My experiences with doctors have only amplified this feeling. In Scotland, after seeing me many times about my anxiety, the family doctor told me in my early twenties that it was time I ‘snapped out of it’. Another GP, in Melbourne, treating me for depression recommended I ‘stop being so gloomy’. It felt like the equivalent of asking someone with two broken legs to just make more of an effort and give walking a crack. Another time, again in Melbourne, when I began having blinding stress headaches, I visited my local medical clinic for help. Exhausted, barely eating, and feeling overwhelmed by the basic demands of life, I didn’t know what I needed. But what I got wasn’t it.
As I walked into the consulting room, a silver-haired lady was hammering the keys on her computer, eyes fixed to the screen as she pushed a sheet of paper across the desk. Having been on the mental health merry-go-round for some years, the form was familiar to me. The Kessler Psychological Distress Scale is a universally recognised tick-box exercise designed to determine the severity of a person’s depression. The questions are brutally direct and immediately focus the mind on just how fucked up one’s life has become. During the last 30 days, how often did you feel hopeless? … During the last 30 days, how often did you feel so nervous that nothing could calm you down? … How often did you feel so sad nothing could cheer you up? There are ten questions, all in a similar vein, scored from one to five, with one being ‘none of the time’ and five ‘all of the time’. Your number reveals your current state. Under 20 is well. Over 30 is a severe mental-health disorder.
The doctor totted up my scores. ‘You got 25, which means you’re only mild to moderately depressed, so there’s not much to worry about.’
I was crying so hard that snot was dribbling from my nose. She didn’t look up, and began scribbling on a prescription pad. I’d been on and off antidepressants since I was in high school. I wasn’t convinced they had made much difference. This time I wanted an alternative. Or at least to discuss the options. My questions seemed to frustrate her. Medication would help, she insisted. I didn’t have the energy to fight so I urged her not to prescribe the class of antidepressants I’d been on as a teenager, which had given me horrendous withdrawal symptoms when I came off them. For several weeks it felt as if electric shocks were zapping my brain as I grappled with crippling dizziness and tremors travelling up and down my body.
The doctor totted up my scores. ‘You’re only mild to moderately depressed, so there’s not much to worry about.’
‘They’re the best antidepressants we have,’ she said.
‘Maybe not for me,’ I mumbled.
She sighed and reluctantly agreed to put me on an older generation of antidepressant medication. But not before asking, ‘Are you suicidal?’
I thought about it for a while and said no.
‘Good,’ she said. ‘These ones aren’t prescribed very often these days because they’re much easier to overdose on. But you’re not suicidal, so that’s fine.’
The whole interaction was over in 15 minutes. And now, I had the knowledge that should I want to kill myself, the drugs she’d prescribed were well equipped for the job.
So on a hot October morning in 2014, when I realised I could no longer carry on without help, I was less than confident about finding it. By now, I was having daily panic attacks in even the most benign circumstances – with friends, on the tram, lying in bed staring at the ceiling at night. Being awake was becoming an exercise in unremitting terror.
I chose a medical practice that my friend Loretta, a free-spirited yoga teacher, recommended. She said the doctors were particularly good with mental-health issues and took an integrative approach that combined Western medicine with modalities such as meditation, Chinese medicine, acupuncture, and nutritional support. The clinic was described online as a ‘wellness centre’ and a ‘community of healing’, which made my sceptical health journo ears prick up. But despite my reservations, I was ready for a different approach.
When the doctor called my name, I shuffled after her into the consultation room. Her name was Fiona – a woman about my age, with a blonde pixie cut and kind eyes. When she asked what she could do for me, I broke down. Then I braced for the judgement and the prescription pad. Instead, she handed me tissues and told me she could see I was in a great deal of pain. Together, she said, we would make a plan to get me to a place where living was not so hard. And then she asked me to start from the beginning. Not from the start of that week or even that year, but from childhood. She wanted to know everything. It was the first time in more than 20 years that a medical professional assessing my mental health had seen me as a whole person, not just as a collection of symptoms.
In the past, I’d felt that things were happening to me. Now I had a doctor who actively involved me in the decision-making process.
Fiona spent an hour and a half going through my family history, my friends, my school days, my working life. She listened attentively when I listed all the ways in which I was going mad. What made this doctor different was her willingness to share a piece of herself. She wasn’t just a clinician; she was a woman who had suffered, just as I was now suffering. Fiona told me that in 2007 she had volunteered with her husband in Africa, and came home burdened by the awfulness of the world, carrying a sense of hopelessness about her ability to make a difference. They moved to Darwin and she threw herself into her work in emergency medicine. But soon her self-worth was tied to an ideal of what a ‘great’ doctor should be. The more she worked, the louder her inner critic became. She began comparing herself to colleagues but always pulled up short. She finally hit a wall when a two-month-old baby died during her intensive-care rotation. While other staff members expressed their grief, she felt nothing but anger. All she could think was children are dying every minute in Africa and nobody cares. Unable to sleep, and experiencing such intense anxiety that she had developed a tremor, she was on the fast track to burnout. Soon after, she quit emergency medicine, moved into general practice, and became a meditation teacher, with a mission to offer care that went beyond the physical and looked at psychological and spiritual wellbeing. It was her passionate belief that six-minute medicine was failing patients. So she started offering longer consultations, integrating conventional medicine with counselling, cognitive behavioural therapy, healing, and emotional support.
In the past, I’d felt that things were happening to me. Now I had a doctor who actively involved me in the decision-making process. A doctor who didn’t expect me to be cured within a few weeks. She went through a range of possibilities in detail. Medication was discussed, but she stressed this was only an option. There were many other things we could try first. But as a matter of urgency she wanted me to see a psychologist. She jotted down some names. She also suggested that I cut out caffeine and alcohol, start taking a magnesium supplement, and try to get out of the house every day for some exercise, even if it was just a brisk walk. And she wanted to see me again in two days.
By the end of the consultation, it felt as if I’d been in therapy. I was grateful to Fiona for her care, but I was still daunted by the road ahead. My face was drained of colour, my body exhausted with the constant surging panic. I felt small, hunched over in my chair, a shrunken, child version of myself. I glanced down at the chipped polish on my toenails and wondered if there would ever again be a time when I could contemplate something as frivolous as painting my nails. When I looked up, Fiona was watching me. She had tears in her eyes. Before I left, she wrapped me up in a tight hug, and for a moment I felt that perhaps I might survive.
Happy Never After is available now at Readings.
Lifeline operates a free, confidential 24-hour online or telephone crisis support service with trained counsellors: www.lifeline.org.au, 13 11 14.
