Let’s get on top of this pain as well they say. Diclofenac doesn’t work so they hand you a prescription for Tramacet and Tramadol, opiates, good for pain they say. Take two tablets, four times a day, they say. They add in Duloxetine. Good for both pain and depression, they say. What a bonus. One day, you wake up to find that you’re addicted to the opiates and the pain is still there. You make arrangements for the children to stay elsewhere for a while and you stop the pills cold turkey and go through withdrawal. Five painful days of body shakes and sickness and diarrhoea and uncontrollable sneezing and ants crawling behind your eyeballs. You are alone and think you’re going to die from this and you call for help. A doctor comes and sits with you for an hour or so in the small hours. He tells you that you’re not going to die but you realise that he thinks you’re a junkie. You don’t sleep for days. You think you’ll never sleep again.
Zopiclone, they say, to help you sleep.
Codeine, they suggest, as an alternative to the pain.
Lorazepam and Diazepam to manage your anxiety. It will help with the pain too. Propranolol to control your heart rate.
Time goes on. And on it goes.
Gabapentin makes your teeth ache.
Pregabalin’s the same.
Risk of tooth loss says Google, so you put them at the back of the cupboard.
They’re not working, you say, and they peer through your notes. Describe your symptoms they say, but they’re not really listening.
You look out of the window. Get me out of here, you think.
Ok, you say, and you think of how to explain it.
You can’t, so you go home and you smoke too many cigarettes and you drink too much and it seems to help you more than the pills but you know you’ve failed.
Not working? They say, when you return for round three.
Bipolar, they ponder, Type 1, no, Type 2, they puzzle aloud. Cyclothymia, hypermania. A mood disorder, a disordered mood. SSRIs won’t work.
Pen taps on paper, then scribbles the punishment.
No. You say. Surprising yourself.
Depakote then. Sodium Valproate.
Ok, you say, but just to end the conversation.
But don’t get pregnant. They say.
Ok, you say.
Round four, you’re desperate. We’ll add in another, they say.
Sertraline this time.
Venlafaxine. You feel electricity jolt through your brain when you turn your head; ECT in a little pill. You feel curiously blinkered as peripheral vision seems to disappear, which makes you feel a bit crazy. At least you can justify this habit of swallowing the pill each morning.
Next time is in hospital. You’re mad with the frustration of being misunderstood and feeling the same so round six is serious.
Anti-psychotics to keep you sedated. It’s haloperidol this time and there’s no discussion because there is no choice.
You come to a couple of days later and find yourself partially naked on top of the covers, your brain doesn’t function as usual. It’s sluggish and you’re dulled. You can’t remember. You don’t feel like you anymore. You feel like you’re barely there at all. Your door is propped open as you’re easier to observe that way. A male patient walks past and glances at you. You try to cover yourself but your hands don’t work properly.
You need to pee but you can’t. Urine retention, says the nurse. A day of agony before that side effect wanes.
They discuss ECT, this time for real.
You escape by pretending you’re better, but still you suffer.
The years come and the years go.
The labels come and the labels go.
ADHD, they suggest. Often misdiagnosed as depression, they say, especially in women. Tell me what you were like at school, they ask, and you can’t even begin.
Amphetamines this time and you secretly enjoy the effects, a welcome break from reality, but you don’t bother to renew it when you get to the last pill, because you still feel the same as you did when you were closer to twenty than forty. Empty and desperate.
They tell you the bones in your spine are crumbling. Osteopenia, they say, and you’re given Alendronic acid to strengthen them.
You take these without fail even though they make your bones hurt. You feel pain in unusual places. Your wrists, your fingers, your toes and your ankles start to ache and you continue to swallow the pills because you’re frightened and you don’t want your bones to turn to dust.
Then a kind pharmacist looks at you with concern when you pick up the prescription. She invites you into a small room. I have noticed your age, she says. Has anyone thought to tell you – you must never get pregnant if you take these pills. She describes misshapen skulls and twisted little limbs. Are you sure you don’t want to get pregnant? You are thirty-three years old. You’re not sure at all. You feel rage as you see that they had written you off. Mental, crumbling bones, disabled. But you think they’re wrong. You’re young and you’re stronger than they think you are. They had no right to make choices for you, so you put the pills away and it’s a relief as the aches go too, apart from in your wrist. It never goes back to normal.
One day you gather up a plastic bag full of drugs and you take it to the chemist. You ask the pharmacist if they dispose of old medication. She’s friendly and smiles at you. Yes we do, she says, but the atmosphere shifts as does her smile which turns to a frown when she sees the bulging Sainsbury’s bag. She instructs you to empty it into a blue tray and you do. I need to wear gloves for this, she says coldly. She looks at you with disapproval. I need to check this for sharps she says, loudly, and her words crash and ricochet around the room landing on the people who queue silently behind. She picks disdainfully through the packets, so slowly, whilst the people sigh impatiently. They judge you. She has already judged you. She thinks you’re a junkie too. You look like a junkie. You’re sleep deprived and exhausted, but it’s not because of drugs.
She makes you wait until she’s finished, you and your small baby, the sleep thief with his – thank God – normal-shaped head, sweaty and pressed against your chest. Then you escape and go home wrapped up in your shame and shut the door behind you as quickly as you can. You apologise to your baby. You worry about the medication as you put him to your breast. They told you it was safe but they told you a lot of things.
The pills have reduced in number but the habit remains. Once a day, after breakfast, you swallow one pill. An antidepressant. 100 mg. And you ask yourself why you continue this habit when you feel the same as you did during round one, so you try reducing it and put up with the withdrawal but don’t feel any worse than before.
And then finally, one day, after years and years and more years of this, you find yourself in a room with other women, survivors like you, talking. Listening. You listen to others tell their stories and you learn how to tell your own. You find your voice and you begin to feel better. This is the right medicine and it doesn’t involve medication at all.
But your habit remains and you end it, replacing it with vitamin D, which you had always kept in the cupboard but taken sporadically, often forgetting because it didn’t feel as important as the prescribed medication which was given to you with so many promises.
You take these little gold pills and they become your new daily habit, and the ups and downs come and go as they always did, but because you have had the right treatment, you begin to think that you know what to do about that after all.
Your new habit feels positive. The side effects are good. They help your bone density and you feel less tired. You stop falling asleep in the day. You write and you draw. Your brain is firing again and it’s not mania, despite what they think. It’s just you.
You have a story.
You’re breaking your silence.
The more you speak, the better you feel.
You’re a survivor.