Hell And Back
A chronicler of the storm is crushed by its sorrows. A skeptic on depression is consumed by a disease he doesn't believe in. A man teetering on the cliff finds his salvation in an unexpected place: modern medicine.
Sunday, October 22, 2006
Chris Rose
I pulled into the Shell station on Magazine Street, my car running on fumes. I turned off the motor. And then I just sat there.
There were other people pumping gas at the island I had pulled into and I didn't want them to see me, didn't want to see them, didn't want to nod hello, didn't want to interact in any fashion.
Outside the window, they looked like characters in a movie. But not my movie.
I tried to wait them out, but others would follow, get out of their cars and pump and pay and drive off, always followed by more cars, more people. How can they do this, like everything is normal, I wondered. Where do they go? What do they do?
It was early August and two minutes in my car with the windows up and the air conditioner off was insufferable. I was trapped, in my car and in my head.
So I drove off with an empty tank rather than face strangers at a gas station.
. . . . . . .
Before I continue this story, I should make a confession. For all of my adult life, when I gave it thought -- which wasn't very often -- I regarded the concepts of depression and anxiety as pretty much a load of hooey.
I never accorded any credibility to the idea that such conditions were medical in nature. Nothing scientific about it. You get sick, get fired, fall in love, get laid, buy a new pair of shoes, join a gym, get religion, seasons change -- whatever; you go with the flow, dust yourself off, get back in the game. I thought anti-depressants were for desperate housewives and fragile poets.
I no longer feel that way. Not since I fell down the rabbit hole myself and enough hands reached down to pull me out.
One of those hands belonged to a psychiatrist holding a prescription for anti-depressants. I took it. And it changed my life.
Maybe saved my life.
This is the story of one journey -- my journey -- to the edge of the post-Katrina abyss, and back again. It is a story with a happy ending -- at least so far.
. . . . . . .
I had already stopped going to the grocery store weeks before the Shell station meltdown. I had made every excuse possible to avoid going to my office because I didn't want to see anyone, didn't want to engage in small talk, hey, how's the family?
My hands shook. I had to look down when I walked down the steps, holding the banister to keep steady. I was at risk every time I got behind the wheel of a car; I couldn't pay attention.
I lost 15 pounds and it's safe to say I didn't have a lot to give. I stopped talking to Kelly, my wife. She loathed me, my silences, my distance, my inertia.
I stopped walking my dog, so she hated me, too. The grass and weeds in my yard just grew and grew.
I stopped talking to my family and my friends. I stopped answering phone calls and e-mails. I maintained limited communication with my editors to keep my job but I started missing deadlines anyway.
My editors, they were kind. They cut me slack. There's a lot of slack being cut in this town now. A lot of legroom, empathy and forgiveness.
I tried to keep an open line of communication with my kids to keep my sanity, but it was still slipping away. My two oldest, 7 and 5, began asking: "What are you looking at, Daddy?"
The thousand-yard stare. I couldn't shake it. Boring holes into the house behind my back yard. Daddy is a zombie. That was my movie: Night of the Living Dead. Followed by Morning of the Living Dead, followed by Afternoon . . .
. . . . . . .
My own darkness first became visible last fall. As the days of covering the Aftermath turned into weeks which turned into months, I began taking long walks, miles and miles, late at night, one arm pinned to my side, the other waving in stride. I became one of those guys you see coming down the street and you cross over to get out of the way.
I had crying jags and fetal positionings and other "episodes." One day last fall, while the city was still mostly abandoned, I passed out on the job, fell face first into a tree, snapped my glasses in half, gouged a hole in my forehead and lay unconscious on the side of the road for an entire afternoon.
You might think that would have been a wake-up call, but it wasn't. Instead, like everything else happening to me, I wrote a column about it, trying to make it all sound so funny.
It probably didn't help that my wife and kids spent the last four months of 2005 at my parents' home in Maryland. Until Christmas I worked, and lived, completely alone.
Even when my family finally returned, I spent the next several months driving endlessly through bombed-out neighborhoods. I met legions of people who appeared to be dying from sadness, and I wrote about them.
I was receiving thousands of e-mails in reaction to my stories in the paper, and most of them were more accounts of death, destruction and despondency by people from around south Louisiana. I am pretty sure I possess the largest archive of personal Katrina stories, little histories that would break your heart.
I guess they broke mine.
I am an audience for other people's pain. But I never considered seeking treatment. I was afraid that medication would alter my emotions to a point of insensitivity, lower my antenna to where I would no longer feel the acute grip that Katrina and the flood have on the city's psyche.
I thought, I must bleed into the pages for my art. Talk about "embedded" journalism; this was the real deal.
Worse than chronicling a region's lamentation, I thought, would be walking around like an ambassador from Happy Town telling everybody that everything is just fine, carry on, chin up, let a smile be your umbrella.
As time wore on, the toll at home worsened. I declined all dinner invitations that my wife wanted desperately to accept, something to get me out of the house, get my feet moving. I let the lawn and weeds overgrow and didn't pick up my dog's waste. I rarely shaved or even bathed. I stayed in bed as long as I could, as often as I could. What a charmer I had become.
I don't drink anymore, so the nightly self-narcolepsy that so many in this community employ was not an option. And I don't watch TV. So I developed an infinite capacity to just sit and stare. I'd noodle around on the piano, read weightless fiction and reach for my kids, always, trying to hold them, touch them, kiss them.
Tell them I was still here.
But I was disappearing fast, slogging through winter and spring and grinding to a halt by summer. I was a dead man walking.
I had never been so scared in my life.
. . . . . . .
Early this summer, with the darkness clinging to me like my own personal humidity, my stories in the newspaper moved from gray to brown to black. Readers wanted stories of hope, inspiration and triumph, something to cling to; I gave them anger and sadness and gloom. They started e-mailing me, telling me I was bringing them down when they were already down enough.
This one, Aug. 21, from a reader named Molly: "I recently became worried about you. I read your column and you seemed so sad. And not in a fakey-columnist kind of way."
This one, Aug. 19, from Debbie Koppman: "I'm a big fan. But I gotta tell ya -- I can't read your columns anymore. They are depressing. I wish you'd write about something positive."
There were scores of e-mails like this, maybe hundreds. I lost count. Most were kind -- solicitous, even; strangers invited me over for a warm meal.
But this one, on Aug. 14, from a reader named Johnny Culpepper, stuck out: "Your stories are played out Rose. Why don't you just leave the city, you're not happy, you bitch and moan all the time. Just leave or pull the trigger and get it over with."
I'm sure he didn't mean it literally -- or maybe he did, I don't know -- but truthfully, I thought it was funny. I showed it around to my wife and editors.
Three friends of mine have, in fact, killed themselves in the past year and I have wondered what that was like. I rejected it. But, for the first time, I understood why they did it.
Hopeless, helpless and unable to function. A mind shutting down and taking the body with it. A pain not physical but not of my comprehension and always there, a buzzing fluorescent light that you can't turn off.
No way out, I thought. Except there was.
. . . . . . .
I don't need to replay the early days of trauma for you here. You know what I'm talking about.
Whether you were in south Louisiana or somewhere far away, in a shelter or at your sister's house, whether you lost everything or nothing, you know what I mean.
My case might be more extreme than some because I immersed myself fully into the horror and became a full-time chronicler of sorrowful tales. I live it every day and there is no such thing as leaving it behind at the office when a whole city takes the dive.
Then again, my case is less extreme than the first responders, the doctors and nurses and EMTs, and certainly anyone who got trapped in the Dome or the Convention Center or worse -- in the water, in their attics and on their rooftops. In some cases, stuck in trees.
I've got nothing on them. How the hell do they sleep at night?
So none of this made sense. My personality has always been marked by insouciance and laughter, the seeking of adventure and new experiences. I am the class clown, the life of the party, the bon vivant.
I have always felt like I was more alert and alive than anyone in the room.
In the measure of how one made out in the storm, my life was cake. My house, my job and my family were all fine. My career was gangbusters; all manner of prestigious awards and attention. A book with great reviews and stunning sales, full auditoriums everywhere I was invited to speak, appearances on TV and radio, and the overwhelming support of readers who left gifts, flowers and cards on my doorstep, thanking me for my stories.
I had become a star of a bizarre constellation. No doubt about it, disasters are great career moves for a man in my line of work. So why the hell was I so miserable? This is the time of my life, I told myself. I am a success. I have done good things.
To no avail.
I changed the message on my phone to say: "This is Chris Rose. I am emotionally unavailable at the moment. Please leave a message."
I thought this was hilarious. Most of my friends picked it up as a classic cry for help.
My editor, my wife, my dad, my friends and just strangers on the street who recognized me from my picture in the paper had been telling me for a long time: You need to get help.
I didn't want help. I didn't want medicine. And I sure as hell didn't want to sit on a couch and tell some guy with glasses, a beard and a psych degree from Dartmouth all about my troubles.
Everybody's got troubles. I needed to stay the course, keep on writing, keep on telling the story of this city. I needed to do what I had to do, the consequences be damned, and what I had to do was dig further and further into what has happened around here -- to the people, my friends, my city, the region.
Lord, what an insufferable mess it all is.
I'm not going to get better, I thought. I'm in too deep.
. . . . . . .
In his book "Darkness Visible: A Memoir of Madness" -- the best literary guide to the disease that I have found -- the writer William Styron recounted his own descent into and recovery from depression, and one of the biggest obstacles, he said, was the term itself, what he calls "a true wimp of a word."
He traces the medical use of the word "depression" to a Swiss psychiatrist named Adolf Meyer, who, Styron said, "had a tin ear for the finer rhythms of English and therefore was unaware of the damage he had inflicted by offering 'depression' as a descriptive noun for such a dreadful and raging disease.
"Nonetheless, for over 75 years the word has slithered innocuously through the language like a slug, leaving little trace of its intrinsic malevolence and preventing, by its very insipidity, a general awareness of the horrible intensity of the disease when out of control."
He continued: "As one who has suffered from the malady in extremis yet returned to tell the tale, I would lobby for a truly arresting designation. 'Brainstorm,' for instance, has unfortunately been preempted to describe, somewhat jocularly, intellectual inspiration. But something along these lines is needed.
"Told that someone's mood disorder has evolved into a storm -- a veritable howling tempest in the brain, which is indeed what a clinical depression resembles like nothing else -- even the uninformed layman might display sympathy rather than the standard reaction that 'depression' evokes, something akin to 'So what?' or 'You'll pull out of it' or 'We all have bad days.' "
Styron is a helluva writer. His words were my life. I was having one serious brainstorm. Hell, it was a brain hurricane, Category 5. But what happens when your own personal despair starts bleeding over into the lives of those around you?
What happens when you can't get out of your car at the gas station even when you're out of gas? Man, talk about the perfect metaphor.
Then this summer, a colleague of mine at the newspaper took a bad mix of medications and went on a violent driving spree Uptown, an episode that ended with his pleading with the cops who surrounded him with guns drawn to shoot him.
He had gone over the cliff. And I thought to myself: If I don't do something, I'm next.
. . . . . . .
My psychiatrist asked me not to identify him in this story and I am abiding by that request.
I was referred to him by my family doctor. My first visit was Aug. 15. I told him I had doubts about his ability to make me feel better. I pled guilty to skepticism about the confessional applications of his profession and its dependency medications.
I'm no Tom Cruise; psychiatry is fine, I thought. For other people.
My very first exchange with my doctor had a morbidly comic element to it; at least, I thought so, but my sense of humor was in delicate balance to be sure.
While approaching his office, I had noticed a dead cat in his yard. Freshly dead, with flies just beginning to gather around the eyes. My initial worry was that some kid who loves this cat might see it, so I said to him: "Before we start, do you know about the cat?"
Yes, he told me. It was being taken care of. Then he paused and said: "Well, you're still noticing the environment around you. That's a good sign."
The analyst in him had already kicked in. But the patient in me was still resisting. In my lifelong habit of dampening down any serious discussion with sarcasm, I said to him: "Yeah, but what if the dead cat was the only thing I saw? What if I didn't see or hear the traffic or the trees or the birds or anything else?"
I crack myself up. I see dead things. Get it?
Yeah, neither did he.
We talked for an hour that first appointment. He told me he wanted to talk to me three or four times before he made a diagnosis and prescribed an antidote. When I came home from that first visit without a prescription, my wife was despondent and my editor enraged. To them, it was plain to see I needed something, anything, and fast.
Unbeknownst to me, my wife immediately wrote a letter to my doctor, pleading with him to put me on medication. Midway through my second session, I must have convinced him as well because he reached into a drawer and pulled out some samples of a drug called Cymbalta.
He said it could take a few weeks to kick in. Best case, he said, would be four days. He also said that its reaction time would depend on how much body fat I had; the more I had, the longer it would take. That was a good sign for me. By August, far from putting on the Katrina 15, I had become a skeletal version of my pre-K self.
And before I left that second session, he told me to change the message on my phone, that "emotionally unavailable" thing. Not funny, he said.
. . . . . . .
I began taking Cymbalta on Aug. 24, a Thursday. With practically no body fat to speak of, the drug kicked in immediately. That whole weekend, I felt like I was in the throes of a drug rush. Mildly euphoric, but also leery of what was happening inside of me. I felt off balance. But I felt better, too.
I told my wife this but she was guarded. I've always heard that everyone else notices changes in a person who takes an anti-depressant before the patient does, but that was not the case with me.
"I feel better," I told Kelly but my long-standing gloom had cast such a pall over our relationship that she took a wait-and-see attitude.
By Monday, I was settled in. The dark curtain had lifted almost entirely. The despondency and incapacitation vanished, just like that, and I was who I used to be: energetic, sarcastic, playful, affectionate and alive.
I started talking to Kelly about plans -- a word lacking from my vocabulary for months. Plans for the kids at school, extracurricular activities, weekend vacations. I had not realized until that moment that while stuck in my malaise, I had had no vision of the future whatsoever.
I wasn't planning anything. It was almost like not living.
Kelly came around to believing. We became husband and wife again. We became friends.
It all felt like a Come to Jesus experience. It felt like a miracle. But it was just medicine, plain and simple.
. . . . . . .
I asked my doctor to tell me exactly what was wrong with me so I could explain it in this story. I will be candid and tell you I still don't really understand it, the science of depression, the actions of synapses, transmitters, blockers and stimulants.
I've never been much at science. I guess I'm just a fragile poet after all.
The diagnoses and treatments for depression and anxiety are still a developing science. The Diagnostic and Statistical Manual of Mental Disorders -- psychiatry's chief handbook -- practically doubles in size every time it's reprinted, filled with newer and clearer clinical trials, research and explanations.
Does that mean more people are getting depressed? Or that science is just compiling more data? I don't know.
Measuring depression is not like measuring blood sugar. You don't hit a specified danger level on a test and then you're pronounced depressed. It is nuance and interpretation and there is still a lot of guesswork involved.
But here's my doctor's take: The amount of cortisol in my brain increased to dangerous levels. The overproduction, in turn, was blocking the transmission of serotonin and norepinephrine.
Some definitions: Cortisol is the hormone produced in response to chronic stress. Serotonin and norepinephrine are neurotransmitters -- chemical messengers -- that mediate messages between nerves in the brain, and this communication system is the basic source of all mood and behavior.
The chemistry department at the University of Bristol in England has a massive Web database for serotonin, titled, appropriately: "The Molecule of Happiness."
And I wasn't getting enough. My brain was literally shorting out. The cells were not properly communicating. Chemical imbalances, likely caused by increased stress hormones -- cortisol, to be precise -- were dogging the work of my neurotransmitters, my electrical wiring. A real and true physiological deterioration had begun.
I had a disease.
This I was willing to accept. Grudgingly, for it ran against my lifelong philosophy of self-determination.
I pressed my doctor: What is the difference between sad and depressed? How do you know when you've crossed over?
"Post-traumatic stress disorder is bandied about as a common diagnosis in this community, but I think that's probably not the case," he told me. "What people are suffering from here is what I call Katrina Syndrome -- marked by sleep disturbance, recent memory impairment and increased irritability.
"Much of this is totally normal. Sadness is normal. The people around here who are bouncing around and giddy, saying that everything is all right -- they have more of a mental illness than someone who says, 'I'm pretty washed out.'
"But when you have the thousand-yard stare, when your ability to function is impaired, then you have gone from 'discomfort' to 'pathologic.' If you don't feel like you can go anywhere or do anything -- or sometimes, even move -- then you are sick."
And that was me.
And if that is you, let me offer some unsolicited advice, something that you've already been told a thousand times by people who love you, something you really ought to consider listening to this time: Get help.
. . . . . . .
I hate being dependent on a drug. Hate it more than I can say. But if the alternative is a proud stoicism in the face of sorrow accompanied by prolonged and unspeakable despair -- well, I'll take dependency.
I can live with it. I can live with anything, I guess. For now.
Cymbalta is a new generation of anti-depressant, a combination of both selective serotonin and norepinephrine re-uptake inhibitors -- SSRIs and SNRIs -- the two common drugs for anxiety and depression.
I asked my doctor why he selected it over, say, Prozac or Wellbutrin or any of the myriad anti-depressants whose brand names have become as familiar as aspirin in our community.
He replied: "It's a roll of the dice." He listened to my story, observed me and made an educated guess. If it didn't work, he said, we'd try something else.
But it worked.
Today, I can bring my kids to school in the morning and mingle effortlessly with the other parents. Crowds don't freak me out. I'm not tired all day, every day. I love going to the grocery store. I can pump gas. I notice the smell of night-blooming jasmine and I play with my kids and I clean up after my dog and the simplest things, man -- how had they ever gotten so hard?
The only effect I have noticed on my writing is that the darkness lifted. I can still channel anger, humor and irony -- the three speeds I need on my editorial stick shift.
And I'm not the only one who senses the change. Everyone tells me they can see the difference, even readers. I'm not gaunt. I make eye contact. I can talk about the weather, the Saints, whatever; it doesn't have to be so dire, every word and motion.
Strange thing is this: I never cry anymore. Ever.
I tell you truthfully that I cried every day from Aug. 29 last year until Aug. 24 this year, 360 days straight. And then I stopped. I guess the extremes of emotion have been smoothed over but, truthfully, I have shed enough tears for two lifetimes.
Even at the Saints' "Monday Night Football" game, a moment that weeks earlier would have sent me reeling into spasms of open weeping, I held it together. A lump in my throat, to be sure, but no prostration anymore.
The warning labels on anti-depressants are loaded with ominous portent, everything from nausea to sexual dysfunction and, without going into more detail than I have already poured out here, let's just say that I'm doing quite well, thank you.
It's my movie now. I am part of the flow of humanity that clogs our streets and sidewalks, taking part in and being part of the community and its growth. I have clarity and oh, what a vision it is.
But I am not cured, not by any means. Clinical trials show Cymbalta has an 80-percent success rate after six months and I'm just two months in. I felt a backwards tilt recently -- the long stare, the pacing, it crept in one weekend -- and it scared me so badly that I went to my doctor and we agreed immediately to increase the strength of my medication.
Before Katrina, I would have called somebody like me a wuss. Not to my face. But it's what I would have thought, this talk of mood swings and loss of control, all this psychobabble and hope-dope.
What a load of crap. Get a grip, I would have said.
And that's exactly what I did, through a door that was hidden from me, but that I was finally able to see.
I have a disease. Medicine saved me. I am living proof.
Emphasis on living.
. . . . . . .
Columnist Chris Rose can be reached at chris.rose@timespicayune.com, or (504) 826-3309, or (504) 352-2535.
