(no subject)
You show up in person, because the other option is to make an appointment with a phone call, and you know if it's down to that you'll never, ever go. You tell yourself you have to walk over, and so you do, but all the things it means are so hard to handle that you're a little wobbly by the time you even show up. You don't know the room number, and if there's one thing you know for damn sure you can't handle right now, it's stopping to explain yourself at the front desk, but you know it's on the second floor, so you cut to the side and go up and find it yourself.
The waiting room is a cliche, but the lady behind the desk slides open the plexiglass as you approach, and she's nice, and she doesn't tell you that you're not supposed to be there. Instead, she hears the wobble, or maybe she's just legally obligated, and she asks if it's a crisis, if you need to see someone now. Which--no. You don't. You try to explain that it's okay, you can wait, it doesn't even need to be that soon if it'll inconvenience someone who needs this more, but you can't actually figure out a way to say it without the words "I'm okay", and you can't bring yourself to say those words. You're not okay. If you were, you wouldn't be here. So you stumble and you quaver and you manage to scare the other desk lady into thinking it is a crisis, because of course if you're not able to say that you're okay, they're going to think you're not. Stupid. You'll feel guilty about worrying her for a while later.
"Can you come in at one?" No, no, because at two you need to be back to the rest of your life, doing your job. Keeping it together. It doesn't matter if you're hanging on by the skin of your teeth at that point, and you won't be, you can cope for the rest of the day, you need to show up. There is no 'or else'. Or else nobody's there to teach your afternoon class, and Julie's not even in town to cover for you today, and everything would come tumbling down in disaster and you'd probably get fired or at least lectured and no, no, you need to be there at two. So you can't talk to someone here at one. You can wait until tomorrow. (You can even wait until next week, if you have to. You'll survive it. Probably it won't get that much worse, and you can handle a little worse, anyway.) You don't want to wait until next week, and even though the two desk ladies have a whispered, worried conversation, like you can't hear half of it anyway, about how the people who're supposed to be there tomorrow are flaking off on their responsibilities and they'll have to figure out who to get in to do it and you know somebody's going to be put out, you don't say so. It was hard enough to do this in the first place. Now is...sooner is better.
They tell you to come back tomorrow, then, eight, or eight-thirty, or nine, whenever you can, somebody will be there, they open at eight and whenever you can make it in is just fine. They both look worried even when you say you will. You don't even realize until you're off trying to track down lunch, because bringing it was too much this morning, ok, you could handle making dinner or making today's lunch last night, and you chose to make today's lunch but then you ate it cold from the fridge at 11:30 last night anyway, when you couldn't sleep and couldn't bear to lie in bed any longer--you don't even realize until then that they never even asked your name. Maybe it's a confidentiality thing. Maybe if they had your name, they'd have to hold you to a specific appointment time, rather than just, "Have some one on call for the blonde girl in the lip ring, because she's not okay." You don't know. You handle the rest of the day. You even manage to make dinner, even though there's still ants all over your counters and you can't deal with dishes either before or after. It still counts as a win.
So, you oversleep, nine full hours, maybe to make up for the night before, even though of course you're stil tired when you get up, and you don't have time to do more than grab clothes and your gym bag before you run out the door. The gym bag is important. The gym bag is necessary. It's a Friday, and Monday-Wednesday-Friday gym days are sacrosanct. If you don't bring your bag, you won't be able to make the choice later, and later you'll want to go. And then next week it will be easier to leave the bag at home still. If you stop going once, you'll never get back up again, and there aren't enough things in your life that you can grab onto like this, so you go to the gym. Even if you can't find socks and just bring the ones shoved into your shoes from Wednesday, you go. It's on the google calendar, that means you don't have a choice.
You manage about three bites of pumpkin bread for breakfast, and all of a large turtle mocha, because caffeine. Maybe you should drop your gym bag off at your office, but someone will see you on your way in if you do. They'll stop you. They'll want to talk. And if you get stopped, if you have to talk, if someone asks you how you are, how you're coping, how the work is going....you're not sure what'll happen, but you don't think you can handle it. You've used up all of the week's spoons just making this pseudo-appointment, even though you won't think of it in those terms until much later. That's not a metaphor you get to use. It belongs to the people who're really sick, the ones with viruses, cancers, degenerative joint conditions, with bodies that fall apart around them: the ones with actual problems. You don't get to appropriate it for obstacles that only exist in your head, when the only reason you fall onto the couch and can't manage to do more than maybe either make dinner or have a shower before bed, is all in your head.
The waiting room is the same, still empty, and Jody behind the plexiglass remembers you. She's abrupt when she asks for your student ID, like you'e done something wrong. She shoves a stack of paperwork at you and tells you to fill it out. She's annoyed with her keyboard, which sticks, at her coworker for commenting on the coffee she made earlier, at the computer system. You've got a stack of forms and waivers. Signing things, writing down names and addresses and facts, you can do that. Describe how you feel? You've been trying to figure out for two days how you're ever going to manage to say that in person, so they don't smile at you, patronizingly, and tell you that you're not depressed, you're just unhappy, but they can put you into contact with the study-skills management people so you can lick that procrastination habit once and for all; pat you pityingly and patronizingly and then later bitch or shake their heads over coffee about poor saps who think they have problems, looking for attention or maybe just prescription drugs. You do your best.
Meanwhile, Jody and Stella are talking about you behind the plexiglass. You can hear their whole conversation, even though they ignore you when you ask what the date is. They haven't kicked you out so far, she didn't look up from the computer when you first handed over your student ID and tell you that, sorry, we can't give you any more services, because you haven't paid those bills from student health that keep coming to your apartment, from that one time those months ago that you actually got up and took responsible care for your self and got that checkup that you thought the insurance was supposed to cover. Only then they started sending you bills.
(Getting up the initiative to do simple chores costs a spoon. Unload and reload the dishwasher, on normal days, one spoon. Water the plants, that's a spoon. Feed the snake. Complicated, multi-step chores, that's a spoon for every single component, plus a whole handful at the start to figure out a plan if you want to ever actually get it done. Figure out what you're making for dinner, thaw things, chop things, cook things, clean the pans so you have space on the stove to even work, and will you even be hungry by the end. Doing dishes around the ants. Find the most recent bill in the pile on the table, find the checkbook and write out a check. Acquire envelopes. You could maybe get them at the grocery store, but you can't go to the grocery store just for envelopes. Find a fucking mailbox. And you could do it, you could, but first you have to find out why the insurance didn't cover it in the first place. Nobody has come after you for it yet. You can't. You just can't.)
Jody can't find your enrollment status in the computer system, or the number of hours is confusing her, or something. The papers in your hands helpfully point out that you need to be in at least five credit hours or you'll be charged extra from the student health fee, which. You had not even been worried about before. You'd been too busy trying not to think about how insurance might not cover this, either, and you could pay for the initial appointment, it's cheaper, it's just an intake, but you're not sure you have $65 to spend on every appointment afterwards. You'll handle it, though, you'll handle today today and worry about that when the bill comes, and maybe if today goes right, by then you'll be able to cope with paying bills something like on time. (They turn off your water after about five months, it turns out. You can get it back on the same day, even if you don't get home until after five, but coming at the end of a full day it'll take enough spoons to figure out how that you won't have anything left in the reserve for keeping it together in public. You'll have enough left in you to feel ashamed about that part afterwards, too, but at least you'll have water.) It doesn't help that, every time a check goes out, you know it's another hundred dollars less cached away for the day money's not coming in, the day you wake up in the morning and can't cope, and get out of bed, and take care of yourself well enough to keep your job and your paycheck for another month. You didn't expect to have to pay an extra student health fee on top of everything else, but it's okay. You have the money. You'll just have to borrow it against tomorrow, like your energy, like everything else.
Jody and Stella talk about you behind the plexiglass like you can't hear every word until you finish your paperwork and hand it in, and Jody promises someone will be out to see you shortly. You don't expect it to actually be shortly, but then, you got here over half an hour ago. You were ready then. You had it together. You're shaking now. It was just fucking paperwork, but you're shaking. And it is shortly, just a minute or two, just enough time for you to run through another round of Ways This Can Go Wrong in your head: You get in, and you can't find the words to convince the therapist that you're not okay. They bring you in, and they believe you, and they give you the drugs and they cure the biochemical imbalance and they make you better, and then you turn around at the end of the day, and you realize that even still, without any kind of DSM-IV crutch to blame it on, without any neurochemical excuse, you're still just a fuckup, only now it's all just you. They bring you in and they give you the drugs and you misreact to them, like people do, sometimes, before it gets balanced out right, like that time with the migrane medicine, like Suzanna hiding in her dorm room for three days on end with side effects and green monkeys, and instead of it getting better, it just gets worse. Yesterday you were pretty sure you could handle a little worse, and it's true, but only a little worse. You're pretty sure you can't handle a lot worse. You're already bad enough to be here. It's taking all of what you have to get through the day now.
But you only have time to run through once before the therapist comes out, and smiles, and shakes your hand, and leads you back through the labarynth to her office, and okay. You're in. You got here. It's like flying by yourself: all the stress is in showing up, being on time, handling the song-and-dance routine on your way in, and then you board the plane and just collapse. It's like that, only instead of a plane it's an office with a lot of plants and boxes of tissues and three squishy chairs, and she tells you to just "Pick whichever one you like best", and you blink at her almost blankly, because there are three near-identical squishy chairs and figuring out the right choice right now is the stupidest, simplist thing in the universe, and you probably wouldn't even be having a problem if she hadn't explicitly given you the choice, but she did. And it's a chair, and it's still, somehow, almost too much.
You pick the one in the middle; they all face the desk and the door, more or less, but it's most directly facing both, and there's kleenex on one side and coasters on the other, for your water bottle, so it's okay. It's comfortable. Only you just barely have time to sit down and she's asking you to make another decision, one that actually matters this time: there's a student training to be a therapist who hasn't sat in on a risk assessment before (risk assessment, you think absently to yourself as she explains, that's what they call this. They're checking you for danger. You should probably be pretty clear on the part where you're not suicidal, or they'll worry), and if it's okay with you, he'll sit in and watch and not say anything. And would that be alright? As if, if you knew or could figure out or understood anything about what you wanted right now, what you were okay with, you'd even be here in the first place.
"Oh, god," was about what I managed to say just then. "I have no idea." It is going to be hard enough, your brain has been screaming at you for two days, to even trust one person, you've been afraid you'd screw up talking to her for two days, and now she wants you to trust two? But she waits, patiently, by the door, while you think it over. And finally you say 'yes', because--you're programmed, even now, finally, doing this one thing for yourself, to be as accomodating as possible to everyone else? Because you're still okay, because you don't need it to be a completely private session, because you're not so fucked up that you can't talk in front of another person, a social work student, completely sworn to confidentiality, because you are not so crazy that you can't cope with one completely reasonable request? Or maybe just because it's the most interestingly self-destructive choice. If you say no, that's easy, as much as anything about this is easy, that'll go as well as this might ever have gone. Yes could be a disaster. Maybe it'll be interesting. So you say yes.
You lose it about ten seconds after she leaves. Over a chair and a student observer. That's how wound up this has gotten you. That's how bad this is going to be, how bad you've known it was going to be since Wednesday night, or maybe 1 AM Thursday, when you were crying on the couch and couldn't even pretend you were completely okay any more. Maybe you won't have any trouble convincing her you need help. But it's not going to do anyone any good here if you're not at least coherent. You're wiping mascara streaks away from your eyes when she comes back with the student observer, who comes over and shakes your hand, and they sit down, and you realize, somewhere in all the nerves and panic, that, oh god, there was a right chair to pick and this wasn't it, for God's sake, she's offered you two choices so far and somehow you've gotten them both wrong and one of them was choosing a chair, because she's not sitting down at the desk. She's in one of the big squishy chairs, and he's in the other one, so now you're surrounded. You can't even properly look at both of them at a time. You're so far gone, so far into disaster over all of it, that you don't even think how ridiculous it is that you're getting upset over chosing a chair. You just grab your tissue and hold it, and hold it together while she talks about credentials and confidentiality clauses, and make jokes about universities whose counseling departments didn't have them. Because they exist, and once, you were really upset about that. Maybe because you knew that if you ever made it back in here again, you'd be so screwed up, need them so very badly, that you wouldn't even be able to care.
And then she asks you--something, some reasonable, stupid preliminary question, maybe one of the ones you've been going over in your head again and again and preparing for, maybe just at an angle to them so it jabs you right in the soft parts because you don't have an answer ready. That's what breaks you, not the question itself, just the final culmination of all the terror over getting this right, of making this work, because now that you've admitted you can't handle it all by yourself, this is your last plan. Because oh god, you're not okay, and you can't even hold it together in front of the therapist. About all you can do is at least apologize, even though you're sure you're not the first person to burst into tears in this chair, you're sure you won't be the last. You ought to at least be able to keep yourself under control, but then, you spent all of yesterday just getting through having to admit to yourself that no, you really can't. That shame's been sapping you since you knew you had to come in here in the first place. There's nothing left to keep you back. So you apologize, for being too stressed to manage any more, and then you keep right on apologizing, while you're in the habit of it.
You're sorry how hard this is for you. You're sorry that you're here at all, taking up her time. You're sorry for caving and coming in to bother them and worry the front desk ladies and make Jody work before she's had her coffee in the morning when, if you weren't here, you would be somewhere else, perfectly fine. You'd be in your office, actually getting some of your own mountain of work done. You wouldn't still be home in bed, or still on the couch. You wouldn't be drinking, or smoking, or working on killing yourself fast or slow. You'd be at the lab, working, because you still can--because you are still perfectly capable of dragging yourself out of the apartment in the mornings, of getting breakfast and coffee, one way or another, of going in and of doing what needs to be done. You're perfectly functional, which means that you've got no business being here and you're sorry for putting them out, but you've hated functioning for so long that you're starting to get scared about hitting a point where you're not any more. You're still getting up and getting through a day and doing what needs to be done through it, but still, you're losing so much energy burned in desperate misery that you're afraid that, sooner or later, you're just going to run out.
You've been there before. When you're in your right mind, enough to actually feel fear? It's fucking terrifying.
And, look, you explain to her. You're doing okay now, but maybe preventative measures would be nice, because. Because last time you were already in therapy when you felt like this, before you got too tired to care at all, and stopped going to half your classes and took all those completely pointless long walks in the rain to stare at Lake Michigan and wonder why you even bothered. And you mentioned it to your therapist then, and she got scared and sent you to the staff psychiatrist and put you on drugs, a week and a half before Mother's day, two and a half months after you first showed up babbling about Katy and codependence and wanting to cry all the time and not being able to, and how recently you felt (oh! so mythical!) happy, so you thought you actually deserved to. And they worked, more or less, pulled you back from the really terrifying place before you decided that just breathing took too much work anyway, long before you got so frustrated with having to do so that you actually got off your ass and did something about it.
You've never wanted to die, you explain to her, but. You're a little afraid of how you'll end up if you don't already have a standing appointment with mental health professionals by the time you hit the point where you don't particularly care one way or another about living. Not that it's happened now, but you're pretty sure you won't actually be able to get in here if it does. So.
By this point, you've more or less forgotten about the observer, because he's been good to his word, hasn't made a sound, hasn't even moved in the corner of your eye, and when you glance at him his expression is patient and neutral, which is nice. Because her face is just all awash with sympathy and compassion and pity and a dozen other things you can't read before it makes you look away. Understanding, no shock. She gets it. She hears everything that you don't even want to admit you're saying.
You know you're probably not going to have any more problems convincing your intake therapist that no, really, you do need help when she says, "But your quality of life sounds horrible," like quality of life actually matters.
You know it's long, long past time to have gone to see her when you stare at your computer screen, hours later, and realize that you can't remember when you somehow convinced yourself that it didn't.
You spend an hour saying a thousand different things; you catch yourself at points and realize that you're rambling, starting summaries of your life and taking off in the middle to explain something else, but she listens and nods and asks questions, like she's paying attention and like she actually cares about the answers. You don't even run out of words. She thinks you deserve to be there. She wants you fixed--not as badly as you do, but she believes that there's fixing to be done, and that it can be done. And then she wins a special place in your heart forever--not when she offers to set you up with the psychiatrist, because she believes you that there's something wrong and neurochemical and not just your fault going on in your brain, but when she understands, before you even have to explain all the way, how helpless and wretched and useless you find therapy right now. There is not an angle of your own thoughts you haven't pondered and dissected and tried to find rational rooting for, not a single instant of action, of desire, of fear, you haven't already analyzed a hundred thousand times, alone in your bed at night trying to sleep and not finding it until you're so exhausted and frustrated and helpless that you don't even realize it until you wake up the next morning with your eyes glued together with tears. And as soon as you even start to explain that, yes, if they want you to, you'll go to the therapy, you're willing to do it, but....., she already knows. And she has an answer.
Cognitive Behavioral Therapy. When you go in and talk about things, and instead of just prodding you to talk more, they help you build actual coping mechanisms for the outside world. So you don't end up back here again. So in ten years, when your circumstances have you unhappy again, not another ride around the merry-go-round of chronic relapsing severe depression, but just unhappy, you don't lie in bed at night going over and over your day, your own actions, telling and retellng everything to someone who only exists in your head and searching in vain for ways to make it better next time until you're convinced that every speck of your own misery is your fault, just because you can't think of a way to make it better. So in ten years, you'll already have ways to make it better at your disposal. And in ten months. Depending on how fast your risk assessment therapist can get you in with someone who isn't on an internship that ends at the end of July, you might even have ways of making it better in a few weeks. Your risk assessment therapist is going to be one of your favorite people you'll only ever meet once for the rest of your life.
She makes you an appointment with the psychiatrist, pending you getting bloodwork done downstairs in the rest of the clinic, to make sure off-the-wall endocrine systems or a particularly evil virus aren't to blame, and promises to call you Monday to check in and schedule you with one of the other therapists for CBT. You stay in the room while she does the paperwork, because the chair is cozy, and there's plants, and the waiting room's full of terrible magazines and Jody talking about you behind plexiglass. Josh, the observer, finally says something when you turn towards him for the first time all interview and ask, a little coy, a little arch, a little teasing, what his deep thoughts are. He claims not to have any, but you talk, a little, about the way being shoved up against a dozen people you've never met before, ten feet away from a stage in a dark and dirty little club, shouting at the top of your lungs and just moving, draws you out of all the vast and labarynthine corners of your mind like nothing else. You mention not having a clue what you want to do with the rest of your life, any more, and he and the therapist, whose name is Lisa, who's at her desk now so you can see them both at the same time, refer you to a woman at career services who's apparently amazing, who can maybe help you figure it out, once you can tell the difference between what you hate for being awful and what you hate simply for the sin of being part of the world. You forget her name almost instantly, but it's okay. It's really all going to be okay. You actually believe that, now, finally, and you don't laugh, but you smile a little.
She finally sends you downstairs to make your appointment for your physical, with a referral slip and a two-page report on your diagnosis. Glancing at it is enough to tell you that no, you really don't want to see her interpretation of your symptoms, all the hows and wherefores of how pathetic you are, all neatly printed out in black and white for someone else to see, no matter how much better you're feeling, not while you're still this raw, but you notice the DSM-IV diagnosis anyway, and it almost does make you feel better. DSM-IV-TR 296.32: major depressive disorder, recurrent, moderate. It doesn't sound like you're faking it for the attention. It doesn't even sound like it's entirely your fault.
You put your mascara back on in the bathroom before you leave, and go back to your office, and get to task on the work you really should've started at 8:00 that morning. You make it through the day. You go to the gym, and bump your training schedule up for the end of the week, as planned, and pretend to ignore the twinges in your left leg and especially your left shin, because if you stop your thrice-a-week routine to baby it, you won't start up again, and you're still not half close enough to okay not to need it. You go home.
You water your plants on the way in, because you've only got about two spoons left for the day, and if you don't water them right now, they won't get any. The tomatillo looks pretty sad after the heat of the day, not to mention the poor baby spinach.
You think about making dinner. You think about ordering pizza. You write a livejournal entry entirely in second-person. You think about deleting it instead of hitting 'post'. You think about maybe just e-mailing it to Kitty, so someone will have a record, because you're still too much of a scientist that you quail fundamentally at deleting data. You think about maybe just locking it to yourself and Leslie instead. You do the smart thing, the one that will come back to bite you least and help you most, and lock it so your mother can't see it, so that when you call on Sunday for father's day you don't have to talk about it.
The waiting room is a cliche, but the lady behind the desk slides open the plexiglass as you approach, and she's nice, and she doesn't tell you that you're not supposed to be there. Instead, she hears the wobble, or maybe she's just legally obligated, and she asks if it's a crisis, if you need to see someone now. Which--no. You don't. You try to explain that it's okay, you can wait, it doesn't even need to be that soon if it'll inconvenience someone who needs this more, but you can't actually figure out a way to say it without the words "I'm okay", and you can't bring yourself to say those words. You're not okay. If you were, you wouldn't be here. So you stumble and you quaver and you manage to scare the other desk lady into thinking it is a crisis, because of course if you're not able to say that you're okay, they're going to think you're not. Stupid. You'll feel guilty about worrying her for a while later.
"Can you come in at one?" No, no, because at two you need to be back to the rest of your life, doing your job. Keeping it together. It doesn't matter if you're hanging on by the skin of your teeth at that point, and you won't be, you can cope for the rest of the day, you need to show up. There is no 'or else'. Or else nobody's there to teach your afternoon class, and Julie's not even in town to cover for you today, and everything would come tumbling down in disaster and you'd probably get fired or at least lectured and no, no, you need to be there at two. So you can't talk to someone here at one. You can wait until tomorrow. (You can even wait until next week, if you have to. You'll survive it. Probably it won't get that much worse, and you can handle a little worse, anyway.) You don't want to wait until next week, and even though the two desk ladies have a whispered, worried conversation, like you can't hear half of it anyway, about how the people who're supposed to be there tomorrow are flaking off on their responsibilities and they'll have to figure out who to get in to do it and you know somebody's going to be put out, you don't say so. It was hard enough to do this in the first place. Now is...sooner is better.
They tell you to come back tomorrow, then, eight, or eight-thirty, or nine, whenever you can, somebody will be there, they open at eight and whenever you can make it in is just fine. They both look worried even when you say you will. You don't even realize until you're off trying to track down lunch, because bringing it was too much this morning, ok, you could handle making dinner or making today's lunch last night, and you chose to make today's lunch but then you ate it cold from the fridge at 11:30 last night anyway, when you couldn't sleep and couldn't bear to lie in bed any longer--you don't even realize until then that they never even asked your name. Maybe it's a confidentiality thing. Maybe if they had your name, they'd have to hold you to a specific appointment time, rather than just, "Have some one on call for the blonde girl in the lip ring, because she's not okay." You don't know. You handle the rest of the day. You even manage to make dinner, even though there's still ants all over your counters and you can't deal with dishes either before or after. It still counts as a win.
So, you oversleep, nine full hours, maybe to make up for the night before, even though of course you're stil tired when you get up, and you don't have time to do more than grab clothes and your gym bag before you run out the door. The gym bag is important. The gym bag is necessary. It's a Friday, and Monday-Wednesday-Friday gym days are sacrosanct. If you don't bring your bag, you won't be able to make the choice later, and later you'll want to go. And then next week it will be easier to leave the bag at home still. If you stop going once, you'll never get back up again, and there aren't enough things in your life that you can grab onto like this, so you go to the gym. Even if you can't find socks and just bring the ones shoved into your shoes from Wednesday, you go. It's on the google calendar, that means you don't have a choice.
You manage about three bites of pumpkin bread for breakfast, and all of a large turtle mocha, because caffeine. Maybe you should drop your gym bag off at your office, but someone will see you on your way in if you do. They'll stop you. They'll want to talk. And if you get stopped, if you have to talk, if someone asks you how you are, how you're coping, how the work is going....you're not sure what'll happen, but you don't think you can handle it. You've used up all of the week's spoons just making this pseudo-appointment, even though you won't think of it in those terms until much later. That's not a metaphor you get to use. It belongs to the people who're really sick, the ones with viruses, cancers, degenerative joint conditions, with bodies that fall apart around them: the ones with actual problems. You don't get to appropriate it for obstacles that only exist in your head, when the only reason you fall onto the couch and can't manage to do more than maybe either make dinner or have a shower before bed, is all in your head.
The waiting room is the same, still empty, and Jody behind the plexiglass remembers you. She's abrupt when she asks for your student ID, like you'e done something wrong. She shoves a stack of paperwork at you and tells you to fill it out. She's annoyed with her keyboard, which sticks, at her coworker for commenting on the coffee she made earlier, at the computer system. You've got a stack of forms and waivers. Signing things, writing down names and addresses and facts, you can do that. Describe how you feel? You've been trying to figure out for two days how you're ever going to manage to say that in person, so they don't smile at you, patronizingly, and tell you that you're not depressed, you're just unhappy, but they can put you into contact with the study-skills management people so you can lick that procrastination habit once and for all; pat you pityingly and patronizingly and then later bitch or shake their heads over coffee about poor saps who think they have problems, looking for attention or maybe just prescription drugs. You do your best.
Meanwhile, Jody and Stella are talking about you behind the plexiglass. You can hear their whole conversation, even though they ignore you when you ask what the date is. They haven't kicked you out so far, she didn't look up from the computer when you first handed over your student ID and tell you that, sorry, we can't give you any more services, because you haven't paid those bills from student health that keep coming to your apartment, from that one time those months ago that you actually got up and took responsible care for your self and got that checkup that you thought the insurance was supposed to cover. Only then they started sending you bills.
(Getting up the initiative to do simple chores costs a spoon. Unload and reload the dishwasher, on normal days, one spoon. Water the plants, that's a spoon. Feed the snake. Complicated, multi-step chores, that's a spoon for every single component, plus a whole handful at the start to figure out a plan if you want to ever actually get it done. Figure out what you're making for dinner, thaw things, chop things, cook things, clean the pans so you have space on the stove to even work, and will you even be hungry by the end. Doing dishes around the ants. Find the most recent bill in the pile on the table, find the checkbook and write out a check. Acquire envelopes. You could maybe get them at the grocery store, but you can't go to the grocery store just for envelopes. Find a fucking mailbox. And you could do it, you could, but first you have to find out why the insurance didn't cover it in the first place. Nobody has come after you for it yet. You can't. You just can't.)
Jody can't find your enrollment status in the computer system, or the number of hours is confusing her, or something. The papers in your hands helpfully point out that you need to be in at least five credit hours or you'll be charged extra from the student health fee, which. You had not even been worried about before. You'd been too busy trying not to think about how insurance might not cover this, either, and you could pay for the initial appointment, it's cheaper, it's just an intake, but you're not sure you have $65 to spend on every appointment afterwards. You'll handle it, though, you'll handle today today and worry about that when the bill comes, and maybe if today goes right, by then you'll be able to cope with paying bills something like on time. (They turn off your water after about five months, it turns out. You can get it back on the same day, even if you don't get home until after five, but coming at the end of a full day it'll take enough spoons to figure out how that you won't have anything left in the reserve for keeping it together in public. You'll have enough left in you to feel ashamed about that part afterwards, too, but at least you'll have water.) It doesn't help that, every time a check goes out, you know it's another hundred dollars less cached away for the day money's not coming in, the day you wake up in the morning and can't cope, and get out of bed, and take care of yourself well enough to keep your job and your paycheck for another month. You didn't expect to have to pay an extra student health fee on top of everything else, but it's okay. You have the money. You'll just have to borrow it against tomorrow, like your energy, like everything else.
Jody and Stella talk about you behind the plexiglass like you can't hear every word until you finish your paperwork and hand it in, and Jody promises someone will be out to see you shortly. You don't expect it to actually be shortly, but then, you got here over half an hour ago. You were ready then. You had it together. You're shaking now. It was just fucking paperwork, but you're shaking. And it is shortly, just a minute or two, just enough time for you to run through another round of Ways This Can Go Wrong in your head: You get in, and you can't find the words to convince the therapist that you're not okay. They bring you in, and they believe you, and they give you the drugs and they cure the biochemical imbalance and they make you better, and then you turn around at the end of the day, and you realize that even still, without any kind of DSM-IV crutch to blame it on, without any neurochemical excuse, you're still just a fuckup, only now it's all just you. They bring you in and they give you the drugs and you misreact to them, like people do, sometimes, before it gets balanced out right, like that time with the migrane medicine, like Suzanna hiding in her dorm room for three days on end with side effects and green monkeys, and instead of it getting better, it just gets worse. Yesterday you were pretty sure you could handle a little worse, and it's true, but only a little worse. You're pretty sure you can't handle a lot worse. You're already bad enough to be here. It's taking all of what you have to get through the day now.
But you only have time to run through once before the therapist comes out, and smiles, and shakes your hand, and leads you back through the labarynth to her office, and okay. You're in. You got here. It's like flying by yourself: all the stress is in showing up, being on time, handling the song-and-dance routine on your way in, and then you board the plane and just collapse. It's like that, only instead of a plane it's an office with a lot of plants and boxes of tissues and three squishy chairs, and she tells you to just "Pick whichever one you like best", and you blink at her almost blankly, because there are three near-identical squishy chairs and figuring out the right choice right now is the stupidest, simplist thing in the universe, and you probably wouldn't even be having a problem if she hadn't explicitly given you the choice, but she did. And it's a chair, and it's still, somehow, almost too much.
You pick the one in the middle; they all face the desk and the door, more or less, but it's most directly facing both, and there's kleenex on one side and coasters on the other, for your water bottle, so it's okay. It's comfortable. Only you just barely have time to sit down and she's asking you to make another decision, one that actually matters this time: there's a student training to be a therapist who hasn't sat in on a risk assessment before (risk assessment, you think absently to yourself as she explains, that's what they call this. They're checking you for danger. You should probably be pretty clear on the part where you're not suicidal, or they'll worry), and if it's okay with you, he'll sit in and watch and not say anything. And would that be alright? As if, if you knew or could figure out or understood anything about what you wanted right now, what you were okay with, you'd even be here in the first place.
"Oh, god," was about what I managed to say just then. "I have no idea." It is going to be hard enough, your brain has been screaming at you for two days, to even trust one person, you've been afraid you'd screw up talking to her for two days, and now she wants you to trust two? But she waits, patiently, by the door, while you think it over. And finally you say 'yes', because--you're programmed, even now, finally, doing this one thing for yourself, to be as accomodating as possible to everyone else? Because you're still okay, because you don't need it to be a completely private session, because you're not so fucked up that you can't talk in front of another person, a social work student, completely sworn to confidentiality, because you are not so crazy that you can't cope with one completely reasonable request? Or maybe just because it's the most interestingly self-destructive choice. If you say no, that's easy, as much as anything about this is easy, that'll go as well as this might ever have gone. Yes could be a disaster. Maybe it'll be interesting. So you say yes.
You lose it about ten seconds after she leaves. Over a chair and a student observer. That's how wound up this has gotten you. That's how bad this is going to be, how bad you've known it was going to be since Wednesday night, or maybe 1 AM Thursday, when you were crying on the couch and couldn't even pretend you were completely okay any more. Maybe you won't have any trouble convincing her you need help. But it's not going to do anyone any good here if you're not at least coherent. You're wiping mascara streaks away from your eyes when she comes back with the student observer, who comes over and shakes your hand, and they sit down, and you realize, somewhere in all the nerves and panic, that, oh god, there was a right chair to pick and this wasn't it, for God's sake, she's offered you two choices so far and somehow you've gotten them both wrong and one of them was choosing a chair, because she's not sitting down at the desk. She's in one of the big squishy chairs, and he's in the other one, so now you're surrounded. You can't even properly look at both of them at a time. You're so far gone, so far into disaster over all of it, that you don't even think how ridiculous it is that you're getting upset over chosing a chair. You just grab your tissue and hold it, and hold it together while she talks about credentials and confidentiality clauses, and make jokes about universities whose counseling departments didn't have them. Because they exist, and once, you were really upset about that. Maybe because you knew that if you ever made it back in here again, you'd be so screwed up, need them so very badly, that you wouldn't even be able to care.
And then she asks you--something, some reasonable, stupid preliminary question, maybe one of the ones you've been going over in your head again and again and preparing for, maybe just at an angle to them so it jabs you right in the soft parts because you don't have an answer ready. That's what breaks you, not the question itself, just the final culmination of all the terror over getting this right, of making this work, because now that you've admitted you can't handle it all by yourself, this is your last plan. Because oh god, you're not okay, and you can't even hold it together in front of the therapist. About all you can do is at least apologize, even though you're sure you're not the first person to burst into tears in this chair, you're sure you won't be the last. You ought to at least be able to keep yourself under control, but then, you spent all of yesterday just getting through having to admit to yourself that no, you really can't. That shame's been sapping you since you knew you had to come in here in the first place. There's nothing left to keep you back. So you apologize, for being too stressed to manage any more, and then you keep right on apologizing, while you're in the habit of it.
You're sorry how hard this is for you. You're sorry that you're here at all, taking up her time. You're sorry for caving and coming in to bother them and worry the front desk ladies and make Jody work before she's had her coffee in the morning when, if you weren't here, you would be somewhere else, perfectly fine. You'd be in your office, actually getting some of your own mountain of work done. You wouldn't still be home in bed, or still on the couch. You wouldn't be drinking, or smoking, or working on killing yourself fast or slow. You'd be at the lab, working, because you still can--because you are still perfectly capable of dragging yourself out of the apartment in the mornings, of getting breakfast and coffee, one way or another, of going in and of doing what needs to be done. You're perfectly functional, which means that you've got no business being here and you're sorry for putting them out, but you've hated functioning for so long that you're starting to get scared about hitting a point where you're not any more. You're still getting up and getting through a day and doing what needs to be done through it, but still, you're losing so much energy burned in desperate misery that you're afraid that, sooner or later, you're just going to run out.
You've been there before. When you're in your right mind, enough to actually feel fear? It's fucking terrifying.
And, look, you explain to her. You're doing okay now, but maybe preventative measures would be nice, because. Because last time you were already in therapy when you felt like this, before you got too tired to care at all, and stopped going to half your classes and took all those completely pointless long walks in the rain to stare at Lake Michigan and wonder why you even bothered. And you mentioned it to your therapist then, and she got scared and sent you to the staff psychiatrist and put you on drugs, a week and a half before Mother's day, two and a half months after you first showed up babbling about Katy and codependence and wanting to cry all the time and not being able to, and how recently you felt (oh! so mythical!) happy, so you thought you actually deserved to. And they worked, more or less, pulled you back from the really terrifying place before you decided that just breathing took too much work anyway, long before you got so frustrated with having to do so that you actually got off your ass and did something about it.
You've never wanted to die, you explain to her, but. You're a little afraid of how you'll end up if you don't already have a standing appointment with mental health professionals by the time you hit the point where you don't particularly care one way or another about living. Not that it's happened now, but you're pretty sure you won't actually be able to get in here if it does. So.
By this point, you've more or less forgotten about the observer, because he's been good to his word, hasn't made a sound, hasn't even moved in the corner of your eye, and when you glance at him his expression is patient and neutral, which is nice. Because her face is just all awash with sympathy and compassion and pity and a dozen other things you can't read before it makes you look away. Understanding, no shock. She gets it. She hears everything that you don't even want to admit you're saying.
You know you're probably not going to have any more problems convincing your intake therapist that no, really, you do need help when she says, "But your quality of life sounds horrible," like quality of life actually matters.
You know it's long, long past time to have gone to see her when you stare at your computer screen, hours later, and realize that you can't remember when you somehow convinced yourself that it didn't.
You spend an hour saying a thousand different things; you catch yourself at points and realize that you're rambling, starting summaries of your life and taking off in the middle to explain something else, but she listens and nods and asks questions, like she's paying attention and like she actually cares about the answers. You don't even run out of words. She thinks you deserve to be there. She wants you fixed--not as badly as you do, but she believes that there's fixing to be done, and that it can be done. And then she wins a special place in your heart forever--not when she offers to set you up with the psychiatrist, because she believes you that there's something wrong and neurochemical and not just your fault going on in your brain, but when she understands, before you even have to explain all the way, how helpless and wretched and useless you find therapy right now. There is not an angle of your own thoughts you haven't pondered and dissected and tried to find rational rooting for, not a single instant of action, of desire, of fear, you haven't already analyzed a hundred thousand times, alone in your bed at night trying to sleep and not finding it until you're so exhausted and frustrated and helpless that you don't even realize it until you wake up the next morning with your eyes glued together with tears. And as soon as you even start to explain that, yes, if they want you to, you'll go to the therapy, you're willing to do it, but....., she already knows. And she has an answer.
Cognitive Behavioral Therapy. When you go in and talk about things, and instead of just prodding you to talk more, they help you build actual coping mechanisms for the outside world. So you don't end up back here again. So in ten years, when your circumstances have you unhappy again, not another ride around the merry-go-round of chronic relapsing severe depression, but just unhappy, you don't lie in bed at night going over and over your day, your own actions, telling and retellng everything to someone who only exists in your head and searching in vain for ways to make it better next time until you're convinced that every speck of your own misery is your fault, just because you can't think of a way to make it better. So in ten years, you'll already have ways to make it better at your disposal. And in ten months. Depending on how fast your risk assessment therapist can get you in with someone who isn't on an internship that ends at the end of July, you might even have ways of making it better in a few weeks. Your risk assessment therapist is going to be one of your favorite people you'll only ever meet once for the rest of your life.
She makes you an appointment with the psychiatrist, pending you getting bloodwork done downstairs in the rest of the clinic, to make sure off-the-wall endocrine systems or a particularly evil virus aren't to blame, and promises to call you Monday to check in and schedule you with one of the other therapists for CBT. You stay in the room while she does the paperwork, because the chair is cozy, and there's plants, and the waiting room's full of terrible magazines and Jody talking about you behind plexiglass. Josh, the observer, finally says something when you turn towards him for the first time all interview and ask, a little coy, a little arch, a little teasing, what his deep thoughts are. He claims not to have any, but you talk, a little, about the way being shoved up against a dozen people you've never met before, ten feet away from a stage in a dark and dirty little club, shouting at the top of your lungs and just moving, draws you out of all the vast and labarynthine corners of your mind like nothing else. You mention not having a clue what you want to do with the rest of your life, any more, and he and the therapist, whose name is Lisa, who's at her desk now so you can see them both at the same time, refer you to a woman at career services who's apparently amazing, who can maybe help you figure it out, once you can tell the difference between what you hate for being awful and what you hate simply for the sin of being part of the world. You forget her name almost instantly, but it's okay. It's really all going to be okay. You actually believe that, now, finally, and you don't laugh, but you smile a little.
She finally sends you downstairs to make your appointment for your physical, with a referral slip and a two-page report on your diagnosis. Glancing at it is enough to tell you that no, you really don't want to see her interpretation of your symptoms, all the hows and wherefores of how pathetic you are, all neatly printed out in black and white for someone else to see, no matter how much better you're feeling, not while you're still this raw, but you notice the DSM-IV diagnosis anyway, and it almost does make you feel better. DSM-IV-TR 296.32: major depressive disorder, recurrent, moderate. It doesn't sound like you're faking it for the attention. It doesn't even sound like it's entirely your fault.
You put your mascara back on in the bathroom before you leave, and go back to your office, and get to task on the work you really should've started at 8:00 that morning. You make it through the day. You go to the gym, and bump your training schedule up for the end of the week, as planned, and pretend to ignore the twinges in your left leg and especially your left shin, because if you stop your thrice-a-week routine to baby it, you won't start up again, and you're still not half close enough to okay not to need it. You go home.
You water your plants on the way in, because you've only got about two spoons left for the day, and if you don't water them right now, they won't get any. The tomatillo looks pretty sad after the heat of the day, not to mention the poor baby spinach.
You think about making dinner. You think about ordering pizza. You write a livejournal entry entirely in second-person. You think about deleting it instead of hitting 'post'. You think about maybe just e-mailing it to Kitty, so someone will have a record, because you're still too much of a scientist that you quail fundamentally at deleting data. You think about maybe just locking it to yourself and Leslie instead. You do the smart thing, the one that will come back to bite you least and help you most, and lock it so your mother can't see it, so that when you call on Sunday for father's day you don't have to talk about it.