David's Inferno (29 page)

I
T
'
S KIND OF AMAZING
that I've managed to get almost all the way through Purgatory without mentioning the word “therapy.” One reason is that, while I have had a good deal of experience in my life with therapy—individual, marital, and some group, I've never gone through any classic Freudian, Jungian, Transactional, Gestalt, or other formal analysis.

But the real reason is that, while I certainly think I earned an advanced certificate in primal scream, therapy wasn't a major part of my Purgatory. This isn't as odd as it seems. An increasing number of psychologists believe that, in the case of major mental illness, it's best to deal with chemicals first and personality or karmic issues second.

We all got issues. We all have things we're afraid of, people we're trying to please, ways that we feel we've been wronged. Send me a self-addressed stamped envelope and I'll send you a list of mine. (But you better hurry … since I emerged from my breakdown I've been crossing them off as fast as I can!)

At its best, therapy can help us identify the recurring patterns of thought, reaction, and behavior that keep us going in circles. It also helps us recognize and understand the triggers for those patterns,
and ways that maybe we could do things a little differently next time around.

Often we're completely unaware that these patterns exist. Sometimes we have realized they exist but don't want to mess with them because the cure might be worse than the disease. Other times we'd love to be free of them but don't know how. And sometimes we know how but just can't seem to do it.

While I may not have done all that much traditional therapy, I have done a good number of what you'd call personal enhancement workshops. They've forced me to take long hard (or, sometimes, short and easy) looks at some of the things in my life that hold me back, and learn ways to be less at their mercy. While occasionally disturbing, grueling, and/or humiliating, for the most part these workshops have been fascinating and made life a lot more interesting … also, in most cases, more fun.

Regardless, whatever work I did before or during my depression certainly stood me in good stead when I emerged. Partly because I was able to enjoy the fruits of this work, but also because I was not only more aware of, but also less susceptible to, the ways familiar patterns of insecurity and worry could trigger more serious episodes of anxiety or depression.

Having been “reamed out,” as a friend put it, there were fewer “sticky” places in there that could grab hold of the smallest worry and transform it into a major neurosis. I realized not only that I didn't need those things holding me back, but they weren't really all that interesting any more.

Ever since Socrates pointed out the importance of
knowing thyself
, people have seen the connection between self-knowledge and self-transcendence. Between being aware of who you are—in particular, how your mind, heart, and body tend to respond to different things—and being able to see your place in the whole thing with compassion and dispassion.

Some spiritual traditions teach that self-knowledge comes before transcendence. My experience is that it's a dynamic. The more you know yourself, the more you're able to step back and see that
you're not the center of the universe—or at least no more than anyone else is.

At the same time, the experience itself was enlightening, and if anything, made it possible to better integrate the work I'd done previously into my everyday life. As if all my understanding from 30 years of personal and spiritual work had been waiting for conditions to be right to come fully into the light.

With all due deference to people who are considered spiritual “masters,” I would say that we all continue to get caught, Velcro-like, on stuff over the years. Those are the steps on our personal Purgatories. At the same time, as Dante discovered, the lighter your load, the easier it is to climb.

While I didn't focus on doing therapeutic work during my illness, that doesn't mean it wasn't being done. At the time of my breakdown, I was more than five years into a writing project in which various characters from history appear in my everyday life: from Agamemnon in our local coffee shop to Harriet Tubman on a park bench in Berkeley at the birthplace of the 1960s Free Speech Movement. My old new friends included the famous, the infamous, and the virtually unknown. Kings, queens, musicians, scientists, artists, philosophers, explorers. There was no need to include a writer.
I
was the writer.

I wouldn't “channel” these people. I'd just imagine them in my life today. And, as with many writers of fiction, at some point my characters would take on lives of their own, occasionally taking over mine in the process.

Under the circumstances, I was more than willing to lay some of the blame for my mental instability on their doorsteps, figuring if I could get them to come to their senses, they might help me come to mine. For example, the Babylonian emperor Nebuchadnezzar had a big-time breakdown at the end of his life. Godfrey de Bouillion—the man who led the First Crusade—was definitely not a happy camper (although I sensed his depression was more situational … all that blood in the name of God). Similarly, the zeal
of Torquemada, the first “Grand Inquisitor” of the Spanish Inquisition, suggests some significant mania, imposed upon big-time anger issues.

I was particularly suspicious of Chopin—who had spent a lot of time trying to get my attention the previous spring in Paris when Wendy and I visited his grave at Père Lachaise and then attended a piano concert of his music later that evening. He had a lifelong pattern of behaviors that were diagnosed after-the-fact as classic manic-depression.

Then there was the simple issue of whether it was a good idea to let so many egomaniacs (in the best sense of the word) run roughshod over my consciousness. Talk about issues!

Still, since I was spending so much psychological time in the past lives of
other
people, I had to at least entertain the idea that my sickness might be connected with, well, some past life of my
own
. Especially when one of my friends of the New Age persuasion claimed she had a vision that in a past life, I had been a scribe in ancient Egypt, and was strangled to death just before sunrise because I was about to spill the beans (or whatever they spilled back then) about the Sun God not being the be-all and end-all of creation. She suggested that the reason why I'd wake every morning at 4
A.M
. with my heart racing and throat chakra vibrating was related to this incident; in other words, through my writing this time around, I was about to reveal certain troubling truths—on behalf of my characters—and I was afraid that some people wouldn't be happy to hear them.

Discussions of past lives have a tendency to veer into timeless narcissism. All I know is that I now write and speak far more freely than I did before. Whether that's because my
ad hoc
primal screaming purged some psychological trauma in
this
life, or some subconscious process helped me deal with a past one, that's about as good a therapeutic outcome as any writer could hope for.

F
OR MOST OF
2006, I was simply miserable. I couldn't write for more than 15 minutes at a time. I couldn't make people laugh. I couldn't finish the simplest projects. I felt totally stripped of my personal power.

Now, years later, I have the temerity to present my experience as an everyman's version of Dante's journey. Back then, I not only felt I wasn't getting anywhere, I felt I was regressing. I not only felt I wasn't learning anything, I felt I had forgotten what I thought I'd known before.

I still believed that there must be
some
meaning behind it, but only because, even in my most existential moments, I couldn't believe that it was totally meaningless. I still believed it would end, but only because I couldn't imagine the alternative.

One day, I had a long talk with a friend who sympathized, using words that took my breath away: “Yeah, man, the universe will whore you out … It will run you ragged. The universe doesn't put things in a human perspective.”

He encouraged me to find whatever protection I could—be it comfort food, crystals, or simple walks in the woods—and hold on tight. Like everyone else, he insisted it
would
end. But by the fall
of 2006, having tried various combinations of vitamins, minerals, herbs, amino acids, homeopathic remedies, acupuncture, meditation, bodywork, meditation, and chicken soup, I pretty much threw myself back at the mercy of prescription drugs.

My psychiatrist's plan was to start by calming the anxiety and then slowly build up an antidepressant behind it, careful not to re-ignite the anxiety. Which made sense, since the same strategy had worked so well in 1999.

We started on BuSpar—an anti-anxiety drug that, at certain dosages, helped a little, but at others made me more anxious. We added Depakote, a bipolar drug. It briefly stopped the madness, and gave me a few days of normalcy before I returned to agitation as bad as before.

Valium remained my late-night drug of choice, but I also gave various over-the-counter and prescription sleeping aids a try—from Tylenol PM to Lunesta. But, as before, the problem wasn't getting to sleep, it was staying asleep. So I'd end up feeling sedated but unable to sleep, drugged and wide awake at the same time. All the different parts of my body were going at different speeds. People were beginning to ask me with increasing frequency how suicidal I was.

That's when my doctor first suggested that the best course might be to check myself into an inpatient psych facility for a couple of weeks—get all of the meds out of my system in a safe environment, consult with some specialists, and then try again.

The writer in me wishes I had taken him up on it—after all, some of the best writing of the last fifty years has been about going in or out of mental institutions, including
One Flew Over the Cuckoo's Nest, Zen and the Art of Motorcycle Maintenance
, and
Darkness Visible
. Of course, from that perspective, my survey of twenty-first-century treatments for depression should also have included electro-shock treatment (ECT).

But that's the writer in me. The guy who was getting increasingly desperate in late 2006 was pretty freaked out at the thought of being institutionalized.

While slowly nudging the Depakote dosage up to standard therapeutic levels, we replaced the BuSpar with Seroquel, which is primarily indicated as a schizophrenia drug. It had some uncomfortable side effects—particularly dry mouth and some weird visual shakiness, but calmed me down enough to stop taking Valium. I even began to remember having dreams—which, as I understand it, indicates reduced mania.

Eventually, we seemed to have found a decent combination of Depakote and Seroquel. I still felt like a zombie. And was still a bit shaky. But it was a start so we tried lifting my mood with a little Effexor—which works on both serotonin and norepinephrine synapses.

Within a few days, I was as agitated as ever and had to start taking Lorazepam three times a day to calm back down.

We began to discuss inpatient psych again.