Ischaemia / All about me

Hail,

Not back yet, but should be soon. I would apologise for the long absence, but I suspect everyone is better off without enduring what I would have had to say during this last fortnight or so.

There seems to be a lag period here. My illness - and that's an oddly painful couple of words - shows up in my head first, then at home, things with Sarah, then at work (if I haven't stopped by then,which I almost always have), then last of all my writing. In fact, if I look back and try and correlate things - this post must have been before that crash, this one around about the time of the other - then things seems to get cheerier, more prolific, more superficially manic just before the crash.

It's always dawniest before the dark, you could say.

The implications to be drawn from this are not pleasant. It seems that as I get more depressed and more needy I write more. And that suggests that I write because I am needy, that it's a tool I use to get people to like me. Something that the black, squalling thing inside me does, something engineered by the black hole of self-loathing that depression reveals at my core.

And as is clinically evident, not quite over it yet.

Clinically evident, by the way, is usually medical shorthand for "preceding doctor didn't do his/her job". If you have to review someone in the ED with mysterious abdominal pain and you put your hand on their belly and feel they have a bladder the size of a basketball, you can write 'clinically evident urinary retention' in the notes.

Anyway, the medications do work. They do work, which is still weird to me, because the pills are real, substantial things, with weight and form and texture and taste. Sodium valproate, which I was on through much of the nineties and am now on again, is hygroscopic, meaning it absorbs water from the air. You pop the purple tablet out of the foil, leave it on the sink overnight, and it becomes a blob of pale violet mush. And lithium induces nausea - it is used to poison lamb carcasses, to prevent coyotes eating them.

I always had this mental image of a farmer (or thremmatologist, as they are also known) stuffing lithium into a dead sheep, and a bipolar person coming along and saying "Look, mate, you're too late: she's not depressed, she's dead".

Well, I found that amusing. More amusing than I found vomiting my way though second year. Note for the inexperienced - if you drop your lithium tablet in the sink, (due to the tremor it has given you) do not scoop it out and pop the wet tablet into your mouth. It, and you, will last about fifteen minutes before you retch your duodenum out into the basin.

Anyhow. The thing is, tablets are real. They have a kind of gravity about them, a kind of mana - they are chemicals, with all the power that that idea implies. The same ideas that made plastic and TNT and anaesthetics make tablets of lithium.

In mediaeval terms, tablets have substance, whereas mental illness only has accident. It is, at some level, less real.

The reasons for this are obvious.

We cannot, or we have not yet, dissected out a paranoia from the brain, in the same way that we dissect out a tumour. Skilled surgeons do not, as yet, spend hours over an opened mind. We cannot separate out the true and false ideas in the psyche like we can healthy and diseased tissue in the brain. Pathology jars in medical museums are not filled with preserved manias, bottled hallucinations, delusions of grandeur cut in cross-section and stained to show the areas of abnormal growth of the ego. Nobody gazes down a microscope to see if the cellular microtubules shows signs of psychotic depression.

Things are, as far as that is concerned, much more subtle. Expression of proteins, subtle anatomical changes, serum levels of cholesterols. Unless you are trained in this way of looking, there is nothing hard, tangible, obvious.

Nothing of substance. Mental illness is still all in the mind, you see.

The thing is, from the point of view of the sufferer, this world-view is inverted.
I got a virus a few months ago, took you through every miserable shudder and droplet of sweat in these very pages - I would rather have that again than depression (especially since the virus makes you thin, but depression makes you fat).

I would rather have another episode of hypomania or mania than do almost anything else - new car, holiday, sex - and I would rather do anything else than clean up after said episode.

There is no doubt in my mind as to which is the more real.

I could go further. When I was twenty four - I think - I drank cider and did Tai Chi in the room above the uni pub. I was a passenger in a car driven by what I now realise to have been a seriously drunken friend, a brown Datsun something that rolled the wrong way down a street in Freo and was only saved by some last-minute Dukes of Hazzarding from my friend, who leapt in the window of the moving car and stopped it. I fornicated in a farmer's field with a red-headed girl, lay naked in the sun, was observed by three curious horses. I listened to Texas blues and to music that I would nowadays deny ever hearing.

But none of that stuff is any more real to me than the owl chorus outside my window, or the circuitry under the earth, or the hands that moved behind and stretched the membrane of the sky, or the serpent creature that stood at the centre of it all. None of it was more real than being two thousand metres high and made of glass. I have to consciously search through my memories of that time to find things that seem as real, as significant, as possessed of gravitas as the things that filled my head.

I don't know. The tablets do work. Maybe that proves they are real.

Anyhow. Much to write about once this crap all goes. I know it will. That neurotransmitter tide I raved on about is rising, covering some of the rocks, the things I normally leave covered. I'm back at work, soon I'll be able to go out without cringing.

Thanks for listening, by the way. Next post - I worked out most of the time I say this it turns out to be lies - next post is/might be on the eponymous Yellow Fever, and on techniques for the getting, rather than the avoiding, of disease.

Thanks again,
John