First Published December 10, 2017
After a storm there is quiet. It emerges from the bluster and disruption quietly and sometimes eerily, but always with purpose. Sometimes it is welcome, and sometimes it is perceived as the harbinger of worse things yet to come. Every morning, when I awake, I experience this calm. For about twenty minutes I am a sane man, I am myself and I am in full health. Then the fuzzy tendrils of post concussion finger their way into my synapses and I surrender to another day of anxious thoughts, depression and tiredness.
On good advice I made another appointment with the doctor to request a prescription to manage the uncontrollable anxiety and outbursts of anger that I have been experiencing. We discussed the mechanism of injury, my current mental state and after a fairly perfunctory, but entirely pleasant consultation I was the proud owner of a shiny new prescription for Sertraline. “Huzzah!” Said I, “I am officially medicated.”
Now, I am aware that there are varying attitudes towards the medication of mental ill health, and although I come down on the side that opposes over prescription, I do believe that (currently) pharmacology has a role to play. Sure, it would be great to have someone massaging my aura, playing me tantric flute music and feeding me superfoods and camomile foam every day, but, even in Hebden Bridge, it just ain’t practical. That said, Psychotropic medication does need to be used as part of a broader process of management and recovery – in my opinion.
However, in this instance, as far as I understood/stand things, there was (is) a pathology involved which meant that I was not, indeed, am not, as able to regulate emotional responses as I was before the accident. Nor, apparently am I able to decide whether I am operating in the past or present tense – although I think this is less related to concussion and more related to having read too many Douglas Adams books.
Of course it may just be the drugs talking.
Any – as they say – old how, I have now been taking the happy pills for 4 days and I am not sure whether or not things have become easier, harder or just a different type of weird. I certainly still experience the same symptoms of anxiety as I did before I started the course, but now I experience a kind of mania along with it, a sense of nervous elation, which is fairly common with the beginning phase of anti-depressant treatment with an SSRI. At this point I suppose it would be useful to explain that Selective Serotonin Reuptake Inhibitors (SSRIs) are a class of drug which keep serotonin in the system for longer. Serotonin being the feel good neuro transmitter that has been made most publicly known by the use of the recreational drug: Methylenedioxymethamphetamine or Ecstasy. Cocaine works in a similar way to SSRIs but acts on Dopamine receptors instead. There you go, a little bit of neuropharmacology, and drug misuse management training. If you want to know more about SSRIs follow this link.
Anyway, on with the story. So the anxiety is still there, the feeling that there is a constant and gentle pressure on the right hand side of my face is still there. The agoraphobia and the confusion I experience when too many people are talking: still there. Sense of smell, still not there, although I do think that a little bit is returning – yesterday I farted and thought I could detect something, it was quite exciting. Sense of guilt that I am a massive pain in the arse and should just get on with things: there. Sense of terror whenever I think about going back to work: yup. However, all of this is now tempered with the reassuring envelope of a chemically induced euphoria. Like the smile of a psychopath, psychotropic medication serves to mask the dark world that lies beneath. It is not a cure, it just slows things down a little so that you can start to think more clearly. The use of anti-depressants has to be accompanied by (and I cannot stress this enough) activities which have both meaning and purpose.
Taking anti-depressants without accompanying therapies is just drug addiction.
One of the positives that has come from starting the medication (and it is very early days, I am still not yet at a therapeutic level) is that I have a greater sense of myself again. I talked about feeling like a facsimile of myself in the previous blog, but this sensation has been greatly reduced by the addition of sertraline. The unmanageable levels of anxiety were serving to prevent me from accessing that sense of self, the executive me. I have been in a kind of anxiety related psychosis where everything has seemed unreal to me, slightly dreamlike. I do feel that I have regained a sense of self over the last few days, which is fantastic. However, I am also aware that this is not yet the time to think that all is well and I can just crack on. Tiredness and depression are still squatting in the attic bedroom, and they are digging through every bit of me that I have stored away in dusty boxes, stacked in the eaves.
We all have negative or darker aspects to our personality. These feelings are always with us, but we learn how to mange them, turn them to useful purpose or simply ignore them. I have had my means of management taken away, so the feelings have been allowed to run rough shod over my psyche. I recognise them all. Fears and paranoia from all through my life, resurfacing like raw effluence. But these are aspects of me, so surely how I perceive them is a reflection on how I perceive myself. From their metaphorical lair Tiredness and Depression hurl pieces of my past, present and future at me to torment and trick me into thinking that I am either worse than I feel or better than I am. Black Dog and the Fear Monkey fucked me up, now they sit in the shadows and snigger at their handy work while they’re accomplices attempt to finish me off.
However, and you must not tell anyone about this, they cannot find out about my secret weapon, but they are also teaching me. This blog is my secret weapon, hidden in plain sight whilst the critters clatter around in the shadows. By writing this blog, by making these reflections, the little daemons are revealing their secrets. I am now no longer just recovering from a head injury, I am also recovering from the process of understanding my own position. I am learning about myself from a new perspective, and slowly, very, very, very slowly, I am beginning to apply this new knowledge. Today is Sunday and we have had a very lazy day. However, I was beginning to feel jittery, un-nerved and experiencing a kind of mortal fear for what might be round the corner. I am weakened at the moment, and the day to day of life is almost too much, but some small part of me said “write,” and I listened. I am learning to listen to a voice that is speaking to me through memory, through a bruised brain and through medication, but it is there: “go and write…”
When I write the daemons disappear, then fizzle away into the structure of me, because they are a part of me too. When I write, I am back in control and making good use of this whole experience. When I edit and re-read and re-write, I am building new pathways, I am repairing what was damaged and creating new code that will expand my understanding of self and not self. When I write, I understand myself, when I understand myself I begin to heal. There are points of recognition now on this map that I am creating, I am just beginning to understand that what I am writing here is myself, I am writing myself back to a state of self knowledge and recognition.
These are the doldrums, and the enemy here is time and how to fill it. There are only so many Netflix boxsets one can watch before intellectual decay sets in. I cannot do anything too vigorous, but I do crave a routine, a path back to full strength. There needs to be rest, but there needs to be action as well. One of my favourite activities in my day at the moment is lighting the burner. We have a wood burning stove in the living room, and at the moment, with cold weather settling in, there is nothing finer than coming home to the orange flicker and glow of fire. Lighting the fire everyday at 2pm has become an almost prayer like ritual. I am rekindling some thing old and creating something new every day. This simple act has taken on great meaning. It is something that I can do for everyone else in the house as well – it has meaning and gives me a sense of belonging and of being needed and appreciated in the house; rather than just being an unwell person.
I am adrift in the doldrums, I have a supply of anti depressants, I have my writing and can cook and light the fire. I have enough for now. I am adrift in the doldrums with no wind in my sails so I will wait. I will be patient, and I will write.