as saddened as I was by the content, I really appreciated getting your email. thank you so much for being so clear, thorough, and honest at a time when clarity, thoroughness, and honesty are all so painful. I totally understand the “hatred of the sound of one’s own voice,” and as you know, I indulge in it myself way more than is probably healthy or necessary. if there’s one advantage to behaving like I do, it’s probably precisely what you alluded to at the end about not feeling the need to put up a front for me. that alone might make the scourge of depression almost worth the trouble. these past couple of years have been so rough that I feel pretty much at home when it comes to these sorts of issues. work or lack thereof, purpose or lack thereof, relationships or lack thereof, solitude, depression, expectations, aspirations, disappointment, stagnation, breakdown, recovery, adjustments, learning experiences, both harsh and gentle. we all have our own version of these things, and try to relate to each other thru the prism of what we ourselves have experienced, either personally or vicariously thru friends, books, dreams, etc.
my depression got so bad this past autumn that I felt that I was well within the official precincts of suicide, and it seems like a stroke of luck or grace that I came out of it not only alive but almost completely unscathed. I was at the point where I was easily imagining myself vanished from the earth and trying to work through the effect it would have on my various loved ones. it was pretty much only the idea of them going thru anguish that ultimately prevented what I think would have been a very simple act. I was that convinced that I had legitimately come to the end. I was just like the thousands, millions of other people who die from disease every year. I’d had this “disease” for over 20 years, and in some ways it has gotten progressively worse. sick people sometimes collapse down to the bare earth and die prematurely. I’m not necessarily any exception to this general rule of illness. (besides, who’s to say what’s really “premature” anyway? are we all really entitled to an action-packed 80 years or so in this era?) it felt like a true mistake to continue on living, an utterly misplaced heroic effort that was utterly failing and clearly no longer worth it. people would eventually understand, I told myself. there’s been a lot of joy in my life, I told myself. I was dealt a pretty good hand. that in part was why my life now seemed unendurable. that all of that love and potential should have come to all of this pain and failure- it was too devastating, too humiliating. in some ways I felt lucky to have had as much time as I had. 38 years I feel constitutes a legitimate human experience. One can cover a lot of the basics. believe it or not, I was mainly feeling grateful for the life I had lived up to that point- I was just really terrified of fucking it up even more- starting to ruin more things, poison more things, lose track of more things- I felt like getting out while I still had a modicum of dignity intact.
anyways, I set a suicide plan (use a hose to turn the car into a gas chamber out in the country) into motion but it broke down midway. there was a sort of technical failure which led to a failure in my composure and the sense that this might not be the proper course of action, at least not quite yet. I alerted the authorities, they came and picked me up, took me to the hospital, and I spent 48 hours in the semi-intensive care unit while the CO2 levels came down. they had just barely gotten up into the dangerous zones.
I was then transferred to my old stomping grounds, the psychiatric unit, for about 9 days. I immediately started a new antidepressant medication (40 mg prozac) and a course of electroconvulsive therapy, also known as ECT or shock therapy. a typical course of ECT is 4 to 6 treatments each spaced out by a couple of days and then 4 to 6 more with progressively increasing gaps in between, from one to four weeks. as you know, there are a lot of misconceptions about ECT. it’s not the electricity itself that causes the healing but the seizure that is artificially induced by a very small pulse of electricity. seizures themselves are completely organic phenomenons that are not very well understood. it is basically the brain trying to heal and regulate itself. it has been suggested that sometimes depression is the result of too much brain activity- the brain on overdrive and eventually freezing or jamming up in some way- ECT has been described as similar to forcing off a frozen computer, or like a kind of reset button. I started to respond positively around treatment 7, which my doctor said is quite common. that was probably too early for the prozac to be making much of a difference, but ultimately it’s impossible to tell.
because time is so limited with the psychiatrist in the hospital, I felt that it would help me organize my thoughts to get them down on paper in a small effort to provide him with an overview which might perhaps help him direct my treatment accordingly. here is a slightly altered copy of the note that I gave him:
I have experienced acute suicidal depression in 1993, 1994, 1998, 2000, 2002, 2010, and 2012. two of these episodes resulted in legitimate suicide attempts and six of them resulted in hospitalization.
between these episodes I have remained relatively stable, while experiencing the full emotional range between robust enjoyment/appreciation of life to an overwhelming sense of being a ruined, worthless, and useless human being, with the possible exception of the handful of people who genuinely value my life and well-being, perhaps partially for the sake of their own mental health.
in 2001 I applied for and was granted social security disability benefits for the 9 year old diagnosis of “bipolar disorder type 2.” I feel that these “benefits” helped solve certain problems but also created some new ones. I was now free to totally retreat into the severe solitary/isolative lifestyle that I had been craving and cultivating since around 1995, 2 or 3 years after the depression problems first appeared. I had never enjoyed college and never enjoyed working and part of me thought that I might finally be thru with these accursed things forever. a total drop-out, a recluse. a reader, a writer, a dreamer, a slacker. I have a sneaking suspicion that a lot of people would try this lifestyle out if they could. some would stick with it. others would hate it, would find the lack of structure and purpose unbearable, and would sometimes feel adrift and embarrassed, like I have been, to be so without a practical social function and identity. it has also been a relatively low-income lifestyle (600-700 dollars a month) but that has never been particularly bothersome, as I don’t have many expensive tastes. I have also received intermittent financial assistance from my parents over the years so in some ways I have never had to bear the true brunt of such a relatively low income. (in many places in the world 700 dollars a month would constitute almost unbelievable affluence.) there have also been intermittent odd jobs over the years that have helped me to sustain a modest financial cushion, as well as providing me with a semi-truthful answer when people so innocently inquire into “what it is I’m doing these days,” with the unspoken implication, of course, being, “what are you doing for money these days?” the honest answer would be that usually I am doing nothing for money. money just comes to my bank account automatically. some people call it a “crazy check.” (the moving company in chicago was extremely flexible in giving me as much or as little work as I wanted. I usually preferred very little, but occasionally I would get a sort of burst of energy and work semi-regularly for a couple of weeks, before returning to my cave and not emerging again for several months.)
I’m not interested in becoming a “normal” or “productive” human being. maybe that’s a failure of will, failure of character, failure of maturity, failure of nerve or the nervous system. or maybe there’s absolutely nothing wrong with not being or not aspiring to be a “normal” or “productive” human being. I just don’t know. the 20+ year record seems to suggest that periods of severe depression and sometimes even suicidal depression are among the tough facts of my life- ones that, for better or for worse, I have basically accepted and learned how to deal with. I feel that my suicide attempts or gestures in 1998 and 2012 do not discount all the many other extreme depressive/suicidal periods that I have moved thru intact and sometimes even enriched.
in other words, I do not expect or even desire a permanent “cure.” any talk of such a thing I will respectfully disregard as well-intentioned but unrealistic idealism.
to the question “so what then do you want to get out of this hospital visit?” I would simply answer: time to review, reflect, and reassess, along with possible medication adjustments and ECT. even with the most positive results from these treatments and therapies, I feel that I will most likely be returning home with the same basic values, expectations, personality, and lifestyle. I am not anticipating a massive or even modest rebirth or renewal, nor would I trust such sentiments to last very long even were they to appear.
the hopeful learning component in regards to the recent suicidal incident and this period of follow-up care in the hospital is that in the future I will not let a major/suicidal depressive episode last as long as I did this one without taking much more pro-active steps to have it addressed and ameliorated, most likely by means of a hospital visit.
