“ANYTIME”…BUT NOT NOW

My ears pricked as I heard a line from the conversation from two women sitting on the two stools beside me in the café. A simple question: “How are you doing?”

 

So ordinary but it stood out. I’d been typing away from my perch for fifteen minutes. The women had preceded my arrival. A lovely back-and-forth between two women in their early seventies. It was clear they were catching up after some time apart. Every so often, one of the women would drop the f-bomb and I kinda loved it. Not delivered with rage. Same conversational tone. But refreshingly unexpected. Human. Be the seventy-something you want to be. 

 

When “How are you doing?” pops up mid-conversation instead of at the start, it means something. It’s not a throwaway alt version of hello. “Fine” or “Good” doesn’t seem to be the acceptable response. Confirming this hunch, I heard the questioner follow with a quick add-on: “Is it okay that I ask?”

 

A few words like sleep and treatment dotted a lengthy response. I made the assumption cancer was in there too, expressly or implied. My ears shut down. They knew this was private. They knew the period of being amused over f-bombs had passed. If another followed, the delivery would be much different. 

 

Oh, how I would love a mid-chat “How are you doing?” It doesn’t come. I can almost see the person I’m with doing an artful dance around it. Let’s maintain some levity, shall we? Laughter is good medicine, after all. Even when forced. 

 

So many topics. Pick from the following:

A.      “Unseasonable” weather

B.      Recent travels

C.      The Tony Awards (even though neither of us 

         has been to NYC this year)

D.      Any Trump trial

 

Hell, even Gaza or Ukraine will do. Anything but a meaningful “How are you doing?”

 

I totally get that a person with cancer doesn’t want every conversation to be dominated or interrupted by the topic. Sometimes it’s nice to instead posit whether Dua Lipa will have the staying power of Lady Gaga (Hope so.) or even talk about whether Edmonton can make the ultimate comeback in the NHL finals (Shrug.). That’s why the woman’s “Is it okay that I ask?” was a perfect followup. Her companion’s reply: “Of course!”

 

Ask me. 

 

Someone. Anyone.

 

I don’t have cancer. Cancer sucks. F-bomb that. In my family, it was a taboo topic with an asterisk, that little star meaning it wasn’t to be discussed with the person with cancer but was open for discussion with anyone else, a trickle down of intel acquired somehow—did someone break taboo or was it all speculation. I mean, just look at her. 

 

It wasn’t just my family that played things hush-hush. Laura Linney starred for four seasons in a Showtime series called The Big C. To be clear, the nasty c-word was cancer, not the nastier other c-word. I’m perfectly comfortable talking cancer; the other word? Nope. Never. Not even a men’s locker room. (Another c-word comes to mind: cavemen.) 

 

We are getting better at talking directly about tough physical health conditions. Cancer. COVID. AIDS versus HIV. It’s partly because I’m a guy of a certain age but colonoscopy has come up in conversation a few times in the past year. I’m not skittish about the topic, just procedure-averse. Any procedure. I’ll still ask questions. It’s part of acknowledging my friend, inquiring about what he’s going through and whether he has any concerns. A colonoscopy conversation sounds more pressing than his take on the Tony Awards. Let’s talk…if that’s what you need. 

 

The taboo is still entrenched when it comes to mental health. Every time another celebrity comes out about an experience with clinical depression, being bipolar or having an eating disorder, I feel hope just as I did thirty years ago when some famous person came out as gay. 

 

It’s not just me. 

 

There is a public name and face for this “quirk.” Regarding anorexia nervosa, few male celebrities have come forward. (Zayn Malik has referred to food restriction while part of One Direction but the oft-repeated quotes do not include a specific diagnosis. Not so helpful. It doesn’t bring a conversation forward. It’s the equivalent to if George Michael said in 1990 that he’d crushed on a guy. What exactly is that…if anything?)

 

Labels matter. Until they don’t. 

 

Me saying I’m gay? These days, so what. Anorexic? Um…How ’bout dem Tonys?

 

My current downward spiral into severe food restriction—beyond my normal restriction practice—began March 25. This is Day 86, an uninterrupted streak. I’m down to the last hole in my belt, a shift of four holes. My face is gaunt, my arms and legs significantly thinner. So much of the muscle gained through decades of disciplined gym workouts is gone even as I continue the same workouts. Muscle is lost before fat. 

 

There was a point during this streak when my body looked “hot.” Six pack, body fat presumably negligible. (I never weigh myself. When I must step on a scale at a doctor’s office, I close my eyes or stand backwards on the device. I’m very clear with the medical provider: Do not tell me my weight. If I know a number, it feeds into a warped game—how low can I go?)

 

I’m well past the point of “hot.” Now I try not to look because sometimes the sight in the mirror makes me cry. I’m doing damage. I can’t stop.

 

Someone who doesn’t have any understanding of eating disorders could easily say, “Just eat something.” A donut. Two. A lunch. A carrot. Hell, a “baby” carrot.

 

The understanding isn’t there because this is a food-obsessed society. I’m more aware of this when I’m in a phase of severe food restriction. Food is all around me. Ads. Signage. Tossed cups and wrappers. Restaurants. Grocery stores. Overheard conversations. The pair of seventy-somethings have left and, at this moment, sitting beside me, two young women have been talking for fifteen minutes about avocado toast, omelets, fried eggs and poached eggs. On and on and on…It’s progressed to “favorite chocolate bar.” This is what friends are willing to talk about. This is much more in the realm of normal than my current state. 

 

Sights. Smells. Imagined tastes plant themselves on my tongue.

 

I’m on a 3-4 month wait list for outpatient support despite having been officially diagnosed by several psychiatrists, assessing me independently of one another. I’ve previously had an extended hospitalization. I’ve been in a group home. 

 

The referral process started at zero again. 

 

So it’ll be September, maybe October before another round of the same ol’ outpatient oversight. I didn’t buy into before as part of an I’ll-try-anything twenty-one month period in 2018 and 2019. I’m not all that hopeful anything will resonate this time around. But I won’t be alone with this. All the group sessions will be filled with people like me. Sort of. People with eating disorders, at least. Women. Under thirty. But I’ll see and feel their nods as I talk. I’ll nod for them, too. The nods won’t be formalities. Instead, they will mean, I see you; I hear you. 

 

If I continue on the current path, I may wind up in Emergency first.  

 

Again, I can’t stop. Despite what I know rationally, the eating disorder owns me. It’s scary. It’s sad.

 

Whereas people with active eating disorder behaviors typically go to extremes to be secretive, I am open. I am hiding nothing. I have previously opened up in an essay published by CBC, in a podcast and as being the patient on a panel for Toronto nursing students (my co-panelists being a professor and a social worker). If I talk, it may help another guy who is struggling. Maybe he’ll seek help. Maybe interventions will come sooner. Maybe his habits won’t be ingrained over four decades before an initial diagnosis. Maybe he’ll move past it.

 

Right now, I’d love to talk, to be heard, to have someone ask away about what they don’t know or understand. Maybe my conversation will break down stigma and allow that person to “be there” to listen and support someone else…and maybe help me just by letting me babble for a few minutes, feeling heard, feeling less freakish, feeling less alone in all this.  

 

I’ve mentioned to my friends around me I’m struggling. The response is always the same, an empathetic spiel something like the following:

Oh, I’m so sorry. That’s awful. I’m here for you, you know? If you ever need to talk about it—anytime—know that you can talk to me. [Pause to catch a breath.] By the way, did you see The Tony Awards? I’m so glad Daniel Radcliffe won. Aren’t you?

 

No lie. A bizarre segue happens. Every. Single. Time.

 

This is what makes people give up. This is one-sided affirmation. What a good person for offering an ear. Not now, of course. But someday. As long as it remains indefinite, in the future, always beyond reach. 

 

I, in fact, feel worse from this demonstration. I know these are good people. I don’t have tolerance for people who aren’t. But they can’t handle it. Just the topic of mental health is too foreign, too scary, too taboo. 

 

If I hadn’t shared, I could have floated the possibility that Joe or Sue might be supportive. Someday, yes, in the future, always beyond reach. Instead, another door is shut.

 

A dream scenario...

I’m more alone in this just from raising the subject. 

 

How am I doing?

 

Fine.

 

Do you think these gray skies will ever go away?

 

 

 

 

POLITICIZING DEPRESSION

Leave him alone.

 

I’m writing about Senator John Fetterman (D-Pa); more specifically, his depression and going public with it. I’m not going to Google the circumstances. I’m going to be less disciplined, using Twitter bits and pieces that came up in my feed while he was trending upon admission and then upon discharge from hospital. It’s those Twitter bits I find problematic.

 

The man is a politician and, thus, everything about him is politicized. This is particularly so because he represents Pennsylvania and won his seat last November with 51.3% of the vote compared to Republican opponent Mehmet Oz’s 46.3%. A close race though perhaps not as close as predicted. The seat had previously been held by Republican Pat Toomey who chose not to seek re-election after serving two terms. As a “flip” (going from Red to Blue) in a Senate that is precariously tipped in the Democrats’ favor (51 to 49, with three of the senators in the Democrat tally officially being Independents), any vulnerability of the elected senator gets pounced on. If he were a senator from a clearly blue or red state, his depression wouldn’t garner as much attention. People would be less inclined to pounce, saying he’s unfit, speculating he was forced to run for office and forced to stay in office. In Hawaii where Democratic Senator Brian Schatz was re-elected with 71% of the vote or in South Dakota where Republican Senator John Thune was re-elected with 70% of the vote, the hospitalization of either politician wouldn’t garner much attention outside the given state. Should anything dire happen to either senator and a special election were warranted, there would be little chance of the opposing party scoring a surprise win.  

 

I’ve made a point of not scrolling or researching too deeply the reactions to Fetterman’s depression and his hospitalization. Snipes about depression are not good for my own mental health. I have dealt with crushing periods of clinical depression and I too have been treated in hospital. While Fetterman is a public figure and his detractors can say he’s fair game, any pot shots that demonize the man or the disorder, risk harm to Fetterman and others, like me, who have had to find our way up and back.

 

I saw many well-wishers, but quite a few judging the senator and his “handlers.” All of it felt partisan and, frankly, that came off as repugnant. If it were Ron Johnson, the re-elected Republican senator from Wisconsin, edging his Democratic challenger, Mandela Barnes, 50.5% to 49.5%, I suspect the same sentiments would have been expressed, just flipped. And that’s gross. That’s how divided the U.S. is. Let a senator’s mental health struggle be an opportunity to criticize him, to question his fitness, to do a little advance campaigning—does campaign season ever end?—so the electorate will think twice—five years from now when Fetterman’s seat comes up again or next year when the other Democratic senator from Pennsylvania, Bob Casey, is up for re-election.

 

I’m fed up with how mental health is manipulated in U.S. politics. I don’t see caring, deep discussions about how to support people with mental health challenges related to depression, anxiety, schizophrenia or any other condition. That’s not altogether surprising. Most countries are behind the times in dealing with mental health and the United States still hasn’t even figured out a compassionate, reasonable, accessible system to support physical health issues. There’s still a frontier mentality. Look out for yourself (and your family) (and your wallet); everyone else be damned. 

 

I was pleased that mental health received more attention during COVID lockdowns. As people struggled in isolation, anxiety and depression got discussed more but, alas, masks are off and everyone’s moved on. It’s the price of eggs, Gwyneth’s skiing skills and train derailments that are at the forefront now. Depression is a downer to talk about anyway.

 

Mental health only trends now when there’s another mass shooting. Okay, so that means it shows up a lot. But, again, the topic is distorted; it’s villainized. The takeaway: People with mental health struggles shoot up schools and malls and churches and movie theaters and concerts. 

 

Damn! They shoot up a lot. 

 

Who says it’s about guns? “Squirrel!” It’s about crazies. Loose cannons. Pariahs. Don’t even think about letting the welfare of schoolchildren and grocery shoppers impede citizens’ right to AR-15s, ammo buildup and all the gadgets that make killing more efficient. Righteous Second Amendment advocates double down. It’s mental health that’s weaponized. 

 

When news first broke that Senator Fetterman was struggling with depression, I naively—and hopefully—saw it as a different kind of opportunity, not one to doubt his competence and vilify his family, but a chance to chip away at the stigma that continues to exist pertaining to mental health. Depression, anxiety and any number of other conditions are not signs of weakness. They don’t mean the person is flawed. Do we say a person with prostate cancer or shingles is weak and/or flawed? It would be rare for someone with either physical condition to deny their symptoms and refuse to see the doctor. Overall, men take longer to seek treatment for an ache, blood in bowel movements or a circumstance that is slowing them down. Testosterone and a persistent tough guy persona can be a detrimental combo. It’s the same—worse, I suspect—when it comes to mental health. I’m a testosterone-lite dude and it took me decades to seek help for depression, anxiety, a bipolar condition and, sigh, I’ve basically told my psychiatrist to nix other diagnoses. I’m enough of a label queen already. 

 

It's of huge significance that Fetterman checked himself into hospital for treatment and did so publicly. F*#k shame. Never mind work and personal commitments. This was an oxygen-mask-on-oneself-first moment. He couldn’t help his constituents, his family or friends, until he got whatever help he needed, be it therapy, rest, a reset in terms of diet and/or medication. Sickness happens. One of the supposed takeaways from COVID was supposed to be to stay away from work when you’re not well. Rest, see a doctor, get better. 

 

Kudos, Mr. Fetterman. He’s been discharged, presumably stabilized, hopefully on the mend. Those who aren’t in the know will continue to shame and judge him. They’ll question his competence. They’ll scrutinize his actions and inactions. They’ll seek to peddle doubt and to cast depression as a character flaw and a liability. I’m hoping though that other people will respect him for being open about depression, at least on a general level. (He has a right to keep personal aspects private.) Let someone see Fetterman as taking action and being responsible in seeking medical help. Depression can be hellish. That notion that it’s a personal flaw deters people from opening up about it. There’s a damaging perception—I know it well—that a person should be able to turn things around themselves. 

 

I’m hoping Senator Fetterman continues to improve and that he reaches out to the appropriate supports when he experiences setbacks and/or when another devastating round of depression settles in. Let Fetterman’s lead serve as a positive example. Let others get help if and when they need it.

  

 

 

 

988 is a suicide hotline in the United States. In Canada, it’s 1-833-456-4566. Wikipedia lists many international hotlines here.  

A DRUG DEAL GOING DOWN

The following is a piece I wrote back in the fall. It may come across as a bit dark; I suspect that’s why I didn’t post it then. Still, today a major Canadian corporation, Bell Canada, is holding its annual Let’s Talk Day, intended to shed light on mental health issues. Thirty years ago, when I interned at a mental health non-profit agency not far from L.A.’s Skid Row, I could not understand why people would go off their meds. If they do some good, why stop? Now I get it. Stigma is still part of the struggle.

I’ve been seeing psychiatrists for five years now and it still feels strange. Unpleasant even.

I had issues when I was going weekly. One doctor and I clashed. He was intent on proving I fit into a textbook model for depression and tried repeatedly to get me to confess that I was an angry person. He’d bait me with a thesaurus. After I’d share an anecdote, he’d say, “And how’d that make you feel...agitated? Huffy? Furious?” If I had any anger, it was session-specific. I eventually decided it was better to go back on a waiting list than to keep seeing him.

My next weekly guy wanted me to buy into mindfulness. I obligingly bought his chosen book on the subject and couldn’t help but scribble all my objections and skepticism in the margins. No doubt what he was scribbling on his legal pad: Resistant to therapy. After a few assigned readings and some futile attempts to incorporate mindfulness into our sessions, he lost the blinking contest. I would never become a disciple. Our sessions evolved into comfortable conversations. Too comfy, perhaps. I didn’t see myself growing. I was the same old mess. After seeing him for three and a half years, he retired last March.

The breakup seemed harder on him. He fretted over the transition for months. I regularly had to reassure him that I would be okay. I didn’t mention that I looked forward to the change. Maybe a new doctor would have a different perspective. Maybe he or she would offer new insights that might lead to improved ways of coping with my anxiety and depression. If nothing else, I knew my time would be freer. Apparently, psychiatrists who do psychotherapy are a dying—or retiring, at least—breed. No more weekly, fifty-minute sessions.

The pendulum has swung too far in the other direction. My new psychiatrist sees me once every two to three months for what comes off as a random chat, never exceeding ten minutes. I leave each time with the same thought: “What the hell was that for?”

I’m certain I’m not benefiting from these brief sit-downs. (Does the chair even get warm?) Still, I have to go. It’s all come down to drugs. He’s my dealer. Today’s appointment feels especially unsavory. Part of it is the setting. My psychiatrist has been assigned not based on my needs or any matching criteria; rather, he works out of the provincial health unit closest to me and he apparently had a space. While I live on the edge of the sketchiest part of Vancouver, his office is in the thick of it. To get to the building, I walk by addicts passed out or pawning their wares on Hastings Street and then take a zig and a zag until I’m alongside the tented homeless community that has taken over Oppenheimer Park for years. The glass door of the office I enter is decorated with the message, NO NARCOTICS ON SITE. I guess the hardware store was out of welcome mats. I arrive, carrying my laptop without my version of the Linus blanket, my Herschel backpack. (At the end of my first appointment, my psychiatrist eyed my backpack on the floor and warned me about a chronic bed bug problem in the building.)

Yeah, so the stage is always set for an unsavory kind of feeling. It gets worse as I dutifully answer his left-field questions—“What’s your writing process?”; “Did you like teaching?”—knowing that the Q and A leads to nothing. He’s going through the motions and, frankly, so am I. All I want is the slip of paper that comes whenever he suddenly decides time’s up. Gimme the prescription.

The sad reality is I can relate to the people I pass on my way over. I’ve learned the hard way, through trial and serious error, that I don’t function without my drugs. Rather, I dysfunction. Grandly. I spiral quickly downward, the bubble wrap coming off what had been neatly packed and stowed boxes of gloom, doom and utter despair. I frighten myself and doctors. I get locked up.

As I fold the paper I’ve come for, pocket it and leave the building, I feel dirty and ashamed. I fret as I have so many times before, wondering what the long-term harm may be from taking these pills. I flirt with a timeline for when I may once again go drug-free, cold turkey. I’ve been stable for almost four months now. My recently retired psychiatrist told me on several occasions that I’d be on meds for the rest of my life. (“Think of it like a diabetic who needs insulin,” I’ve been told by several well-intentioned professionals.) Still, I hold out hope that maybe I’ll learn some effective strategies to work through anxiety without needing to reach for an Ativan and I’ll be able to talk myself through heretofore crippling bouts of prolonged depression without Seroquel or Abilify or Mirtazapine. But I know I’m not going to learn any strategies from my bimonthly chitchats with my current psychiatrist. And the lift I get from a current pop song like this or that is fleeting. I don’t have answers now and I have plenty of bad memories from psych wards and meltdowns in doctors’ offices. Despite the bargaining, wishing and protesting, there is only one option: I have to stay on drugs.

By the time I walk back past the tent city, around the woman on the sidewalk nonchalantly shoving a needle into a vein in her arm and dodge several zombie impersonators walking wobbly lines, I know I can’t really relate to these neighbors. I catch a couple hugging and see groups huddled together. I hear laughter, some of it with another person by their side, some of it alone, and it’s our differences that are more pronounced. They are the ones who have all the connections they need.

I walk into my drugstore, have a seat in front of a familiar pharmacist and pull out my paper, my doctor’s note that hooks me up for the next ninety days. I try to smile and make eye contact but mostly I stare at my right knee, bobbing up and down, one hundred fifty times per minute. With only a glance at the piece of paper that I slide across the counter, he knows I’m not here on account of a persistent hemorrhoid issue, a case of the crabs or the latest flu strain. Those things shall pass. As many times as I’ve done this, my face still burns.

When I return in an hour to pick up the prescription, I’ll pay for a bag of chips and a box of Walkers shortbread as well, not on account of any expected surge of the munchies; to the contrary, those items will sit untouched in my cupboard for many months. I just need to normalize the experience, like how I load up a basket of groceries when the only pressing purchase is a twelve-roll package of toilet paper. Pharmacists and grocery clerks know too much. I’ll shove the pill bottle in my jacket and go bagless on the chips and cookies. The shame in walking home and coming off as a junk food junkie is nothing.

COVERING UP

Seems I’ve spent too much time hiding what I read.

I remember checking out E.M. Forster’s Maurice from a Dallas library and being relieved that it was one of those old hard covers without any illustration or adornment. Title, author, that’s all. (Maybe that’s where the expression, You can’t judge a book by its cover came from…a time when you, quite literally, couldn’t.)

I wasn’t one to check out a lot of gay fiction from libraries. Fear? Perhaps. But back then I wasn’t much of a novel reader in the first place. Newspapers, magazines and way too many textbooks provided enough—too much—reading for my liking. I filled much of my free time watching hours and hours of television.  Maybe that proved to be a good thing. If I’d read even a few gay novels, I might have concluded that, once out, my social circle would consist of gay prostitutes. I might still be in the closet.

Somehow I mustered up the gumption to buy Randy Shilts’ And the Band Played On: Politics, People and the AIDS Epidemic while still living in Dallas. I don’t remember where I bought it. I can’t imagine twenty-three-year-old me doing it without having to take a shower as soon as I got home. No doubt, I bought a few other books—never read?—at the same time so I could sandwich The AIDS Book in between them. Maybe the cashier wouldn’t notice the word AIDS in bold letters on the cover. Maybe he or she would see the word Band and think I was a musician. But maybe not. This was 1987 in the midst of the AIDS crisis when people talked about getting it from toilet seats and water fountains. Call it an act of enlightenment that the clerk didn’t put on a pair of latex gloves just to handle the book. (I’d have remembered that.) I am certain I was red-faced and sheened in a layer of perspiration by the time my books were bagged and I rushed for the exit.

When I moved to L.A. two years later, I could buy books without embarrassment at A Different Light bookstore in West Hollywood. A gay bookstore! How wonderful to browse without having to wander away for a single Gay and Lesbian shelf in the Self’-Help section of regular bookstores. (The message I took always away was that, if you were gay, you needed help.) Still, I appreciated having a plain paper bag to take the books back to the car.

I’d also pick up a copy of Edge, the free gay newspaper of the time, whenever I was in West Hollywood. No bag to hide it from view. I was not so ironically on edge about Edge as I carried it back to my car. I worried that the wrong person might see the name on the front cover. If I folded it so the back cover was in sight, things were worse. Invariably, the back had a full-page advertisement for a gay chat line with an alluring image of buff boys in jock straps. I felt like I presented a clear target for anyone venturing to West Hollywood wishing to bash a fag.

Fortunately, I’ve evolved. But then so has society. In fact, my ability to buy a gay book—even one with a let’s-be-clear title like Two Boys Kissing—without going red in the face may be more about society’s enlightenment than my own personal comfort level. The lion in The Wizard of Oz oozed courage than I do.

I felt shame again today as I stepped up to order a Frappuccino at Starbucks. I had about an hour to kill before my appointment with my psychiatrist and I had pulled my current read from my backpack. While paying, I set the book on the counter. The barista glanced at the cover and I realized the title was in clear view with an even clearer title: Marbles: Mania, Depression, Michelangelo, & Me. I quickly flipped to the back cover. An obvious signal that I didn’t want the guy to read it, right? Well, he went out of his way to bend over and read the spine. I was momentarily mortified.

And then I regained composure and shrugged it off. So what if he saw the title? Why should I care if he concludes that I have a mental health problem? My problem, true enough, but in this context, not my problem.

Maybe there’s a smidgen of personal growth. Give it another decade or two and I won’t give a flip what people think about my books…assuming books still exist as we know them!