ANXIETY ON SCREEN: Wallander

Last night I watched an episode of Wallander, the BBC series featuring Kenneth Branagh in the role of Henning Mankell’s Inspector Kurt Wallander.

I’m a Wallander tragic. I’ve read all the books, and I’ve seen as much of the related TV work as possible, including the Swedish language spinoff TV series featuring Krister Henriksson, and the earlier, more faithful Swedish TV adaptations of the books featuring the man who owned the part like no-one else, Rolf Lassgård, my favourite screen Wallander.

I’ve always felt that Kenneth Branagh was wrong for the part, but I’ve watched his takes on the character now many times, and over many viewings I’ve come to grimly accept that he’s never going to be Lassgård, no matter how much I might wish it so. For one thing, he looks much too “together”, even at his shabbiest. He looks too put-together. Usually, at least.

But last night I was watching the adaptation of book three in the series, The Man Who Smiled. It’s, in my opinion, the weakest of the original novels, with an organ-trading rich bastard who is so plainly and calmly evil he could be a Bond villain. I was shocked, reading the book, at how awful a character he is, how almost comically bad, how two-dimensional. And in this TV adaptation, the actor does his best with the part, which doesn’t ask for much other than cool, calm, smugness, a glib sincerity that in the beginning Wallander finds disarming, and even admirable.

But, what’s truly striking about this adaptation is what’s happening with Wallander himself. In the previous episode, he’s for the first time in his life killed a man in morally complex circumstances, leading to what appears to be a complete mental breakdown. He went on indefinite sickleave to a faraway guesthouse near a wintry beach, and Wallander spends, we’re told, six months just standing on the beach all day long, lost in depression and crippling anxiety. Indeed, at the beginning of Smiled, he’s approached on that beach by an old friend who’s concerned about the circumstances surrounding his father’s death. He wants his friend Wallander to look into it, but Wallander turns him away, a shattered man who knows he’s not up to it.

But of course events lead from one development to another on a familiar road of plot (broken man finds wholeness and redemption in work), and soon Wallander, shaking and sweating with anxiety, is on the case, trying to figure out what happened. He’s a detective in not much more than name only. He shakes, and slouches; he sweats and stammers, and barely even speaks or looks anyone in the eye. He sweats so much during his presentation of mysteriously suggestive evidence to his former team that afterwards, slinking back to his office after everyone tells him he’s got nothing, and treat him almost with contempt, he wipes his sweaty armpits on his office curtains.

I’ve seen this episode a few times already, but watching it last night, in the wake of my own recent struggles with major anxiety and depression, I saw it as if for the first time. Wallander is a desperately sick man, barely able to function, as sour and useless as the expired and mouldy food in his unpowered fridge.

This episode, despite the whole organ-trafficking storyline, does a spectacular job of portraying anxiety and depression. It’s unrealistic that Wallander is back to his old self by the end of the episode. In the books his recovery takes longer, and the traumatic memory of shooting a man continues to haunt him for the rest of the book series. But in this TV adaptation, Branagh, who has always done intensity well, makes a convincing anxiety sufferer. The actor has either known it himself, or has studied it closely. I was amazed, watching it, the sheer subtlety of his performance, the minimal touches in the way he carries his body, the way he speaks, movements of his head. It’s an amazing thing to see, at least for me with my own recent experiences.

DEAD INSIDE

One day when I was about ten years old, I believed I was dead. It was a bright, warm day, the sun beating down. It might have been a Sunday, but am not sure. I have few details to go with this memory, other than that cold, numb sensation that at the time, I thought, could only be death.

I’m reading about the writing of memoir lately. Ever since my experience last year in hospital, I’ve been nursing the thought of trying to write down the story, if I call it a story, of my life with mental illness. But the more I think about the prospect of sitting down to work on it, it seems to recede in my mind, as in the sort of dream where you run towards a point up ahead, but that point telescopes out in front of you, a sarcastic version of Zeno’s Paradox, where not only can you never beat the tortoise to your destination, the destination gives you the finger and runs away.

So, writing a memoir about my life living, as if with a terrible house-guest, with mental illness, bipolar disorder, in my case. Where to begin? The memoir-writing book I’m reading at the moment, Beth Kephart’s Handling the Truth: on the Writing of Memoir, suggests, before you very seriously sit down to Begin the Memoir, perhaps instead you should, sort of, ease your way into it, as if perhaps it’s a party and you don’t know anyone there, with journalling. Which is why I’ve been using my website lately. This is me working my way up to writing a book about my life with a terrible house-guest sharing my head, and messing me up.

Kephart suggests lots of exercises to limber up your writing muscles, to start thinking like someone writing memoir, and I’ll be trying some of them here in the near-future. But the one I’m doing today is the recommended exercise of trying to write down your first memory.

My first memories are elusive and fragmentary. I hardly know where to begin with them, other than perhaps as random blurry snapshots not to be taken at all seriously. But considering my overall goal, I thought it would be good to try to describe my first remembered experience with depression.

Looking back from my middle-aged perspective, I can see things from my pre-diagnosis past that look like episodes, or instances, of depression. The first that I can think of was this one where one Sunday when I was about ten years old I suddenly realised, as I lay in my bed that day, a feeling upon me of being far away from my life as I had so far understood it. I was just a kid, and I was used to odd things happening–that was life: practically everything that happens is new to you. And this feeling was new. New and strange.

I felt as if I had died, that I was in fact dead, but because I was already lying down on my bed hadn’t fallen over. That I was awake and conscious seemed weird, but not overly so.

What was I doing before that? I have no true idea. The memory consists of only the details I’ve described. I don’t even know what happened after that. I have a vague and therefore unreliable recollection, possible fabrication, that my mum appeared in the doorway and asking her if I was dead, but I don’t know. I felt numb and, as they would say today, disassociated. Separate from myself. As if looking at me from the outside. Not sad, either. It was like a freedom from feeling. Numbness. Blankness.

I’ve experienced that again many times over the course of my life, up to and including this past week. Depression is like this, like your heart has been removed. Like you’re a lump of something inert and lifeless. And like you’re far from home, perhaps on the Moon, and made of the same arid grey stuff.

DOCTOR VISIT

Today’s visit with my psychiatrist went well. Things are in motion. First up, I’ve been given a referral for a sleep-study, to see if there any problems there that might be contributing to my alarming weight-gain. As well, he has sent me for a blood-test to see if the Nortryptaline is at the right level. The concern is that it might be too high. He also doesn’t want to mess with a drug that in other ways is working reasonably well, considering the extraordinary difficulty I went through last year in hospital.

I also asked him, essentially, what else he had, treatment-wise, besides medication. I said I’d even consider ECT if he thought it might be of benefit. He isn’t too keen on that, but he did ask how I’d feel about trying rTMS (repetitive transcranial magnetic stimulation) again.

I was introduced to rTMS last year, and did not like it. You sit in an uncomfortable chair that reminded me too much of a dentist chair, and there’s this machine against the side of your head that makes these loud clacking noises, and there’s a physical sensation like a woodpecker is attacking your head. Last year, I endured just three sessions of it, hated it, and withdrew my consent.

But now I feel different, generally speaking. I’m up for trying it again, and that would mean being hospitalised again, since the treatment is, as the name says, repetitive: a total of about 20 sessions, one a day except Sundays. It’s a very daunting prospect, but potentially it could mean much less medication.

And speaking of medication, depending on how my blood-test results go, he’s thinking of replacing one of my medications, Latuda, with Topamax, which should help with anxiety, and possibly help with the weight, too. He’s also thinking about a drug called Duramine, about which I know nothing, but which he thinks could also help. The only thing I know about it so far is that it’s some sort of actual stimulant, which is a little troubling.

This all seems pretty daunting, just looking at it here, but it troubles me much less than everything I endured last year, an experience I would not want to repeat. For a while there I had no effective control over my bipolar condition, and suffered a full-on depressive collapse. I did not know until later that my doctors were shocked at the severity of it. The plan had been that I would be weaned off the meds I had been on for about 30 years, and eased onto a new drug, called Zyban. But the Zyban had no effect on me, bit by the time that was apparent I’d been on it long enough that there would be problems cutting it off quickly, so had to endure the weaning off period for that on top of weaning off the original drug (Clomipramine, a nasty tricyclic antidepressant).

Fun Fact about psychiatric medication: any given drug, even the shiny and sleek new ones, have only about a 50% chance of working on any given patient. And with the Zyban, there was simply no clinical response. Which is to say: I could not stop crying. I had a world of trouble sleeping. Michelle or my parents would come to see me, and I’d bawl my eyes out every time they left, and often while they were there. It was awful. It felt shameful. Sitting on the toilet in my room weeping buckets, because it was the most private space I had. And all this because of tiny things measured in milligrams. How could such tiny, birdseed-sized things, cause such all-consuming storms of wrongness? Because it always felt, and to this day continues to feel, like a terribly wrong thing, to cry.

But that’s a story for another time.

APPREHENSIVE

I’m watching Korean TV while Michelle’s making a Korean soup (rice cake soup), and it’s nearly 7pm. I’m preoccupied, though, because tomorrow, Monday, I’m seeing my psychiatrist for a review of my current treatment plan–and the problems I’m having with it.

The main issue is that I’m taking 150 mg of Nortriptyline, a tricyclic antidepressant, and while it does a good job of balancing my mood, it’s having a catastrophic effect on my weight. Nortriptyline’s side-effects include not only weight-gain but also increased appetite, and I’ve got both these things in spades. It’s also given me an extremely sweet tooth, so that I’m always wanting to eat very unhealthy things, and this turn has a drastic effect on things. Since I left hospital in November last year, I’ve regained 10 kg out of the 51 that I managed to lose since December 2012.

I’ve had misgivings about the Nortriptyline since the beginning, because I knew up front that the drug would have effects like this, but for a while it appeared to be doing a decent job of balancing my mood. But all that time, my weight was climbing, and as it climbs, my mood sours in inverse proportion, which in turn leads to unhealthy, emotional eating, sometimes to the point that I don’t care about my weight. Which tells me I’m deeply troubled, to say the least.

So I want to look at possible changes, up to and including coming off the Nortriptyline altogether and trying something else, if there is anything else, or maybe try other sorts of treatment, like maybe ECT, which, while a daunting prospect, is reputed to be highly effective.

My doctor also floated the possibility of starting me on Topamax, an anti-anxiety medication which has the very striking side-effect of weight-loss!

The only potential problem here is that I spent almost half of last year in hospital trying to sort me out with new medication (which is how I ended up on Nortriptyline), and it was a harrowing experience in which I tried a great many things, most of them unsuitable, before going on the Nortriptyline. The experience (withdrawal, anxiety, full depressive cycle, some manic cycles, you name it) was so bad I can’t see my doctor being keen to do all that again.

So I’m apprehensive about tomorrow. I know I’m not yet remotely recovered from last year–I am depressed and anxious as I write this, but I feel a great need to do something to arrest my climbing weight. The way things are going I could end up putting back all the weight I lost, and more, before too long. It’s just about all I think about, my day organised around the daily lunchtime weigh-in.

So am hopeful, but fearful, about tomorrow.

BASQUIAT

BASQUIAT

Michelle and I are out for coffee and lunch at a cafe in Subiaco. For such a wet and miserable day, it’s surprisingly busy here. There’s a constant clatter of plates and cups from the kitchen area, the rush and gurgle of the espresso machine, and a background hum of people chatting. It’s quite pleasant, and although noisy, I haven’t had to resort to my noise-cancelling headphones just yet. I have them with me, just in case.

On a giant TV screen is a series of news headlines, and among those is a piece about the sale in New York of a work of art by Basquiat, which has just sold for a truly colossal sum of money, eclipsing the amount for which a Warhol sold for some years back. The Basquiat picture shows a highly stylised head, but it looks to me like a picture of madness, rage, death and destruction. You can’t easily tell if the figure in the picture is victim or perpetrator or perhaps both, caught in a cycle. In broader terms it seems like a picture of the times we live in now, and I wonder if that very zeitgeisty aspect of the thing is why it’s just sold for so much money. Because these days that face could be reading the news on a cable channel and nobody would think twice about it.