Ketamine II

I posted recently about my experience of taking IV ketamine to intervene in disabling depression that at that point had persisted for over two years. All in all I found it to be a boutiquey experience, a fix for desperate members of the middle class that was financially out of reach for the low-income and depressed.

At the end of this experience I felt that dollar for dollar it made a lot more sense to snort street ketamine than to pay a rich doctor $500 a pop for something that didn’t have a significant duration of effect, or any effect at all in plenty of cases. It is ironic that the recent embrace of psychedelics for the treatment of mood disorders has materialized as remarkably expensive riffs on easily accessible drugs.

Despite the inadequacy of this treatment regimen, after another two years of misery I had occasion to revisit the experience. I made an appointment for a consultation with a treatment resistant depression specialist practicing out of a large state university.

It is my experience that becoming a new patient of a psychiatrist is almost always miserable. The requisite discussion of my life history is punishing. They ask you about all the things that are impossible when living with a serious mental illness- employment, education, relationships, dental hygiene. That shit goes out the window when you spend your days in what is essentially a state of existential horror, and to revisit how little I’ve done with my life as a diagnostic exercise makes me nostalgic for the time I got tested for chlamydia.

Looking at these things makes me feel endangered. I am always glancing down the ladder I climb, hoping to create some distance between myself and the realistic miseries of group homes, homelessness, institutionalization and antipsychotics that threaten all of us with serious mental illness. No matter how fast I climb the tide continues to come in. 

So I went to this consultation. I have been through several psychiatrists and there is almost always a rote response to my suffering, which is a change in medications or simply another pill loaded on top of the existing cocktail. It feels decidedly imprecise because it is. What is insulting and upsetting about this approach is that there is no acknowledgment that they are throwing stones in the dark, trying to hit a shadowy and amorphous phenomenon that they know little to nothing about. 

Regardless, there was no threat of new drugs as I had an NP prescribing for me. This was a relief. I’ve been fending off the advances of medical professionals who are essentially acting as extensions of pharmaceutical sales reps for years now. And before the reader renders judgement on me for failing to jump on every possibility for relief, know that many psychiatric medicines come with severe and ofttimes intolerable side effects. If you doubt me do some reading on akathesia. Try to imagine living with it. 

To my surprise and pleasure there was no exhaustive psychosocial history taken. They did ask me about illicit drug use which is a funny thing. So many psychiatric medications are worse for you than the drugs that people take for fun. So I lied a bit. It’s not unusual for me. I’ve taken bucketloads of acid, mushrooms, DMT, weed and ecstasy and don’t regret any of it, but it’s generally not a good idea to express your enthusiasm for recreational drugs to psychiatrists, social workers or psychologists. They’re quick to regard this not just as a problem but the problem.

After rattling off the long list of psychiatric drugs I’ve been on in the last five years of my life the doctor drew a little graph. It depicted the likelihood of response to new medications. As the number of medications trialed increases the likelihood of response diminishes until you reach no fucking chance at all. I could have told him this, but it was nice to be validated. Then he said that the first thing he’d like to do was administer ketamine twice a week for two months. 

I went home with a bunch of pamphlets. What I was to begin taking was not the ketamine of Vietnamese battlefields and veterinary sedation but a derivative of it, altered so that a pharmaceutical manufacturer could make money. This was esketamine, sold under the brand name of Spravato.

The ad men of big pharma have an uncanny ability to choose stupid names for chemicals, names that sound upbeat, that try to evoke something of the promised effect. I’ve been on abilify, lexapro, prozac, wellbutrin, effexor, seroquel and zoloft and every time I picked up a bottle I felt pandered to. 

Reading up on Spravato I was skeptical. I’d taken ketamine before to little effect, or at least little antidepressant effect (I definitely got high). From what I could find about ‘non-responders’ I was likely to be one of them. Apparently a history using benzodiazepines is a predictor of a lack of response and I’ve been taking between one and four milligrams of clonazepam for five years. And while I truly wanted relief tripping on ketamine seemed like a pretty good consolation prize.

For two months this past winter I somehow made it to my appointments. There were many times that I felt disappointed. Not only was the depression somehow worse but the Spravato wasn’t producing the fucked-upedness I was hoping for. It comes in very streamlined looking two shot bottles. I started out on one and ended up at four. This quickly took me over the limit set by the insurance company and suddenly I found myself snorting regular racemic ketamine. 

The first dose rocked my world. I saw a herd of wild horses fording a river and a beautiful girl with red hair in a field. I saw legions of people at some point in the distant past, marching with spears. Then hazy colors bloomed and I experienced the strange but pleasant experience of being folded, elongated, compressed and rotated that seems unique to ketamine. I walked out of the office like a newly birthed colt, shakily walking into the future.

I am still taking ketamine under the care of this doctor. He thinks it’s working. For myself I can’t tell. There are too many variables in the equation. I’m on a new antidepressant and have gone through a month and a half of transcranial magnetic stimulation in addition to the ketamine. I’m a bit better than I was. I still experience searing anxiety in the morning but eventually it lifts. The automatic self-hatred and fear of the indubitably terrible future has softened. I don’t lay on the couch, conscious and hating it, for hours at a time. I don’t sob uncontrollably.

Of course I live in fear of descending to those depths again and this is an uncomfortable way to live. I examine my feelings, pouring over them in search of the reemergence of crippling misery. I pan for them. I am a depression prospector, and I always find a shiny nugget to obsess over, but it is too small to bother with. I toss it over my shoulder, sit in the shade for a bit and then return to the creek.

A Children’s Story That is Entirely Innapropriate for Children

Shane loved to feed the birds. He would watch out his window as the cardinals flew from the feeder with a single sunflower seed or a grackle shoveled its way through the mess looking for exactly the right morsel.

One day he noticed a crow overhead, simply watching. Shane didn’t know why it chose to be alone or why such a big bird didn’t simply bully its way through the other birds. He grew concerned that it had no food or friends. He left a salty nut for the crow such was his sorrow for its situation. 

The next morning the nut was gone and two crows were in the tree, croaking and flying from branch to branch. They ceased their play when Shane came into view and looked down at him expectantly. That day he left two nuts, such was his gladness at seeing the newfound friends frollicking. 

On the third day there were three crows. Shane understood then that there were many crows living a beautiful life of play and food and kinship, rising above the houses and farms to giddying heights grokking their laughter for no one but themselves. He left many nuts that day. He wanted to live beneath them and be a part of their world. 

Soon Shane had an entire murder of crows greeting him every day, cavorting around the yard, always curious for the sake of being curious. From both books and observation he learned about them. He learned to tell them apart from their habits and their size. And they learned about him as well. They could tell Shane apart from the cruel boys down the street with their pellet gun and from the woman who would throw rocks at them when they alighted in her yard. Shane was theirs as they were his and they began to follow him.

When he left on his bicycle they flew above, and when he stopped at his destination they sat watch, guarding him from cats and boys with bad intentions. 

As Shane grew, there were times when he became sad. Sometimes he felt so sad and angry that he couldn’t stand it. At these times the crows would circle above him, croaking in the way that crows do. They performed a ritual, unseeable to people, in which they called up the sadness into the sky and ate of it. Sadness didn’t hurt crows nearly as much as it does humans and so they ate of it when enough had been drawn off and distilled in the space between the trees.

For Shane’s part, he knew that his spirits rose and the anger drained from his face and his fists as he watched the easy flight of the crows he thought of as his. They would perch on his windowsill and bring him tidings of good or ill fortune. 

For his part Shane would see to the care of the crows who were ill or injured and he learned the ways of a doctor, splinting wings and administering fluids, keeping them in relative security of his home until they were well again. And when the crows neared the end of their lives they would huddle on the ground while the rest of the murder croaked their song of passage. Shane would come and sit watch alongside them, and when the end finally came it was Shane who wielded the shovel, wrapped the bird in white linen and interred it, plucking a feather from its wing. He inserted the feather in the hollow of a mighty oak that the crows favored. In the morning following such an event the feather would be gone and there would be sprigs of holly and the blossoms of honeysuckle on the disturbed ground. 

There came a time when Shane left his family’s home and went out into the world. He bid farewell to his crows with a heavy heart and he believed that he needed the crows much more than they needed him. But as he drove away he saw the entire murder following behind him. As the miles fell away beneath  the wheels of the car the birds turned back, one by one, until finally there was one remaining. As he arrived at his destination it landed on another grand oak, and Shane knew that despite all his worries he was not alone. In a matter of days another extended family of crows had arrived and accepted into their lives the crow from his home. 

His life proceeded along these lines. Shane became a veterinarian, and a husband, and a father. He was good at all these things because he had learned that life and death are part of the same cycle. In its turning it travelled through the grand spiral of time towards a brilliant white light, distant but pregnant with promise.

Shane did his best to live in the world, but he knew his share of sadness, grief and anger. The crows did their best to clear it away so that it didn’t clutter his life, for it is crows who are responsible for the cleaning of soiled time. 

One day when he was a very old man Shane was walking through the woods. Things suddenly felt strange, as if the world was no longer the world. He could hear the crows overhead, and for the first time, the music in their calls. He looked above, behind and around himself and the branches were weighted with birds of all sorts and the crows had gathered around him, looking up and in their deep dark eyes he saw sympathy and he saw love. 

The sound of dark wings beating brought him to his senses and a crow many times his size came to rest on the ground before him. It groomed itself, watching him as it ran its beak over its feathers, surveying him and assessing his character. Then it bowed to him, turned around and presented its back. Shane knew the favor it offered and was only too pleased to gently climb its huge, soft back. He wrapped his arms around the sides of its neck and sighed with pleasure as he felt himself taking flight.  

Ketamine

I’ve taken ketamine many times in my life. Once was recreationally. I snorted several lines of powdered material off of my cousin’s coffee table and rapidly lost all sense of myself, the remnants of my identity dissolving into a vast space that included everything, excluded nothing, in which I knew that some part of conscious observation would remain for eternity. During the brief moments of this experience when I could open my eyes, I felt as though there was powerful energy surrounding me, energy that I could hold in my hands and manipulate to my great delight. Afterwards, I was forced to balance a profound sense of well-being with a nausea inducing headache. I also had a deep appreciation for why it was considered a rave drug, though I have never been to a rave. 

The other times I have taken Ketamine it was administered by infusion in a clinical setting. On these occasions, I took it with the intent of mitigating treatment resistant depression, a condition that I have contested through a variety of measures both wise and foolish for the entirety of my adult life. Following on research that shows Ketamine’s efficacy at addressing depressive symptoms the medical administration of the drug has become an industry unto itself. There are a growing number of these clinics where you can be given a series of IV infusions of the drug at significant cost. 

This is an unsurprising development. While major depression is a troubled term with no biological means of diagnosis, the cluster of symptoms that typify it comprise one of the keynote maladies of contemporary life. Estimates vary, but in a given year around 7% of the American population suffers from what clinicians would call major depressive disorder. Selective serotonin reuptake inhibitors, the treatment of choice for a number of common forms of suffering, depression included, have a poor rate of success, improving symptoms in only a third to a half of people who take them. They also come with a host of unpleasant side effects and can be profoundly difficult to stop taking after long periods of use. With this being the case, any alternative that offers relief is bound to generate interest and lots of revenue. 

For myself, I decided to make an effort at divorcing myself from SSRIs after twelve years of use- twelve years in which I experienced little to no relief and in which my life has fallen apart completely a handful of times. While going off of SSRIs- which I have made several efforts at- I experienced horrible withdrawal effects. It is increasingly well-documented that withdrawal symptoms are both more common, more severe, and longer-lasting than is generally acknowledged by American psychiatrists, and this was true for me. I dealt with obsessive, panic-inducing thoughts for weeks, followed by a period of anhedonia in which it became impossible to engage in the basic tasks of life. This plateaued after a time, but in this most recent effort, three months out, I contend with a near constant state of bodily anxiety that makes it hard to work and sleep. I struggle to engage in basic activities- when one can’t watch television, the low bar for conscious experience, there is evidence of a real problem. 

In my years of navigating the contours of depression, I have heard at many junctures about the possible benefits that can be derived from a myriad of psychedelic drugs, Ketamine being just one of them. Psilocybin, LSD and DMT have all been investigated in clinical trials in recent years and have shown promising results. The problem that arises is that for those of us who have engaged in treatment with conventional antidepressants, the therapeutic effects of these substances become difficult to access. SSRIs cause a superabundance of serotonin to build up in the brain with a corresponding decrease in the number of receptor sites over time. 

These receptor sites are the keyholes in one’s brain that psychedelics unlock to occasion mystical experiences, and for the depressed and medicated there is the significant hurdle of withdrawal to overcome before one can access the benefits of psychedelic therapy. In my years of SSRI use I have made heroic efforts to overcome this unfortunate side-effect to no avail. My most recent attempt involved ten grams of mushrooms and two tabs of acid with no discernible effect. Imagine my frustration. 

Ketamine gets around this problem. It is not a classical serotonergic psychedelic, instead acting on the glutamate system. Its benefits, as explained to me by a psychiatrist with an unnerving capacity to type while speaking, lie in its stimulation of the production of brain derived neurotrophic factor (BDNF), which prompts neurogenesis. Apparently there is quite a bit of synaptic pruning that occurs for those of us with severe depression, reducing the connectivity between regions of the brain, literally isolating the ego and hard-wiring a ruminative, self-hating and anxious state of mind. The stimulation of the production of BDNF occasioned by repeated infusions of Ketamine (and also prompted by psilocybin, LSD, and DMT) is thought to stimulate the development of synaptic connections, turning a one way street of a brain into a thoroughfare that is hopefully less obsessed with itself and more interested in the rest of the world.  

With this said, the profusion of articles that have appeared in recent years touting the benefits of Ketamine administration for treatment resistant depression convinced me to try it, while the high cost convinced me to put it off indefinitely. Ketamine is ‘off-label’ for the treatment of depression, meaning it has not been through clinical trials to assess its efficacy. The problem lies in Ketamine’s ‘age’- it is in the public domain, so to speak, having been approved for use in the United States since the 1970’s. With drug companies lacking a financial incentive to invest in extensive trials the FDA will not approve it as a treatment. This creates a situation in which only those with disposable income can afford the relief that it (hopefully) provides. 

With a recent death releasing some liquidity into the family coffers, I was able to move forward with the treatment. It was surprisingly easy to become a patient of the clinic I chose. I just called, filled out an online questionnaire, and was scheduled within days. After an initial consultation with the psychiatrist in which I went over the sad details of my sad life, an experience that I have frequently and that is never pleasant, I was declared a good candidate for the treatment and was placed in a recliner and dosed. 

This was a very different experience than my self-administered experimentation in my cousin’s livingroom. Likely this has to do with the accepted effect of set and setting on any psychedelic experience. In my cousin’s apartment, I had someone else to exchange exclamations with, someone to giggle “I’m so fucking high” to. There was art on the walls to lose myself in, and no clinician to tell me what to expect, merely the thrill of a new drug that was taking me to a place in my internal world to which I’d never been. 

 In the clinic on the other hand, there was dim light, a businesslike nurse inserting a needle in my arm, and a desire on my part to be left alone while I went through whatever it was that was about to occur. There was no large space in which I lost myself ( although lose myself I did) and little desire to move my body. Ketamine, at least in this context, was far different than other psychedelics with which I am familiar. It had little of the narrative making and storytelling faculty of DMT or psilocybin or LSD. Even at high doses of these drugs, there is at least an awareness that you are a person who has a conception of oneself, however much the substance might convince you that this conception is misguided. 

On Ketamine, there was no me to be reoriented in the trip, and instead a distinct absence of any self- who I am, who I was, who I might be were erased completely. When I was able to summon some sense of self, there was a profound alienation from that person, a disbelief that the thinking subject on the drug could possibly have anything to do with anyone.  There is also little about the trip that is visual- instead of strange landscapes, playful entities or shifting patterns,  there are simply torrents of strange and muted light that press upon the mind’s eye, and an odd sensation of being shifted and rotated. When you come up, you come up relatively quickly. You’re offered crackers and water (I declined) and are left alone to put yourself together.

In the immediate aftermath of the clinical experience, you feel distinctly as though you should not be up and walking around, but this is exactly what you do, against all odds scrawling your signature on a release stating that not only will you not drive for the remainder of the day, but that you will refrain from going out alone or from making any important life decisions. Then you toddle into the world, and whoever your kind-hearted driver happens to be takes you home. 

All in all, I liked snorting it with a friend better than I liked having it pumped into my vein by a psychiatrist, but I suppose the important question is whether it did anything to alleviate my depression, and the answer is yes, with caveats. I can state unequivocally that I felt not only a diminishment but a complete cessation of my depressive symptoms in the hours following administration, which was wonderful and for which I am grateful. With that being said, it barely affected the anxiety I experience, and in the days that followed each administration depression slowly crept back, although the length of time this took varied, and after the sixth infusion there seems to be a lingering effect.

This is my great fear, and sadly a fear that is likely to be realized- That after all these strange, sometimes unpleasant clinical experiences, the misery will creep back into my life, perhaps stronger and darker than before, and it is a bitter pill to swallow. I have been told that should this happen I can return for a ‘booster’ infusion, but this is honestly something that I’d prefer to avoid. As I imagine most people with depression feel (we’re not a social bunch, so I haven’t asked around) I want to get on with my life, for this to be a chapter that concludes rather than a running narrative. Unfortunately, when one reads between the lines, this is not the story of depression, Ketamine or no. Depression haunts you, sometimes actively, sometimes merely by dogging your memories and lingering in your awareness. 

In conclusion, if you have the money and you’re desperate, this is an option that has the ancillary benefit of being a really strange experience. It feels like an industry, and it is, but so are the majority of other avenues we use to treat emotional distress. Of course, there are a host of other substances that offer similar benefits for a lower price, however they happen to be illegal and, depending on your predilections and risk tolerance, don’t have the benefit of taking place in a medically supervised setting. 

Discourse with the TV

I watch a lot of TV. Some of it has been glorious, most of it has been background noise. I like the constant distraction. It makes me more able to focus because instead of thinking about myself and my ailments I’m thinking about what’s happening in America. 

Last night I smoked a joint and became anxious immediately. This happens every time I smoke a joint but I keep on doing it, just like with the television. I nearly dive into the couch such is my desire to stop thinking. I piled my laptop on my groin. Throwing the laptop in the mix creates a more hardened firewall between the mind and the mind than television alone. 

MSNBC talking head Chris Hayes was on. He seems like a decent enough person, like the affable kid you were kind of friends with in junior highschool turned into an acceptably progressive media personality. And he buys you lunch or something. I’ve heard that his book Colony in a Nation is good but I haven’t read it. 

He was hosting an episode of his show dedicated to a discussion of, among other things, the ‘Reform Movement’. While I assume there was someone on the program purporting to represent the aforementioned movement (I was with the internet periodically) I did not catch them. On the occasion of my cognitive arrival there was an African American man who was somehow employed by a police union fielding questions from Chris Mathews to which he provided by rote a litany of the most tired of strawman arguments in defense of impunity for the police. . Then some mayors fielded questions from people beamed in from elsewhere. 

I take umbrage at many of the ways in which this show went down. The ‘Reform Movement’ thing rankled me. Who exactly picked that name? The people in the street? Or the people who have proffered themselves as their representatives? Whatever the case, nobody asked me. 

Not that I should be the first one to be asked. I’m no organizer and I’m not among the population of people who are most impacted by the criminal justice system. Not that I haven’t gotten caught up in it in my life, but there as well is a minefield of privilege. What I’m saying is I’m white and I’m crazy in a way that doesn’t result in lots of contact with the police. This seems like the better kind of crazy for me if we’re going to look at it in a black and white world, and I would know because I’ve been both kinds.

But if you did ask me what I thought about the police, I can answer “fuck ‘em” with conviction. “Reform” doesn’t reach a sticky finger towards what needs to happen in order for justice to be served. It’s the phraseology of talking heads who want something that can take the resounding clamor for abolition and grind it up into digestible chunks, a process that bears no small similarity to dog food. 

As for me, I’ll continue to show up to the stuff as I can. I miss a lot, not being on social media. I am mostly aware of things after they’ve occurred. I don’t like this, but the cost of being immersed in the emotional economy of the internet is high. I’m brittle. Seeing the heights that others have reached makes me feel bad about the little bit that I cling to with such effort. 

And besides that is that this state of affairs forces me to reach out to friends for information. Sometimes this turns into a plan. It’s nice to have someone to say ‘fuck the police’ with. It’s so easy to become so lonely when you’re so sick for so long. The lives of others burn and it becomes easy to want to avoid them. And I would like it to be about some failure on my part to come to peace with the fact that I want less than most people and will never be congratulated or celebrated for achieving it. People don’t recognize the labor that goes into being only yourself in a world full of incitements to be otherwise. It’s all very taoist.

Bad Jobs

My life has been hellish for a while. If I’m honest with myself about it the decline has been going on for years. There’s precedence for this in my extended family, a streak of sad madness that manifests ultimately in an old age of dementia addled depression. If we make it that long. 

This isn’t to say that everyone is mad. There are enough high performers to float the more broken of us through the hard times. I am lucky in this respect and a few others, but mostly I am cursed. My brain doesn’t work right and it tells my body that there are many things wrong already and more on the way. I twist and turn, I sweat, I can’t sit still. I am not psychotic, but I think I might know a piece of that experience, the electricity that courses through your body until you are exhausted. You fall asleep and an hour later you awaken, refreshed enough to feel terrible again. 

My great uncle committed suicide by swimming over Niagra Falls. I hope that he felt relief on the way down. More than that, I wish he had stayed alive so I could ask him how to live with this burning inside. 

I lived in Tucson, Arizona for many years. They were good years for me. Lots of friends and lots of fun. I lived off of loans, which is a wonderful way to get by, then I was in graduate school pursuing a PhD. I loved it for a time until I didn’t, and then I fell apart, again and again. Depressions and phobias descended on me like mosquitos, so common that I stopped slapping at them. Finally I reached a point where I couldn’t do it anymore. Like I said, I’m lucky, I had solidly middle class parents to mooch off of, and I did, moving home at 33 under the auspices of starting a business, but really to escape the fact that I was truly falling apart. 

Moving home is hell. People do it for survival and it makes a lot of sense. If someone does it’s almost always because the other options are far worse, but still, it sucks. In my case, my father was displeased with the arrangement and when he wasn’t toiling he was beaming resentment at me. I worked part-time for an old friend as a laborer in the hamptons, spit shining the dream homes of the fabulously wealthy after a 2 hour commute. I would wake up at 4:30 in the morning to drink coffee and get as high as possible before heading out to join the slow procession of misery that heads east every morning. Of course I was depressed, but my vital signs were being monitored and I maintained myself.

I got tired and bored and resentful of this arrangement. I lined up a job for myself at a farm in Sag Harbor. The same miserable commute, but I thought it would be more pleasant work at the same wage. The owner of the farm was a Trump supporting white guy with dreadlocks and a drinking problem and it took less than a day for me to hate him, but he was lazy and absent and I liked my co-worker, a young guy named Max from Oaxaca. We spoke English and Spanish and Spanish and English and I got pretty good over the course of a month. 

My primary interest in working at this farm was that they produced mushrooms. I am not bad at this. In fact, I was better at several aspects of it than the farmer. I took pride in this and hated him all the more as time went by, while he just seemed to warm up to me more and more. He decided that he was going to take me with him to Kennett Square, Pennsylvania to pick up shittake blocks. He said he wouldn’t pay me for this trip, but would pay for my motel room and take me out to the strip club. This is the point at which I decided I would probably be better off quitting. That was far too much time in a truck with this asshole, and there was no way I was going to sit at a strip club with him while he ogled trafficked women in rural Pennsylvania. 

Later that day, working in the greenhouse transplanting starts as fast as I could. The farmer came in and began to boss me around, showing me how he wanted me to work, faster but less organized, less comfortable for me, and of course, he was talking at me all the while. 

While I worked with him lurking and correcting, some Sag Harbor luminary stopped by, a woman with some association to a private school, and he quickly turned himself to regaling her with the hardships and simple pleasures of the farm life. They left the greenhouse and I returned to doing things my way.

Max smiled at me. He got it. He hated David as much as anyone. He’d worked as his farm manager for years. He got a studio apartment and $12 an hour out of the deal. I got $15 an hour and the use of a camper parked on the property, though I never used it. I preferred to get as far away from David after work as I could and drove the hour plus back to Sound Beach every day, smoking weed and drinking coffee, listening to Propaghandi’s Less Talk, More Rock day after day, crying as I belted out the lyrics to “Refusing to be a Man” on the William Floyd Parkway. 

On this day though, David returned with his guest to the greenhouse. Before he could correct my technique again his phone rang and he shoved it in my hand, said he was too busy to answer and to take a message. Leaving aside the fact that nowhere was secretary in the list of duties for which I had been hired, voicemail is a common and well-known function of cellphones and I felt incredulous that this asshole thought it would impress this woman to assert his power over me in the late hours of the day, but I am easily flummoxed and I took the phone. It was a person calling to see if he wanted to renew his prescription for Cialis. I promptly handed his phone back to him, telling him it was about a medical issue. 

He became angry, cursing at the man on the phone. The woman from the school excused herself. He made a clumsy effort to explain why he was on an erectile dysfunction medication- what other reason is there for that than having erectile dysfunction?

I drove home without my usual sense of relief. Clearly I would need to quit this job. Things were only going to get worse. The market season would be starting soon and David himself had stated that his tendency towards bossiness went into overdrive at this point in the season. Getting yelled at while he cleared thousands of dollars in market sales from the idle rich summering in the Hamptons was going to drive me to violence. I was already fantasizing about punching him in the mouth, the gut, the groin, until he was on the ground, ready to be kicked. 

I cried through what was my weekend. I didn’t want to quit another job. I didn’t want to get another job. I wasn’t even sure if I wanted to be alive anymore. It was two years since I’d left Arizona, and it had been terrible. I wasn’t quite so plagued by terror- I no longer thought that the airplanes flying overhead were surveilling me or that random people I met were confidential informants out to entrap me for drug crimes, but I was trapped in a revolving series of miserable exchanges with my father and hopelessly stagnant with no vision of what to do besides advance this mushroom business that serious consideration would have revealed as a foolish and hopeless idea.  

Sobbing at the breakfast table with my mother and sisters in attendance, my new baby nephew asleep nearby, I decided that it would be a reasonable thing to go on disability. I didn’t have any knowledge of how this worked as a bureaucratic process, I just assumed that one went to a psychiatrist and made a compelling case that you could no longer work. 

So that’s what I did. It went poorly. I got the referral from my primary care doctor, sat down in the office and narrated my sad life to someone in nicer clothes than I owned who would, for the rest of their life, avoid any real experience of the afflictions they claimed to treat. It was at a University facility and so his supervising physician came in. I explained to him that I was having terrible anxiety and anger as I encountered all the incipient Trump voters that made up the blue collar slice of white life. He challenged me, said didn’t it make me the intolerant one that I couldn’t accept opinions different than my own. 

I wanted to kill him- to wrap his tie around his neck and pull until the blood vessels in his eyes popped and he was no longer breathing. I wanted to end his life that was no doubt so much better than mine, free of the endless failures, disappointments and breakdowns that characterized my own. But I am not a murderer, though I understand that drive. I simply got up and walked out. 

When I got home I examined the bottle of Zoloft that my sister, an NP, had prescribed for me. I opened it and threw it in the garbage. I decided I was done with psychiatry. 

There was a moment of joy shortly after this. I drove into Queens with my mother to visit my sister. I was feeling wounded, woozy and weak. I was rapidly coming to believe that I was a loser- the data was in and it was confirmatory. We took an unusual route home, an earlier exit off the expressway than usual, past a series of office complexes where anonymous people did boring work, somehow dulling their urge to run and go to ground in the face of such meaninglessness. 

I am a mycophile. Even at my darkest, my eyes are searching the ground for the odd eruption of fungus, and we had torrential rain the day prior. Glancing at the landscaping in front of this monolith to boredom, there were generous flushes of mushrooms erupting from the wood mulch. Improbably, they looked like Psilocybin cyanescens, a powerfully intoxicating species of wood loving mushroom, but my mother and I parked in the lot in her shitty Suzuki Aerio and walked through the geraniums, ignoring the searching looks of the of those people parked over their desks, engaged in unfathomable tasks. 

My eyes picked over the mulch, large clusters of recently fruited mushrooms showing the characteristic blue bruising that indicates the presence of psilocin. I took one specimen and took a sore print. In addition to the bluing it produced the right colored spores and so I left my parents house, returned to the office complex and picked most of the mushrooms. I was acutely aware of the possibility of the police becoming interested in someone poking around in the dirt and so I brought my dog along to provide me with some plausible deniability. When I was done I had several wet pounds of fungus. I brought it home and dried it and my many troubles moved from the center of my attention. 

This is what I love about fungus. Their very appearance in the landscape is more exciting than their possibilities for alleviating depression and anxiety. There is a shock when passing them, a demand that one species recognize another. They appear in the most unlikely places and assert their power to turn the world upside down. 

Say His Name

I attended a protest of the death of George Floyd last month, driving from the white enclave in which I reside (albeit in a basement apartment) to a predominantly black and latino community about a half an hour to the west. I was pleased to see a large crowd that I passed and honked at many times as I searched for parking. Once I did I had a half mile walk to the event. 

It was hot. I have an unfortunate mix of factors that contribute to my discomfort in heat exceeding 80 degrees fahrenheit. For one, I’m overweight. This isn’t a sin and I’ve tried to not care about it but no matter what the lifelong shame of being observably heavy makes me extremely self-conscious. It also makes me sluggish in the heat.

I am also an incredibly sweaty person. When I exercise I can ring out my clothes as if they were wet rags. There is an acute emotional discomfort to this that runs in tandem with the physical irritation of my clothes staining with sweat and gradually becoming saturated. It drips off my brow and into my eyes while I wonder how the people around me perceive this. Will they laugh? Will they point? Are they revolted or simply amused? 

So, I arrived at the event and there were several hundred people in attendance. They were doing what people do at a protest in the suburbs, lining the road and holding signs, chanting slogans that taper off awkwardly at the end. Regardless, it was impressive to me to see this many people gathered together in the motherland of alienation. 

A friend was there, someone I really like, and we found each other. Social distancing was impossible but after several months of deliberately avoiding others there was something nice about being gathered en masse, like being at a church that really hates cops. So I stood at the back of the crowd, holding up a sign that was given to me by an organizer. It read “No justice, no peace, no racist police”. I agree with that sentiment and I appreciated the sign. I’m not the type to make my own. It hangs out in my car now for future gatherings. 

Small talk with my friend eventually led him to point out the people he knew at the protest. He is 31. I am 39. I had an acute feeling of being old and of how fast it happened. Despite the agony of the last four years in hindsight it feels as though it ran through my fingers. But despite my discomfort at the idea that I am hurtling towards 40 and about 20% of my life has been spent in a state of disability I was moved to see all these young people stepping into leadership roles in the absence of any formal organizational frameworks. I came to learn that many of them were former DSA members who spun off after an organizational split. 

One of these young people was a former partner of my friend and after they talked for a bit he introduced me, adding that I was a veteran organizer. I told her that it had been a long while since I could be considered anything resembling an organizer and the times in which I was such a thing ultimately came at a profound psychic cost, in fewer words of course. 

I did a lot of reflection after this exchange. For one, I am unable to accept a compliment or even an acknowledgment of my existence. I feel much safer blending into the crowd. Second, I thought back on my history of being involved in the politics of the radical left. I always tried to hang back but moments of necessity plunged me deeply into the scene. I can remember the oppressively hot protests against the Republican National Convention. After this I spent five days in jail in a holding cell that contained not just me but four other people. There was so little space that we slept in shifts, heads adjacent to the toilet. I was in a state of panic. I thought I had prepared myself for this discomfort but I had not, and when I was finally released I felt near collapse. My employment was likely over with and my girlfriend was likely done with me. I fell asleep in a friend’s van with the windows closed in the oppressive heat and I awoke feeling as though I was suffocating and on the verge of a stroke. I stumbled out of the van, gasping for wet summer air. 

It was only a few months later that I realized that I was under FBI surveillance. This became a terrifying part of my life tempered only by the apparent incompetence of the people following me. They would get confronted by neighbors, the suburban impulse to be suspicious of everything working to my advantage. Then they offered a friend money to become a confidential  informant and my understanding of what was happening became much more clear. 

A few months later I was arrested at gunpoint in an apartment I was renting with a girlfriend. I stayed silent throughout the process, keeping my mouth shut as I was passed through various points in the chain of custody. I ended up in a cell with a young man who was facing deportation proceedings. I wished him luck when the marshals came to bring him before the judge. I was moved into a cell formerly occupied by men who appeared to be part of some sort of organized crime. They were loud and boisterous, confident that their arraignment would end with them getting out on bond. Somehow they got the marshalls to bring them pizza. I pondered the pizza. Maybe it was drugged and I would not be able to maintain my silence, but it was pizza after all and I ate 3 slices.

When my lawyer arrived, fearless and competent, he advised me as to what to say during the arraignment and I was able to follow these directions. I was released on bond. After all, I am a white suburban kid with middle class parents. Driving home with my father at the wheel I started to cry uncontrollably. I continued to sob when I arrived home and I spent the night sleeping on the couch with my sisters and mother. For months I didn’t leave the house and my emergence back into the world was cautious and painful. 

I have no glory days, nothing that doesn’t feel like an error or a misstep, but I don’t tell this young woman that. She deserves to feel confident in the path she and her fellow organizers take. If all I can offer are cautionary tales of the misery it is possible to descend into then I might as well shut my mouth. In part because I don’t want to be a downer in this raucous crowd of twenty-somethings- they deserve their moment- and in part because mistakes are contextual. The things I participated in when I was their age might not be errors in the present moment. 

So I kept my mouth shut about this history that has lodged itself in my throat.  I complimented the organizing. She moved on, working the crowd, and I stood where I’d landed, sweat trickling into my ass crack and my skin growing more pink and then more red as the earth rotated. When I left I was surprised to feel hopeful, the wellspring of youth temporarily flowing into the dry well of my aged, damaged brain. 

Fungal Politics

For mycophiles, it is a point of fact that small things matter, and that ‘smallness’ itself is very much a matter of perspective. The enormity of the largest organism in the world was  concealed by the limits of human vision and common-sense. In part, the forests of the world are a construction of organisms whose contribution has been largely invisible and unquantifiable.

There is a commonality between the tiny labor of the fungi’s and the position of the mass worker in capitalist society, in that the enormous aggregation of tasks performed in the course of our lives gives substance to a world of forms that seems somehow greater than the humble parts of the sum. So we have that in common: The things we do can’t be seen, and our contributions get put down to good fortune for the structures around us.

Perhaps I like them because of their humility. Mushrooms don’t brag – there’s no appearance of stability to them, like vascular plants, or extensivity, like animals. More often than not they are concealed, hiding behind or below, doing the important work of eating shit and death. 

For people who believe in social justice, there is an apt metaphor to be drawn from the work that mushrooms do: We should not forget that small things matter. That ephemerality of appearance is not an indication of absence. If there is a lesson to be taken from the present period of post-Arab Spring, post-Occupy malaise, it is that we should not forget that small things matter. We live in a time when we begin to realize the enormity of the small things done by small creatures. Where network effects and nano-forces conspire to make huge changes, and where seemingly isolated events are connected through branching threads that travel underground.

Let us not forget the importance of the impulse- the flash of pain that precedes the massing of social forces. It is politically naive to credit the acts of single people for the outbreak of mass protest, but it is equally politically naive to ignore the network effects that connect to single acts, and that fact that the nodes of these networks are more accurately conceptualized as the branching threads of the mycelial network.

Paul Stamets, in a widely circulated TED talk, asserts that mushrooms will save the world. This is quite a responsibility to pin on an order of organisms that played no part in bringing us to the present ecological crisis, and somewhat mis-states the problem in that, in point of fact and in emphasis of the talk, it is not the world that needs saving. It is human beings. We need saving from ourselves. More specifically, we need saving from the society that we’ve created.

Despite the impulse of a bitter, reactionary environmentalism to banish human beings to ecological uselessness, and the incredible trauma inflicted upon the non-human world in the industrial period, I feel it would be a damn shame were the species, or the technological achievements of the species, to expire from the planet.

The gravity of the task that the mushroom undertakes in ecosystems parallels the importance of the social movements: To decompose those structures that have ceased functioning. To invade them, break them down, and make something useful of them. There is also the task of the symbiotic mycorrhizal species, which is to form relationships of mutual dependence and to fulfill them.

We are everywhere.

Anosognosia

I frequently experience thoughts of suicide. They are rarely actionable and they are rarely fantasies about actually ending my life- these seem to only emerge in my darkest moments. Instead, these they are little snippets of conversation that I imagine occurring between people I know in which they discuss my passing by my own hand. I think this stems from the embarrassment I feel at the state of my life, and a sense that this would be a thing that would put my feelings in the proper context for people, that it would be a full expression of the desperation I feel at the slow drag-along-the-ground that I am experiencing and that I fear will be interminable. 

In my most desperate periods of fear and agitation I have taken myself to the emergency room, towards what purpose I no longer understand, but one must be very careful in these environments. Talk of suicide can get you institutionalized. Ideally, when you visit the emergency room you get a little bit of valium instead of a trip to an institution. 

And an institution is a place to be avoided. Statistically, one is much more likely to commit suicide after release from a mental institution. This is paradoxical at first glance, but makes more sense if one is familiar with the mental health system. A mental hospital is not a place of healing. It is simply a legal obligation on the part of the state to warehouse people with inconvenient or unpleasant thoughts, feelings and behaviors- they don’t provide you with talk therapy, or healing touch, or meaningful assistance with the material problems of your life. While there are pretensions of providing trauma-informed care in most hospitals, it is often the care itself that is traumatizing. Therefor, I am very careful with my statements to the myriad of healthcare professionals with whom I interact in my thus-far futile efforts to turn back into a functional adult person. I don’t talk about these specters of suicidality, lest I end up hospitalized and emerge sicker and more medicated.

It is a strange experience visiting a psychiatric facility for work when I feel so off myself. Certainly, I am doing a bit better than the majority of people committed here, at least on the outside, but not two years ago I was in a partial hospitalization program at this very same facility . They slapped a number of new diagnoses on me related to substance use, drug-tested me and had me participate in a bunch of useless, insulting ‘life skills’ groups. I discharged myself from the program after they played Sweet Home Alabama in music therapy. I can take pointless breathing exercises and stress management worksheets, but I draw the line at singing along to segregationist anthems. I am lucky that I had the choice to discharge- many others do not. 

The patients on the top floor of the hospital are those that are considered the most ill. I don’t know if this is a spatial arrangement that holds true in other facilities. This is the only one I’ve ever been to, excluding the ones that I was committed to as an adolescent, and those are too far in my past to remember. All I really recall of those experiences is the sense of confinement and the fact that the ceilings were covered in pats of butter launched from spoons by bored patients.

Patients on this unit are not infrequently forensic cases, which means they have been committed in lieu of going to a correctional facility if they are found to have been insane at the time that they committed a criminal act. Everyone on the unit is involuntary, and while there are many people at the facility who are being held for emergency evaluations that typically last three days, this is not that type of involuntary. These are people that the state has decided they are going to apply to treat involuntarily, which generally means at least a three month stay. It is rare that I know the particulars of why someone is in the hospital, but occasionally a patient will tell me, will even show me their court paperwork. 

Very rarely, the person in charge of advocacy at the hospital will provide me with some insight into their case and I have generally perceived this to be in the service of biasing me against the patient in some way. There is only one occasion that I can recall in which this was not the case, and it was a passing comment in which she implied that she thought a particular patient did not belong on this top floor unit. Then she hedged and said something about the patient believing she had pinworms, which still doesn’t mean she’s a threat to herself or anyone else (other than being a potential vector for pinworms). 

This unit is the only place in the facility where the staff are friendly to me. I don’t know why this is, and I never asked for fear of changing the dynamic. The degree to which this is helpful in navigating the floor is profound- I can ask who is new, who is having a bad day, and who might want to talk. This is purely for my own convenience. I’ve been burned out on this job since I began- it has never been easy for me to walk up to a stranger who is legally confined and ask if I can help them while knowing that I definitively, absolutely can’t. My role is strictly window-dressing to make the system seem more humane. The things I most frequently do with patients are refer them to their lawyers, refer them to another advocacy organization, or help them fill out the hospital’s own complaint forms, which are frequently ignored (though this is ostensibly illegal) and when they’re not, are responded to with a great deal of victim-blaming and dissembling. The people who generally want to speak with me are too psychotic to realize that I’m useless to them. 

On this occasion though, every staff person I encountered pointed me towards the woman who the patient advocate had mentioned. They said she didn’t belong, that it was a mistake that she was in the hospital to begin with. This is a strong statement considering the sources. My colleagues don’t hold the floor staff in high regard, comparing them to cops and prison guards. I have a hard time lumping them all in like this- certainly some of them are brutal and some of them are dicks but on the whole they are just working class people, and the hospital is a stop along the way to somewhere else. With that being said, there are few of them that would question the logic of involuntary commitment and it is exceedingly rare that they question the premise under which someone is hospitalized.  

After being directed by several staff to intercede on behalf of this person I headed back to the low stimulation area, which is a misnomer. This is a segregated area of the floor where they put all the newly arrived patients and all the people who are loud enough that they’ll disrupt the flow of the unit. It’s a hell of a place to put someone fresh out of the emergency room. There was a young woman crying on one of the impossibly heavy, unthrowable chairs that they furnish the units with. Obviously this was her, the woman that didn’t belong on the unit. I introduced myself and she said what everyone says, which is that she didn’t belong there and that I needed to help her get out. She said that they were already discussing seeking an order to treat involuntarily- to my shame I scarcely understand the process of involuntary commitment, though I have tried at many junctures to get a grasp on how it works, however in my limited understanding, the wheels are already in motion from the moment you arrive in the hospital and they plan on keeping you past a three day observation. 

She’d arrived in the hospital after witnessing her fiance commit suicide with a handgun. She told me very little of this event, just the bare details- that the police had shown up at their house for reasons that weren’t clear to me and that he had walked outside and shot himself in the head. Understandably, her reaction to this trauma was some sort of meltdown, the specifics of which I do not know, and this had somehow landed her on the top floor of the hospital. 

She seemed distressed but lucid- she wanted to get back to her house, she was bereft that she had missed her partner’s funeral, and she was awakening to the fact that she was in a total and austere institution that was not interested in helping her but in holding her. She said she had a job at a nursery to get back to and a cat that might very well be starving to death in her absence. 

I offered to speak with her and her psychiatrist. This never helps, but sometimes it makes people feel like they’re being listened to. I asked her psychiatrist to meet with us and had to explain my role to him. Then he stated bluntly that it was his opinion that she was suffering from drug-induced psychosis. When she tried to ask clarifying questions he accused her of being hostile towards him and stated that he would leave if she interrupted him again. I asked him if he had considered the significant trauma she had experienced in his diagnosis. He told me he didn’t have any more time to talk to us and walked out of the room without excusing himself.  

I sat with the patient in silence for a moment, and then I said that I thought that her psychiatrist was very much an asshole. She agreed. Psychiatrists rotate through this unit every two months because the tiny, rural state this facility is in can’t retain them permanently. Some of them are decent (for psychiatrists), some of them are bad and some of them are worse. This man ranked among the worst. I expressed this to the employees in the low stimulation area and they agreed sincerely. 

On my way to the unit clerk to pick up complaint forms the woman’s social worker pulled me aside. This is always a bad thing. It means either that I am going to be asked to break someone’s confidentiality or that the social worker herself is going to break confidentiality. In this instance it was the latter. She wanted to tell me that though the patient presented well that she was a heroin user and that she was using other drugs- that she had been told by the woman’s sister that she used ecstasy, which according to the social worker was a type of speed that causes psychosis, and that her dead fiance was a well-known heroin dealer in the little town that they were from. I nodded my head through all of this nonsense. 

It was unclear to me what the social worker’s intent was. I doubt that she was unaware of my relative lack of power in the grand scheme of things, so concern that I would get the patient released was an unlikely motive. Sometimes treatment teams interpret advocacy efforts as harmful to the patient’s recovery, as if it somehow perpetuates delusions. Or perhaps she was embarrassed by this particular commitment and wanted to mitigate my judgement of her, her colleagues and the institution as a whole. Either way, I ignored her and  assisted the woman with a complaint in which she requested a new psychiatrist based upon his rude and dismissive behavior, and then we called her attorney to request a preliminary hearing to contest her commitment. 

I visited the unit a few days later. The woman I had worked with was in good spirits- she was braiding the long, tangled hair of one of the other patients and had picked flowers in the courtyard garden and arranged them in styrofoam cups on tables. Her legal aid attorney had secured her a hearing and the hospital was releasing her rather than taking her to court. It is at this point that I made the observation, not for the first time in my life, that relief is better than pleasure, and that there is nothing finer than deliverance from fear- not that it lasts, not that it sustains, but that it is like the finest analgesic regardless. Her release from the hospital would not wash away the image of a loved one killing himself, or relieve her of whatever other struggles would surely plague her the second her medicaid cab ride started driving her towards home, but they were momentarily forgotten with the promise of freedom.

I have tasted this myself at times. Sadly, most of the time the relief doesn’t last and the near miss turns out to have hit you dead on. Sometimes waking from a nightmare is not enough, and the preconditions that gave rise to it don’t just haunt you, they possess you entirely. I would be surprised if this were not the case for this woman, but still, I am glad that she wasn’t robbed of months of her life, that she got to smell flowers rather than disinfectant for the remainder of the short northern summer and that she wasn’t shot full of antipsychotics against her will. I hope she got to visit the grave of her lover and come to some sort of peace with that, although I have my doubts about peace and its presence in our lives. 

Two Baby Squirrels

I work with people whose lives are ugly. They are all chopped up. They have no teeth. Things are breaking down in their bodies. Their minds are against them. They have no place to sleep.

This is obviously a judgment from without. I don’t know how many of these people would find their lives ugly. Perhaps there is beauty there that I don’t see. And I truly don’t see. This might lead one to ask as to whether I find my own life to be ugly, and the answer would be that I do. My mind is against me. My body is breaking down, teeth included. I am lucky in that I have a place to sleep, but when my parents die or some other sort of calamity strikes this might no longer be the case.

For work I visit psychiatric hospitals in New England and talk with the patients there under the auspices of providing advocacy. Someone with a less dire outlook on things might feel better about what they do, but I leave this position feeling as though I’ve done nothing for anyone, myself most of all.

Most of what I do is talk with people. Often this is just getting talked at. People who are manic will talk at you for as long as you occupy the same space, and mania seems to be a feature of many people who wind up in the hospital. I’ll walk onto the unit, sit down with someone, and an hour will pass in which I’ve said nothing and learned nothing. I burn an hour and all I have to do is nod my head. 

I feel bad writing this. There is a strong preference among my colleagues for not discussing mental illness as a physical affliction or material condition of people’s lives, but, with some remorse, I don’t share this inclination. My own experience has been that there is something distinctly different about my neurological makeup that makes me more prone to various forms of suffering, and I assume the same about the people with whom I meet.

With this being said, the afflictions that are most common in the hospital are poverty and isolation. One could argue that there is a chicken and egg problem at play in this statement. Is a person mad because they are poor or poor because they are mad? Do you lose the people in your life because your thoughts and emotions are disordered, or do your thoughts and emotions become disordered because you’ve lost people? My thinking is that neither is true- these conditions arise simultaneously and are intertwined, and whether or not I’m right about this or not, it doesn’t change the fact that the problems of poverty and isolation require remedy, nor does it change the bleak reality that this remedy will likely never be delivered, and certainly not on a locked psychiatric unit.

Yesterday was the worst. I was plagued by the realization that I am awful and that the world is also awful. I saw a woman at the hospital who had been injured by staff while being restrained and helped her file a complaint. According to her she punched a nurse and this is what precipitated the hold, but it is not my place to judge her actions.

I’ve worked with this woman before. I helped her and her former boyfriend navigate a period of homelessness, mostly by paying out of pocket for motel rooms. After we filed the complaint we talked about him. She says she’s done with him. He is currently in state prison. Apparently he has an ugly rap sheet, one that includes lewd and lascivious acts with a person under the age of 13, a fact that I am not surprised he omitted from our many conversations.

In the course of their relationship, which I observed to be violent on the part of both parties, they had both pressed charges against one another on multiple occasions, and apparently he neglected to attend a court date related to one of these incidents. It was only when she searched him on the prison’s ‘inmate finder’ that she learned about these other convictions. It made me sad to learn this about him and she was deeply distressed by it- somehow she hadn’t known. People can be excellent at keeping secrets as long as the secrets are their own.

She has been homeless for who knows how long. I drove her to a court date once, and she told me that a few years ago she’d been shot with a 30.30 right in the gut by her father and that she’d almost died. She’d had a happy week or so where it appeared that she was going to receive some sort of settlement stemming from this (how the man would have paid anything out after 8 years in prison was unclear to me) but the money never materialized, and not long after that she ended up back in the hospital.

This isn’t the only woman I’ve met in this job who has been shot by a man in her life. Up north, in my first months of working here, I met a woman who had just arrived from Oregon, fleeing her family for reasons that I didn’t entirely understand but that seemed to center on them being heroin addicts. She was homeless, having been beaten up and thrown out by the man she was staying with when she refused to have sex with him, and was sleeping in motels using vouchers from Economic Services. Years earlier she had been shot in the back, and most of the bullet had exited her chest. She showed me the exit wound right below her clavicle. She said she still had little pieces of bullet left in her body.

But as I was writing, yesterday was unbearable. I didn’t get shot in the chest or anything like that, but on a spiritual level I felt dead inside. I sat through a meeting in which a hospital bureaucrat grossly distorted statistics about patient complaints and ate a bad sandwich composed of some sort of deli meat. Possibly ham. When the meeting was through, I walked out into the parking lot. 

It was stiflingly humid but it had been windy earlier in the day and somehow there were two baby squirrels, unweaned, their eyes not yet open, dying behind my driver’s side front tire. Perhaps it would have been more humane to ignore their presence and end them abruptly by mashing them into the asphalt, but I couldn’t. I thought maybe it would be better for them to die in the cool grass in the shade, so I picked them up and put them somewhere that looked peaceful. I wished that I could save them, but I don’t know the first thing about dying infant animals. I walked by where I had left them today and their corpses weren’t there. I wondered what took them, hoping that perhaps something ate them. There seems as though there’s dignity in being eaten.

I drove home and talked to a friend who is also deeply depressed. Despite his struggles, I envy him. There is a functionality that he has that I do not. He complains that he can’t stand working part-time, that all the unstructured time is getting to him. I don’t like working part-time either, but I definitely don’t want to work full-time. I am more of a no-time person.

After this I went to therapy. Therapy has been helpful for me in some respects. It helped me go back to work. Not that working is something I want to do, but in the present it appears to be necessary. I told the therapist that I was badly depressed. He asked me if psychotherapy was working for me. He wanted to know, because it didn’t really seem as though there had been any breakthroughs.

I’m not someone who can be honest in the moment. I need time to sort things out. So I did not say all the things that occur to me now. That no, psychotherapy is not working, just like meditation, medication, drugs, no drugs, busyness and idleness have all failed to work. That maybe nothing will work, and it might just be that non-existence is the magic bullet. But therapists don’t tell you to commit suicide, even if they think you’re beyond help.

Face Down, Fist Raised

This blog is where I’ll be posting about my experiences of living with treatment resistant depression and severe anxiety. While I’m not sure I’ll be able to accomplish this, I am interested in articulating some political analyses of both the psychiatric regime and the experience of being sick. Otherwise you’ll find personal essays from the perspective of someone trying to stay afloat in the treacherous waters of the current moment where economic survival is untenable and spiritual fulfillment blockaded by a traitorous brain.