PhotoMarinSardy4In the aftermath of Robin Williams’ suicide, a plethora of articles and blogs have been published on the topic of mental illness and depression. As a writer whose work often directly or indirectly addresses mental illness, do you think this sort of mass response is helpful?

In some ways, yes, absolutely, the mass response is very helpful. The cultural silence around mental illness, without a doubt, made my experience as a child of someone with schizophrenia far worse than it needed to be. I had no one to talk to about it and no vocabulary for it even, and so that silence stunted my ability to even do my own thinking about it. In a culture without open conversation around mental illness, I was cut off from social support that could have helped enormously. So I’m pretty much glad across the board whenever anyone is openly discussing it. But with this I’ve also been glad that most of it seems to be aimed at educating people and fighting stigma.

stossel

Scampering through Cape Cod, searching for an outhouse, looking out for Arnold Schwarzenegger and the Secret Service…

So I’m staying at the Kennedy Compound because I’m writing a biography on Sargent Shriver, the guy who started the Peace Corps. Bill Clinton is there, sailing with Ted Kennedy. Arnold is there. I’m out walking around town when suddenly the anxiety hits. Anxiety leads to a certain gastric distress so I’m rushing back to the house, sweating, looking out for celebrities and the secret service, wondering if I can make it back. I get there—and the toilet breaks. Sewage rises around me, ruining my pants. I mop it up with towels just as the dinner bell rings for some sort of fabulous Kennedy soiree. I sneak out and race up the stairs, half-naked, wrapped in a towel and run straight into JFK Jr. “Oh hi, Scott,” he says. He was totally unfazed. We had met the day before.

978-0-307-26987-4Some eighty years ago, Freud proposed that anxiety was “a riddle whose solution would be bound to throw a flood of light on our whole mental existence.” Unlocking the mysteries of anxiety, he believed, would go far in helping us to unravel the mysteries of the mind: consciousness, the self, identity, intellect, imagination, creativity—not to mention pain, suffering, hope, and regret. To grapple with and understand anxiety is, in some sense, to grapple with and understand the human condition.

Greta Gerwig

Women catch courage from the women whose lives and writings they read, and women call the bearer of that courage friend. –Carolyn Heilbrun

I.

On a blistering August day in 1989, my boyfriend, Adrian, and I were trudging up 123rd Street on our way to his dorm, and I was lagging behind. He always seemed to be several steps ahead of me, which wasn’t surprising, since I was barely five feet tall, and he was close to six. But he felt that I should have walked faster, and he diagnosed the problem as hesitation, fear. (He studied the existentialist theologian Paul Tillich, who wrote a book called The Courage to Be.) Whenever he noticed me falling behind, he made this observation: “You fear to step.” It made me laugh, and also caused, as he seemed to intend, a stab of shame about the pervasive anxiety that in fact kept me from moving forward. “You fear to step,” he announced, as we sweated up the hill, and I protested that my feet hurt because I wasn’t wearing any socks. I began to compose a mantra of my own inadequacy:

Listen. Happiness? It just looks different on people like me.

                                            —Lidia Yuknavitch, The Chronology of Water

 

 

In Ithaca, New York, Tibetan prayer flags hang from the eaves of rambling Victorian houses, and quaint little carriage houses, and dilapidated A-frame houses with Pabst beer cans lining porch railings. Their lilting red, blue, orange, white, and yellow squares make no sound in the breeze, so thin and soft is the translucent fabric. On Aurora Street, in Ithaca’s Fall Creek neighborhood, the Namgyal Monastery Institute of Buddhist Studies sits nestled in a nondescript turn-of-the century house painted a deep burgundy with gold trim. The prayer flags alight the house like year-round Christmas decorations. Down the narrow alleyway running just behind the monastery, Cascadilla creek burbles over shalestone, plastic bottles, discarded road signs, and outposts of tall, thick grass that curve like spider plants.

Since psychiatry has proven itself to be anything but a science, the entire concept of mental anguish must be reexamined. Might the elements of “mental illness” more properly be called personality traits as well as reflections of the societies in which those traits occur? Might those elements even be called talents of a sort?

Psychiatry’s masterwork of pseudo-science, the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), once included homosexuality amongst its “scientific” diagnoses. Psychiatry thus reflects the “values” of the United States far more than concerning itself with patients, much less looking past and through society’s existing prejudices.

Even those behind psychiatry’s Shroud of Turin question its validity. Of late, there has been talk of attributing DSM diagnoses by degrees rather than mere labels. Thus, a person would “have” a “mental illness” on a scale, not just “have” it. In such a case, the flatliners who dominate the population would once again establish the “typical American’s” plot-pointed life as “sanity.”

Yet no one who suffers emotional distress would applaud the benefits of that distress. To do so would be to refute its existence and betray oneself as an imposter. Far more likely is it that many flatliners never mention their irregular heartbeats. Could it be a Second Renaissance lies beneath the ever-recycling digital ruins and its constant skies of acid rain?

Consider anxiety. Those with anxious traits are often highly-attuned. To call them “sensitive” is, in this society, an insult. “Sensitive” implies weakness, an inability to “man up.” Instead, the anxious should be viewed as a tuning fork against which society reveals itself — rather than the “patient” — as out of tune. That no one else recognizes society’s discordant sounds only proves the anxious to be society’s musicians. Countless permutations of that metaphor support themselves.

The same may be said about every other “diagnosis.” Schizophrenia might be viewed as a William S. Burroughs’ cutup of “reality” as presented, emphasis on “presented” because, of course, most of our environment has nothing natural about it and is, in fact, a presentation in every sense.

Some conditions do respond to medication. Usually, the reasons remain unknown. In turn, the medication may solve one “problem” while creating many more. Those who take most antidepressants may no longer feel depressed about nothing, but they feel depressed about their diminished sexuality, especially males whenever they try to… express their end of sexuality’s conclusion.

Returning to anxiety, medication does relieve its incapacitating aspect, but the medications that accomplish the effect also accomplish something else, that being the worst addiction known to humankind. This class of drugs, benzodiazepines, includes Xanax, Valium, Ativan, etc., the whole lot of tranquilizers, excepting the rarely-prescribed barbiturates. In some cases, antidepressants may relieve anxiety. However, they do so for reasons as unknown as the reasons antidepressants diminish depression. Likewise, they alleviate anxiety but create symptoms that mirror anxiety, such as trembling hands, odd emotional states, etc.

Rather than diagnoses, all of these traits show themselves to be products of society, products of the product society uses to diagnose those personality traits, and the products society sells to treat the products of the product society uses to diagnose those personality traits. That’s to say, they’re products of an environment completely divorced from nature.

All of this enshrouds some rather simplistic facts about a complicated subject. To martyr those suffering in the way biographers now “diagnose” every author, musician and artist “of the ages” as “bipolar” reduces suffering by labeling it, making suffering a product of their products, that being books and, eventually, films based on those books. Those who write memoirs about their “mental illnesses” bend over backwards for sainthood and reveal themselves willing to do endure any humiliation in exchange for profit.

On the other hand, failing to notice the strange talents hidden within the emotionally inflamed creates an even greater injustice. These strange talents do not prove the existence of artistic talent, as many would like to believe, but they do reveal an artistic temperament. No one can suffer emotionally but for recognition of something and, more likely, many things, and their recognitions go unnoticed by the general public. Why does no one listen to them? Who do “doctors” listen only to themselves when they recognize nothing beyond the power of their prescription pads? Is it because they realize their absolute lack of talent, strange or otherwise?

Most of those suffering in the ways described cycle through life in various stages of function and dysfunction, and most have periods of absolute dysfunction. To calls these periods “nervous breakdowns” would be far more accurate than to split the hairs of the suffering with psychiatry’s blunt axe. They must be tended to as they once were, in humane sanitariums surrounded by the true environment. Such sanitariums could — with no joke intended — be established on useless golf courses around the nation.

With that, some proposals:

1) Psychiatry should be abolished. It simply lacks the will, or even desire to have the will, to fulfill its dream of being medicine. Psychiatrists should be stripped of their meaningless licenses and sent on their way to more suitable careers, like accounting.

2) The “mentally ill” should be educated to understand their conditions as also encompassing strange talents, until they begin to believe the fact that their recognitions are true even when masked by the wildest hallucinations.

3) Medications should be dispensed by doctors who have achieved certification in dispensing those medications. They should know, and prove that knowledge by required yearly testing, that they understand prescribing medications and the facts of addictions that may occur to any such medication they dispense.As it stands, psychiatrists receive eight hours of addiction “education.”

4) Medications known to cause addiction should be removed from any policing or government surveillance whatsoever. Those subject to mental anguish should not be criminalized for trying to relieve that anguish, including and even especially when relieving the added anguish of addiction to a prescribed medication.

5) All those suffering from the acute perceptions so well described in Rumblefish should ultimately determine their own treatment, including beginning or continuing use of addictive prescribed substances, even when addiction has established itself, for the suffering caused by eliminating that addiction will likely lead to more dangerous and illegal addiction.

Flatliners already receive society’s benefits. Those who benefit society without society knowing it — those with strange talents — deserve just as many benefits.

You are nervous, you’ve noticed, but you haven’t got any drugs to help with that, and visiting an unethical psychiatrist in order to acquire a prescription for those drugs would have a negative effect on your ability to obtain health insurance, should you ever feel inclined to do so. You sit on the edge of your bed, feet firmly planted on the floor. You are attempting to ground yourself, so as to move through the nervousness and enter a calm reality. The floor is cold, though, and it is physically painful to keep the sensitive soles of your bare feet flat upon the surface of the freezing floor. You begin to bounce your feet up and down rapidly, and because you had been leaning your elbows on your knees, and resting your head in your hands, the rest of your body shakes along with your bouncing feet. You allow a noise to escape from your mouth – a hum of sorts – and the shaking effects the hum as well. With your eyes fixed on an arbitrary spot on the wall, your feet bouncing on the freezing floor, your elbows jerking up and down with the bounce of your knees, your head wobbling along with the rest of your body, and this jittery, moaning, staccato hum escaping your mouth, you appear to any voyeurs looking through your window to be something of a dunce.

I met Jen in rehab in 1995. She was trying to kick a methadone habit and I was in an ugly battle with the bottle. She’d been in treatment a few weeks before I arrived. And when I did arrive I was running on a two-week binge that had me buckled over and racked with blurred vision. I could hardly move except for my hands that wouldn’t stop rattling. I showed up at their door with a duffle bag full of clothes and a couple of books. One of them being Camus’ Exile and the Kingdom.

They immediately put me in detox. In the bed next to me was this young dude who was hooked on speed. On the other side of me was a middle-aged man whose drug of choice (DOC) was morphine.

“I got addicted after a car accident,” he told me, his eyes pale and gone. He lost two fingers in the accident. “That was the first time I tried morphine. In a hospital of all places.”

When I was in the clear they put me through an assessment and found that I was highly depressed, was loaded with anxiety, suffered from sleeping disorders, and had a problem with alcohol.

I was a walking time bomb.

I was lethal.

I already knew this.

One of the first things they tell you when you enter rehab is that it’s not a place to find romance. Don’t look for a boyfriend or a girlfriend in rehab. That’s not what you’re there for. You’re there to rewire your brain. You’re there to get clean. You’re there to fix yourself. You’re not there to get fucked. You’re already fucked. That’s why you’re in rehab.

But when I met Jen there was an instant attraction between us. She was pretty, had beautiful green eyes, fair skin, and short brown hair. Over the next week I’d see her around the facility. We’d stop and chat, talk about our treatment and whatnot. Small talk. But there was something else going on. One night after a group session I was walking out to my car and she stopped me.

“So, what are you doing tonight, Reno?”

“Try not to walk into a bar and get shellacked,” I said, laughing.

“Sounds like a good plan. How about some coffee? Want to join me?”

That night over coffee and her burning cigarettes we told each other’s story. She came from a wealthy family, was born and raised in Miami. Two brothers, one sister. Mom was a materialistic pill-popping bitch and dad was a functioning drunk who owned a Budweiser distribution center that allowed him to fill up his houses with kitschy shit and wrap his neck and fingers in diamonds and gold. Her brothers were alcoholics and her sister, who owned a successful talent agency, was addicted to everything. Coke, booze, opiates. She was a professional addict who never missed a day of work, never lost control, never went to rehab.

“She has her addictions under control,” Jen said. “If there’s even such a thing.”

Jen worked as a graphic designer and was heavy in the Miami art scene. That’s where she was introduced to methadone. Like many addicts, she experimented with all kinds of drugs including alcohol. But it was methadone that did her in. Her story was the typical drug tale: at first her using was recreational, a weekend thing. And then quietly and suddenly she was in the throes of full-blown addiction: methadone was running her life, waking her up, putting her to bed, and calling all the shots in between.

She avoided friends and family. Her work started to suffer and then disappeared all together. She lost self-respect, her dignity. And then she didn’t care. Didn’t care what happened to her. She packed up and drove across the states to Vegas not remembering much of the drive. I knew the story all too well. I lost my fiancé over alcohol. I disconnected from friends, family, and eventually myself. I told her that when my addiction was at its worse I knew damn well I was killing myself but didn’t care. The pleading voices over the phone didn’t mean a fucking thing. The concerned faces of those who loved me were featureless, blank, nothing.

The bottle won and was eating me alive.

We started to see each other a lot. We’d go to the movies, have dinner. We’d jog the Vegas Strip, hike Mount Charleston. We flew to California and sipped lemonade on the Santa Monica Pier. We watched the sunset and held each other. We couldn’t change the past. What the future held in store for us was a mystery. There were no guarantees—our promises just fragile utterances that could be snapped by the deceitful, cunning, and destructive voice of the addictive mind. But we were sober today. That was our mantra.

Today.

Today.

Today.

On the night that it happened we were walking in Sunset Park and I reached for her hand. We walked for quite a while without saying a word. But there really wasn’t much to say. Our hands weaved together said all there was to say.

“Want to go to my place?” she asked.

We sat at her kitchen table listening to Derek and the Dominos and talked long into the night. We wondered and worried if we were ever going to kick our habits. We knew we were in trouble, that our addictions had a stranglehold on us. We knew that if we continued to use then the end result would be the grave. There was no doubt about it. Two months before I lost a dear friend to heroin. A year before that another friend lost his fight with alcohol. One dead at forty-one, the other at twenty-seven. Good men. Funny, intelligent, gentle. But sick and damaged beyond repair. I was right behind them. So was Jen.

We knew we were in control of this.

We knew we were out of control.

“Reno, I know you don’t love me,” Jen said, looking through me. “But will you make love to me?”

My ex-girlfriend’s face flashed in front of me. Her telling me to wait, to not sleep with anyone, love anyone, that it will only complicate matters, not yet, get clean, please, I’ll wait. I shut off my picture-making machine, pushed away her words, and followed Jen to her bedroom as the opening lead to “Layla” slurred behind us.

Let’s make the best of the situation/Before I finally go insane/Please don’t say we’ll never find a way/And tell me all my love’s in vain

I woke up to Jen sitting on the bed Indian-style reading a book of poems I bought her. She looked beautiful, peaceful, her green eyes bright and clear.

“Hey,” she said, in a soft voice.

“Good morning.”

We stared at each other, examining each other’s face looking for something. I finally sat up, held her face in my hands, and kissed her. Tears rushed down her face. And then I started crying. We crossed over. We broke the rules of rehab. We cared for each other now. We wanted each other to get well, to be happy. We wanted the best for one another. We wanted each other to be clean and sober. We held each other thinking the same thing: please don’t use, don’t drink.

* * *

After three months we completed the program. Jen finished before me, but continued her treatment at another facility. We continued to see each other, but as time passed we saw less and less of each other. We were in love, but knew that because of our addictions a serious long-term relationship would be a precarious situation. We were dangerous for each other and didn’t want to bring the other down if our addictions surfaced again. The statistics said there was a high probability they would. This terrified us and eventually broke us up. We cared for each other too much to take the chance.

I remember our last phone call which would be the last time I’d hear her voice. We thanked each other, wished each other good luck, said that we’ll always love one another, but that it just couldn’t be. It was devastating. I hung up the phone empty, crying, lost, but sober. To this day I can still hear her voice coming over the wire.

“We’ll be all right, Reno. We’ll be O.K.”

December 11, 2009 – L.A.X.

In general, I feel good about this. Three months isn’t such a long time, and I certainly wasn’t accomplishing anything in L.A. So what if all anyone has told us about Brazil is that it’s dangerous, and we’ll be beaten and robbed within seconds of landing in Sao Paulo. Just because everyone has a third- or fourth-hand account of a girl who was slashed or a guy who was shot doesn’t mean we’ll be slashed and shot. Never mind that story in the Times about how Brazilian police kill hundreds of innocent people a year. Just don’t ask the police for help. And just don’t think about that other story in the Times that said gangmembers in one of Rio’s favelas just shot down a police helicopter. That was Rio.

Everything’s going to be fine.

 

December 15 – Sao Paulo

On Sunday, Day One, it was raining, so after breakfast we went to a nearby mall. I don’t see how Sao Paulo can be dangerous. At the entrance a man stands with a machine gun strapped to his bulletproof vest, the cuffs of his black cargo pants tucked into his army boots. That seems to be the hip look for scary paramilitary types. When a man tucks his pants into his boots, you can just assume he has no problem with cold-blooded murder. Think about it: those Blackwater Nazis? Tuckers, to a man.

Inside, there are five security guards for every civilian. Men in dark jackets stand about thirty feet apart, watching every move we make.  When I take my wallet out of my pocket to pay for some cheesebread, I do it very slowly.

Yes! We successfully ordered cheesebread! We communicate with the natives via pointing at what we want. As a result, we tend not to get exactly what we want, but we are adaptable and our stomachs are strong.

 

December 16

Stomach pain!

Shouldn’t have gone from being vegetarian straight to eating chicken wrapped in bacon.

Also, Portuguese is hard. It shares words with Spanish, but Brazilians pronounce the Rs like Hs at the beginning of words but like Ds in the middle of words. They pronounce Ds like Js, and Ts like CHs (as in “Chanukah”), except when they don’t, and I have no idea when that is. Basically I have to rely on context to make a guess about what people are saying to me.

Have discovered local Starbucks. Emotions: conflicted.

 

December 17

Karen is jealous that I get to hang out all day while she has to work. I sympathize, but hey, I’m working. These crossword puzzles aren’t going to do themselves! I mean, I’m trying to plot my novel, but well, it sucks. And right now, someone is using a circular saw right on the other side of this wall, and the sound is like a demon screeching inside my head. I would leave this place, but I’m waiting for coffee. Still learning the local customs. I’m relying wholly on tone and context here, but I think the barista just said to me, “Sit down, bitch! I’ll bring you your goddamn coffee when it’s ready!”

I miss my dog.

 

December 18

Brazilian greetings are complicated. Before noon, it’s “Bom dia!” (but you say, “Bong gee-a”). Then, “Boa Tarde!” (“Ta-ch-jee!”) and then at night, “Boa Noite” (“Noichee or Noich.”) But you also might get, “Tudo bem?” or “Tudo bom?” which are apparently interchangeable. If someone says “Tudo bem?” your response is supposed to be “Tudo bom!” and vice versa, but so far all Karen and I have been able to do is smile and repeat whatever they’ve said to us, or lapse into a lame “Hi.”

I’m at a mall. I flew six thousand miles to sit in a mall. Next to Starbucks. But in my defense, it’s an outdoor mall, and it’s the only place in like a three-mile radius where you can be outside without suffering the noise and air pollution from the cars that clog every street.  And I’m not at Starbucks. Just next to it. At Fran’s Café, which, I’ve been told, is the Brazilian Starbucks.

There are security guards everywhere. The patrons of this mall are professionals and the super-rich. I’m the sketchiest-looking person here.

 

December 19

I did our laundry for the first time yesterday. It’s a complicated business, that begins with my calling housekeeping and saying, “Posso reservar a lavanderia?” and the housekeeper’s saying, “Que?” and my trying again and her saying something unintelligible that goes on way too long but ends abruptly so that the silence extends into awkward territory until I say, “Um…” and she says, “Agora! Agora!” and I say, “Oh, now? OK!”

I took the elevator down to the stiflingly hot basement where the laundry room is and where the housekeepers all marvel at the gringo man doing laundry. I don’t know much about Brazil yet, but I’m guessing they don’t have house-husbands here. I think of saying in Portuguese, “A woman’s work is never done!” but my courage fails me.

The machines are slow and stubborn, and the dryers don’t actually dry. I used up my entire allotted three-hour window, and still had to hang clothes from every possible place in the apartment to dry them. I managed to hang all of Karen’s undies on hangers, five each, which I then hung from our dining table chandelier. If all else fails, I will become a panty-mobile maker and sell my crafts by the roadside.

 

January 4, 2010

New year, old shit. Trouble sleeping. How can I detach the critical part of my brain?

I’m in the penthouse common room of the hotel. The view is 360 degrees of high-rise buildings, beautiful in a sort of tragic, pre-apocalyptic way. Every now and then a helicopter flies by and keeps going or lands on one of the office buildings in the neighborhood. Those guys — the ones who take helicopters around the city — just have to be all-star douchebags. There’s just no way around it.

There are security cameras in here. They’re also in the hallway outside our room, and in the elevators. Do they make me want to adjust my scrotum and pick my nose more than usual, or am I just more aware of these urges?

 

January 7

The housekeeper is messing with me. I leave the room at the same time every day to allow her to clean, but today I leave for two hours and come back, and she still hasn’t been here. What do I do? I am a home-person. I’m the roommate about whom other roommates moan to their friends, “He’s always home!”

I can only sit in so many cafés, and the hotel roof gets too hot in the afternoons. Where can I go?  Who will care for me? Is this how my ancestors felt? Would building a golden calf make me feel any better?

 

January 8

No.

 

January 9? 10?

I’ve lost track. Feeling a bit… low. I’m working at the juice place I’ve been going to so the servers at the cafés don’t think I’m stalking them. It’s pouring rain. It’s rained every day that we’ve been here, which is fine with me. I could go back to the room, switch the green Favor Arrumar o Quarto card on the door handle back over to the red Favor Não Incomodar, but then the room won’t be cleaned! What if we should want to shower again today?! The towels will be — gasp! — damp!

Karen says she doesn’t think the room needs to be cleaned every day — we certainly don’t have a housekeeper in real life — but I’m afraid of setting a precedent. Skip a day and the housekeeper may never come back. Or skip a day, and then I’ll skip two, and then three. Before we know it, we’ll be living like animals.

Also, I just left the hotel, and I can’t run that gauntlet again. On my way out I had to walk past the front desk, where no fewer than four blue-blazered hotel staffers milled around, all smiling fakely and saying, “Tudo bem?” or “Tudo bom?” or “Bom Dia!” Then there was the stoic security guard at the door, his deep “Bom Dia,” and then the three valet parking attendants. I just nodded and kept walking, like someone who is busy, very busy. No time for chit-chat, I have places to be, people to order coffee from!

No. Can’t go back to the hotel.

 

January 11?

Why can’t I get my shit together and get some work done? What’s my problem? Why won’t the housekeeper be consistent? Why doesn’t this hotel have a back door?

It’s too hot to think in this climate.

Stomach pain is back. Yesterday we accidentally ordered a stew that had at least four different animals in it.

When we get back to the States, I’m going vegan.




The coyote is lying on the side of the road. Lazily, softly, as if it is sleeping. But dead—this is obvious. A dead coyote, the color of maple, with thick, lustrous fur that makes it seem pettable and friendly. My tires whiz by its body with one final indignity: the spraying of filthy sleet.

The air outside is frigid. It is early morning, January, and from the gunmetal sky fat snowflakes fall quickly to the earth. I notice how long the coyote’s ear is, splayed backward and open, now quietly filling with snow.

A little further up the road is another coyote, in similar posture. Then 50 yards later, one more. A trio of coyotes, struck down, I imagine, in quick succession. Perhaps they were a family. Perhaps each was running to the aid of its fallen mother or brother. At the thought of this, I almost start to cry.

The snow starts falling even faster now, in a diagonally blowing wing that howls faintly and whips around my car. I slow my old Saab, make sure the lights are on, but the other traffic, I notice, is moving at its usual highway pace of about 90 miles an hour.

I have a baby in the car with me, just two months old. She rides, well-anchored, facing toward the back. I peer at her car seat in my rearview mirror, and my heart stutters. My baby, Muirgen, sees no dead coyotes; she only hears the music on the radio or the soft cadences of my voice. I take her to the art museum where I work. She lies quietly underneath a baby gym or in my arms as I make phone calls. I nurse her and type with one hand.

But I hate to drive anywhere with my baby. I hate to leave the house. Catastrophe and death, I fear, await us, as if we too were coyotes, scrounging for food in the wasteland of winter fields, dodging speeding semis and Jeeps in our quest for a small puddle of water from which to drink.

I can picture clearly the accident that will kill us. It plays in my mind like a film. I feel the steering wheel spin through my helpless hands as the car flies off the road, flips in the air. There is a pause, during which time we hang upside down, wondering, suspended, What is happening? Is this real?

I can almost hear the delicate whisperings of angels as they hover by our impending wreck. But this is not reassuring—instead, it is terrifying—and then angel whispers are drowned out by a crash, massive and final. Glass and metal crush and smash. I scream and reach out for my baby, but we are both strapped in too tightly, unable to escape.

This is the scene that I picture when I drive or even think about getting into the car. There are more scenes, equally horrible.

I picture my child burning alive, myself overcome with smoke, unable to rescue her. I see her in a tiny coffin, being lowered into the ground. I cannot bear to even imagine this horror.

This pervasive sense of doom and dread, the heart palpitations, nausea, the crushing pains in my chest—it is anxiety, I learn. Just one little word for this terror that haunts me. I am simply anxious.

Am I also depressed? I tell the psychiatrist that I don’t think so. Oh, but anxiety goes hand-in-hand with depression, especially post-partum, I am told. I must have PPD—post-partum depressive disorder.

I bristle at this diagnosis. I have read horror stories about PPD-suffering new mothers who lost their minds and smothered their babies. I love my child; I am certainly not sad that she exists, or that I am her mother. I am not crazy. I would never hurt her. In fact, all I can think about is how to keep her safe.

It is, I learn, hormones that are most likely the cause of the problem. I am seriously depleted, running on empty as far as estrogen goes. Stop nursing, I am told. Take Zoloft. Take Paxil. Go on a vacation and leave your baby behind.

This PPD that I am told I have renders me consumed with worry, even during quiet, happy times. I hold my daughter and rock her, read to her, sing. She gives me a radiant, gurgly smile and looking into her chubby face, I feel joy. A nanosecond later, I am sure that we will be savagely murdered by the repairman who is coming to fix our washer—so sure of it that I can imagine exactly how he will corner us in the kitchen with an enormous knife. I will try to flee, but he will catch us and pull us back, stabbing brutally, relentlessly, before we can wriggle out the window.

I picture all of this while sitting on the couch frozen in terror, clutching my baby. Then I have an idea. I steel myself to get up, lock all the doors and post a note saying we had to run out. I huddle on the couch with the baby, hiding, keeping still, until the repairman gets the note and drives away.

Only then can I breathe normally.

I tell my husband about my horrible daydreams, but briefly, and always with a touch of humor. (“I just thought Satan was speaking to me through our child. Ha ha. I think I’ll go lie down on the couch.”)

I don’t want to scare him, but I just want him to understand that I need help and hugs and comfort. This he offers, but because I am not completely honest, he never understands either the depth of my fear or how close I might be to a breakdown.

**

The word “anxiety” is interesting to me. It slides off the tongue and sounds almost elegant, but is derived from the Latin angere, which means “to choke.” Anxiety is a disorder that is sadly commonplace, and, by definition, frustratingly vague.

Anxiety can be either low-level, or “generalized,” or it can manifest itself into full-blown panic attacks, post-traumatic stress disorder, or obsessive-compulsiveness. According to psychiatric literature, anxiety is often not attributable to a real or appropriate threat and can be a symptom of other problems, physical or psychological.

The sort of anxiety I have feels like full-blown panic sometimes, but apparently it is only generalized. There are people much worse off than I am, those who actually pass out from fear, those who cannot ever leave their houses.

After consulting a pharmaceuticals textbook, my university-clinic doctor prescribes low doses of Valium because, she says, “That’s the most cost-effective way to treat this.”

I don’t take the Valium because I am still nursing, and because I need to drive. Instead, I make up excuses not to come in to my part-time job in Cedar Rapids. “My car tire blew out,” I say. “I can’t find my keys.” Oops—couldn’t call in sick (had to e-mail; the coward’s way out) because I misplaced my phones.

I buy life insurance—much more than my father says I need. I want to be sure that my child is cared for, in case the worst should happen. I hope she will remember how much I love her, but I know that if I die before she reaches a certain age, she’ll probably retain no memories of me at all. That doesn’t matter, I tell myself. It is now that matters. Do the best you can for her now. Keep her healthy and safe.

While Muirgen naps, I go online and visit the PPD survival group chat rooms. I see a posting from a woman who, it seems, is just like me. She got pregnant on her honeymoon and now is struggling with both PPD and trying to maintain a good relationship with her husband, who claims he hardly knows her anymore.

I write to her. I say, “It’s so hard to be hit with all of these changes at once—getting married, being pregnant, possibly moving house, having a baby.”

Her husband, like mine, probably had about two weeks to look around and say, “Wow, we’re married…” before being faced with a nauseated, exhausted woman, a woman whose pretty face got puffy, whose nice clothes no longer fit. A fat, tired stranger—and then, suddenly, two strangers, one of whom cries a lot and has stinky diapers.

“Of course it isn’t easy for us; we’re the ones actually experiencing all these things,” I write, “But it’s got to be almost equally weird for these men.”

She writes back that we are kindred spirits, in the same boat, exactly. She tells me that her son is named Vegas. I assume, rather stupidly, that she is Hispanic, but then she explains that her baby is named after Las Vegas, where she honeymooned.

“Good God,” I think, “She named her kid Vegas.” I can’t bring myself to send her another note.

I drop out of the chat rooms. I resist the psychiatrist’s reluctant offer of psychotropic drugs. I decide to handle things on my own, to let my body adjust naturally.

There are some women in this online PPD group who are seriously ill. Their children have been taken from them. They cannot get out of bed. They are hallucinating and could be dangerous.

Some are glad that their mothers or in-laws are taking care of their babies. Some desperately long to get their children back. They all have to wait, though, for the drugs to kick in, for their hormone levels to stabilize. This could take weeks or months.

Meanwhile, their babies are growing fast, sadly apart from their mothers, swaddled and alone with relatives who may be forcing outdated, even harmful baby-care practices on them—feeding the newborns “pablum,” insisting that they only get a bottle every five hours on a strict schedule, that they not be picked up when they cry so as not to “spoil” them.

Some women vent about this. I read their postings but keep silent, feeling grateful, despite my own problems, that I am not in their shoes.

The biological point of anxiety, its reason for existing, is to help us run from danger. But if the danger is all in our minds, well what’s the point of feeling “fight, fright, or flight” in response to that?

I understand that PPD is essentially the result of a chemical imbalance, but it seems like a disorder we should have evolved not to have. Post-partum is a crucial time, a time when we need to be fully present and strong for our babies. As a species, how can we afford to have up to a quarter of all new mothers paralyzed by fear, wracked by tears and hallucinations, hearing demonic voices? What could possibly be the benefit of all this?

Does PPD keep us safer by, in a seemingly sexist, eerily fundamentalist way, keeping us at home? Does the very presence of this disorder spur husbands and relatives to help more with the baby? Or, is PPD just a sick example of natural selection—weeding out the neurotics, the especially paranoid?

**

I am driving home from work, south on the Avenue of Saints from Cedar Rapids to Iowa City. I remember the coyote I saw the previous summer, when I was heavily pregnant but could not yet even imagine how much my life was going to change. That coyote stood in a field that had just been mown, hay tied in neat bales that dotted the landscape. Her ears were back, and she looked scared, as if thinking, “What happened to everything I knew? Where is the long grass that used to hide me?”

Everyone says that coyotes are smart, that they are brave, adaptable hunters who will eat flesh or fruit, whatever they can. But many farmers see coyotes as nuisance animals, predators that will steal and kill their sheep or chickens. Coyotes are, therefore, unpopular guest on the land that they hunt—and the rest of the land is being taken from them and used for new roads, new subdivisions.

The world is changing for coyotes. I realize that the world is changing for me. Still, the coyote adapts, using its innate cleverness to negotiate the changing landscape. Of course, I will need to do the same.

The image of the anxious-looking late summer coyote is imprinted on my brain.

When I see, months later, the dead coyotes, I wonder if she was with them, if her life is over now, if her presence has been savagely erased.

I don’t believe that my life, with all its blessings, is really anything like a coyote’s. But it is the coyote that reminds me how quickly things can change.

 

 

The windows around the front door look like aliens. I seem to be the only one who recognizes it, but it’s so obvious. They are tall, skinny aliens with arms that reach down to their knees. Their bug-eyed heads are elongated just like the aliens on TV, except that the top comes to a little point like a dollop of whipped cream. As a kid, I ran up the stairs feeling their noodle arms reaching out to grab me and pull me out of my world and into theirs. I always felt them just an inch behind me.

Standing in the laundry room, if I tapped unexpectedly on the metal surface of the washer or dryer, the noise might be startling, and suddenly I was thinking, “What if that’s the signal?” The signal for ghosts or aliens or whatever might be waiting in the ether for its moment, its chance to come abduct me or just to show itself, thereby ruining the reality on which I had an already tenuous grasp. I would do it again to disrupt the signal — rap on the washer once quickly, try to make the exact same noise — was it once for yes and two for no? I don’t remember. Do it again just in case. What if I have said something I don’t even understand in their alien language? Tap out a complicated rhythm to indicate a scratching out of what has inadvertently been written on the paper of time-space continuum. If all else fails, run out of the room and all is forgotten.

I experienced life in fast forward and slow motion at the same time, a contortion that threatened to tear the flimsy tape of continuity. It starts with the combination of silence and the ever-present humming in my ears. No one is speaking, no power is running, yet there is a subtle ringing in the upper reaches of my inner ear. Careful about tuning in to that. It’s not an imagined noise. It’s the sound of the ear existing. Catching air or whatever.

Listen too hard, and things get twisty. Internally, things are faster. Externally, I am surprised by the slow sound of my own voice. It comes out syrupy. I try to talk faster to catch up. I try and think slower. Things are out of sync.

I had dizzy spells for no reason. When I was still very young, they were fun. I would lay on the soft carpeted floor of my bedroom and let the experience envelop me. I didn’t have a word for it, yet. It had not occurred to me to ask if this is normal. The room shook. My heart raced. I just lay there and enjoy the natural high of overactive nerves.In high school, it would become a problem when I had to grip the sides of my desk to keep from falling out.

I have trouble wearing nail polish. I can’t keep it on. The minute there is a crack, I have to peel it all back. I chip it off, bite and scrape, leaving little flakes on my desk, clinging to my skirt, and stuck with sweat to my palms. I’m bent on deconstruction. When the nail polish is gone, I start on my cuticles. You would think I could outgrow this. You would think I’d eventually figure out there is nothing but blood under there, but I don’t. I keep digging. If not cuticles, then scabs or zits or dry skin — have you ever soaked your feet in a warm bath until you could just run your fingernails along your heel and come up with an inch long strip of skin? It’s not really skin anymore.

I learned my triggers, and then I felt funny about using this word, “triggers.” It’s got to be some kind of AA jargon, but I’ve never been in AA, so I must have picked it up from one of my friends who went to AA or NA, and I feel like a phony for using their lingo. I mean, they’re the ones with the real problems, right? Who am I? What right do I have to sit here and feel sorry for myself? But anyway, phony or not, I know my triggers: Alcohol, laziness, Sunday evenings, those things make it harder. Coffee, sex and exercise make it better.

I like to read about philosophies and religions that point us toward making peace with ourselves. I like Buddhism, but I don’t like to sit still for meditation. I don’t like to go to church or listen to preachers. I want a teacher, but I wouldn’t listen. I’m all I’ve got, then. But I do like the idea of oneness. I appreciate the fantasy of melting into a larger identity, not just for the delight of finally getting out of my skin but for the escape from being a person who must get dressed every day, and go to work, and pay bills, and be nice to people. Briefly, I can imagine that if I melt into the larger whole, I would be something much larger, much more magnificent than my little self with my little job and my chipped nail polish.

Sometimes I practice so-called magic, making creative use of salt water and a handful of herbs, knowing intellectually that it does nothing, and yet the ritual gives me comfort. I direct my unruly energy toward a cup of salt water on my desk and feel better about things without knowing why, exactly. The logic of the anxious is a bit more flexible. Solutions don’t need to make sense if the problems don’t make sense. I was sitting at my desk thinking the world was going to end, and a cup of saltwater made me feel better.

If I write down everything that makes me anxious, somehow, this makes it better, too. I apply words like a salve to this mysterious wound. I practice these home remedies until it stops hurting, and then I live like a normal person until it starts hurting again.

Pee Shy

By Kristen Elde

Humor

The other day I swung by Quest Diagnostics for some routine diabetes-related testing. First up: the blood draw. Ridiculous, but I near-hyperventilate just thinking about this procedure. I always make it a point to inform the phlebotomist of my irrational fear well before he/she does his/her thing, just in case doing so guarantees me a really great draw courtesy some extra care. This woman, pleasant and chatty, laughed and said, “Oh, you’re too much.” Word.

Anyway, it was fine. Fast, painless. Great story, huh? Stay with me.

After blood came urine. Ah, everyone’s favorite: the ol’ pee-in-a-cup trick. Because I’m a decent human being, I’ll skip to the end—to that part when you’re left standing in the middle of a private bathroom, one hand warmed by the golden specimen it’s wrapped around. Generally, this rude sensation need not last long. Following instruction, you simply set your cup, capped tightly and marked with a personal identifier, on a designated shelf. With a thorough scrub of the hands, you’re on your merry way.

Today, though, things went a bit differently for me. For starters, at the point that I was ready to hand off to the shelf, I realized the bathroom was not furnished with one. The words of the friendly phlebotomist came back to me: “Just bring your sample back here [bloodletting room] when you’re finished.” I then realized there was no lid to go with my cup, nor was there a strip with my name on it. Wha? But it could be anyone’s! What if there’s a mix-up? What if someone else gets my diabetic pee? What if I end up with a meth addict’s pee? Highly unprofessional! Gingerly setting my cup on the floor, I washed my—wait, no water? And none of that deliciously foamy soap to go with it? Nothing! Remembering that I’d be handling the cup again anyway, I let it drop (the issue, not the pee).

More than a little freaked, I nudged the door open. There were several people—staff, patients—filling the small hallway, and while I knew my room was close, anxiety was clouding my ability to recall details. Is it that room two doors left or the one just right? By now I had completely cleared the bathroom, putting me and my pee in full view of passersby. I took a left that should’ve, turned out, been a right, and when I went to correct myself, I felt the pee slosh in its cup. Whoa! This was followed by visions of dampened pant hems, disgusted faces, injurious slips… Oh, to hell with it. I walked into the nearest empty room and placed my cup, its contents exposed to plenty of airborne bacteria by now, on the handiest surface I could find (probably too close to the computer, but hey) and aimed to jet. On my way down the hall, I caught sight of my phlebotomist. Muttering and pointing, I made it clear where my pee was resting. Then I realized I was without wallet. Which meant I still needed to locate my room. Thankfully, without that cup in hand, my brain function restored itself and things fast settled out.

If ever I could’ve benefited from an open container law…