The 2021 Bette Howland Prize

We are pleased to share Valeriya Kipnis's essay "Little Yellow Pills," which was selected by Emily Bernard for the 2021 Bette Howland Nonfiction Prize. The prize was established by the author Honor Moore, and is awarded annually to a graduating New School MFA nonfiction writer. Most recently the editor (with Alix Kates Shulman) of Women’s Liberation: Feminist Writings That Inspired a Revolution & Still Can, Honor Moore wrote about her friendship with Bette Howland in the afterword to Calm Sea and Prosperous Voyage: The Selected Stories of Bette Howland.

The week I turned 27, I was diagnosed with obsessive compulsive disorder (OCD) for the second time.

It was February of 2021. The therapist, a forty-something-year-old woman sitting in front of a cream wall in a four-by-four-inch box on my laptop screen, squinted at the notes in her lap, looked up at me, and said, “This doesn't come as a surprise, right?”

She was funny, smart, personable, and, for some reason, I still lied to her.

“No, it's not.”

The truth is that it was a giant surprise.

I had not thought about my first diagnosis in years, or at least not seriously. It had lodged itself so far in the back of my mind, that it had become wholly inaccessible. The first time I went to therapy, I was twenty-four, and I just wanted to talk to someone. “You come from a long line of crazies,” my father used to joke when I was younger. His nebulous wording bothered me immensely. I wanted someone to tell me I wasn't crazy, or that I was, but to tell me which specific kind. I wanted an exact name for what I was feeling. I needed a word. When I got my initial diagnosis from Linda Galanis (whose name I've changed), a clinical social worker in Brooklyn, I finally admitted to my parents that I was seeing a therapist, that I was seeking help for the first time. I'd hoped they would be concerned and sympathetic, that maybe they would ask questions, but my parents gently pretended they didn’t hear me. Perhaps they didn’t understand, perhaps they didn’t know what to say. We were driving, it was light out, Mama sat in the passenger seat, her bare feet propped on the dashboard. I could swear I heard her mutter in our native Russian: Amerikanskaya chush, meaning: American nonsense.

I replayed Linda's words in my head in the quiet of the car. The engine softly hummed as we drove on the Belt Parkway. “Maybe all of these compulsions you speak of, all of these ‘I have to’ statements, maybe they're all part of a larger condition,” Linda said six months after sitting across from me in a small room with no windows in a building overlooking the East River in Dumbo, Brooklyn. “Maybe we should consider that your type of anxiety could be categorized as obsessive, as compulsive?” She let the word compulsive leak into a heady-sounding hmm, an upward inflection, as if she wasn't really asking, as if she was already diagnosing. Compulsivehmm? Even in memory, this induced a gut reaction. Denial first, confusion second, but ultimately relief. So there was a word for this. Reticent, I said, “I guess we could categorize it as such, but now what?” I imagined Linda scribbling “OCD” next to “depression” into her yellow legal-pad with delight. “Now, we work through it,” she said.

After the incident in the car, and after a contentious moment at a family dinner a few weeks later, where my mother claimed, “At least I don’t need help, at least I’m not crazy, like poor little you.” I stopped showing up to sessions and started dodging Linda’s calls. Despite how good it felt to finally have a word, I had internalized my mother's skepticism as denial. A part of me, maybe the part that was unintentionally keeping in line with family tradition, wrote Linda's diagnosis off as fallacious. I made a bet with myself: if the behaviors stopped on their own, then Linda was wrong, leaving Mama to be right.

Finally, at some point, Linda emailed to let me know that she was, regretfully, filling my spot. She cautiously recommended that I not give up on therapy, that there was more work to be done. I left her email unopened in my inbox for months. Soon, I ceased tapping the nine-digit code to my high school locker on my white Ikea headboard. The intrusive thoughts about dead family members which once plagued my romantic life dissipated. I stopped bleaching my bathtub. Then, the floor. I no longer counted Subway ads or avoided cracks on sidewalks. I did not have to cleanse my body of impure thoughts. For the first time in a year, I began showering only twice a day. I was mostly better. Shamefully, I buried the initial diagnosis somewhere deep inside, deeming it nonsense.

But then, as always, it returned. Not that I would have said so in the moment. For a while, I believed my behavior was mostly sane, or at the very least: sane for the time. The year was 2021 and the coronavirus had kept the world in a terrifying lockdown for close to a year. My once manageable quirks had grown into full-blown impediments. The intrusive thoughts came all at once and my need to shower several times a day resurfaced. I began having trouble breathing. I was crying often and without much warning. The circular logic of my obsessions and their accompanying compulsions infiltrated my mind. If I called my father at nine o'clock, then he wouldn't crash his car that day. If I texted my mother before bed, then she would be alive in the morning. I had to buy a white noise machine so I could drown out my neighbors' heavy metal at one in the morning. If I didn't buy the machine, then I couldn't write. If I couldn't write, then there was no point in living. There were too many white noise machine options to choose from and so for two weeks straight I manically looked for apartments on top floors of buildings because that seemed easier than making a decision. Defeated, I settled on downloading an app. Rather quickly, I had become a prisoner to my own thoughts.

The coronavirus pandemic had made things unsurprisingly more difficult—the virus’s presence was thick, like goo: inescapable. It was like wading through syrup or trying to wash off already congealed Krazy Glue from your pointer finger and thumb. The minutiae of everyday life turned sticky. In the spring of 2020, I began dousing my body with technical-grade ethanol—the only form of sanitizer available at the time—before bed and after being outside. Every day, I spent long showers scrubbing every bit of skin that had been exposed to the air outside my apartment in scalding hot water, and a nasty case of dermatitis crept onto my hips and knees. I could see the virus all around me: it was in my hair and in my lungs. It looked like phosphenes, the luminous floating stars and zigzags that dance inside your eyelids after a particularly rough sneeze or a tight squeeze of your eyes: light existing in the absence of light, everywhere. “Shut all the windows,” I directed my partner from across the room. “It can travel up, you know.” Once, while boarding a flight for a reporting trip in October, I began to sob hysterically: I was convinced I had contracted the virus from the person in front of me. I needed to shower, but I couldn't, which meant I was going to die, or worse, give it to someone I loved and then they would die. I started to panic. This is it. This is it. This is it. Heavy tears leaked into my N95 respirator mask creating a greenhouse around my nose and mouth. I could barely breathe through the thick cotton. Even so, I put on a surgical mask and face shield and sat in pure panic for seven hours. For a week after the flight, a red bruise-like ring engulfed my nose and lips. I tested negative for COVID-19.

A month later, an uncle brought over flowers for my mother's birthday. He seemed sick, but had tested negative for COVID-19, so he stayed and chatted for a few minutes before leaving. The next week, my entire family and I, whom I was living with at the time for pandemic-related financial reasons, tested positive for the virus I had spent months ethanolyzing. I was convinced we were all going to die. And this time, it wasn't just my brain telling me this. It was the world: “U.S. Records More Than 3,000 Deaths in a Single Day, a New High”; “Grim Day in U.S. as Covid-19 Deaths and Hospitalizations Set Records”; “US Covid-19 Hospitalizations at Record High for 12th Day.” Sometime during the four weeks of testing-positive-hell, of being trapped in my childhood bedroom for sixteen days, of taking care of my seventy-five-year-old grandmother in the ICU of Maimonides Hospital, of praying for the first time in my life, please just not my grandmothers, of recurring bouts of panic and breathlessness, of never-ending fatigue and frosty toes—I decided I was going to die. I wrote my will on the back of a paper plate, slid it through the gap at the bottom of my bedroom door, and resigned myself to a week of fever-induced sleep.

For a brief moment, things got better: my family survived, and we all had the coveted antibodies. I was going to be okay, a person from the New York State Department of Health assured me over the phone. I was free to leave my house, go back to work, they said. I was lucky, they said. Who was I to tell them they were wrong?

My parents and I emigrated from the recently collapsed Soviet Union in the winter of 1995. We came as Jewish refugees looking for a different life, a better life. I was one when we settled in a Russian enclave of Bensonhurst, Brooklyn, and six when we were naturalized in the United States. My parents were in their late twenties, my grandparents in their fifties. Even as American citizens, my family managed to operate within a Russian-speaking world. For stints, my parents worked for American employers, but have mostly spent their time surrounded by other immigrants from the former Soviet Union. My grandmothers, who speak little English, spent most of their days in Russian medical offices with other Russian retirees. Because the majority of my childhood was conducted within a world built by this Soviet diaspora, I only learned to speak English in the third grade, after three years of English as a Second Language classes at my local public school. Now, I am accentless, leading people to always try and guess where I am from. Our lifestyle left me equally uncomfortable in both languages, a permanent outsider of both worlds. For the last twenty-six years, my family has taken up residence in a nuanced no-man's-land—a place that is not exactly American and not exactly Russian. It is neither or, really.

When we immigrated to America, Russia was only beginning to reckon with its relationship to psychiatry and its dark past of institutionalizing political dissidents under the guise of treating mental illness. My family was reckoning with its own complicated history: my great-aunt, who died with the voices in her head; my grandmother, with her fainting spells; my mother, whose mood swung like a metronome. And then there was my sister, me. The two of us, the “Americans,” were not entitled to any mental turmoil. We could be sad, but not depressed. We could be nervous, but not anxious. We could be particular, but not obsessive. Therapy and medication were completely out of the question. “Life is too good for you to feel any of those things,” Mama used to say as she steeped valerian root in boiling water for my sensitive nerves. “I did not come here for you to be depressed, for you to be anxious.”

For my parents, there was no such thing as depression, anxiety, or OCD because there was no true linguistic equivalent in their native tongue. For their entire lives in the Soviet Union, such terms were virtually nonexistent in colloquial speech, which makes sense, as they were absent from official scientific dogma by design. A psychiatry that is more akin to its Western equivalent has only recently gained traction in the former Soviet republics, and society has been slow to catch up. According to my parents, up until the 2000s , there was sadness and unhappiness and the feeling of being overwhelmed but there was no authentic depression. “Anxiety? Forget about it,” Mama tells me. “Now things have probably changed,” she presumes. But if so, the change benefits only those who stayed behind to see a new Russia—not people like my parents who left four years after the collapse of the Soviet Union. For them, mental illness has remained undefined.

For a long time, I blamed their resistance to mental illness on a lack of lexicon. But as I've gotten older, I've come to realize that it wasn't that simple—it was also a deep-rooted reluctance to accept that even after fleeing their home to provide their children with a better life, something could still go wrong.

The virtual therapist asked many questions. “Do you have rituals? How often do you do them? Do you obsess over anything?” Mostly, I was honest.

She suggested I begin treatment, immediately. “Eighty milligrams of Prozac,” she said. “We'll work up to it. It should help with the depression, too.”

We? We weren't working up to anything. As far as I knew, I was doing this all alone, and it was my body that was going to take the hit. My natural urge was to resist her diagnosis.

I didn't come here for this, I just wanted to talk to someone, I'm just crazy, I wanted to say. But instead, eager to get away from her, I half-smiled, nodded at the screen, logged out of the Zoom call and turned off my computer. This time, hearing the words said aloud, having my brand of crazy defined, didn't work like it had the previous time. I felt wretched. I ran to the shower to wash off the conversation. But even the scalding hot water couldn't relieve my mounting panic.

I kept thinking about the questions she had asked me at the beginning of our call: “How about your family? Does anyone in your family have a history of mental illness? Does anyone take medication for mental illness?”

“Nope,” I told her, shaking my head.

She marked something in her notes and looked up at me, wordlessly, expectantly.

“No,” I softly repeated.

I resented her questions. My family did not know how to have such conversations. We did not have the language for the trauma of their past lives, for our immigration, for the disjointed sense of identity we all shared, to varying degrees, in our new home. In my family, illnesses of the mind were often felt but rarely defined. Nothing was ever as bad as what they had left behind, and so everything was always rendered fine, just fine. I didn't want to admit to this new, expectant therapist that maybe I never knew how to look beneath that. But as I stood in the shower scalding my skin red, I couldn't help and think about my grandmother and her little yellow pills.

For twenty-seven years, I watched my grandmother faint in elevators, in subways, in cars. She blamed this on hypertension and nervousness. I watched her hands shake, her teeth chatter, her face flush a deep rose pink. I watched her hobble into the bathroom with her green plastic pillbox. I watched her blood pressure jump into the 200s. Once, when I was eight, and the two of us were in Illinois to visit her distant cousin, she fainted in an elevator and didn't wake up like she usually did. With my still-broken English, I ran outside and begged a stranger for help. “Nervous. She is nervous,” I kept saying. The kind and frazzled stranger dialed 911. Inside the ambulance, my grandmother pointed to her pillbox and whispered: “the little yellow pill, give it.” Carefully, when the EMTs weren't looking, I placed it in her extended palm. She swallowed. Her blood pressure dropped and she was no longer distressed. I don't remember exactly how, but we were released almost immediately upon arrival to the hospital.

This became our little secret.

In the early years of our immigration, when she and I still shared a room, a bed, whenever she would begin shaking violently and breathing quickly, I would run, grab her pillbox, and hand her a little yellow pill. Not once did I ask what it was for.

After the second diagnosis and the scalding hot shower, I called Mama and asked her if she ever counted ceiling tiles or cracks on the sidewalk. If she ever checked that the door was locked or if the stove was turned off one or maybe two or maybe eight times before she left the house, if she ever tapped rhythms into her bed frame, if she ever heard voices in her head telling her what she had to do and what would happen if she didn't.

I needed to know if I was alone in this.

“Do you have rituals? How often must you do them? Do you obsess over anything?”

Plainly, she told me no, that she had no idea what I was talking about or why I was asking. She was fine. I was fine. Everything was fine. She then proceeded to tell me how she sometimes felt the urge to reorganize the hallway closet before she could make breakfast. How she had to alternate which foot could step onto which stairs, onto which side of the sidewalk. How she couldn't sleep until the black grout in between the bathroom tiles was cleaned. How she had to text me before going to bed or something bad would happen. She admitted she used to shower often, but only because she ran cold. Sometimes, she liked to repeat things to herself, little mantras, but only when she was nervous, which was often.

“But that's not O-CEH-D or whatever you want to call it,” she told me. “I'm just particular.”

That, she certainly was. And that was an answer I would be willing to accept any other day than today.

“Right,” I said. “But do you remember the voice in my head? When I was in elementary school?”

Mama paused, either caught off guard or confused. Perhaps, a little bit of both.

I wanted to jog her memory. I wanted to see if she remembered the moment when I realized something was different about how my mind worked, and the moment she convinced me that there wasn't.

When I was in elementary school, I had a voice inside my head tell me what I could and could not do. I was ten, maybe eleven, when I learned of Christianity and immediately grew enamored with the name "Jesus." I loved the way it sounded on my lips in my newfound English. Gee-zeus. That was also the year I began to conceptualize mortality, obsess about it even. This voice, whom I named Jesus, would tell me about which sidewalk cracks I had to avoid in order to prevent worldwide destruction and the end of the human race. The voice would tell me which patterns to tap out on my left arm so that my grandmothers could keep on living. The voice would tell me which milk carton I should pick from the large metal freezers in our cafeteria so that my school wouldn't burst into flames.

Once, Jesus told me that the only way to keep my parents from dying was to stick out my legs through our fire escape and let them dangle. The voice told me to squeeze my body through the railings, hang on by my arms and count to ten. If I could do as the voice said, then my parents would live. I did what I had to do.

I remember when Mama found my body dangling from the third floor. I remember the fear in her eyes, how scared she was of what I told her, how scared she seemed of me.

“But I did it so you wouldn't die,” I reasoned. Her pupils widened. “Jesus said so.”

“We all live with our own little demons in our heads,” she told me. “You just can't let them dictate your life.”

Truth is, I don't remember what happened next. I don't think Mama scolded me, but I do know that my grandmother never left my side after that. When I had compulsions and my grandmother would stand in the way of them, I would cry for hours.

“You're making me kill people,” I would scream.

She would nod and make tinctures of valerian root, patting my hair with her warm, arthritic hands. She would start a hot bath and sit with me until I calmed down.

“Do this when you get nervous,” she instructed. “Ten drops of Valerianka and a warm bath. No need to worry your Mama.”

I must have done just that: my mother seems to have no memory of any of this.

With time, the voice inside my head lost its power and slowly receded into the background. Jesus was gone. But something new took its place: rituals. That is where my obsession with cleanliness began, and never left. To this day, I find comfort in showering several times a day. On a good day, I can get by with three showers. On a bad day, I can take up to eight. Mostly I shower because I need to rid myself of certain thoughts, of certain feelings. I clean obsessively because it lets me feel in control. At times, my mind skips like a broken record: Did you close the door? Did you wipe the counter? Did you clean the sink? Did you really wash that dish? But are you sure? I have rules that are unusual but easily mistaken for "Type A" or "anal." No outside clothes inside the house, no shoes past the doorway, no sitting on the couch unless in pajamas. Trouble comes when these rules are disrupted—when friends come over, when an innocent dog jumps onto my couch, when I'm on a shoot for work. That’s when I start seeing the phosphenes. That's when the compulsions get triggered. That's when I have to shower. My thoughts run in circles, and I can get trapped in certain obsessions for weeks at a time. Seemingly innocent ideas about things like moving or adopting a dog or buying a certain pair of hiking boots will take up agonizing amounts of time and leave me wrought with anxiety. Sometimes gruesome, inappropriate images flash in my mind on repeat and make me feel evil, disgusting. On the most inconvenient occasions, intrusive thoughts haunt me in the least appropriate settings.

But mostly, I've learned to get by. Mostly, I've convinced myself that everyone's got their little demons. Mostly, I try and keep this all to myself. Mostly, I've accepted this all as a burden I'm destined to carry. There's no need to worry Mama.

After the coronavirus left her body, my mother, at the age of fifty-six, started experiencing severe hypertension, the sort which my grandmother also suffers from. Just like her mother, Mama's spikes in blood pressure are accompanied by violent shaking and bouts of panic. In the moment, she fears that she will die. She says so, too. Though the anxiety isn't new, the high blood pressure is. This past month, she was prescribed little yellow pills by her doctor. The new medication has opened up space for questions.

“What are your new pills for?” I ask her in March on one of our nightly phone calls. At first she tells me about hypertension and nervousness. She asserts that these are the long-term side effects of the coronavirus. Finally, she whispers words still foreign to her tongue: “Doctor say it is anxiety, panic disorder.”

For a moment, I'm quiet. I think about all the times I begged her to let me see a psychiatrist, to get help for what I was feeling, but I resist. I think about how she called me crazy when I suggested she get help. I remind myself to breathe, just breathe.

“Are they the same as grandma's?”

Mama takes a pause. I can imagine the soft skin around her muddy green eyes crinkle.

“Yes, they are.”

When my father calls to tell me that my mother's panic attacks are getting more frequent, and her blood pressure more elevated, I call my grandmother, intent on getting answers. I'm worried about my mother and the likelihood of a stroke. Selfishly, I want to know how much my grandmother knows, how much she's always known. I want to ask about my great-aunt, her sister, who we are not allowed to speak of. My grandmother is reluctant but matter-of-fact. For the first time in twenty-seven years, she admits that she was diagnosed with sensitive nerves and claustrophobia in her midtwenties. That she developed hypertension and an intense panic disorder just like Mama, in her midfifties, a year after immigrating to America.

“Anxiety? Did they say you have anxiety?” I ask in English, because I still don't know how to say the term in our native language.

“Not really in those words, but I've come to see that this is what I had,” she replies in Russian. “Back then, they would just tell me that I panicked easy, that I had sensitive nerves.”

“And your pills? Your little yellow pills? What are they?”

“Lorazepam,” she tells me. “I've been taking them for the last forty years.”

A Google search tells me: Lorazepam is a prescription medical treatment used to manage anxiety.

“But why did you never tell me?” I ask.

She's quiet for a moment, then she clears her throat.

“I didn't know how to say it,” she says. “I didn't know what to say.”

For a brief moment, I am rendered speechless. On the one hand, I am relieved. At least I am not alone. My anxiety, my OCD: it's part of a bigger story, a lineage. On the other, I am angry. To live a life in which you are told that what you feel is crazy or sensitive or fine, is difficult at best. But to be told all those things by people grappling with their very own mental health issues is painful. Almost intentionally cyclical. As immigrants, my grandmother, my mother, my entire family did not have the language for mental health, they only knew of the stigma surrounding it. Because of this, they denied their children and grandchildren the opportunity to make sense of patterns, to come to terms with genetic inheritances. The immigrant part of me, the naive part of me, the outsider part of me, the part of me that deeply envies those who are of this country, who did not build their national identities out of piecemeal recollections of immigration and trauma, who did not have to fight every part of themselves to seek help only to be called crazy, wants to scream: but that's not fair.

I can't help but imagine what my life would be if the women of my family had a language for their mental illness and spoke about it openly. If they had the words to define their own lives, to pass down such knowledge to future generations. If they were not filled with shame. Would their lives have been brighter, their language carefree? Would they have taught me what they knew? Taught me how to embrace the brand of crazy that we all are? I can see it now: I am born into this knowing, into this embrace. I navigate this world with words at my command. Language is my armor, not my weakness. I not only understand myself, but I understand my mother, and her mother, and so on. They understand themselves, and they understand me. I am gentle with their stories, and I am forgiving of them. I do not battle with my thoughts, and I do not battle with my diagnosis. I am accepting of help and guidance. In this world, I start taking the Prozac, to make life more bearable, more manageable.

But that is not my world, and that is not my story. I am still my mother's daughter. And my mother is still my mother. Some days she is distant, trudging through her no-man’s-land, still denying her diagnosis. Some days, she gets closer. In these moments, she is lucid: forthcoming about her emotions, regretful of her attachment to shame. She seems to teeter: stuck in both her past and present. Maybe I do too. For now, I am still not ready for the medication. But I am ready to embrace the words I've been given, and to let them hold weight in my life. I am ready to be patient and to offer what I have come to know to those who came before me and to those who come after. “You come from a long line of crazies,” I'll tell my child one day, “but let me tell you which kind.”

Valeriya Kipnis is a Russian-born, Brooklyn-raised writer. She received her MFA in Nonfiction Writing from The New School, where she was awarded the 2021 Bette Howland Prize by writer Emily Bernard. The recipient of a Fulbright grant to Ukraine, she works as a reporter and producer for Vice News Tonight.

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