A story about about meeting someone you did not expect to meet.

Content warnings

• medication intake
• anxiety
• panic attacks
• depression

The short story

It was a strange feeling, like I had slept deeply for a really long time, with everything before that seeming foggy and unclear. Like walking through mud that reaches up to your hip and even using your hands doesn’t make you move faster. Like the first moment of waking up, where, for a few seconds, you are in this weird limbo between sleeping and waking, a complete disorientation as to where the here and now is. Like a piece of chewing gum, chewed on for so long that it does not taste like anything anymore, becomes hard and bitter, but still, you keep it in your mouth because there is nothing else to do. Like being in the middle of a group of people that are all happily chatting away, being their best social selves, and you are just standing there, quietly, not knowing what to contribute, but also not wanting to leave the situation.

Focus, Paula. You are awake and you need to focus. What do I remember? My mind is a blank slate, thinking nothing and everything at the same time, thoughts racing, like one action potential at a time. I was apparently travelling (to somewhere or from somewhere?) and suddenly I am in the middle of a train station whose name I don’t recognize. Where am I? Why am I not home? Where was home again? (God, my head hurts.) I take my phone out of my coat pocket to check Google Maps, but the connection seems to be gone and all I see is emptiness, a never-ending loading screen hiding my true location. And here I thought the internet was supposed to help us orient, get places, know things, not confuse us even more. Frustrated, I put my phone back in my coat pocket and look around. The train station is bustling with people, everybody seems to be busy, impatient to get to the next thing on their never-ending to-do list. Well, that’s not fair, Paula, you love to-do lists, they give you safety and help you remember the thousand things you have to keep track of. I can feel myself getting restless, it has been a long day. (I think? If I am honest, I have no idea how long I’ve been travelling). I feel tired. (I think? because I also feel like I just woke up. But why am I so tired then?). I feel perspiration on my forehead and under my arms. I don’t deal well with ambiguous situations like this, where I don’t know what to do. And I have to admit, this is definitely one of the weirdest situations I ever found myself in.

My clothes suddenly feel too warm, scratchy and uncomfortable. I usually have everything under control, planned to the last second, because this gives me the peace of mind I desperately need to navigate life. Today is different. Something is out of place, I can feel it, but I don’t know what and it is driving me crazy. Why can’t I remember anything anymore? I didn’t get drunk last night, did I? Get a grip, Paula. If something is not right, you need to fix it. You are an adult, I tell myself, even though I don’t believe it. I am a literal mess right now who has no idea what she is doing. Like always. But then again, isn’t that everyone’s strategy, faking it and hoping nobody notices? I have been doing a pretty good job for the last months, letting nobody see the tornado that constantly wreaks havoc in my brain.

I take a deep breath and look for an info point or someone looking like they know what they’re doing. Everything seems normal and out of place at the same time. But something is very very wrong, I can feel it. Why am I here, in this place (city? country?) I don’t seem to know? I look around for familiar faces, or to be honest, anything remotely familiar at this point. But nothing does. I glance at my analogue wristwatch, at least this one I can still trust (I think), with all the weird things going on around me. It shows 3:35 pm – when was I supposed to arrive again? Maybe I just got confused, went out at the wrong stop and will be laughing at my own stupidity in a few minutes. Or not. I should start to do yoga or some form of meditation again, I think. Or even better, start my meds again. Simpler times, where the only thing I had to worry about was taking a pill around the same time every night, a seemingly easy task that wasn’t actually that easy. You’re better now, Paula, I tell myself.

I start walking in the direction of what looks like the way to the train platforms. Maybe the incoming trains will give me an indication of where the fuck I am. A train must have arrived a few minutes ago, because a constant, blurring mass of people pushes through the huge, swinging doors into the main hall of the train station I am currently standing in. A huge tsunami wave of people who have their life figured out (or at least more figured out than me, which is not hard), crashing down on me, tumbling over each other, never stopping, always moving, never ending. For a moment, I think it would be better if I just stand here and let them swallow me whole. That might be easier than actually doing something, anything, right now. But then I come to my senses. Just as I turn to step aside, I see her. I mean, I see me.

(…)

Read part 2 here!

This story was originally written in English.

The paper

Rütgen, M., Pletti, C., Tik, M., Kraus, C., Pfabigan, D. M., Sladky, R., … & Lamm, C. (2019). Antidepressant treatment, not depression, leads to reductions in behavioral and neural responses to pain empathy. Translational Psychiatry, 9(1), 1-13. https://doi.org/10.1038/s41398-019-0496-4

Connection between story and paper

The paper and first part of the short story both deal with depression, a debilitating condition where people have strong reductions of positive mood, as well as lack of control and motivation. This might be accompanied by imposter-like symptoms such as feelings of worthlessness or desperation. People with depression often feel like things are never going to get better again, which is a truly horrible experience. In the past, many studies have found that people suffering from depression have lower empathy, meaning they can feel less with the emotions of other people. The study investigated whether it is actually the depression itself that leads to lower empathy, or possibly the medication that people are taking to counteract their depression, so-called antidepressants. They measured the empathic abilities of twenty-nine people with depression before and after they had received treatment with antidepressants, and compared their empathic responses to a control group without depression or medication. Empathy was measured by asking people how unpleasant it made them feel when they saw another person in pain. The authors found that while the two groups had comparable empathy levels before starting the medication, the individuals with depression had lower empathy afterwards. This suggests that it is the antidepressant treatment that might lower one’s empathic abilities, not the fact that people have depression. The fictional short story is the first I ever wrote and (I know it sounds weird but it’s true) came to me in a dream. It follows Paula, a young woman with a history of depression and anxiety as she meets someone she didn’t expect to meet.

How good do you think your empathic abilities are?

The author

Helena has developed Science and Fiction and writes many of the stories herself. Her current research as an active scientist focuses on the behavioural and neural basis of pain, pain modulation and treatment expectations based on placebo and nocebo effects. She completed her PhD at the Social, Cognitive, and Affective Neuroscience Unit at the Institute for Psychology of Cognition, Emotion and Methods at the University of Vienna, where she investigated empathy and prosocial behaviour in the area of pain.