“Right after the match, I was on my way to the back walking up the aisle and I’m looking out into the crowd. Some fans were cheering, some were booing. Some were upset and I remember this one guy, a guy who asked me to autograph his chest during a meet and greet before the show, a really good looking guy. Any way he’s holding a sign with my picture on it and he tears it up and then throws the pieces down in front of me. I should’ve kept walking but I recognized him immediately and I wanted to ask why. Then he starts yelling obscenities at me, telling me that I’m worthless, that I’m garbage, a disgrace to my family and have no business here. He’s getting very animated and starts to scream before security comes to throw him out. So I make my way to the back and it’s like..,” she pauses in search of the right words to describe the feeling of being buried alive beneath an avalanche of anguish, suffocating under the icy weight of despair but finding none she elects to make do with the first image that pops into her mind, which is aided by the sound of bubble wrap being popped by Christian as he tidies up out of sight in the living room. “It was like an explosion I suppose, a big pop and I just started crying”.
“I see..,” The voice is calm and level, refusing to give up so much as the slightest hint to the thoughts occurring behind the softly glossed lips which draws Cat’s attention further up to the woman’s eyes. Though the eyes may be a window to the soul, the bespectacled baby blues belonging to Dr. Gwendolyn Stark prove to be every bit as even as her voice. From behind black rimmed glasses she looks on, her gaze never once leaving her subject’s and seldom blinking. A rich blonde mane, meticulously styled falls from her scalp, slinking down the sides of blemish free, smooth skin and pronounced cheekbones and gently cradles a tenderly angled face. An older woman, whom she estimates to be roughly Christian’s age wearing a neatly pressed black pant suit, offers no clues by way of reaction. Instead the seasoned psychiatrist patiently listens, quietly assimilating the information provided, breaking in every now and then to ask for further detail or pose another question. “What were you thinking of the moment that the ‘explosion’ went off”? She asks, electing to use Cat’s terminology, an old tactic used to keep the subject on track, “Were you thinking of your family”?
“Yes.., yes I was”. Surprised at the connection made to her family she momentarily stumbles, tripping over scattered images of her father, uncle, cousin and others, failing to recall her previous mention of them by the angry fan who had chastised her; an important yet subtle clue to the woman seated at the ornately crafted Gold colored Victorian style dining table. She leans forward, propping her elbow on the polished cedar top with extended scrolled decoration apron closer to the therapist. “I could see their faces”, she confesses.
“Were they angry”?
“They were very angry”, Cat concedes through a downcast whisper. “They were upset with me for ruining the legacy they had built. I was trying to apologize, swearing to do better, to train harder but they were so mad”.
Through further prodding Cat relives the moment in question, struggling to fight back the tears brimming at the corners of her eyes and threatening to overflow into the conscious landscape. She works diligently to distract herself from the impending surge; kicking off her Grumpy Cat house slippers– a Christmas present from Christian who openly preferred that she not walk barefoot over the hardwood floors during the winter - nudging them towards the thick trestle base of the dining room table and propping her feet onto an open, button backed chair similarly crafted to match the relaxing color scheme of the room. A low, guttural growling emanates from beneath the table as Genie, the housecat having detected a change in Cat’s emotional state comes trotting in across the impeccable sheen of the white tiled flooring and bounds into the young woman’s lap, drawing a huff from her and peering over the table at Gwen who regards the arrival with a smile. Tugging absently at a loose thread on a pair white washed Levis cut off shorts Cat resumes her oration and bundles her hands in the red cotton fabric of one of Scott’s oversized tee shirts which she favors for sleeping. Eventually she manages to make through the re-telling of the scene up to the arrival of Christian who had found her near the loading docks on the basement level and allowing the Doctor to scroll further along through a mental checklist of depression symptoms as she quietly begins to stroke Genie’s long, silken coat.
“In the time since then, have you experienced any angry outbursts, irritability or frustration, even over small matters?”
“Almost every day”, Cat offers while rolling her eyes over scrolling images of daily nuisances like slow drivers, indecisive shoppers and that one sock that always seems to go missing from the laundry basket. “I mean, like, other than every day stuff like cashiers who spend more time on the phone than at work but it’s mostly due to wrestling and stuff you know? Other things don’t get me going so much”. Though she fails to understand the meaning behind the query she unknowingly provides precisely the answer Dr. Stark was expecting and glosses over her reply casting it aside without a second thought to the mundane aspects of daily life that would serve to upset almost anybody. “I mean that little stuff I forget about as fast as I notice it”.
“Alright..,” the Doctor pauses while jotting down some notes into a pad, notes relating to her replies to the various questions along with subtle observations in her subject’s replies, demeanor and reactions. Scrolling further down the list she clears her throat to ask the next question, “Have you noticed any loss of interest or pleasure in normal activities; things you might do every day such as sex, hobbies or sports”?
“Umm.., not really”, she responds in an uncertain tone. “I mean, well, as far as sex goes I’ve been focused on my career and frankly I haven’t met the right person”.
While a seemingly innocuous response The Psychiatrist nonetheless picks up on something in the words which prompts another flash of the sturdy, chrome office pen as she writes down a question next to the question posed, ‘bisexual’? And returns her attention to Cat nodding for her to continue,
As for normal activities..;” she allows a brief pause to add emphasis on the last word spoken and resumes, “That seems to sort of come and go. Like, right after the match for the next… three or four days I think I didn’t really feel like doing anything except stay in my room and watch TV or browse the internet. I didn’t do anything for about a week I suppose until Dani hit me up on Twitter wanting to go out”.
“Did you accept”?
“Not at first, I didn’t want to spoil her fun with my sour mood but I went downstairs to get a drink and when I told Christian about it he almost pushed me out of the bloody door insisting that I go, so I did”.
“Where did you go”?
“Dani gave me the choice”, continuing on while gently scratching Genie behind the ear her expression slowly fades from the deadpan merry go round of the question and answer session while her mind harkens back to the night spent with Dani Weston to the faint hint of a smile brought forth by the memory. “I wanted to go to Chuck E Cheese – I can’t help it I’m just a big kid so that’s where we went”.
“What did you do, and did you have a good time”?
“Yeah..,” the sliver of light becomes a beam as the events of the evening begin to crest to the surface. “We both wore onesies; I wore my pizza onesie and Dani wore this pink unicorn outfit and even added pink and blue highlights to her hair to go with it. She was so beautiful! Everybody kept staring at us well, probably mostly at her but we didn’t care..,” a soft chuckle escapes with her breath a parting gift from the famous game zone cum restaurant. “We were so busy trying all of the games and flirting with the mascot that we didn’t even notice until we started getting tired. I had so much fun..,” the reverie offers up another chuckle in grateful respite to the strong under currents of the week which had left her adrift for so long that she had forgotten that simple pleasure.
With a gentle smile of her own Gwen listens attentively, continuing to steadily write down notes on her yellow writing pad while Cat tells the story of Dani playing a man for game tokens on the basketball pop-a-shot game which she won handily, allowing them to play the rest of the evening for free and the car ride home where they stopped by a nearby Cinnabon and gorged on the savory rich and gooey cinnamon rolls. Once finished the smartly dressed therapist resumes her trip down the dimpled roadmap of diagnosis checking off the exits as the questions are answered along with personal notes and observations. She enquires about Cat’s sleeping habits of late, her energy and appetite; feelings of anxiety or restlessness, changes or difficulty in speaking or body movements, concentration, feelings of helplessness, worthlessness or guilt or fixations on past failures or self-blame. With each answer the pair is brought closer and closer to the desired destination while the engine of psycho analysis hums along with the driver pausing intermittently to point out sites of interest by way of a question or observation until finally downshifting and she settles the assessment into park. Following a quick scan of her notes the well-groomed woman fills the interim of silence by assimilating the gathered information and reaching into her left breast pocket to retrieve a small 6 by 6 silk polishing cloth which she uses to wipe down the lenses of her spectacles. Realizing it to be nothing more than a simple ploy for time, Cat busies herself petting the protective Persian in her lap, patiently awaiting the Doctor’s thoughts and prognosis.
Coughing softly into a tissue Gwen adjusts her plastic rimmed glasses and studies her notes hastily scribbled down on the pad which brings Cat’s attention back onto the woman in a nervously inquisitive stare.
“Mind you..,” the psychologist begins while exercising care in her word choice over the potential impact they may have, “This is not a full prognosis, it is just a preliminary overview based on what you’ve told me and what I have noticed, but from what I’ve been able to gather you appear to suffer from a mild to moderate form of panic disorder, which is a form of anxiety”.
“Anxiety,” Cat frowns in confusion. “I don’t understand, I thought I was depressed”?
“Anxiety and depression are often intertwined”, she explains to the bewildered young Briton. “It’s a complex relationship and often unique to the individual but generally one will lead to the other as in your case. Your fear of disparaging your family’s legacy was brought about by a latent anxiety disorder which compounded into a depressive state”.
“What do you mean by latent”?
“Typically anxiety and depression are caused by certain chemical imbalances in the brain. These chemicals are naturally occurring transmitters called neurotransmitters and send information to and from the brain. There are four of these chemicals associated with anxiety and depression..,” with a brief pause she licks her thin, loosely pursed lips while recalling the subject matter of psychology 102 and continues once the lesson plan is retrieved. “First is Serotonin which is primarily associated with mood, appetite, and other regulatory functions in the body and tends to be the culprit more often than not. Next is Dopamine which influences attention, energy levels, rewards and movement. It is not as likely to trigger anxiety as Serotonin but it can lead to symptoms. After that you have Norepinephrine; it is related to anxiety as it involves the fight or flight response or how a person may react to stress. Finally you have Gamma-amino butyric acid – we just call it GABA – it plays a role in balancing excitement or agitation and feelings of calm and relaxation”.
“Ugh”, Cat groans, burying her face in the soft furry coat of her self-appointed protector. “All of these chemical names have my head spinning, I feel like my brain is drunk”.
Gwen nods in understanding with a weak smile. “Alright, let me simplify it for you; sometimes the human brain does not produce enough of these chemicals which generally regulate mood..,” she begins with the patience of a veteran grade school teacher. “When that happens the extreme side of the specific functions the chemical in arrears is responsible for regulating tends to show up more often. Now, you asked what I meant by ‘latent’. Sometimes in one’s youth the brain produces enough to effectively manage your mood and feelings but as you grow older that production drops off which is why you may seem fine during childhood but as an adult you suddenly begin to experience these things”.
“Sort of like a late bloomer”, Cat observes, lifting her face from Genie’s side.
“Not quite how I would put it but essentially correct. As for your particular case, I am going to write you a prescription for Sertraline which is the generic form of Zoloft. I want you to take one pill every morning when you wake up – without fail”! She emphasizes. “This is a relatively slow working drug and missed doses will only set back your recovery. It usually takes three to four weeks to start seeing improvement. We’ll start with a fairly high dosage to build up your system and then gradually taper it off until we find the right amount for you”. With her hand gripping the wide bodied pen she hastily scribbles onto a prescription pad, a soft shade of blue with white letterhead, accents and a discernable watermark in the center. “Let’s see.., we will start with 150 milligrams”, her voice is soft yet sure as she tears the page off of the pad and reaches across the table handing it to her patient.
Taking a curious whiff of the paper Genie plops her head back down to resume her nap as Cat takes the paper into her hands and studies it. The cursive handwriting in blue ink is surprisingly neat with proper use of capitalization and punctuation that denotes her name, sex and age in addition to the drug being called for along with dosage and refills allowed with the Doctor’s signature in the bottom right corner. With an arced brow Cat frowns.
“You’re not a Doctor”, she mutters with a shaking of her head, “No way”.
“What..? “Gwen responds in genuine confusion, her normally smooth features muddled in perplexity. “What makes you say that”?
“I can read your handwriting”, the young woman states flatly gesturing to the physician with the paper in hand. “I’ve seen a lot of prescriptions but this is the first I have ever been able to read, let alone understand”.
“Oh”! Rearing her head back Gwen finally ditches the aura of professionalism with a hearty chuckle brought forth by an age old question. Still, as a matter of pride and perhaps ego she can’t help but to defend her title as many doctors feel compelled to do. “Cat, I spent eight years in school, plus another year as an intern followed by a year of research for my doctoral thesis and then two more years working on my Ph.D. I assure you I am a doctor, but if it sets your mind at ease, most doctors have sloppy handwriting because they’re overloaded with patients and that means volumes of paperwork and they just don’t have the time. For you however; I made a house call and have plenty of time to do it right. But if it makes you feel better I can write it sloppy”. Her words taper into a warm and sincere smile, which Cat is quick to trust by shoving the paper into her pocket.
She shakes her head “I was just kidding”, she offers, looking to shrug it off. “But I am curious, what did you write about for your Ph.D.? those are usually pretty heavy”.
“Oh I wrote about panopticism in the digital age”, she says passingly while loading her belongings into an embroidered black leather satchel which she then closes with the muffled snap of a gold buckle. “It’s basically a form of behavior modification practiced on prison inmates”.
“So, did you shrink her head? That must have been quite a job”. Standing at the foyer bearing Gwen’s coat folded over his arm Christian regards the short, stylish blonde with a smirk, a smirk she refuses to return in kind, instead opting for a narrow eyed glare of annoyance which catches him off guard.
“Ugh, Christian you know I hate that word, that term and everything associated with it”. The term ‘head shrinker’ , a phrase originating from South American tribal witch doctors and the practice of shrinking heads as a means to harness the spirit of an enemy and compel them to serve the shrinker. Later it was adapted as an affront to Psychologists and Psychiatrists by wary folk of the 1900s, distrusting in the fledgling science. “Please don’t use that around me”.
“I’m sorry”, he mopes and bows his head in atonement. “I was being facetious. What did you learn about Cat”?
“Panic disorder” Gwen huffs accepting the full length beige winter jacket. Setting the satchel on the marble floor beside her she dons the asymmetrical Bouclé Walker Coat and starts to fish in the right front pocket for the familiar feel of a plastic key fob which is pulled out, clutched between the manicured fingers of her right hand. “I set her up for 150 milligrams of sertraline and a review after 45 days, but I did want to ask you about your own observations”, she continues, cradling the black key fob bearing the familiar silver arrow logo of Mercedes Benz. “Living with her you are in the best position to note changes in her daily activities”.
Hoisting the heavy satchel off of the floor Christian patiently holds onto it as Gwen adjusts her jacket and wraps her bare neck in a black chiffon scarf. His mind quickly rewinds over the days following the incident accessing his recollections of the daily routine favored by his house guest and compares the images provided with images taken from better times.
“Well”, beginning in a somber tone he speaks slowly allowing his mind to retain the images a few moments longer before shuffling them away. “Cat has always been a happy sort; curious and more interested in a good time than in the mundane trivialities of daily life. One of her favorite activities was rough housing with Genie – those two have a unique relationship”, he observes with a hint of a smile over the recollection of various shenanigans wrought by the unlikely pair. “They would practically destroy the house trying to beat the other; over the last nine months my insurance claims have totaled over $20,000. But since then she hasn’t seemed the least bit interested”.
“Have you noticed any improvements since the first week”? Taking the satchel offered by the long should strap she drapes it over the opposing shoulder and allows it to fall against her left hip.
“Oh yeah, for sure”, he nods his head in confirmation. “She’s regained most of her appetite, though I think all of those chocolate cakes and pies I whipped up for her had something to do with it. She’s more active around the house and even ruined my fourth microwave. Slowly but surely she’s coming around again, I think. Are you sure this isn’t some sort of one off episode”? He asks hopefully.
“No”, she shakes her in a stern dashing. “There is no such thing as a one off episode. The thing about anxiety and depression is that it ebbs and flows as you have experienced yourself. All it takes is one incident to set it off again so until the sertraline takes hold you want to keep her away from what set it off to begin with”.
“Wrestling”, he mutters and bobs his curled sandy mane in agreement. “I’ll do it, I just want her destroying my house again.., I don’t care how much it costs, send the bill directly to me”.
“I’m afraid I can’t do that”, she says reaching for the gleaming brass doorknob and giving it a twist, pulling the four panel solid timber door with heavy, bolection molding and polished chrome ironmongery open allowing a crisp breeze to filter in through the foyer.
“What..? Why the hell not”?
She offers a brief smile and explains, “Geno beat you to it”.
“Damn his ass.., I mean, bless his heart”, he groans in mock disappointment inwardly grateful for the unrequested assistance before locking his pleading hazel orbs onto the physician’s own blue lenses. “Gwen please.., whatever it takes, I want my kitty cat back”.
