“How do you want this next phase of the pandemic to feel?” That’s what my therapist asked me last week after I spent the first half of our session cataloguing the fears and anxieties that are currently dragging me down and eclipsing any hope that things will ever get better. People have been giving lip service to the importance of mental health since the early days of the pandemic, but I saw the writing on the wall the day the first stay at home order went into place. At the time, I was newly in therapy, working my way through a mental health crisis that had started the previous fall, but really that I had been living through, in a cyclical fashion, since I was 18 years old. In winter, the world goes dark and I can’t see my way out. It’s not just about the sun and the seasons. The first time it happened, I tried to end it all in Tucson, and I’ve been suicidal in June, too. It’s never been quite that bad again, but last winter it got close enough that I scared myself back into therapy after four years of trying to twelve step my way through all my problems. By March, I was working my way up and out of the latest deep hole. I felt more optimistic about my marriage, my parenting, my work–my life. I wasn’t thinking about dying.
Then the pandemic hit, and death was imminent and everywhere. Even if COVID wasn’t coming for me, it was gunning for my grandma, and my parents, and my in-laws, and even if they survived, somebody else’s grandparents, somebody else’s parents, somebody else’s children would not. I read those early projections in horror: 200,000 to 2 million Americans could die before this thing was over. Faced with the threat of disease, something inside me shifted, and I started actively trying not to die, and to not kill anybody around me, either. I stayed home.
That’s not to say my mental health during the first part of the pandemic was great. It was absolutely not! Luckily, my weekly counseling sessions transitioned relatively seamlessly to phone and then video, and I was able to keep doing the hard work of carrying on in these difficult times. Therapy was a lifeline. Knowing I had space to talk about intense feelings enabled me to set them aside and live my life in the meantime. Therapy helped me respond to ordinary stressful situations, cope with the additional challenges of the pandemic, and even address issues that I didn’t even realize were still lurking in the background (read: leaving Mormonism). Therapy helped me hold it together.
The cracks started to show in the summer. What happened was I got sick. It came on suddenly. In the morning I was running around in the summer sunshine with my daughter. By lunch I had a splitting headache and wanted nothing more than to take a nap. By mid-afternoon, the room was spinning, my stomach was churning, my temperature was spiking, and I couldn’t stand up. As my physical symptoms mounted, so did my panic. I was too tired to move and feeling guilty about it. I was snapping at my family and feeling shame about that. We were supposed to go camping with friends in a few days and I didn’t know what the hell to do about that. I didn’t know what to do because I didn’t know how much of what I was feeling was real and how much was a physical manifestation of the deep anxiety that comes with getting sick in a pandemic. I didn’t know if my symptoms warranted a COVID test. I didn’t even know where to get a COVID test. I didn’t know if my non-COVID symptoms warranted a doctor. I didn’t even know if I could get an appointment with a doctor. Even if I wasn’t really sick, my anxiety was so off the charts bad that I knew I needed to talk to someone. You see, sometime after headache came on but before the gastrointestinal issues set in, my thoughts had turned toward self-harm. As the hours wore on and I got sicker and more confused about what to do, it started to look like the only way out.
It is my professional and personal opinion that one of the best things to come out of the COVID pandemic is expanded access to healthcare through telehealth. Unfortunately, when I was in desperate need of a virtual appointment, I was too sick to figure out how to navigate the health plan website to request one, and it remains unclear whether I would have been able to get one as urgently as I needed it. Instead, I pulled on heavy sweats (because I was shaking from chills), an N95 mask, and rubber gloves and drove to urgent care, barely managing to not throw up on the way there. When I got to the front door, I was met with a sign telling me to go back to my car and call instead if I had any symptoms of COVID. I had to sit on the ground and catch my breath before mustering up the energy to walk back to the parking garage.
From the safety of my car, I called the urgent care practice and spoke to a nurse practitioner. I told her I had a fever, chills, nausea, cramps, and vomiting. I told her I couldn’t breathe, but that might be because I was also having a panic attack. I told her I wasn’t okay, that I was anxious and depressed and didn’t know what to do. I told her I needed help, I needed to talk to someone, anyone now. I stopped short of describing exactly how bad things were in my mind because I was afraid. I didn’t want to go the ER in a pandemic. The NP told me none of my symptoms were typical of COVID so she couldn’t recommend a test. I could get one if I wanted but I wouldn’t get results for five days. She didn’t say a word about my mental health. I took the jab in the nose and it came back within 24 hours negative for COVID, but I stayed sick for weeks, cycling between anxiety and depression the whole time. I still don’t know if I had COVID. The fatigue I labored under all summer makes me think “Yeah, maybe.” It’s the aftereffects of the encounter at urgent care that I still can’t shake, though. I know our healthcare system is broken, and I know COVID has put it under unbelievable strain, but I am a white, married, cisgender, able-bodied, employed, and insured. I never dreamed I could walk into a doctor’s office begging for help and be sent away.
I had to wait for my next therapy appointment to start to process that trauma. I identified the root of my panic as not having a place to go or a person to call when I am thrust into a medical crisis. My former reliance on urgent care and the emergency room to address any serious pain or scary-seeming thing was not viable in a pandemic. With my therapist, I made a plan to finally get a primary care physician. I haven’t had one since I was living under my parents’ roof. When you have a history of abusing prescription pharmaceuticals, going to the doctor is fraught. It took awhile to find a doctor covered by insurance (fucking insurance websites!) and it took even longer to get an appointment (fucking COVID!). By the time I got in the door, I was desperate enough to fill out the intake questionnaire honestly. Little interest or pleasure in doing things? Yes, many days. Feeling down, depressed, or hopeless? Yes, most days. Thoughts that you would be better off dead or hurting yourself in some way? Yes, some days. At my appointment, the doctor broached the subject gently. “Your depression screening was positive. “Really?!” I chirped. “You mean I don’t have depression?” “No, that’s not what I mean.” I deflected some more. “I mean, doesn’t everybody feel hopeless right now? It’s bleak out there.” The doctor couldn’t disagree. She raised the issue of medication. I had a lot of resistance, but I asked the doctor what she thought. She looked me straight in the eye. “I think you could probably feel better.”
It’s not like I hadn’t thought medication about it before. You don’t plumb the depths as long as I have without wondering if one of the pills everybody else you know is taking will pull you up and out once and for all. Like going to the doctor, taking medication when you’ve been addicted is complicated. I’m afraid if they give me the good drugs, I’ll abuse them. I’m afraid if I tell them about my concerns, they won’t give me the good drugs. The good drugs, of course, are the only ones that seem worth the trouble. I don’t want to alter with my brain chemistry if it’s not going to get me high. I don’t care if it will make me feel better. I want to feel good.
My doctor told me to call her if I wanted to revisit the conversation about medication. I agreed, but was renewed in my commitment to toughing it out on the basis that my brain is not always a scary place to be. I have more good days than not. I generally enjoy my life, except when I’m sick, and in non-pandemic times, I really enjoy my life.
That was six months ago. I knew this winter would be hard, and it’s been so much harder than I thought. At this point, I am completely devoid of hope that the world will go back to any semblance of normal, that my daughter will go back to school, that I’ll go back to church, that I’ll see my family on the other side of the country, that we will get together with friends, that we will be free to walk around outside without me freaking out when my daughter strays too close to a neighbor, that we will be able to gather in groups, that we will stop wearing masks. The light on the horizon is gone, and operating in this context is getting to be too much. I’ll spare you the grisly details and family dramas and leave it at this: I’m worn down, and it feels like I’m going lower than I’ve ever been before. I was explaining all this to my therapist when she asked me, “How do you want this next phase of the pandemic to feel?” I mulled it over for awhile. My knee jerk response is that I want to feel good, goddamnit, but I know that’s asking too much. It would be weird to feel good right now. Really, all I want is to feel better than I do. I hearkened back to the doctor’s words last summer. “You could probably feel better.” I hearkened back to my own words back to her. “Doesn’t everyone feel hopeless right now?”
Maybe I’m glutton for punishment, but I’m not going on meds. Not right now. I can’t do it, not during the pandemic, for the same reason I’m not buying a bigger house or moving to the country or adopting a puppy or putting my kid in private school. I don’t want to make life-altering decisions in reaction to circumstances that, God willing, won’t last forever, and I don’t want to introduce another variable into the hot mess that is life today. I don’t want to wake up in a post-COVID world and wonder why I moved to a red state. I don’t want to wake up happy and wonder if I could’ve gotten there on my own. I might wake up in a post-COVID world and decide I still want to feel better after all, but at that point I hope the decision will feel like mine.