Coming of Age on Zoloft (20 page)

But it wasn’t all flaying, either. Horney’s ideas didn’t just make intuitive sense to me; the way she talked about neurosis felt good, even hopeful, in a way that the chemical-imbalance theories never had. She thought, for one thing, that almost all people were neurotic to some degree, and that our society tended to make us so. While she didn’t think that neurosis was healthy, she believed that struggling with it was a basic theme in human life. (As if to underscore the idea, she often illustrated her points with examples drawn from world literature.) I liked the way her theories seemed to imbue mental suffering with a meaning, and therefore a dignity, that had always been conspicuously absent from the discourse of faulty neurotransmitters. Thinking about having a chemical imbalance had always made me feel helpless, the victim of forces beyond my control. To my twenty-first-century ears, the word
neurosis
sounded strange and old-fashioned at first, maybe even subtly non-P.C. But the idea behind it soothed and heartened me, making me feel legible to myself and connected to other people in a way that nothing else had.

John never mentioned any specific psychological theories, but it was easy to map what we were doing onto the process of therapy as Karen Horney described it. He even pointed out how often the little word
should
popped into my statements about myself, and he tried to help me see past it. Letting go of “should” is scary. The demands that I uncovered felt like responsibility itself. I was terrified of relaxing them—I’d be slovenly, I’d never achieve anything at all!—but peeling them back, and peeling back the constant, low-grade sense of anger at and disappointment with myself that they entailed, allowed me to begin to take a different, deeper kind of possession of my life.

It is in the context of the idea of “shoulds” that I understand one of the moments from therapy that I remember most clearly. In the spring of my second year at Cornell, I went in, and I didn’t know what to talk about. John had told me to pay attention to feelings, though, so I said, “I’m feeling grumpy.” He asked me why, and I told him I was feeling grumpy because I didn’t want to do any of my schoolwork. I had readings and deadlines, but I wasn’t excited about them. I had developed a new, almost scary sensation that I could simply ignore my work, not do it for a while. As I was trying to explain this feeling, I got choked up. The emotion caught me completely by surprise. I had thought this would be sort of a throwaway session, one where I didn’t have much to say. John asked me how I felt, and I said I felt really weird; I apologized and said I had no idea I’d cry about this. Then I sat there and wept for longer than I’d wept about anything in therapy up to that point. John asked me if I’d ever really allowed myself to feel this way before, and I said, no, I hadn’t. He asked what would happen if I stopped doing my work, and I said probably nothing, for a while. It felt so wrong, so screwed up not to care, and I sat there crying and crying. I wrote in my journal later that I’d “broken the Kleenex barrier, or at least the record for number of Kleenex used.” Later we talked about elementary school, and I said I remembered feeling like the puppet of adults who took my good performance in classes as a sign of obedience, and treated me like I was special, while inside I both loved this feeling and resented it and, eventually, myself. “It feels crummy to be a puppet,” said John, and I nodded and smiled and grimaced and blew my nose. Later still, he told me that he was glad I was doing this stuff now, that it’s so much better to do it at my age than at forty. I felt fanatically grateful for the suggestion that he had some idea what it was I was doing, because from my vantage point, it felt like the only thing I was doing was falling apart.

After that session I had errands to run, but instead of doing them I took a fifty-mile drive in the country outside of town. It was late afternoon and golden light fell across the small farms patchworking the hills. I felt agitated, not in a bad way, but as if ten thousand microscopic particles inside me had shaken loose and were sifting through my body, floating free and preparing to rearrange themselves in new ways. I thought back to the things we’d talked about. I thought about growing up. I was still in the habit of flinching a little every time John referred to me as an “adult,” which he did with some regularity, but it was getting to be true. I thought about whether part of being an adult is realizing that no one else cares as much as you about the things you do. It seemed like a lonely thought, but maybe it didn’t have to be. If it didn’t matter as much to anyone else, maybe it was time to start taking responsibility. Maybe that’s what responsibility meant. That you might as well try to make yourself happy—that nobody else was going to tell you how to, not because they were mean or uncaring but because they didn’t really know how, and anyway, it wasn’t any other person’s job as much as it was your own. I did squeeze in a few more days without doing homework, just to see how it felt. Nothing bad happened.

THERAPY DIDN’T CONVINCE
me that antidepressants were useless, but it did move me toward a more specific estimation of the things they can and can’t do. For me, I decided, antidepressants were great at blasting through the most acute states of anxiety and sadness. When I’d lost the ability to eat and sleep normally, or interact socially without suppressing tears, medication knocked me back to a calmer, more cheerful place, and quickly. But as I continued in therapy, I saw more clearly that there were things I had needed for a long time, as much or more than I needed drugs. Antidepressants had gotten me moving, but they hadn’t given me the sense of direction I craved. They had picked me up, but they hadn’t made me more self-confident in any meaningful way. In fact, it began to impress me how much, once antidepressants had gotten me over the hump of whatever immediate misery I was dealing with, I had been able to go back and inscribe some of my old problems onto the drugs themselves. Not knowing what I wanted in the world, for example, had given me a fear of being influenced and changed, which translated handily into a fear that antidepressants would change me. Having a tendency to write off and doubt my own achievements anyway, I found in antidepressants a perfect reason for questioning whether the things I did were real, or whether I truly deserved credit for them. During the time I lived in Ithaca, I kept on using antidepressants, but over those two years it was therapy that made me feel better in ways I had never experienced before.

Critically, therapy taught me about the magic of cause and effect: that the things I do really affect the way I feel. I learned that emotional junk food—“shortcuts” to intimacy, or whatever kind of immaterial gratification you may be seeking—will make you feel as queasy and malnourished later as real junk food will. Emotional life is not unlike cooking or growing a plant: if you take your time and put in quality materials, chances are that you will get good stuff out in the end. It may be funny that I needed to do deliberate work to absorb this elementary lesson, but I did. In a way, antidepressants had long been giving me the opposite message: if you suffer for no reason, because there is simply a glitch in your brain, then it doesn’t make much difference
what
you do. For me, antidepressants had promoted a kind of emotional illiteracy; they’d prevented me from asking or noticing the reasons I felt bad, or appreciating the effects of the world on me.

Most of all, therapy helped by making me see that some of the things I like most about myself and some of the things I like least stem from the same sources. Before I came to John, I was used to feeling two different ways. Sometimes I felt capable, well composed, on top of the world. Other times I felt abject and lost and horrible. Antidepressants had contributed to this tendency; one group of feelings meant “sick,” the other, “well.” John taught me to reexamine those assumptions, to think about the relationship of the bad to the good. Slowly I began to realize that some of the qualities I value about myself—that I feel things strongly, that I’m sensitive, that I care about doing well and about things being right, for myself and in the world—were precisely the things that made it possible for me to get cast down. But at the same time, these were the qualities that allowed me, on a good day, to be empathetic, warm, observant. A good friend, a hard worker. Some people find comfort in thinking about depression as a kind of disease, but for me, recognizing it as a potential nested deep inside me, intertwined with the traits that made me strong, made me hate my depression less, and made me hate myself less too. Depression is pretty hard to love, but I did learn to regard at least my tendency toward it with a little fondness and a little humor that, I like to think, took the edge off.

As I began to see myself as more nearly whole and seamless, another thing happened: I started to feel less alone. I had learned on that front porch in Portland, and many times over the years that followed, that I was far from the only person to take an antidepressant. But each time the knowledge had hit me and then receded like a wave. Maybe it was because having that kind of problem wasn’t something I wanted to associate myself with. After all, the premise of biological psychiatry is that depressed feelings—no matter how many millions of other people have similar ones—are fundamentally abnormal, moods apart. But the longer I went on in therapy, the less unusual my problems began to seem, and the more I started to see other people in the multiple dimensions that I had begun to make out in myself. The true picture was so much more complicated, and more
interesting
, than any division into categories of sick and well: we were all collections of strengths and weaknesses, trying our imperfect best to get along in a difficult world. I remembered a line from Karen Horney that perfectly captured this change in perception. As the result of a successful analysis, she had written, a person may “experience himself for the first time as a being neither particularly wonderful nor despicable but as the struggling and often harassed human being which he really is”
5
—in other words, as a person among other people, subject to the same problems and limitations, but deserving of the same enjoyments and respect.

Feeling less unique made me able to talk to other people more openly, and listen better too; when I did, I realized as if for the first time how many of my friends and acquaintances also had problems with depression and anxiety, though it wasn’t always apparent at first. Amelia referred to herself, half-jokingly, as “neuraesthenic”; Jules, who seemed so happy-go-lucky, took Zoloft; Louise had been on antidepressants before. I began to notice how many of these people also possessed a certain cluster of traits: they were sensitive, moody, empathetic, creative, funny, demanding of themselves, self-absorbed at times, but also capable of joy and a deep interest in the things that moved them. I started to wonder whether people like this tended to cluster in the places I’d been drawn to, like academia and the arts. Maybe being a little melancholic was an occupational hazard of being a certain type of person in the world, an annoyance but also a feature that could pull us toward each other. If that were true, then depression lost even more of its sting; it was a potential to be fought by any means necessary when it became acute, but not something that needed to be feared or rejected for any reason other than its simple awfulness in itself.

ONE DAY IN
the spring of my second year of school, I lay in the grass in a small park in Ithaca and realized I would leave. It was May. The leaves were green and it was finally warm enough to lie on a blanket on the ground in only a long-sleeved shirt. My mind wandered over the past and peered into the future. I realized that leaving wasn’t a hypothetical choice; it was something that I could really do. I felt the sensation of freedom that I remembered from my long drive in the country. As before, it felt both somber and light. It felt real. I turned my head and looked at the world through blades of grass. The sun was getting stronger; parents took long, smooth strides through the park while around them children ran, tripped, and fell. I knew there would be leave-of-absence forms, explanations, logistics, and probably doubts. I knew it, but I tried to leave that knowledge aside and just lie there in that moment, when the choice in front of me seemed terribly clear.

I ANNOUNCED MY
intentions. Summer came, and then August. My friends threw a party for me at the dive bar downtown. People I hadn’t expected to show up did show up. My friend Maria, who was an MFA student, had a custom T-shirt made that said
A PAINTER AT CORNELL
♥
S ME
. I’m wearing it in all the pictures of me hugging and kissing friends and acquaintances at the Chanticleer that night. The day I left, friends gathered at my apartment to help me pack and load; I ordered everyone pizza. The chicken farmer, who had moved back to town and resumed his previous occupation as a graphic designer, came by to check the knots and cables on my car.

Let me mention one final lesson of and benefit from therapy. Over the two years that I saw John regularly, I became less afraid of strong feelings. I learned that powerful emotions and destructive emotions aren’t the same thing. Destructive emotions felt cramped and conflicted, like a frantic frightened animal running around and around in a circle. Other emotions, even negative ones, didn’t have this turbid quality; they hurt sometimes, but they didn’t harm. I learned that there is a difference between simple sadness and depressed sadness. Unlike depressed sadness, simple sadness doesn’t feel like it’s going to destroy you. Simple sadness is like a benediction, a flag planted in the ground to mark the spot, a flag that means “this is gone now, but it was good.”

It was simple sadness that I felt for John when I left him. To call it simple doesn’t mean that it wasn’t powerful. I will never forget walking down the long, cool, echoing hallway of the DeWitt Mall, away from John’s office, on the last day. The feeling was so big. It almost didn’t have any qualities other than its size and intensity. It wasn’t good, and it wasn’t bad. It just was, and it was so much. I stopped at the landing for a moment and steadied myself on the stone window ledge. It washed over me like a hurricane and I gave over to it completely and then it was gone, and I was still there, walking.