"contents under pressure" by Lynda Majarian

Despite what they may say, everyone breaks down. For an hour, a year, or half a century. For ten minutes, maybe, when in a distracted state the lunch tab comes-a sea of numbers and symbols that can't be deciphered. Or in an office meeting, when the words burbling from people's lips become an unintelligible soup. For some of us it gets worse. Like sitting at a traffic light, unable to stop the racking sobs that are causing other drivers to stare. Like the times when no substance or diversion can soothe the rising panic that beats its furious wings like a trapped bird. Until finally, one is faced with a reflection that is beyond being recognized. These are the shadows of who I have come to be.

Dr. K. leans back in his expensive ergonomic chair, his long, dour face like a colorized daguerreotype of Abraham Lincoln. “Hopelessness,” he says. “Agitation. Lethargy.”

My rubber rain boots drip on his polished hardwood floor as I tell him how strongly I identify with each word on a scale of one to ten, and he scribbles down my responses.

“Any suicidal thoughts?”

I say, “They come and go.”

A space heater blows on a shriveling ficus. He crosses his legs, exposing a hairy patch of ankle. He says, “I can't help but notice your affect has flattened.”

I am not sure what that means. “I feel deflated,” I say. “Closed in on myself, with all the air and light sucked out.” Why don't I mention the double gravity, how I am slowly being compressed into one dimension? How I bite the inside of my cheek until it looks like hamburger? Or how I pick off the skin—scar tissue, really—around my raggedy fingernails? Because I don't want him to think I'm more of a freak than he already does.

“Have you made any social plans?” he asks. “Gone anywhere?”

I shake my head. All my friends from Arizona dispersed, as I did, after graduate school. There, I'd had a built in network of social contacts, a life of parties and book groups and meetings over coffee. Here in Vermont, everyone has settled down to work and reproduce. On “Facebook” they all use their children's photos as their avatars; it is as if having a child has completely usurped their identities. All my former best friend can talk about is breastfeeding. Plus the chronic bad weather saps everyone of sociability; accustoms us to holing up for weeks on end.

For instance, it has been a summer of perpetual rain, and I am a person who needs sun. Here, we don't see a sliver of sunshine for days. The Vermont state color is grey. So strawberries rot on the vine, outdoor festivals are cancelled or skimpily attended under drizzly skies. On July Fourth, we sit in my father's car with the heater running to watch the fireworks. Then it rains and keeps raining all through foliage season, matting wet brown leaves on the ground and depriving tourists of the shock of brilliant colors they drove miles to see.

Fall fades into my first New England winter in five years. The air is thick and white, like an opaque layer of ice. On clear days, I can barely make out a wan, white, faraway sun. Heavy snow falls, sometimes for days, breaking records with its endless volume of white nothingness. My mood drops as dramatically as the temperature, hovers near a torpid state. Hopelessness worries itself into a wiry ball in my chest, weaving messages of doom. I make regular visits to Dr. K.'s well-appointed office, though I'm not sure why. The drugs don't help much, but without them I fear fading into mist, invisible but still acutely in pain. He's a placebo, more or less, to help me believe something is helping.

I spend whole days in bed. The prospect of doing something, anything, is overwhelming. When forced to move, I slog through the bleak weeks like a night train without lights tumbling blindly forward until it skips the tracks. Motion is my enemy; energy the prettiest, most popular girl in high school who dropped me as a friend. My body wants to hibernate, to slumber in a dark cave. In my head I am already there. Sleep is the only answer; my life will never be any other way.

When my mother calls, which she does all the time, I try to convince her of my well-being. Why hear her wave my troubles away with Oh, you're never happy, or Just be glad you have a job.

“I don't buy it,” she says. “You have that dead tone in your voice.”

“I feel a migraine coming on,” I lie.

She used to have migraines, too, and hers were even worse than mine. I had to stay home from school and take care of her. She would lie in bed with the blinds pulled down and a cool cloth over her eyes, frequently racing to the bathroom to vomit and, usually, pass out. I can still see her, ninety-five pounds in her cotton nightgown, struggling with one thin hand on the wall and the other over her mouth. I was her ghost nurse, trailing her down the hall, and in the bathroom holding her head to keep it from banging the edge of the tub. When she went slack, I pulled her back against my legs and held her up, always worrying she might not come to.

“What I want to know is why you are paying that doctor all that money when he hasn't done you any good,” my mother says.

“I like him,” I tell her. “He's nice.”

“He may be as nice as Jesus,” she says, “but if he's not helping you it's time to show him the door.”

My sister, Sally, calls me weekly from Tucson.

“I never should have moved back here,” I confide. “It's boring and cold and all my old friends and new co-workers are obsessed by their oversized babies and SUVs.” Leaving Sally, despite her lack of interest in me, was the most difficult part of leaving Arizona. But there were no guarantees five years ago, when the two of us loaded up a moving van and took a road trip three thousand miles west, ready for anything. She continues to live the adventure with her girlfriend, while I have returned reluctantly to start. In the game of Life I am still on the second square.

Back in July, my mother mailed me an employment ad for a job at a college in Vermont. Her timing was perfect. Tucson was a ghost town, and tips were down at the bar where I cocktail waitressed part-time. I hated my studio apartment, with its six-by-six stucco balcony covered in bird shit, squatting in a large anonymous complex. The swimming pool full of screaming kids, where I guessed the water-to-urine ratio was fifty-fifty.

I showed the ad to Sally. It sounded like a good job, and was in my field—public relations.

“Be serious,” Sally said. “I thought you hated public relations.”

“That's true, but I don't hate it as much as I hate other jobs.”

“You could go back to bartending,” she said. “You made money doing that.”

For a moment, I considered that, but I couldn't put up with people's crap anymore. In Vermont, I always worked as and was treated as a professional. But when you give up the corporate world to experience life in the trenches, you begin jobs under a veil of suspicion. At the Tucson Macy's, my supervisor checked my handbag for stolen merchandise before I left the store. When I temped at a law firm, an office manager with heavily penciled eyebrows instructed me not to speak to the lawyers-even though they were the ones chatting me up. I had to punch in and out on a loud, archaic-looking clock in one place, clean the ladies room at another.

The romantic notions of waitressing at rustic diners filled with fascinating, dissolute strangers, pouring out shots for cowboys, riding through the desert in a convertible at midnight to sit around a raging bonfire, all that had been a naive mirage. Sure, there were characters, like the retired Navaho police chief who wanted me to take his crippled granddaughter to Lourdes. The pimp drenched in gold chains and Vaselined hair who tipped me twenty dollars every night and, I suspected, wanted to turn me out. This was not the sort of romance I was looking for. I quit my job at the bar, lolled around aimlessly for a couple of weeks, and then moved home.

Affection is absent in Vermont, too. Everyone who is not a total freak is already attached. I briefly date a manic-depressive artist who carves T-R-Y onto his chest, and a cheap reporter who orders from the children's menu.

Everyone says they envy my luck, landing the position at the university's public affairs office, especially when the local job market is especially tough. So many disgruntled professionals have settled in Vermont to escape New York and New Jersey, believing they have found a simple life when all they've done is drive up the cost of living and necessitated construction of look-a-like housing developments, Starbucks, and Wal-Mart stores.

After a few months, I begin to call in sick at least once a week. Plus every Wednesday I claim to be working at home. People are always supposedly working at home in our department, but nobody seems to get anything done. When our secretary tries to reach them on these work-at-home days, their phones just ring and ring. Who are they kidding? In turn, my work folders remain undisturbed on Wednesdays, though at least I answer the phone. Otherwise I curl up under a blanket, watching sugary snow drift past the rattling windows, follow the quick fall of darkness lit by lumbering school buses glimpsed through the twiggy hedge.

Other changes: I used to read a novel a week, but now I can't wade through anything weightier than a fashion magazine. The world violence reported on television proves that not only me but the whole planet is hopeless, so I stop watching the news. Instead I sit through endless reruns of sitcoms, inserting myself as the invisible friend in the happy TV people's pleasant lives.

I think often about suicide—it makes me feel better, more in control, to have an exit plan. I imagine this is how retired New Englanders feel about their winter homes in Florida. Everyone wants to have someplace to go. I could leave on the gas, take too many sedatives, down a fifth of vodka or a bottle of aspirin. Ideas flood in unexpectedly.

On TV one afternoon, Oprah Winfrey interviews a beautiful actress who talks about being so despondent after her divorce that she sat with her car running in a closed garage until it was almost too late.

My mother calls me after the show. “Tell me you're not going to do that,” she says.

“Of course not,” I tell her. “I don't even have a garage.”

My therapist is a kind, sixty-ish woman named Jackie, who instructs me to call her every day, just to check in, and has me sign a suicide contract. Maybe she is just covering her ass, but she says she cares about me and I believe her. She and Dr. K. talk of admitting me to a hospital. But being in a ward of people exactly like me is the last thing I need. I function best by pretending to be normal around healthy people. But my best is still excruciating black thoughts that feed a fetid swamp with no bottom, no foothold to boost myself up.

I wish I could try harder. I feel guilty for feeling sorry for myself. Although it feels to me that time has stopped, it is simply dragging me along as dead weight. I am wasting days and weeks and months I will never get back. I can't re-live them as a normal, contented person. All those millions of moments—moments when I could have been making more of an effort—are gone.

Some people lead ordinary lives interrupted with periodic bouts of serious depression, and other people, like me, never quite make it to a standing position. Usually I can feel a major depressive episode sneaking up on me, inch by gloomy inch, but sometimes it arrives briskly with hurricane force. It's always been this way. When I was a little girl in my pink bedroom full of white French Provencal furniture from Sears, I would lie on my fuzzy pink rug, close my eyes and wish myself gone, dissolved, a handful of fairy dust scattered in the wind. In eighth grade I pressed a paring knife to my wrist until my mother unexpectedly walked into the kitchen and screamed. Praying for high school to be over, I shielded my pimply face with a curtain of black hair and had only one boyfriend, who quickly dumped me for a fat and vapid blonde. After attending an all-girl college where I never had a date, I progressed from melancholy to nearly catatonic. For three months after graduation, I was unable to get out of the house, paralyzed, unequipped and inadequate to begin adult life. Some vital life lessons, important coping skills, had passed me by. I had no inner well from which to draw a smidgeon of confidence. I was sure no one would ever like me enough to give me a job, and I certainly didn't see much to like in myself.

Slowly, I learned to negotiate the world and pretend to cope. At twenty-six, after a short, disastrous marriage, I stopped eating and sleeping for a whole summer and took antidepressants for the first time—the old kind that caused constipation, cotton mouth and weight gain—so even if my mood brightened, no one would want to go out with me. I got off the medication as soon as I could, preferring my own methods of consolation. Wrapped in a chenille robe with dried oatmeal on the collar, every night I drank three or so concoctions I called “divorced dessert”—root beer floats made with low-fat frozen yogurt and more vodka than root beer. And if I needed the Percocet from various medicine cabinets to relax, the only person I was hurting was myself.

I wonder how much of my current malaise stems from work. My co-workers remain relative strangers; they keep to their own offices, computer keys chattering like frightened mice. The new PR director-a short, egotistical tyrant with no social skills-changed the parameters of my job shortly after his arrival. In addition to writing for in-house and alumni publications, he demands that I place six positive stories about the university per semester in national media, regardless that nothing special happens at our third-rate and vastly overpriced institution. My work days consist of useless, dreaded chores—writing press releases about irrelevant, esoteric faculty research and endlessly pitching self-serving ideas to impatient reporters and irritable editors. I am good on the phone, though, and know a few professors whose work is vaguely interesting. Occasionally I place a story—never meeting my boss's quota, but enough to keep him from going through the bureaucratic hassle of firing me.

In April Dr. K. agrees to put me on one of the few antidepressants I haven't tried. I have researched MAO-inhibitors, which have proved successful in borderline personalities and among people with chronic low-grade depression—and that's me, isn't it? The drugs are rarely prescribed anymore because of the strict dietary guidelines that must be followed to avoid potentially fatal chemical interactions—a person could die, for instance, by eating a hot dog. The food restrictions don't bother me-I can give up processed meats and cheese and red wine—it is the month it will take to clear all the old antidepressants out of my system that may be tough. But certainly this is the miracle cure that will finally jumpstart all the feel-good chemicals currently hiding in my brain.

“I don't think you're a borderline, though,” Dr. K. states for the record.

“I'm on the borderline of borderline,” I suggest.

He regards me with his long, sober face. “I'm more inclined to regard you as a high-functioning depressive.”

Lucky me, I have found my secret skill. Except I am not high-functioning, I barely function at all. I just know how to fake it. After working for years in public relations I can't help slapping on a bright face at work and, usually, with family. I won't cry in front of anyone, even my therapist. When I can't pull myself together enough to manage, I just stay home.

I think about the slightly younger version of myself: the girl who backpacked through Europe; flew to New York for seminars and spent the per diem on theater tickets; got lost in Paris alone after midnight; bought hash on a boat in the Czech Republic; wrangled a free trip to China; moved to Tucson without knowing another soul besides Sally; drove around all night in a Vegas cab with a Canadian I met playing Blackjack, making out like high school kids and half-joking about getting married to help him win a bet. That girl was a lot of fun. But she only exists in new places, where everything is exciting and fresh, an adventure. Vermont is anathema to my mental health, but I always come back. Why? Nothing ever goes right here. And that girl I have glimpsed in other places—I wonder if she will ever have another reason to come out.

As I slowly taper off my old medicines, distressing symptoms appear: crying jags, dizziness, tremors, nightmares, and frequent fizzy little zaps of electricity in my brain. My bloated skin is sore to the touch. I am annoyed with everyone. Raw. The crying jags are avalanches of emotion, overflowing the boundaries of skin and bone. At first crying is a release, like vomiting can be. Purging and purifying me from the inside out. All I can do is wait. After hours of this, though, it feels as if I am regurgitating myself, and I get scared.

When the hand tremors are very bad, my mother drives me to the supermarket. Her lips are set in a thin line, as though she is trying not to blurt out something. She also brings me to an acupuncturist, who looks at my tongue, feels my pulse and says my chi is stagnant. My insurance won't cover his expensive services, so I just take his horrible-tasting herbs.

Sometimes, alone in the post office or drugstore, I think I hear my name. I look around, but no one is calling me. Am I actually hearing voices? Simply misinterpreting what people say? Or is this how my mind functions without pharmaceutical support? I begin to believe I am going insane.

At work, I pass time on the internet researching antidepressant withdrawal. Several reputable and easily accessible studies report symptoms like mine-dizziness, insomnia, nightmares, water retention, brain zaps, crying jags and even fear of insanity-as being especially common for people withdrawing from Paxil. There is even a class action lawsuit alleging the company held back information about that aspect of the product. Dr. K. didn't tell me to expect any symptoms, and he had me withdraw from the drug more quickly than the manufacturer recommends. “You're an old pro at this,” he said.

“He let me think my baseline was insanity,” I tell my sister.

“Maybe he just isn't up to date medically,” she says. “I mean, I don't think someone would do that intentionally.”

“Incompetence is no excuse,” I say, “but it feels good to know I'm not crazy.”

“Don't rush to judgment,” Sally says. “Kidding.”

“Funny,” I say.

“You're just as sane as anyone else walking the streets of Hazelhurst, Mississippi,” she drawls, reciting a line from one of our favorite movies, Crimes of the Heart.

“Even more so,” I reply, keeping with the script. “Much more so.”

The day I begin the MAO is a rebirth-a better me is on the way. I am convinced this is the cure that will allow me to enjoy life like everybody else. From now on I will awake looking forward to each day instead of crouching in dread and fear. I will form healthy relationships. I will have relationships, instead of sitting at home with my cat.

After being on the new drug for two weeks, I see my primary care doctor for an annual check-up.

“What's going on with your blood pressure?” she says, frowning and pumping up the band. “I don't like these numbers.” When I tell her about the MAO, she looks alarmed and checks my blood pressure again. “Listen to me,” she says, “I want you to stop taking that medication.”

“But it's still too soon to know if it might be effective,” I counter.

“I think I know a little more about your overall health than your psychiatrist. And every week there are new medications to treat depression, meds that won't elevate your BP to dangerous levels,” she says.

“I've tried them, or most of them,” I tell her, watching translucent bubbles of future happiness float by, pop and disappear. The MAO is supposed to be my miracle. How can she snatch it away?

“Trust me,” she says. She's been my physician for a while, and got my hypothyroid condition under control when no one else could. She's always complimentary about my hair. Reluctantly, I acknowledge she's probably right.

“You've got so much going for you,” she says.

“People say that,” I tell her, “but you can't tell by looking from the outside in.”

She gives me a funny look. “I'll call Dr. K. and let him know,” she says. “Go home and throw those pills away.”

Maybe my physician and my mother are right about Dr. K.—he really isn't helping me. I ask Jackie to recommend another psychiatrist. “Somebody more up on things,” I tell her.

Dr. R. has a chubby round face that is benign and welcoming. His office is smaller and more cluttered than Dr. K.'s, but he holds a position of some importance at the hospital. At our first appointment, he puts me back on two of the newer antidepressants and adds Ativan for my anxiety. The brain zaps disappear, and I sleep better, but the jolt to get me moving never comes. Like Frankenstein's monster awaiting an energizing bolt of lightening, I stagnate through many weeks without much hope.

I try to put more energy into my job, but no matter how fast I work, whenever I complete a project my boss has changed his mind and wants it done a different way. The old bait and switch routine. If I dare to question his decisions, he shouts and turns red and lectures me, and I have to stay home the next day to recover. His yelling gives me headaches. But I don't mind my migraines much, because they give me a legitimate excuse to lie in bed all day, head packed in ice, versus feeling guilty for my sluggishness.

A few months into our collaboration, Dr. R. convinces me to try a third drug on a short-term basis.

“Abilify?” I say. “But I'm not bipolar.”

“It's very commonly used in low dosages for depression,” he explains. He says he is obligated to inform me the medication has potential, though very rare, side effects. Something called “tardive dyskinesia,” a permanent and involuntary smacking of the lips and/or uncontrollable wormlike motions of the tongue.

Sally says I should take it anyway. “If you're worried, I'll take the medicine, too,” she tells me on the phone. “Worst case scenario we'll form an act. The Smacking Sisters. Add some dance steps and take it on the road.”

The funny thing is I know she really would. As children we formed a pact: if one of us ever got sick—had cancer for instance, suffered through chemo and went bald—the other would shave her head. We planned to wear inexpensive nylon wigs. I had in mind a black pageboy, and Sally, curiously, wanted to be gray.

“Maybe the medicine will help you,” she says. “Anyway, when did you ever refuse a pill?”

“Good point,” I agree. “What's one more medication? As long as I have insurance, might as well sample the whole pharmacy.”

“Now you're talking,” Sally says, and loudly smacks her lips.

A week after the new crazy pill hits my neural pathways, I begin to improve in tiny increments. I am an autumn leaf in a breeze, tentatively aloft with no promise to remain airborne. I consider the possibility of a future. I am calmer, not always fidgeting. Colors are brighter. I feel like Dorothy, transported from dull old black and white to the colorful kaleidoscope of Oz. Or maybe it's just that the sun comes out after two weeks of grayish gloom.

Through my kitchen window, I study the family of cardinals that live in the woods behind my apartment. The males are an astonishing, saturated red that takes my breath away. For creatures so beautiful to exist is surely evidence of the God who has cursed me for prior sins, is testing me, is powerless, does not exist, or loves me and is willing to listen. The cardinals make me believe for a moment that I am part of a universal spirit, that the only difference between those impossibly gorgeous birds and me are a few strands of molecules. In this light, how messed up can I be? And what does it matter?

I sign up for a pottery class and hang around the studio on weekends. My pots are lumpy failures, but I like the feel of the clay slipping through my hands. I let the more experienced potters help me. Jackie convinces me to send out some resumes, and I take a second, part-time job teaching a creative writing class at a local community college.

On the afternoons I teach, I neatly denote three vacation hours on the attendance sheet at my regular job. If I tell my idiot boss I am doing something unrelated to him, he will find a reason to forbid it. Most of my students are lazy and uninvolved, but others are curious, searching. They are not tomorrow's doctors or lawyers or judges or Genius Award winners—they can't afford to be, and don't have the connections. Enough of them are as bright as the university students I have encountered. When I'm explaining something about a story—a certain narrator's vulnerability, or the strength of what is inferred but isn't said—when our eyes meet and I see them connect to the writer, a brief flurry of sensation suggests I may have something to give.

Over time, my intrusive negativity-that clattering screech in my ears—doesn't feel like a rape anymore; the black thoughts are like a clumsy boy whose hand I can slap away with a little effort. But I must diligently stand watch and shine light into the cobwebby recesses of my mind where, like a trio of witches, depression stirs the stew. Even if in my heart I feel the best part of my life has passed, I have to pretend to be content in order to survive. I know now that I will not fill my pockets with stones, or wade into fatal waters. I don't want people to know I even think about thinks like that, don't want them feeling sorry for me, or casting judgment. Plus I'm stronger now. I tell myself I won't let it happen, won't fall to pieces again. And I try to believe.