Tuesday, June 18, 2019

JAGGED LITTLE PILL

Twenty-nine years ago, long before I ever knew I had struggles with mental health, I spent my first summer of law school doing an internship at Mental Health Advocacy in downtown Los Angeles. At the time, one of the great mysteries was why so many clients went off their meds which caused them to unravel. Their explanation seemed too simple: “I don’t want to be controlled by medication.” Their resistance was maddening.

Now here I am, a client of one mental health organization or another. I’ve been off my meds for three weeks and I’m falling apart. The distress this weekend was excruciating. While I wasn’t suicidal, I couldn’t figure out why I was alive. I couldn’t fathom living another day. I couldn’t see continuing into July. Existing was painful. I’d just returned from a trip to Whistler which followed a trip to the Grand Canyon and I was desperate to find another place to flee. I struggled to even breathe in my tiny condo. I hiked, I ran, I cycled, I cycled some more—a gerbil on a wheel.

This morning I’m still frantic. I can’t figure out what to do with my day, much less my life. I fled my condo for a cafe after feeling like I was burning up even though a check of the temperature showed no cause for overheating. I can’t be by myself right now.

I’ve been unsettled ever since I got out of the hospital. Prior to admission, I had a steady routine. I filled my days. Six weeks of interrupting eating disorder behaviors interrupted everything else as well. Suddenly I can’t read or write. I can’t find purpose. I can’t stand to be in Vancouver but continuing to travel is unsustainable.

When I met with a friend on Saturday, he asked me to promise to take my medication. I couldn’t even offer an insincere yes. Like those clients from three decades ago, I am trying to ride this out. My last psychiatrist (who just retired) told me I’d probably have to be on medication for the rest of my life. He and several other professionals have compared my mental struggles to a physical affliction. “If you had to take meds for diabetes, you would, wouldn’t you?” Hell, I don’t know. Maybe. Probably.

I don’t even like to take vitamins. Or Tylenol.

I feel I’ve gotten so close to being officially medication-free. Two years ago, I was taking three drugs, a cocktail that I often resisted but admittedly worked in making me feel stable, pretty much well. A year ago, I went off all of them and eventually crashed, almost ending up in the hospital again. As a bargain with my psychiatrist, I agreed to go back on two out of three of them. I was okay again. Then six months ago things seemed to radically change. My affect was flat. No joy, no sadness. I existed in a tunnel. Technically safe, but wholly unsatisfying. I couldn’t emote. When I went out with friends, I couldn’t respond genuinely. I was just keeping a seat warm. I wasn’t myself. I felt like time was just passing. It was agonizing.

I missed laughter. I missed smiling. I even missed crying.

While I was in the hospital in April and May, all the people working with me noted my flatness. The hospital psychiatrist took me off one of the meds, which brought me down to a single medication.

Being discharged felt like regaining freedom and control. I immediately went off the remaining medication. I anticipated having to ride out a few lows. I even welcomed the prospect of being depressed. It was better than feeling nothing. And, surely, if I could feel lows, I could experience highs too. I could laugh again.

So far it’s just depression, laced with strong bouts of anxiety. Intense frustration, crying fits. No laughter.

Tomorrow I may go back on my medication. Or maybe the next day. Or next week. It’s illogical, but I continue to resist...and suffer.

2 comments:

Rick Modien said...

RG, Just read this post–-almost a cry for help.

I can't say anything you haven't already heard, but I know how you feel. I've always been an anxious person, but, over the past four or so years, it's gotten a lot worse. I've seen several counselors. I've tried various meds. Late last year, I attended what are called Rapid Access sessions for people suffering from anxiety. These sessions get you in a group setting with other anxiety-sufferers right away, until you're accepted for group counseling. I was accepted for group counseling early this year and attended nine sessions where we tackled anxiety using Cognitive Behavioral Techniques. The people there knew I struggled with taking meds to help me settle down at night, so I could sleep (that's when my worst anxiety hits––after I've gone to bed, turning some nights upside down). What they said makes perfect sense: As long as I resist taking meds, make more of them than I should, I will continue to need them. When the meds just are, with no judgement from me around taking or not taking them, then I probably won't need to take them anymore. Not going to lie, I'm not there yet. But I'm working on it. Some days are better than others, but I'm really focusing on not being critical of myself because I'm taking meds to help me cope. I have to do what I have to do, and, in the meantime, I look forward to the day when the meds mean nothing to me, and I no longer need them to cope.

I'm not saying you're in the same situation as me. In fact, I know you're not. But what I am saying is, take your meds, and stop judging yourself for taking them. Aren't you already too critical of yourself in so many ways? Take the pressure off. It's not worth it.

Hope this helps in some small way. I'm thinking of you.

Aging Gayly said...

Thanks for sharing your own experiences regarding anxiety, Rick. I very much appreciated reading your thoughts. I have tried CBT and, while I initially wasn't open-minded enough to consider it, I've warmed to it over time. I do need much more practice with it. I've been honest with my psychiatrist about going off my meds and we continue to have discussions about it. I wish more than anything that I didn't need meds as a support but it's looking more and more like being med-free isn't realistic for the time being.