November is a tricky month. It’s the month of my birthday, and I’m an old-fashioned birthday girl. I love the passing of the years that are marked with kitsch candled cakes, taffeta-ribboned packets and long-distance phone calls. The sky is always so bright and full of summer promise in November. But the November sun often also brings with it the harsh rays of warning, the tap, tap, tapping away at my psyche, the feeling of dis-ease, discomfort nagging at my soul. All the excitement has a sort of dark lining; it’s all kind of touch and go.
On one particular November Friday, it was not so much touch as it was go, go, go … vroom, vroom, vroom. I woke, went to gym and then did a million unnecessary, frenetic things. If anything was wrong with me, it was being too ‘up’. I thought I was possibly a bit manic. At the time I was going through a liquorice phase – Panda liquorice with its picture of a cute panda – stockpiling black-and-yellow boxes of the stuff.
I was hanging beads and eating liquorice when Jason said goodbye, off to do some work. A bit nervous, I dropped the beads and followed him, Panda in hand, to say goodbye. As he got into the car, I started to cry. I tried to explain: What would I do when my Panda was finished? No, I didn’t just want to go to the shops and buy a new box, because I loved that particular box. Then I was crying inconsolably for the inevitable loss of my Panda liquorice. Within an hour I was hysterical, truly off my trolley.
Psychiatrists have lives independent of their patients, so they’re not always contactable on a Friday night. My Cape Town psychiatrist was out of town, but we got hold of the Happy Potter doctor in Johannesburg. He said, ‘Go to hospital and try to get some food into yourself while you’re there.’
Take a psychotic person to a regular hospital and nobody really wants to take responsibility. My father used to say that hospitals aren’t too keen to give beds to psychiatric patients because hospitals are run like hotels. In any hotel, the bar brings in the money. With hospitals, the bar is the operating theatre. So, unless you’re having electroconvulsive treatment or you need an anaesthetist, you’re essentially just wasting precious bed space. But Jason, long-suffering Jason, managed to get me, still clutching my liquorice, across town and admitted to hospital. So much of this is just a blur. I have a fabulous way of forgetting. Daddy used to say, ‘You don’t always need a good memory; sometimes you need a good forgettory!’
I’m a gifted amnesiac. I remember in minute detail every birthday and anniversary celebration. I remember childhood happenings and everything to do with my friends’ lives. But the recollections I have of depressive episodes are fractured. Always, I recall the feeling of people’s care and support. I remember trying to pass the pain of time by watching outdated but funny movies like the Marx Brothers and trying to keep my anxiety focused on just one thing: my incessant beading – long strands of crystals and pink shimmering baubles. I would concentrate intently on stringing one bead after another.
I remember the smell of fresh roses, but not the putrid decay of my despair. The details of getting into a hospital bed draw a blank. How did my clothes get there? Did Jason pack them with me, or did he bring them the next day? How did he know what to pack? What did he do with my dogs? What did he tell the neighbours? I have no idea.
Mornings that I thought were the preceding day were in fact the following evening. Days became weeks, which are lost. In this way I’ve misplaced years of my life, and maybe it’s just as well. When you enter a depressive episode you enter the twilight zone, and amnesia is a blessing, a God-given tool of survival.
I’m sure many psychologists would say that I’m in a state of denial and that I should face what has happened. But I’m grateful for what I can forget. If the darkness is visible, cool, I’ll look it in the eye. But if it vanishes into nowhere, well, that’s also fine, because I want to live in this world, not in the melancholy nothingness of illness. To write about it, though, I need to try to step backwards, into the darkness.
Saturday morning I woke in a strange hospital bed, alone, afraid, no Jason, no doctor, just despair and an empty breakfast tray with a toothpick staring at me. I think people get suicidal in hospital because it is last-resort territory – the end of the road. It’s what you get when all else fails. There’s this myth that if you go to hospital, all those doctors and nurses in their chirpily starched outfits are going to take control. The nurses, so smart and contained, their shoes so shiny, the corridors of their wards so polished that they can see their reflected faces. They’ll take the troubling malady away, but if they can’t, oh God, if they can’t make you better, who can?
The next day, three friends came with Jason to visit me. One brought long-stemmed roses, a shiny gold box of Lindt chocolates and a huge bag of popcorn. That I remember. Then it’s a blur – days of doctors trying to medicate my mood while friends tried to make me smile. Until the psychiatrist recommended moving me from the psychiatric ward in the regular hospital to a special psychiatric clinic, where the doctors and nurses were trained to attend to me 24/7.
There was something awful about that place. In the normal hospital, I could pretend I was there for ‘other’ reasons. Reasons ‘other’ than being insane. But that place – it was One Flew Over the Cuckoo’s Nest, it was Girl, Interrupted.
I remember the smell: musty, chlorinated, with whiffs of cheap air-freshener. The registration form upset me, because I had to promise that I’d never communicate with any of the other patients after I checked out. I didn’t even want to communicate with them inside, they all looked so weird. There was a communal bathroom. The curtains in the room were a shade of vomit brown. A girl came and touched my hair, saying, ‘Is dit die nuwe meisie?’ (Is this the new girl?) All this I remember. I can touch my fear.
When Jason left, I wanted to die. I didn’t want to kill myself; I simply wanted to be dead. Did I make it through a full night in that place? I’m not sure. By the following day, however, I was out of the psychiatric clinic and back in the regular hospital, with its regular nurses. The psychiatrist had had the good sense to test my thyroid – thyroid problems and mood disorders apparently are best friends. If anything, my thyroid at that stage indicated overactivity. I was keen as mustard on the diagnosis, knowing that an overactive thyroid made you skinny. The doctor suspected that the thyroid might change direction. But things got better and my mood improved day by day, until I was discharged.
Livicky came to Cape Town to be with me. Psychiatrists may be unavailable when you need them the most, but my mother is always available. Realities of life, work responsibilities – none of it exists. When I need her, she’s there.
Free of the hospital again, I had a fabulous birthday, a glorious social summer. I felt cool. But the decline was insidious.
As so often happens, my mood was triggered by weight gain. I felt my jeans getting snug, looked in the mirror and thought my face looked fat. Stood on the scale and counted the extra God-forbidden numbers. Then I decided not to go to the beach because I couldn’t face being in a bikini. I became less and less motivated, lazier and lazier. One by one, activities were cancelled out of my life. One day I was sick and missed a session with my trainer. She was nasty about it, and Gigi said, ‘I refuse to let you be upset by someone with a brain the size of a pea.’
But it wasn’t just gym. Everything became more of an effort. I was flat but not quite depressed. I ascribed it to the change in medication. After all the fuss of November’s episode, I refused to entertain the idea that anything else could be wrong. For days I just slept. Slept and ate. By January, I started to get concerned. I underwent a series of tests. I had a thyroid virus: Hashimoto’s thyroiditis, an autoimmune condition. For some unknown reason, the body fails to recognise the thyroid as its own organ and treats it like an invader. The misguided immune system then bombards the gland until the virus ensues. The condition is triggered by stress.
I always feel guilty when I’m depressed, particularly in hospital. It feels like I’m copping out of life. Everybody else is working and functioning in the world while I’m catatonic, crying, needing to be taken care of. But whereas a week in a hydro is relaxing, a week in a depression leaves you drained and exhausted. The misconception is that a person who has stepped out of the stresses of day-to-day life has removed herself from stress. In fact, she has stepped into the most stressful chaos imaginable: chaos that comes without respite, relentless chaos because it’s not caused by the screeching of car breaks or the moaning of bosses; it comes from inside, it comes from the place that doesn’t end at the end of the day.
I’m appalled at how many educated, intelligent people envy me my condition. How often they’ve said, ‘God, you’re so lucky! I wish I could take a few days’ timeout.’ Make no mistake – this is not a timeout. This is war. This is fighting a merciless battle amidst despair and nothingness. But there’s no blood, no physical evidence of injury.
We live in such a physical, tangible world in which everything has been scientifically proven. We want hard evidence, or we can’t believe. Sometimes I think that’s why I cut myself, to create a physical manifestation of pain so that I can wipe away the blood and apply a plaster.
If there’s nothing broken or bloodied, then what’s wrong? Often I admonish myself, ‘There’s nothing wrong. Snap out of it. You’re just feeling sorry for yourself.’ But saying those things only makes it a longer, harder journey. Self-love is the biggest schlep, the hardest part of all.
My body was feeling the knocks, because by January it was in rebellion. The thyroid virus was the body fighting itself. The doctor explained that there was nothing we could do. We just had to wait it out. I waited. I lay around waiting, me with my obscure sickness. I can never just get flu. No, it has to be some weird, off-the-wall sickness with a strange name.
My hair started falling out. I put on nine kilos. I was too exhausted to leave the house and, if I did, I had panic attacks. I got more and more depressed. By February I had the crying germ, another full-blown depression.
My GP came to the house to administer injections for the migraines and the anxiety, but my desolation remained impervious to help. Eventually he recommended hospital again as the best solution. This trip back to the hospital is a blur.
The psychiatrist tried and tried. Eventually he suggested ECT (electroconvulsive treatment, or ‘shock treatment’, as it is sensationally named). We’ve probably all seen Janet Frame’s Angel at my Table, One Flew over the Cuckoo’s Nest or The Bell Jar. For some reason, ECT is a very cinematic procedure. The camera loves the convulsions of the body, much as it loved Marilyn Monroe’s curves. I think it’s a procedure that’s been given a pretty bad rap. The way it’s depicted is always so archaic. Sure, it’s horrific, but, gee whiz, make no mistake, so is depression.
I used to have an aversion to the idea of ECT, but I began to read more about it and over the years my feelings towards it softened. I spoke to people who swore that it had saved their lives, that it was the only catalyst out of despair. I used to suspect that it penetrated and shocked the patient’s spirit with lasting repercussions, but the sadness I’d known had also penetrated the very core of my spirit and shocked it indelibly.
My Cape Town psychiatrist was at a loss; nothing he did seemed to make any difference. A week and a half had passed and I hadn’t improved. Livicky and my sister started saying that I should go back to the Happy Potter doctor in Johannesburg. I said that there was no way I could fly in that state. The Happy Potter doctor phoned Livicky. ‘Rahla is terribly sick. She must come here immediately.’
A good friend came and talked me through it. Another packed my bags, while a helpful neighbour booked the ticket, drove me to the airport and physically put me on the plane. Jason packed up my hospital room. Gigi and her kids were at the airport in Johannesburg, waiting for me, and Livicky was at the clinic. I was carried through the chaos by love.