The Withdrawal Diaries, cont.

Day Five (Tuesday): I stay at 30 mgs. I am somewhat tired, and find it hard to get out of bed—but that may be because I took a melatonin to sleep last night. As the day progresses though, I feel very good. I feel extremely happy, facebook-status-updating happy. Nothing in particular happens, not really, but I feel so blessed and lucky: lucky to have this child who runs up to me and says “I love my mommy!” and to have my health, which is really something after all. I feel somewhat focused on my current writing project and I have a little bit of time to work on it, and that makes me happy. Or content. I also feel very happy to see an old friend, someone I’ve known for nearly 20 years and have had a difficult but intense relationship with—from periods of not speaking to periods of obsession—achieve a certain success. He is wildly talented, and I’ve been his biggest fan since we were 18 and he first starting giving me his stories to read. I’ve also seen him struggle, really struggle, in the way that artists/writers must in this corporate American culture, particularly those of us who come from messed up families, and so it is beyond satisfying to see him, say, profiled in the New York Times or in the (gulp) New Yorker. It’s surreal and bliss. It is not as Gore Vidal said (Every time a friend succeeds, I die a little) not at all, though I understand that response. It is rather this confirmation that something is Right In The Universe, that something worked, dammit! It renews my faith in art, in struggle, in expression. He is my hero and inspiration, all over again. I cried when I read the New Yorker piece, written by the lovely Hilton Als, which seemed to aptly and critically assess who he is as an artist and a person, to truly key in on his self-invention. It is all too much, the way I read this and then recall him, the two of us so lost, all those various times we were both suicidal, when he was at Sarah Lawrence/ I at Barnard or when I was in my illegally sublet 5th floor walkup on MacDougal and he was in Brooklyn. Somehow he knew Wally Shawn also lived on MacDougal street, above Houston, and we used to play ding dong ditch with the buzzer on his townhouse. I’m not sure why but we loved Wally Shawn. Once he came over and we read Marie and Bruce together, just for fun, but he kept directing me on how to be Marie--I wasn't crazy enough, or flat enough, or something enough. I think it was that MacDougal summer that he said he would write a play called John Simon/John Lahr. We were constantly seeing theater, reading reviews and talking about how these two playwrights represented opposite extremes as critics: the caring loving enthusiastic and supportive father (Lahr), vs. the cruel, attacking, cold and distant father (Simon). And then, most incredibly, the other day Simon writes a nasty but ultimately HILARIOUS review of his play.



Day Six (Wednesday): I continue to taper incrementally; I’m back down to 28mgs-ish. I’m thinking I should get on with it, maybe go to 20 tomorrow, but I’ll wait till I see Domrab. I haven’t had any more Brain Zaps or Didionesque-headaches. I’ve caught Goo’s early summer cold, which is a drag, but other than that, I’m you know fine*. I’m writing. See ya.




*Goo has this wonderful new obsession which goes like this. He says, “Hi Mommy. How you DO-ing Mommy?” To which I say “I’m fine. How are you?” And he replies, “I’m good.”

The funny thing; I’ve tried to alter the script, but discovered that is NOT allowed.

"How you Doing mommy?"
"Oh, I’m okay, a little tired." OR "I’m really hot."
He looks at me and then shakes his head. “No, no mommy.”
“What?”
“You’re fine, Mommy.”
“I can’t be tired?”
“No, no tired, Mommy.”
“Okay. I’m fine.”
“Mommy's fine. Mommy's good.”

(He’s a little fascist, this guy. Adored, of course, by every woman.)

And so there we go: we are all, always, fine. And good.

The Withdrawal Diaries

For various reasons I am tapering off of Cymbalta. My doctor did not tell me that there could be any problem with this process, and so I made the mistake of googling something like: “How to go off Cymbalta”. If you’ve ever googled this, which I don’t suggest you do (but likely that’s how you found this very post), you will discover a large network of troubled people out there who apparently have had very difficult experiences going off this drug. It is utterly unhelpful to read their advice, which (as most advice gleaned from a Google search) ranges from Go Off This Drug Cold Turkey to Go VERY Slowly or you’ll be Sorry! Etc. Some suggest taking two weeks off of work to do this (what to do with your two-year old they don’t say). Some suggest getting hospitalized. Much of this advice is proffered in the All Cap mode, with the requisite proliferation of exclamation points. The first time I tried to get off Cymbalta (preggers), I didn’t read any of it. I didn’t google it, so preoccupied was I with my developing intrauterine embryo.

This time, however, I’m a bit nervous. Because this drug, however problematic, helps me in very certain ways. For example, with the whole getting out of bed thing. That is, it gets me out of bed at 6 am. I put my running shoes on, actually go for a run. All before 8am. On a Sunday. Now this may be your regular morning routine, but for me, dear reader? Not so much. Pre-Cymbalta, that is. Even the Nardil couldn’t do that for me. I’m, uh, not a morning person. To put it mildly. Maybe you know this about me. In which case, I’m very sorry.

But anyway, I have to get off of it. It’s messing with my womanly parts, and I don’t want to keep not getting a period, for example. That’s one side effect (and the miscarriage, natch) which reveals all too clearly how effectively this is messing with my reproductive life. I mean I dunno but maybe I’ll change my mind and actually want to have a child, say, before I turn 40. Or after, even. It’s not my plan but you never know. As Sandra Bernhard said: I’d like to keep my options open. What girl doesn’t?

And so. I’m kicking it.


Day One (Friday): Down to 30 mgs-ish. No noticeable effect except a late afternoon depression which may have been a result of the apocalyptic storms we had that day (a tree fell directly on D’s car, incredibly). I spent hours at yoga that afternoon, hoping to counteract any possible reduced equanimity.

Day Two (Saturday): No noticeable effect until 1:30 am when I woke with the kind of headache that must be what Joan Didion was referring to in that incredible essay “In Bed”. It began at the back of my head, and wrapped itself around the bottom of my skull, like a helmet that fit too tight and was pulsing, or very slowly but forcibly shrinking. I have never had any sort of real headache except the kind that come from not drinking coffee. I actually thought I was going to die. I thought my head was going to explode. It was like childbirth, but in my lower head, not my lower back. I woke D. He told me that I wasn’t going to die. I didn’t believe him. He told me to take an ibuprofen. I stumbled to the cocina, took an ibuprofen and stumbled back into bed. I began to cry. I prayed (Sartre again: Once a Catholic, always a Catholic). I imagined that I would not see Goo again. I thought about how amazing it would be to see Goo again. How I would do anything I would give anything just to be able to live until the next day so that I might see Goo again. I really wanted to be alive, though I knew my brain was about to explode. Either that or I had a tumor. D told me to take deep breaths and to try to relax. I asked him how long it would take for the ibuprofen to work. He said about ten minutes. I cried some more. Eventually I did fall asleep. When I woke the next morning, I felt fine. I felt so happy.

Day Three (Sunday): I increased the dose a bit. I’d cut down by 10 mgs (to 30) but today I cut perhaps 8 mgs. It is very hard to divide a capsule and I won’t tell you all the bad advice you can find on the interwebs about how to do just this. So, without being careful about how much more, I took more. Not quite back to the 40 mgs but more. And I was fine yesterday, very happy, though I wanted to be writing rather than doing all of the lovely family father’s day activities we’d planned (but that’s my perpetual un drug-related conflict: how does one resolve the need to be an artist/writer w/ the need to sustain relationships?) until the late afternoon, that is, when I was overcome by severe anxiety—the sort which gets me imagining all of the horrible things that might/could happen to Goo. Turning the mind, turning the mind, cultivating awareness, etc. But Still. It was brutal. And then, insomnia. Intense insomnia that had me reading Janet Frame at 2 am and then getting caught up in an online conversation w/ a friend whose reviews had just come in from his NYC theatrical debut. And getting way too involved in that high-stakes drama. All night. And then sort of relieved when Goo wakes up with a scream at 3:30: “I had a bad dream!” he tells me, though I’m guessing he’s aping Caillou, but anyway I bring him to bed and try to get us both back to sleep. I fall asleep by 4, maybe, and Goo wakes me up before 6 with a kick and a laugh. “Hi Mommy! How you doing, Mommy?”

Day Four (Monday): I feel like hell, but that’s likely more about sleep-deprivation than it is about Cymbalta withdrawal. I’m down to 30 mgs. I’m going to stick with that until I see Domrab on Friday.

I think that’s what I’ll do anyway.




PS In the course of my Cymbalta withdrawal “research” I discovered the non-scientific but evocative term Brain Zaps, which I’d never heard but which perfectly describes what I too often experienced with Nardil—in fact, occasionally while driving or teaching, which could be very scary. I thought it was that I’d had too much coffee, violated the MAOI diet-restriction list (which everyone violates, I assure you)—but I think in fact it was just this syndrome that MDs don’t ever mention but which anyone who has experienced can explain & identify. I recall telling doctors about it from time to time over the years and not one of them ever said “Oh yes” or “That happens” or “That’s what they colloquially call a brain zap—it’s a side effect”. And so I was sort of relieved and sort of terrified to discover this online world of men and women who have had the same experience as a result of taking various crazy-meds, from Nardil to Cymbalta.

Why I have not posted lately

Because I am trying to real write this summer, now that classes are over, now that grades are in, now that we’ve returned from various travels. I am Real Writing with Real Goals: a manuscript to finish by the end of the summer. Two, perhaps, though one is already complete but needs editing. The other is a huge scary mess that I force myself to deal with every day, however painful it is some days (i.e. today). I forge ahead. I recall Anne Lamott’s Bird by Bird and allow for the possibility (probability) of a Shitty First Draft; I look to Gabe Gudding and try to remove Intrinsic Cravings (Enemies) and seek more Comprehensive Insight (Wisdom):

A capacity not to become despondent about the disappointing, fallow times—to keep working through them; and the concomitant ability not to become too attached to the “ups,” or to the successes—so that one doesn’t turn the joy at a writing success into an expectation that it should continue—because such an expectation about one’s writing will inevitably turn into a disappointment—as the process is always and inevitably changing. An implicit understanding of this—an understanding that this insight can be cultivated.

I wish this for all of you, too. Forge ahead, my writer friends.

For Silas

Today is the day that her son was born so many years ago or was it just two years ago. And then he died. Three months later. He went to sleep and didn’t wake up. They told her it was "textbook SIDS". She never forgot that phrase, or the woman’s voice who spoke it, over the phone: textbook SIDS. It was about then that she left, that she felt herself moving away from the whole thing--not rising above it, not avoiding it—that would have been heroic, or a relief—but away. And with that movement the word: textbook. She thought about the word, the first word, because the second was not a word not really but many words. Many vulgar graphic words that still didn’t seem to describe what happened, that brought to mind a car crash or a sci-fi concept. So she focused on textbook. She saw a thick book with an American flag on the cover. She saw the words We the People in a scrolled font. She saw another girl's name: Dina Badami (a sexy name for a sexy girl) written in a bubbly Palmer Method inside the front cover: the only entry in a list of “Student Name” and “School Year”. She would add her name next, below Deneen’s. She liked to think of this textbook that was only hers for a time, that did not belong to her. That had been someone else's. It was liminal that way, it was hers for the school year but not forever. She could write in it but at the end of the year Sister Georgiana would have them go through searching for any pen or pencil marks, erasing any marks they had made in this textbook she had carried and read and studied all year and would soon relinquish. It was hers but not hers.

Like every writer worth remembering (what I'm reading)

I bought the recently published Janet Frame novel yesterday, Towards Another Summer, and am nearly halfway through it. I don't quite understand how it could have been (and by whom?) considered "too personal for publication" during her lifetime, given the publication of her autobiographies. In any case, it is an incredible book. Aboard Aer Lingus to Shannon two weeks ago, I read David Gates' NYT review, which convinced me absolutely that I needed to read this novel. In the review, Gates provides a refreshing refutation to a tendency to pathologize creativity/art; and I think this is in line with Frame's own refutation ("It's no use saying Freud, Freud. People do you know. Like squeezing a stale sponge."):

Like every writer worth remembering, Frame exploits — or creates on the page, to be absolutely puristic about it — her peculiar sensibility, her private window into the universal. Has anyone not felt the strain on those hawsers connecting the self to its various social impersonations? A writer’s neurochemistry may matter to physicians, biographers and general-­purpose gossips, but it’s not the reader’s business. Frame’s sad, slyly comic fish-out-of-water story needs neither explanation nor excuse, and Grace’s aloneness isn’t a medical condition — it’s a human one. from "The Visit" by David Gates, May 14, 2009, The New York Times

Gates compares Frame to Beckett, Pinter, Plath, Woolf and even Mary Gaitskill--if I hadn't already admired Frame, this odd company might just persuade me. Indeed, there is something so lovely in Frame's ability to create her peculiar sensibility. I feel very close to her somehow, as if I'm the one in my room, afraid to come out, to go downstairs, to join the others for lunch:

Nothing was simple, known, safe, believed, identified. Boundaries were not possible, where nothing finished, shapes encircled, and there was no beginning. Frame, Towards Another Summer (p 6)

Toward a response to Daphne Merkin's essay in last week's Times magazine

1. But who are you to decide that (because she is rich? because she writes for the New Yorker?) she is not really depressed? Why would someone fake it? Why would someone commit herself to the NYSPI? Because she had nothing better to do?

2. Because I read the entire essay.

3. But I can’t find anyone else who did—read through to the end—save for a few Facebook Friends who deemed it 1.) a retreading, a reduction; or 2.) duplicitous, disingenuous, dangerous.

4. (And I hope Merkin avoids the internet. Because people are MEAN. Because if she weren't already depressed, etc. And though I agreed, mostly, that that other recent Times essay, in which she somehow failed to disclose her connection to Madoff was, um, irresponsible; this is different. And who are you to fetishize her comment re anorexics? Have you ever been depressed? So depressed that you feel like you're wrapped in gauze, that everything is fuzzy and distant and yet too real? No? That's what I thought. So, it's like this: you think some weird shit when you’re depressed. You envy anorexics. You envy anyone who can form a sentence. Who can get out of bed. It’s fucked up, depression is. Get it?)

5. But why duplicitous, disingenuous, dangerous? I asked. Because I really wanted to know. I wanted to talk about it. No one wants to talk about it or anything anymore and I felt like I was in that old John Patrick Shanley play again, screaming: I WANNA TALK ABOUT IDEAS! (Except for when I don’t.) But see, I had VERY mixed feelings in response to this article, which was beautifully written, and unsurprisingly, as I have long been a fan of Merkin’s belletristic facility.

Because I think it is smart and brutally honest, full of evocative detail (her perky roommate who wore "Frownies" to bed each night), the kind of details that truly evoke the bizarre/banal ward experience--and yet I see that Merkin ignores A LOT, including, yet again, some serious class issues (esp in ref to the sort of treatment she has been able to afford for "four decades"--talk therapy w/ a modern Freudian analyst in NYC).

So is this what you mean? I asked my Facebook Friend.

6. But yes, she said. But also that, “despite her class, this is what she thinks is the last word in depression treatments." Which, she had a point. And I'm sort of relieved that I eventually stopped being able to afford that treatment, which--once you are in it--is very hard to let go. It is seductive and provides a level of comfort--but ultimately, it got me nowhere. It is a one-way street, that sort of treatment. It is like banging your head on the wall, after a while.

My friend went on: "I am not, by any means, a hairshirt against pharmaceutical intervention, but to write an article about suicide, depression, and not talk about food, exercise, meditation, literally feeding and treating your heart, -- the organ, not the sentiment — is Unbelievable. What was MISSING was tremendous.”

7. Okay, I said. I hear you. I agree. But this is the NYC bias. This is what you think is the best-that-money-can-buy when you are depressed in NYC. It is the best, too--within a certain very limited and highly problematic paradigm. And I wish Merkin, too, could see out of that paradigm; but guess what? When you’re depressed, it’s not so easy to be the cultural/social critic you need to be.

8. (Still, I can’t help wonder what might have happened had I had my own early breakdown at a college that wasn’t part of Columbia University, which is part of (yeah) NYSPI.)

9. And I suppose I am more than a little defensive because I have long felt a certain kinship with Merkin, though we have little in common (like, for example, I am NOT rich) aside from the fact that we both went to Barnard. Still, I’ve always felt like she was my strange, dark and so smart older sister, the one who was into S&M. The one who could show me what not to do—kind of the way I function for my younger sister. And so when she began writing about depression, I paid attention. As a sister might, with some apprehension. Because it is a minefield; there are so many ways to fail. And it becomes a matter of failing better. And this article, however flawed, was a far better failure than the one in '99, which I read one February night just before getting a call from Dave and we then ended up talking about what it is to write nonfiction/memoir about depression and he noted immediately how dangerous it is, referring to the (then recent) Andrew Solomon book, the Styron memoir, implying or saying that it has been done and done well. So don’t do it? Well, that doesn’t seem to be the kind of advice he would give, but that’s what I took away from the conversation. (Though my memory, as ever, renders me unreliable here.)



(I have more to say about this, I think, but I must go pack. Maybe I'll even post at some point in the coming weeks from our wee cottage in the West of Ireland. Maybe not. But if you read this, or read the article, please tell me what you think/thought. Please talk to me. About I-DEEE-uhs!)

April is the cruelest month, and yet

I have this thing with May.

It starts with my birthday which is okay but only if I work really hard to make it okay and honestly I’ve been working on it since my thirtieth, before that (my twenties) I’d spend the day curled up on a dingy old futon mattress in some walkup apartment in some city that could give a shit for my existential woe. Or I’d be on a fifth floor in some other city, eating my tapioca. Or not eating it, more likely. Sitting in a phone booth, talking to my dad. Having received a bouquet of red roses which how Bell Jar can you get? Roses? Really? I turned 21 that way. With roses. On a fifth floor. And my Dad? Still he sends the Hallmark cards. Still the roses.

And then at 30 I felt a resurgence I got all Marty Seligman on myself, Faking it Till I Make It. Turning the Mind, Radically Accepting, Half-Smiling. Lipstick.

Still. I am starting to believe in chemical depression. Because here I am in May which is beyond Lovely in Chicago in Andersonville with the Swedes and us homos and the lilacs the magnolias in blossom and here I am. Thinking of Death.

But then my birthday is followed by Mother’s Day--which should decidedly be Happy for me, now that I am actually a mother, now that at least in one direction I am a member of the relationship being celebrated—but again gets me all Thinking of Death and loss until my stomach aches while I sit in a Waldorf class with Goo, singing songs about fairies, wondering if Rudolf Steiner was a Nazi, removing myself from any possible interaction with the other mothers, feeling that old familiar lingering sense of entitled longing.

And then yeah.

I will say goodbye to my Women’s Lit students soon and I will try very hard to look each one squarely in the eye to say Thank You to say I Will Miss You but it will be hard not to cry and I will be tempted to gloss over the goodbyes, to not feel. To dissociate. We will have a party a potluck (Bring a dish inspired by your favorite book this term!) we will eat figs (Annie John) and eggs (The Handmaid’s Tale) and Vietnamese sandwiches from Bale (The Lover). Some will eat chicken (Woman at Point Zero) and we may even sip beer (The Awakening).

And then finally there is the end-of-month anniversary of my mom’s death, a day which brings me back to 1980, a day which renders May just one long flowery, bucolic, promising if deceptive journey toward a reminder of ultimate loss. Toward Thinking of Death.

This is my Default Setting for May. And I’ve just read Tim Jacobs lovely review of This is Water wherein he reminded me of DFW’s wise advice and yet still I know all about my Default Setting and I know about Willingness. And I know that DFW knew about it too. And I know that some days we are just not willing. We are unwilling. And I start to believe in the chemicals in the brain that make it easier to go this way. Toward the Unwilling.

I am starting to believe in chemical depression. Which is something that I, you know, don't really believe in.

And I could say more about this but at the moment I'd prefer not to. Default setting and all. Unwilling. Chemically enhanced unwillingness. A serious volition for refusal.