Every Saturday morning, I take the last Lexapro in my blue pill organizer and then dutifully refill it. 10 mg a day. Them’s the ones that keep you from screamin’, my husband likes to joke in a gravelly voice. Screaming has never been one of my symptoms, but he’s not exactly wrong either. Lexapro is an SSRI, a selective serotonin reuptake inhibitor. As a physical chemist, I’ve long joked that I like my molecules small. And serotonin, a neurotransmitter, is a small molecule. It has a molar mass of 176 grams whereas table sugar has a molar mass of 342, and protein molar masses are in the tens or hundreds of thousands. Serotonin seems simple and accessible. C10H12N2O. Surely there is more to my story than the 25 atoms in this molecule.
It seems like forever-ago. Sometime in graduate school, your Blockbuster membership keeps you company. Films are only interrupted by a nightly call from your boyfriend back in Seattle. On weekends when he flies in, you eat dinner in nice restaurants that he pays for, wear uncharacteristic skirts and dresses that you charge to a credit card, and have ridiculous amounts of sex. It is a shock to reenter your life of solitude when he leaves. Alone again, you watch movie after movie on your couch. You get lost in Casablanca and Grizzly Man and Full Metal Jacket. You keep odd hours, numb, bathed in blue television light in your living room. In this azure reality, you start peeing in the kitchen sink instead of bothering to walk upstairs. When you finally head to the loft to sleep, you hear animal cries coming from your quaking body on the floor of your bedroom. You watch the dog stare in head-tilted curiosity. You feel separate from your suffering, like it is happening to a self that is another species. You are always surprised by how intense this other animal’s pain is. You don’t connect with this sad creature. Afterward you forget about her.
In your field of physical chemistry, much experimentation is done in the gas phase, where interactions are simpler because molecules are further apart and interact less. Compared to gas-phase chemistry, solution-phase chemistry is a nightmare. Molecules in solution are in much closer contact with each other, repelling and attracting, impacting the distribution of one another’s electrons, bumbling around in close quarters, at slower speeds, with fewer degrees of freedom at any moment. This is where you do your research, in the most chaotic space. Part of the allure of this research was that the chemistry of biological systems happens in solution phase, because living things are all giant bags of salt water. You want to understand the messiness of this chemistry of life.
But your actual research is done away from other life forms, and your days are dominated by an expensive, bulky laser with an eight-picosecond pulse width. Your advisor is an organic chemist, and you are the only member of his research group. The other physical chemists in your incoming class are working on the femtosecond timescale, but your proton transfer reactions are slower because they happen in solution phase, not gas phase. You feel your picoseconds are old news, and you are embarrassed that your laser is not homemade. You collect data, tabulate rate constants in Excel, swap out benzophenones, anilines, and solvents in between runs. You are searching for the elusive inverted-region, where more exoergic reactions begin to happen slower rather than faster, a behavior that suggests quantum phenomena are occurring in the fundamental reactions you are studying. None of your academic cohorts seem to understand what your research is about, and you aren’t sure you do either.
In the morning you trudge your human shell to campus with swollen eyelids. You are hollow but try to seem purposeful. The sun is too bright, there are too many wavelengths. Going into the world is like going into battle. The only social gatherings you attend, Pint Night at the Walnut Brewery and Happy Hour at the Mountain Sun, involve lots of beer. You are lonely, but you can’t make conversation without alcohol, can’t remember how to contract the right muscles in your face in order to smile. Sad Creature doesn’t understand small talk, so she scowls with arms crossed, leaning back in her chair away from the other humans. At school, you hurry everywhere so that if you see someone you know, you can just nod and continue on your way. Every day you order a panini for lunch at the student center across from the chemistry building. The bread is greasy, and cheese seeps everywhere. You eat alone in the courtyard. If there is a drum circle protest you eat in the cafeteria that bustles with undergraduates. On days when proximity to strangers is unthinkable, you eat in your lab, filling it with the scent of caramelized onions that will be rancid when you come in the next morning.
When you get home from the university, you eat piles and piles of un-tasted food. An entire bag of Salsa Fresca salad disappears into you, including all the dressing and the too-salty salsa and the tortilla strips, and you immediately return to the fridge for more of anything that will keep you out of your own mind, out of the place where Sad Creature lurks. You sometimes brave a drive-thru and order a McFlurry or frozen custard. You eat half a pizza in one sitting. You marvel at the feverish pace of trips made by a flying fork, at the instinctual grabbing of salty morsels in crinkling bags, at the quiet bliss in these unthinking moments that end with you kneeling at the altar of your toilet.
The linoleum in your bathroom is ugly, the square tiles truncated at both edges of the room. Every time you sit on the toilet, you imagine moving the tiles a few inches to the right or left such that an even number of squares might be displayed beneath your feet. But when you purge, you don’t notice the floor. You clack the lid and seat up together and the faint smell of urine wafts towards you. You lean, center your face over the bowl, and hope you don’t get any splashes on yourself this time. You use your index finger on your right hand because it is more dexterous than your longer middle finger. With it, you poke at the back of your throat, sometimes touching your uvula. You never feel nauseated; this is pure reflex. The contractions in your stomach are easier now. The first one is stifled by esophageal spasms that press the food back down into your stomach. But the second contraction is enough. You try to pull your hand out of your mouth before it gets covered in vomit but don’t succeed. Acrid food rushes forth. Tears are in your eyes, the automatic kind. The squares under your knees start to jostle. You feel yourself shrinking, a withering balloon. The rim of the bowl expands until it takes up the whole room and it is all you can see. Your fingers grasp at it. Far below you, lettuce leaves float on placid water. Why does the salad always have to come out first? One of the floor squares slips out from under a knee, and you cling to the looming bowl. You are so small now, at last. Your remaining hand is trembling as the last square blurs away from underneath you and you dangle on the rim. Chunks of half-digested carbohydrates are pouring out of your mouth, you are a fountain of acid, conservation of matter no longer applies here, your hands are slipping, your fingers clawing at the porcelain until you can’t hold anymore and you let go, falling, falling, falling empty into your human-scented nest. The next thing you see is a down feather floating above you and then there is quiet and darkness.
When you rouse yourself from bed, you wash and wash your hands but the smell persists. Your dog now seems concerned about the amount of time you spend lying on the carpet crying. In the beginning she whined and licked your tears and snot, but now she seems frightened by your behavior. She hides in the closet. She is uninterested in the beer that you vomit up on the wood floor of your studio, unable to make it to an appropriate vessel in time. You clean it, crawl up the spiral staircase to your bed and pass out. Inside your brain, it begins to register that your behavior has deviated far beyond normal.
You get yourself to the campus medical center’s mental health department. In the intake interview, you grudgingly admit that you do have a plan for suicide, and you are crying again when you say it would take days before your body would be found. The intake man doesn’t ask you to recount the specifics of your plan, which is simple.
Take dog to kennel.
Buy incompatible household chemicals.
Mix them in your bathtub.
Die of asphyxiation.
You worry about inadvertently hurting your neighbors or the emergency workers who will retrieve your body. Also you don’t want to end up still alive and brain damaged from oxygen deprivation. But this method seems suitable for a wannabe PhD chemist. The man refers you to someone off-campus whose name is Harold.
You won’t tell Harold that middle school was the first time you told your mom you wanted to die. Standing in your room, you made eye contact with her for an instant. You turned and flopped on a bed that still smelled of white paint and sawdust. You heard the door close and she was gone. Mom didn’t check on your blanket cocoon that night, where the solidity of your floor began to falter.
Harold’s office is in a building that also houses an in-patient facility. You get out of the elevator and hear someone screaming behind the locked doors at the end of the hallway. You are reminded of how good you have it. Harold is a cognitive behavioral therapist, and he has red hair. His office is spacious and you sit across from him at a little table rather than on a sofa. You are supposed to take notes and hold yourself accountable, but Harold will hold you accountable, too. Harold’s goal is to change your unhealthy thought patterns. This feels a lot like judgement to you.
You admit to him that you ate an entire bag of baby carrots in one sitting. This transgression is minor so you are willing to share it. It is only vegetables, not ice cream or chocolate or cookies or chips or fast food, but you can’t look into his eyes when you start to say the words. Harold leans back in his chair. Well, that’s just too much, he says. You fight to keep your face still. You seethe, quiet.
Harold tries to reframe your struggles with body image by suggesting that you consider women of other ethnicities who are better able to accept their curves. He wants you to own your chub. Harold himself has a runner’s build, bordering on scrawny, and he is shorter than you. You tell him you went for a run around several blocks in your neighborhood. He looks at you, incredulous. And you were out of breath afterward? It is clear that Harold is not someone who can be helpful to you.
You miss your last appointment with Harold. You can barely get out of bed, but you call him and will your voice to sound cheerful. He sounds disappointed that you aren’t coming in, but he doesn’t question your recovery, your assertion that you no longer need him. When you hang up, you’re overwhelmed by failure. Again. You even fail at therapy.
Because this was not your first time. Florence, who was also your mom’s therapist, was your first. As a freshman in high school, you saw her for thirty-five dollars a visit. She was British and in her seventies. When you accidentally kicked a hole in the wall next to your twin bed, Florence impugned, Well that wasn’t a very mature thing to do, was it? You refused to speak. You went outside to wait for your ride home, sitting on the curb, sorting pebbles to occupy your mind, to keep your focus on the stones and not on the increasing porosity of the ground beneath you. Then there was Brenda during your first year of grad school. Her office had a stunning view of the Flatirons and a fluffy white rug. It was rectangular with one side significantly longer than the other. You found this off-putting but went anyway. Brenda was a talk therapist like Florence was. You talked and talked until you decided you were adjusted to graduate school and stopped seeing her.
At the school, you’ve now spent three years jumping over the hurdles of coursework, cumulative exams, synthesizing molecules, oral exams, publishing four papers, and all you have left is writing your doctoral dissertation. This process is even more isolating than your lab work was. The soundtrack of your day is no longer punctuated by the loud snap of your laser and the metallic scooting of the optical stage as it moves between pulses. You settle on a title: Kinetics and Energetics of Solvent-Mediated Proton Transfer, Electron Transfer, and Bond Dissociation. These words encompass all of your research. They are your life, and you are so very tired of them. You trek to campus to see your advisor only when you finish a new chapter. You are mostly adapting your already published work, but each chapter still takes a week or two. You are jumping through hoops. Your contributions feel meaningless. You doubt anyone will ever read your words.
As you spend less time with other humans, your mind becomes a torture chamber with a lone heckler and you believe everything she says. If they’ll give you a PhD, they’ll give one to anyone, she sneers. Your body feels larger and slower and more tired every day but you can’t sleep. You’re so fat! Everyone is staring at your disgusting body. It’s amazing you even fit in your car! You watch more movies, buy and throw up more food. Your life is dirty dishes and laundry and silence, except for The Heckler, who gets louder each day. You aren’t even sure if you like music anymore. It is too bright outside, but you don’t know exactly what the weather is because you only stare at the ground, as if to make sure it is still there. Watch out! Huge-monstrosity-of-a- human coming through, she cackles. You manage to avoid stepping in dog shit and start to recognize others by their shoes.
You write mostly at Starbucks. Baristas are some of the only humans you still talk to, and the whole ordering process takes about 45 seconds.
Vanilla latte, with half the vanilla, please.
You take care to pronounce it slowly and clearly. You have a habit of rushing the interaction, and having to repeat yourself is embarrassing.
Would you like a receipt?
No, thank you. You allow your eyes to flick upward to his. You’ve forgotten how long it is socially acceptable to make eye contact with a stranger, so your eyes jolt downward again to your wallet as your cheeks flush. You shove your VISA back in the wrong place, in a hurry to shrink out of the spotlight. Everyone is staring at you, The Heckler hisses.
You scurry toward your usual corner table, your laptop bag weighing down your right shoulder. You are limping! The Heckler observes. You perch on the edge of a chair with your back against the windows so you can see when your drink is ready. You open your laptop, push the power button, and hear your name called at the coffee bar. You stand and march to the bar. You reach for the paper cup. Thank you. Have a good day, you say. This intimacy leaves you overextended, so you turn and bumble back to your seat. These words are the first you have said out loud all day. It is three in the afternoon.
Your boyfriend finally convinces you to try medication. Maybe he got tired of listening to you cry on the phone. Maybe he was worried about your drinking or your weight gain. This convincing itself is a remarkable achievement, but you will retain no memory of it. Your first appointment with a shrink is an hour long. The psychiatrist listens to you intently, and you note that he is even taller than your father. He gives you new words to describe your condition: you are mood reactive. This means you have highs and lows even when you are depressed. He notes that your mood cycles rapidly, so he prescribes the mood stabilizer Lamictal rather than a traditional SSRI like Prozac. He believes you might develop bipolar disorder and wants to avoid the possibility of inducing mania. Mood stabilizers have a smaller side-effect profile and do not cause cognitive fuzziness. You tell the doctor you are terrified of cognitive fuzziness. You want to remain present, even if present is excruciating. (Your penchant for alcohol and other drugs makes the validity of this desire suspect.) He refers you to Colleen, yet another therapist.
You arrive at your first appointment with the new therapist lady. You are early. A skylight above lets the September sun into a small waiting area. You sit in a chair and leaf through a copy of Psychology Today. You do not attempt to read the words. This is about appearances.
You rehearse, dreading the onboarding appointment where you spill your baggage as quickly as possible. You will have to mention your transgendered ex-lover, and you will have to clarify that you aren’t gay. At least not very. You will not mention your occasional ecstasy and hallucinogen use. You don’t think it is relevant, and you don’t want to be considered irresponsible. Besides, you barely have a hookup now so your usage is sporadic. You will mention your extensive family history of depression and anxiety: mother and sibling both diagnosed with major depressive disorder, paternal grandfather committed suicide, father has depression which has never been professionally diagnosed and is possibly bipolar, mother has generalized anxiety disorder, and sibling has a history of panic attacks. All of this will make the therapist take you seriously more quickly. Especially the suicide. You will mention body image and your mom’s unhealthy attitudes toward food and her own body. You won’t mention your own purging, at least not yet. You haven’t told anyone about that because you know better and it is private and besides you can stop whenever you want. Similar story with the credit card debt you are amassing. Also, you will downplay your drinking. But insomnia, crying, emptiness, lack of confidence, social anxiety, and imposter syndrome are all on the table. The Heckler rolls her eyes at all of these things. What a drama queen! she sighs.
A lady who must be Colleen opens a door at the end of the hallway and strides toward you, hand outstretched for a firm handshake. She looks to be in her thirties. She is wearing mostly black. Her practical shoes are also black, with low heels, and they border on ugly. Her elvish face is clear of makeup, her hair is shoulder length and straight and brown. You are unfeeling as you follow her into her office.
You sit on Colleen’s couch, tissues ready. You are matter-of-fact, clinical. You know all of the right words in the right order. You try to say them all fast, without stopping to inhabit the feelings behind them. You mention your grandfather’s suicide. Making this about heredity is safer than letting The Heckler out.
You bring up the emptiness that is consuming you. Your favorite metaphor is this: the floor keeps falling out from under you. You try to move the conversation past this, but the first leak in your resolve is betrayed by bodily fluids. You reach for a tissue and quietly dab at your eyes and nose. You apologize. You know that you are fortunate in so many ways, but it feels like you are living in a hole and you have nothing left. You’ve even resorted to medication. Self-loathing spills out between your sentences. You can’t say the words fast enough. Your mind catches them and lingers and you crumble.
Colleen speaks: You care deeply about yourself and that is why you are seeking help.
You look up from your lap. You sit up straight. Her conclusion is unexpected, and you have an urge to argue with her.
And you don’t get a medal at the end of your life for suffering through without help.
You sit in silence as these sentences filter through your bullshit detector. They pass the test. They resonate.
You can’t even make eye contact with a barista at Starbucks, you tell her.
It sounds like you are trying to protect yourself, like you are in a really fragile place. You know the old saying the eyes are the window to the soul?
She sees you.
After the appointment, you walk back to your car in a blur. You blink back tears. The Subaru door chunks shut and you lean your head against the cool glass of the car window. You sob. Surprised. Spent. Relieved. This, a voice inside you says. Yes, this. You sit up straight again. This voice is new and quiet, not the taunt of The Heckler.
The next week, Colleen greets you with a smile. You slump into the couch across from her, and she asks you how you are doing. You tell her about crying in your car. About feeling like a walking wound, tender and oozing. About having hope for the first time you can remember.
If you are not willing to have it, you will, she says. You make a confused face, so she elaborates. The key is willingness to feel emotions but not be bullied by them, she says. To have feelings on your terms. If you aren’t able to accept your depression and anxiety, you will be stuck with them. Imagine you are locked in a battle of tug of war with your disordered moods. She will teach you to drop the rope. You cannot change the content of your feelings, she says, But you can change the process by which you deal with them.
The second appointment leaves you feeling exhausted and weak again. You want to cry, but you have run out of tears. You have been run over by a truck. You try to let yourself feel this way. You try to stop fighting.
You devour a book by Cheri Huber that Colleen has loaned you. Its font looks like handwriting, there are few words on each page, and its Buddhist leanings feel familiar. “Should” is a stick we use to beat ourselves with, it pronounces. What if you put your stick down? What if The Heckler is actually just a stick?
Colleen says your eating habits stem from a need for instant gratification rather than a lack of willpower. You hold onto this thought and your refrigerator door stays closed. It is a miracle.
Emotions are just emotions, she says. They aren’t inherently positive or negative. For homework, you focus on your willingness to embrace emotions wholly rather than struggling against them. Colleen suggests you take a longer lunch and go home to walk your dog as an act of self care. Colleen keeps asking you to try to treat yourself how you would treat others, and you begin to hear her voice in your head, coaxing you toward self-compassion. You get a cold that week, so you decide to let yourself be sick. You stay home from work, watch movies, and read. It feels indulgent. Your body gets better and The Heckler goes quiet, as if soothed by the time off.
Colleen tells you that the parts of the brain that allow you to excel are the same parts that make you sad. There is no Good Self that is functional, insightful, and productive, and Bad Self that is sad and lacks confidence. You are whole. Dichotomies of the self are not real. You wait to hear what The Heckler has to say about all this, but she is still missing. In her place is one steady and quiet voice, a deep knowing. Sad Creature is still around, still sniffling under the covers and feeling melancholy. But Quiet Voice is patient with her. She just needs to be held sometimes. Quiet Voice knows what to do, you just need to learn to listen for her.
Months pass. You know you don’t have unlimited time with Colleen. You will defend your dissertation on April Fools’ Day, less than seven months after first seeing her, but the seeds of acceptance that you were missing have already been sewn.
The change is gradual, like a slow awakening on a lazy weekend, until one morning I look around and realize I am feeling better. Smiles warm my face. Jokes rouse belly-laughs. At the grocery store, my eyes can meet a stranger’s. Inspired, I write down my core values in my therapy notebook, like Colleen asked. Contribute to community; cultivate understanding of myself, others, and the natural world; recognize the value in all people (including myself) and be compassionate; act in an honest and genuine way; and respect nature. My hand cramps as it grips the pen, and I can barely write fast enough. These words pour out of me like I have always known them. And in their presence, I am sure-footed for the first time.
Underneath my suffering, I am doing something that I once loved: I’m furthering my understanding of the natural world. And maybe I still have love for this. Maybe the interested, curious part of myself is still in there, buried. There is a stirring, a reawakening, as I scroll through the 146 pages of my thesis later that evening. The billions of little solvent molecules banging around in my cuvettes, equilibrating reactant and product state so a proton can tunnel through a potential energy barrier, are at least a little miraculous. The intricate dance of molecules in the universe endures, and I am a part of it. This matters, Quiet Voice says, getting louder.
I get through the final year of graduate school. I take medication to stay functional. I work on accepting this. Thanks to my seven months with Colleen, I start to understand that depression can be a normal part of the human experience, especially for someone with my genetics. And that battling it makes me miserable. Depression does not mean I am broken; it means I am human. The Heckler still speaks, but her voice is quieter and she is only a little part of me. Sad Creature pops up when I have an off day, but I know how to nurture her better now. It is okay that she is a part of me too, even if she is not my favorite part.
I see Colleen for the last time on the weekend of the chemistry department graduation ceremony. I give her my update. I’m living in California with my boyfriend. I have my first real job, and I feel like a grownup attending work meetings in my slacks and heels that are too dressy for a Bay Area tech company. My face flushes red every time I speak up in a meeting, and we both know there is more work for me to do to heal myself.
When the hour is over, I lurch to standing. I don’t know the protocol for saying goodbye to someone who helped save my life, but Colleen takes the lead and gives me a hug. I notice tears in her eyes. I force myself not to hide my own as I walk away from the cocoon of her office.
I still hear Colleen’s voice in my head. I can hear her words more easily than I can conjure up an image of her face. Somehow, a great deal of erasure has taken place. I’m tempted to explain away the darkest times, painting over them with a not-that-bad brush. Living with the primary goal of protecting myself and avoiding pain was not really living. Maybe that is why the memories feel so far away, like they happened to someone else, in another life, or at least to other parts of myself.
In the years after all this, I send Colleen the occasional Christmas card. She knows I married my then-boyfriend, the one who insisted I get help. She knows we have two children, and that other talented therapists continued the work of saving me from myself, from my genes, for years after I walked out of her office. I’ve told this story before, when my brain was not aided by Lexapro, and the ending was different, gloomier and less complete, told by a person still treading on unstable ground.
I like to say that I broke up with chemistry after graduate school, that I am a recovering chemist. But I still carry chemistry with me. When my children start learning about the periodic table, atoms, and bonds, I already know my enthusiasm for the theory, the academic part of my science, will come roaring back. And while equations and laws are useful, I hope to teach them that the magic of chemistry is also in the intricacies of a wet lab, in the solution phase, where things go wrong, where sometimes results are not reproducible, where the earth can shake, where the search for answers is never really over.