Madness (4 page)

Each week I have an appointment at the local Community Mental Health Clinic. It is a hot spring. The asphalt radiates heat, black and thick. Birds and people move slower. Leaves, wilted, move slower in the slow breeze. There are no clouds. The Community Clinic is housed in a building owned by the electricity company; it is an incongruous spot at the front, a blemish. Mad people come here.

Michael greets me in the same way every week: ‘Hi Kate, will you marry me?'

‘Hi Michael,' I say. ‘No.'

‘Why not?'

‘I don't want to marry anyone right now.'

‘Okay. Who are you here to see? Me?'

‘Helen.' Michael goes outside to have another cigarette, shoulders slumped, perfectly baldhead round as a sun in the sunlight. Later he pulls up a chair and sits facing me in the waiting room, legs spread, his knees reaching the sides of my chair.

‘Michael,' says someone from behind the desk, ‘that's inappropriate.' He sighs heavily and pushes his chair back. He has the darkest brown eyes and he hardly ever blinks.

Helen calls me from the door to the offices. We walk together down the long corridor, tiny rooms to either side just big enough for two chairs and perhaps a desk. Helen is a psychologist and case-manager. Her role is to provide a single point of contact for the outpatient clients (and carers) of a public mental health service.

‘How are you?' Helen asks, sitting down and arranging her floral skirt around her knees. I look up at the ceiling for cameras. The people in my head pour into my left ear–

kill her we said kill her do it do it

I hold my hands tight together so the knuckles go white and the fingers blue.

‘Okay. Yes, okay,' I say. I hunch my shoulders a little. Helen is adept at using silence as a means of communication. She waits.

‘Well, at least I'm not in hospital,' I say.

‘Yes. What have you been doing?'

‘Drinking.' I look at the floor; find a stain pattern on the carpet that looks like a flower.

‘How much are you drinking?'

‘Half a bottle of Scotch . . . over an evening and a night.'

‘Why?'

‘Keeps my head in check. All the spewing . . . shit.'

‘What would happen if you didn't drink?'

‘I'd go mad.'

John died today. Sensitive, funny John. Married, two kids John. Musician John. Small-business owner John. We met at a personal development course several years ago (an almost-cult) with lots of hitting and banging things and shouting, but we survived that, and Shaz and Zoë and I and John and Andrew and others formed enduring friendships. Our beautiful St Kilda friend hanged himself today.

Dear John, all the things we want to say, all the things you need to hear . . . here we are tonight, sitting in a tight, urgent circle, one by one trying to explain what you mean to us; which parts of your soul we managed to glimpse; why we've all failed you so badly. The sun throws its red-gold light across the water, and I ache that you do not feel the warmth on your arms and face. I'll be looking for you along Fitzroy Street – your guitar, a bright orange shirt and your smile.

Back home in the very early morning and I can't sleep, so I sit in bed with the cats and the tears that fall and fall and write for him.

The weekends pass, blurred into half-consciousness, unconsciousness and small periods of extraordinary white light when I manage to walk to the bottle shop. Whether as a result of ECT or as a result of acute illness or some combination of the two, I can't recall addresses of friends, passwords, bank account details. And I can't remember where I might have written them down before I went into hospital. It is odd to be able to remember the serial white cell counts of a patient, to be able to explain to a colleague the histological subtypes of melanoma, and yet not to know whether my parents' phone number begins with a 5 or an 8. It is odd, but it is explainable: I have a kind of retrograde amnesia, common after ECT. It means I can lay down new memory fine, but I've lost some old memory and I have to relearn the simplest things.

So this outer shell of Kate, a foreign entity, is a careful observer, a careful mimic, paralleling appropriate behaviour in the presence of others. It runs a tight ship during the workday and it negotiates social events like a rather comely old lady. With every ocean wave falling on it, the outer shell presses out another layer, re-moulds itself, sets.

Most of the rest of me is crossing the divide from existentialism to nihilism. Nietzsche knew all about nihilism: our existence (action, suffering, willing, feeling) has no meaning. Existence without intrinsic value. Black cloth, the cloth of death, of funerals, the cloth of death. Time stretches inside the shell as a desert does – distant, uncharted, wide and flat as ice. There is no calm.

‘John died,' I tell Helen. ‘He was . . . vibrant. I mean really. He kind of shined. He had two gorgeous children. See what depression does? It wrecks families. And the tree out the front of the clinic, the crepe myrtle, has new flowers, did you see it?'

‘I'm very sorry,' Helen says.

‘The incongruity.'

‘Yes.'

‘And the injustice. I don't get it.'

We sit. The air doesn't move either.

‘Grief is so visceral, you know? There's that moment when you first wake up and it hits you like a fist, right in the centre of the chest.'

‘Yes.'

We sit. Both of us here and not here.

‘How are you managing at work?' asks Helen after a while.

‘Oh. If the worlds stay nice and separate.'

‘Tell me about that.'

‘The researcher-doctor-person is focused and measured and normal and knowledgeable. We all have some kind of professional front, right? I guess mine is this whole other individual squashed into the bony skeleton, inside the shell but beside, not of, myself.'

‘Mmm,' says Helen. ‘Is that tiring?'

‘Most days I end up on the floor of a toilet cubicle.'

‘So it must be a relief to come home at the end of the day?'

‘Doesn't matter, the darkness is always there.'

Helen sits quite still, she sits with the darkness, she doesn't try to brush it aside. The darkness oozes into the room.

‘Are you sleeping?' she asks.

‘Some,' I say. ‘Till the dreams . . .'

‘Dreams?'

I tell her about the dreams. Most nights the dreams have a theme: barbed wire is hacked across my face, the blood that runs from my forehead is so red and thick and warm that it blocks up my nose and mouth and causes me to choke. I am hit from behind so that I fall forward onto the concrete floor and am left there and it is so cold that my teeth clench into each other and my elbows are numb. The room I am in has no light. I know there will be a knife and I try to curl into a ball, my arms are bound behind me with wire that is prodding the veins on the back of my hands, my head is wrenched back, I am choking, I am probably naked, there is dirt in my eyes, I can't tell if I'm crying, I feel white and helpless as a newborn, there's the iron taste of blood, and salt and grit, the acute sound of a hammer on metal, the sudden cold of metal on the skin of my back and the only accompaniment is laughter – gleeful, mirthless.

‘Are you thinking about harming yourself?' Helen asks.

‘Most days.' (Every day). I smile.

‘I'll arrange for review with a psychiatrist.' She takes my hand and puts it between both of hers. She has small hands; her palms are soft and dry and warm.

I walk out into the Community Clinic waiting area. People are playing pool in the corner of the room. There are posters up on the walls about schizophrenia, panic disorder, depression and mania. There are empty polystyrene coffee cups on the floor and bits of newspaper. Someone has been painting with watercolours and has left paints in a mess of yellow and blue on the table. A young woman sits waiting, the skin of her hands pink as a sunset. She has almost no hair except for some fine, long wisps near the base of her skull and on the very top of her head. She is reading a book of poetry – I can tell it's Emily Dickinson by the use of long dashes.

Outside the heat of the day lifts up from the ground. There is a strong northerly wind, the branches of the trees bear down and the leaves rattle. I walk home. The people in my head have begun to comment on my movements.

now she's brushing her hair now she's getting dressed wasted breath ugly fucking ugly

I don't look in mirrors. I'm terrified of the sight of my body, of its pathetic mass of flesh, scars like red infestations under the skin of my arms and legs. I haven't looked at my body for several years, I shower with my eyes closed, towel dry with my eyes closed.

Hippocrates described melancholia (black bile) as a state of ‘despondency, sleeplessness, irritability, and restlessness.' A depressive episode can last longer than a year without effective treatment. Even with treatment, many people like me continue to experience ‘subsyndromal' symptoms in between episodes of acute illness. These are by definition less severe, but they complicate day-to-day life.

To those lucky enough not to have experienced it, depression may appear selfish. Depression is not selfish. It's a barren well, deep and dark, and you're alone right at the bottom of it and there is no light at the top of the well so you cannot see beyond your own suffering. After weeks, months, sometimes years in the well you lose even the basest urges of life: hunger, thirst, sleep, libido, hygiene, health, social contact, order.

Theories for the causes of depression include aggression turned inward, object loss, learned helplessness, negative cognitive schemata and neurochemical imbalance. It is probably a combination of these as well as genetics; all under the influence of personality.

you are rotting

I am rotting; my innards are turning brown-grey like the decomposition of the dead. Soon there will be nothing left inside me except air and water.

I meet with Jim, the psychiatrist, Friday evening after work. He is balding, has a slight paunch and a youthful face. He wears a suit; his shoes are polished. He asks me the usual battery of questions: appetite, sleep, sadness, pleasure, energy, somatic symptoms, psychotic symptoms, suicide. He leans back in his chair with his legs crossed and his arms folded over his chest.

‘What medication are you on?' He asks.

‘Venlafaxine and lithium.'

‘Let's add mirtazapine 30 mg and some clonazepam at night,' he says. ‘See you next week.' I walk away with the prescriptions and a hole in my heart.

Simon is sitting in the waiting room, hunched in a large brown coat, big boots on his feet. He looks hunted. ‘Simon?' I say. His eyes are deeply black all the way through, there's hardly any white. He doesn't recognise me, or perhaps can't. I need a bath. I smell like sweat and whisky and cigarettes. Back home I take some sandalwood incense (such an aromatic smoke) and I take the flame (the blue and yellow light) and I atone atone. Flame on pale skin goes red then white then black, always in the same order. Will the perfume linger?

Morning. Light drifts in with the dust motes. It is already warm. The lion-cat is stretched out at the end of the bed, his convex belly moving up and down rhythmically with his breath. My fingers are sore and swollen, skin reddened with white and black holes where the incense burned in.

kill yourself shriek coffin worth the price die bitch shrieeek we're killing you

I keep my head low to avoid the internal blows and walk out into the sunlight with hot coffee, holding the cup between thumb and index finger. There are honeyeaters in the potato plant and a wattlebird in the red flowers of the grevillea. I stand quite still, watching them.

By 11 p.m. Sunday evening it is no longer possible to ignore the normal tasks required for the looming normal week. Wash clothes. Grocery shopping – chocolate, cat food, cat milk and a pair of supermarket flannel pyjamas. Wash self. Wash hair. Dry self. Dry hair. Dry clothes. Breathe. Set alarms.