MEMOIR: TESTOSTERONE (Rewrite)

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.

MEMOIR: THE WRONG LENSES: THE SCALES Postscript (Updated)

MEMOIR: THE WRONG LENSES: The Scales Postscript (Update)

I wrote a long essay about my anxiety last year over our wayward, unreliable scales, and my need for accurate information about my weight.

Now, while it’s not that I regret writing it, I am feeling deeply stirred up about it. That whole experience, the intensity of my neediness, my self-hatred over the effect it was having on Michelle, was dreadful. When I think about what a shit I was, how I often I felt the urgent need to apologise, because I knew Michelle was fed up. She was doing her very best to humour me and help me, and was utterly wonderful, despite a very demanding job, and the other calls on her time. Writing about that period reminded me, even made me re-experience to some extent, that same sense of need and shame, how dreadful it was, and one of the worst things was knowing it was affecting those closest to me.

Anxiety about anxiety. Thoughts about thoughts. Feelings about feelings. The thing about my sort of mental illness is it’s like when you’re at the optometrist, and you’re sitting there with this thing against your face that makes you look a bit like a suburban Aztec Sun God, only in a t-shirt and tracky pants, and the optometrist is slotting different lenses into the Sun God mask device, and you say, “better” and “worse” until he gives you a lens with which you can see clearly. The illness is like all those wrong lenses. It distorts everything you perceive, including your perception of yourself, and you sometimes don’t understand how much its affecting what you see–but sometimes you’re only too aware, too hyper-conscious, that you’re looking through a very wrong lens, but you can’t help it. It’s your whole brain that’s wrong.

You know it’s wrong, and that people around you are upset, but there’s nothing you can do. You’ve got the wrong lenses in. You know these lenses are wrong. But you’re in the middle of what the staff call a “cross-titration period” where you’re easing off one drug and easing onto another one. Your doctors are tearing their hair out trying to find you the perfect set of lenses, but it takes time, and experimentation, and patience. And you’re just hoping and hoping your wife and your mum and dad will hang in there with you until you can see the same reality as everyone else. But in the meantime you’re Mr Magoo.

Sorry, Sweetie.

MEMOIR: MURDER SOUNDS (Rewrite)

MEMOIR: MURDER SOUNDS (Rewrite)

It was the middle of a wet Saturday afternoon last year, I was on day release from hospital, and we had stopped at a cafe for lunch. I was all excited to be out and about after a week cooped up on the ward.

The cafe was quiet, with only a few other customers, three of whom were trying to chat up the girl behind the counter.

But then a guy comes in and orders a coffee. Girl behind the counter, pleased for the distraction, gets busy making coffee.

Michelle and I were sitting in the middle of the cafe, with plenty of unoccupied space around us. Another member of the cafe staff was sweeping or possibly vacuuming at the back of the room, because the place would close for the day pretty soon. The place would be closing soon; we were among the last customers for the afternoon. Michelle turned pages of the newspaper, and I was aware of the sound of the pages turning, as I was aware of the vacuuming, the boofheads at the counter, the coffee machine’s hiss and gurgle, and of course the never-ending noise in my head.

The guy got the coffee he ordered. I forget what he ordered.

As we’ve seen in coffeeshops in North America, this place had a separate bar area, in the middle of the room, right near our table, where you bring your coffee to add sugar, flavourings, and so forth. The guy with his coffee comes over to the bar. He removes the white lid.

Up to this point, everything is okay. I’m feeling a bit angular, a bit round-peg-in-square-hole, as if I don’t quite fit into this day. By this point in my hospitalisation, I’m still a building-site, with part-built cinder block walls, a slab of concrete, and big piles of sand everywhere, with a scattering of construction-crap here and there. I’m a work in progress. But just at this precise moment I’m doing okay. I’m aware of things, I’m prickly, sensitive, but not yet freaking out.

Then the guy with the coffee puts some sugar in his coffee.

And I’m still okay.

Coffee Guy grabs a thin wooden pop-stick and begins stirring his coffee. It makes a little, repetitive sound as the stick bumps against the inside surface of his cup. It’s very faint. I can only barely hear it. Thump-thump-thump-thump-thump, it goes, very soft, but repetitive.

And that’s it. Without even being aware of doing so I’m staring at Coffee Guy as if staring could kill him. I mean him actual, no-kidding harm.

Back in the 1970s there were these excellent paranoia thrillers like, eg, TELEFON, with Charles Bronson, whose premise was that the Soviet Union had these sleeper agents hidden in the United States, only they didn’t know they were sleeper agents. Only if they heard a code-phrase would they wake up to their true self and carry out their true, deadly assassination mission. It was brilliant.

And I was like that. Coffee Guy’s quiet stirring of his coffee was the code-phrase that “woke up” the killer in me.

Which sounds funny, and I am kind of playing it light here, but the thing is, it wasnt’, and isn’t, funny. I really did mean him harm. If I were the sort of person who attacked people at random, if I were the kind of person who was into “one-punch king hits”, Coffee Guy would have been on the floor. I mean it. When I was a kid I had a vile, towering temper. I’m sure it was part of my illness. It was out of all proportion to my small size. And when I heard that guy stirring his coffee, I felt it rush through me again.

I wanted to yell at him, though he was not even a metre away from me, to, “PLEASE STIR YOUR COFFEE QUIETLY!”

It feels exactly as if someone, some utter bastard, has insulted your sainted mother’s honour. As if someone is coming right at you with a wicked knife, and you know they will try to kill you.

It feels like you know, in the most fundamental cells of your marrow that if you don’t get up right now and leave, Something Bad will have to happen. And that guy is STILL stirring his coffee.

We leave. I sit in the car, breathing hard, my heart galloping, my hands shaking, nerves shredded. Adrenaline is flooding through me. Worse, acute mortifying embarrassment, shame, and anger are along for the fun-ride as well.

Because this is not the first time this has happened to me, and it won’t be the last.

All last year, in hospital, I told my doctors I had this weird new thing. And part of what was weird about it was that very newness. For decades I had developed an intimate familiarity with my set of specific illnesses: I had the bipolar disorder, and a specific anxiety involving crowds and cramped places. I’d known these things since I was a kid.

But last year, right around the time we started messing about with taking me off the Clomipramine, this new thing appeared. And it seemed like madness. I experienced a debilitating, violent sensitivity to certain sorts of sounds. Quiet sounds, repetitive, often at a high pitch but not always. Biological noises like chewing food, even soft food, the wet, smacking noises of people eating, even with their mouths closed. Chairs dragged across floors, and all kinds of other things. Sometimes I found new “trigger” sounds almost every day.

My doctors understood that it was a sort of anxiety, but they knew little about it, and, just as they had stared at me blankly about my writing-juju going away, they stared pretty blankly about this, too. Staff gave me anti-anxiety meds to ease things off. I developed a constant stance of what’s called “hyper-vigilance”, where you’re at high alert all the time, watching and listening for threats. Because what’s happening is the brain is taking these innocuous noises and referring them to the fight/flight/freeze department of your brain. It bypasses conscious thought altogether. You don’t get to choose whether to murder the guy stirring his coffee. You’re lucky that you can just barely choose to leave the scene without touching the poor sap.

All day long, from first waking to switching off the reading light at night, one of these noises could occur at any moment. And every time, I felt like murder. If you could in fact kill someone with your gaze alone, I would now be one of history’s greatest monsters (ha-ha!). Everywhere I went, I was on alert, on edge, primed and ready, because it was only a matter of time before somebody nearby clicked his pen over and over. Or before I heard someone using a knife and fork against a china plate, making a little squeaking sound. There was always something.

One of my doctors one day asked to see me, and she gave me a printout from the web, with a Post-It. This problem I had, it turned out, had a name, and there were other people out there with it, or variations of it.

It was called misophonia.

The Post-It had info about a Facebook support group. The printout was from a website acting as a clearinghouse for reliable information about it. Which wasn’t, and still isn’t, a lot. The reason my doctors stared at me so blankly was because it’s a newly classified condition. But that doctor was the first person who helped me with this thing. I’d felt like an isolated mutant (even more than the bipolar, etc, already made me feel) with this strange thing nobody knew about, but here, look, there’s an entire worldwide community! I have since joined that community. It seems most misophonia sufferers, unlike me, have had the condition all their lives. Many have withdrawn from society to some extent. Some have withdrawn entirely. I can relate (see my post, “Recluse). There is also a lot of discussion about noise-cancelling headphones.

My condition seems closely correlated to depression and the anxiety that goes with it. I can tell when I’m not as well as usual, because I notice little sounds–suddenly I’m staring-as-if-to-kill at someone or something. When I’m doing better, those same sounds don’t bother me so much. It comes and goes, but for some people it’s a constant thing, always on, always with the same intensity. I am lucky. It could be much worse.

It’s now a year since my misophonia was at its worst. When I lurched from one sound attack to another, never knowing when the next would be, when I was exhausted all the time from the hyper-vigilance, the tension. When I hated the way Michelle and my parents felt they had to change the way they did everything for fear of making the slightest sound around me. They didn’t want to upset me, and I appreciated that, but I hated that my stupid problem was unfairly making these other people change how they lived their lives. It seemed unjust. Unreasonable. It made me angry and I hated it.

It’s possible my overall illness was making me hate this.

These days I always have my Bose QC-25 active noise-cancelling headphones with me when I go out, except when I visit the local swimming pool. They are not waterproof, sadly. Going to the pool still presents serious problems for me. The sounds of little kids playing sometimes feel like a crushing punishment sent from above. They’re just splashing about in water, just like I did when I was their age (see “Drowning”), but when they scream and squeal and yell the noise goes through me like knives. It’s awful, unbearable.

What has helped is working with my psychologist on various mindfulness-based approaches for helping to change the way I think about noises like these. And to stop me doing what some people with the problem do, who never leave their homes. The world is full of noise, including all these little, simple, quiet, innocuous sounds (Michelle eating an ice cream or a Tim Tam), but I can’t let them force me to stay home barricaded against them. I have to live in the world. I have to be able to function, even though it’s very hard.

One weird thing about misophonia: the noises you perceive to be threatening, that make you want to kill people, are perfectly okay and fine if you are the one making those noises. Michelle comes home from work, feels like an ice cream on a stick. These come in wrappers. If she unwraps it, it would set me off. If I unwrap it, it’s fine. So I unwrap everything now.

I have had to learn to adapt the way I approach my life. It’s difficult, especially when, after a long period of feeling fine, you have a relapse, and suddenly it’s as if you can hear your hair growing because your hearing is so acute. People around me have had to learn to adapt as well. I hate and feel embarrassed that because of a problem that I have, other people have to tip-toe around and mind what they do. It bothers me very much. I have issues. But I can work on those. I remind myself today that things are better now than they were a year ago. I remind myself how long it’s been since I’ve needed to use the headphones while out in the world. How long it’s been since I needed to resort to the emergency supply of Lorazepam tablets I carry with me at all times. It’s getting to be quite a while.

Writing about it helps. I hope reading about it helps, too.

MEMOIR: THE SCALES (Partial Rewrite, Updated)

MEMOIR: THE SCALES (Partial Rewrite)

One of the things you don’t often hear about bipolar disorder is that as well as all the fun and laughs with the mood swings and so on, you can also get paranoia and delusions. You can find yourself believing all kinds of wrong and crazy bollocks. Like the time, when I was sixteen, and I believed my dad could read my mind.

And like the time, last year, during my second hospitalisation, when my anxiety was so bad, so off the freaking charts, that it started to hurt my relationship with Michelle. And it was all because of our bathroom scales. I have been on a weight-loss campaign for a long time. I weigh myself at least once a day (sometimes more than once). Accurate, reliable data is crucial. I had our bathroom scales in my hospital room. They’d always been a bit iffy, bit in a consistent way. You could correct for it. But during this time in the hospital they seemed to go off on their own, making up all kinds of crazy figures. It made no sense. I found I could no longer trust the scales. The scales were suspect.

This was, as I say, my second hospitalisation last year. In many ways it was a familiar, even comforting sort of experience. I knew in large part what to expect, what the daily routine would be, from morning meds around 8 am, to morning obs, to breakfast and so on. More confounding was why the air conditioning in my room seemed so broken. It was the middle of winter, but the air conditioning was pumping cold air into my room. I felt so cold I imagined myself refrigerated. I took to referring to my room as “the Tupperware” because I often felt like I was in storage, in a Tupperware container like leftovers stuck in the back of the fridge.

The crisp freshness of my room, though, was the least of my troubles. I was much more agitated and bothered about the scales–and Michelle was tired of hearing about them.

She understood that I was sick. She was doing everything she possibly could to help me. It was hard for her, visiting me and then going on to do her shift at the pathology lab. It was an exhausting double-bill. I was only too aware of the toll my illness was taking on her, and I was very keen to get “well” as soon as humanly possible, to reduce the pressure on her.

But, well, the scales…

To explain about the scales, and about my weight-loss saga, I need to go back to 28 December 2012, one of the days the trajectory of my life radically changed. There have been several moments when, looking back, I can see my whole life swing, like a bank vault door, heavy but perfectly balanced, around a pivotal moment. 28 December was one such moment, one of the most significant of my whole life, when just about everything changed. The morning of that day I weighed myself. The result was 165.5 kilograms.

It was a shocking figure. I had given up weighing myself years earlier, because it had been so depressing, back when I had been weighing myself daily, seeing the total go up every day no matter what. So I stopped doing it, and tried to get used to being fat and more or less happy or at least comfortable with my roly-poly self. I felt as sexy, as desirable, as a blob-fish, but I could go about my business. I wrote books, lived my life, travelled overseas to promote my books, and tried not to feel burning shame when asking flight attendants for seatbelt extenders (I always felt the burning shame; the flight attendants were always extremely good about just handing it to me without comment).

My psychiatrist had been encouraging me for some time to consider some kind of weight-loss program, but I was the fat guy who resisted all such suggestions, or who made only half-hearted, soon-forgotten “commitments” to it. I was a writer, too, and spent most of each day at my desk, in front of the computer, sometimes actually working, and sometimes goofing off, usually on Facebook (mortal enemy of writers everywhere). I was pleased, once my broken arm healed, to have my arm back working again with full flexibility and function, and loved to tell the story of what it took to get it back, because it made me look good. What didn’t make me look good was my ballooning body. Having the busted arm made me even less active than usual, a level of inertia matched only by the likes of materials frozen to absolute zero. I was a bin bag of dirty laundry dumped on the couch, watching TV, eating something bad, feeling lousy but kidding myself that things were fine.

Even worse, my knees had been screaming in pain for ages. So loud, so intensely, that I was inclined to believe that other people could hear them crying out in agony at having to support their unbearable burden. My GP had diagnosed osteoarthritis. I had been having cortisone shots, and was chewing through major painkillers. My screaming knees were a big factor in my inertia: activity hurt.

My psychiatrist, one day, in the course of talking more about the need for me to lose some weight, suggested iced coffee protein shakes. There was this whey powder stuff, he explained, and told me all about it. I had tried commercial high-protein diet shakes, and had not liked them. They left a nasty chemical aftertaste in my mouth. Combine that with a general sullen refusal to deal with my weight, and that was that. But this thing my doctor was talking about sounded different. He convinced me to have a go.

The whey powder was a body-building product, which puzzled me. I had been expecting something from the weight-loss industry. It smelled good when I opened the giant container, and when I mixed it up as directed and tried it–it was good! No chemical aftertaste! It tasted better than iced coffees I’ve paid upwards of $6 for in actual cafes! I could not believe my, well, my taste-buds! This was something that might work.

As well, I signed up for adult swimming lessons. I never quite learned how to swim properly when I was a kid, so had never been much of a swimmer, and never went near deep water for fear of drowning (see my post, “Drowning”). And swimming lessons, though exhausting, were marvellous fun.

The weight started to shift. The protein shakes twice a day plus a bit of exercise made a difference. I stuck with the shakes, and the swimming lessons. After a while I added pool-walking as well, charging as hard as I could up and down the 25 metre lanes 80 to 100 times, trying to get my heart pounding as fast as possible.

People started to comment about how I looked like I’d lost weight. They started commenting about my face. My swimming shorts appeared to grow so large and hot-air ballon-like that I needed new, smaller ones.

Then one day I noticed that my knees had stopped screaming. When I went to see my GP, my vital numbers were good. At the pool I was racking up literally thousands of walking laps. People would stop me on the pool deck to tell me how I’d lost an amazing amount of weight, and it looked so good. I needed new clothes. I could finally get all the funny and geeky t-shirts I’d always wanted but couldn’t get because I was too big. So many things I hadn’t been able to enjoy because I was too big.

Example: after I finished my first term of swimming lessons, I felt deeply empowered, that I’d really done something good for myself. What else, I wondered, could I do? What did I want to do? One thing occurred to me. I’d love to try sky-diving. But when I looked up sky-diving services here, they all insisted on a weight cut-off of 115 kg. And at that time, I was still a gelatinous monster.

So I decided: I was going to get to 100 kilograms, and when I did, I was going sky-diving. This would mean a total weight-loss of 65.5 kg.

And, flash-forward four years, I was in hospital (ostensibly to get my medication changed to something more effective, and with fewer nasty side-effects), and, as I had been doing every day for years, I was weighing myself every day, at noon.

I had gotten my weight down to 114.3 kilograms. This was a loss of 51.2 kg over that four-year period.

I was so proud. If I had climbed Mount Everest I’d be less pleased with myself.

People would tell me I’d lost a whole person. In the supermarket I saw 25 kg bags of rice, things the size of mattresses, so heavy I couldn’t shift them. And I thought, I’ve lost two of you bastards. I was on my fourth pair of swimming trunks. The shirts I was buying were two sizes smaller than I used to need. My knees were silent. At IKEA, I could race up the stairs to the first floor without even breathing hard, and with no knee complaints. My wife could hug me and reach her hands all the way around. I felt light. My older clothes hung on me like curtains, or circus tents.

But I was now in a psychiatric hospital, and the doctors were changing my medications around. They were all agog that I’d managed to lose that much weight while on 250 mg of Clomipramine, notorious, like all the tricyclic antidepressants, for its weight-gain side-effect. My psychologist said I was probably the only patient in that hospital who was losing weight, because psychiatric medication is often a total bastard about weight-gain.

And that was the problem, right there. I was terrified, after four years of continuous, obsessive, grinding effort, of the weight coming back. The thought, and the fear, obsessed me. What if it all came back? What if, in fact, it not only all came back, but brought even more with it? What if I ended up even bigger than I had been? I had read a great deal about obesity science. I know that people who manage to lose a great deal of weight often wind up regaining it all, and more besides.

It was all I thought about.

I needed to know what my weight was doing from day to day. Needed it like oxygen. Needed it like water. Like heroin.

And I could not trust the scales.

We had bought them years ago, once my weight-loss campaign showed signs of success. Prior to that I borrowed my parents’ bathroom scales. It was on their scales that I first learned about the 165.5 figure. A figure so horrifying, so mortifying, that when I posted about my weight-loss efforts on Facebook I referred to it as OMG! kg, and each successive milestone as OMG! minus the total I’d lost, such as OMG!-51 kg.

That figure was and is important to me. Everyone in the family understood that, but even I didn’t understand how OBSESSED I had become about it.

We bought our own set of scales. When they arrived, the first thing to do was to calibrate them against Mum and Dad’s scales. The new scales showed they varied from the others by about +1.3 kg, so whatever figure they showed, I had to subtract 1.3 from it, and the data would be consistent.

This was fine for a long time. I periodically checked again with the parental scales to see if the error remained the same. Here you can already see the beginning of the obsession, the madness.

Because, after a while, the amount by which our scales varied from the parental scales changed. Sometimes it was +0.8 kg, and sometimes as much as +1.5 kg.

By the time I was in hospital last year, our scales were about four years old, and they were showing truly distressing numbers that made no sense. My weight appeared to be climbing. I asked my parents to lend me their scales. They showed I was not gaining weight.

But sometimes they did show that I was gaining. During my first hospitalisation, at one point I was put on Seroquel to help me sleep, and to help with anxiety. This first hospitalisation was also the worst, the most harsh and distressing. I was in a terrible, deeply fragile state, barely holding myself together, even worrying my doctors. Seroquel was a wonderful drug for sleep, but it has a dreadful reputation for weight-gain. I keep a daily chart of my weight, and it showed a sharp upturn corresponding to the time I was put on Seroquel.

There were, across all three hospital stays, and even since then, since I’ve been home, numerous incidences where a medication seemed to make me gain weight. Between the effects of being strung out as I went from drug to drug, and my worries about my weight, and the NEED to preserve the weight-loss I’d achieved, I needed above all else reliable data. I needed to know where I was from day to day, week to week.

Michelle allowed me to buy new scales. Because, like a Cold War spy in a LeCarré novel, I could no longer trust the old scales. I lashed out and got the Fitbit Aria scale, which looked truly space-age, all white and sleek, and supposedly just bursting with all kinds of chewy data, and dying to work with my Fitbit Flex wristband thingy. It was fabulous, and I was dead excited.

Except, once it arrived, Michelle rolling her eyes by this point because she had had a gutful of me and ScaleGate, it didn’t work. In fact it would not work. I Googled support forums, and found loads of disappointed customers, who had found, as I had found, that the scale used a different wifi protocol from what we used in our household wifi. I either needed to buy new scales (Michelle’s patience gossamer-thin by this point), or buy an older modem that supported the older wifi protocol.

I could see this was deeply upsetting for Michelle. My parents, too. They essentially gave me their trusty, reliable scales to use in the interim. Michelle took the Aria unit back, and got a refund. I swotted over the JB HiFi and Officeworks sites online, looking for new scales, because I had to have reliable data.

And all the time I could see in Michelle, when she came to visit, how stressed she was. It made me ache and burn with shame. I was doing this to her. My stupid, pathetic, useless anxiety, and my even more stupid, pig-headed pride, was doing this to her. And yet I could not let it go. I had to have reliable data. Had. To. Have. It.

Had.

To.

Michelle agreed to one, final set of scales. But she told me This Was It. I felt cold all through. I found a new set of scales, a German brand which looked reliable, and the unit seemed to offer lots of data. It was also much cheaper than the Aria. When it arrived, it worked. When checked against Mum and Dad’s old reliable unit, the new scales agreed with it perfectly. It was weighing-machine kismet.

Peace reigned across the Kingdom. Birds chirped, bunnies hopped, and the sun shone. All was well.

Then, right at the end of my third hospitalisation, my doctors, in despair over what they could give me that was strong enough for my “treatment-resistant major depression”, and yet whose side-effect profile was “weight-neutral”, they fell back on another tricyclic antidepressant, of all things. We had gone through everything, and now we came back to the tricyclics, and of those, Nortriptyline was said to be the least obnoxious in its side-effects.

Except for the weight-gain.

And the increased appetite.

The struggle against my weight continues. Nortriptyline seems to be a terrific drug. I give it four stars! But my weight is nuts. Since leaving hospital last November (as I write it’s mid-July) I gained 13 kilograms, my weight rising from 114 to 127.1 kg. I panicked. I was desperate. The weight was coming back, like a tide coming back in, refilling the bay. Nothing seemed to help. I was doing a lot of emotional eating, and that would have added to the gains. I was telling my doctor to Do Something, that I was up for anything. Because, as I say, I am obsessed. I am my own white whale.

My doctor put me on a drug called Topamax, which is mainly an anti-convulsant and anti-anxiety drug, but which has the unexpected side-effect of weight-loss.

I also looked into what measures I could take on my own. I’ve hit upon an eating and fasting pattern I call the “low-food diet” which involves about one meal a day, lunch, and fasting much of the rest of the time, as well as daily exercise. Since I started this regime, and have been on the Topamax, my weight has come back from what I called “the Peak of Madness” of 127.1 kg to this morning’s reading of 117.9 kg. I’m close to where I got to last year, the 114.3 kg figure. If I can hang in with this admittedly extreme system for another month, I’ll likely get there. But it’s hard.

This long climb back down from the Peak of Madness has been good for my anxiety and panic. It’s also been good for my waistline and hips. I’m now physically thinner than I was last year at my lightest. I’m eating myself.

It does occur to me that this may not be healthy. All I know is that four and a half years of weight-loss has killed my metabolism stone dead. If I eat more than a bare minimum each day, I gain weight. That’s the crux of the problem. Anything other than near-starvation means weight-gain.

My doctor today ordered me to double my Topamax dose, and to increase it still further next week. I told him I miss food. I miss eating. I wanted to lose weight, but I’ve lost food as well.

But at least I have reliable data, and a beautiful graph. Yay.

MEMOIR: THE SCALES (Partial Rewrite)

MEMOIR: THE SCALES (Partial Rewrite)

Things were bad, and I didn’t know what to do. The scales were crazy. I couldn’t trust them. Every day, several times a day, I was weighing myself, and getting numbers I couldn’t believe. It made no sense. I was in hospital. This was my second hospitalisation, and I was having a profoundly bad time with anxiety, even paranoia. One of the things you don’t often hear about bipolar disorder is that you also get paranoia and delusions. You start to believe all kinds of things that aren’t true. Like the time when I was sixteen and suddenly realised my dad could read my mind. Back in the present, all I knew, all I could think, all I could talk about, was that I couldn’t trust the scales. And that was catastrophically bad. It was as bad as bad could be. It was an emergency. Because I needed accurate, reliable data about my weight. Every day, and sometimes several times a day, I weighed myself, and recorded the result. I was trying to lose weight. It was and remains extremely important to me. So I needed to have faith in the data from the scales, and for that I needed reliable, accurate scales, and the ones I had at the hospital were clearly wrong, and that wrongness was making me mental.

This was my second hospitalisation last year. In many ways it was a familiar, even comforting sort of experience. I knew in large part what to expect, what the daily routine would be, from morning meds around 8 am, to morning obs, to breakfast and so on. I knew what to expect. More confounding was why the air conditioning in my room seemed so broken. It was the middle of winter, but the air conditioning was pumping cold air into my room. I felt so cold I imagined myself refrigerated. I took to referring to my room as “the Tupperware” because I often felt like I was in storage, in a Tupperware container like leftovers stuck in the back of the fridge.

The crisp freshness of my room, though, was the least of my troubles. I was much more agitated and bothered about the scales–and Michelle was tired of hearing about them.

She understood that I was sick. She was doing everything she possibly could to help me. It was hard for her, visiting me and then going on to do her shift at the pathology lab. It was an exhausting double-bill. I was only too aware of the toll my illness was taking on her, and I was very keen to get “well” as soon as humanly possible, to reduce the pressure on her.

But, well, the scales…

To explain about the scales, and about my weight-loss saga, I need to go back to 28 December 2012, one of the days the trajectory of my life radically changed. There have been several moments when, looking back, I can see my whole life swing, like a bank vault door, heavy but perfectly balanced, around a pivotal moment. 28 December was one such moment, one of the most significant of my whole life, when just about everything changed. The morning of that day I weighed myself. The result was 165.5 kilograms.

It was a shocking figure. I had given up weighing myself years earlier, because it had been so depressing, back when I had been weighing myself daily, seeing the total go up every day no matter what. So I stopped doing it, and tried to get used to being fat and more or less happy or at least comfortable with my roly-poly self. I felt as sexy, as desirable, as a blob-fish, but I could go about my business. I wrote books, lived my life, travelled overseas to promote my books, and tried not to feel burning shame when asking flight attendants for seatbelt extenders (I always felt the burning shame; the flight attendants were always extremely good about just handing it to me without comment).

My psychiatrist had been encouraging me for some time to consider some kind of weight-loss program, but I was the fat guy who resisted all such suggestions, or who made only half-hearted, soon-forgotten “commitments” to it. I was a writer, too, and spent most of each day at my desk, in front of the computer, sometimes actually working, and sometimes goofing off, usually on Facebook (mortal enemy of writers everywhere). I was pleased, once my broken arm healed, to have my arm back working again with full flexibility and function, and loved to tell the story of what it took to get it back, because it made me look good. What didn’t make me look good was my ballooning body. Having the busted arm made me even less active than usual, a level of inertia matched only by the likes of materials frozen to absolute zero. I was a bin bag of dirty laundry dumped on the couch, watching TV, eating something bad, feeling lousy but kidding myself that things were fine.

Even worse, my knees had been screaming in pain for ages. So loud, so intensely, that I was inclined to believe that other people could hear them crying out in agony at having to support their unbearable burden. My GP had diagnosed osteoarthritis. I had been having cortisone shots, and was chewing through major painkillers. My screaming knees were a big factor in my inertia: activity hurt.

My psychiatrist, one day, in the course of talking more about the need for me to lose some weight, suggested iced coffee protein shakes. There was this whey powder stuff, he explained, and told me all about it. I had tried commercial high-protein diet shakes, and had not liked them. They left a nasty chemical aftertaste in my mouth. Combine that with a general sullen refusal to deal with my weight, and that was that. But this thing my doctor was talking about sounded different. He convinced me to have a go.

The whey powder was a body-building product, which puzzled me. I had been expecting something from the weight-loss industry. It smelled good when I opened the giant container, and when I mixed it up as directed and tried it–it was good! No chemical aftertaste! It tasted better than iced coffees I’ve paid upwards of $6 for in actual cafes! I could not believe my, well, my taste-buds! This was something that might work.

As well, I signed up for adult swimming lessons. I never quite learned how to swim properly when I was a kid, so had never been much of a swimmer, and never went near deep water for fear of drowning (see my post, “Drowning”). And swimming lessons, though exhausting, were marvellous fun.

The weight started to shift. The protein shakes twice a day plus a bit of exercise made a difference. I stuck with the shakes, and the swimming lessons. After a while I added pool-walking as well, charging as hard as I could up and down the 25 metre lanes 80 to 100 times, trying to get my heart pounding as fast as possible.

People started to comment about how I looked like I’d lost weight. They started commenting about my face. My swimming shorts appeared to grow so large and hot-air ballon-like that I needed new, smaller ones.

Then one day I noticed that my knees had stopped screaming. When I went to see my GP, my vital numbers were good. At the pool I was racking up literally thousands of walking laps. People would stop me on the pool deck to tell me how I’d lost an amazing amount of weight, and it looked so good. I needed new clothes. I could finally get all the funny and geeky t-shirts I’d always wanted but couldn’t get because I was too big. So many things I hadn’t been able to enjoy because I was too big.

Example: after I finished my first term of swimming lessons, I felt deeply empowered, that I’d really done something good for myself. What else, I wondered, could I do? What did I want to do? One thing occurred to me. I’d love to try sky-diving. But when I looked up sky-diving services here, they all insisted on a weight cut-off of 115 kg. And at that time, I was still a gelatinous monster.

So I decided: I was going to get to 100 kilograms, and when I did, I was going sky-diving. This would mean a total weight-loss of 65.5 kg.

And, flash-forward four years, I was in hospital (ostensibly to get my medication changed to something more effective, and with fewer nasty side-effects), and, as I had been doing every day for years, I was weighing myself every day, at noon.

I had gotten my weight down to 114.3 kilograms. This was a loss of 51.2 kg over that four-year period.

I was so proud. If I had climbed Mount Everest I’d be less pleased with myself.

People would tell me I’d lost a whole person. In the supermarket I saw 25 kg bags of rice, things the size of mattresses, so heavy I couldn’t shift them. And I thought, I’ve lost two of you bastards. I was on my fourth pair of swimming trunks. The shirts I was buying were two sizes smaller than I used to need. My knees were silent. At IKEA, I could race up the stairs to the first floor without even breathing hard, and with no knee complaints. My wife could hug me and reach her hands all the way around. I felt light. My older clothes hung on me like curtains, or circus tents.

But I was now in a psychiatric hospital, and the doctors were changing my medications around. They were all agog that I’d managed to lose that much weight while on 250 mg of Clomipramine, notorious, like all the tricyclic antidepressants, for its weight-gain side-effect. My psychologist said I was probably the only patient in that hospital who was losing weight, because psychiatric medication is often a total bastard about weight-gain.

And that was the problem, right there. I was terrified, after four years of continuous, obsessive, grinding effort, of the weight coming back. The thought, and the fear, obsessed me. What if it all came back? What if, in fact, it not only all came back, but brought even more with it? What if I ended up even bigger than I had been? I had read a great deal about obesity science. I know that people who manage to lose a great deal of weight often wind up regaining it all, and more besides.

It was all I thought about.

I needed to know what my weight was doing from day to day. Needed it like oxygen. Needed it like water. Like heroin.

And I could not trust the scales.

We had bought them years ago, once my weight-loss campaign showed signs of success. Prior to that I borrowed my parents’ bathroom scales. It was on their scales that I first learned about the 165.5 figure. A figure so horrifying, so mortifying, that when I posted about my weight-loss efforts on Facebook I referred to it as OMG! kg, and each successive milestone as OMG! minus the total I’d lost, such as OMG!-51 kg.

That figure was and is important to me. Everyone in the family understood that, but even I didn’t understand how OBSESSED I had become about it.

We bought our own set of scales. When they arrived, the first thing to do was to calibrate them against Mum and Dad’s scales. The new scales showed they varied from the others by about +1.3 kg, so whatever figure they showed, I had to subtract 1.3 from it, and the data would be consistent.

This was fine for a long time. I periodically checked again with the parental scales to see if the error remained the same. Here you can already see the beginning of the obsession, the madness.

Because, after a while, the amount by which our scales varied from the parental scales changed. Sometimes it was +0.8 kg, and sometimes as much as +1.5 kg.

By the time I was in hospital last year, our scales were about four years old, and they were showing truly distressing numbers that made no sense. My weight appeared to be climbing. I asked my parents to lend me their scales. They showed I was not gaining weight.

But sometimes they did show that I was gaining. During my first hospitalisation, at one point I was put on Seroquel to help me sleep, and to help with anxiety. This first hospitalisation was also the worst, the most harsh and distressing. I was in a terrible, deeply fragile state, barely holding myself together, even worrying my doctors. Seroquel was a wonderful drug for sleep, but it has a dreadful reputation for weight-gain. I keep a daily chart of my weight, and it showed a sharp upturn corresponding to the time I was put on Seroquel.

There were, across all three hospital stays, and even since then, since I’ve been home, numerous incidences where a medication seemed to make me gain weight. Between the effects of being strung out as I went from drug to drug, and my worries about my weight, and the NEED to preserve the weight-loss I’d achieved, I needed above all else reliable data. I needed to know where I was from day to day, week to week.

Michelle allowed me to buy new scales. Because, like a Cold War spy in a LeCarré novel, I could no longer trust the old scales. I lashed out and got the Fitbit Aria scale, which looked truly space-age, all white and sleek, and supposedly just bursting with all kinds of chewy data, and dying to work with my Fitbit Flex wristband thingy. It was fabulous, and I was dead excited.

Except, once it arrived, Michelle rolling her eyes by this point because she had had a gutful of me and ScaleGate, it didn’t work. In fact it would not work. I Googled support forums, and found loads of disappointed customers, who had found, as I had found, that the scale used a different wifi protocol from what we used in our household wifi. I either needed to buy new scales (Michelle’s patience gossamer-thin by this point), or buy an older modem that supported the older wifi protocol.

I could see this was deeply upsetting for Michelle. My parents, too. They essentially gave me their trusty, reliable scales to use in the interim. Michelle took the Aria unit back, and got a refund. I swotted over the JB HiFi and Officeworks sites online, looking for new scales, because I had to have reliable data.

And all the time I could see in Michelle, when she came to visit, how stressed she was. It made me ache and burn with shame. I was doing this to her. My stupid, pathetic, useless anxiety, and my even more stupid, pig-headed pride, was doing this to her. And yet I could not let it go. I had to have reliable data. Had. To. Have. It.

Had.

To.

Michelle agreed to one, final set of scales. But she told me This Was It. I felt cold all through. I found a new set of scales, a German brand which looked reliable, and the unit seemed to offer lots of data. It was also much cheaper than the Aria. When it arrived, it worked. When checked against Mum and Dad’s old reliable unit, the new scales agreed with it perfectly. It was weighing-machine kismet.

Peace reigned across the Kingdom. Birds chirped, bunnies hopped, and the sun shone. All was well.

Then, right at the end of my third hospitalisation, my doctors, in despair over what they could give me that was strong enough for my “treatment-resistant major depression”, and yet whose side-effect profile was “weight-neutral”, they fell back on another tricyclic antidepressant, of all things. We had gone through everything, and now we came back to the tricyclics, and of those, Nortriptyline was said to be the least obnoxious in its side-effects.

Except for the weight-gain.

And the increased appetite.

The struggle against my weight continues. Nortriptyline seems to be a terrific drug. I give it four stars! But my weight is nuts. Since leaving hospital last November (as I write it’s mid-July) I gained 13 kilograms, my weight rising from 114 to 127.1 kg. I panicked. I was desperate. The weight was coming back, like a tide coming back in, refilling the bay. Nothing seemed to help. I was doing a lot of emotional eating, and that would have added to the gains. I was telling my doctor to Do Something, that I was up for anything. Because, as I say, I am obsessed. I am my own white whale.

My doctor put me on a drug called Topamax, which is mainly an anti-convulsant and anti-anxiety drug, but which has the unexpected side-effect of weight-loss.

I also looked into what measures I could take on my own. I’ve hit upon an eating and fasting pattern I call the “low-food diet” which involves about one meal a day, lunch, and fasting much of the rest of the time, as well as daily exercise. Since I started this regime, and have been on the Topamax, my weight has come back from what I called “the Peak of Madness” of 127.1 kg to this morning’s reading of 117.9 kg. I’m close to where I got to last year, the 114.3 kg figure. If I can hang in with this admittedly extreme system for another month, I’ll likely get there. But it’s hard.

This long climb back down from the Peak of Madness has been good for my anxiety and panic. It’s also been good for my waistline and hips. I’m now physically thinner than I was last year at my lightest. I’m eating myself.

It does occur to me that this may not be healthy. All I know is that four and a half years of weight-loss has killed my metabolism stone dead. If I eat more than a bare minimum each day, I gain weight. That’s the crux of the problem. Anything other than near-starvation means weight-gain.

My doctor today ordered me to double my Topamax dose, and to increase it still further next week. I told him I miss food. I miss eating. I wanted to lose weight, but I’ve lost food as well.

But at least I have reliable data, and a beautiful graph. Yay.

NOTEBOOK: GO FOR TOPAMAX THROTTLE-UP

NOTEBOOK: GO FOR TOPAMAX THROTTLE UP

Today I saw my psychiatrist for the first time in about three weeks. He’s amazed at my continuing transformation, and all my news. I showed him my year-to-date weight graph, and he was gobsmacked. He says I look much better now than I did this time last year, and that in general I look 15 years younger.

I also, though, conveyed to him how extraordinarily difficult it is to keep the weight going like this, that I’m eating very little, because to eat more than that brings the weight thundering back.

So he’s increasing my Topamax dose from its current 50 mg each night to 100 mg, for a week, and then throttling up again (second-stage booster kicking in) to 150 mg the week after, and then I see him again to discuss findings for further graph inspection.

He says I need to maintain my current food discipline program (what I not-so-jokingly refer to as the “low-food diet”) for six months in order to convince my body’s ha-ha-hopeless metabolism that this is the new normal, so it will stop trying to push me back to 165.5 kg, where I started in December 2012. As of today I’m 117.9 kg, and I want that to keep going down.

Flippers crossed!

MEMOIR: WRITING AND SILENCE (Updated)

MEMOIR: WRITING AND SILENCE (Updated)

Last year, for the first time in my life, I lost access to the part of my mind that has always made me want or perhaps need to write. Where I used to hear from that part of my mind all the time, as if listening to a constant chatter from a radio station aimed only at me, suddenly, in the midst of my illness and treatment, that radio station went off the air, leaving nothing, not even static. It, the creative, scribbling part of me, felt dead.

I had known quiet or fallow periods in the past, and was well familiar with manifestations of “writer’s block”. I sold my first two novels in the same year, during the 90s, and while deeply pleased about this I was also deeply worried about following up with a third book. What if it wasn’t as good? The usual “difficult second album” anxiety, only transferred to the prospect of a third book. I tried all kinds of things, and started in on different projects, each time thinking this would be the one. But no. I got so anxious about this that I stopped even trying to write, and fell silent.

But my head was not silent. I was still getting at least, as it were, “carrier wave” from that radio station. There was just no programming, no content, but the station itself was there and transmitting normally. In the end, as that silence went on, and I became more and more bothered by it, I ended up making a New Year resolution of, “this year I’m going to write a book even if it kills me.” My psychiatrist suggested I try writing longhand, rather than use a keyboard, to see if the unfamiliar writing method and environment made a difference. It did. I sat each day and scribbled out pages of what I knew was utter rubbish, but I didn’t care about that. I was writing. A story was being told. The story sucked, but that was fine. One thing led to another. The ice cracked and thawed. The radio station resumed transmissions, and, two junked manuscripts later, I ended up with something half-decent, my third published novel, HYDROGEN STEEL.

But last year, while I was in hospital, and during a time when my biochemistry was utterly out of whack, one day I noticed a a strange silence in my head. You know how you are just sitting there in what you think is a silent room, but then the airconditioning or a refrigerator shuts down, and suddenly that unnoticed background hum you never noticed is no longer there and you’re left in a state of “more silent than silent”? And it’s spooky and gives you chills because you didn’t think silence like this was even possible? It was like that. The signal from my radio station was gone. Or, if not gone, then I could no longer receive its signal due, no doubt, to interference at my end.

It was one of the most disturbing aspects of the entire experience, and one of the strangest things I can remember ever happening to me.

I have written, and wanted to write, since my earliest days. Some of my earliest memories involve stories, books, being read to, and reading books myself. I devoured shows on TV, then wrote imitations and transcriptions based on what I could remember about them. This is how you learn writing: you learn writing by imitating and copying other writing, and other stories. This naturally makes you produce derivative bollocks, but you get past that and start getting your own ideas. Even with the stuff you’re writing based on other things you’ve read and seen, there are flashes of crazy original stuff, embellishments and improvisations, that are all your own work. And over time these things become what you write about, and become the basis of your creative voice.

My creative voice died, though. It went away, and it was as if it had never been. It was like the characters in 1984 who get deleted from history, and suddenly never existed, because people like Winston Smith assiduously edit the official record of the past, to remove all trace of them. The part of me that has always, always written, was likewise deleted. It was as if I’d never written, and those books of mine now belonged to someone else.

I told my doctors about it. They would stare at me, astonished, and baffled. This was not a symptom or side-effect they knew about, or were expecting. And it was, indeed, most likely a consequence of the huge mental earthmoving operations going on in my brain. My brain was very likely simply too busy dealing with withdrawal from one medication and the phasing-in of another. I went through a great many medications, trying to find something that worked, and which didn’t bring with it unbearable side-effects.

I was not used to this silence. It was startling. I grieved for the loss of that radio station, and for the person I used to be because of it. It made me who I was. I was a writer before I was anything else. But if writing was gone, what was I now? If I wasn’t working on my writing, what would I do? I’m a guy in his 50s: the statistics about employment opportunities for men my age are not encouraging. But questions of work and employment aside, this felt to me like an existential question: what am I now? It was that abyss which, when you stare into it, stares back at you–and whispers that you’re only a couple of years away from being able to move into an early retirement village.

You’re reading this essay (I hope someone is reading this essay), so you know Adrian got his groove back. You know there’s something like a happy ending here, though I am suspicious of tidy endings. I am writing lately, and even writing every day, which is marvellous. But I don’t know if this is the new normal or what the future holds. Me and everyone else in the world, I suppose.

But this time last year there was the real and confounding possibility, indeed a likelihood, that I could perhaps be made well and whole again, but that I would lose my creative mind. I might no longer receive those transmissions. How did I feel about that? Was that an acceptable price to pay for being able to function in the world, to live my life? This was a question I faced. My doctors thought it was a fair deal. I was much less convinced. I who had always written the way I had always breathed.

A great deal of reflection did remind me that I did have one very serious, very important job, quite apart from my writing life–I was husband and partner to my wife, Michelle. She is the breadwinner in the household. Michelle works for Clinipath, a commercial pathology firm, where she works the evening shift in the Haematology section. My job has always been to look after everything else, more or less. My psychiatrist reminded me of this one day, pointing out, “you’re the drummer, but you want to be the lead singer”. My doctor has a way with metaphors. But he was right back then, and the thought remained true last year, in the midst of my strife. Even if I was no longer a writer, so what? I was still Michelle’s drummer, maintaining the steady rhythm in the background that allowed her to do her thing. Michelle doing her thing got us this far. Our house, for instance, is all paid for. We have a nice car, and very little debt. Michelle has managed to accrue savings, and we live in privileged comfort.

But could I live with “just” being the drummer? Could I bear no longer hearing from the radio station? They say you can get used to anything. I recently read Viktor Frankl’s Man’s Search for Meaning, which includes his memoir of life in Nazi concentration and death camps during the war. Even he says you can get used to anything.

So what happened? Why am I writing again? And so much, so often? I had been waiting for my condition to settle down. I’d been waiting for some sign or indication that I was no longer sick, that my ordeals of last year were over. That I was well. I explained this to my psychologist. She told me that maybe I could use writing as a form of self-therapy. Maybe I could write my way to wellness.

Since starting this journal, I have indeed felt much better about things. I’m starting to get the occasional signal from the radio station. Writing is causing writing. Writing is meaningful to me, and I’ve read (in Frankl’s book among other places) that pursuing activities and occupations that are meaningful to you will lead not to happiness but to a sense of contentment. So I’ve been doing everything I can to pursue meaningful activities. All the things that are important to me, from writing to weight-loss, I’m pursuing as hard as I can. And it seems, so far, to be working. I feel quite okay. I don’t know, at this moment, if I will ever write another novel, but I do feel that all this writing will one day lead to some sort of memoir, or at least that’s the aim. And that might be enough.

Meanwhile, I’m still Michelle’s drummer. I can live with that.

MEMOIR: MEDS (Total Rewrite, All New)

MEMOIR: MEDS (Total Rewrite, All New)

Recently my doctor referred me for a sleep study. There was a lot of paperwork. Amongst all the paperwork was a request that I list all my medications.

Well, bugger. I had to go to some trouble for this. I am on quite a few medications, almost all of them new since my hospital experience last year. I had to get them all out, squint at the tiny print on labels, and copy details onto the form provided. It was quite a list. I think it came to eight or nine items, of which half are for psychiatric purposes. The others are for “you’re an old fart now” purposes.

This new regime works well, so well that my doctor (desperately grateful to have found a combination that works after the horror of last year’s medication change) is loath to change anything. I kind of want to change one thing. The main powerplant of my recovery from last year is a tricyclic antidepressant called Notriptyline. It’s not one of these fancy new high-tech drugs with a low side-effect profile and even makes coffee. I tried all of those drugs last year and they weren’t up to the job. The doctors told me I had “treatment-resistant depression”. They needed a nuclear weapon, and Nortriptyline is that.

The problem, though, is that it makes patients stack on weight. Two of its major side-effects are weight-gain and increased appetite. And since December 2012 I’ve been on a huge weight-loss campaign, and managed to lose fifty kilograms. I was keen to preserve and extend that if I could. But could I do it on Nortriptyline?

The answer is yes, but only just. It’s extraordinarily difficult, and requires a great deal of work on my part. It’s exhausting. I would like it to be less hard. But my doctor sees that my recovery is going really well. Look at all this writing I’m doing! Look at all the exercise I’m getting! I’m functioning at a very high level, higher than possibly at any time before in my life. Isn’t that great? Isn’t it?

It is, but at what cost? is what I want to say.

Welcome to the world of psychiatric medication. Where everything is a trade-off between function and side-effects. You want to be able to live your life, do your job, look after your family, maybe even enjoy yourself a bit, without finding yourself tangled up in a sticky web of nasty side-effects that make your life worse than the condition the meds are supposed to treat.

Last year, every time the doctors proposed a new medication for me (and there were many, many medications) there was a fact-sheet about it for me to inspect, and amongst all the facts and figures there was always a discussion of common, less-common, and rare side-effects that had cropped up during testing and trials, some of them guaranteed to be terrifying. So right away you’re thinking about trade-offs and compromises. You might get at least some of your life back, but at the cost of some other part of your life. Take your pick. And be aware that any given drug will only tend to work on about fifty percent of patients who receive it anyway.

Such as me and the great hope that was Zyban. When I went into the hospital last May for what I’d been led to believe would be a quick transition from the drugs I’d been on (for about thirty years, more than half my life) over to a sleek new powerful drug, I’d been on an antidepressant called Clomipramine (another of the tricyclics, in the same chemical family as the Nortriptyline I’m on now). It seemed no longer effective. I’d been very ill for a long time.

Almost right away once installed in the hospital the staff started reducing my Clomipramine dose, doing it over several days. This created some emotional turbulence with withdrawal symptoms, which they moderated with tranquilisers, which helped a bit. In time, though, it was time to start on the Zyban. The doctors had talked this up. It was new and exciting. It was an Italian supercar of a drug. Its biochemistry was amazing. It did so many clever and subtle things at once, it was like nothing else. I was going to love it. It sounded fantastic. And I was already feeling sufficiently unglued and stressed out, heading for a full depressive crash, that I would have tried anything if I believed it would help.

The night I had my last Clomipramine was a special occasion. I’d been on that stuff since about 1986. About the same time I was getting together with Michelle. I’d left university just the previous year. The Space Shuttle was still flying. I was in my twenties. I saw the last Clomipramine tablet in the little plastic cup, and wished I’d had my iPad with me so I could take a photo of that last tablet. It was lights out for a huge phase of my life. Every night for thirty years I’d swallowed ten of these little bastards, and while they’d done an okay job of moderating the worst of my depressive cycles, they had side-effects I wouldn’t wish on my worst enemies.

I started the Zyban, and within a couple of days felt pretty decent, even fine. I thought, this can’t be the new drug already, can it? Some drugs come on very quickly, I was told. So who knows? I thought, all chuffed.

That weekend I went to a writers’ group meeting at Edith Cowan University in Mount Lawley. Right away, as soon as I arrived, I was feeling brittle, antsy, irritated, aware of noises, some in particular. Every chair I sat on seemed made of broken glass and spikes. Wherever I sat it wasn’t quiet enough. There were people talking and eating, and wandering about the stacks. I kept having to change desks, trying to find a quiet spot, and I couldn’t believe there was this much noise in a library, especially a university library.

I ended up sitting in the lobby of the library, heaving with tears from the stress of a few people talking and eating and walking around. Michelle came and got me. Two dear friends stayed with me while I waited for her. On the way home I felt hollowed out, raw inside, undone and broken.

Back in hospital after weekend leave, feeling like a failure again, I saw my doctor, and told him about my experience. He concluded the Zyban, far from kicking in early and being great, was in fact having no clinical effect whatever. I was not in that lucky fifty percent who felt the Italian supercar thrill of the fabulous drug.

But this meant that I had no effective defense against depression. For the first time since my breakdown when I was sixteen, I was alone and naked far out at sea.

People get concerned about taking medication for psychiatric conditions in a way they don’t get concerned about taking, for example, painkillers for a headache, or cold and flu tablets when they’re under the weather. I think they worry that the psychiatric medication is going to profoundly alter their personality, their sense of who they are. And to some extent, with some medications that can happen to some extent.

I’ve never worried about that. I’ve always seen medication as a corrective to a distortion caused by the illness. As something like using corrective lenses to fix bad eyesight. Taking the right medication, for me, has enabled me to feel more like myself than less like myself. When the stuff works well, and these past few months my medication has worked extremely well, it feels even like I’ve had an upgraded to a higher, better version of myself. I feel like I can think more clearly, more creatively, and certainly more productively, than I ever could before. I tend to think of my former medication regime as like a nasty, dirty, noisy diesel engine, spewing out soot, rattling and banging, compared with the silent, efficient molten salt solar tower I’m using now. It’s as transformative as that.

And yet, I have encountered creative people who say that medication stops them feeling creative, or otherwise interferes with their artistic selves somehow. I’m never sure what to make of these claims. I can’t get inside their heads. I don’t know what else is going on in their lives that might be contributing to a crisis in their creative life. If everything was okay they wouldn’t have doctors prescribing medication. But it is possible the specific medications and the specific brains involved simply don’t work together. What should an artist or writer do?

My own feeling is that they should get the help they need that lets them work and function as normal as possible. If one sort of medication isn’t working, try others–there’s loads out there to try. And not only medication: these days there are non-medication treatment options (transcranial magnetic stimulation, for example, or even ECT), and the “talking cure”, meeting with a psychologist or counsellor to talk over your troubles can be very effective, too. The point of treatment is to help you get your life back. A life you can live with, that lets you do your thing. That lets you thrive.

Admittedly, this is a relatively new thing. In the years after my diagnosis, the Years of Hell, after I left D20, and tried to get used to my new existence, it was hard. I and every psychiatric patient I knew walked around looking like we’d all just escaped from a car accident. We all looked stunned, shocked, confused, kind of angry and nervous. We were hesitant and shaky. The blunt instrument medications we were on then were no Italian supercars. They were East German Trabants by comparison, belching out foul exhaust and barely functional. We were, as a group, either really fat and sluggish and prone to shaky-handed, sad-eyed smoking, or nervy, edgy, jittery and thin to the point of emaciation, and also inclined to smoke. We were on such heavy-duty medication we could barely function, let alone embrace the artistic, creative life. It was all some of us could do to make a cup of tea.

Medication has improved greatly. The Italian supercar drugs work a treat for the people who notice them. The non-medication treatments work well, too. I tried the transcranial magnetic stimulation last year, but I was in no condition to go through it. I couldn’t lie still in the chair, and the sound was, for me, at the time, intolerable. This was during my second hospitalisation, which while not as hard as the first one, still brought plenty of torment my way.

It took me a very long time, during those Years of Hell, to get used to the idea of taking medication every day, and to take so much of it each day. When I was eighteen I was taking about ten or twelve different pills each night. They all did something important. But it was hard to remember to keep taking them. With other things, like a course of antibiotics, you’re lucky if you can remember to take all of those, and that’ only two weeks, but this was every night forever. It did my head in, that forever. That I would never be well, not properly. I would always, as I came to see it, walk with a limp that only I noticed, but which I always noticed.

What helped in the end was coming to see the illness as no different from something like diabetes. When I found out what diabetes patients go through day to day, and across their whole lives, it resonated with me, and helped me very much. I could see my own chronic illness in context with another chronic illness. It helped to diffuse some of what at the time was still a heavy and suffocating stigma surrounding anything to do with mental illness. Nobody talked about it, but some people, once in a great while, simply disappeared, or died “and police report there were no suspicious circumstances”. It took me a long time to understand this bit of code.

Another thing that caused me problems when it came to taking medication as a teenager was my dad, who was generally against medication for anything, and would wheel out the old chestnut, “pills for dills with aches and ills”, which was to say, only an idiot takes pills. The rest of us are too smart for that. And he would use that to justify not taking anything for himself, and that undermined my own efforts to keep at it.

The most serious problem I had, as a bipolar patient, with psychiatric medication was this: when on a manic cycle you feel so ridiculously great, at least at first, for a while, maybe at least a few days to a week, that it’s like your whole brain has gone somewhere nice on holiday and is lying by a pool sipping cocktails and wearing sunglasses. You feel crazy-good, and you’re obviously not remotely sick, can’t you tell?

When you feel so fantastically upbeat, so cheerful, full of mad energy, hardly needing to sleep or eat, the last thing you want to do is take stupid pills. And yet that’s exactly when you need to take them. I have had the conversation with my mum where she tells me the fact I feel so fine only proves how sick I really am.

I am most likely stuck with the Nortriptyline, simply because it’s doing it’s job so very well. I am having depressive spells, but they are not so severe they are interfering in any serious way with what I want to do each day. The weight issue is a very urgent concern, so I imagine we’ll look at options there. A month or so ago my doctor started me on Topamax, an anti-anxiety drug that, unbelievably, has a weight-loss side-effect. To the extent that it’s prescribed off-label in the US in diet clinics. He might increase my dose of that and see what happens.

This is life on psychiatric medication. There’s always some damn thing to deal with, consider, weigh up, discuss. It’s exhausting just trying to achieve the normality most people take for granted and never notice.