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February 24, 2007I’m outing myself.Right here on the Bulldog.IF YOU KNOW ME AT ALL WELL,you possibly already know—no, not that I’m hetero-flexible, though indeed I am—you possibly already know about, or perhaps been the brunt of, my bipolar disorder. Just a “garden-variety manic depressive” as Hannibal Lecter put it. To just-for-fun add to the mix, I had a lousy childhood. “I am a refugee,” as Joni Mitchell might have said, “of a crazy family.” My family did not put the fun in dysfunctional. Which came first—the bipolar disorder or the lousy childhood? Or was it just a marriage made in hell? Schizzed-out genes encouraged to thrive and develop by my toxic environment. It’s why I’m best off on my own—I am not recommended for everyday use. My immense and intense need for down time and solitude is not compatible with having people around constantly. At times I am simply not fit for human consumption. Nothing personal against you or anyone, but when I’ve been around people for too long, I feel contaminated, and have to shake it off. THE VILLAGE DOCTORin “The French Lieutenant’s Woman,” divvies “melancholia” up as follows: Natural—born with a sad temperament. Occasional—that is, springing from an occasion–like a divorce or a death. This is an acute depression that any human being is likely to experience in a lifetime; Obscure—no one knows what the devil has caused it. That’s me all over—obscure—though, thank God, humankind has made much progress in the arena of where these things originate; in another century I might have been chained to a wall. THE ENVELOPE ON THE NIGHTSTANDI have long had my suicide note prepared, though I have never been tempted to use it, nor do I expect to. I just like knowing it’s there, like the East River was for Spaulding Gray. “It’s too hard being me.” I have too much respect for my own right to live to consider this as an option. There can’t be anything having more weight than my potential to rise above it. Life is my priority. I CLEAN UP NICELY.I can pass for “normal,” except when I can’t. It was no secret around the office that I was a high-strung and moody gal. In fact when my boss was reviewing the job description I wrote to replace me I told her, “We forgot one important thing: bipolar need not apply.” My friend Stefan said for people to submit two resumes: one for their good days, and one for the bad. I’ve taken only five days off from work in 30 years because I knew there was no way I could haul my carcass there—and they’ve all been in the last year. I could hold a job—until I couldn’t. In case you wondered what was so intolerable about the job I quit, it was nothing. It was just a job. I am what was intolerable. I could no longer tolerate my life in that setting, that circumstance. My bosses were just people who needed to hire other people to do things for them—for a while I was one who was able to do these things, but at the end of nine years, I had ceased to function. At age 51, it has become obvious to me that I am no longer capable of working a 5-day 40-hour full-time job. THERE ARE CERTAIN STRESSORSI simply have to avoid, like trying to fit too much into too little time—like a job into my own time on earth. Stressors like a relentless repetitive schedule, the need to be “on,” alert and responsive all day, the unpredictable demands of the public and coworkers. I don’t use my disorder as an excuse for my behavior, I don’t wear my “meds” as a badge of honor, like some do, nor as a badge of shame, but by now there are things I just plain know, and accept, about myself. That occasionally, despite my plans, I have to spend an entire day resting. That I can’t take important, demanding, 24/7 sorts of jobs because I am simply too inconsistent to deliver. That life is sometimes going to throw me for a loop, but that I’ll bounce back. That I must surround myself with things that nourish me and make me happy and scrupulously avoid those that don’t. SIMPLIFY, SIMPLIFYI’ve got to keep it simple. No husbands, no children, not even a dog I have to walk every day—too excitable and demanding. Cats on the other hand are furry tranquilizers. Nothing soothes me more than lying down with a cat on my chest or my back, behind my knees or warming my feet. Had I not sold my house and escaped just in time, I would have lost it big time and I’m talking supervised rest cure. Of course the crux of the issue was that I was not doing work I love, only that which paid my mortgage (and barely), which left me exhausted and discouraged. The two months since I left that job have been the happiest of my life. I am so much more relaxed, happy, energetic, it’s truly a different life. People have much higher-demand, higher-stress jobs and more complicated lives than mine—bully for them—but I can’t handle it. Maybe they can’t either. After all, Prozac has been prescribed over 50,000,000 times. TOM CRUISE, SHUT YER PIE-HOLE!I happen to like, or did like, Tom Cruise. I think he’s a decent-to-good actor who is enjoyable to watch in Hollywood fare like “Jerry Macguire” and “A Few Good Men,” and who has turned out two exceptional performances, in “Rain Man” and “Magnolia.” His Frank T.J. Mackey in that film is a standout even in the stellar ensemble that surrounds him (and if you’ve any desire to see him do a backflip with his pants down around his ankles, put that on your Netflix queue). I was however, deeply offended by his remarks chastising Brooke Shields for taking antidepressants for post-partum depression. That’s akin to George Costanza wanting to pose as an architect. “I don’t see architecture coming from you,” Jerry Seinfeld said. I don’t see psychopharmacology coming from Tom Cruise. Even though he said, to Matt Laurer I think, “You don’t know the history of psychiatry, I do.” Even if he does—there’s one thing he and everyone on earth beside myself knows nothing whatsoever about, and that is what it’s like to live inside my head. You don’t want to go there. That’s why I’m here to advocate for the other side of the debate. GIVE ME DRUGS AND LOTS OF THEMAlprazolam, Imipramine, Paxil, Buspar, Serzone, Zoloft, Prozac, Strattera, Wellbutrin, Xanax, Trazodone, Lithium, Klonopin, Zyprexa and Abilify have all passed through my system at some time or other. At the moment I take 602 mg. a day of five of these in varying doses, morning, afternoon and night. It took me about eight years of trial, error and experimentation to arrive at this package which has completely stabilized me and doesn’t have intolerable side effects (like Paxil, which launched me into a five-year manic high, and the atypical antipsychotic Zyprexa which padded me with 20 impossible-to take-off pounds; I’ve switched to a kinder, gentler drug and have lost one notch on the belt). I also use tranquilizers and/or pot as needed. The net effect is that I have a life. There was a lot of treading water, but I’m back in the swim. We hear a lot about how antidepressants are over-prescribed, overused, and a crutch for dealing directly with our problems. They’re a symptom of 21st century malaise. The era of the quick fix. You’d have to be crazy to not be disturbed by the state of the world, and perhaps Prozac takes the edge off for scores of folks. This stuff, however, is not candy. It alters your brain chemistry, for God’s sake. Take a look on the web at the indications and side effects for any of these drugs. I don’t know who in their right mind (literally) would take them if they didn’t have to. But what you don’t hear trumpeted as often is that for those for whom these drugs were really developed, they save lives. I bet Virginia Woolf would not have walked into the water had she had a phalanx of drugs on her night table. WHEN DO YOU HAVE TO?You have to consult a doctor. First off you need an attentive and thorough medical doctor and a trusted shrink who cares about your wellbeing. That is essential—professionals to guide you through the process. There is no doubt there is not a human on earth who does not experience the range of emotions, from the Himalayas of your life to the Zasu Pitts of your soul; the question is to what extent do they disrupt your life? Enough to lose friends, jobs, spouses? Do you sob uncontrollably—every day—for no good reason? Have completely inappropriate and disproportionate fits of rage, sparked perhaps by some imagined slight or insignificant trigger? Do you find yourself frozen in space and time and have to physically snap out of it? Spending all the money you have and lots you don’t? Are you super confident that everything will fall into place, until it falls apart? WHY SHOULD I SUFFER?The drugs don’t cure you of being human. They just make your suffering more appropriate to its cause. Though h would sing the praises of hash oil, as would I, and there must be naturopathic alternatives to medical treatment that work for some people, I intend to stay on these drugs for life. I had a massage therapist and a hypnotherapist (and a boyfriend) who all very obviously considered the drugs a cop-out, an easy fix and poor substitute for doing “the real work” of therapy. But if the symptom is crying every day and on the drugs I no longer cry every day, I’m happy with that. Period. End of story. I don’t know if any bipolar patients have been treated successfully with only talk therapy, but I would doubt it. Manic depression can be like something alien that possesses you. I had a friend with a severe case who would go into scary hallucinogenic trance states that had no bearing on her real personality, which was sweet and mellow. So I don’t blame myself for this disorder, any more than you would blame yourself for being diabetic. I don’t bring it up generally because usually it’s irrelevant. There’s a lot of guilt about depression when there’s so much unjust suffering going on in the world, when outwardly you might seem to have a great life. The entire third world would walk into my flat and think it was a palace. So why can’t I get out of bed? I’m in the grip of something—but I am not powerless. I have my will and instinct for self-preservation, I have my friends and doctors for support, I have the drugs. It’s been a challenge, to put it mildly, but I’m making it. And yet…I don’t know that I would change it. It’s who I am. I feel manic depression has immeasurably enhanced my life, in fact, by drawing contrasts, deepening and enriching my perception in ways others (you “normals” out there) don’t have access to. If I could change only one thing about myself, it would be to have the sense of physical direction and orientation I now totally lack. ALL THE FITS THAT ARE NEWS TO PRINTThe natural state of my brain is one of disorder, like a pile of pick-up sticks that has been thrown down–only you can’t manage to move a single one without disturbing the others. It’s easy to get a false sense of security when you’re doing well and to think, oh I don’t need these drugs anymore. So you wean yourself off, and it goes well for a while, until you’re back where you started, in need of drugs. There are beaucoup de social consequences to this sort of thing of course. No one wants to be dumped on because your wires are crossed. You apologize for a lot of stuff after the fact. THE SCARLET BI’ve been discriminated against as a mental health patient. The firm I worked for has a salary times one life insurance and LTD benefit, yet my benefit was reduced to the minimum coverage of $20,000, specifically because of my diagnosis of bipolar disorder. The letter from the insurance company actually specified that my condition during the “down” cycle could not be anticipated—a nice way of saying I am more likely to kill myself than someone else. Actuarially, I guess this is akin to preexisting heart conditions or cancer. But the fact is, I have no down cycle. I’ve been in treatment since 1996 and am no longer swinging from a chandelier. “A note from the doctor” does not impress underwriters. So if so had I been hit by a car, my sister would have lost more than $20,000 in life insurance benefits due to the stigmata on my head. OH BROTHER, NOT THATThere’s another poor relation in the world of affective disorders I’m dragging out of the closet, the unwanted step-daughter, Attention Deficit Disorder. Boy does this one get a bum rap. Normally I don’t reveal to anyone that I suffer from this because of its rep as a cop-out for every type of behavior. And yet for me it has been even more disruptive and damaging than the depression and perhaps a contributing factor to it. And “suffer” is not an overstatement. I CAN’T TAKE ANOTHER MINUTE OF THIS!Have you ever felt like you’d explode if you can’t separate two paper clips? Or bust a gut if someone won’t get out of your way, or a stranger jostles you on a bus, or if someone will not shut up! or get to the point already because you have a feeling you need to leave quickly—except that there’s nowhere you need to be—it’s just that you can’t wait to escape into silence with no one or nothing coming at you, to just relax and breathe and calm yourself down. And what are you worked up about? Nothing. Have you been listening to a friend’s interesting story, when somewhere along the way your mind wanders and you don’t even realize you’ve been gone until you’re back, asking yourself who’s Tom? or, what is she talking about? Or you realize you’ve been asked a question and you don’t know what it was, just that someone is waiting for you to respond? And where have you been? Nowhere. Your mind has simply been lost, out of commission, not doing its job. OUT OF ORDER. I’ve always felt that my achievements have been in spite of myself. THE MAGIC BULLETEveryone’s looking for it—but for me, the search is over. I found it in a ½”-long blue capsule reading Lilly 3229, containing a granulated white powder that has revolutionized my brain. It’s called Strattera, its target market the adult sufferer of Attention Deficit Disorder. It was the missing brick needed in my foundation of drug-induced sanity. By the evening of the first day I tried it I could feel the difference. By the next day it was nothing short of a miracle. The revolution: quite simply, my brain relaxed. It stopped trying and failing to process everything coming at it from every direction and is now able to deal with one thing at a time. I used to become overwhelmed to the point of paralysis. I once fell behind two years on my taxes and was about to have my wages garnished before I was forced to deal with going through every paper in my house, strewn or stuffed anywhere and everywhere, to glean the information I needed, my hands shaking the whole time. But not before ending up tranquilized on the couch for two days. “I AM A STRATTERA SUCCESS STORY!”I left that message on my shrink’s machine. ASK YOUR DOCTOR!I learned about it through a TV commercial! I thought, I am the freakin’ poster adult for ADD; if I don’t have it, no one does. So I “asked my doctor about prescription Strattera” and he gave me a four-page questionnaire with “every day / once a month / occasionally / never” sorts of scenarios. One question actually used the very words I’d said to a friend only days before: Do you have a “sense of impending doom?” Decades of journals are rife with allusions to my basic human condition of “low-level anxiety.” Does one pass or fail such a test I can’t say, but I did walk out with a scrip and a box of samples. DON’T BE AFRAIDAnti-depressants can be efficacious for “occasional” melancholia—to pull you up from clinical depression after a traumatic event—and can be used in the short-term. There are “treatment-resistant” people for whom they don’t work at all. I just want to say, if suffering dominates your life, don’t be afraid to get the help you need. Do the research, discuss at length with professionals, and don’t despair. It may take a while, but it could be, as with me, that your life will be transformed. If there is one person out there who needed to hear this stuff, well, that’s why I wrote this column. Good luck, tovaritch. I’m off to Mexico. Una cerveza negra, por favor.
The kindred spirit the author encounteredon her last trip to Puerta Vallarta. ------------------------------------------------------------ Bupropion for breakfast
Been up and down so long, it looks like up or down to me, I can't tell copyright Alexandra Jones 2007 |
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