My Journey With Medication (Transcript)

This is a transcript of an IGTV video posted to my Instagram account on 13th March 2021. The video itself was recorded on 10th March 2021.

Disclaimer #1: This is not eloquently written at all because it is literally a (very lightly edited) transcription of my speech. Apologies for any headaches the colloquialisms & tense inconsistencies may cause a reader.

Disclaimer #2: My (admittedly politically-incorrect) use of the word “normal” is meant to signify, “not mentally ill” and nothing more. Again, apologies for any offense caused, no harm intended.


Hello, hello! It is your girl Akotz, also known as The Spider Kid, coming to you live from my bedroom in Accra.

A few days ago, I asked via Instagram Stories if people would be interested in a video about my journey with medication, and the answer was a unanimous yes. So, this is that video. I am going to be talking about my journey with medication.

Timeline

Just to start, here is a brief timeline:

My depression started in 2012. That is as early as I can remember the onset. I did not go on antidepressants until 2019, and this year, 2021, is when I started coming off the medication. As of right now, I’m less than a week free entirely of medication and I haven’t been doing too badly, so that’s a good sign.

Why is there such a long gap between when my depression started (2012), and when I got on medication (2019)? It’s because I resisted medication for a really long time. I didn’t like the idea of something messing with my brain chemistry. Because I felt like if I put strange chemicals in my body that changed the way my brain would work, then it would change me as a person. I didn’t want to not be myself in any way.

Here’s the irony: I didn’t want to change my brain chemistry because I didn’t want to become unrecognizable to myself. But without medication, my depression worsened, and I did eventually end up becoming unrecognizable to myself. Long story short, I am really glad I got on board with the medication thing, because frankly, it’s possible that without the medication, I wouldn’t even be here today. When I tell you my depression was severe, I’m not lying. Just believe me. I’m not lying.

What Changed My Mind?

Hhow did we go from “I don’t want to change my brain chemistry” to “Okay, I’ll do the medication thing”? Well, I had a massive breakdown in the latter part of 2018. At that time, I was studying abroad in Cape Town, South Africa. After my massive breakdown, I basically told my parents, “If you make me go back to school for the next semester, I am going to kill myself. No bend, no curve. Like, it’s just… I’m not going to come back alive.”

So, my parents agreed to let me take the semester off. I’ve written about how I felt about that in a blog post called “Terror + Taking A Semester Off.” And the idea was that being home would make me feel better, and I wouldn’t have the demands of school upon me, and I would get or behave healthier.

But that wasn’t happening. I wasn’t getting better, and a month or two into my semester off, it got so bad that I would go to sleep crying, I would wake up crying, and I would go to my mummy’s room and be like, “Mummy, I don’t want to live anymore, I don’t want to do it anymore.”

I think my mother was really scared for me. She has been scared for me for a long time. But she decided at this point that, “You know what? My daughter needs help, I don’t feel that I have the capacity to give that help, let me get her professional help.”

So she contacted this therapist who eventually ended up seeing me for the remainder of my time in Ghana during my semester off. And I was lucky enough to get a therapist who treated me for free. It’s her way of giving back to the community, according to her, and I really appreciate her for that. But she was immensely helpful.

Honestly, this was not my first therapy attempt. (That’s an aside.) And not even my first therapy attempt with this woman. I had tried her before, although not very regularly. I’d seen a number of other people as well, but none of it ever seemed to work for me. So, at this point, me, I didn’t really believe in the ability of therapy to help me. I think the only reason that I agreed to my mother’s recommendation was because, well, I felt like I had nothing to lose at that point. It was like, “Well, if nothing is going to help me, it doesn’t make a difference whether I do it or not, does it?” So I was like, “Okay, I’ll go and see the therapist… again.”

So I did.

Now my therapist treated me with Cognitive Behavioral Therapy. But she insisted on this two-pronged approach. So there’s the behavioral side of things, and there’s the brain chemistry side of things. She directed me to a psychiatrist that she partners with, and it is that psychiatrist who diagnosed me once more with severe depression, mild anxiety and basically determined that my case was severe enough to warrant medication.

Note: Medication is NOT compulsory!

I just want to add that medication is not compulsory for any depressed person. Unless your diagnosis determines a need for medication, you will not have to be put on medication. That’s one of those things I want to throw out there.

See a psychiatrist! If they tell you that you need medication, you might want to go with it. I wouldn’t recommend going on any medication if you have not been expressly told to by a medical professional.

Therapist/Psychiatrist Meeting Rhythms

I was seeing my therapist biweekly, I was seeing my psychiatrist biweekly.

For two years, 20mg of Fluoxetine daily was my dosage. I was taking the medication, I was going to therapy biweekly. When I started improving—and I did start improving—my psychiatrist meetings ended up becoming more sparse. It was like, instead of every two weeks, it was every one month and so on.

Note: Your Medication Depends on Your Diagnosis!

Another thing that I want to add is, the medication that you are put on is also dependent on your diagnosis and the way your mental illness is manifesting. For me, my illness was manifesting in the form of low energy, perpetual tiredness, oversleeping… There was this constant lethargy, like I feel like I couldn’t be awake. My brain was not alert. And that was the reason my psychiatrist deemed Prozac to be the right medication for me. Because according to him—I’m just quoting him here—Fluoxetine has a component of alertness. So that was supposed to counter all the lethargy that was coming about as a result of my mental condition.

The 2-Week Delay in Effects

So, here’s what happened: When I was being put on the medication in the first place, I was informed that it’s common for antidepressants to take up to two weeks to actually start doing what they’re supposed to do, which is anti­-depressing you. What I mean is that, you will be taking the Prozac every day, but for two weeks, you might not see a change in your moods. It doesn’t mean it’s not working. It’s just a delayed release, your body getting used to the medication, and so on and so forth.

However, medications have side effects. The side effects vary from person to person depending on how your body receives things, and even though the actual anti-depressing can take two weeks to start working, the side effects can start immediately. Changes in appetite, changes in sleep—which could both lead to weight gain or weight loss—mood swings, stuff like that… All these side effects. They can start immediately, even if you don’t start feeling better.

I was there taking the Prozac for two weeks daily. I took it every night. And the reason I was required to take it in the night was because of the things I just mentioned: the lethargy, the oversleeping, and so on. Because Prozac had an element of alertness, it was supposed to be helping me to be less tired and sleep less. I took it closer to my sleeping time so that, you know, I could hopefully sleep for like 8 hours—you know, a normal amount of time—instead of like, thirteen, which is the kind of thing that I was doing quite regularly.

When I first started on the medication, I was as bad as ever. Things were going exactly as they had always gone. I still felt like there was a weight in my chest, that the world was dark, that I was sinking in a pit…

And then the miracle happened.

Rapid Improvement After Delay Period

The miracle happened in the third week, as was predicted. My goodness. I could not believe the change in myself. I became normal. And when I tell you that I had been depressed since 2012—I didn’t know what normal felt like. It had been years—like, seven years—of not knowing how to function like a normal person, and suddenly, I felt normal.

Let me tell you something. I have had chronic headaches for pretty much my whole life. As soon as I reached adolescence, these headaches started. And they would be triggered by different things. Sometimes, it would be staring at a screen for too long, because I have photosensitive eyes. Could be staying awake for too long. Could be PMS. Basically, anything and everything that could possibly give me a headache gave me a headache. It was the sort of thing that could incapacitate me for days. As in, like, an entire weekend, you’ll not see me because I’m stuck in my bed, because my head dey bash.

So I had all these problems with watching TV or watching movies or what not, because I know that if I spend too long looking at the screen, I am going to have a massive headache. But I started watching a TV series—multiple TV series, actually—and I would binge-watch them. Let me tell you, binge-watching is not something I can, or I could, comfortably do, because of the whole headache business. Like, unless I want to be incapacitated for a week, binge-watching anything is a terrible idea.

But I started watching TV—five or six, seven episodes a day, which was unheard-of for me, and I felt absolutely fine! For seven years, it was rare for me to even go three days without a headache. And here I was, counting the days like “Eighteen, nineteen, twenty, twenty-one…” I was like, “This is not possible. This cannot… How… How is this happening? How am I functioning like a normal human being?” I was so happy. Herh. Is this how the rest of the word lives?

Because my brain was now getting accustomed to this new thing that had been introduced to its chemistry, the effects were very, very strong, very noticeable, very strange to me. That’s what happens when your body is introduced to something new. It’s like a shot of adrenaline kind of thing.

Good Effects + Bad Effects

I began to even out in the coming weeks. I started to feel less superhuman and more human. I was able to recover a lot of my energy in the coming days and the coming weeks.

And then I stopped being able to sleep.

Basically, the Prozac was doing too good of a job at combating my depression lethargy. At my meeting with my psychiatrist, I mentioned the changes I was going through. He instructed me to stop taking it in the night, start taking it in the mornings instead. So I wake up, and hopefully, the alertness lasts me through the day and then I’m able to sleep normally at night. And that is exactly what happened.

I started becoming more stable, more functional, more normal…

Self-Rediscovery + Mourning Lost Time

It felt like I was re-discovering myself. It felt like I had been the wrong version of myself for the last seven years and I was only now starting to discover who I was. Because the last time I felt like I knew myself, I was a child. So it was a kind of bittersweet thing. It was like, “Oh my God, thank God I’m finally normal” and also like, “I’ve never been a normal teenager. That is tragic.” That’s time I will never get back. Sometimes, I still regret that I was depressed my entire teenage life, because nobody wants to waste all those years, you know?

Anyways…

Regular Life & Regular Depression

Once I became stable, my therapist and my psychiatrist declared me fit to return to academia. I went back to school, and I was meant to continue on the Fluoxetine daily, every morning, until at least graduation. So that would be two full years of medication. And that’s what I did. From 2019 to 2021, from February to February, I have been on Fluoxetine daily.

Something happened that drove me back into a terrible depression, and that thing was the slow, agonizing process of breaking up with my best friend of four years. But at the very least, that depression had an identifiable trigger. It wasn’t like, “Oh, nothing has happened, and I’m sad.” You know, it was more logical.

Aside the whole best friend thing, there was also a lot of drama happening with my family. You could say it had been going on my whole life, but it worsened significantly the semester I was off from school.

I kind of dreaded coming home, for one because I felt like my whole social circle had shattered because of my separation from my best friend. And also, I didn’t want to come home because I didn’t like the state of my family. I felt like it was going to be oppressive, unhealthy, and toxic… In the end, I only had to worry about one of those two things, and that thing was my family, because it really was bad… Ahaha.

And then, there was a pandemic. Hm-hmm.

The pandemic affected my mental health the way I assume it affected a lot of people’s mental health. The idea of uncertainty, being kept in all the time, separation from your loved ones, the lack of physical intimacy, all of those things, you know. They were taking a toll on me.

But then I started to get significantly worse, even though I was still on the medication. So about seven months into the pandemic, it felt like I was getting close to losing it again. It was that sort of thing where I’ll just be there, then I’ll start crying, and I don’t understand why I’m sad, that sort of thing.

I was stranded/quarantined/being generously housed in my family friends’ home in Maryland. (Shout-out to the Amate’s!) My uncle thought that it might be homesickness. I don’t know if it was, but I did know that being at home had worked to restore my mental health before.

Once Kotoka opened its borders back to travelers, I was able to return home. And then I felt better, and then I graduated, finally!

One day I will talk about the stress and what a miracle it is that I actually graduated at last, because it’s not a trivial thing. If you know me, if you know anything about me, the fact that I graduated from college is not trivial at all. But that’s for another day!

Fear of Life Without Medication

I graduated. And, having achieved what I was meant to achieve on the medication, it was now time to reach out to my psychiatrist and be like, “Hello! Yeah! I’m done—what do we do next?”

But then, fear set in, and I procrastinated reaching out to my psychiatrist for at least a month. Because I was like, “Okay, I feel okay. I graduated. But I’ve been feeling okay because I’m on medication, right? So if I go off the medication, I’ll probably return to the depressed state, right? So maybe I shouldn’t go off the medication. Maybe I should just stay on it forever. Ooh!”

Of course, I didn’t like this train of thought either. Because I never want to be dependent on anything—not even if that thing is “good for me.” I don’t want to be dependent on medication, but it didn’t change the fact that I was terrified of what might happen if or when I got off it.

I procrastinated reaching out to my psychiatrist, but my mother kept being on my case. Up until this point, she had been the one collecting my prescriptions from my psychiatrist because I was in the abroad. She would collect my prescription and fulfill it, and then send it with whichever family member is coming to America. (When the pandemic set in, she sent my medication through FedEx.)

Weaning Off + Withdrawal

I finally reached out to my psychiatrist in January. And then, throughout February, I began the process of weaning myself off the Fluoxetine. I switched from daily to alternating days. So, every other day, I would take the medication.

The most obvious side effect of the Fluoxetine for me has been the changes in my sleep. There have been times where I have missed a dose by accident, either because I had missed a dose, or I had run out and hadn’t received my replacement. But, whenever that sort of thing happened, it was my sleep that was first to go haywire.

What happened when I started weaning myself off the Fluoxetine is that my sleep, energy, and mood levels went all over the place. The lethargy started coming back full force. Once, I slept for like, thirteen hours. Another time, like eleven? Twelve?

I started working out less, you know… Sleeping ridiculous amounts. And I would have these mood swings. Like, I’d be super exhausted, and I wouldn’t sleep, but two hours later, then I’m suddenly full of energy, and then not too long after that, I’m back to the exhaustion state.

I’ve generally been sadder than usual… I’ll just be sitting there, then I’ll start crying. This happened at least three times during the month that I was doing alternating.

Here’s something that I noticed about the alternating days. I felt better on the days when I didn’t take the Fluoxetine. I think the reason for this is that the Fluoxetine has a slow release. When I take it, it doesn’t work until the next day; I would be happier or more energetic on the days that I didn’t take the medication, rather than the days that I did.

Since last month, which is when I started weaning myself off the medication, there have been a few tragic events in my life, in my family. And that has contributed to a lot of sadness in my whole demeanor. But to a large extent, that sadness is rational, because, you know, there have been sad things happening.

Warning: Going Off Meds Can Be Initially Tough!

My psychiatrist in agreement with myself [decided] that we will try to see what I am like when off the medication entirely. So, last week was my last meeting with my psychiatrist. Since Sunday, I have not taken any Fluoxetine, and I seem to be doing well.

Once again, there was a warning that for the first two weeks or so that I go off the fluoxetine completely, it might be rough. Like, I might experience a serious downhill turn and it might be frightening, but I should be prepared for it. Hopefully, it should even out in the coming weeks and days.

Surprisingly, I haven’t had that low dip yet, and it’s been a few days. But I still feel okay. I still feel stable—thanks be to God.

But I still feel kind of scared that it is going to happen, that it might happen. And I won’t lie, I am still absolutely terrified that I will return to the unrecognizable version of myself, the depressed version of myself, whom, frankly, I never want to see again.

So Far So Great? 😊

But, so far, so good. And I am out here telling myself, trying to make myself believe what I think is true in this moment, that my God is bigger than my depression. I keep trying to tell myself that and banish the fear, because I don’t want to be afraid, much less of myself. I don’t want to be afraid of myself.

Yeah, to anyone who might be considering the whole medication thing, here’s my story. Hopefully, it helps you in some way. If it doesn’t… sorry?

Spider Kid out!

Silk Ribbons Unraveling (A short story)

I killed you in your sleep.

I thought it was only fitting, what with “knocked out” being your default state whenever I was around.

You used to tell me it was because you found my presence so comfortable. Personally, I think I just bored you to the point where being unconscious was literally more appealing.

“That’s not true,” you’d have said, if you were alive. “And I invite you to lie with me sometimes.”

And that second part, I’d acknowledge. But even if you sometimes fell asleep holding fast to my body, you wouldn’t be out five minutes before your arms slid off, like silk ribbons unraveling. I wanted arms that held fast, like the tug-of-war ropes from primary school P.E. Ropes that grazed the underside of our upper arms while dragging feet created dust clouds along the barren ground.

But all your arms could ever remind me of was silk ribbons unraveling.

(more…)

Notes on My Non-Linear Healing Process

Rationality and Irrationality

I suspect that wanting to live—wanting anything at all, just wanting—is a human default. It does (or should) come as normally as breathing. According to this line of reasoning, a mentally healthy human being shouldn’t need a reason to want to live. There’s a reason why survival instinct is called what it is. A desire to live is thoughtless; instinctive.

As I progress in my journey of recovering from mental illness, the thoughts in the paragraph above have been foremost in my mind. The healthier I seem to get, the more I seem to want to live. When I am healthy, I wake up and do things, without necessarily contemplating the futility of it all. And when I do consider the futility of it all, I almost instinctively brush those thoughts aside and continue to do life.

The most fascinating thing about my fluctuation between good and ill health is that in each condition, I continue to think the way I’ve thought for ages. Most things about life as it is, I still consider to be largely meaningless, unnecessarily stressful, and stuff I simply do not want to have to deal with. I’m still frequently baffled as to why Someone thought it was a good idea to put me, alive, into this world. In other words, I don’t consider the sentiments of my mentally unhealthy mind to be the results of irrationality. Most of its reasoning still makes very good sense to me. The difference is that, when I am more healthy than unhealthy, those very good reasons have much less weight on me, in my day-to-day life. After all, many people who aren’t depressed are also not under any illusions that this world is in good, perfectly acceptable condition. So, no, I don’t consider my unhealthy mind to be mostly-irrational. If anything, maintaining the desire to live is one of the most irrational things a human being in this world can do.

 

The Function of Desire

On the subject of “wanting” and how thoroughly it can just vanish: In my healthy states, I find myself wanting something considerably frivolous—a high-spec Microsoft Surface, complete with a Surface Pen. I don’t need these objects—but I want them badly. Badly enough that I wake up in the morning, think about how I can’t yet afford them, and thus find motivation to go to work so that, sometime in the future, I might be able to. This deep desire for an object as otherwise insignificant as a fancy, underrated computer, is one of the main things I use to confirm that I am alive and (close to) mentally healthy. Because when I am unhealthy, there is absolutely nothing that I want—besides nonexistence or death, I suppose—however desirable my healthy mind considers it to be.

For example, a couple of months ago, a significant paid performance opportunity came my way. It ended up not pulling through—but for the period I thought it would, in working towards it, going to meetings, etc., I felt no positive emotions towards the opportunity. In fact, in that period, I frequently woke up in tears and confessed repeatedly to my relatives that I didn’t want to live anymore (which is nothing new to them, anyway). To put this into better context—and here, the post Work, Worth and Wages might be useful—I’ve spent so much of the past few years worrying that, as an artist, especially in Ghana, significant paid opportunities would never come my way. And here I was in 2019 with offers almost bombarding me successively, and I didn’t want any of it, even though I had been wanting this very thing for half of my life. That was one of the most obvious indicators that mentally, I was far, far gone.

 

Re-Learning What Healthy Looks Like on Me

On how I personally distinguish between good and ill health: If you had asked me, six months ago, if I thought I was ill, mentally or physically, I might have said no. I even admit to having published a blog post last year to that effect. My reasoning, which I still consider legitimate, was the rationality behind many of the thoughts and sentiments behind my depression and even suicidality. The world is and was trash, my friendships were indeed breaking apart, my academics were legitimately stressing me out, my relationship with my family was in shambles, etc. Verifiable facts. It’s a similar phenomenon with my body. After being plagued with chronic headaches since age twelve, and the various physical malfunctions I’d become used to and exhausted of at the same time, I suppose I came to regard these things as a kind of Akotowaa default. You know, when you’ve been sick for so long, you start believing your sick state is your natural state?

Sometime in January, I started taking two types of regular medication: vitamin supplements—to help with my lack of energy problem—and anti-depressants. Alongside these, I began cognitive behavioral therapy sessions with a qualified, Christian, Ghanaian woman. (This combination of my therapist’s identities is very important to me.) At the beginning of this treatment journey, there were a few things my professionals made clear to me:

  1. Anti-depressants don’t necessarily start doing what they’re supposed to do until about two weeks after you’ve started taking them. (The side-effects, however, begin immediately.)
  2. For a case like mine, anti-depressants wouldn’t be enough to set me on a meaningfully progressive trajectory. I would need cognitive behavioral therapy as well. Likewise, therapy alone wasn’t guaranteed to have much of an effect on me if my biological and neurological problems remained untreated. So, neither the medication nor therapy could be taken in isolation; I needed both.
  3. My healing process was supposed to be a general upward trend, but it was almost certain to be non-linear. This meant that I would be getting better slowly, but each day would not automatically be better than the last. I would still be experiencing bad spells and relapses, but the hope was that a bad spell this week, for example, would be less bad than a bad spell from two weeks ago.

All of these things turned out to be perfectly accurate projections—which is not to say that the forewarnings significantly reduced my panic, doubt and discouragement during bad spells and relapses. But, for now, I want to focus on my reaction to the physical transformations I went through when the meds at last started doing what they were supposed to do. That is, after the first two weeks of taking them.

Those second two weeks of being on medication, I experienced literally the highest level of physical health I had ever experienced in six or seven years. Chronic headaches and photosensitivity, in particular, have plagued me since adolescence began. But the third week into being on medication, I started a new TV series, which I quickly descended into binge-watching. Note that I have never, since 2012, been able to watch things—even movies at the cinema, or projections during classes—without consequences on my eyes and head. So, imagine my surprise when I carelessly got into the habit of watching six to seven 45-minute episodes a day, expecting to be crippled by migraines before bedtime, and instead… Nothing.

I don’t think there are words to properly articulate my wonder. I went twenty-one days (I counted) without a headache, even though it seemed I was doing almost everything in my power to self-sabotage, at least, according to the patterns of my body which I had gotten used to after seven years.

In those weeks, I literally could not believe the state of my health. Not only were my screen habits not severely affecting my health (I say “severely” because I still got occasionally dry-eyed), but I also felt baselessly happy and full of energy for a majority of the days. I’m not exaggerating when I say I felt like a completely different person. This healthy person, I assumed, is what I could have been several years ago, had depression not interrupted my growth.

But it was also jarring and terrifying to experience this bout of high health. For one thing, I began wondering if anything I thought I knew about myself was true. How much of what I thought constituted my personality was actually a side-effect of depression? Am I even introverted? Or has it always just been depression sapping my energy when I’m around people? Do I really have extra-sensitive eyes, or was it just chemical imbalances in my brain mimicking the photosensitivity effect? (And so on.) Among the few, few things that remained constant was that I still had a great love for good stories, storytelling, and lexivism.

Another negative effect of my good health spell was a certain rage. Rage at depression for stealing the entirety of my teenage years. What a waste of the woman I could have grown into by now! What a useless forfeit of all I could have achieved, with a healthy mind and body at fifteen, seventeen, nineteen… Yeah, I think I’m still quite mad about this one. I don’t appreciate how much of my life I feel I have lost.

The point, however, is that, now that I know what healthy feels like, it’s that much more obvious to me that I haven’t been healthy for the past few years, no matter what I have said in previous blog posts. I said those things because I didn’t understand what healthy looked like on me. Now, I do.

The further consequence of understanding my health is a general inability to continue accepting my moments of ill health as my default. (I say “general” because, when I’m depressed, my thoughts tend to return to the idea of me as a permanently-damaged being.) A few weeks ago, I realized something so powerfully striking that I had to write it down: “The sick version of me is not the final version of me.” It’s much easier to recognize depression as an affliction that I have, as opposed to a part of my makeup. My therapist was invaluable in helping me digest this one. Now, it’s easier to recognize my moments of ill health as just those—moments. In no way permanent. Because I’m recovering, however winding this process may be. I’ve decided that being depressed is not my purpose in life; therefore, I cannot stay in it.

NonLinearHealingProcess

 

Non-Linearity in an Upward Trend

More on non-linearity: If you’re quite bad at athletics like I am, this analogy might make more sense to you.

You have a lap to run, around a track. You go on your marks with full vim, ready to tear the track up. Go! The whistle blows, you start sprinting. This is easy, you’re going to get to the finish line in a breeze. Less than halfway, and your breath is already giving out. You get slower and rockier, your body unable to keep up the pace. You fear you might stop altogether. But you don’t stop. You don’t return to the speed you started with, either, because you don’t have the strength for that. As you approach the finish line, you’re sort-of-jogging at the only pace your body seems able to go at without stopping altogether. But it’s fine because at least you’re stable now. Though you may still stumble, you’re not as erratic as you were in the middle, nor as fast and unsustainable as you were in the beginning. You hope, with a little more time and practice at running laps, that the speed at which you started will one day become your stable pace.

That initial speed is kind of how my body reacted to being put on new medication—the second two weeks. New chemicals had been introduced into my body and my brain was fired up by them. Three weeks without a headache? Unheard of, in this body. But after that, my brain and body were like, “You know what? We actually can’t keep this up. We’re going to stop now, sorry.” Then I returned to chronic tiredness, and random bursts of energy, then back to tiredness. The erratic part of the lap. Now, I feel like I’m stabilizing better, somewhere at a fraction of the initial splendid health. I’m doing life almost—but not quite—like a functional human being, on most days. I’m certainly more productive than I was four months ago. But my mind and body are still swift to let me know when I’m overextending. The migraines from going too long without food, the incapacitation when I worked too much the previous day, the occasional carelessness that brings my anxiety back…

With fair frequency, I have moments of clarity. Quite often, recently, I have been able to find so much joy in personal writing projects. My desire for and pleasure derived from work, both paid and unpaid, has made me think back often to the essay, “Why Work?” by Dorothy Sayers (which is possibly the best essay I have ever read). She says in it, among many other things,

“[…] work is not, primarily, a thing one does to live, but the thing one lives to do. It is, or should be, the full expression of the worker’s faculties, the thing in which he finds spiritual, mental and bodily satisfaction, and the medium in which he offers himself to God.”

I’m still slow at most things, which can be crippling and discouraging at times, simply because the world feels so fast to me. It’s a difficult—yet somehow, increasingly easier—thing to accept that the speed at which I think I should be running, in order to be properly aligned with this world, might never be sustainable for me, and thus never achievable if I want to avoid completely wrecking myself. Another difficult prospect to accept is that I might have to be on medication for a long, long time. The future of my health is just so uncertain. Maybe I’ll stop needing the extra help soon. But… maybe I won’t. I don’t think I’m in a hurry anymore to get off it. I also think and hope that if I do get off, and subsequently experience a grave relapse, I won’t throw a fit if I have to get back on drugs.

C’est la vie, I suppose. Personally, I just want to write lit things.

-Akotowaa

Terror + Taking A Semester Off

At six years old, I wrote my first end-of-term examination of primary school, in Class 1. I emerged with the overall first position in my class. The same happened the term after that and the term after that. Then throughout Class 2, 3, 4, 5, 6, Form 1, and two out of three semesters of Form 2 (the term I wasn’t first, I was second) before I transferred schools. Altogether, I’d been overall first 23 times, which is wild to me whenever I think about it now. My intense experience of the effects of ranked success at a young age didn’t leave me unscarred.

When I was 10 years old, my father enrolled me in a graphic design course over the long vac. Four times each week, I was taking lessons on Photoshop, Illustrator, CorelDraw and more, and all my classmates were adults between their twenties and forties. During one class break, I was talking to one of them, a man probably in his thirties. He expressed how impressed he was with my intelligence and my ability to keep up with the course. During that conversation, I remember telling him my fears that all my “smartness” was a succession of flukes with an expiry date, and that one day my ability to succeed with barely any effort would just… stop. He said it wouldn’t. I didn’t believe him.

That was a smart move, because it happened a few years later.

Starting approximately from my first year in high school, my ability to succeed with minimal effort began trickling away. I’d always known theoretically that this would happen, but as it was happening, I couldn’t help but feel defective. No logic could explain the sudden intensity of my struggle to me. In the transition from one level of formal education to the next, I’d lost my superpowers.

I don’t think I’ve ever regained them or that I ever will.

So far, I have spent five semesters in tertiary/higher education institutions. Four out of five have been difficult and depressing. For three out of five, I have been some degree of suicidal. The most recent semester, which began in July 2018 and ended in November of the same year, and which I spent in Cape Town, South Africa, was psychologically the worst of them all.

When I express statements like this to my mother, she always wants to narrow the problem down to something specific, logical and straightforward enough to attack. Trying to make her sufficiently understand me is always difficult, but in this season, it seemed particularly impossible to give her anything close to what she wanted to hear.

The combined elements that made up my Cape Town semester suggested that it should have been my most enjoyable one yet. I had escaped America—the country that had been trying to suffocate me—and was back on my own continent. I was living with—or a handful of minutes away from—my best friend in the whole world. I mostly enjoyed the subject matter of my classes and admired my professors. I had a wonderful mid-semester break trip to another African country. I was financially secure. I should have been killin’ it.

Instead, I wanted to kill myself.

There was the stuff I was relatively used to: days of immobility, not being able to shower or get out of bed. Constant crying. Interspersed insomnia and hypersomnia. Normal. A lot of things were relatively new: the violent and spontaneous effects social media had on me and my consequent, too-frequent deactivation (software, databases and algorithms didn’t take kindly to my erraticism, I can tell you that); trying to cut myself open with blades; feeling a terrifyingly clear division between two internal personas like a schizophrenic Jekyll-Hyde experience. But I still think the most awful new thing was my sudden inability to write.

I wish I could explain how deep and jarring this was. Writing, for quite a while now, has kept me alive. No matter how low I’ve gone, I’ve always been able to write. It’s been my anchor in nearly every storm. Many times, I can’t even pray, and when I can, I do so in writing. Naturally, not being able to write scared the living daylights out of me. I couldn’t help but conclude that if the spirit of writing had left me, then my breath and sanity were certain to follow. If they wouldn’t do so on their own, I was invested in making it happen myself. I decided I never wanted to see a day of 2019; I had to make sure I died before January.

My academic life during my Cape Town semester was difficult and challenging and brought me immense anxiety. I was late on a few papers, missed a lot of classes, spent inordinate amounts of time trying to just comprehend homework instructions, and had all but given up by exam time—but even I could tell that my reactions to my academic difficulties were disproportionate to the true intensity of the difficulties.

It was about school, but at the same time, it wasn’t. I just wanted to not be alive anymore. I wanted to quit everything. Including struggling so hard to succeed in an academic system I thought was BS anyway. Including trying to build a life of future stability for myself when I had already decided there was no point to my existence. But there were, in fact, real reasons why school seemed to be making me crazier than most of the other factors in my life.

Most of it goes back to my childhood and everything I have internalized about academic success, its role in my life and future, how it factors into my parents’ and other relatives’ pride in me, how deeply ingrained it is into my perception of my own self-worth. I was terrified—no, petrified—of failure, and I still am.

Above all, it is the mechanics of my upbringing that keeps doing me in. It often feels like there’s robotic programming within me that determines what I will do even if I don’t believe in what I’m doing, even if I don’t want to do it. It determines how I feel no matter how much my mental perception stands in opposition. I know that academic success doesn’t dictate my worth as a human being. But the mechanics of my programming render me unable to be any type of relaxed when I’m not executing, or at least attempting to execute, stellar performance. I can fix my mind, with as much determination as possible, that I’m not going to let some measly assignment stress me out—but mechanics make my whole body tense up when a deadline approaches, drive me to harm myself if need be, just to get the work done in the end. Mechanics have me constantly performing even when I want to let go, then constantly feeling wretched for performing because with all the counteracting evidence, how will I ever get people to believe that I’m not doing okay?

Add this all to my many other struggles. Anxiety, my relationship with suffering, my friendship struggles and heartbreaks, my relationship with my body, my refusal to take care of myself… I was tired, and the world/my life felt far too much for me. It was as if everything crescendoed into cacophony in my ear. I knew what I needed, if there was any hope of recovering my health or will to live, was for everything to stop so that I could work through things, a step at a time, without the anxiety-inducing threats of deadlines or mandated tasks. I was already dying, but school was accelerating the process several-fold. I knew, without having to be told, that if I simply powered on, attempted to “weather the storm,” or “hang in there,” and try to finish school uninterrupted, I would soon succeed in killing myself. Without a doubt. It was clear to me that my life was at stake—but would it be clear to anyone else? (The people responsible for paying my school fees, for instance.)

 

“How can I fail?”

I asked this question several times to myself and aloud, in the presence of my best friend. I just couldn’t fathom it. Me and failure? The two just didn’t go together. If I failed, my world would end. I felt like I would rather kill myself than fail—even if I believed that giving myself permission to fail was probably the only way I’d be able to make it through my Cape Town semester. I was burned out, but I had to make it out alive, to crawl out of the fire on my hands and knees. If I could just survive, giving up the worry that I had to be stellar, giving up the anxiety about how much money I’d be wasting if this semester ended up counting for nothing, giving up the notion that I was worth nothing if I couldn’t ace my damn semester abroad. I was so high-strung, I had to release pressure and relax—which meant not taking the “necessity” to succeed as seriously as I did. It meant giving myself permission to fail, if I just couldn’t do what was demanded of me without permanent damage to myself. But the thought of failure elicited a visceral and violent reaction from me. I might start heaving whenever I thought about it.

The day I texted my parents an essay explaining that I couldn’t take it anymore, I wanted to kill myself because I was already dying, and that I refused to go back to school the next semester, fear of failure was all I could think about. I kept wondering how my grandparents would react, if or how to explain to them what was happening to me. I thought about the consequences of possibly having my graduation date pushed back and what it would feel like to watch the people I’d started school with graduate and leave me. I thought about what it meant that I, and not them, was suffering to this extent, why I needed a resting/healing period and they could just carry on uninterrupted.

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But then I was (and am) also afraid of rest. I don’t even know how to do rest.

The fear of failure is pervasive. It influences your relationships with time and with productivity. I always feel like I should be doing something “productive”, no matter my state of health. I’m not yet good at respecting my tiredness. Rest makes me feel like I am wasting my life and failing at something, and so even doing nothing gives me anxiety. (Highly ironic, since, when my life feels overwhelming, nothing is all I want to do.) The idea of taking a semester off terrified me partly because it meant resting, which, to me, was synonymous with being on the straight path to failure.

Even before I came back home, I knew that the concept of rest would be difficult for many family members and people back home to understand. I was perfectly right. “So, are you going to be taking classes at the University of Ghana?” “Are you going to find a job?” “Are you going to set up a business project?” “What are you going to be doing?” Every time I get asked any of these questions, I go into a slight panic. I want to scream, “I know how to keep myself busy, okay? Why can’t I just exist without all this wahala?” (How I’ve wished there was a way out of existence.)

Things have been relatively manageable at home over the Christmas + New Year break, because it’s a legitimate break. But when February comes and I’m still in Accra, dealing with the comments and questions might get harder. I feel the pressure of needing something more than “trying to stay alive” as a valid explanation for what I’m doing while off school. The pressure is murderous.

During the pre-decision, decision and now post-decision seasons, I’ve been wrestling with triggers about the value of my life. Are my life and health worth these attempts to preserve them? Shortly after I set my decision in stone, I was speaking to my favorite cousin, who said to me that he was happy it was just a break, that I hadn’t decided to quit school entirely—because he knew the value of a degree and how stressful my life would be without one. I have no doubts at all that he meant well (how could he not?) and was only trying to be helpful, but his “advice” felt so dreadfully violent to me that I began to cry when he gave it. Did he not fully understand that I was very ready to straight-up kill myself, or that trying to live this perfect, prescribed life would kill me? For me, his advice was just further “proof” that high performance and avoidance of failure were more important than my literal presence on this earth. I couldn’t be a Failure + Alive. My only options were to either be an Achiever + Alive, or just Dead (from trying to achieve).

Even after I’d declared my decision to my parents, I spent several days and weeks wondering if I was making the right one. And then, if I concluded that it was the right decision, I would be angry at myself for not being healthy enough to just go back to school and finish, like a normal person. In any case, my doubts about whether time off was necessary were cleared when my body tried to finish me in December. If I wanted to keep my life, powering on stolidly was not an option.

So, this is where I am now. In Accra, wrestling with rest. Watching my colleagues return to the groove of academic life. Trying to want to be alive. Knowing that my path is the correct one and yet still being uncomfortable with the fact of that. And writing, always writing, because this is how I know how to stay alive. The terror hasn’t gone away, but the acceptance will soon, I hope, be loud enough to drown it out.

-Akotowaa