Salud mental

“I’m trying to think positively,” said Pablo, “They tell me I gotta think positive, so I’m trying.”

I had asked him how he was doing.

I can do that now. I’m back to normal, back to my schedule of waking, doing the trot, plunging myself in the ocean for five minutes, returning home, writing, cafeing (guess what just happened!) and doing a bit—a very little bit—of housework.

If that comes at the price of eating jellybeans at three in the morning, it’s well worth it. 

I can do it because I have a good shrink—a Harvard man!—and good supports. 

But what about Pablo?

He’s just a kid, maybe 21 or 22. And he’s a cashier at Supermax, the little grocery store in Old San Juan. For reasons that make perfect sense in Puerto Rico and nowhere else, I have become something like a therapist.

Well, not surprising. Happened at Walmart, too. Most of my classes—I confess this now—drifted into group therapy sessions. Motivational talks as well.

So Pablo told me, a couple weeks ago, that he’s depressed and having panic attacks.

‘Why,’ I thought, ‘he’s a kid, he’s good-looking, smart—what’s he got to be depressed about?’

Answer—how old were you, Marc, when you first got depressed?

Sixteen—I was going to kill myself in the gravel mine in Shorewood.

So I told Pablo—“you gotta get to a psychiatrist.”

He agreed wanly. And I knew.

He won’t go.

Could be that he doesn’t have insurance. Could also be that the insurance doesn’t pay for it.

My guess, though, is that he doesn’t go for the same reason I didn’t go.

He’s stuck.

Look, I worked for ten years as a psychiatric nurse, and could I diagnose myself? I had to have a brother screaming in my face before I got help.

And how am I now?

Happier than I’ve ever been.

A lot of that is medicine. I ran out of the drug I was trying to taper off recently, and went ONE night without it. By four the next day, I had started having leg cramps, just as I did when I was trying to stop taking the drug. And no—I wasn’t imagining it. I looked at my calf, and could see the muscle constricting.

Well, I knew what to do. I went to the pharmacy, got the prescription refilled, took the pill immediately after leaving the pharmacy (bought water just to be able to take it sooner…) and waited. Forty-five minutes later, I was fine.

A lot of it is routine. A rainy day comes, and I don’t do my trot? I feel it. I write in the mornings and promote Iguanas in the afternoon. I have a to-do list that is longer than I could possibly do.

A lot of it is support. Between 5:45 and 6:00 every afternoon, the gate below will click, I’ll hear the lock snap, and Raf’s footsteps climbing up the stairs. He does not go to the glen to mix with men—an old phrase from somewhere.

Nor do I.

Now then, let’s run back to Pablo.

Is it logical to tell a depressed guy to think positively? Would we tell a diabetic to concentrate on lowering his blood sugar? By definition, isn’t thinking positively exactly what Pablo can’t do? Aren’t we setting him up to fail?

And what’s the message here? ‘Oh, you just need to straighten up and get out and chase those nasty thoughts out of your head!’ Depression as a form of badthink. (Darling computer, badthink was a term invented by Orwell—so stop with the red squiggly, hunh?)

I didn’t tell any of this to Pablo, though maybe I should have. I did ask if he was exercising, and told him my own regimen. 

“I could do that,” he said, “I live five minutes from the beach….”

That, I thought, was the classic example of the depressed mindset.

You are five minutes from a beach.

A beach you cannot get to.