Here in Boston winter is coming. It’s cold and clear out and the light at noon is watery and weak. Facebook helpfully reminds me how I felt on this day two years ago, and it’s the same today. Fuck off, I wrote. Fuck off.
I probably shouldn’t give you a tip today, and not this tip. This tip isn’t even funny. This tip will not ease your pain. This tip is some dark shit and if you want to run from it I respect that. I would also like to run.
What I hope this tip does do is help you honor your pain for what it is: trauma.
I am 46 years old. I have suffered from depression for almost as long as I can remember.
Max and I were watching a documentary about The Velvet Underground the other day. In it there’s a cartoon image of someone receiving electroconvulsive therapy. I guess Lou Reed got ECT at some point. It upset me, the image, just like I was upset when Carrie Mathison from Homeland got ECT, just like I’m upset that Nurse Ratched wears such great clothes while torturing patients with ECT.
I have had ECT.
I started a course of ECT in September 2012, on Rosh Hashanah. I had it three times a week for six weeks and then I went down to one time a week, except for a week in November that year when I was hospitalized after the death of a friend, and then I had it three times that week before they could discharge me, and then once a week for a few more weeks, and then I stopped and I haven't had ECT since.
People assume that when I say that reading or seeing or talking about ECT is triggering for me, that I mean the experience of the ECT itself was traumatic, that it was the treatment that is triggering. But that’s not it.
There were some hard and strange things about the ECT itself, of course. It was physically exhausting to undergo, and of course it fucked with my short-term memory some and had some other awful side effects, like incontinence, that nobody will even cop to being a thing except other patients, maybe sometimes. (It went away, eventually).
But the pain I feel is not because of the ECT. I chose that course of treatment, I researched it thoroughly. I read books and journal articles and I met with people who had gone through it before I myself chose to.
I am not sure I would do it again. But I'm also not sure I wouldn't. The treatment was not the trauma.
The trauma was the pain I went to the treatment to be treated for. That's what still hurts so much.
When they do ECT, they put this conductive gel in your hair to stick the electrodes to. I think it’s the same gel they use for ultrasounds. And my first treatment they put the gel in my hair, and it dried in my hair and two days later when I went in for my second treatment the nurse saw that there was dried gel in my hair, and she said “oh honey, you need to wash that out.”
And I just looked at her. What did she think I was there for? Why would I have ended up choosing this? If I had been able to get up and wash my hair at will just because it needed washing then why would I have come here on purpose to be shocked and have a seizure?
Whatever was going on in my head was consuming so much energy that the rest of my life was being absorbed by it, or displaced by it, or bent by it. That is why I went to be shocked. I needed to kill those threads, make room for new ones.
Turn the computer off, turn it on again. Maybe that will fix the problem.
“Watch how my mind bends always backwards toward bitterness,” I wrote, some time later. That is how the depressive mind works, it remembers negative things. It’s called negative memory bias. There are many studies about it. I even remember negative words better.
Theft, death, grief, sad, excruciating, horrifying, loss, nightmare, insomnia. Sigh. Grave. Destruction. Darkness. Fear, anxiety, terror. Scream. Cry. Weep. Wail.
Grief, grief, grief. Sometimes it seems my very name must be grief.
The depressive mind does not remember pleasure, it cannot remember even the words for pleasure. Sometimes I search my mind for the words for positive affect and I find only “positive affect”, a descriptor drained of any positive affect itself. To combat this effect I make lists of positive words, I make lists of positive memories.
I even built a positive memory palace in my head. It has a slanted porch with a cherry tree next to it, it has a tiny Paris cafe with a zinc bar inside, it has a pond stocked with catfish. At night the whole palace is surrounded by fireflies and shooting stars and owls. At sunset I may choose a patio in Rome, with a Campari soda served in a small glass bottle, or an Aperol spritz. Or my own black membrane rooftop here in Boston, sitting on a yoga mat leaning up against the rotting doorframe, watching the clouds move across the sky and turn all kinds of pink, listening to Amazing Grace every night at 7pm, turning the other direction and catching the moon rising, impossibly orange, next to the Pru.
That’s probably a different tip, the positive memory palace. Please hold, for some other week’s woe.
If I had been able to wash the conductive gel out of my hair, I would not have been sitting on that hospital bed at all, while the anesthesia nurse praised my good veins and a blood pressure cuff was pulled tight around my ankle.
Why is there a blood pressure cuff on your ankle, Amy? Because in the IV drip, among other things (Zofran for the nausea, Toradol for the pain, all of it burns like fire going right into your vein), there is a paralytic, so you don’t convulse when you convulse. The blood pressure cuff keeps the paralytic out of your foot so when you start having a seizure they can tell by the twitching of your foot. And yes, maybe that’s a detail fit for a horror novel, but it’s still not the thing that’s so triggering for me about the ECT.
The thing that is so triggering is the memory of my desperation.
By now I have an awful lot of desperation piled up.
Most of my most serious depressions were not caused by anything in particular.
(Theft, I think. Death.)
But what is your tip, Amy? What do you want us to know?
I want you to know that “I shouldn’t feel this way, there’s nothing wrong with my life” is a stance that over a lifetime might be obliterated by nothing more than the mere repetition of the thing itself, the dark night for no reason.
You may indeed also experience traumatic treatments, involuntary hospitalizations, uncaring doctors, uncomprehending family, unsympathetic bosses. You may lose a job or a partner or a friend or worse while the dark night overtakes you, and all of that could be traumatic too. But even without those secondary traumas, you may find yourself traumatized by the pain itself.
And like any kind of trauma sometimes the memories it makes are so clear and vivid because they have been marked with pain.
Even that zinc bar in Paris, the one I put in my positive memory palace -- I remember it so well because I was in so much pain when I stood at it drinking espresso for several mornings in a row in mid-April of 2017. That was a month I nearly went to McLean instead of Paris, a month every day of which I sent an email to nobody telling no one how much I dreamed of death.
This is the tip, then: Treat your depression like the trauma it is.
Maybe you’ve been lucky and it never brought you any trouble other than despair.
Maybe you never drank too much or cut yourself or fucked someone who was mean to you because why not, you deserved it, you’re just that horrible. Maybe you never drove too fast for too long too late at night trying to escape it, maybe you never got locked up because of it, maybe all your doctors were terrific and you never had a bad reaction to a med, maybe you never had any trouble paying for your care. Maybe you never lost a single person you cared about or missed a single moment in your children’s lives because you couldn’t get up out of bed. Maybe it never drove you to call a hotline or get electrodes stuck to your head with conducting gel. I hope that for you, I really do.
But even so, all that pain piles up in the body, just like any other kind of trauma would. It’s unreasonable, a disease that breaks you again and again on its rack, takes years of your life from you even when you survive each episode. It wears you down and it uses you up.
It’s The Machine from the Princess Bride, it’s the Nothing from The Neverending Story, it’s implacable and terrifying and you can and should make a moat around your positive memory palace, pile it high with sandbags full of joy, if you can remember what that tastes like. There are things you can do. You should do them if you can. I don’t mean to say otherwise. The less often you find yourself in that prison, the less time you can spend there when you do, the better off you will be.
But even just one long dark night might be a sliver of glass in your heart that you carry with you forever.
And you have a right to treat that pain with gravity, to call it a demon, to cry out to any god or none to spare you from it, as you’d ask to be spared from any disaster.
You get to treat that pain as trauma and try your best to go on with it while accepting that it’s marked you in ways you can’t erase.
You get to give the pain its proper place.