BREATHING

My dad was breathing and I could hear it. I could hear it over the general chatter of conversation between my parents and me. In and out, in and out. My dad has a cold at the moment; his voice is a bit croaky, and he’s congested. I can’t normally hear his breathing. Tonight, though, every breath, in and out, each one an epic undertaking, each one a journey, worthy of metaphor.

Not that long ago, this sound would have driven me screaming from their house. My fight/flight response would have switched over to FLIGHT mode, and I would be executing the order with extreme prejudice. It would, as I slunk home, dragging my sorry arse like an unloved doll, be the cause of much self-loathing and recrimination.

Instead, I was reasonably okay. I was aware of it. I noticed it. It was a feature of the environment, along with the chat, and the slight winter chill. It was okay. I managed. I did not have to leave early, in great haste. There was no sorry arse to drag home.

Where I come from, this is what recovery looks like. It’s when daily life, in all its manifold details, tasks and challenges, begins to resemble something less than a SAS obstacle and ropes course, and more like a Friday afternoon in Ballajura, visiting your mum and dad.

SEVEN MONTHS

(UPDATED)

Today, 9 June, marks seven months to the day since I left hospital for the third time last November.

It was also the day Donald Trump was elected President.

The time since has been almost as much of a struggle for me as the time before. There has been constant adjustment in my medications, especially the Nortriptyline: when I left hospital I was taking 75 mg; now I’m on 150 mg. And in that same time my weight has shot up at about the same rate. Only in the past fortnight have I managed to achieve some measure of control over the trajectory of my weight.

It’s also been a struggle in that here in the outside world it’s an uncontrolled environment. It’s very noisy. It’s crowded. There have been plenty of times when, finding myself floundering in response to noise and crowds, I’ve thought for sure I’d be going back to hospital.

I was hospitalised three times. I was only ever supposed to go in once. It was meant to be a quick, intense thing where I would come in, my meds would ne swapped out in favour of something better with a much improved side-effect profile, and they’d roll me out the door as soon as I looked stable. And this almost happened.

The first thing they put me on after taking me off the Clomipramine I’d been on for 30 years was called Zyban. It was meant to be this brilliant new high-tech modern drug with few side-effects, and was even meant to be weight-neutral, of all things! They put me on it, and there appeared, for a few hopeful days, to be a result. I seemed to feel a bit better (and I had been feeling very bad). But it turned out this was all placebo. There was no real clinical response. It was a dud, for me at least.

I wound up on a different new drug, Cymbalta, and that looked pretty good, and did seem to work. I was discharged, and went home, like Caesar returning to Rome from Germania, full of plunder. I was Victorious. Life was good. Or a close facsimile of good.

I was still brittle, and fragile. Sounds were a problem. Crowd situations were hard. People around me going out of their way to cater for my needs were upsetting me. I felt guilty. I still couldn’t write.

But I was home. I didn’t have to go back to my room at the hospital, my room that I took to calling the “Tupperware” because I often felt cold and like I was being stored in a box at the back of the fridge. Being home, I thought, made up for a lot of shortcomings and problems.

But the problems kept accumulating, especially the problems involving sound. I simply could not stand a whole range of perfectly innocuous, quiet sounds.

I lasted about ten days, and was back in the Tupperware.

The second time I was discharged, Great Caesar, this time back from Gaul, lasted three weeks, and was pleased to have lasted that long before winding up back in the Tupperware.

And now this third time seems to have stuck, at seven months and counting. The thing about post-discharge time is you are constantly looking back over your shoulder. The hospital looms behind you, dark and menacing, a huge and sinister presence, and no matter how you try, there seems no escape from it. I asked my doctor about this, that it seemed strange to fear a place that was actually so good and healing for me. He said it’s not the physical hospital but the emotional place you’re afraid of, that sense of profound brokenness, that you’ll never be “right” again. That’s the thing, and he’s right. It’s nearly impossible to know when you have attained this “rightness”, if you ever do. You might feel really good for a long time, but then something will happen, you’ll hear a triggering sound, or a stray fragment of dismaying news, and down you go into the pit again.

Because of this, you spend almost all your time monitoring yourself. Awake, asleep, in conversation with other people, even your beloved, even your dog, you’re wondering, in the back office of your mind, am I okay? Am I going all right? How am I? You’re taking note of everything around you, from what people are eating and drinking to the ticking of clocks and the hum of refrigerators.

(As I write this, I’m sitting by an open window looking out into our backyard. We have a gigantic eucalyptus tree, a beautiful shaggy monster of a thing, and local birds love it. I love it, too, the size and scale of it, and the sound of wind wishing through it. But most of all I love that bird sounds don’t bother me in the least. If you eat a TimTam next to me I might wish you harm, but honey-eaters chirping outside are welcome anytime.)

Even when nominally relaxed, I’m still just a bit vigilant, a little bit alert, watching my surroundings, keeping an eye on people who might be problems, which is to say, who might drag a chair, who might have a noisy child, who might stir a cup of coffee, who might not stop talking in a certain tone. It’s tiring. I want to not care. I want to not even notice. Sometimes, in recent months I have achieved this. I’ve been places, done what I came there to do, and only on leaving did I realise that the entire time I was there I didn’t once notice the noises around me.

It hasn’t just been external noises making my recovery difficult. It’s also been the news every day. I said that the day I was last discharged, Trump got elected. And every day since then, as I’ve attempted to put my life back together, the news is full of him and his people. And when I say the news is full, I mean full to overflowing. I have never seen anything like it before. It’s distressing. Every day is Trump Day. Every story is refracted through the lens of Trump. We are living in the Trumpocene Era.

It’s unbearable. I no longer watch regular TV. I limit my daily news consumption. It was harming my recovery. My psychologist, when I tell her about this, and how it makes me feel, tells me she has lots of other clients (and her professional colleagues have other clients) who are likewise in despair over what’s happening. And there’s so little we can do, here in Australia. Terrible things are loose in the world, vile forces and ideas, things once thought utterly defeated, but reborn and embraced by the worst people, and there’s nothing anyone can do.

I’ve been interested in US politics since I found out about Watergate, aged 11, in the 1970s. I watch US election campaigns, especially presidential campaigns. So when I saw Trump campaigning over the past two years, I could see how utterly unconventional he was, and how his candidacy should not have worked, but it did work. There were enough people in the US who bought what he was selling. And one of the most scary things about what Trump was selling in that campaign, is that politicians here are starting to sell that same thing, and it’s going over well.

It’s not politics-as-usual. It’s not the same cynical system politics we’re used to. It’s something raw and brutal. I don’t know what to make of it. All the maps I’ve always used to make sense of my place in the world in relation to the larger features and structures no longer make any sense. There is no longer a clear path from the past to somewhere that might be the future. Where there used to be the future is now just “later”. I’m more or less in my right mind, but I have rarely felt so vulnerable, so lost, so anxious. A new sort of anxiety, and a new sense of loss. I don’t know where I’m going.

I hope I don’t wind up back in hospital.

THE WALKING CURE

(This is another long one. 1900 words.)

 

THE WALKING CURE

I’m just now back from a lovely long walk to the nearby 7-11 convenience store and service station, where they have a machine that makes damn good coffee, fast, cheap, and consistently. Two lousy dollars gets me an iced coffee as good as any I’ve had from most cafes around Perth. It seems like a modern technical miracle, like wifi.

The main point of going to this little cave of wonders, though, is the walk itself. There and back it’s almost exactly two kilometers, and takes me about 30-35 minutes. And lately, even though we’re at least theoretically in winter here in Oz, the weather has been perfect for late afternoon strolling. Clear, sunny skies, faint breeze, slanting, setting sun. And there’s a picturesque park to walk through, with a winding path. It’s so nice it’s sort of ridiculous!

The walk does me good. Gives me time and space to think, often about what I’m going to write about on a given day. Today I was thinking about this post I’m writing now, and about another possible piece about “fear of relapse”, since today is seven months to the day since leaving hospital. I may do that as well, or I may not. My only rule with this journal is that I do at least one thing each day.

Walking has always done me good. I stumbled across it by accident when I was about 12 and very likely in a manic phase. I convinced my friend Michael (my murdered friend Michael) to join me in entering, for laughs, the annual City to Surf Fun Run. We’d done enough running in school to know that Nothing Good ever came of running. It was a wholly terrible enterprise with no redeeming features. We were especially amused by the name, “Fun Run”. This was hilarious, and oh, how we laughed!

The thing was, though, you were also allowed to walk the distance. In fact it didn’t matter how you covered the distance, as long as it was under your own power. People in wheelchairs would have a go. People on crutches. Crazy morale-fuelled teams of hospital staff would push a hospital bed over the distance. And the sheer numbers of participants! It was as if a mass street protest decided spontaneously to run to the beach.

Once Michael understood that I had no intention of actually running the distance from the centre of Perth to, I think, City Beach, he was fine with the whole mad idea. It was just walking. How bad could it be?

As it happened, it could, and was, very bad indeed. The course for the event snaked the length of the Canning Highway that is one of the two main ways to get from Perth to Fremantle (the other being Stirling Highway, on the other side of the river). Canning Highway is extremely hilly. And we slogged our way up and dragged ourselves down each one.

This is the kind of story told about one’s childhood adventures that seems hilarious given forty years of hindsight, but which, truth be told, was an agonising, backbreaking, blister-bursting ordeal at the time. And we never even got to the beach. Once we reached Fremantle I suggested we go and visit my grandparents, who lived in Freo. Previously, I’d only ever been there with my parents, in the family car. I didn’t realise that their rambling, breathing old red-brick pile of a house, the sort of house immortalised by Tim Winton in CLOUDSTREET, was way over on the far side of Fremantle. Needless to say, my grandparents were extremely surprised, indeed shocked, to see us stagger in!

This ridiculous and painful enterprise gave me a love of walking long distances, though. My dad, when I was a kid, sometimes told a story about how, in something to do with his military service (back in the 1950s, during a period of conscription), had a thing about walking from Perth to Fremantle, in full battle-dress and pack. This is one of those family tales that comes down to you delicate, as if made of the dust that has settled all over it, and is so fragile that peering at it to pick out details can make it dissolve into nothing. But I think my dad did this because at the beginning of his military service he was very fat, and the epic walk in full gear was a way to lose weight in a hurry.

I was always intrigued by this account. I look back now at my younger self’s fascination, remembering how Dad telling this story ignited the desire to replicate the feat. Perth to Fremantle, if you go along Stirling Highway, is about 12-15 miles. (Miles! Who remembers miles! How quaint! But a mile is 1.6 kilometers.) And along Stirling Highway, unlike Canning Highway, the gradient is different: rather than a succession of steep hills, Stirling Highway is just uphill almost all the way.

Michael and I, purely for laughs, and sometimes sticking as close as we could to the river shoreline as possible, walked this journey a number of times. It was always my daft idea. “Hey, do you wanna walk to Freo again?” and, if sufficient time had elapsed, he’d groan, but agree, and off we’d go, full of adventure and sunburn. And what sunburn! Sunburned and peeling earlobes! Toes! Who knew you could even get sunburned toes?

We got older, and Michael went off to university to pursue a degree in chemistry. The world turned, and life moved on, as it always does.

In time I went to university as well, starting in 1983, at Curtin University, which at the time was still known as Western Australian Institute of Technology, or WAIT. I was signed up for Theatre Arts and Creative Writing.

University was, at one and the same time, the very best and the very worst experience I had ever had. One day I may write about it. For now, though, what you need to know is that I crashed and burned, my emotional life in ruins, my mind like the surface of the Moon, and quit in the midst of third-year, 1985. I went home, shrouded like a mummy in bitterness and depression, and lived on icecream and sleep for months.

Then one day I discovered I weighed 140 kilograms. This was the first message from the outside world that reached me in ages. It was like a fire alarm going off. I started eating properly. I started walking, and even running, every day at a local park.

Somehow, I no longer remember how, I went from doing laps of the local oval in Girrawheen where we lived at the time in government housing, to walking from Perth, along the river, to Matilda Bay in Crawley, near the University of Western Australia, one of my favourite places.

I feel as if I’ve lost the third reel of a feature film. How did I get from doing laps in Girrawheen to walking to Matilda Bay? I have no idea, but I did.

I used to walk to Matilda Bay almost every day. I’d get the bus into the city, change into walking gear, then head out along Mounts Bay Road, which runs right by the river on one side, and the looming bulk of Kings Park on the other. It was a spectacular walk. The sight and the smell of it, the wind in my face. Even on stinking hot days, it was a wondrous experience.

Matilda Bay has been one of my favourite places since childhood, when we, the family and me, would go there. Dad, a marine motor mechanic, was often there working on someone’s boat, or he might be playing with a boat of his own (so many memories of launching and retrieving boats from the ramp there), or sometimes we’d just sit there and eat fish and chips at sunset, in the gathering, salt-smelling twilight, watching yachts and other boats, cranky seagulls hoping for a chip. Some of the happiest times of my life were spent at Matilda Bay.

And in the 80s, as I recovered from university, walking there from the city did me a world of good again. I’d spend hours building sandcastles. Or just sitting on benches, watching the birds, or boats coming and going, listening to the wind in the beautiful trees. It was healing.

Then one day, as I walked along Mounts Bay Road, heading for Matilda Bay, I wondered for the first time: what if I kept going? Mounts Bay Road becomes Stirling Highway. In order to go to Matilda Bay, you go along Mounts Bay Road until you get to the point where you can turn left onto Hackett Drive and there you are–or you could keep going. Less than fifty meters further on, the beginning of Stirling Highway beckons you on to Fremantle.

How far along Stirling Highway could I go? Could I go to Fremantle, like I did in the old days, with Michael? Was I fit enough? Was I mad enough?

I was, and I did, and it was bloody brilliant fun! I would go and walk to Fremantle from Perth three or four times a week. I lost loads of weight, just like my dad, back in his army days, and I got fit. It was invigorating.

It took me two hours, plus two short breaks along the route. It was a beautiful walk. Exhausting, but thrilling. And I only stopped because one day I got a job, working for the government at the Bureau of Statistics. Which was fine. By this point I was starting to go out with Michelle. I needed the money. Up to this point I’d been on disability because of my illness.

(I’d been on what was then known as the invalid pension since 1980, when I finished high school. I was also at the time in the outpatient system at Sir Charles Gairdner Hospital. My capacity for work was thought not good because of my illness. And it was a very different, more generous time. People today enmeshed in the grinding, maddening gears of the Centrelink “service” with its deliberately punitive approach to people with problems would be shocked, and quite possibly enraged at how very decent the system was 30 years ago. Once Michelle and I started living together, our combined income was too great for me to continue receiving the pension, and it was stopped.)

Walking has always been good to me, and continues to be so. These days, middle-aged and arthritic, I’m not as flexible or strong as I was. I have managed, for some years now, to slog out laps in the pool at the local aquatic centre, which has been a big part of my current weight-loss program. But in the past week or so my right knee has started playing up, complaining at almost all times, and a visit to the doctor, and most likely scans, are in my future. It’s conceivable I might even be a candidate for knee-replacement surgery now. Last time I was referred to an orthopaedic surgeon for a consult, before I’d lost so much weight, he said my weight at the time would crush any knee replacement device he installed. It’s now 40 kilograms later. Things may have changed.

In the meantime, I’ll enjoy my 7-11 robo-coffee, and the pleasant walk there and back, giving me time to think.

VOICES AND MIRRORS

Recently, I was at the local aquatic centre, ready to my laps. It was right around the time my weight seemed desperately out of control, when it seemed as if mere breathing could make me stack on the kilograms. I had gained back about 13 kg off the 51 I’d previously lost. I was close to panic.

After changing into my chlorine-faded swimming trunks, feeling worried and embarrassed, I saw myself in the change-room mirror. There I was, Mr Potato Body. Then, worse, a huge roll of pale fat skin bulged over the top of my shorts. It looked like the sort of colourless bloating you associate with corpses.

And a voice in my head said, “You’re disgusting and loathsome!”

It was emphatic about the exclamation. That’s what that voice told me, utterly disgusted at what it saw in the mirror.

Mirrors, how I hate them. Speaking as a mid-career fat guy, I can report that I have been looking at myself in mirrors all my life. I’ve seen the way age has stolen across my features, and seen the way fat at different times in my life has come and gone, like a gruesome toxic tide. What you see in a mirror is true, but all wrong, backwards, sideways. It is how you look, but not remotely so. That’s why photos of you always look so odd. Your mirror self pipes up as if to cast doubt on the photographic evidence.

So there I was, a ghastly fat shambles of a man, fish-belly white and bulbous, ready to take to the pool, freshly informed of my loathsome and disgusting appearance. I felt terrible. That voice has not bothered me in a long time, but there it was, all refreshed and full of bile reserved just for me. I rearranged my attire to conceal the bulge, and went out onto the pool deck, playing that line, that voice, over and over in my head like an earworm, like the rantings of a mad cockatoo, “Loathsome and disgusting! Loathsome and disgusting! Rawwwrk!”

I bashed hell out of my laps that day.

But the voice remained, playing on a loop, round and round in my head. I finally managed to get rid of it by applying a technique I’d learned about in a book, THE HAPPINESS TRAP, by Russ Harris. He suggests, among other ingenious ideas, replaying messages like this one in different, funny voices. I tried it with the voice of Brian’s Mum in Monty Python’s LIFE OF BRIAN, “He’s not the Messiah, he’s just loathsome and disgusting!” Which made me laugh, and that dislodged that specific message from that voice.

But I have other voices. They are often playing in the background of my mental awareness like a TV in a laundromat nobody’s watching. A steady murmur of running commentary, none of it nice or complimentary, a bit like the way Terry Wogan used to comment on the Eurovision Song Contest.

These other voices are all my anxieties eating away at me. They’re a game of Whack-A-Mole–every time you smash one, it or others pop up rudely. I habe learned, with the help of that book I mentioned above, to pay less attention to these voices. They are not worth my attention. They are transmissions from the other side of the mirror, from my mirror self, who is me but isn’t. Who occupies a different, less pleasant reality.

Lately, since I started keeping this journal, my mirror self is telling me I’m a “smug narcissist wanker”. I feel as though I need a Suggestions Box, or Complaints Office to receive messages like this. Like “loathsome and disgusting!” I hear from “smug narcissist wanker!” all the time lately. The more I write here, the more I hear it. I know it’s my mirror self, dyspeptic and bitter, possibly even envious of the fact that I’m writing again for the first time in over a year. Definitely bitter. I know about bitterness. I can smell it miles away, and can definitely smell it from the other side of the mirror.

Still, despite knowing this, despite all the “Jedi Mind Tricks”, as I call them, that I’ve read about and learned from my psychologist, this one continues to sting like a tentacle lash from a bluebottle. Smug narcissistic wanker. Has a certain ring to it, of an old metal rubbish bin lid slamming into place. It has a powerful poison about it, and all the more effective for being from me, on the other side of the mirror, to me on this side.

I worried about this last year, while in hospital. I posted about the experience, the few ups and the many downs, on Facebook. One day, worried about it, I asked one of my doctors straight out, “look, am I just a narcissist?” He laughed, a huge head-back, full-throated laugh. He said no, not at all. “If you were a narcissist I wouldn’t be treating you.” That helped, but the niggle remained. The voice just whispered it instead of yelling at me.

That leaves the suggestion of smugness. This stings because I worry it’s true, and I hate it. I worry that I’m, perhaps, too upbeat about my recovery, that I’m obsessing over it, that I’m “pleased with myself”, perhaps to an unseemly degree. This really stings, this thought. My mirror self knows me well. Brian’s Mum’s Voice is no match for this drop of bitter poison.

But what if it’s true? Am I embarrassing myself here? Am I horribly self-absorbed? This is an abhorrent thought. I feel as if I’m paying as much attention and care to the rest of the world as I possibly can, and especially to Michelle, who needs me to be there for her, to be her “drummer”. She has no complaints, at least that she’s informed me about.

I don’t want to stop writing about this stuff, now that I’ve started. But the worry is there. Even if loads of people tell me it’s all fine and I shouldn’t worry, I would still worry. I’m a worry-based lifeform. And Mirror Adrian knows me too well to let go as easily as that.

PRIVILEGE AND SHEER DUMB LUCK

I’ve just been for a long walk, thinking about the post I just uploaded here. While it is great that my doctor, and his team (including numerous other people), was able to help me so much, I find myself unable to let go of one piercing, painful issue:

I could only get all this fantastic and wondrous help because of Michelle, who works at a job where she gets paid more than the average salary. This means we can both be covered by the maximum level of private health insurance. And that in turn means I don’t pay anything to see my psychiatrist; it’s bulk-billed (he once told me, when I asked about this, because he used to bill me upwards of $150/visit, “I don’t need the money”). Each of the three times I was laid up in hospital last year, it cost about $200 for admission, and that was all, for 3 x 7 weeks of inpatient care. I only had to pay at the end of each stay for the medication I consumed.

This is a high-end private psychiatric hospital. In their orientation book it does say patients who don’t have such robust health insurance, who are on Medicare, have to pay $800/week, each week, to get the level of care I received.

This is outrageous. I am no more deserving of that level of care than anyone else. I’m just ridiculously lucky. I’ve long thought I was the luckiest man in the world, but there are times when you have such a painful apprehension of the magnitude of your own privilege (white, male, middle-class, middle-aged, home-owner, university-educated, no serious debt) that you can hardly stand to face anyone.

It’s unjust that the high level of care that I received, and continue to receive, is only available because of my fortunate circumstances. This bothers me very much. It makes me burn.

POINT OF INFLECTION

Today at my psychiatrist visit, it was all the usual stuff with medication review, discussion of mood, ups and downs, and all the usual stuff.

But then he surprised me out of my gourd: he said, “Thank you,” for placing my faith in him, for going along with his treatment plan this past year, for, I suppose, not being angry with him over the unexpected ghastliness of the whole exercise.

I was taken aback. It has never occurred to me to be angry with him. The “medication change” plan from last year was meant to take, at most, a few weeks. But here it is more than a year later and we’re still working the problem, seeking a fine balance between treatment and function, that lets me live an ordinary life. Indeed, today my doctor filled out a prescription for an anti-anxiety drug, Topamax, and talked about cutting back one of the two anti-depressants I take, Cymbalta. He says it’s time to “simplify” the baroque complexity of my medication, and fair enough if I can get decent coverage without quite so much faffing about with pills.

During the truly bad times last year, I did contemplate changing doctors, not because I wasn’t comfortable with the way things were going, but because of the near-impossibility of actually seeing the guy. I was one of dozens of patients under his care, and for the most part I had to make do with seeing one of his junior doctors, one of the registrars. Who were excellent doctors in their own right, and would all go on to become consultant psychiatrists in time. But I was always in a hurry to get well again. I wanted to be fixed now.

Because every time I saw a registrar to talk about my case, they would tell me that they would have to talk to my consultant and get back to me, and that could take days. When you’re badly strung out, and vibrating with spiky anxiety, that wait seemed eternal. I did sometimes see my actual doctor, when he knew I was in catastrophic shape. But for the most part I was assigned to the registrars.

I did understand that my doctor had dozens of patients in the hospital, plus his usual line-up of outpatient visits in nearby consulting rooms. I also saw him sometimes in the hospital, in the midst of meetings, bustling about carrying laptop and files, talking on the run. I didn’t know it then but he saw me at those times, too, and was deeply worried for me. Sometimes I wondered not so much about when he might squeeze in a few stolen moments for me, but about when he might see his family.

I think he has come to regard what happened last year as an horrific mistake, something so dreadful that he would not recommend it to me again. I think he feels sorry for what happened to me, and that was why, today, he thanked me for staying the course, and having faith in him.

While I would not say it was a pleasure, I would and did say it was no trouble. It was also worth it, to reach this point, in far better emotional and psychological shape than I have been in for years. It has been nothing less than a transformation in my life, much like everything that changed in my life in 2012 when I broke my arm. This experience has certainly been a personal crisis, bit also an inflection point, from which I have a new trajectory.

I should be (and have, many times) thanking him.

TURNING POINT

Tomorrow I’m off to see my psychiatrist again. Last time I saw him (two weeks ago) I impressed upon him how dreadful I was feeling about runaway weight-gain, which at least in part is a side-effect of the drug Nortriptyline. I asked him what other treatment options he had, other than bombing my illness with that drug.

He is very reluctant to change things too much. It was so difficult just getting me to this point–my mood is consistently pretty decent, as long as I don’t get thinking about my weight (see my earlier post, The Scales)–that he is loath to mess up something that more or less is working.

He told me last time I saw him that he was thinking about changing one of my other medications, Latuda, for an anti-anxiety drug called Topamax, in part because of that medication’s reputed side-effect of weight-loss. It’s that rare thing, a psychiatric medication that doesn’t make you stack on the kilos. My only concern about this is that I was on it for a couple of weeks last year in hospital, during which time I had to urinate so often I was more or less living in the loo. I have mentioned this to my doctor. He says that at the time I was coming off and going on to so many different drugs that it was hard to assess whether it was the Topamax causing the problem, or what. I’m also on a completely different set of meds at the moment from those I was on last year. Maybe the constant urination thing had more to do with my medication situation last year, and won’t be a problem now.

As for the possibility of quitting the Nortriptyline altogether, the doctor wants me to organise a sleep-study, and a blood-test to check my blood-levels of the drug. I have sent the sleep clinic a request, but they have yet to get back to me. I’m still in the process of organising the blood-test.

The other thing that has changed in the past two weeks since I last saw the doctor is that I’ve managed to lose 3 kg. I have altered my diet and eating patterns, and this has arrested the crazy trajectory of my weight-gain. I thought it was out of control, that nothing I tried was helping–but that was before I really, seriously tried. One day recently the scales told me I had reached 127.1 kg, up from my lowest weight, recorded while I was in hospital, of just over 114 kg. Since then I’ve been working hard, mainly reducing as much as possible the tasty treats, without stopping them altogether. This morning my weight was 124.2 kg, exactly 10 kg off my record best, my “personal least”. I would dearly love to get back down there, and keep it going down. I still want to go sky-diving when I hit 100 kg.

The doctor also asked me how I’d feel about trying again with the repetitive transcranial magnetic stimulation (rTMS), a treatment I tried last year, but which I hated. But now I feel like I could try again. And if it meant no longer having to take quite so much medication, I would be all for it.

Wish me luck!

WEIRD KID 1

It was a weekend afternoon, the sun well on its way to the horizon, and I was a little kid, maybe eight or nine, and we, the parents and I, had come to visit my Uncle Bill and Auntie Rita.

The thing is, though, when we arrived, and it was time to get out of the car and actually go down the steeply sloping red path (manicured lawn on each side), I could not bring myself to exit the car.

And this wasn’t the first time.

By this point Mum and Dad knew it was pointless arguing with me (tears, yelling, the whole catastrophe), so they got out of the car, deeply not happy with me, and they went down the sloping red path, up on the porch, knocked and were welcomed. I stayed in the car, in the metal box of heat, starting to sweat, and feeling a tangle of sticky, horrible feelings.

I knew I should be with Mum and Dad in the house. And I did love Uncle Bill and Auntie Rita. They were wonderful to me at all times. Uncle Bill was a retired grocer. Auntie Rita, ten years older than Uncle Bill, was my dad’s father’s sister, as far as I could figure out. I mainly remember her kindness and her sweetness.

But I also remember I was deeply weird around them. I would sit in the car for, it felt like, hours. Sometimes I would muster up the nerve to go down the path to their door, and they would welcome me, and I remember they never made a big deal about it. It was as if I had simply been unavoidably delayed, but was here now, and that was lovely.

I remember feeling so shy and very likely anxious that I would burrow in next to my mum on the lounge room couch, and sort-of try to hide behind her.

I would hear about all this later. It was embarrassing, and not right. But I couldn’t help it. It also didn’t have anything to do with Uncle Bill or Auntie Rita. They were lovely. I was blessed with a wonderful extended family. No, the problem was me, and the way I just didn’t much like being with people. Being with people made me feel on edge, not sure what to say or how to just be there with everyone. I was quiet, usually in my own world, even when otherwise present.

From this distance I no longer remember whether I did this anywhere else. I have fleeting fragments of something that might be memory telling me I did do it with some friends of the family, and possibly when we visited my maternal grandparents in Fremantle, but I’m not sure. I might ask my parents what they remember. Certainly they have told me many times that I was a “difficult” kid in many ways. And probably most weird, and most difficult when it came to food and eating.

But that’s a story for another time.

HELPFUL BOOKS

I’m not much into self-help books, and don’t plan to write one, because I’m far from an expert. I’m not even an expert about myself and what I’ve been through.

Over the several months I’ve been visiting my psychologist, she has recommended books to me that she thought might help me. The first of these was MINDSIGHT, by Dan Siegel, a therapist who uses mindfulness techniques to help his clients. It was this book that convinced me of the value and effectiveness of mindfulness as a way of changing your thinking about your illness. It was a very powerful read for me, and helped me very much.

My psychologist also recommended THE HAPPINESS TRAP, by Russ Harris. This one looks at a variation of mindfulness, in which you accept you have all these unhelpful and generally awful thoughts and feelings, but rather than trying to get rid of them, instead the book teaches how to pay less attention to them. Most important, for me at least, is the emphasis on living a rich, meaningful life, rather than trying to be happy. The author says chasing after happiness will generally lead to unhappiness, but that aiming to live a meaningful life is better, and more satisfying. Choose to do things, even in your spare time, that mean something to you, that are important to you. It’s because of this book that I’m writing again.

Last, MAN’S SEARCH FOR MEANING, by Austrian psychiatrist Dr Viktor Frankl. It’s a short book, and is divided between the author’s memoir of his experience in Nazi death camps, and a brief introduction to his therapeutic method, called “logotherapy”, which, like the Russ Harris book (THE HAPPINESS TRAP), is about pursuing a meaningful life. Frankl credits this technique with helping him survive the camps.

While I recoomend these books, I make no promises that you will find them as helpful or useful. I think people are too strange and various for that. But I did find them the most helpful to me of all the many books I’ve read, and you might get some benefit, too. I particularly endorse the idea of pursuing meaningful activities and endeavours in your life, where possible.

As soon as I understood the idea, the first thing that occurred to me was that my number one meaningful thing was writing. Writing is my thing. For a long time I forgot that.

MANIA

Everyone knows depression is awful. There have been many books about it from all kinds of different angles, including plenty of sometimes harrowing memoirs. I’ve written here about the horror of full clinical depression, too. Maybe you’ve read a couple of my earlier posts about it. As an experience I give it no stars. It is wretchedness. You’re left feeling like a World War I battlefield, picked over by carrion birds.

The thing about what’s called “bipolar disorder” (what was once called “manic depression”, and what a doctor, when I was 16, called “biochemical, bipolar, manic depressive psychotic disorder”) is you get two experiences that, usually, alternate. You get the full-throttle–or perhaps the no-throttle–depression that everyone knows about, and everyone hates. But you also get mania, and, to me, mania is worse. Much, much worse.

I have had this conversation many times over the years since I became what feels sometimes like a “professional patient”. Which is worse, depression or mania? It’s like that awful question wankers sometimes pose, “if your wife and your child were both drowning but you could save only one, which one would you save?” It’s an impossible question, or seems like it. For me, mania is worse, no question.

When you’re depressed, you can lie down. You can sit. You can stay in one place. Your thoughts come at you one at a time. They’re horrible thoughts, full of anger, accusation, criticism, and poison, but they come at you as if over a dial-up modem connection, at 33.6 kbpm. When you’re depressed, it doesn’t seem unreasonable to stay in bed for days on end. You don’t much want to eat (unless your interior voice is making you want to eat everything). Bathing is out. Answering the front door, or picking up the ringing phone is also no good. Depression is inertia. Your miserable mind congeals around your self-loathing.

Mania, on the other hand, is gigabit broadband madness, and your thoughts and ideas and feelings blast through and around your head faster than you can imagine. You can’t lie down. You certainly can’t sit. What you can do is move, walk, run, dance, swim naked at midnight in winter. You can walk all night long, and the whole time your mind is lit up like a movie premiere, searchlights and all, and you have more ideas per second than anybody in history, and all these ideas are BRILLIANT!

You get angry because your stupid made-of-meat mouth can’t keep up with the extreme bitrate of your thoughts. You can stay awake for days, just like if you were on methamphetamine.

But there is no possibility of rest or peace. You can try to lie down and close your eyes, but the whirling light-storm of ideas zooming around behind your eyes means you can’t rest, even though you are exhausted. Your useless meat-puppet body is not up to what your brain is doing. Because your brain is screaming, supersonic, oh and did I mention that everything is FUNNY? You are the funniest guy ever. You imagine going pro as a comedian. You imagine recording a comedy album. You might even begin writing one. And people you run into do seem to laugh. At least at first, you are in fact pretty funny. But your audience gets exhausted. You can see it, and you try to keep them, but your mouth can’t keep up. You trip over your million-miles-an-hour words, and you get frustrated the way you get frustrated over a computer that won’t do that one simple bloody thing–

You scare people. You can see it, and you are horrified, and you try to make them understand, that you’re okay, you’re a nice guy.

Then there are the delusions of grandeur, that you have uniquely penetrating ideas, key insights nobody else has ever understood before. You become paranoid about assassination, about people reading your mind.

Once, when I was 16, and I was in Sir Charles Gairdner Hospital’s psychiatric unit, I realised one day, sitting next to my dad, that my dad could hear my thoughts. He could hear me thinking. He naturally did not let on about this. It was a secret. He sat there, cool as a master spy, taking careful note of my thoughts, and even more careful not to reveal that he knew I knew.

When I’ve had mania, or manic episodes, I end up sleeping only because the meat puppet is exhausted. Not that there is any rest. You wake up, as if hungover, but with a bit of luck the phase or cycle is finished with you for now, and the guards can drag you back to your cell.

Because you can find yourself wishing for depression.