18 April 2018

Why can't we have anti depressants that work?

I had another mental health episode recently. You wouldn't know anything was wrong to look at me; no talking to angels or strangers. But inside, I felt dreadful; an emotional flu, spiritual hangover, psychological gastro. Without going into gory details, in weighing up my options and desperately wanting to feel better, I considered heading to hospital. But I didn't, because aside from not much being in the mood for boiled carrots, I knew there was very little they could do to make me feel better. Sure, they could give me some valium to take the edge off and make me sleepy for a few hours, but that was about it.

Pharmaceutical treatments for depression are still stuck in the Prozac era of taking some pills, waiting three weeks and hoping for the best in the meantime; yet as I discovered there are other treatments which may well offer longer term cures; but the powers that be have decided we can't have them.

When it comes to antidepressants, we really haven't moved pharmacology much past the Prozac Nation era of the early 1990s. There have been minor developments, tinkering here and there, but SSRIs and SNRIs remain the fundamental pharmaceutical approach to depression. If someone suffering severe depression seeks medical help, the best they can be offered in most cases is to take these pills and hope there will be some improvement showing in a few weeks time.

There is some evidence that SSRIs are linked to increased rates of suicide, particularly in the early stages of treatment; whether this is because the drugs elevate energy levels before they improve mood, or due to another mechanism, is still a topic of intense debate in the psychiatric community.

Perhaps the worst aspect of modern antidepressants - aside from the fact that they don't actually make you feel better - are the absolutely horrendous side effects when you quit using the drugs. Symptoms of discontinuation syndrome include dizziness, confusion, fatigue and the brain zaps which will be familiar to anyone who's suffered from them (you know when you're falling asleep and feel like you're falling? I had that happen when I was walking down the street. It wasn't so great). Nearly half of users who tried to quit were unable to because of the severity of symptoms. My current primary medication, Effexor, causes withdrawal symptoms within hours; this is especially grim when I run out of pills near the end of the fortnight and have to wait a few days to afford to fill the script.

And when people stop taking them, they are still depressed.

So I kept searching for answers and found myself in forums for people who felt just as bad as I did. People struggling with severe depression, complex trauma, PTSD, able to openly share how bad things were and what they felt were their options. And of course the subject of suicide came up; someone said how they'd been dealing with the fall out from sexual abuse for decades, they'd tried every treatment available and now they were ready to give up. And someone said to them, I understand where you're coming from but before writing life off entirely, please try DMT. It will change everything.

N,N-Dimethyltryptamine (DMT) is a psychedelic compound found in the ayahuasca and other plants. It's been called the spirit molecule, an experience which cannot be expressed in words (although this very long and odd article from VICE tries). It's been used in South American spiritual ceremonies for centuries, and there's a tonne of testimonies online of people who have used them successfully to treat depression, anxiety and PTSD, but in Australia DMT is a Schedule 9 substance prohibited except for research purposes.

Many online commenters suggested one should travel to South America for the authentic ayahuasca experience under supervision of a shaman, but if I was able to afford an overseas trip I wouldn't be so depressed, so that's out. There are DIY groups holding ayahuasca ceremonies in Australia, but you have to know they right sorts of people to be invited, which I don't, and anyway it all sounds a bit too much like ponchos and white guys with dreadlocks for my liking.

What I would like, without having to break the law or learn Spanish or hear bongos, is to be able to take myself along to a nice, clean medical centre and access treatment that would actually make a real, tangible difference in the way I feel.

The Greens yesterday launched their policy of legalising cannabis for adult use, a sensible move long overdue (and I don't even smoke the stuff and still won't if it's legalised; I just never liked the way it made me feel). But overshadowed in the fuss is the Greens calling for more research amid concerns that Australians are missing out on a global renaissance of psychedelic drugs used in treatment for depression, addiction and in palliative. Australia is lagging behind on use of psychedelic drugs in psychiatry and there are no trials underway, with authors of an article published in Australian Psychologist advocating for the research into their use lamenting the conservatism in academic and research circles (remember when Australia used to be a forward looking, innovative nation? Now we can't even have decent internet let alone medical research).

Stephen Bright and Martin Williams write in Australian Psychologist that whilst a range of effective therapies have been developed for conditions such as obsessive compulsive disorder, panic disorder and phobias, current treatments for severe depression and PTSD are not as effective. Psychedelic drugs enjoyed a period of successful use in psychotherapy:

First synthesised by Albert Hofmann in 1938, LSD [...] led to a paradigm shift in psychiatry as numerous medicines were developed based on this new understanding of the brain. In the context of psychotherapy, LSD itself was also found to be effective in the treatment of a range of mental disorders, including addiction, anxiety, and depression. Just one or two sessions of LSD-assisted psychotherapy were found to produce profound, rapid, long-lasting positive effects with little need for further interventions, unlike psychoanalysis which involved years of therapy sessions.

But despite little direct evidence of ill effects, the recreational use of psychedelic drugs in the 1960s lead Richard Nixon to ban all use under the guise of the War on Drugs, despite the protests of psychologists and psychiatrists as to their therapeutic value. Moral panics were indulged, risks wildly exaggerated. We know now that the War on Drugs has been one of the largest and most expensive failures in human history, but as the rest of the world begins to wind back the prohibitions on therapeutic use of psychedelics, Australia remains stuck in moral panic mode.

It seems that there are drugs out there that when you take them, can make you feel better right away and offer some long term relief from symptoms of severe depression and trauma. Can we have them please? The war on drugs has had many terrible effects in four decades, certainly one of which is that people struggling with severe symptoms of trauma and depression cannot access real relief. For myself and others like me, any risks have to be weighed against the risk of the days when I don't know if I should board the train I intended to take at the station or jump under it. Let's get the trials going; I'll be the first one in line. 

03 April 2018

The appalling legacy of Jocelyn Newman

Howard government minister, political matriarch, social reformer and Godmother of Centrelink Jocelyn Newman passed away over the weekend at the age of 80.  Don't go to a Centrelink office to express your grief, though; security guards are trained to surround you if you cry. Instead, I thought we'd take a chance to reflect on Ms Newman's terrible legacy.

Campbell Newman being interviewed (cropped)
No, not him.

When I refer to Jocelyn Newman as a social reformer, it is not a compliment. Ms Newman was architect and engineer of Centrelink, the interface of the Australian welfare system. Centrelink was established on Ms Newman's watch in 1997, combining several previous government departments such as the Department of Social Security and the actually useful Commonwealth Employment Service into a one stop shop of human misery. It's worth reflecting that it whilst the Liberal party claims to be for individual choice and small government, it was a Liberal government who created a horrifying byzantine bureaucracy. They labelled it all under the auspices of choice but for Australia's disadvantaged, the "choice" means submitting to the routine humiliations of Centrelink, or resorting to poverty and potential crime. And for all the rhetoric of a single government agencies reducing inefficiency, duplication and waste, the myriad sections of Centrelink are often completely separate from each other, unable to access each other's systems or even contact other departments.

A full account of the miseries Centrelink uses to punish those who require its services would be depressing to write and tedious to read. The mainstream media brings us frequent accounts of Centrelink woes, sometimes ironically, such as in this article from the Daily Telegraph about the Welfare Super Bludger, which is not a really shit new children's superhero but a mythical recipient of Newstart allowance with the article highlighting one putative job seeker who stuffs up. (Apparently the guy misbehaved at 99 job interviews. How does anyone get 99 job interviews in a single year, let alone through employment service providers?!). There's little indication of larger issues, such as the cost of all the monitoring, the fact that people with disabilities are largely forced to rely on Newstart (and comply with "mutual obligation" requirements) instead of receiving the disability support pension let alone basic problem the ratio of jobseekers to jobs. 

It all feeds in to the myth of the welfare bludger, whom everyone seems to know - any facebook post about the low rate of Newstart is flooded with irate commentators describing their neighbour who's been on the dole for years, spending all day playing video games, getting tattoos and going on holidays - triggering endless audits and crackdowns that but never shows up in audits. When there are not enough jobs to go around - especially with the loss of blue collar and unskilled employment - demanding job seekers comply with mutual obligation requirements is a farce. Requiring job seekers to show up at an office for a day a week applying for jobs that don't exist without addressing any of the reasons why they became unemployed serves little purpose other than to punish the job seeker for being unemployed in the first place. It's not at least giving them a chance or getting them out of the house; it is demeaning, humiliating and horrible.

And today we won't even get started on the changes to granting of the disability support pension with insanely restrictive criteria forcing thousands of ill and injured people to deal with the job search system and providers with no understanding of disability - again, all to catch out the mythical bludger:


"The best form of welfare is a job" is the homeopathy of social services. It doesn't work and it makes no sense, but its adherents cling to it with religious fervour and become defensive and angry when challenged.

Jocelyn Newman cannot of course solely be blamed for the sorry state of affairs for Australian job seekers today, just as Centrelink cannot really be blamed for the policies they are forced to enact, like denying dying people the disability support pension. It's takes an entire government, and their mindset of the disadvantaged as a societal evil writ in policies punishing the poor for their very existence, for that. (Not that Labor is ever much better; witness the Gillard Labor government turfing single parents, regardless of training or childcare or anything else, off single parenting payments and onto Newstart).

In truth, it's been decades of bloody minded adherence to neoliberal policies in spite of all evidence that has created the whole welfare hell; but in creating Centrelink, Jocelyn Newman opened up a corporatised, centralised portal to that hell.

It's worth examining how far the current Australian welfare system has strayed from the ideals under which it was established in the days after World War Two: 

"The moment we establish, or perpetuate, the principle that the citizen, in order to get something he needs or wants and to which he has looked forward, must prove his poverty, we convert him into a suppliant to the state for benevolence.

That position is inconsistent with the proper dignity of the citizen in a democratic country. People should be able to obtain these benefits as a matter of right, with no more loss of their own standards of self-respect than would be involved in collecting from an insurance company the proceeds of an endowment policy on which they have been paying premiums for years."


Which raging lefty socialist uttered these words? Why, it was Robert Menzies. Now there's a legacy I'd like to see revived.

24 March 2018

The only guide you'll ever need to the Reserve Bank of Australia Museum

Some people mark the end of their treatment for cancer by going to Disneyland or swimming with dolphins. I celebrated the end of my treatment for carpal tunnel syndrome by visiting the Reserve Bank of Australia museum. Don't hate me cause you ain't me.

You may not even have known there was a museum at the Reserve Bank of Australia HQ, which is on Martin Place in the Sydney CBD, bucking the trend of Australian government entities being based in Canberra. I didn't know there was a museum there, until I happened to be walking past after completing treatment at the Sydney Hand Hospital and saw the small sign proclaiming the existence of a museum. I decided to go in and take a look. I figured somebody should.



I neglected to take a camera to capture my experience in the full, rich detail it deserved, so photos are from the Reserve Bank Museum website. It was less busy when I visited. Considerably less busy. In fact I was the only person there, and the nice but not overly friendly lady behind the desk look slightly startled to see me (although people often look slightly startled to see me, once including John Cleese. But that's another story). She walked me in, explained the layout and exhibits, and told me there was a university group visiting from Sweden I think it was? and I was welcome to join there tour if I wanted, but I'm sure none of you will need smelling salts to learn that I decided I'd have a look around for myself.


The museum is dedicated not to the economic history of Australia in general, with all its panics, crashes and housing bubbles, but to the history of Australian currency manufacture, a very specific and odd focus, considering Australian money is printed elsewhere - at Cragieburn in Victoria, for those of you playing at home - and one that may well be rendered completely redundant by technology in a few years. They do not give out free samples, although I'm sure every Dad whose ever visited asks.

Image showing a £20 note

For history buffs or those who like to reminisce fondly about old money, the museum is interesting enough in a low grade sort of way, with chronologically organised displays ranging from a brief and unsatisfactory paragraph about the barter system in traditional Aboriginal society; through rum currency; shillings and pence, the introduction to decimal currency (Menzies wanted to call the Australian monetary unit the Royal, I learn with very little surprise) and on to the bragging rights to our world leading polymer currency. I never did find the Swedes, but I did run into a class of bored and unhappy 12 year olds being lectured by a museum guide about the introduction of polymer currency, with the new $5 featuring a portrait of the Queen "...of course this was in 1992, when she was considerably younger". "Well, we've all lost some bounce since then", I chimed in helpfully, but receiving only blank looks, I decided it was time to call a halt to my brief new career as assistant docent, and moved on.

I was pretty much done with the museum after about fifteen minutes, but didn't want to leave quite so soon. When I visit these niche museums, I'm always worried that if I leave too soon, I'll hurt the staff's feelings. You walk past the guides on your way out, and feel you've let them down somehow. "I'm sorry, you've got a great little museum here, but it's just not what I'm looking for right now." But I was hungry and tired, and decided I was going to have to make a break for it. Luckily on my way out the nice guide lady was busy with actual Reserve bank staff, so I was able to leave without upsetting anyone, unless they read this guide, and I'd like to think I'm actually encouraging people to check it out for themselves.

The Reserve Bank of Australia Museum is located at 65 Martin Place, Sydney, and is open from 10:00am to 4:00pm Monday to Friday excluding public holidays and NSW bank holidays. The author traveled on an Opal and has this weird itch on the back of her knee.

20 March 2018

Cruising



It's coming up to autumn in my corner of the world, and my friend Ridge* and I have been discussing going on a cruise. I know - I know! - I can't afford it. But I've been through kind of a shite time, what with all the custody stuff, and maybe if I save real hard... I know cruises aren't everyone's idea of fun - someone on Twitter described them as going on holiday at a Westfield mall - but I like the all inclusive aspect; you just get on the ship and switch off your brain for six days. My brain is always whirring to dark and uncomfortable places; it needs a rest. And above all, at less than $100 a day if you get a good deal, covering travel, food, accommodation, activities and sightseeing, they're cheap.

Anyway, it's fun to day dream, although slightly unsettling. Once you've been searching for cruises, the logarithms dreamed up by the boffins of the internet keep showing you stories about cruises, nearly all of them bad

Cruises have been in the news lately for all the wrong reasons. A ship was forced to return to Sydney last month after a brawl broke out after a toilet queue (I bet it was rice on the buffet. Everyone assumes it's the seafood, but did you know rice is actually the leading cause of food poisoning in Australia? See, read this blog, you learn something). That same week, another ship  returned to dock early and nine passengers removed after claims of repeated brawls and trouble allegedly started in a fight over a thong (the kind that goes on your foot, not your butt).

If you die on a cruise, you want a bunch of other people to die too. If you die with other people, then you're part of a tragedy. The Prime Minister will make a statement, flags with be lowered, you'll get your name on a memorial plaque. If you die on your own, then you'll forever be just the idiot who fell off a ship.


But genuinely terrible things can happen on cruises, and with issues over jurisdiction, justice can be hard to come by. There's an organisation called International Cruise Victims who are not, as one might first assume, a bunch of Baby Boomers complaining about the wine service, but the victims, families and friends of crimes on cruise ships - murders, sexual assault, disappearances. I spent some time reading around on the site; many of the stories are truly horrific.

And you'd think any or all of this would put me off, but no. I want to go on the damn cruise. 

So there's the question of what kind of cruise to go on. Ridge and I want to avoid: families with small children; schoolies; the  elderly; Baby Boomers; bucks and hens tours...that doesn't actually leave very many people we would actually want to be stuck out at sea with for eight days. We discussed going on a gay cruise, but a gay cruise is not without its issues; whilst Studs n Suds night may be fun at night, it's not so much fun when it's ten am and you just want a cup of tea and you have to step over two guys fucking in the corridor.

Food, wine and comedy cruises sound like fun, but they only go out to sea for a few days and back again. We want to actually go somewhere, even if its just for a bit of wading and buying a t shirt that seems fun on Mai Tai island and looks ridiculous in Sydney Central Station. And a bit of sun would do me good. How does an Irish person end up with Vitamin D deficiency in Australia, cause I did (my iron stores are too high, though, if anyone's running a bit short). This is all right in the inner west, where every natural skin colour is considered all right, but is very odd when I go to the parts of Sydney where white people don't like brown people even though they spend all their spare time trying to get as brown as possible.

David Foster Wallace compared the cruise experience to being in the womb; a tranquil, pampered nothingness. I think my first time around was marred by osmotic resentment, so I'm keen to have another go. Who wouldn't want to be born again? Yep, a cruise is just what I need. I'm ready to float on warm, tranquil waters and emerge red, screaming and covered in goo, counting myself lucky to have survived. 

* He picked his own pseudonym. So don't blame me. 

03 March 2018

The Best Church in the Whole Wide World

I need a new church. As I've mentioned, I moved house recently. My old church wasn't perfect and I certainly didn't agree with them on many doctrinal issues, but they were a sedate enough bunch and served my spiritual needs adequately. In inner Sydney moving 5km might as well be moving to a different state though, and it would now be a pain in the arse to get to Sunday services in time on public transport, so I've been looking for a new church.

My quest for a new church could be summed up pretty well in this comic from Berkely Mews:


But I'm going to prattle on about it for another few hundred words regardless. Evidently, churches have decided a big reason people don't go to church anymore is not feeling welcome when they get there. And what churches have decided to do, pretty much all of them, is to assign parishoners to stand at the door of the church in the manner of greeters at Walmart and welcome newcomers, except it would be like if the Walmart greeters then followed you around the store. Be a first time attendee at most reasonably sized protestant churches these days and there will be someone at the door wanting to know who you are, where you're from, if you're from the area, do you go to church normally and which one, what do you do...there's no chance of slipping past them and quietly taking a seat waiting for the service to begin either, as they'll insist on sitting next to you and, very likely, introducing you to people on the way. Now, I'm sure some people really appreciate this welcome to a new setting. But if you're shy, awkward or going through a hard time - in other words, people who may well be seeking spiritual comfort - it is a nightmare. 

Feeling a bit low, I went to the evening service - which, given it was advertised as a "fun, informal community!", was probably my first mistake - at a local, mainline protestant church. There was the usual "HI HOW ARE YOU WHAT BRINGS YOU HERE?!?!" when I walked in, but nothing too bad. The service was pretty okay; I liked the music, the guy playing the guitar could really sing. But then there was after. Oh god. I wasn't allowed to leave. Every bloody person there had to be introduced to me. Beverages were shoved in my hand. I only just avoided being forced into table tennis. But worst of all was the incredibly nosy person who wouldn't leave me alone, asking question after personal question, seeing my reticence as a sign to go in harder. In desperation I even mentioned that the social thing is a little off putting for introverts in a new church and she's like "well, we won't leave you all by yourself!"

At length I managed to leave, feeling a little upset, even a touch violated. When I left, the pastor noticed, and started off a chorus of about 30 people yelling "BYE NICOLA! - this was awful. I felt obliged to acknowledge it though, so I turned around and stood there grinning awkwardly.

All this made me consider going back to the Catholic Church. Oh, I still disagree with them about... Well most stuff actually. But the Catholic Church is a lot like McDonald's. You walk in, no one cares who you are, you do your little ritual (whether it's the Eucharist or ordering a big Mac), you walk out. No awkward chit chat, and no matter where you go in the world you know what you're going to get. No one wants to know where you've come from, your faith background, if you're new to the area or if you want to be introduced to everyone. In fact, chatting at all in a Catholic church is forbidden, particularly in the Irish Catholic tradition I was raised in. In a Catholic Church in Ireland, the closest you might talk to someone is if, say you saw your brother across the pews for the first time in a year after he'd been missing in a war zone, you might just nod your head slightly to acknowledge each other. Even that might earn you a reproachful "Ah-HEM" if there's a particularly diligent nun nearby.

In the end, I couldn't quite go Catholic but I think I've found the right church for me. They follow all the beautiful and complicated liturgical traditions I love, without the bit about the Pope; but the best bit is no one talks to you. There's a brief thank you to the person who hands you the hymnal, but that's it. The only discordant note was when I went to use the washroom; as I emerged, I saw one of the priests pulling up skirts of his voluminous robes, to save time before using the facilities himself. But that's okay. Frankly, I'd rather he defecated in my hand than go through the bestest church in the whole wide world again.

FWIW Going to church occasionally doesn't change anything my feminist and democratic socialist beliefs (and if I'm challenged about issues such as a woman's right to choose, I just like to say "I'd like to concentrate on getting the Christianity in Acts 2 right first before we worry about things that aren't even in the Bible"). Yes, the Abrahamic religions are inherently patriarchal and some would say sexist. But there's massively sexist dirtbags in atheism as well.  I'm feeling like the problem might be letting dickhead men run things unchallenged, not religion or the lack of it. 

01 March 2018

Moving

Posts have been a bit scarce lately because - I don't even want to know how many times I've posted this in the fourteen years since I started blogging - I've been moving house. Again. What can I tell you. Luckily, with so many moves under my belt, I've got the whole thing down to a fine art: starting two weeks ahead of moving day, I pack one beautifully organised box full of books, clearly label it "BOOKS", stick it in the corner of my lounge room and do nothing else until the day before the move.  

I hoped that maybe this time, though, things could be different. Looking online for boxes, a major retailer's website promises me that I can  "Take the stress out of moving with Officeworks handy moving guide". Excellent; who doesn't need to destress when they're moving house. So I read the guide, which seems mostly to consist of suggestions to purchase Officeworks products. However, they are a big smart corporation and I am just a people, maybe they know something I don't; and anyway the fact I'm moving all the fucking time clearly indicates I'm in no way qualified to make decisions regarding my own life. Anyway, I head to Officeworks.
Officeworks has gone down the Walmart path of having a greeter at the front of the store, which is kinda weird. I mean, it's okay if you're walking in with a spring in your step, and can respond to their "Hi, how are you today?" with a cheery "I'm excellent! Thank you. I'm so looking forward to purchasing binder files.". But if you're like every other person who's ever gone to Officeworks and you're just trying to get the materials for the class project on food groups then get out as fast as you can because it's late and your child only told you at bed time the thing is due tomorrow morning and you know you'll be up until 1am doing the damn assignment for them even though half of you wants to strangle the little shit darling child, well, the perky welcome seems only to poke fun at your gloom. 

In between all the packing, you've got to find removalists, unless you've got friends willing to help you move, and I don't. Pretty much every removalist firm also promises to take the stress out of moving. Look, if everyone could just get together and designate one of you to stress out of moving, because it's not happening at the moment with everyone fighting over the job.

Moving day arrives, much too soon. Removalists have ridiculous start times. I'm not at my best in the morning, partly cause of medication I'm on and partly cause I'm a lazy bludging lefty that's everything that's wrong with this country. Can we kick off around ten, I ask when I make the booking. No can do; the morning slots are 6am (6am!) and 8 am. I pick the latter. At any time of day, it's not great having strangers in my house, touching my things. I know that these are technically my employees, and I shouldn't feel guilty for needing to sit down in front of them and not lifting boxes myself - that's a big reason why I needed to hire movers in the first place. Nevertheless, it feels weird sitting down in front of guys lugging my stuff, and I make sure to sit on a hard surface on an angle of at least 20 degrees to the perpendicular, whilst adopting the facial expression I normally assume on thinking about Sydney property developers, to let them know that whilst I am reclining, I am not taking any enjoyment from the experience and am not just sitting around like a pampered princess whilst others work for me.

Not that the removalists didn't hesitate to let me know their feeling that I was Marie Antoinetting the move. My new flat is up several flight of stairs, which was explained when making the booking, but I was still treated to a litany of complaints about every last one of them, as well as the company they move for, the heat, and that Donald Trump is just trying to do his best. (I can't help but feel they'd find the stairs easier to manage if they'd given up on the chain smoking, which they did, lavishly and with gusto, whilst handling my soft furnishings). They even complained to me, on their seventh or eighth trip down to the truck for more cartons, that I have too many books, and I'd have flung them off the balcony if there weren't a bunch more cartons to go. Saturate my nearly new pillow top mattress with disgusting Marlboro smoke? I'll smile politely and let it go. Disparage my books? You are not getting a tip.  

Finally, my stuff was in my new house, the movers left, and I had the opportunity to really take stock and organise my possessions in a way to bring me comfort and happiness and help me live my best life, so of course I set up the TV, got put the kettle, and shoved everything else in a corner where it can stay for the next several months.

There was a minor issue with my power supply, and I had to ring the power company. On the third ring, without my pressing anything, the IVR said "please hold while your call is being transferred". Corporations are getting in early with transferring calls these days; they do it pre-emptively to everyone.  When I was transferred through to the right department, the hold voice said "Moving house is stressful. And while we can't carry the boxes for you, we can at least ensure the power is on the day you move in." Finally some honesty, not another corporate entity promising all but to assemble your bed then give you the best sex of your life on top of it. Now that would be moving.

19 February 2018

The Hollow Woman



I read Lena Dunham's article about her decision to have a hysterectomy at the age of 31 with a great deal of interest. I've never been a big fan of Ms Dunham for all of her clunky clueless white feminism that leaves those of us who are white and poor, queer and disabled on the outer, when there's a heap of white feminists who are poor and pissed off and trying to make space for ourselves. but of course it's impossible not to feel a great deal of sympathy for Ms Dunham having to make such a heart breaking decision. Even so, I find myself second guessing the choice. Maybe it is human nature to think we know better, stemming from a subconscious need to protect ourselves, thinking that it, whatever it is, can't happen to us because we know better. If she wanted a child so much, why didn't she have just one and arrange the hysterectomy at the same time as the c section?

This post isn't about Lena Dunham though. It's about me, and the other women like me. The mothers who don't have primary custody of their children. Except it's not called custody anymore, someone will tell you, sometimes after you've just poured out your sadness to what you thought were sympathetic ears. You don't have custody because no one has custody any more; we now call it being the primary carer. It should be legal to slap those people.

Don't even get me started on men's rights groups, the ones that claim women are favoured in custody cases. Very few Australian custody decisions end up in court, and of the ones that do, the courts nearly always leave the children with the parent they're already staying with. No matter if that's the mother or the father.

The next thing people want is to know to why. It's still so unusual, after all. As much as we give lip service to the notion of shared care, most people still believe, deep down, that a mother should be with her young children, and they wonder if something is wrong with you - is it drugs? Violence? I've written about my struggles with mental health, is it that? Actually, in the end, my situation is pretty simple. My ex husband and I were living with his mother when we separated, so remaining separated under one roof was never an option and I was the one who had to leave. I wanted to bring my son with me, of course I did. But my ex decided that it was better if Mr G stayed where he was, in the neighbourhood he was used to and I couldn't afford to live in. I had to leave without him.

Maybe you think you'd never give your kids up without exhausting all options, without fighting to the end. Maybe you would. If you ever find yourself in this situation, drop me a line and let me know how you're getting on. You might find things are a bit different than how you imagined, if it ever happens to you and I really hope it doesn't.

It's happening to me though, and I can tell you it's horrible. Maybe we should be beyond biology, past the stereotypical gender roles that women belong with their small children; but I am not. I feel the pain deep inside, of the child I bore being taken from me, I am the hollow woman, I am the cat going crazy when her kittens are taken away, I am Medea, I am Rachel, refusing to be comforted. I am not there to feed my child dinner, give him a bath, read him a story; my little boy goes to bed without his mother to tuck him in and kiss him goodnight. I have missed a thousand hugs, drawings, imaginary cups of tea served from toy kitchens. Divorce is one thing. It's very sad, but it can in the end be dealt with. But this? All my pretty ones? Did you say all?

I get to see him once a week. That's if I'm lucky, at the moment, because that separation has made him so attached to his Dad that he doesn't want to leave. Do I give in to my own broken heart and insist he comes stay at my house, or do I try to make my child happy by saying he doesn't have to come with me this weekend? What do I do in this awful situation? What on Earth do I do? There have been times where I've insisted, and he cries for his father at bed time. There have been times I've walked away from scheduled pick ups, gone home alone, collapsed on the floor sobbing, closed the door to his room because it hurts so much to see his things, to see his toys lined up forlornly waiting for him, thrown out the kids' yoghurt and crumpets he likes, that I could hardly afford to buy, because they've passed their expiration dates, uneaten.

Time marches on, months turn in to years, and the gulf between us only grows. I am told how lucky I am that to have so much time to myself, how good my ex is for stepping up. Yes, it is good that the man I share a child with is able to capably handle parental duties. You know what would be better? If my child lived with me.

"I couldn't stand it if that happened to me. I'd just die!". Here's the thing, though. You don't just die from pain, no matter how bad the pain is, you don't just stop existing, as much as you might wish to. And you still need to eat, drink, sleep and ablute. You try to take pleasure in the ordinary details of life, and I do, most of the time. But then you've some painful reminder how how skewed and chaotic life is. This isn't what I signed up for. You see and hear children everywhere, and they're not yours. Sometimes you see children being hit, pinched, sworn at. Other people mistreat the children they do get to live with. There are children brought into the world unloved and mistreated. The bitter unfairness of it all, and there is no where to put your pain and rage.It's not like your kids going away to camp. Please don't tell me how sad you were when your kid went to camp.

There are things you can do to try and bear it, and I do try. I lived next to the beach for a year, went on long walks in nature, and the loneliness drove me mad. I have exercised, with tears running down my face as I wracked up distance on the rowing machine. There are at least the wonders of modern psychiatry to rely on. There's a delicate chemical balancing act in my body with the rainbow of medication I taste every day. It's not quite perfect. My legs and feet are swollen to the point the only shoes I can wear are some ugly old men sandals; this is merely a fashion problem in a Sydney summer but it will be an issue as the weather cools. I'm reluctant to upset things by changing medications. There are legal avenues available. I know the ins and outs of the system.

So if I don't want your advice and I don't want you to tell me how you wouldn't cope, what do I want? I understand the desire to fix things, I do. But I'd like to be able to speak up without feeling judged or derailed. Decisions made years ago brought me here, and there's no easy fix. I'm still a mother. But that means something different to me, something my darkest thoughts could never have imagined.

You might like...