A Vulnerable Chemistry

31st January 2018

This week I received a shocking piece of news. A lady that I knew in AA committed suicide last weekend. This shocked me to the core, not because I was particularly close to her but because, it turns out, our mental chemistry is the same.

I saw her a couple of weeks ago, and she had taken time off work due to anxiety. I asked her whether there was a Mental Health First Aider in her workplace and she said no, but that her boss was fairly understanding. She did not, however, feel it appropriate to unburden herself of her mental health status to the Head of Human Resources. I grieve that this stigma about mental health difficulties remains, as it continues to cost lives. Indeed, this lady had seen me, a couple of years ago when, during a depressive episode of my own, I had spoken unkindly to another AA member in a meeting, and I had been embarrassed ever since. I had mentioned it to this lady a while afterwards, apologising for perhaps having caused her to feel uncomfortable. “You weren’t well” she had said. No, I said; I certainly had not. So, when she mentioned her own situation a couple of weeks ago I hoped that she would know I wasn’t judging, and that I would understand. Another lady spoke to her and they swapped telephone numbers, and I stepped back, not wanting to crowd this lady. She is dead now, and I regret that I did not insist, and give her my own number, but when she said at the time that her aim was to return to work the following Monday I thought that she seemed stronger than she was. Hindsight can feel cruel.

I have had a tough time for a year or so with feelings of depression which overrode the medication that I take, and a series of investigations revealed that this has largely been due to release, by contraceptive implant, of the hormone progesterone into my bloodstream. I had been able to have a different contraceptive device fitted, but it had been before the removal of the implant in my arm, so there may have been a higher amount of the hormone in my system over the past ten days. I have been haunted by issues from the ‘brain injury days’ as I call them, and this has felt excruciating at times, eating into my ability to cope as the single parent of a child with special needs.

On Monday, the news of the lady’s death hit me hard. There are so many occasions on which I haven’t reached out to other people, believing that they wouldn’t understand, and I have just pushed through (using exercise and AA meetings) when I can, and laid low (avoided calling or speaking about it to people) when I can’t. I saw – I see – what a narrow squeak I often have, with this cocktail inside me which has been affecting me so badly at times. My son is the incentive for me to hang on in there, but this has meant, at times, that thoughts of self-harm (cutting) to distract or detract from the mental pain inside have scared me greatly. This has, at times, had me scuttling to the GP for help, but none of that had proved effective; hence the investigations and the switch of contraceptive device.

Yesterday morning, I took my son to school and then sat down in tears. It turns out that, had the lady pulled through, the guy for whom I have had feelings for a long time would have made every effort to “hang out” with her (his words), “have lunch”, those sorts of things. I’ve wanted us to meet up for a month now; I’ve even urged him to come clean about not wanting to spend time with me by text, because of so many cancellations on his side. I have longed to cycle into the town in which he works and have lunch; but I haven’t dared. I haven’t dared because, evenings and weekends during January were taken up with other commitments on his part, or feeling low due to the weather or the time of year.

His words, by text message and previously, when we saw each other, had given me much hope; but the behaviours have left me feeling at arm’s length. The efforts that he would have made for the recently deceased lady and the devastation have told me all I need to know. I’ve been unacknowledged, in the shadows (so to speak); I’ve struggled greatly and this has been apparent in posts on Facebook, but he hasn’t offered his support, merely called me when he has been feeling low. The last time I saw him, I put my arms around him and he stood, stiffly, like a mannequin. He was talking to me on Monday night as though I were a friend, and nothing more, and when I heard about the efforts that he would have made for someone else, that he never made for me, my heart felt like a football being kicked around a muddy pitch.

Yesterday morning, I wiped my eyes and cycled to the Centre who had fitted one device, and removed another, and asked for the new device to be taken out. I cannot afford, with  my mental health history, my goals in life and my beautiful little boy with Autism, to mess myself up like this. My relationship track record last year comprised two people who spoke love with their lips, but whose failure to contact me or make efforts to spend time with me, meant I had to pull away. I have ended up feeling used; that all the talk was merely ‘Booty Call’, so what need have I now for contraception that costs me more than it enables me to do?

I sat in the waiting room, crying silently. I knew I needed to do what this poor lady may not have done: reach out, take measures to manage my mental health as effectively as I can. I don’t know whether she did or not but, faced with the finality of what she did, and the awful wrench of knowing that this guy is not the one for me, I had to simplify: to strip away all that might be messing with my head: the hormones and the mooning over Mister Too-Damn-Busy-Or-Shut-Off. I sent text messages to two female friends to tell them where I was and what I had come to do. My close female friend called me and, through the tears, I found laughter:  this is Women’s Stuff; no-one understands hormonal torment better than us. We need one another. And, I told her, I am taking my power back. I’ve been waiting and wishing and dreaming and longing, but the writing’s on the wall; it’s time for me to withdraw and to regroup.

This is a somewhat miraculous capability that, until about a year ago, I didn’t know I had.

Just over two years ago I had a breakdown. In the run-up to my son’s fifth birthday I was aware that I was not coping well. Exercise – specifically cycling – had proved a game-changer in terms of stimulating energy and motivation, but I was aware, as I cycled home from my voluntary job one afternoon in 2015, that my limbs felt floppy and my heart felt leaden. I remember that I wondered whether I should cycle another 8km or so to try to counter this sense of impending fade-out, but something made me turn left at the traffic lights and, feebly, cycle the two roads home. I think it was a Tuesday.

I almost didn’t make it through the birthday preparations. My own mother, seeing my fatigue, reminded me that I could postpone the party but, I’m a Mummy; I had to make it special and it had to be On The Day. Ever since my son’s traumatic birth I had been driven (neurotically perhaps) to make everything Just Right. The party was scheduled for Sunday but, on Thursday, driving back from Kingston with a bounty of bought gifts and party tableware, Peter Gabriel’s “Don’t Give Up” played on my in-car compilation. I was a couple of roads away from my own house. The words tore through me: “Don’t give up/You’re not beaten yet/Don’t give up/I know you can make it good.” As I turned the final corner I could hardly see through my tears. Post-traumatic echoes of the birth tugged inside me like a clenched fist, and I wondered whether I should call the Doctor or the Samaritans.

The GP surgery gave me a time an hour or so hence from when I called, and I lay down on my bed, exhausted, hoping to conserve energy to get to the appointment. Serendipitously, my close friend’s name flashed on my ‘phone screen and, knowing that he isn’t squeamish, I answered the call. “Ask them to refer you to Professor Libby,” he said; he had done wonders for my close friend’s wife, and daughter, and my close friend himself was on the appropriate medication and has been able fully to function for some years now.

“Are you in crisis?” asked the Doctor. I didn’t know. Let’s face it: after self-harming and starving for years as a teenager and almost dying on heroin in my twenties through accidental overdose and a scary milieu; after identifying an ex-partner’s body after an overdose; after detox in which I had burned myself repeatedly in an attempt to cope with the mental and physical torment; after continued self-harm, starvation, bulimia, traumatic brain injury (classified Severe) in 2007; a traumatic relationship and my son and I nearly dying in childbirth; after my son’s father turning on me after we got home from the hospital a week later; after a failed house-move and my mother having to step in when I was crying and rocking too much to feed my baby; after the eviction of my son’s dad from my house (bought by my parents, who could see I couldn’t cope) and somehow getting to playgroups and appointments whilst still brain-fogged from the injury and now the break-up; after the post-traumatic echoes from the birth (which I didn’t know were post-traumatic), I couldn’t pick out now whether I were in any crisis or merely a continuation of a tough and rocky road.

“I don’t know.” I blurted numbly. I’d had a breakdown before, and Mum had looked after Daniel while I had lain for days, unable to move or function, in my bed wanting to die. But I could not die: what about my son? So I had gone to an AA meeting and – serendipity again – a woman there had volunteered to take me through the Twelve Step programme, with incredible success as I was able to cope, somehow.

Until now. I asked for the referral and took it easy when I could. The Doctor (newly qualified) seemed relieved, and I headed home. I focused on the party as hard as I could and the day went well – a happy child and lots of chocolate cake and presents. My close friend came, too, and sat with me in the quiet of the living room while friends and family made merry noise in the kitchen and the dining room. Whilst waiting for the referral I could only function minimally: I dropped my son at school in the mornings, came home and got into bed. I rested until about 2:00pm, then drank strong coffee for an hour until school collection time. Then I fed and looked after my son, and felt guilty for not having the energy to play with him, until I had put him to bed, whereupon I put myself to bed also. Mum stepped in again and took my son to stay with her to give me respite periods.

Finally, when I met Professor Libby, he took a history from me and listened to my account of the brain injury and other ensuing difficulties. Had the brain injury done all this damage? His opinion was that you couldn’t pin it on the accident per se; it had, effectively, thrown a “vulnerable chemistry” in the air. It was a pre-existing neurochemical imbalance, in his view, which had been exacerbated by the accident and its aftermath. This explained a lot. Before the injury, I had struggled desperately with my mind and with coping, and had used unfortunate coping mechanisms (whatever could get me through, as long as it wasn’t alcohol or drugs), and I had held down two jobs at one point, whizzing about on my bicycle from one to the other. However, since the brain injury, I had simply broken down, unable to function except minimally and with supervision. The Professor prescribed the medication that I have been on ever since and, slowly, slowly, I began to stay awake for longer; to cook and clean to incrementally greater extents. For 18 months I was too scared to get on my bicycle, in case it expedited another crash-and-burn and I regarded it sorrowfully, sitting in the garage gathering dust. I missed it. I patted it from time to time and wondered if we could ever have adventures together again, like a small child looking through a toy shop window at an object of desire.

I can’t recall exactly when I rode my bike again, but I know I was delighted. I remember sitting on it, on Kingston Bridge, surveying the glittering river and filled with the feel of the wind on my face; the reassuring pinch of the helmet on my head. I was Coming Back, in teeny-tiny footsteps.