17th April 2011
I moved amongst them, but was not of them. I don’t recall ever feeling such an absoloute lack of empathy, connectedness, belonging. You have now started taking Quetiapine. People. There were people. And then there was me. And we belonged to different tribes, different species. You described that the first two days of taking medication your head felt much clearer and you relaxed but you were disappointed that you are now feeling worse than when I saw you two weeks ago. And I wondered what did I need them for. People are but tawdry masturbatory aids, dreary distractions, obstacles, problems, predators, idiots, the enemy, a great, heaving, crushing mass of brain scrambling chatter and clammy flesh. However you reported having had one good day over the weekend which you enjoyed with your family and waking up the next morning feeling back to depressed, irritable and not wanting to see or talk to anybody. So should I seek isolation? Then what? What would I do? Just eat to live, sit in motionless silence, sleep, repeat. Nothing to communicate, nothing to share, no interaction. Like some dumb animal living in a cave. Your wife is struggling not knowing how to help you when you are feeling low in mood. Animals. That’s all any of us are. But God hates us above all his other detested and sadistically wrought creations – he must do. God torments us with an intellect that grants us an awareness and the means to reflect upon our own naked futility, and a knowledge of the certainty of our death, a knowledge that makes a laughable nonsense of all our comforting delusions. You have not been leaving home at times when you feel depressed. I did not recognise any serious concerns regarding your safety. Made of dust, to dust we will return, and in the tortured space in between, sat waiting in the dust. Life’s a stupid game, like a puppy’s frolics, devoid of significance, just a diversion, all our grand achievements a child’s baubles, pretty, worthless trinkets strung along the short and aimless path from cradle to grave. We discussed and you agreed to increase the dose of Quetiapine to 300mg at night as the first step. Born in blood, in blood shall we die. When you realise this – what then? I gave you a prescription for Quetiapine modified release tablets 300mg to be taken at night and I have advised that you see your GP to get further prescriptions before the medication runs out. How do you maintain the lies and self deception upon which equilibrium, happiness, contentedness depend? It’s one thing to lie to yourself – but when you KNOW you’re lying to yourself, what’s the point? I don’t know. I don’t know much anymore. If you continue to remain really depressed despite increasing the dose of Quetiapine I have advised that you see your GP and I have left instructions for your GP to prescribe antidepressant vanlafaxne 37.5mg twice a day in addition to the Quetiapine 300mg daily. Could it be my antipsychotics are actually making me psychotic? Or have they just torn down the facade, the elegant mental constructs we spend our whole lives fabricating in order to distract us from the awful truth? I don’t know. Unfortunately you have missed your appointment to be seen at IAPT today for asssessment for CBT. All I know is that I feel dead. An empty head in a tower of diseased, putrefying meat. You have agreed that you will phone them and book yourself in for another appointment as I believe psychological therapy alongside medication would be beneficial. I’m not sure I like what my medication’s doing to me. All that’s happening in my mind are dark and distant mutterings. I want to hear something in there ROARING again. I have given you another appointment to see me on Thursday 21 April at 2.30pm. I’m craving intoxicants – pot, booze, cocaine, ecstasy – anything. Anything that’s going to make me feel DIFFERENT, anything that’s going to make me feel not like myself. I can’t cope with this – the emptiness, the lack of engagement, the inability to kid myself anymore that there’s a point to any of this. The masks are all off and the faces behind them are slack jawed and empty eyed, the flesh weeping and alive with maggots. I fear that somewhere beneath this suffocating silence is a scream to rend the horizon from end to end, to pull down the heavens, to annihilate the sky and smash the stars. Beneath the still and fathomless ocean is something massive and bloody and monstrous. I’m losing my mind, or I’ve found it. Either way this is not good. I can tell I have very poor impulse control at the moment – anything could happen. There’s nobody I can confide in without terrifying them. I’m trapped in this spiral of loathing and despair, winding tighter and tighter, denser with each rotation, bleaker and deeper with each revolution. These may be the end days. I don’t know.