on the spot because there’s nowhere to run. It’s a line that I throw at other people when they ask about my life, when I show them the set I live it on: the fields of thirsty silver and gold, the perfect line between mountain and sky, toy churches glowing in the sunshine and smudges of pink bougainvillea, the horizons made up of Cycladic blue sea. It’s an exorcism, for when my soul is in the right place. How can you be depressed in a place like this?

With the sunshine picking out highlights in your hair and warming up your skin, how? How, when you have to lift your hand to shade against so much beauty, when there is more and more to love everywhere you look? When everything is so light, so weightless that you can imagine it just floating away on a jasmine-scented breeze, how can you possibly conceive of any kind of weight? But depression is the chill inside, where the sun cannot reach. Depression is the filter that turns everything flat and grey. It’s a desolate landscape. It’s the mathematical formula that multiplies everything by zero. Depression only understands love as lost, as unrequited; as regret. And it always tips the scales in its favour; there is no counterweight when your soul is in the wrong place.

At times like this, that sunshine, those endless, generous skies are like a personal affront. They hurt. Beauty hurts, lightness hurts when you feel ugly and weighed down by things you cannot see. Things you cannot hold or handle, cannot pick up and examine and toss aside, cannot show anyone and say look, see? Here is the thing that hurts me, so you can take it apart together and scare it away. Depression cannot be shared and when you’re standing in the sunshine against a sky of endless blue, that’s all anyone can see. A girl framed by light, and how can you be depressed in a place like this?

I’ve said it before, to guilt-trip myself into recovery, when depression has already taken hold. How self-indulgent, how ungrateful. How shameful, when other people would give anything to have a little of what you’ve got; how wasteful. But that’s depression talking, when it tells you you have the best of everything and yet you’re empty and poor. When it shows you all the love in the world, tantalisingly out of reach. When it says your soul is in the wrong place. Pinned down by grief, an inarticulated sadness, too heavy to flutter in the breeze.

It helps, to be in a place like this. It can help. You can take yourself for a walk to the top of a hill and gaze out to sea and place the magnitude of everything in context. You can force yourself to look at the spaces of sky between trees, all the entry points for light to filter through and heal you. It can help, to see depression contrasted with beauty, but it isn’t beauty that we forget about when depression takes hold; it isn’t beauty that we need reminding of. What we forget is that our soul is always in the right place. No matter how uncomfortable it feels, our soul is exactly where it needs to be.

I’d forgotten this yesterday, when depression took hold. It was with me when I woke in the morning and by late afternoon I could barely move for its syrupy embrace. I tried to summon gratitude as the antidote, but it is hard to be grateful for anything when there is nothing that you want. I tried to not be wasteful of the beauty all around me, but I sat in the sunshine and it just wore me down. I took my coffee outside and smoked a cigarette and gazed at mountains and sky, and there was only pain. Emptiness. A mockery of everything I could feel; everything I should, by rights, be feeling if my soul was in the right place. Pinned down by grief for all the love that was out of reach – but some instinct told me to reach. Only a little, only as much as I could. Only as far as sending my friend a message. Everything is shit, I said. I’m tired of everything. I don’t want anything at all. Will you come round?

And he came. And we sat on my terrace, on the sun-warmed stones as the sun began to set upon the fields of silver and gold. He didn’t ask to see the sadness, the intangible weight I was asking him to lift; he didn’t ask how, in a place like this, with the sunshine in my hair. We didn’t look at the sky changing colours in the west or the mountains turning to shadows behind us. Steeped in this beauty, we looked at each other, because all of it is background, the set we live our lives on, but the place is where our souls are at, and the people are what make it a living. Looking at the sea stretching out beyond your horizon can help you remember how small you are, how inconsequential your sorrows, but inconsequential talk between two people on a Wednesday afternoon is what will put you back in your place, right where your soul is at. A friend turning up to sit with you when you have nothing to offer, a friend bringing nothing but the fact that he came: that’s where it’s at. No matter what’s happening around you, in the background, on the set, this is the only place that matters. No matter how uncomfortable it feels, this is the place where you can never be depressed. How, when your soul is exactly where it needs to be, and love is never out of reach?

I am not making light of depression here; there is nothing light about it. But reaching out can help. It won’t be shared and it won’t be halved, but it might loosen its grip on you, to remember that you are loved.

Coincidentally, my friend Keith wrote about his own struggle with depression a few days ago. Read his post here.