what one doesn’t expect to do on a friday night

i went to the mental health/crisis clinic in portland tonight. didn’t know i was going to wind up there (was supposed to meet some ppl online, but when i hadn’t heard from them by 7pm, i gave up on them.)

having drinks at the local lesbian bar. the coworker i’d invited for drinks (had invited her because she’s having a really rough time, and needs someone to talk to) bailed on me. on drink two, drinking slowly. playing pool by myself, guy finally asks to play. solid, tall, well-built. kicks my ass. neither of us hardly say anything. he asks if i want to play again, i say no, i’ve gotta go somewhere, but you play really well, thank you.

i’d pondered on whether to do it or not. on the one hand, the state of denial i’ve been living in is what’s enabling me to subsist. and to question that thick veneer of denial, to go to a mental health/crisis clinic to talk of the very things i’m denying… pavlovian reflex not to. but then i stood there in the bar at 7pm, both parties i was supposed to’ve hung out with having bailed on me, so detached in denial i am not even there, i feel nothing. address already in my little book, and it being only 8 blocks away, without fully thinking, i am then walking the sidewalk toward the clinic, motorcycle bag and helmet in hand.

as i walk, i think i am, very detachedly, neutrally, trying to figure out what i’m going to say, when they ask me why i am there. and that my response will probably be: “i don’t really know why i’m here. (pause) possibly because someone i’ve known a while has been reading what i’ve posted online, and seriously suggested i get help. and then that friend called up to find out where i could get help, and told me to come here.” however, when it got to the point where they asked me specifically what i was there for, i didn’t know what i would wind up saying.

nice clinic. a far cry from the dingy, grungy, cracked out, homelessness of most clinics in san francisco. it was clean, spacious, well-lit. everyone was white. everyone in portland is white. i fill out the initial paperwork after the clipboard was handed to me. under purpose of visit, i write: “depression, suicidal thoughts.” leave it at that. as i sit in the waiting room (when not out smoking, staring into nothing, sitting cross-legged on the ground off the parking lot), i resist the urge to crazy myself up, make it seem like i belong there. and also ponder my impulse to make myself seem normal.

maybe 20-30 minute wait. (again, far cry from san francisco clinics, in which the initial wait is usually 2-6 hours.) a small woman with a limp finally beckons me down the white carpeted hallways, to a very clean, well-lit room. she begins to ask me questions.

to sit there at 8 oclock on a friday evening in a well-lit room with someone you don’t know, and tell this person of why you are there… to tell them that you’ve been dealing with severe depression the past 4 months, that you are wearing the same clothes every day, barely eating, crap at that, showering once a week, completely given up, everything lost, not paying your bills, nothing tying you to this planet, you’ve sorted out all your affairs, written out your suicide note, posted it online with all the passwords and such to all your online blog accounts, readied the methods by which you’d publicize the location of that… that, in response to the question “do you ever harm yourself?” and you say, “isn’t that what life is about?” and she laughs but in a non-mocking way, as if to say, yes, that’s true, and she says do you ever bang your head on things, and you don’t want to say it, it’s so embarrassing, so teenage, and you finally say in a voice stripped of all concern for what you are saying, “i’ve cut myself.” several times in the past 10 years. last time? she asks. in december. then qualify it by saying “not enough to do any damage.” what you don’t tell her is that the reason you didn’t do any damage is that you found yourself holding the very sharp knife over your left forearm, the white of your wrist, and bent it down into your skin, making a cut, and it slid so cleanly, so easily, you were so close to slicing your wrist open right then, and you put the knife away right then. because your cowardice is still too strong.

you find yourself telling this person that there is nothing tying you to this planet, but that you are not actively suicidal, at this exact moment in time. that if… if &/or when you do it, you believe it will be spur of the moment, so therefore you don’t believe that you can be actively suicidal. but that the state you’ve been in the past 4 months, it’s prime material for such an event to occur. and you are here because of that, because it’s getting worse.

when she asks you if you’ve made plans, decided on what methods you will choose, you don’t know how to respond. you don’t want to be classified as 5150. so you don’t tell her of the incident with the knife. you do not tell her of planning to the detail driving your motorcycle off a cliff into the columbia gorge, down to whether you’d pause on the road or just drive straight off, whether you should drink, take the rest of your ativan before you do it, and, despite the intense cold, whether you should strip off your gear before driving over the edge, to better ensure you will actually die from the impact. you don’t tell her about holding your bottle of ativan, looking down at it, considering taking the entire thing, but aware there’s not enough pills in it to do any real damage. you don’t tell her about the elaborate plan you concocted in which you drove yourself to a local hotel room (this plan was hatched on the day you wrote your suicide note) and take your bottle of ativan along with several beers, wait for it to kick in, and then hang yourself from whatever was strong enough to kill you dead with your camping rope. and that you planned to set your camera to film it, livestream it, so the performance could be saved somehow, posted online, for the sake of Art. you don’t tell her that you’re leaving portland in a week (because that will reduce your chances of receiving services), and that when you’ve referred to it as a suicide run in your online posts, people don’t get that you mean that literally. that the reason you don’t want to ride along the coast, that instead you want to take a bus, is because you’re scared you will never make it to san francisco. because the temptation is very great, given the homelessness and no job waiting you in san francisco, the tall cliffs, narrow roads, are so easy to drive off, that you’ve contemplated it down to the smallest detail. that with your plans to do dispersement camping in a national forest along the way, driving off a dirt road into the dark roads, you’ve planned it down to the tiniest detail. finding an out of the way spot, your sharp knife with you, downing your bottle of ativan, wait for it to kick in. you’ve drained the gas from your motorcycle, cellphone battery is drained, no chance of anyone coming on you/your body in at least 6-12 hours. and when the ativan has kicked in you take your very sharp knife and slice your wrists open, and bleed there in the darkness. and you’ve thought enough ahead to know to post-date an entry to your blog, for 10 days in the future, so that people will see what you’ve left for them online, your suicide note and tying loose ends, but giving you enough time to delete the entry in case it somehow doesn’t happen.

you don’t tell this stranger sitting in front of you in this clean, well-lit room any of this. you just say you haven’t been able to find yet a method that was foolproof. when she asks if you own a gun, you say no (though don’t say that you’ve considered buying one here in portland, since the laws are so lax, and have access to guns in san francisco, where you’re going), that even if you did, it’s not a method you’d choose, as it’s too easy to miss the brain-stream, and instead just blow part of your face off, leave you disfigured, paralyzed.

you don’t say any of this, you instead hedge, evade, some weird dance, her questioning, you evading, you only say, i’m not actively planning on killing myself at this time, but not clarifying how on the edge you are, how close to doing it you are. because you’re scared if you say this she’ll force you to stay, force you into a hospital, and what will that accomplish? (or maybe it’s the loss of freedom that bothers you more, hating being told what to do.)

she writes many things, both sides, on her piece of paper, her form, scribbled in margins, written diagonally. all stuff i’m not going to recount here, because i’m tired of it. and she posits the suggestions that perhaps what you need is not medication, but instead counseling. and you think you remember saying, i’m not against counseling (oh yes, you’d referred to counseling as a misuse of money, so sterile, clinical, so removed from the true transformation a human being in need… needs), but you are in a very bad space… oh, you don’t remember what you say, but the meeting is ended with her deciding you are going to see the psychiatric nurse afterwards.

the psychiatric nurse sees you 30 minutes later, again, down the white, clean corridors, her referring it to as a laboratory rat maze. finally into a room, with a desk, several chairs.

and it gets bad. you are so detached, so removed. you are not yourself, haven’t been yourself for a long, long time. you are not sleeping well, barely eating. you are not going out, not paying your bills, don’t have access to pay any of your online bills, things are going to collection. you are leaving in a week, putting everything you have onto the back of your motorcycle and making your suicide ride along the pacific coast. and that if you somehow make it to the bay area, what awaits you is… the depressed economy, hardly any jobs, no place to live, hardly any money with you, and sf so unfriendly to homeless people, and on top of all this you are so riddled with crippling depression you don’t know you have what it takes to look for work, to make it work. you are catatonically scared that this truly is a suicide run, you are heading to the end.

you have all this on top of you as she begins to talk to you. and you somehow break down. not in a crying way, not in an opening up way. but in a you’re not there, you are not there, i can’t give, i can’t talk about this, and it’s half an hour of you losing your conversational abilities so bad that she doesn’t know what to do, and you have you rhat over your eyes, staring into the nothing carpet, and you keep scratching your nose, you don’t know why, just know it looks weird, and she’s offering nothing definite, keeps backtracking, almost as if she’s expecting you to decide what she needs to do, or is that not it, is it instead you are socially missing, you are so deadened and detached you’re not capable of talking about it, it, the reason you are here? it gets very bad, and you respond by pulling in further, and she’s evasive, circling in her speech, and it’s the kind of speech you have the worst time with, and it makes you pull in, get frustrated even more, and she’s telling you that you don’t need psychiatric medication, instead you need to sleep, and you say yes, i’m not getting sleep, but somehow can’t explain convincingly enough that the depression has stripped you, drained you, you can’t function, can’t think, every ability to function, be a person is gone.

and you made the mistake of saying that being put on paxil as a young’un spiraled you into a manic episode. (is that even true?) cuz now she’s unwilling to put you on an antidepressant. when the antidepressant is what you want, you so fucking desperately want and need. and you made the mistake of saying that you had major neuroleptic side effects in response to the depakote. that trazodone and seroquel both, prescribed for anti-psychotic purposes, made you highly aggressive and gave you very bad nightmares. the reason you telling her all this is bad is because she’s staring at you, and you have you hat down, staring at the floor, in a very bad, compacted space, and she’s telling you she doesn’t know if she wants to give you any drugs, given the bad reactions you tend to have to most medications.

and you tell her yes, i haven’t had a good history with medication, and i stopped taking medication because of the side effects, but this, what i am dealing with right now, the depression, the being on the edge of actively suicidal… i compare the two, and the side effects from the medication is worth it, if i have to choose between the two, i will choose the side effects.

and this is what she says to you, this is honest to gods what she says to you: she looks at you, and she says, you may think it’s bad, the end of the world, but i look at you and you are functioning, able to speak, form sentences…

and you’ve already grabbed your jacket and bag, ready to go. she honestly can’t be telling you this, she honestly isn’t telling you this. she can NOT be telling you what you’ve been told so much of your life, that you’re forming coherent sentences, presenting well, then, obviously, it can’t be that bad.

the next half hour is awful. you’ve lost all ability to take part in the conversation after that. but you’ve broken down, and you realize at some point that you are trying not to cry, but it’s pushed down so deep, and you are failing, failing very badly at the human give and take, you’ve descended into a very non-functional place. she’s at a loss, it’s like she’s staring at you, waiting for you to say something, take part in the conversation, and she finally leaves, tells you to wait, she’s bringing someone else in.

and you sit in the small room, staring emptily at the floor, and the agitation is intense, and you are not there, and your eyes are not focusing and you are burning up and the humming of the room is surreal if you allowed yourself to think about it.

and the original intake person comes in, and then it’s the two of them in that tiny room staring at you. and you’ve lost the capacity to be a functional human being. and they are telling you that what they can do for you is limited, that your needs are complex, multi-layered, and you need more full-time care, and there’s nothing a crisis center can do for you. you sit there, head bowed, completely dead, empty, not knowing what dark place you will head for when you leave this clinic.

and then somehow the psych nurse has an a-ha moment, says to the intake person, hey, what about haldol? that would be a reasonable course, wouldn’t it? i somehow manage to ask what the drug is, and she says, it’s an anti-psychotic. i ask, is it an anti-psychotic like seroquel, trazodone? she says those drugs aren’t anti-psychotics. i said, oh, the clueless psychiatrist had given them to me for anti-psychotic purposes, i honestly don’t know if he knew what he was doing. she continues to do her circular conversation thing, but seems closer to a terminus, and finally decides to give me a prescription for haldol, says it will cost only $4, 30 1mg tablets, i’d cut them in half, take once a day. and possibly, if i don’t get massive side effects, when i come back in a week for the followup, she might give me a low-strength prescription for celexa as well, for antidepressant purposes. she says the haldol is a personality glue, can be used to pull a person together, together enough that they can start to function again.

you know, in some corner of your mind, that this is an interesting person, and somehow you and she sit there in the small office for 20 minutes, her telling of her own ptsd, similar problems to your own, on her own medication. she tells you that she thinks that you don’t just need a mood stabilizer, you also have a personality disorder, that your situation is multi-leveled, and needs closer looking into. the majority of you doesn’t want to hear this, because the majority of you is too far down, does not have the strength. all you can handle is a quick fix, anything, at least something to take the depression away, give you back your ability to think, manage your affairs. but a dim part of you files a note away that what she’s doing, this hyper-detailed look at you, is a good thing, it’s what more people who dispense psych meds needs to do. and she talks about herself, how she likes working on the front-line, in crisis clinics, and how the portland budget is getting slashed and she may be out of a job in june. and you know you should connect, emote, listen with more empathy, but you’re not capable of it, but you honestly wish you could.

she walks you down the rat maze out to the main door.

you walk back down hawthorne, past the lesbian club, dykes milling about, you too in another dimension to be a part. your thinking is sluggish, has been. you go to two different pharmacies to try to fill the prescription, none pan out. you give up for the night. you are clumsy when filling your motorcycle with gas. you merely sideswipe a car. you feel borderline paranoid, like the walls of reality are floating, your mind is truly falling apart. you purchase an incomplete 6pack of beer, the guy has to point it out. you go back for another bottle to round out the pack. you walk back to your motorcycle, start it, to find you left your helmet across the street at the corner store.

you finally drive thru the oddly warm portland friday night air down dark city streets, clumsy and everything floating, and when you arrive home you somehow manage to get yourself in the front door, only to find that the lightbulb has died in your room. so you sit here, in a pitch black room, typing this post, and then you publish it.