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Almudena Sánchez : Fármaco (Pharmakon)

A few days ago I read another novel about mental health issues and it is interesting to compare these two works. The author of the previous one was a twenty-year old bipolar Italian man who was involuntarily detained in an institution for seven days. The basic premise of the work was that the doctors and nurses were of little help and that the patients were better off sticking together and helping one another. He was sceptical about legal, medical drugs but felt that illegal, non-medical drugs helped. The book was an essentially realist account of his seven days in the institution.

Almudena Sánchez takes a different approach. She is older – thirty-something – she is depressive, not bipolar and is not institutionalised. In particular, her writing style is very different, more flamboyant, more humorous, more writerly. She tells us her aim at the very beginning:

My own head exploded and here I am telling that story, with no intention of writing an educational text or self-help piece and taking great pains for this book to contain more literature than grounds for morbid curiosity, more literature than technical facts, more literature than anything that isn’t literature.

I always got the feeling that Mencarelli was being both serious and didactic while Sánchez is going to tells us what is going on but is happy to veer off on tangents, talking about literature, as she says but also other things. Mencarelli certainly focussed on himself but also examined the other patients and the staff, while Sánchez tends to focus on herself. This is not to say that others do not get mentioned – of course, they do – but primarily in how they interact with her. Both writers mention their mothers and not always positively. I would need two-hundred pages to delve into my mother—a whole novel and My own mother is like God: I never see her, but she sees me. That’s what God is, right? Omnipresent. Maybe God is mothers but will later says that she does not want to blame her parents for her depression.

As mentioned the drugs (legal, medical) do help. Long live chemistry and long live Effexor. Long live the white powders that brighten our existence. Mirtazapine (brand name Rexer) is her favourite drug. When everything goes wrong, when my emotions jam and my mind points only toward the kitchen—the knives in the kitchen—or the bathroom—the razors in the bathroom—I take a Rexer and fall asleep.

This points to another issue shared between the two books: suicide. Both think about and talk about it. Sánchez even discusses the issue of suicide notes as high literature and refers to the fact that many artists (in the broadest sense) had mental health issues. She considers suicide more than once but backs off.

More than Mencarelli, she delves back into her childhood: my underwater childhood, my rotten childhood, my childhood spent in a car driving up one street and down, out to one end of the island. She did not have a particularly happy childhood. I’m allergic to my own childhood she tells us. Like many children, she felt that her parents did not understand her. She becomes a carer for a four-year old and really enjoys it, not because she wants a child of of her own but because it’s a marvel how a damaged childhood can be healed by someone else’s happy one.

When she first suffered from depression, she thought it was temporary. Depression was just people needing to snap out of it or pull themselves together. People blowing things out of proportion. But it is not. It hinders her writing. Indeed, she feels she may never write again. But, of course, she does as we are reading what she wrote.

She can be very poignant – This book is for sad people with a sense of humour who at some point in their lives, noticed that their brain was leaving them, that it was slipping through their hands and tells us of her wanderings through the streets, her difficult relationship with her (unnamed) partner and her very depressive views: Why bother: we are condemned. Sooner or later, we will die. We’ll be eaten by worms.

But she veers onto other subjects such as the fact that she lives in a Catalan town (They spoke to me in Mallorqui and I answered in Spanish and that’s how I spent half my childhood, speaking two languages that were close but different; two beautiful, competing languages, two overlapping languages) but is condemned by her teachers for her lack of love for Catalan. But she also reads a lot – from William Styron to Virginia Woolf (of course), (and Woolf’s mother) from Janet Frame to William Faulkner (So as to die well, I groom myself, watch my health, document my life, have fun, exercise, and read Faulkner.)

Her diet is wrong, her body feels different, she cries, she makes a plea to God but she can veer off to other depresssives such Winston Churchill and Charlie Brown (of Peanuts) and take up a craft – decorating flowerpots.

Some days things are better and some days they are worse. I am, rail-thin, brittle, scared, slipping on a mound of cold moss but, as she concludes, by quoting Virginia Woolf, It is death against whom I ride with my spear couched and my hair flying back.

I certainly enjoyed this much more that the Mencarelli (if enjoy is the right word), not least because she is not matter-of-fact, telling a chronological story in a fairly realist manner. Rather she jumps around, up and down, now talking about her misery, now about her childhood or literature or about her suicide attempt. She writes as a writer who has depression, rather than as a depressive who wants to write. Her approach gives us a much more compelling account of depression and what it really means to someone suffering from it, as, sadly, all too many people do.

Publishing history

First published in 2021 by Random House
First English translation in 2023 by Fum d’Estampa
Translated by Katie Whittemore