MEMOIR: TESTOSTERONE (Rewrite)
Every two weeks, since last year, I visit a men’s health doctor, where I get an injection of testosterone in my backside. It takes all of about five seconds, and is as close to painless as you could possibly get without quite managing to ne painless. There is the tiniest of stings, but it’s worth it.
Frankly, if the process involved shoving a garden hose into my fleshy backside to get the testosterone, I’d be fine with that, too, because the stuff is so good.
Let me explain. I was sick (ie, chronic, major depression, so deep and long-lasting that it had become my “normal” and I didn’t realise I was sick) for at least a few years prior to last year’s medication-swap adventure. I spent most of each day in bed. It was usually 2-3pm before I got up, sometimes later. Michelle spent huge amounts of time on her own. She was lonely; I was lonely. When I did get up, I’d plant myself on the couch like a garbage bag full of dirty washing.
I was doing a bit of writing, but not much. In early 2015 Fremantle Press published my most recent book, the novel BLACK LIGHT, a fantasy novel about a science fiction writer who has to embrace the supernatural to survive. This was a new book, but I wrote most of it years earlier. It’s just that in about 2013, at a time when, full of depression and poisonous bitterness about writing and the book industry generally, I was thinking about retiring from writing, but I had these old floppy diskettes, and one of them had the old manuscript for BLACK LIGHT. It appeared out of nowhere, a new book that just required a bit of fixing up. Later that same year I did write the third Spider Webb romp, ETERNITY LEAVE, and I hope to see that published someday.
But other than that brief flourish of writerly activity, a mad Catherine Wheel of fizzing, spinning light in the darkness, my depression had kicked the stuffing out my interest in writing. I felt like a failure in every respect: failure as an author, and a failure as a husband, failure as a man.
Because it turns out that when you have this sort of illness, you get prescribed medication which helps to varying degrees, depending on sometimes not much more than sheer luck–but which comes with truly diabolical side-effects. The two worst, yet most common side-effects are weight-gain and sexual dysfunction.
This can manifest in all kinds of ways, including simply making you feel like a mouldy potato starting to grow roots while it’s in the cupboard. You feel cold, inert, and repulsive. You want to hide your physical self. You no longer get anything resembling the sexy feeling that drove you nuts in high school. If you’re a guy you’ll remember that. Starting around age 12 or so, suddenly your penis wakes up and begins to lead a life of its own, keeping its own hours, popping up unexpectedly at odd and unwelcome moments, amd generally being a pain in the arse. You have to start remembering always to carry a bag or a jumper or large books with you everywhere you go because your willy might find the bumping and jostling motion of the bus you’re on rather entrancing, and suddenly you have company in your lap. Or you’re in class, bored out of your mind, aware that your willy is on a secret rampage but it’s okay because you’re sitting down and nobody can see it–but then Mr Philpott asks you to come up to the blackboard to show the working on this algebra problem, and you know very well that you simply can’t stand up right now, but Mr P is staring at you and you’re sweating, and you can feel your willy is almost somehow smug about your predicament. You remember this sort of problem. Everything reminds you of sex. You have no idea what sex is, but you know you know you want it. One day you hear a group of classmates whispering that Singo’s got a “franger” and there’s fevered discussion about what this means, only you don’t know what a franger is, but you gather it fits in a matchbox, because all these boys are boiling around this matchbox, peering in at what could be a fabulous treasure like the Hope
Diamond. Whatever a franger is, it’s something to do with sex, so that’s as exciting as it gets, that’s weapons-grade excitement. Only many years later do you learn that a franger is a condom, and you’re all, “ohhhhhh, I seeeeee!”
But when you take psychiatric medication, all of this goes away. It dies, like an old man with emphysema breathing through a hole in his throat. It’s horrible. You feel hollow. You feel like no man at all, like you’re made of plaster.
I lived with this for a long time. Once in a while, on a good day, with the wind behind me, I could do my husbandly thing, and feel pretty decent about Things and Stuff. Then I’d read an article where someone was explaining that normal couples have sex at least once a week, and my morale would sag like, well, other sagging things.
Last year, when I entered the hospital the first time to begin the medication swap, one of the first things that happened was I had to talk to the registrar on my usual doctor’s team, give him my history, explain who I was, what was wrong, why I was there, and so on. I explained about all the usual things.
But I also realised I had an opportunity here. For decades I’d lived with this dreadful sexual dysfunction. It filled me with horror and shame. I could not being myself to talk about it, not with anyone. I could barely discuss it with Michelle. When she and I did discuss, she imagined she was the problem.
She was not the problem.
So when I found myself with this registrar, I saw an opportunity that I might not get again. I explained, through tears, The Problem. It was bad. It was so bad. It was like confessing a secret sin of the worst, vilest, most shameful sort. The doctor nodded, stroked his beard, made some notes, and said we’d better get onto that then.
I got referred to a “men’s health” doctor, who specialises in not only issues surrounding sexual health, but also psychiatric stuff, and even general practice. An unusually versatile doctor. He examined me (gulp!) and, to my enormous relief, found nothing unusual or obviously wrong or freakish in the general equipment. Fifty-three years old, but pleased like a schoolboy to be told everything looked just fine–neither too small nor too large.
At length I started taking Cialis every morning for its, let’s say, salutary effects on the equipment. Almost immediately, I started getting, let’s say, news reports from the Trouser Department. Things were going well. I couldn’t believe it! I practically wept, I was so grateful.
It shouldn’t be like this. Psychiatric medication should be better than this. It’s always been a blunt instrument. Yes, it will more or less, if you’re in the lucky fifty percent, help you to some extent, but at considerable cost in terms of side-effects, including some that you will absolutely hate. In my case, I was getting sexual dysfunction from both Clomipramine and the carbamazepine. I remember when, thirty years earlier, when my previous doctor and I were going through the MIMS book trying to find me a combination of drugs to replace the lithium I had been on since my initial diagnosis. We settled eventually on Clomipramine and carbamazepine, but I did see in the book where it listed the side-effects, where it said sexual dysfunction. I knew then, just as I was getting to know Michelle, before we’d even started going out, that things would be tricky, to say the least.
This is one of the great perverse things about psychiatric medication: that you’re taking it to help you with certain problems, but it ends up causing you fresh anxiety and depression about other things. You can find yourself feeling as if you’re playing Whack-a-Mole, where every time you smack a problem, something else pops up. It’s endless.
I wound up on testosterone last year when my consultant suggested that it was a master hormone that had regulatory effects all around the body, and that it was thought to boost the effects of certain antidepressant medications as well. By this point I was up for anything that would make me feel less broken and useless, a forgotten doll of a man complete with weirdly-blinking eyes.
A year later, I can report that between the effects of the Cialis and the testosterone, things are greatly improved. It also helps that I have lost a huge amount of weight and I’m getting regular exercise. I’m no longer a bag of dirty laundry on the couch. I’m awake each day in the mornings. I spend loads of time with Michelle. We’re pretty happy. Better living through chemistry, indeed.