The last weekend I spent out at the East Quogue house I packed the kitchen up with Zoë; the two of us, hoarders by nature, argued back and forth about which itty-bitty item of food or half-finished beverage could be dumped as opposed to being dragged back to the city in a jumble of boxes and shopping bags. I was more relieved than anything else that it was time to be going—that I had gotten through August without crashing to a halt. The end of the summer had always made me sad in years past, but this time was different. I would miss the garden and the talkative chickens, would miss closing my eyes and giving myself up to the sun, but not much else. I had tired of perusing the Hampton glossies and walking through the shabby little town on my way to the Jitney, wondering why I had traveled two and a half or sometimes three hours only to land here. And although the fall didn’t precisely beckon, there was always a chance things would take a turn for the better once I was at home.
I arrived back at my apartment and was glad to be among my familiar companions, my thousands of books, again. They called to me from the bookcases, old and new, suggesting all manner of directions I might roam in. For a moment everything felt freshly come upon, as though my depressed self had stepped back in honor of my homecoming, giving me room to move forward. I had forgotten what it was like to be without its smudgy imprint, and for a moment I floundered, wondering how I would recognize my life without that telltale darkness.
35
I go on a Thursday evening to see my psychopharmacologist, a preternaturally young-looking man who trained as a neurologist. We have struck up something of a friendly relationship beyond the confines of the patient-doctor interaction; we will sometimes share a taxi across town, for instance, if mine is his last appointment. I have sent a bunch of people—ten or twelve in all—to him who mean a lot to me, so convinced am I of his skill and understanding. And yet I don’t believe in his expertise when it comes to my own predicament, mutter darkly about the guesswork and hit-and-miss character of medication (Why does no one know how, exactly, any of these pills work?), insist that what ails me is not biochemical at all but rather hinges on a lack of vital nurturance when I was young.
“It’s not either/or,” he explains once again. “It’s susceptibility. Not everyone who went to war or gets raped develops post-traumatic stress disorder. But etiology makes no difference at this point. What happened, happened.”
Is there to be no undoing, then, no way of going back and putting myself—my chemistry—in order? If what happened, happened, what front am I fighting on? Between us we hold an ongoing forum on the nature-versus-nurture debate, the plasticity of the brain, and the efficacy of therapy as opposed to pills. For one thing, if this were the fifties or sixties, when nurture was all the rage, I probably wouldn’t be seeing a psychopharmacologist to begin with; the spotlight would be on the psychological dynamics. But now that the biological view of emotional illness is in the ascendant and insurance for psychotherapy is practically non-existent, the environment is given short shrift.
The real point, beyond the fluctuations of a given cultural moment, is this: if there is a propensity for depression in your family history, there is a 50 percent chance you will develop a depressive illness. But if depression doesn’t run in your gene pool, your childhood might be Dickensian and you might all the same not develop a depressive illness. Although it is difficult to hold on to both the nature and nurture sides of the situation, depression comes about because of a confluence of genetic propensity and the triggering circumstances. The latest research on schizophrenia suggests that it involves no less than 108 genes; it’s unlikely that depression will ultimately involve one gene or just a few.
I have explained to Dr. M. more than once that I don’t see my family as particularly “loaded” for depression, despite the incidence of it among my siblings. By this I mean that neither of my parents suffered from it, and that although there have been instances of depression on both sides, they don’t suggest a more-than-usual occurrence in a Jewish Ashkenazi family of European origin. Hell, look deeply into any family’s background and you’ll find a melancholic uncle here and a clinically depressed second cousin there. All of which suggests no more than a 50 percent chance that I would have developed a bad case of the lifelong blues.
I tell him I am tired of the struggle. “I should be dead by now,” I say. “I appreciate all you’ve done but this isn’t what I want.” (“This” being life.) “I’ve stayed around long enough.” He insists that this is my depression talking, something apart from me. “You have a major depressive disorder,” he says regretfully, as if this were the first time he’d come to this conclusion.
“Do I?” I ask. “Are you sure?” The truly strange aspect of my so-called condition is my own difficulty in believing in it as a condition, a disorder, a verifiable illness. Much of the time I make light of it, dismiss it, the same as everyone else does, try to prod it into submission. Pull your socks up, stop thinking about your feelings, that sort of thing. I am deaf to my own pleas for tolerance, unforgiving as a Midwestern accountant of what I know on some level to be a disease written into my bones, a cancer of the psyche, in addition to whatever my personality flaws may be.
Dr. M. tells me he has seen me worse than I am today—that the first time I consulted him, some years ago, when I had gone off all medication at the suggestion of the therapist I was then seeing, I could barely speak. “You looked terrible,” he says, “like someone underwater.” Today he decides to go up on one of the pills I am on—Abilify. The problem with Abilify, not that anyone will state it upfront, is that it makes you put on a significant amount of weight. I was once a relatively slim person—thin enough to pass muster, at any rate—but this is no longer the case. I have often wondered whether the thirty to forty pounds I’ve gained since I added Abilify to my regimen of pills some years back has deepened my sense of despair about myself, given how important the mandate of thinness in women has become in our culture. A friend of mine, a younger woman with a highly developed regard for her own looks and a bipolar disorder, went off Abilify precisely because of this unwanted side effect and immediately shed many pounds. “They fell off,” she announces happily.
There are other drawbacks to both Effexor and Abilify, none of which have been spelled out to me by Dr. M. beforehand but which I discover as time goes by. These include a rise in my blood sugars and liver count; the latter is so high that I had a liver biopsy done two years ago to try and assess what was causing the problem, with nothing much determined other than that I had a fatty liver.
All the same, I sense some hesitancy on Dr. M.’s part connected to the use of this drug, although I can’t precisely put my finger on it. I wonder whether there is the unspoken possibility of my eventually developing the symptoms of tardive dyskinesia, which can occur as a side effect of taking antipsychotic medication, also known as neuroleptics. This is a disorder that involves involuntary movements, especially of the lower face—such as grimacing, tongue-thrusting, and repetitive chewing—which are hard to reverse and can become even worse with time. You occasionally see people with tardive dyskinesia on the subway, looking as though they can’t fit in their own skin.
“Is there something wrong with Abilify?” I ask.
“No,” he says, “but it is an antipsychotic.”
“Meaning?”
“You don’t want to prolong your stay on it.”
“I see,” I say. I entertain a vision of myself as an elderly woman in a dragging coat, screwing my face up wildly, frightening strangers left and right.
“Would you take it?” I ask, thinking to ensnare him.
“If I had your condition and it helped, I would,” Dr. M. answers.
Once again I am left being me, with my particular past—“What happened, happened”—when this is so transparently not who I want to be. Sometimes, for minutes on end, I forget who I am in Dr. M.’s cozy office, imagine us both as intergalactic fighters, familiar with the evil forces of Planet Depression, as he calls it, and all they
entail. At those times I feel valiant, like someone who has determined not to surrender to an enemy most people can’t even see.
36
In a few weeks I will turn the age Virginia Woolf and Deborah Digges were when they committed suicide. It is by now well documented that nonlinear creative types, artists and writers in particular, often suffer from depression; whole books have been devoted to exploring the high incidence of both unipolar depression and bipolar depression in this group. Anywhere you look, there they are, the unhappy poets and painters, drinking or drugging themselves into a stupor, cutting their wrists, hanging themselves, shooting themselves, jumping from buildings, and driving off bridges. It is a matter of some amazement to me that I am still here, given my recurrent desire not to be. In that way I’ve surprised myself: not giving in to the undertow.
But perhaps I’ve all along underrated the pull of life itself, slyly offering up its enticements. I tend to give short shrift to these enticements when I’m sinking, but they are very real. They would include but are not limited to the supreme diversion of reading and the gratifications of friendship, the enveloping bond of motherhood and the solace to be found in small pleasures, such as an achy Neil Young song or finding the perfect oversized but not voluminous white shirt. Not to overlook my (mostly) inextinguishable sense of curiosity; a certain pleasure I take in beautiful things and aesthetic experience generally, such as a filmy, dun-colored scarf, or the cerulean shade of sky on a late summer afternoon, or listening to Vivaldi’s The Four Seasons played as if it were newly composed one May evening in the Sainte-Chapelle in Paris. And, yes, the tug of love, when I allow myself to feel it, for all those who help tether me to this world.
Still, how many times have I shoved off thoughts of suicide, walked myself around the wish to die, back to some kind of truce with life? How many times have I explained my suicidal frame of mind in a slow, halting voice to a therapist who first threatens to call 911 and then asks me to put off killing myself at least until the next session, as though he were asking me to postpone a decision to get a haircut? I agree for the interim, give my word that I won’t act on my lethal wishes, at least for the moment. All the same, how long can you flirt with suicide before embracing it? Spalding Gray, whom I never saw in performance but whose journals I devoured with the avidity of one who recognizes a fellow desperado, listed “suicide victim” as one of nine alternate identities for himself (along with “a Zen monk” and “a movie star”) years before he finally called it a day and jumped off the Staten Island ferry.
In my fantasies of suicide, I never write suicide notes—with a few exceptions they strike me as, on the one hand, gratuitous, and on the other, slightly melodramatic—but of late I have been thinking I would owe my daughter, at least, an explanation. And an apology, for all the good it will do. (In Death Becomes Them, in the chapter “The Art of the Suicide Note,” there is oddly no mention of children as the potential recipients of such notes: “Suicide letters have been addressed to siblings, husbands, wives, lovers, bosses, friends, fans, mentors and enemies.”)
I have heard all the terrible statistics about the children of mothers who kill themselves, the lingering harm it does; I think of Nicholas Hughes, the zoologist son of Sylvia Plath and Ted Hughes, who was an expert on “stream salmonid ecology” and hanged himself in 2009, when he was forty-seven. He was reported to be suffering from depression, and I glean from what little information is out there that he was something of a loner, but would he have killed himself without such a ready maternal model at hand?
Then, too, my daughter has been dealing with the reality of my depression for so much of her life that I’m convinced it half bores her, like a story that’s gone on too long. On the other hand, I worry that my relentless misery has taken away her right to assert her own unhappiness as legitimate, equal in seriousness to mine. Not to overlook her happiness, a capacity for which I fear I may also have thwarted. She is a creature of many moods but she keeps most of them to herself, as if to keep her distance from my own tendency to spill my emotions—my “rawness,” as she calls it, with a note of disdain in her voice—all over the place.
The only exception to her disinclination to talk about herself is when she has had too much to drink, which she sometimes does at social gatherings. Then she opens up like a flower, becoming giddy with merriment, pleased to confide her innermost secrets to perfect strangers instead of merely being the ready listener. You can see at those moments the person Zoë was meant to be, engaged with the world in a free and easy way. Once, when we were attending a family wedding together, she got the rather closemouthed man sitting next to her to divulge his sexual loneliness in the wake of his wife’s death by virtue of her gentle probing. At other times, though, the effect of drinking is more troubling—leaving her sodden with sadness. Then she will call me in a slurry voice to tell me how tragic everything is, and I fear this is the true inner Zoë. My one consolation is that she seems willing to be talked out of her gloom, at least until the next go-round.
I think of how much more Woolf had done by this point in her life than I have in mine—all the books written, the founding of the Hogarth Press with her husband, Leonard, her intense rapport with so many people by way of conversations and letters. It’s not that I have accomplished nothing—I have published three books and written hundreds of thousands of words for a wide-ranging assortment of publications, been a passionate if not always reliable mother, a caring sister, a good friend, and a devoted aunt—but that it falls so short of what I once hoped for.
I suppose you could say that the mere fact that I’m still banging around is itself a triumph of something—strength, fear, indecision—but I wonder whether it isn’t also a failure to keep my word to myself. I have promised myself suicide the way other people promise themselves a new car, gleaming and spiffy. It is something I think I deserve, a reward for bearing up under what feel like intolerable conditions, the dreary dailiness and balefulness of existence coming at you again and again. I understand that taking one’s own life is not in itself a positive thing, of course, that it represents a turning on the self of the most radical order, but I also think it is possible to look at it as a kindness, a way of paying utmost attention to one’s own utter bereftness.
Then there is this: I have always secretly believed that suicides don’t realize they won’t be coming this way again. If you are depressed enough, it seems to me, you begin to conceive of death as a cradle, rocking you gently back to a fresh life, glistening with newness, unsullied by you. If you are depressed enough you are prepared to jump off the ledge of dailiness and into the embrace of oblivion—in the private and entirely unprovable knowledge that oblivion will yield to an expanse of green field, dotted with wildflowers, where you will run and run, unencumbered by the heaviness you have been carrying with you for what seems like forever.
This secret conviction bears some resemblance to religious faith, although it demands nothing and offers nothing back except its own irrationality. Because I suspect myself of harboring this dubious and childlike belief, I have written down a quote from Rilke’s “Ninth Elegy” that tells me otherwise, in which the poet acknowledges that while happiness barely exists except as a prelude to unhappiness, this world is all the same our one and only ticket. If I could heed the poem’s unsentimental message and last the dark season out—and the next one—there might be something durable, a more permanent holding:
But because truly being here is so much; because everything here
apparently needs us, this fleeting world, which in some strange way
keeps calling to us. Us, the most fleeting of all.
Once for each thing. Just once; no more. And we too,
Just once. And never again …
Somewhere along the way, I’ve apparently internalized this message enough to have scribbled my own version of it while looking out at the Long Island Sound one summer, committing it to memory like a prayer: O My Lord, what a tragic and terrible, weird and slightly wond
erful life this is. My one and only, our one and only, hold it close, away from the worms, live it through, give it every chance you’ve got.
* * *
Despite my pronounced habit of losing things, I still have my Virginia Woolf doll roughly forty years after first receiving it, having managed to hold on to her through at least four moves. She is, admittedly, a bit worse for wear, my Virginia: she is missing one black sock as well as the miniature envelopes that once nestled in a pocket. But she is still dressed in the clothes she first arrived in, that knitted maroon cardigan over a gray wool skirt. This Virginia is resilient, would have gone on to write many more astonishing books, would have sat in the garden with Leonard as the sun went down and their hair turned white and the latter half of the twentieth century came in.
Would Virginia Woolf have lingered longer if she had been properly diagnosed and put on the right medication? Can it really all be a matter of tweaking the serotonin uptake level here, and upping a dopamine infusion over there? Or is this just the latest fashion in wishful thinking? The history of antidepressant psychopharmacology is a relatively young one, about a half century old, and the ways in which the complicated circuitry of the brain affects mood is still a matter of informed conjecture. Undoubtedly the increasing number of people who look for cures to what ails the psyche in the chemistry of the brain and who refer the vicissitudes of emotional development (or “affective disorders,” as they are called) back to inherited temperament would say they could have set Ms. Woolf right.
Others, who look less to cut-and-dried biochemical answers and a bit more to a complex interaction of proclivity and life experience, might choose to hedge their bets, given the traumatic loss of her beloved but elusive mother when Woolf was thirteen, followed less than seven years afterward by the loss of her beloved half-sister, Stella. Not to overlook the sexual abuse she suffered at the hands of her stepbrother, George Duckworth, or the effect of living with an eccentric and fiercely demanding father at the tail end of a repressive and misogynistic age. But even with the most advanced treatment—some ideal combination of medication and therapy—there is always the possibility that Virginia might have chosen to commit suicide eventually, one or two—or ten—years later. These things are hard, if not impossible, to gauge. “Life is one long process of getting tired,” Samuel Butler said. There will always be people who feel that although everyone else is tired, they are too tired, have waited long enough, and that it’s time, now, to get going.
This Close to Happy Page 23
