Under Water

Every summer we get the public service articles and news casts. “Drowning doesn’t look like drowning!” they tell everyone. And they’re right. Most drownings aren’t made of splashing and screaming. Someone just quietly vanishes into the depths, unable to bring themselves back to the surface where they can breathe. People drown because they’re out of their depth. Because they get too tired. Because once drowning begins, the rational portions of the brain get over ruled by instinctive panic.

Depression is like that too. On the really bad days, people just vanish. I know that my hardest days have me pulling inward, not reaching out. “Get help” everyone says to depressed people, but help is hard to summon if you’re already underwater.

Trial and error is an astonishingly bad way to treat an illness. Unfortunately for many bodily ills, it is all we have. I ran up against this when I had my tumor almost twenty years ago. “Let’s try surgical removal.” the doctors said, only they used many more polysyllabic words. When the tumor came back I was not thrilled to hear “Let’s try surgical removal AND radiation therapy.” It was a relief to talk to the oncologist who walked me through case studies and evidence. He showed me “We know what this is. We can’t guarantee that radiation will work, but it is your best chance.” I took that chance. It was miserable. The emotional after effects took a decade to shake. Yet it worked. I have to remember that in the middle of the process it felt like the doctors were just stabbing away in the dark.

“Have you tried therapy?” “Let’s try this medicine.” “That side effect is unfortunate, let’s try a different medicine instead.” “Well, you have to find the RIGHT therapist. Sometimes it takes a couple of tries.” At first seeking help for mental illness is a hopeful experience. sort of. I don’t know anyone who gets to see a mental health professional before they’re exhausted from managing their issues. You finally get in to see a doctor and that is a triumph. He’s an expert. He’ll know what to do. Then at some point you realize that even the doctors are stabbing in the dark, trying to figure out what will work. They just have a bigger wealth of knowledge and experience. But it is general knowledge, not specific. You have to be the expert on you or on your loved one.

The doctor hands you a flotation device, but you still have to swim to shore. The therapist teaches you how to use your arms and legs effectively, but you still have to swim to shore. Your loved ones want to show up in a boat and rescue you. But this is where the metaphor falls apart a little, because depression doesn’t give you a choice about whether or not you end up in the deep water. Learning to swim is imperative, because sometimes the friends and relatives don’t notice when the drowning happens. They can’t watch all the time. The only way out of the water is to swim. It is hard to watch someone who won’t swim and resists learning.

Lately my life feels like waterworld, no land to be seen, just swimming forever. It doesn’t help when trial and error brings me to a therapist who might be able to help my son if given enough time, but then life events mean that the therapist has to stop being a therapist. I thought we were at a point where we could just keep swimming (Swimming, swimming Dory’s voice sings in my head.) Instead I have decisions to make. Do I continue to use the grad student program and risk another therapist bailing on us? Do I venture out and try to find a different clinic? Do we let it rest for a while and see what the summer brings? I can’t even tell if therapy was accomplishing anything other than to give us a mandatory appointment each week. I’m quite tired of appointments. It also doesn’t help that we’re in a process of switching or adjusting medicines for two kids. I have to second guess all of my decisions.

So when the therapist tells me his news and asks what I’d like to do, I don’t have an answer. Just the soft feel of water closing over my head. Drowning is silent and it doesn’t look like drowning. I don’t stay under water because I learned how to swim long ago. I don’t even know why so small a piece in the ongoing treatment dumps me so deep in the water. I just have to follow my training: Find the surface. Float face up until you have strength to swim. Then start swimming in the direction of the shore. I can’t actually see the shore, but all rational measures tell me it is out there. And I have to remember that only a day or two ago I was out of the water. So were my loved ones. Many of the days are good and even on my worst days I can think of a dozen people with whom I would not trade troubles.

So on the swimming days, I’ll keep swimming. And I’ll excuse myself from some of the expectations. And maybe I’ll go watch Finding Nemo and let Dory sing to me.