A DRUG DEAL GOING DOWN

The following is a piece I wrote back in the fall. It may come across as a bit dark; I suspect that’s why I didn’t post it then. Still, today a major Canadian corporation, Bell Canada, is holding its annual Let’s Talk Day, intended to shed light on mental health issues. Thirty years ago, when I interned at a mental health non-profit agency not far from L.A.’s Skid Row, I could not understand why people would go off their meds. If they do some good, why stop? Now I get it. Stigma is still part of the struggle.

I’ve been seeing psychiatrists for five years now and it still feels strange. Unpleasant even.

I had issues when I was going weekly. One doctor and I clashed. He was intent on proving I fit into a textbook model for depression and tried repeatedly to get me to confess that I was an angry person. He’d bait me with a thesaurus. After I’d share an anecdote, he’d say, “And how’d that make you feel...agitated? Huffy? Furious?” If I had any anger, it was session-specific. I eventually decided it was better to go back on a waiting list than to keep seeing him.

My next weekly guy wanted me to buy into mindfulness. I obligingly bought his chosen book on the subject and couldn’t help but scribble all my objections and skepticism in the margins. No doubt what he was scribbling on his legal pad: Resistant to therapy. After a few assigned readings and some futile attempts to incorporate mindfulness into our sessions, he lost the blinking contest. I would never become a disciple. Our sessions evolved into comfortable conversations. Too comfy, perhaps. I didn’t see myself growing. I was the same old mess. After seeing him for three and a half years, he retired last March.

The breakup seemed harder on him. He fretted over the transition for months. I regularly had to reassure him that I would be okay. I didn’t mention that I looked forward to the change. Maybe a new doctor would have a different perspective. Maybe he or she would offer new insights that might lead to improved ways of coping with my anxiety and depression. If nothing else, I knew my time would be freer. Apparently, psychiatrists who do psychotherapy are a dying—or retiring, at least—breed. No more weekly, fifty-minute sessions.

The pendulum has swung too far in the other direction. My new psychiatrist sees me once every two to three months for what comes off as a random chat, never exceeding ten minutes. I leave each time with the same thought: “What the hell was that for?”

I’m certain I’m not benefiting from these brief sit-downs. (Does the chair even get warm?) Still, I have to go. It’s all come down to drugs. He’s my dealer. Today’s appointment feels especially unsavory. Part of it is the setting. My psychiatrist has been assigned not based on my needs or any matching criteria; rather, he works out of the provincial health unit closest to me and he apparently had a space. While I live on the edge of the sketchiest part of Vancouver, his office is in the thick of it. To get to the building, I walk by addicts passed out or pawning their wares on Hastings Street and then take a zig and a zag until I’m alongside the tented homeless community that has taken over Oppenheimer Park for years. The glass door of the office I enter is decorated with the message, NO NARCOTICS ON SITE. I guess the hardware store was out of welcome mats. I arrive, carrying my laptop without my version of the Linus blanket, my Herschel backpack. (At the end of my first appointment, my psychiatrist eyed my backpack on the floor and warned me about a chronic bed bug problem in the building.)

Yeah, so the stage is always set for an unsavory kind of feeling. It gets worse as I dutifully answer his left-field questions—“What’s your writing process?”; “Did you like teaching?”—knowing that the Q and A leads to nothing. He’s going through the motions and, frankly, so am I. All I want is the slip of paper that comes whenever he suddenly decides time’s up. Gimme the prescription.

The sad reality is I can relate to the people I pass on my way over. I’ve learned the hard way, through trial and serious error, that I don’t function without my drugs. Rather, I dysfunction. Grandly. I spiral quickly downward, the bubble wrap coming off what had been neatly packed and stowed boxes of gloom, doom and utter despair. I frighten myself and doctors. I get locked up.

As I fold the paper I’ve come for, pocket it and leave the building, I feel dirty and ashamed. I fret as I have so many times before, wondering what the long-term harm may be from taking these pills. I flirt with a timeline for when I may once again go drug-free, cold turkey. I’ve been stable for almost four months now. My recently retired psychiatrist told me on several occasions that I’d be on meds for the rest of my life. (“Think of it like a diabetic who needs insulin,” I’ve been told by several well-intentioned professionals.) Still, I hold out hope that maybe I’ll learn some effective strategies to work through anxiety without needing to reach for an Ativan and I’ll be able to talk myself through heretofore crippling bouts of prolonged depression without Seroquel or Abilify or Mirtazapine. But I know I’m not going to learn any strategies from my bimonthly chitchats with my current psychiatrist. And the lift I get from a current pop song like this or that is fleeting. I don’t have answers now and I have plenty of bad memories from psych wards and meltdowns in doctors’ offices. Despite the bargaining, wishing and protesting, there is only one option: I have to stay on drugs.

By the time I walk back past the tent city, around the woman on the sidewalk nonchalantly shoving a needle into a vein in her arm and dodge several zombie impersonators walking wobbly lines, I know I can’t really relate to these neighbors. I catch a couple hugging and see groups huddled together. I hear laughter, some of it with another person by their side, some of it alone, and it’s our differences that are more pronounced. They are the ones who have all the connections they need.

I walk into my drugstore, have a seat in front of a familiar pharmacist and pull out my paper, my doctor’s note that hooks me up for the next ninety days. I try to smile and make eye contact but mostly I stare at my right knee, bobbing up and down, one hundred fifty times per minute. With only a glance at the piece of paper that I slide across the counter, he knows I’m not here on account of a persistent hemorrhoid issue, a case of the crabs or the latest flu strain. Those things shall pass. As many times as I’ve done this, my face still burns.

When I return in an hour to pick up the prescription, I’ll pay for a bag of chips and a box of Walkers shortbread as well, not on account of any expected surge of the munchies; to the contrary, those items will sit untouched in my cupboard for many months. I just need to normalize the experience, like how I load up a basket of groceries when the only pressing purchase is a twelve-roll package of toilet paper. Pharmacists and grocery clerks know too much. I’ll shove the pill bottle in my jacket and go bagless on the chips and cookies. The shame in walking home and coming off as a junk food junkie is nothing.