May
is Mental Health Awareness Month. Part of shedding stigma involves
talking and writing about our experiences. In this post, I discuss my
ongoing resistance to medication as a means of treating my bipolar
diagnosis.
I suppose it was foreboding that, during the summer after my first year of law school, I landed an internship with a non-profit called Mental Health Advocacy, just off skid row in downtown Los Angeles. On my first day, a client walked in and wanted to speak to an attorney about filing a lawsuit against whoever was misappropriating his image everywhere in public. He claimed to be the guy in the WALK signal at traffic lights. It would have been funny, but the guy wasn’t joking. He was agitated, incensed even. A coworker quietly leaned over to me and said, “Ronnie’s off his meds again.”
So
funny was actually sad. During
my stint with the agency, I heard many sad stories and a lot of
them—but certainly not all—had a common theme. Things got messy
whenever a client decided to go off medication.
I
didn’t get it. I
knew I wasn’t supposed to be judgmental but privately I did an
awful lot of head shaking. Just
take your meds!
A pill a day, maybe a handful. Before or after a meal. Or after every
meal. What was the big deal?
That
was three
decades ago—1990—when
I was twenty-five and thought I knew everything. Okay, not quite. I
didn’t have a cure for AIDS, I
didn’t know how to serve and volley like Stefan Edberg
and I didn’t
have a clue why Jon Bon Jovi’s “Blaze of Glory” was a number
one hit. (No, I’m not adding a link for the song. You’re on your
own with that.)
As
mental health has established permanent residence in my life, the
medication issue has become far more complex. Muddled even. I
frustrate healthcare professionals. I make their lives difficult. I’m
one of the resistors. I hate meds.
Some
of it may be rooted in childhood. While I reported daily tummy aches
in kindergarten—we didn’t know much about anxiety a
half century
ago—I was an incredibly healthy child. Nothing
to report other than a
case of the chicken pox that I don’t remember and the occasional
fever that would make me think the chair in my bedroom had
mutated
into a murderous monster. Piddly
stuff. My mom was trained as a nurse and my dad was a doctor. I never
ever went to a doctor’s
office
or a hospital. If I complained of an ache or a pain, my
parents would
pull out a thermometer and maybe let me lie down with a water bottle.
But days marched on. I was the kid who
got a perfect attendance certificate at the year-end school assembly.
Every year.
In
the ’70s, the main thing people
talked
about for staying healthy was Vitamin C. My parents went through
phases when they’d make my brother, sister and me take a vitamin
pill each morning. I always made it an ordeal. “Can’t
I just have an orange? Isn’t that more natural?”
My
parents held a united front. “Just. Take. Your. Vitamin.” I’d
shrivel up my nose as I stared down at an approximation of a
Flintstone character in the palm of my hand and then I’d put
it in my mouth and swallow. No, not exactly. A bunch of water would
go down the wrong way and I’d have a coughing fit, the vitamin
still hanging out under my tongue. I’d try again. And again. I’d
conjure up contorted facial expressions to convey the notion that I
was being tortured but my mother would turn to the sink and my father
would bury his head in the sports pages. Eventually, the chalky,
half-dissolved mess would go down and I’d
be left to face
my now soggy, cheerless Cherrios.
“Tim
Goodwin’s mom let’s him eat Froot Loops,” I’d say. Cue
newspaper rattling and increased volume on AM radio station.
There
was a period in my twenties when I could have veered into
pill-popping territory. I was playing a lot of tennis and
experiencing sidelining back pain. Hello, Advil. Hey, Motrin.
Somewhere I’d heard something about long-term liver damage and I
would give the handful of pills—usually twice the recommended
dosage—the evil eye before swallowing them. Luckily my back pain
went away and the lone bottle of pain relief currently
under
my bathroom sink has an expiration date from five years ago. Nasty
habit averted.
Six
years ago, I had
my first ever
hospital stay.
Psych ward, involuntary admission. I’ve mentioned it in many
previous posts. After twenty-four hours in lockup, I was ready to
leave, but that wasn’t my decision. I learned to follow the
rules—not a natural thing for me—and fake fine. A
psychiatrist prescribed an antidepressant and I obligingly took it
whenever a nurse showed up with two little paper cups: one with the
pill, one with water.
On
the night I got my freedom back, I drove to my local drugstore to
fill the prescription and was mortified when the pharmacist on duty
was the parent of a student who utterly adored me. She’d
read my children’s novel and wanted to be a writer, too. He
saw the hospital identification on the prescription pad, looked at
the drug name and startled
me by saying,
“It must have been really difficult.” How much did he know? Was
there some sort of code for “suicidal” scrawled on the paper? In
my tiny community, I was a pillar; now I was damaged goods. I’d
heard the compassion—no, pity—in his voice. I turned red, broke
into a body shellacking sweat and hid in the toilet paper aisle for
twenty minutes until my order was ready for pickup.
The
medication interfered with any attempt to sleep and, at home, there
weren’t nurses hanging out at three in the morning peddling
blue tablets that
offered a Fast Pass to dreamland. After a few days, I took myself off
my meds. I was still emotionally frail, existing with zero sense of
purpose, but rejecting pills felt like a teeny tiny victory. If I
were going to carry on, I’d have to find the will and the resources
on my own.
For
the next two and a half years, I dutifully attended weekly therapy
sessions, two different psychiatrists pushing pills to no avail. Even
when I finally assented to give meds another try, the twice daily
ritual met with a resistance not much more nuanced than my childhood
vitamin protests. At best, I’d tell myself, “This is temporary.”
Surely I’d pick up tangible, effective coping skills through
psychotherapy, by attending peer-led mood disorder groups, while
flipping through much buzzed about books on mindfulness and
dialectical behavior therapy and from participating in a series of
eating disorder interventions.
Dammit,
nothing stuck. I’m mental health Teflon. Insert asterisk here.
Asterisk
explanation: The meds kinda sorta sometimes worked. Things might have
even been better if I remembered to take them every day. Maybe I’d
be fine if I didn’t secretly go cold turkey off them a couple of
times with disastrous results. Maybe I’d get to a point of
happiness—instead of just being functional—if I didn’t keep
demanding that psychiatrists change up the drugs and refusing to
allow them to up the dosages. Maybe all that My Body empowerment is
just self-destructive nonsense.
I
can’t count how many times a medical professional has given me the
diabetes speech. (They always unpack it
like
they wrote it from scratch while
I do my best to appear curious and not roll my eyes.)
“If
you had diabetes and had to take insulin for the rest of your life,
you’d take it wouldn’t you?”
I
don’t have diabetes.
Diabetes
is a not a mental health condition.
Give me strategies, not dependency.
“What
you’ve got is biochemical...” they’d
say next.
Whatever
that is.
“You can’t just
rely
on coping tools.”
Whenever
the duel looks like it’ll end in a draw, I pull out my trump card.
“I don’t like the side effects.” Sleep disturbances,
grogginess, dizziness, flatness of affect. These concerns are real.
With my current medication, I can’t skip a day. No pill means no
sleep. Zippo. Midday naps are a thing of the past. I’m
one hundred percent dependent on Seroquel if I want any shot at rest.
The dreams are surreal and/or vividly annoying when they’re not
wake-up-screaming nightmares. This supposedly beats the six months I
“lived” as a walking zombie on my previous meds—I completely
lost my laugh.
My
Body...
If
needed, I vaguely refer to possible long-term damage. There’s a
page and a half of fine print that comes with each new medication. If
I read it, I’d be so freaked out the entire contents
of the bottle
would instantly get flushed down the toilet. My Body...
When
all this COVID-19 focus quiets down, I’m due to visit my family
doctor. If I’m staying in
this city and
not moving, I need a referral for a new psychiatrist. (My last
session with my current psychiatrist—the first in three months—was
a phone call that lasted three minutes, sixteen seconds. Has he given
up on anything
but meds?) I need to try a different medication. It means another
period of trial and error regarding the dosage and new side effects
to navigate.
I
now have much more empathy for Pedestrian-Walk-Symbol guy. I see my
own likeness in him, if
not the traffic sign.
I get the appeal of
going off medication. In my mental health social circles over the
past six years, I’ve watch many stare down at their kneecaps as
someone else in the room complains about a new med—what is does,
what it doesn’t do. I’ve heard others speak with pride and
determination about no longer taking medication. The struggles remain
to some degree but I recognize the sense of control
and autonomy that
persons with mental health challenges desire.
We
all have our issues.
It’s
four and a half hours until I’m
due to
pop my evening pill. I’ll
do it. No
scrunching up my nose, no gagging. Still, I’m holding out hope that
one day antidepressants and mood stabilizers won’t be necessary and
that healthy food, exercise, travel and an ability to ride out the
lows will be enough.
