Pharmakon – Almudena Sánchez

[Fum d’Estampa Press; 2023]

Tr. from the Spanish by Katie Whittemore

Four thousand miles, an ocean, and a sea between us, Mallorcan writer Almudena Sánchez and I live with the same invisible illness: depression. Or, as she describes the condition, “Nightmares, if they happen at night and in bed, are bearable. What’s unbearable is for them to occur in the world of our five senses.”

Although Sánchez endured this real-life nightmare while writing Pharmakon, translated from the Spanish by Katie Whittemore, the memoir is about much more than depression. Combining personal stories, memories, dreams and nightmares, retweets, analysis of other books, along with countless tangents, it pushes the boundaries of memoir, falling somewhere between narrative and personal essays. The story is intimate and raw, detailing her painful experiences: her despair and suicidal thoughts, her failure to write creatively, and her childhood development and its effect on her mental health. At the same time, it’s an inquiry into sadness that explores how depression is a deeply human experience.

Despite these themes, there are moments of humor. The reader must have an appreciation of dark comedy, but every few pages I found myself smiling and jotting “LOL” in the margins. A memorable section includes one of her nightmares that simply consists of a conversation between two worms. In another amusing scene, Sánchez explains that the only reason she continues shaving her legs and applying aloe vera is to look good in death. One of my favorite chapters describes how her anxiety and apathy drive her to a new hobby—flowerpot decorating—and her dream of doing this until retirement. “Almudena Sánchez, flowerpot decorator, follow me on Instagram,” she says. And then there are metaphorical or philosophical lines like this: “I don’t know if God looks more like a nebulous entity or a pine tree.”

Pharmakon has a fragmented, nonlinear structure that fluctuates between brief, sometimes single-line chapters and ones of several pages. For instance, there is a retweet chapter: “Poetry is a noradreline [sic] uptake inhibitor and a neurotonic agent. – La_poesía_es_@poesia_es_Bot.” Frenzied and manic, Sánchez’s writing swerves from one topic to the next, mimicking the chaos of her mind. She jumps from a discussion of childhood growth spurts to Charlie Brown’s depression to elephant-shaped clouds to Nietzsche. However, this experimental construction does not detract from the quality of the memoir. It was refreshing to read something distinctive: something poetic and literal, tragic and funny, impulsive and philosophical. She writes in a confessional tone, an amalgam of staccato sentences and lyrical, almost ethereal prose: “When you’re getting used to a pill that affects your brain, you are yourself but with reinforcements. It’s like a balm for wounds. The brain doesn’t scar, but thoughts do.”

Sánchez didn’t believe in depression at first—or any mental health condition for that matter. In her whole life she’d never received any advice on how to deal with her emotions. Like me, she’d learned that people just needed “to snap out of it or to pull themselves together.” If only it were that simple.

What is depression anyway? When Sánchez tries to define the word, she realizes “everything is depression.” She criticizes people for casually throwing the diagnosis around in conversation. When someone doesn’t have time to go swimming, they’re depressed. If the store is out of my favorite candy, I’m depressed. You ran out of lens wipes for your dirty glasses—how depressing. As I read, I wondered, if people keep calling themselves “depressed” instead of “disappointed” or “frustrated” or whatever they really mean, how is a person who’s diagnosed supposed to describe their feelings? The more we use a clinical term like this as a label for everyday behavior, the more the word is stripped of its true meaning.

Throughout the book, Sánchez describes the impact depression has on her body and mind: the constant state of fear and panic; the incessant tears and foggy brain; the lack of will to get out of bed, to open the curtains, or even to speak. Her family must drag her through life like a ragdoll. Like anyone with this condition, she wants the pain to end, and the only way she can imagine that happening is by erasing herself from the world. Her suicidal fantasies consume pages: pills, cars, rooftops, knives, wires, bullets, bombs. “The day comes when you want to explode with despair, like a firework, period,” she writes. “Let it all end in glittering pieces.”

I applaud Sánchez for bringing up suicide as much as she does. The worst we can do as a society is keep this topic taboo. Everyone with depression has some risk of suicide, and the more we talk about it, the less that risk becomes.

Sánchez discusses her family’s desire but inability to help her. When she begs over and over for her partner to rid the depression from her body, they’re useless. “All they can do is hug you tight. And wait,” she says. Aunt Antonina is someone special to Sánchez because she sits with her in the darkness but doesn’t try to drag her out. I agree with her approach: What matters most in terms of support is to stay by someone’s side and be willing to listen without trying to solve their problems. That’s not possible anyway.

In many chapters, Sánchez examines her difficult childhood and its impact. She delves into her history with school bullying, including an incident where she was locked in a classroom alone for several hours. At sixteen, doctors discovered ovarian cancer and performed multiple surgeries to remove both ovaries and fallopian tubes. Sánchez was terrified of sickness, but she was more terrified of embarrassment. She then discusses feeling misunderstood by her parents for quirky habits such as not being affectionate and disliking compliments and her birthday. “I’m allergic to my own childhood,” she writes, and she felt it would never end. It’s not until Sánchez looks after Carla, a four-year-old girl, that she appreciates “how a damaged childhood can be healed by someone else’s happy one.” Together, they experience life’s simple pleasures: climbing trees, dancing, eating ice cream, walking barefoot in the grass. Sánchez relishes in Carla’s playfulness and gets a second chance at what she missed years ago. Through babysitting, she begins to see childhood for its joys and not only its negatives.

I recognized much of my own mental health journey in this memoir, identifying with the ache of emptiness, the torturous side effects of medications, the agony of fighting a losing battle as well as many anecdotes from her life. What I most related to was that in the face of immeasurable pain and suffering, we can still find moments of humor, even happiness. And in the end, Sánchez shows us hope—she may be medicated, but she’s “okay.”

For those living without depression, situations like this can feel incomprehensible, but reading Sánchez’s memoir is one way to deepen their understanding of the experience. Although she acknowledges that hers is just one perspective and that mental health conditions manifest themselves differently in everyone, this book is a valuable resource for anyone seeking to explore the mind of someone with depression and suicidal thoughts.  

Marisa Russello writes fiction and nonfiction and works at a mental health nonprofit in upstate New York. Find her newsletter, Of Mice & Mental Health, on Substack, and say hi on IG @marisarussellowrites.