We Need to Talk about Antidepressants

The fall of my senior year in college, I had a nervous breakdown. Until recently, I didn’t even know what happened to me could be considered a nervous breakdown. When I hear that term, I think of a padded cell and a 5150 hold. I think of a complete psychotic break — like running around the streets naked and smearing feces on cars, or something. That didn’t happen with me. Instead, I spent a week huddled under my electric blanket, feeling like my heart was going to beat out of my chest, convinced I was dying of Swine Flu, crying and eating cereal and watching Frasier on an endless loop. This was triggered by the PTSD I developed after studying abroad the previous semester.

Accurate.

A “nervous breakdown,” according to MayoClinic, refers to a stressful situation when someone is unable to function in day-to-day life. It’s really helpful for me to read that definition out loud to myself. It helps me realize, to this day, that yes, things were that bad. Until recently, I kind of just referred to that time in my head as the week I binged on Lifetime Original movies and drank a lot of wine and missed a lot of class. As it turns out, I wasn’t just “having a bad week.” I wasn’t just “feeling stressed” or “feeling sick.” I had completely ceased to function in the world. I had a full-on nervous breakdown. And maybe had I known I was careening toward a breakdown, I wouldn’t have been so reluctant to start taking some medicine.

Pretty much verbatim what I told my roommates and coworkers

So after my full-on, hiding-under-the-covers nervous breakdown, I finally admitted that yeah, maybe I wasn’t doing so well with just therapy and a bottle of wine. And perhaps — just perhaps — I needed to kick it up a notch.

Up until that point, my therapist had been cautiously suggesting that I try an anti-depressant. And for months she had respectfully nodded and hadn’t pressed me when I all but laughed in her face. Well, I didn’t quite laugh in her face, but I made it clear that the thought of taking medicine was ridiculous. Hello? I thought. Haven’t you been paying attention? I freak the fuck out when I have to urinate, and I’ve been urinating for my entire life. If I start getting weird symptoms because of these pills, I’m going to have a heart attack. I’m going to start obsessing every time I take them. I’m going to start feeling imaginary symptoms. I’ll over-think every twinge, every cramp, every unfamiliar ache. It’ll make my anxiety worse. So for months we’d do a cat-and-mouse where the subject of meeting a psychiatrist (for medicine) would come up and I’d awkwardly try to side-step. And by side-step I’d be like:

But after that week in October, I felt like it was very literally my last option. Either I could take some medicine and hope that it worked, or I’d cease to function like a normal human. And that kind of panic — that flu-like feeling of sickness — is simply unsustainable. I’m not saying I was suicidal. But I really don’t know how much more of that I could have taken. So when I went crying to the campus nurse about how I had the Swine Flu and all my “Swine Flu” symptoms turned out to be anxiety induced, that blessed nurse scheduled a therapy session for me immediately. And from there I saw the psychiatrist.

Psychiatrist guy gave me two things — and I feel like it’s important for me to tell you what they were, at the risk of sounding like a druggie, because every week or so I’ll get an e-mail or an instant message with someone asking me about anti-anxiety drugs and what they’re like. There’s a definite undercurrent of shame, and fear, and, well, anxiety about what the side effects are going to be — which was totally my preoccupation before I started trying them. So. Psychiatrist guy (who looked curiously like Tobias Funke) gave me xanax, which has short-term effects and calms you down in the midst of an anxiety attack, and started me on Zoloft, which is an anti-depressant. Basically, untreated anxiety or PTSD feels like you’ve got your hand on a hot skillet and you can’t take it off. You’re expected to function as though everything is fine, but inside you’re thinking HOLY SHIT THIS HURTS I CANT FOCUS ON ANYTHING ELSE BUT THE BURNING IT BURNSSSSSSS!!!! Xanax is like splashing some cold water on the skillet — a temporary relief, but your hand is still on the skillet, and it’ll heat right back up again in a few minutes. Zoloft is like someone coming up behind you and turning off the burner — gradually, the anxiety goes away, and you start acting and feeling more like your normal self.

Seriously. Can you tell I was an English major?

So I started the zoloft that day. And I’d be lying if I said I had about a million tiny little anxiety freakouts and IBS flareups wondering what the side-effects would be. And I did get side-effects — nausea, primarily — for a few weeks until it started to kick in. And boy, did it kick in.

About a month after I started taking it, sometime in the first week of December — about ten months after the incident that spurred my PTSD — I woke up one morning and I felt lighter. Physically lighter. My limbs were looser. And the biggest difference was that I could breathe. It was a totally unparalleled feeling and I’m sure I looked like a complete dumbass, because I would just walk around campus and take deep, long breaths, sucking all the cold air into my lungs that I possibly could. It felt wonderful. I hadn’t even noticed until the anxiety went away how completely crushing it was. A weight had literally been lifted, and I felt joyously free. Right in time for finals. And then winter break.

When I went home for winter break, the primary feeling I felt was utter bliss. I’m not kidding. It always really irks me when people refer to anti-depressants as “happy pills,” because they make me functional, not happy. But this period was the exception — I had been living under the crushing weight of PTSD for so long that I had forgotten what it felt like to just feel normal. I could take big, deep breaths. I could  hear the doorbell ring or the blender turn on without hiding under my covers. I could wake up and actually feel excited about the day, instead of dreading all the millions of little noises and random events that would trigger an episode. I spent the whole winter vacation in my parents’ house, absolutely blissed out, reading books and lying on the couch and just feeling like I had gotten my life back. I could talk about my anxiety triggers without actually feeling triggered. I could think about India without feeling like I was dizzy or short of breath. I could ride in a car or a train without willing myself not to jump out of it. It was heaven.

Oh, it felt so good

I kind of sound like a druggie, don’t I? Obviously, anti-depressants aren’t for everyone. And Zoloft, specifically, is not for everyone, I’m sure. I wasn’t high or anything, but getting your life back after ten months in hell? Oh, it was wonderful. I couldn’t breathe deeply enough.

And then — I got depressed.

Stay tuned.

What a Nervous Breakdown Looks Like

IV. Fall Breakdown

That fall, after suffering through a kidney stone obstruction, coming home early from my semester abroad, and having weird anxiety symptoms for the next six months, I went back to college on the north side of Chicago. I was still having panic attacks, but in my mind, there was nothing else to do but grit my teeth and get through them. I still didn’t really fully understand what was causing them.

I was glad to get back in the swing of things. I was still having weird bouts of anxiety where I would feel like I’d have to run away and hide in a cave somewhere. I was still having shortness of breath when someone would ask me how my semester in India had been. I didn’t want to travel very far outside of my campus-work-apartment radius, in case one of those bizarre attacks came on again. And if a cab honked too loud or my doorbell rang, I’d have to run to the bathroom so I didn’t literally shit my pants out of anxiety. But other than that I was getting back to normal. A new normal. I felt frustrated because whatever happened in India had happened months ago. It was no longer a part of my life and I wanted to move on. I felt like my mind had moved on — but my body hadn’t yet.

I started seeing a therapist at the Wellness Center. I’ll call her K. K was very calm and sweet and talked about her kids and husband even though she didn’t wear a wedding ring which confused me to the point of distraction. I told her I had been struggling with anxiety and slowly we began to unpack all the shiz that had gone down in Bangalore. More than once, she’d raise an eyebrow at me.

“This doesn’t sound like run-of-the-mill anxiety,” she’d say. “It sounds like you went through something incredibly traumatic. Maybe you’re having PTSD?”

“Yeah, I guess, or maybe something else,” I’d say. I knew, deep down, that if this were a “serious” diagnosis and not just some run-of-the-mill panic, I’d have to go on antidepressants and I couldn’t stomach the thought of having side effects. I couldn’t stomach the thought of being on medicine for something like this. Medicines were for sicknesses. I wasn’t sick. I just wanted to move on. I was just biding my time until my body caught up with my mind. My mind had moved on. I wanted to put all of this behind me. There was no way I was going on drugs.

One week in October, everything changed.

My mom called my phone when I was waiting in line at the campus cafeteria. “You want to know something crazy?” She said, mid-conversation. “Steve [our neighbor] thinks he might have Swine Flu.”

In an instant, everything went still. I felt my stomach drop to my knees. I felt a warm rush of anxiety crawl across my skin, very much in the same way it would crawl across my skin four years later, when we got the news that our son had Spina Bifida. I had just seen Steve over the weekend, and he hadn’t seemed sick. I vividly remembered taking a sip of his wine to test it out.

At that point, my biggest fear was that something would happen regarding my body that I couldn’t control, and I would have to go back to the hospital. Now, in my anxiety-riddled mind, my worst fear had come true. It was inevitable. The virus was already inside me. And the most terrifying part was that I wasn’t showing any symptoms now, but inevitably I knew I would be. I didn’t know when. Or how. But surely in the next two or three days, it would attack. I’d have to go back to the hospital. I would wake up in the middle of the night, sick and incapacitated, and have to navigate my ass all the way to an unknown hospital — again. I had to fight to keep from vomiting right there in the cafeteria line.

And hadn’t I heard that Swine Flu was potentially deadly? Hadn’t a few people died from this thing? I fought off a fresh wave of panic. I could die. This could be my last week alive.

I got off the phone as quickly as I could and high-tailed it back to my apartment. I climbed into bed, got under my electric blanket, and willed myself to fall asleep as fast as I could. It was the only way I
could shut off the thoughts that kept forcing themselves inside my head. I slept for hours and woke up exhausted. Here it is, I thought. It’s beginning. Swine Flu. 

I didn’t go to class the next day. What was the point? I was going to get the Swine Flu symptoms any minute, and I had to be ready once it hit. I stayed in my room all day and watched Frasier. I felt sick. I got a headache. Swine Flu is starting, I thought. Here it is. I was nauseous. I had the chills. I packed a bag in case I had to go to the hospital, and waited. It wasn’t serious enough for me to head to the hospital yet, but soon enough, it would be. I couldn’t take the chance of getting suddenly sick in class, or on campus, around a hundred other people — that would be humiliating. So I just sat in my room under the electric blanket and watched season after season of Frasier. I emerged once to go to the Dominick’s across the street and got a huge bottle of wine, some pierogies, and a romantic comedy. I watched the movie back to back for the next twelve hours.

Meanwhile, I had exhausted the supply of xanax my doctor had given me a few months before.

I believed so many lies when I had anxiety, and writing this, I think that’s one of the saddest things about the whole situation. Anxiety lies. I knew — I knew — that if I called the doctor back and asked for more xanax, the doctor would think I was a drug addict. Or a scammer. I cried. I can see now, in hindsight, that my brain was truly sick. Only a crazy person would think that a terrified twenty-year-old, who had carefully rationed 20 pills of low-dose xanax for the past six months could possibly be a drug addict. And knowing my doctor, who is a wonderful, kind-hearted woman, that would have been the last thing she would have thought. She would have helped me. But I was convinced otherwise. People would laugh at me. I’d get in trouble. They’d call me a liar. I couldn’t call the doctor. I was trapped.

Instead of calling and asking for more xanax, I just bought wine. But in my weird, altered reality, if I drank before 5 pm, I had a problem. Never mind the fact that I had been holed up in my bedroom for the past few days, crying and watching The Proposal, waiting for the Swine Flu to kill me. I bought wine as a cheap substitute for xanax — something to calm me down — but I vowed that I wouldn’t drink it before it was socially acceptable. Five o’clock.

For the next three days, I did nothing. I stayed inside. I cried. I waited for the Swine Flu to kill me. I watched Frasier on a loop. And I white-knuckled it until exactly 5 pm, when I would emerge from my room, pop open a bottle of wine, and drink the entire thing by myself. Totally rational, I thought. I mean, what else could you do, when you were waiting for the Swine Flu to kill you?

Here’s the scary thing: Normally, I could drink half a glass of wine before I started to feel woozy. Get more than a couple beers in me under normal circumstances, and I’d be climbing in my roommate’s Ikea wardrobe yelling about going to Narnia. But not this time. Now I was in such a heightened state of hyper-arousal, it took three or four big glasses of wine just to get me feeling like my ‘normal’ self. I didn’t feel drunk. I could drink two bottles and barely feel it at all. It should have been a big red flag that I was going out of my mind with anxiety, but it barely registered. I was just doing what any normal person would do if they didn’t have anti-anxiety medications and they were twelve hours away from dying of the Swine Flu. Right? And it wasn’t like I wasn’t functional, right? I mean, I could wait until 5 to start drinking. So I was fine. I was in control. Right?

The terrifying thing about anxiety, too, is that it completely changes your brain. You think in a way that’s not rational, that’s totally illogical, that’s completely unlike how you’d think normally. That fall, at my school, three students died in unrelated ways, all within a two or three week span, right around the time I was convinced I had the Swine Flu. One died after a long battle of leukemia. One after a horrific bike accident. Another I think had some infection. This solidified my belief that I was going to die. I was next in line. Death was hovering over my school like a cloud, and the fact that three students died in random ways unrelated to each other made it even more sinister. Like Death was just picking kids at random. And now I had the Swine Flu. I was definitely next. I literally didn’t leave my apartment unless it was absolutely necessary — I was next to die, after all. It didn’t matter if it was Swine Flu or something else — I could be crossing the street and get hit by a truck. It was going to happen, in one way or another. There was no way out.

About four days after I had received the phone call from my mom, I woke up at midnight shaking. Okay, here we go, I thought. Swine Flu for real this time. I went in the other room and threw up. I had awful diarrhea. I was freezing, aching. But to my surprise, I didn’t even have a fever. From what I heard of the Swine Flu, or any Flu, you had to have a fever. The thermometer’s broken, I thought, because OBVIOUSLY I had the Swine Flu. I suffered through the symptoms until the next morning, when I dialed the college wellness center and told them what was going on.

“I have the Swine Flu,” I said, crying. “Can you give me Tamiflu right now or should I just go to the hospital?”

“Hold on,” the nurse said, after hearing my symptoms. “If you don’t have a fever, you don’t have the Swine Flu.”

“That’s wrong, because I definitely have the swine flu,” I insisted.

“Honey, people who have the Swine Flu say that their body aches so bad their hair hurts. What you’re describing doesn’t sound like you’ve got the Swine Flu.”

“I PROBABLY HAVE A SLOWER-ACTING STRAIN,” I screamed. Was everyone in the world incompetent? Would I die alone, in my apartment, and have nobody find me for weeks after?

Somehow, the nurse was able to finagle me into calming down and coming over to the wellness center for an appointment. I don’t remember how I got there. But I remember very vividly sitting in the doctor’s office and crying and mumbling about Sanjay Gupta and how he got the Swine Flu and almost died and had to go to the hospital and so I just don’t want to go back to the hospital so if you just give me Tamiflu I can go back to my apartment and hide under the covers, okay? OKAY?

The nurse held my hand, and what she said next shook me.

“I can tell you right now, you don’t have the Swine Flu,” she said, and her eyes were very sad and very kind. “By any chance, do you have problems with anxiety?”

I was floored. How could she possibly know that? I mean, sure, I was a little nervous, but who suffering from a deadly strain from the Swine Flu wouldn’t be nervous? If you asked me, I was handling this pretty goddamn well, considering I was at death’s door. I walked all the way to the Wellness Center and I was still alive, despite the Swine Flu decimating my healthy blood cells, slowly shutting down my organs.

“A little bit, I guess,” I told her. Was this bitch going to call an ambulance or what? “Why do you ask?”

“I think all of this is anxiety-related,” she said, and dug out a small white bag filled with losenges and tylenol. Seeing that bag, it hit me. I didn’t have the swine flu. That wasn’t something you’d give someone with the Swine Flu. That was something you’d give a hypochondriac who was convinced she had the swine flu, to assuage her panic. I deflated like a balloon. My face burned with shame.

“I’m going to pop in next door to see if your counselor is available,” she said. I hardly heard her. She disappeared out the door and I burst into tears.

What We Talk About When We Talk About Crippling Anxiety (Part 3)

III. After

(Part I is here. Part II is here.) 

The flight home could have been a lot worse. I took a five (ish?) hour flight from Bangalore to Dubai, and met my uncle at the airport, who was coincidentally traveling on business. Together we flew from Dubai to New York, and from there, Chicago. I kept passing “shards” on the way there, but it wasn’t as  excruciating as it had been on campus, back in India. I mustered the courage to look in the airplane toilet after I had peed, on the flight from New York to Chicago — still blood, but not nearly as much as there had been. The symptoms were going away. Was I recovering? Instantly, I felt a rush of shame. Was I getting better?

Could I have stuck it out in India? Was I a total pussy, deciding to give up and go home? Should I have just waited it out a few days longer? Embarrassment flooded me. I realized that other than a nagging ache in my back, I was able to navigate three international airports on my own, with no problems, without once getting a sudden “kidney stone attack.” Before I could barely walk across campus. And now I wasn’t peeing as much blood as before. I wasn’t throwing up. I was a little nauseous, but otherwise … I was able to travel mostly by myself. I probably looked like any other passenger, except for the slight limp in my step. What a total privileged princess I am, I thought. I get one tiny kidney stone and I throw up a few times and I high-tail it back to the States, where people speak English. What does that say about me — that I’m only comfortable in a place where I understand the language, and the doctors wear lab coats? What kind of racist, privileged bullshit is that? 

Shame was a major component of my recovery, which meant it was a long time before I could muster up the courage to talk to a therapist. Surely it couldn’t have been that bad, I kept thinking to myself afterwards. I stopped passing shards like, the instant I boarded the plane back home. And then when I got back to my parents’ house in Chicago, I was almost totally back to normal. I probably could have stuck it out a few more weeks and have been totally fine. I could have finished out the semester. What a total pussy I am. Cut and run. But when I’d think about taking a return flight back to India, I would break out in a cold sweat. I would have to  put my head in my hands and take deep breaths to keep from feeling like I was falling. I would run to the bathroom and have instant, IBS-style diarrhea. Hell no, I’d think. If going home makes me a pussy, so be it. I’m not going back. I got out. I’m out. I’m okay. 

I had returned home in the middle of the semester, in the middle of February, so I was in a limbo at my parents’ house until school started up again in the fall. Talk about culture shock — I had gone from a wet, sweltering, hot, city where you literally could not escape from honking cars and barking dogs, to a large house in the middle of the Chicago suburbs, deafeningly silent in comparison and surrounded by snow. I spent the next couple of days just hanging out on the couch, happy beyond measure that I could snuggle up to my then-fiance-now-husband instead of lying naked by myself on a gurney in an Indian hospital. I went to my doctor’s office (where I could understand what everyone was saying, where everyone washed their hands and wore white lab coats, where it was five minutes away instead of twenty minutes by rickshaw, where I could just get in the car and go instead of having to haggle and be harassed by an autorickshaw driver). They checked me out and told me I was better. I was better. I was normal. What was I supposed to do now?

I got a few part-time jobs, nannying and babysitting, and cobbled them into a full-time work schedule. I worked and saved. Friends and co-workers and acquaintences back at college would text, or call, or message me on Facebook, and go, um, did you come home from India? What happened? Are you okay? How was I supposed to explain everything? I’d start by saying Oh well I woke up one morning with this excruciating pain– and then suddenly I couldn’t breathe. It would feel like I had an elephant sitting on my chest. I’d get sweaty and have what my doctor calls trampada a la puerta — a sudden urge to run to the bathroom. The gag reflex in the back of my throat would start to itch. I learned to abbreviate what had happened in the shortest way possible. “Oh, I got sick,” I said. “Long story. Hospital. Surgery. Had to come home.” Any more explanation than that, and I would start to feel faint. Sometimes I would relay parts of the story to friends or family who would ask, and after telling them about getting cathed, getting prepped before surgery, having surgery, even the ordeal of being in pain and trying to get to the hospital — and I would have to lay down afterwards and take a nap. I was wiped. The only thing that helped me feel better was lying in bed and turning my electric blanket to its highest temperature. And sleeping. It was the only thing that shut off my brain. It was my only respite.

I had begun to experience Post Traumatic Stress Disorder.

It was months before I went to the doctor, months before I even knew that there was any reason to go to the doctor. My mother, who I was living with and who had a history of anxiety as well, noticed my weird symptoms and told me to get myself checked out. Really? I’d say. I’m okay, though. Aren’t I? I’d make plans to go into the city and visit friends, and then come down with all these flu-like symptoms. Chills. Body-aches. Even a low grade fever. I’d cancel plans and within an hour, I’d feel back to my normal self. That’s weird. I thought. But not a reason to go to the doctor. Probably just some bug I’m fighting off. Any time I’d travel, or be in a situation I couldn’t immediately get out of (like dinner with friends. Like riding in a car or traveling on a train) I’d come down with these weird flu symptoms. And if I went to dinner anyway, or rode in a car against my better judgment and decided to ignore all these “flu” symptoms, I’d start falling down a rabbit hole of pure panic. Hyperventilating. Uncontrollable crying. Immediate diarrhea. Shaking. And crying some more. What was wrong with me?

There were other triggers too. And slowly — very slowly — I noticed a pattern. Sudden, loud noise? Panic attack. If I had to pee and couldn’t immediately get to a bathroom? Panic attack. If I was stuck in a traffic jam and couldn’t “escape” if I needed to? Panic attack. I had a constant urge to escape (even if I was in the craft section of Michael’s or something) and if I couldn’t immediately escape from any given situation (like if there was some fat chick blocking the exit at Michael’s) I would need to run to the bathroom and hyperventilate/cry for the next fifteen minutes. After a while, there wasn’t much that didn’t trigger a panic attack. It was hard to go outside at all. After all, pretty much anything triggered an attack. And once I had a panic attack, I was literally immobile. I realized it was a lot easier to just stay inside. I could avoid most of the triggers there. Or I could turn off my brain and sleep. Or I could stay under my warm, wonderful electric blanket and watch TV shows where there was virtually no conflict and no loud surprises. Nothing that scared me. Nothing that hurt me. No reminders of India. Or the hospital. Or anything medical. Or anything unexpected. I watched a lot of House Hunters.

I had begun to experience agoraphobia.

Eventually, I went back to the doctor. They gave me some xanax, and that helped, for a while. Ultimately though, everything got a lot worse before it got better.

What We Talk About When We Talk About Crippling Anxiety (Part 2)

II. Recovery

A nurse was shaking me awake. The procedure was a success. We pulverized the stone. She said. They had inserted a scope up my urethra and did something to the kidney stone — blew it up, or something? — and now it was gone. I would continue to keep passing “shards” of the stone for the next few days, they told me. Sure, okay, I said.

I was groggy from the anesthesia, but I instantly felt better. That I’m-going-to-pee-my-pants feeling was gone. And after I had been wheeled out of recovery and back into my room, a kind nurse helped me wobble over to my “English” toilet and let me pee for the first time in three days.  It stung a little, but that was normal, they told me, because of the scope they had stuck up there. I looked into the toilet and there was blood. Not streaks of blood, not spatters — the entire bowl was dark red.

That’s normal, the nurse told me. I still felt faint. She helped me wobble back into bed and I laid in the dark feeling nauseated from the anesthesia. I threw up a couple times. But I felt lightyears better than I had felt in the past day. I had been in the hospital about 18 hours at that point. The nurse gave me something to put me to sleep. My two friends stayed the night with me in my room, and called my mother every few hours to update her on what was happening. I’m certain that the entire experience, as hellish as it was for me, was way worse for her.

They released me the next day around noon. I was a little sore, still, but the stone had passed, and there was no need for me to be hospitalized any more. I could pee on my own. I still peed blood, but again, they said, it was no big deal. It should taper off in a few days. There was still a lot of it.

In Bangalore, we walked everywhere. Our campus was large and vast, and for some reason there were a lot of wild birds everywhere. The walk from the main gates of the campus back to the girls’ dormitory took maybe fifteen minutes. Getting anywhere on campus, from point A to B, was a fifteen or twenty minute walk. On the walk back from the hospital, my classmates approached me, horrified.

We heard you went to the hospital?! They said. Are you okay?!
Oh, I’m totally fine! I’d say, brushing it off. Toooootally fine. I had a procedure and they blew up my kidney stone like the Death Star and I’m all good now. And I thought I was.

The next day, in my lower back, I got a tingling pain, very slight, in the place where the kidney stone had lodged. Within minutes, it had evolved into an agonizing ache, and in another minute it was so painful I had to lay down on my back and take deep breaths. I was at a mall when this happened. Oh God, I thought, the stone is back. I have no way to get to the hospital. I’m all by myself. I can’t even move. What am I gonna do? 

The pain subsided after a while and I was able to hobble back to my dorm room, terrified. I didn’t know what had just happened, but it felt like an attack. It had come out of nowhere, and was crippling, and I had no idea if it would happen again. I decided to skip class that day, to rest up, in case whatever it was came back.

It came back a lot.

On my way to class, on my way to the dining hall — wherever I was going for the next four or five days, I would randomly get this stabbing pain in my back, and a paralyzing fear would grab me. If I was on my own in the city or on campus, and I had this pain creep up on me, I’d be stranded. I’d have to lay down on my back, or sit on the ground and breathe through it.

Meanwhile, my Indian phone was running out of minutes, and I had to take an auto-rickshaw across town to buy a calling card with more minutes. I couldn’t walk across campus — whenever I walked anywhere, that stabbing pain would come back — so my phone minutes just petered away. My laundry was piling up — and in India, we did all our laundry by hand. Literally. We took it up to the roof, lathered some soap on it, beat it against a rock, and hung it up to dry on a clothesline. It was hard work. I could barely pick up my laundry basket, so the laundry kept piling up. Students at the University bought food at the supermarket across town to keep in their dorms, or ate in the cafeteria at the edge of campus, or both. The few times I had tried to walk to the cafeteria, I had been besieged by the stabbing pain and had high-tailed it back to my dorm room. I mostly ate some leftover biscuits I had been keeping in my room, so I wouldn’t have to leave my dorm. I didn’t change clothes, because I couldn’t do my laundry. I didn’t go to class, because the kidney stone pain might have flared back up. The stones are coming back, I would think, whenever the stabbing back pain would creep up on me, like a pocket knife slowly inching into my back. I’m going to have to go to the hospital again. I’m going to need surgery again. Eventually I couldn’t leave my room. I kept a bag packed next to my bed in case I had to go back to the hospital. I was in a near-constant state of pain or waiting expectantly for the pain to come back. I was a hostage.

Meanwhile, I was still peeing blood.

The hospital had given me a prescription for some medicines when I had left. I had to take the perscription to a pharmacy and have them fill it. I couldn’t tell what it said, because of the handwriting. I managed to decipher some of it and looked it up on Google when I got back to the dorms. One of them was a medicine that made me pee. Another was a painkiller. Another I had no idea. Was I allergic to this medicine? I had no idea. They hadn’t asked if I had medicine allergies. Would it interfere with the meds I was already taking — the anti-malaria pills my doctors had given me back home? Nobody knew. The doctors didn’t ask if I was taking anything else. They didn’t seem to care. Neither did the pharmacy guy — who, by the way, was like, just some fucking dude in a garage. The first time I went to the pharmacy to fill the perscription, it was closed. I came back a few hours later, still closed. The guys outside the garage-like building told me the pharmacist was on his lunch break and to come back later. I did. He was there. No lab coat, just some dude in jeans, with his friends hanging outside his shop, talking on their phones and making jokes. Was this real life?

Here’s a good example of what an Indian pharmacy looks like. (I got this from Google images.) As you can see … it’s just some fucking hole in the wall.  Don’t bother asking the guy who runs this any questions about any of the medications, because he has no clue.

After five or six days of this, still peeing blood and having this random, paralyzing pain, I went back to the emergency room. I was exhausted. Terrified. I was a prisoner. I sobbed to the emergency room physician that I was still peeing blood — a lot of it — and I thought I was still passing stones. They wouldn’t stop. I couldn’t go anywhere, or do anything. I couldn’t function. Or get groceries. I had lost five pounds. I hadn’t been to class.

I couldn’t understand what they were saying, their broken English. They did the Indian head bobble at me — which, if you’ve ever been to India or talked to an Indian person, you know that this head bobble means exactly nothing. It can mean yes, or no, or maybe, or anything, really, it’s just a gesture. I don’t know what that means, I kept telling them. Is that a yes? A no? Do I have kidney stones again?

I can’t believe I found a gif of this.

They did some more x-rays. No stone. I cried and cried. Please just tell me what’s going on, I begged the physician. I literally have no idea what this pain is or when it’s going to sneak up on me next. The physician patted my head and told me I just needed some tea. Then put her hand on my stomach. Then she started to pray. In tongues.

Make no mistake — I’m a big believer in the power of prayer. I have felt it work many, many times. That time, however, was not a time I felt it work. And that was not a time I appreciated being prayed over. Is this real life? I kept thinking. Is she a real physician? Did she just wander off the street and put on a lab coat? I laid there on the gurney and just cried harder.

After she worked her voodoo, they discharged me with more prescriptions. I was passing kidney stone shards, apparently — remnants of the original big-ass kidney stone they had already blown up — and it should be over soon. I should stop peeing blood any day now. It wasn’t and I didn’t.

I filled the perscriptions at the pharmacy when the pharmacist decided to randomly show up (there were no hours of operation, the pharmacist dude just came and went whenever he felt like it). What the hell were these medicines, and what did they do? Hell if I knew. Side effects? No idea. One was a painkiller. I tried to google the rest. No results. I had no information, even from Google, because the only English websites about these medicines were sites like the FDA, which didn’t recognize the names of any meds because they weren’t American medicines. Great.

The next day, I was so nauseated I couldn’t stand up. I made myself puke in my private bathroom in the dorms so I could end my misery, but I was still just as nauseated as before. I couldn’t eat — not that I had groceries anyway. Some friends brought me some strawberries and I puked those up too. I was still peeing blood. A lot of it. Every time I looked in the toilet my heart would start to pound, and I’d get this warm, tingling wave of anxiety all over my body. One day, I just stopped looking. Somehow, I managed to crawl out of bed and I went back to the hospital. There was an on-campus doctor at the university, but he only came every other wednesday (or every wednesday, I don’t remember), so it was either lying on my dorm floor, puking, or back in the hospital, trying to figure out what was going on. So I went back to the hospital.

Oh, said the physician, when I told her I had been severely nauseous. That’s a side-effect of the medication. I’ll give you another medication you can take. 

LOL, I thought. There’s no way I’m taking anything else you give me. I lied and told her I was fine and got the hell out of there. I lied and told her I had stopped peeing blood days ago. Before, my choices were the Indian hospital where nobody knew what they were doing and some freak voodoo bitch was trying to poison me, and my dorm room where I had no clean clothes, no food, and no contact with the outside world since my phone had run out of minutes a week ago. I’m getting out of this hell-hole, I decided. I’m going home.

Immediately, I ambled back to my dorm room and tried to buy a flight home. Lots of websites were blocked at the university for some reason, and I couldn’t access any travel websites. Because terrorism, or something. The next day I went to leave campus and go to an Internet cafe where I could purchase a flight, only to be told that nobody was allowed to leave the campus because there were mobs of people just randomly attacking women all over Bangalore. Is this real life? I called my parents, who had to jump through a bunch of hoops to purchase an international ticket (because again, terrorism, or something), and finally — finally — about ten days after this nightmare had begun, I was getting out of there. I threw everything in my suitcase. I threw out what didn’t fit. I hired a cab and hugged my friends. And I started the 30-hour journey back to Chicago.

What we talk about when we talk about crippling anxiety (Part 1)

I. The Kidney Stone
The thing that spurred my PTSD was a medical event. One day, during a semester studying abroad in southern India, I woke up in the most excruciating pain of my life (transition during labor was a close second). I felt like there was a knife in my back, and for some reason I was sweating, with chills, and retching like I had the flu. I had never experienced anything like it in my life. And it came on so suddenly, I had no idea what to do. For the next few hours, until I finally made it to the hospital and got a shot of morphine (or, you know, whatever they gave me, like I cared at that point), my brain only functioned in a primordial, reptilian state. All I could think was pain, need drugs, need hospital as I paced around the room in agony. The only reason I got to the hospital was because some very kind friends called a driving service and practically carried me out the door.
In India, everything takes like three fucking hours, and is unbelievably inefficient. Need to buy some food? Nobody stands in a line. They just crowd and push each other in one big mob until you shove yourself to the front of the line and yell your order. So too, is protocol in an Indian hospital. When I finally showed up and waded past the mob of people just ambling around the door, I had to fight my way to the front desk and fill out a stack of paperwork that asked about my mother’s maiden name and what my father did for a living. “Can I just get a shot?” I sobbed, probably sounding like a junkie, but in too much agony to care. “Can I fill this out later?” Alas, no. I had to fill out all the paperwork before being seen. And before I had an ultrasound, an MRI, or any kind of test, I had to pay for it up front, in cash. In between trips to the ATM, I ran outside to throw up. The friends who escorted (dragged) me to the hospital filled out the paperwork for me.
So I’m running back and forth between the waiting room and outside, throwing up and in unbelievable pain. I would so much rather throw up in the bathroom because the thirty or forty people outside the entrance just wandering around are staring at me whenever I rush outside and vomit. I find a bathroom and duck inside, only to find that it’s a squat toilet. I can barely stand I’m in so much pain, but somehow I shakily manage to position myself over this thing in what feels like an excruciating game of Twister. And by the way, the urge to pee is unbearable. I have to pee like I’ve never had to pee in my life. And the worst part is, I can’t. I want to so badly, but I can’t. Every time I try to sit down and fill out the “paperwork,” I jump up and start pacing. “I have to pee,” I keep saying. “I’m going to have an accident. I have to pee.” Nothing comes out. But I keep running to the bathroom anyway, because that’s what you do when you have to pee. Even when nothing happens, it’s instinctual. I just keep running back to the squat toilet and hovering over it and praying that something comes out, praying for just a tiny bit of relief. Nothing. I don’t know it at the time, but I have a kidney stone totally blocking my urethra. I squat over the squat toilet and retch while I’m trying to pee.
The squat toilet. It looked like this. Only not as clean.
Finally they grab me and take me back to a triage room and give me a little bowl to throw up into instead. They tell me I probably have a kidney stone and that I have to try to pass it on my own. They give me a water bottle. Great, I say, except I keep throwing up everything, and by the way, can you give me some painkillers or put me in a coma or something? Awesome. Finally – FINALLY – a doctor comes over and says they’re going to give me pain meds. I look at the clock. It’s been over THREE HOURS since I woke up in pain. They have to give me a shot in the “behind.” Oh you mean my ass? Awesome, here it is. I yank down my pants in a very un-ladylike way and wag my butt in the air desperately. “Uh … let me go grab the medicine first,” the doctor says, disturbed, and pulls back the triage curtain. Every person in the triage room turns and looks at my lily-white ass. I don’t even care.
About three and a half hours after I woke up in the worst pain of my life, I’m given pain meds, and it’s like a big bear hug from Jesus. I still have to pee badly, but the awful, white-hot, stabbing pain is gone so I’m delirious with glee. “I have to pee soooo bad, you guys,” I keep saying to my friends, who, like guardian angels, are fielding the questions from the nurses and helping me retch into my bucket. I keep trying to pee in the hospital bed I’m on because the bathroom is way far away and also because it’d be kind of funny. Still nothing is coming out. Every nurse that comes by wants to know if I’m a student. And what I’m studying. I keep making things up because WHO CARES. Can’t they see that I’m dying?
When was the last time you peed? The nurse asks me. Well, shit, if you put it that way … three days ago? I start to panic. How did I not realize this? Who doesn’t pee for three days and just figures that’s normal? The nurse clucks disapprovingly. It’s a kidney stone. We’ll have to catheterize you to get the urine out. She goes to get the supplies and another nurse.
Meanwhile: I call my dad.
“Dad?” I say, when the call goes through. “I’m in the hospital.”
Click. The connection drops. I try again.
“Hello?” My dad sounds gruff, concerned. “Sarah?”
“Dad, I’m in the hospital.”
Click. Cut off again.
I call my brother and finally get through. I tell him I’m in the hospital and the call drops out, AGAIN. There is no reception at all in the triage room. I can’t leave because the nurses need to cath me. I start to feel faint. I’m going to die of uremic poisoning three thousand miles from home and nobody will know. One of my friends takes the phone outside, finds reception, and calls my dad back. She calls my fiance. They’re concerned but ultimately can do nothing. I’m thousands of miles away. I don’t know it at the time, but my dad starts looking up flights to India.
The nurses start to cath me. Nothing. They try again. Nothing. They try a third time and still nothing comes out. It’s the stupid stone that’s blocking everything. They’re going to run some tests and admit me until I pass the stone, since I have a fever and they’re worried I might have some sort of infection.
Here’s something that’s hard to talk about, because I’m afraid it sounds too much like a privileged, first-world problem: The hospital was kind of shitty. There were cracks in the walls. Dirt on the floor. Not completely run-down, but nothing like you’d see in the States. The whole building and everything inside it looked like a relic from the 1930s — the IV drips were glass, instead of plastic. The paint on everything was chipped. Nobody wore gloves. There were puddles of water (I hope it was water) on the floor. There were no soaps in any of the bathrooms — and I peed in a lot of different bathrooms. For a long time, I was ashamed to tell this story, because the condition of the hospital was part of what was so traumatizing, and if that isn’t a First World problem, I don’t know what is. Like, wahhh, I went to a poor person hospital, I’m so traumatized! The thing is, all of these weird things in the hospital combined — the squat toilets, the no-soap, the no-gloves, the weird puddles on the floor — made it seem not-quite like a hospital. And cumulatively, it added to me feeling generally terrified and unsafe. I went in for an MRI and the technician was in jeans and a hoodie. Was he a doctor or just some dude off the street? None of the nurses wore gloves — didn’t these people know how bacteria was transmitted? Every nurse that came to see me asked if I had a fever. They never took my temperature — and to be honest I’m not sure if a thermometer existed in the whole hospital. I never saw one. Do you have a fever? They kept asking me. What’s your temperature? “I think so,” I kept saying. “Can’t you take my temperature?” Nobody did. They just kept asking. How qualified were these people? And not that speaking English is a good standard of care, by any means, but the fact that everyone had broken English made it even more terrifying. I didn’t know what was happening, and I couldn’t understand them when they tried to explain. I had no way of knowing. I just had to trust that I was in good hands. And I wasn’t so sure. It felt like a fever dream. Like a bad joke.
Anyway. I get an ultrasound (I had to pay for it first, of course). I get an MRI. I get some x-rays. Doctors are still asking me if I have a fever. I’ve stopped throwing up but I still can’t pee. They say if I don’t pee on my own, they’re going to admit me for surgery. I keep drinking and they keep running tests. They find a kidney stone on the x-ray and tell me to keep drinking water. I want to die I have to pee so bad. A few hours later, I haven’t peed, and they admit me. I pay an extra three thousand rupees for an air-conditioned room with an “English” toilet. They schedule surgery for that night. I’ve never had surgery in my life. For anything. I’ve never even had a cavity. I have no idea what anesthesia is like. I have no idea what to expect.
That night they prep me for surgery. A nurse comes in and shaves me with a single blade and a dingy cup of water and I decide that I’m going to get tetanus or hepatitis by the time I’m out of this hospital, if I don’t die of uremic poisoning first. Being naked in front of this stranger shames me, and tears leak out of my eyes as I stare up at the ceiling.
Why you cry? She asks, jostling me. You’re okay! Don’t cry! You’re fine!
I’m not crying, I say, wiping tears away. She keeps jostling me.
The nurses come in and take me down the hall. I beg them to put me under because I haven’t slept at all and hardly slept the night before. I’m exhausted and amped up on adrenaline. I’ve never been in surgery and I don’t want to be awake when they’re prodding me and cutting me open. Please just knock me out, I beg the nurse. He advises me not to use the phrase knock me out when I ask the anesthetician, but they agree to do it.
We are going to catheterize you and then insert the scope, the doctor says, and puts the gas mask over my face.
Gotta … buy me … dinner … first … I whisper, and fall asleep.