The pad at the base of my thumb has become sensitive and sore from the way I’ve rubbed the nail of my middle finger across it. Again and again. I fidget in the chair and feel the way the seat cover sticks to my clammy thigh.

“I think I’m in trouble,” I mumble. “There’s a elephant sitting on my chest.” My words feel rushed and tangled. My tongue trips over the simplest of phrases. I’m having difficulty keeping the volume of my voice even.

On hearing its name the elephant shifts. It crouches on its haunches like a dog. Its weight rests on a single point in the centre of my chest. My lungs deflate with all the elegance of yesterday’s party balloon. I heave in a wave of breath and feel the air retreat too quickly: a riptide of confession and shame.

The shame isn’t from my condition. My family tree is crowded with bad brain chemistry.   The shame is from asking this of a friend. My friend is an esteemed neurologist. She’s been my friend for years. This year she’s been my mentor, my voice of reason and, in many ways, my guardian angel. Despite everything we’ve faced this last year, I can’t look her in the eye today.

I blink and consider the alternative. I imagine the cheerful, slightly camp nurse at my GP’s rooms who insists of taking vitals no matter how trivial the complaint. I know he will shake his head at my blood pressure. Blood pressure that I know (I KNOW), despite evidence to the contrary, is too high. He’ll jot it down and bite back the life style advice he knows I am too fragile to hear.

“I know I should start exercising. I know it will help. Eating better will help. But right now I can’t. I. Just. Can’t.” I scramble through the words and stutter to a halt.

She doesn’t blink when I confess to wanting to hurt Joshua’s athletic friend as punishment for the crime of being too healthy.

“He’s too vigorous. Too vital. I want to beat the crap out of him,” I admit, shamefaced.

She waits. The flood of disclosure peters out.

“Can you prescribe me something?” It comes out as a whisper. Heat shimmers from my neck and face.

This was a mistake.

I have abused our friendship.

I’ve overstepped the mark.

She pulls a prescription pad from the top of her handbag. I wonder briefly if she always has it or if she’s been waiting for just this moment.

“I’ve seen you suffering from anxiety and depression for a while now,” she says with a sad smile before her expression turns business-like. Then she is all doctor. Her glasses, which I never normally notice, glint with scholarly intent. She lists potential side effects. She instructs on times and dosages. She tells me I might feel worse before I feel better. Then, in a flurry of hugs and coffee cups and promises to visit soon, she is gone.

I clutch the prescription.

The elephant slides clumsily from my breast.