One morning a couple of weeks later, after I’d waded through rivers of pain and sadness, the Happy Potter doctor smiled his familiar warm greeting. ‘You’ve got a good smile,’ he said.
I scanned the tubs of pencils for any new stationery to fiddle with, trying not to look nervous. ‘Oh, how do you judge the behaviour of a person’s smile?’
‘That’s a healthy smile,’ he said.
I thought, ‘Oh, that’s rich. You still smile like a Teletubby,’ but put on a deadpan face and asked, ‘What are the criteria for a healthy smile?’
He looked at me with empathetic eyes, behind which I knew an unseen universe was quietly going on. He discreetly made some notes in his weird psychiatric code.
‘It’s spontaneous, not too over the top, not too up, sincerely happy and relaxed. Not contrived and forced. It’s just right. No anxiety. A happy, healthy smile.’
‘Yes, well, that’s hunky-dory, but I’m also scatterbrained, lacking in direction and terribly lazy.’
‘Does that matter? You have your health.’
Not appreciating the sentiment, I leant over and grabbed a pen shaped like a long Prozac pill. ‘Well, it doesn’t seem right. I just lie at the pool all day ordering cappuccinos. It’s ridiculously indulgent.’
He laughed. ‘Nice work if you can get it, Rahla. You’re recovering from a long period of seriously debilitating depression, and it might be a little while before you conquer the moon.’
Until that moment I’d pretty much forgotten just how bad I’d been feeling a week or so before. ‘It’s not that I’m ungrateful. I love that my mood is good. I appreciate that I’ve stopped crying. But my brain, she’s all over the show!’
‘Are you feeling a bit blonde about the brain? Well, that could be a few things. It could be the Topamax, an anti-epileptic that has the miraculous side effect of working as a mood stabiliser. Or it could be the Luvox, an antidepressant with a soporific effect.
‘And then it could also be the after-effects of depression. When you’re depressed, your brain cells temporarily stop regenerating,’ he said.
‘I don’t care,’ I said, chewing unconsciously on the Prozac pen, ‘it’s dull. Anyway, I blame the Luvox. I’m so lethargic.’
‘Maybe next week we can look at decreasing the nightly Luvox and replacing it with twenty-five milligrams of extra Wellbutrin.’
Trying not to make it obvious how keen I was on that idea, as Wellbutrin makes me a bit up and takes the edge off my appetite, I said, ‘That could work.’
He laughed. ‘Yes, I thought you might like that idea. Wellbutrin is a skinny drug. Yesterday I gave a woman of ninety-two a prescription and she asked me if the medication would make her fat. You women are all mad. The god of pharmacology doesn’t appreciate the emaciated female form!’
Shit, I thought, he’d seen through me now. ‘I just want enough energy to visit my husband on set,’ I told him, ‘and no, I wouldn’t mind fitting into my jeans and having my own functioning brain, pharmacologically maintained or otherwise.’
‘Your problem is that your natural state is higher than the rest of ours. You’re chirpy. It’s a kind of ongoing soft mania.’
I replaced the Prozac pen and picked up the broken Montblanc of my early consultations. It still didn’t work, which I found oddly comforting, because neither did I. Although I’d come a long way, the whole business was confusing. It took truckloads of psychotropic drugs to get me out of my depression and truckloads of psychotropic drugs to get me back to my own naturally, slightly manic – not too manic – state. Ordinary girl, I am an ordinary girl.
The doctor interrupted my reverie. ‘The film industry isn’t at all bipolar friendly, you know. Maybe 70 per cent of the people in it are bipolar, but they’re what we call ‘toxicity level’ bipolars. Fake bipolars. A few months cleaned up and out of the industry, and if they haven’t done indelible damage, they’d be absolutely fine.’
‘Oh. And where does all of that leave me?’ I found the notion of people willingly creating the mayhem I have to conquer in order to live entirely annoying.
‘You should be writing it all down. Look at Stephen King. He only writes five hours a day and he makes a modest living.’
I replaced the pens and gave an amused smile. ‘Ja, ja, thanks for the career advice, can I have the new script?’
‘Let’s wait and see your smile next week.’
As I left, the voice-over in my head said, ‘Writing is all fine and well, but what are you writing towards? It doesn’t matter, just write yourself out of it, and write yourself out of the funk, out from the inertia, away from the pink palace, down the yellow brick road and home to never-never land. Rahla, go home and write.’
As it turned out, the Happy Potter doctor had decided to use other treatments instead of ECT, so that option is still out there, waiting for a very rainy day. He had a theory: ‘In psychiatry, when in doubt, think.’ He had taken one look at me that first evening, at my sad eyes, and said he was going away to think. The next morning he’d thrown away the tablets for migraines and the tablets for panic attacks. The morning after that he’d cut down the dosage of one of the mood stabilisers. And gradually he’d started to clean me out.
Eventually, he announced his intention to detox me completely. I’m a born quitter – I’ve quit tobacco, drugs, alcohol, red meat, chicken, sugar, shopping and even mania! I love quitting, so I embraced the quitting of psychiatric medication with huge enthusiasm. At times I crave a purity of form; I hanker after a non-toxic, healthy lifestyle. Often I thought the only contradiction was the fourteen or so pills I took a day. Quitting them was a joy.
A full-blown depressive episode totally takes it out of you. Each episode has its own special reason for being the worst, most shattering experience of your life. But now that this particular episode was behind me, I convinced myself that I was cured, even though I had no foundation for my theory. It was clearly explained to me: you’re experiencing a honeymoon period, a ‘window period’ in the illness. After a very bad episode, sometimes there’s a respite in the illness, a stage where the patient is naturally normal and stable, but not cured.
For the first time, there was a new goal in sight. The Happy Potter doctor told me that he thought this was my chance for the baby I had wanted so desperately for so many years. He explained that the window period would allow time for me to fall pregnant. If we could hold off any psychiatric mishaps until my first trimester was completed, then everything would be fine. Typically, I didn’t doubt that everything would go perfectly according to plan. Motherhood felt right. My only concern was that baby names wouldn’t be ready on time.
Jason had been terrified of having a baby, but when I told him what the doctor had said, he didn’t hesitate.
Now may be the time to mention that very few marriages sustain mental illness. Very little mental illness can sustain marriage. Invariably they are mutually exclusive.
A friend of mine threw her husband and his belongings out of the house during a manic episode. Mania gives a person an enormous supply of confidence and energy. You’re so driven and proactive, it feels as if you can take on the entire world. My friend’s manic cycle lasted long enough for her to sleep with her husband’s best friend and get the divorce proceedings started. By the time she crashed back down to reality, it was too late. She’d wrapped it all up: years of marriage, homemaking and child-rearing. The marriage was Oise Yom Tov. Over, finished, a casualty of mania.
Holding a relationship together through the ups is one thing, but depression really tests romantic love. During tough episodes I’ve barely existed as a human being, bubble-wrapped in gloom, crying, cutting at my flesh, an inexplicable misery to everyone, while Jason has continued to function in the world, keep the house going, earn a living, pay the bills and make excuses to everyone for my bizarre retreat. Depressed people emanate a dark energy that’s draining and exhausting.
Oddly, when I first come out of a depression, I assume everything is completely cool. In reality, that re-emergence and the re-establishment of normal relations is a huge adaptation, almost like getting reacquainted with my partner and learning to trust one another all over again.
That time, the time of my ‘honeymoon period’, I left the Happy Potter doctor in Johannesburg and flew back to Cape Town, but Jason wasn’t at the airport to meet me. I didn’t think he might be caught in peak-hour traffic; I simply assumed he didn’t want me home at all. But he did want me and he did get through the traffic. He even got through my resentment and anxiety at not being collected on time.
None of it was easy. The doctor had told Jason, ‘Okay, this is the time. You now have approximately three months to make a baby, and if she doesn’t get pregnant in these three months, well, it’s now or probably never.’ It was no small amount of pressure for a man. Jason had just finished shooting a film and wasn’t feeling financially secure. I can’t imagine he was feeling too confident about his wife as a mother, either.
We tried doing the ‘getting to know you routine’ in Cape Town. After a couple of days we threw the dogs in the back of the car and drove to Plettenberg Bay. We’re happy when we’re together. It’s the simplest recipe for a successful life. We love each other, relish each other’s company. We were in a cocoon of love, having loads of sex in the required positions. Baby-making was the order of the day.
But I didn’t fall pregnant. Perhaps we should have gone straight to a fertility clinic, but I didn’t want to become neurotic and worry too much about not conceiving. I rationalised that possibly my medication had been working overtime as a contraceptive for the previous six years. But I believed it was going to happen. I imagined my fantasy daughter Tallulah packing her petlach in heaven. I was so steadfast, so confident. I was so sure that I was never again going to take another psychiatric drug, because I was cured. Miraculously, marvellously cured.
The Happy Potter doctor had explained carefully about the window period, but I didn’t believe it, not a word. For roughly five months I was clean, clean, clean. I noticed a difference in my brain. On medication I’d always thought through a bit of a fog, a haze. Off it, my brain was clear. Cerebrally, it was bliss. I didn’t constantly misplace my car in parking lots and I remembered people’s names. My skin had a healthy glow and there were no bags under my eyes.
But I was on edge. I knew my mood was unprotected. When I opened my eyes in the morning it was like looking out at the view from the edge of a fifty-storey building. I happily conducted my days from the edge of that building, but for five months I knew that my feet weren’t on the ground emotionally.
Worse, I continued to get fat and remained stubbornly unpregnant. Eventually, in desperation, I went to a fertility clinic in Johannesburg. Jason was in pre-production for a feature film, so I felt rather alone. A series of tests showed that falling pregnant wasn’t going to happen easily. We had things to fix. I felt the fragile thread of my mood slipping further and further away. I don’t just wake up one morning in a state of semi-consciousness and want to die. It creeps up on me. There are warnings, sinister signs.
It’s like when you leave a dish in the oven for too long and you can smell it burning, but you think that when you retrieve it, it’ll be okay, you can just scrape off the edges. But it’s a foregone conclusion; it’s out of your hands. I try. I burn incense, I buy flowers, I exercise, I go to the movies, but I can smell the burning of brain cells and I’m just a small, silly, insignificant girl thing trying to fight off Alexander the Great’s armies with cosmetics.
I thought, ‘We’ve got this small chance of getting naturally pregnant; it’s going to be fine.’ But slowly, with each day that I visited the fertility clinic, with each procedure and each doctor I tried to smile at, the reality of being in a window period and not in a miraculous cure began to hit home. The window was getting smaller and darker.
We met with two experts in a calm, beige office. With great compassion they told us that Jason and I would never have children. The scientific facts fell out of their mouths with such authority and ease. Great care they showed, but the truth was definitive. They gave us options – adoption and surrogacy – and then sent us away, Jason in his car to a studio, me in mine to a hotel room. I was shattered. Any pretence of holding it together fell apart.
My body was so completely cleaned out, I thought that it would be like a dry sponge and absorb the new drugs immediately. But I found out that mood stabilisers don’t work like Ecstasy. It takes two to six weeks for the medication to kick in. Two weeks of sitting in a hotel room contemplating my barren womb.
Maybe God had a different plan for me, one that didn’t involve my lifelong ambition for motherhood. And who was I to question the Divine? There were so many other considerations: movies to be made, houses to be built, finances to be raised, and sickness to be conquered and lived with. Sometimes things I’ve dreamt of have slipped away, like my tenuous grip on sanity.