Black dog lost #MentalhealthAwareness

Black Dog Lost

Trigger warning: This post describes suicidality, suicidal ideation and symptoms of severe depression.

'Foul devil, for God's sake, hence, and trouble us not; For thou hast made the happy earth thy hell, Fill'd it with cursing cries and deep exclaims.'

—Spoken by Lady Anne (Act 1, Scene 2) Richard III

I've just deleted what I've written so far. I was doing what I've done before, which is to write impersonally and objectively about depression. For what? To protect what or whom? By the grace of something and with no idea why or how that shift happens, I'm no longer depressed. The curse has run its course. But I know that under the right, or should I say wrong, circumstances I could go to that hell again — anyone could. And if I do, I must remember that I can come out of a depression — even one that lasts for two years. Two years. I still can't get my head around it. But because of depression's deceitful nature, I probably wouldn't remember. I could read this and think this was the lie. I think you could call depression of this order psychotic, not as visible as manic psychosis, but equally good at distorting 'reality'.

Suicidal people who 'complete' the final act of self-destruction can't tell us how it felt to live and die like this. Suicidal people might be so depressed they can't describe how it feels even if they wanted to. It's the loneliest place in the world, but it's a very real place, and I feel the need to describe what it has been like, for me, in my particular hell, uniquely constructed by my life experiences, and not so uniquely by this society, which has taken us collectively a long way away from anything that could be said to resemble sanity.

So please don't read on if knowing that I have been suicidal for two years is enough information, because I am going to describe my day-to-day life for the last hundred weeks or so, and for some this might be way too much information and just too damn upsetting. Am I even allowed to express this? Should I risk it? Should I shut up about it? Or is it OK, important even (if only to me) to write this down, to describe that place, as an aspect of experience, which I am so glad to now remember is after all a human one, if an acutely unwell human one?

That's why in the past I've described this most personal and subjective state impersonally and objectively. And why I have been quiet and hiding for so long. To want to die, or rather to no longer wish to live like this is unspeakable because you know that you are betraying life on every level, once again, there you are, that naughty, angry, desperately sad and ungrateful child, throwing the ultimate gift out of the pram. It is wrong and you know it.

But how do you know it? Not because God, or the state or anyone else has told you that it's wrong, but because it is wrong — very, very wrong and you feel it in the deepest part of you — you know that you should be happy, you know it was your birthright. Or if not happy then at the very least in a functioning state of wonder at this wild experience of consciousness, in a body so exquisitely designed and adapted for its purpose that we don't even notice its miraculous daily doings. You're too busy grieving for your lost life, where once upon a time all its needs were met in a warm, dark womb and never again fully after that; for its potential, and in that polar opposite of living that you find yourself, your grief must come before, not after, your death. This crucifying guilt and profound internalised sense of badness must have come from somewhere. But where? If mania can feel like spiritual enlightenment, then this is its brutal, diabolical, polar opposite. A blackout — spiritual endarkenment.

It begins in hospital where I have been for three months or thereabouts, having had yet another life-saving surgery for bowel cancer. I'm awaiting another; hooked up to TPN (Total Parenteral Nutrition made of who knows what) while trying to cope with a vesuvian ileostomy, which makes my permanent colostomy seem easy. I know that more systemic poisoning in the form of chemo is on the horizon, and I haven't got the strength to refuse it. All that wouldn't be so bad, but my life, the house of cards that it was, is collapsing ... and so am I. No warrior now, no cancer' thriver', no. I'm now the coward I must always have been after all behind that once-so-convincing persona, which now is becoming clear to my very sick self to have been a charade. My anxiety levels are through the roof. I recognise this to be the prelude to the damnation I've felt twice in my life before. I watch its approach like a tornado. I can't run and I can't hide.

The Healthcare Assistants that take my obs — my sky-high pulse, my low BP and 02 saturation — tell me to chill as my heart races, pumped with adrenaline for the flight I cannot take. Other patients seem superhuman in their bravery and cheeriness and I am deeply ashamed of my inability to be as they appear. They are fighting for their lives, but I already know that mine isn't worth fighting for, even if I could begin to. I'm given diazepam by kind nurses to calm me, psychiatrists turn up at the bedside and prescribe mirtazapine. I gulp them down, knowing their help will be fleeting, at most. Friends and family visit, full of loving concern, but my connection with them is getting weaker, fading out like a distant radio signal as I sink lower down the dial, before dying completely. I'm alone. Undetectable, unreachable and lost.

God, this is hard. Step outside, fill the bird-feeder. I don't know if I can do this. Breathe. The sun is out. The world is exquisite in her beauty. I'm almost blinded by it as I adjust to the light. If I wasn't so physically screwed maybe I would be flying towards that light right now, propelled ever higher by the phenomenal force of my spirit's return. But no — no auras around life forms, no special signs just for me. Go back to the kitchen table and sit down again.

Home. Except it isn't. It's an empty stage. Half-packed up as we were about to move. An ill-judged plan, initiated by mad me, naturally, which we had no choice (or rather, I had no choice, meaning that we then together had no choice) but to back out of at the last minute, knowing that this would severely affect the lives of the other people in the chain. I cited upcoming chemo as the reason, but there was much more to it than that. I knew I couldn't even pack a box.

My beautiful, sensitive, affectionate dog greets me hopefully and lovingly, sensing my sickness. She tries to get close, curling into me at night as I toss, turn, lie awake, already knowing exactly where I am. In the days and weeks that follow she distances herself, particularly after one day when I go properly mad; I lose it — if I still had it to lose — punching walls and clawing at myself, totally unable to contain my pain. It scares me, my husband, and her. I've blown her trust, just like that. But, like the loyal animal she is, she follows me into darkness, mirroring my despair and losing her love of life too. Why wouldn't she? I'm no longer able to fulfil my responsibility to her — but she does hers to me. And yes, I might want to die, but I sure as hell don't want her to.

I start to think the unthinkable, that I must send her away because I can't meet her needs, let alone mine — or anyone else's. She's so pure and uncomplicated in her response to this new circumstance. She hangs her head and walks away from her food, disinterested. She stops running and playing like she did. Always skinny, her hip bones start to show and I'm terrified. I can't take it. I just can't bear it. She stops coming to my room at night, steers clear of me, growls. Wow. Get me. I even manage to make an enemy of man's best friend.

Seven years ago, during my last major depression, our stunning, beloved, athletic, six-year old black Labrador became ill and died of lymphoma. That must have been my fault too, and I can't risk it happening again. Even our childhood family dog (our completely untrained childhood dog) was put down after biting me. He must have sensed the bad in me. Fuck, fuck, fuck this piece of shit that is me. I destroy the animals that I loved so much, or in this state, feel that I maybe I didn't love. Not only do I want to die, but I fucking deserve it.

Every day is the worst of my life. I wake in the night, if I sleep at all, in a sweat of fear. I scrabble in my bedside drawer for a pill and lie waiting for it to kick in, becoming more immune to their action with each one I take. Sleeping pills give me no more than one hour and eventually, no respite at all. I was over-prescribed quetiapine. One can knock me out for three or four hours. I have a packet left. I'll have to do it when they run out. I wake and take more. I get hold of some other benzos, and two of them do the trick.

On waking again I take more, to blot out the light and sounds of the birds, knowing their chorus is beautiful but finding it too agonising to know it but not feel it. I might do this again. Maybe twice. It's warm in bed, it's relatively safe, it's dark. I'm trying to crawl back inside my mother, before everything went so wrong. I find myself once more searching online for anything that could give me even a glimmer of hope of recovery, or validate my horrific experience in any way — even if that means concluding that I am an alien, exiled from humanity forever.

I'm baffled by the simplest task, how on earth do people manage their bills, finances, car insurance or tax returns? I couldn't survive without my husband who, despite problems in our marriage that never been dealt with because of the time and energy taken by a decade-long cancer journey, has put up with me for years while I gave nothing, nothing, in return. I would starve without him because I cannot go to the shops. I cannot face seeing anyone. I can't bear to be alone yet being in company is almost worse.

All the while the taunting voice tells me that I messed up everything and everyone I ever came in contact with, that I am fundamentally bad, that anyone who loved me or liked me must be a fool, that I can do nothing, which is true — I can't. I scroll through all my friendships, actions, decisions. I am the most fucked up person on the planet. I'm 53; I have no job, I'm on benefits, I've got no friends because they were friends with a fake, not this husk that I really am. I've contributed nothing; how could I? My paintings are rubbish; my books absurd and embarrassing. I cancel my account with the printer. I am nothing.

I delete my twitter account, all those follows and follows back I'd enjoyed accruing over years, tuning into the organisations and people I admired. All gone with a couple of clicks. Same goes for Facebook. I have nothing to share of any worth. 'Are you sure you want to delete this account?' Yes, I am sure. (Luckily, Facebook makes this nearly impossible. My account is deactivated, much like me.) I am also sure when I delete a memoir about my cancer journey, including treatment abroad, that I had worked on for two years (thankfully it appeared on an external hard drive). Sure too when I do the same for emails, photos (again, thank God for the cloud) and all deletable evidence of my existence before the ultimate undoable deletion of myself.

I go and see my dad because he is nearby and it means I don't have to be alone. He loves me dearly, wants to help me desperately, and he's frustrated that he can't. He doesn't understand, who does, who could? He listens to my lament — that I've been stupid, reckless and impulsive all my life, and yes, he did believe the hype about the old me. He writes me a cheque, for which I'm grateful and tells me there's nothing wrong with me.

I tell him I should be in a mental hospital, a therapeutic community, somewhere, anywhere other than walking up and down my street trying to appear 'normal'. I am seeking asylum. I wish I had a black boiler suit to wear, some signifier of my banishment, like the widow's weeds of mourning. I'm in no normal state, and acknowledgement of that might, at the very least, be helpful. But our culture still doesn't find it easy to acknowledge or accommodate acute psychological distress, preferring the head-in-the-sand, socially acceptable positivity of our 21st-century fools' paradise.

He tells me he doesn't agree. What I do need is to do summon the blood, count my blessings and remember just how lucky I am, to think of others, listen to peaceful music, stop wasting my talents and just do something. And that everybody feels like this — it's the human condition — and all the things that make a depressed person hate themselves even more, if possible, because yes, he's right of course. People close to those suffering mental agony can say deeply inappropriate things, which of course they may not mean, nor even register saying, and which would be deeply regretted if their effect was understood. But as my nephew so wisely put it, when he was very small, 'Sticks and stones may break my bones, but words can hurt my feelings' — a much-needed upgrade of an outdated adage if ever there was one.

I'm told to be kind to myself. But as I tell my therapist, I can't even treat myself to a deep breath. I don't enjoy food. I have no desire to nourish myself. All self-care has gone out the window. I couldn't care less, and even if I did, I still couldn't do it. Even the thought of washing, dressing, household chores, cooking, gardening and the ultimate — getting out the door — brings me to my knees. They are insurmountable, impossible tasks.

I don't recognise myself in the mirror. I don't know what to wear, how to dress this creature. Nothing looks right, feels right or is right. My hair is a short, frizzy mess and reminds me of how I looked as a very awkward eleven-year-old. I am ugly. This is the true me, The Picture of Dorian Gray version. I have it cut shorter into some sort of shape and am told I look like a French woman shorn for being a Nazi collaborator, which is a strange thing to say, to put it mildly. I sit stunned, mute, wondering if maybe that is what I was in in a past life. Sounds crazy, but there it is.

How can this be real? How can this be my once so beautiful, rich, colourful, manageable if difficult life? I go to the psychiatrist and sit in the formal glass box of a room as if I'm being interviewed for a job (as if). He is a nice man, and I'm sure in this line of work for all the right reasons. He suggests trying yet another potentially suicide inducing anti-depressant, another toxic mood stabiliser, and all the 'right' things, like volunteering, which I agree to try.

I've already reluctantly attended free courses and they haven't changed a thing: Understanding Psychosis, Dealing with Depression and Anxiety and so on. I drag myself to rooms in libraries and charity centres to be with strangers who are also trying to cope with the many and various symptoms of their deep pain, however that pain is mani