Serum misery level

First off - I should point out that I can't actually read this, or any comments. I write these on a memory stick and Sarah takes them in for me.

Well, I had lots of therapy yesterday. No wonder I’m feeling like shit.

First off was the psychiatrist. My psychiatrist while I am here is one Dr Tesla, an extremely tall man, an ectomorphic patrician with sea-green eyes, hooked nose and closely cropped hair. He speaks in a precise, European accent, and for some reason the thought of disobeying him, or of concealing things from him, does not enter my head. He sits, long legs crossed above the knee while I explain things to him – first the vegetative signs (the sleep, the appetite, the concentration, etc.) and then what I think of as the personal things: the thoughts, the feelings, the memories.

Conveniently, I suppose, I arrange it a little like presenting a case, all I would have to add would be the introduction: “Mr Bronze is a thirty nine year old man who came in as a voluntary admission with a diagnosis of bipolar depression…”

He generally attacks at dawn, like a Masai, seeing his first patient at seven AM. I think this is why psychiatrists think mental illness is so widespread. Many people who present as suicidal, homicidal or floridly psychotic at seven AM would be perfectly reasonable two hours later with a cup of coffee and a decent breakfast inside them.

So, I sit in a room with him and talk about myself. One thing I am struggling to come to terms with is what we call lability, the fact that my mood is so changeable. Some hours of the day I feel okay. These are the hours I write, or go to the gym, or read. Autobiography of a Geisha. Anatomy of Melancholy. A Maze of Death. Some book on scurvy that would have made a damn fine two thousand word essay rather than a thirty thousand word book. Ganong’s Review of Medical Physiology – this last one I brought in because when I can read it I will be well enough to go home.

Actually, the therapy started earlier, if you want to count chemical therapy. That starts just after breakfast, with the valproate and reboxetine. And the pantoprazole to cover the side effects of the valproate. And the citrus-flavoured, quick dissolving wafer of anti-psychotic I can take if I want to (I try to keep that to a minimum. Both my parents have type two diabetes. I might be crazy, but I’m not that crazy).

One day, by the by, someone will explain to me why the side effects of the psychotropic drugs seem to come on within hours while the beneficial ones take weeks. Are there side-effect receptors in the body, and entire separate (and very fast) side-effect physiology? Is there a way we can take advantage of this, develop a drug for some mild condition that as a side effect cures schizophrenia?

Anyway. Those are the good hours, and when I came in they were essentially absent and now they are the majority of most days. So I am getting better.

But there are other hours, other days. The bad days, or bad half-days, like I’m having tonight. Nightmares. Waking early. Eating and still being hungry, sleeping but still being tired. The still watches of the night where all the stupid feelings that got me here come back.

And the thing is, at the moment I am so pathetically fragile. One slip-up, one minor thing goes askance, and immediately some part of my brain throws up its hands and says “Right, everybody, into the car, we’re all going to go jump off the Narrows”.

Last night I had a dream. I (in the dream I was thin, red-haired, rather androgynous looking) was a counsellor or teacher of some kind, teaching disadvantaged children. I was going to see this kid about his truancy. I sat on a low brick wall talking to him, went through his pockets and took the knife he had made – a fine handle but a weak, rusted blade. I tried to lead him somewhere to get help, but we got lost. I remember writing directions in the sand and the wind blowing them away.

We ended up at the beach, and it was a beach where sand-dunes sloped precipitously into the sea, and the wind whipped the skeleton grass. Everything was eroding. He ran into the water so I followed him, he was near the rocks and I was in the deeper water. There was a lizard underneath the water, some kind of iguana-creature, who had been there a couple of weeks. I tried to reach him, to save him or be saved by him but he was too deep, the water was too cold, and I felt myself being drawn out to sea, away from everything.

I woke up physically frightened and sweaty, five AM, so tired my eyes stung.

These kind of dreams need no interpretation. Loss, erosion, failure, weakness, cold, the ground moving under you, the knife with the weak and useless blade.

On the bad half-days, the bad days, the bad couple of days, I realize something essential is missing from me.

Anyway. I don’t want the rest of today to be crap, so I have to commence the protocol.

Grab my morning medications.

Peruse the newspaper, which appears to have a picture on the back page of a goat, dyed in Australian colours, with the name of one of our cricketers batsmen painted on it. The goat looks suitably repentant and is surrounded by angry Indian men. From this I deduce we won the Champion’s Trophy, and have been celebrating it with our trademark courtesy and restraint.

Psyche myself up for the gym.

Maybe read a book rather than just buying another one.

Try and convince Dr Tesla not to increase my dose of olanzapine.

Anyhow, thanks for listening (and sorry for the bleak and unhelpful posting),
John