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April 22, 2007Drugs and lots of ‘em“Everybody takes that stuff.”H INFORMS MEmy bipolar column was the most discussed of them all among his inner circle. Apparently many compared their own drug arsenals. YOU DON’T HAVE TO CONSULT A DOCTORNot in Mexico, anyway. I unbelievably left on this 20-day trip without my drugs, of all things to leave home. When I landed in Guadalajara, I told a friend of Jon’s who met us at the airport, what I’d done, and she marched me into Farmacia Quadalajara in the town of Chapala, kind of a one-stop shopping emporium, and told me I might have to go to a doctor to get prescriptions, but no–I gave my shopping list to the pharmacist and he went around to the stacks behind the counter, collected them all and handed them over. Just like that. I don’t recommend flying down there to do the same. MENTAL ILLNESSis making headline news and the Seung-Hui Cho tragedy is spreading awareness of it. Probably more people than we would suspect suffer from some sort of mental disorder. They are probably as common as they ever have been, except that people used to end up in asylums or hid their troubles. Advertising prescription drugs on television might lead to some irresponsible prescribing and overuse by people who don’t really need them, but one good thing about it is that people are exposed to the availability of treatment and realize that help is out there for the asking. It is now “OK” to need and seek help. It’s OK to not be OK. Now the crazy uncle need not be put in the home. Often people will recognize someone is disturbed but still would have no way of anticipating what they could be capable of under certain circumstances, like killing 32 people. Who could guess at what point any given delusional paranoid schizophrenic would become a murderer? Not all of them are going to “snap.” IS THIS AN INSTALLATION OF SOME SORT?I would ask my friend Pete if he were sitting here with me at the Duboce Park Café, as we did of odd objects that drew our curiosity. On the wall of the café is a seven-shelf white cabinet containing hundreds of round amber medicine bottles of various sizes which all bear the same instructions: “RX Take once or twice a day at regular intervals before a meal or on an empty stomach. Swallow with a glass of water. Do not take more often than directed. Too much could be dangerous to your health. Do not stop taking unless advised. Stopping suddenly could cause discomfort. Store at room temperature away from moissture and heat.” The “moissture” is sic, but I find at least one bottle where it is spelled correctly. On the outside of the cabinet on the glass door are 6″-high white letters reading “NORMAL.” What is this piece saying? That behind the façade of normalcy, everyone is drugged up? That it’s now normal to be drugged up? That to be fucked up (in need of drugs) is normal? The bottles are all empty. Does that mean that despite the volume of drugs consumed, we will never be normal? That there is no normal, that it has ceased to be relevant? Or that far more people need help than anyone knew? Or is its ambiguity the point? THAT’S ALL THE THOUGHTI care to give it (the piece does not really speak to me), but my own definition of “normal” has no pejorative or sarcastic element to it. I use it only as an indicator of behavior deviant from that of the mass of people, and “deviant” has no pejorative element to it. Perhaps “normal” would be better expressed as “average.” It’s not normal to cry every day could be rendered: on the average, people do not cry every day. It is not with pride or shame that I separate myself from the general populace, but I definitely think of them (you) as “normals.” When I am impressed by someone who is doing something I couldn’t handle, I can’t stop myself from thinking, “Yeah, well, she’s normal.” I AM NOT NORMAL.My brain does not function normally. My brain needs intervention to act normally. On the drugs, I am still not normal; I am in constant treatment for a chronic mental disorder. But my behavior has normalized. Normal is being able to pass in the normal world as a normal—but I just don’t care anymore whether I can. I can no longer feign interest in the petty workings of the straight world. It’s the crooked path for me. I have lost my capacity to bullshit. NORMAL HUMAN FEELINGSand behaviors include fear, anxiety, anger, unhappiness. I don’t wish to shield myself from any of this; it is the human condition to suffer—and soar. It’s all a matter of the degree to which these normal emotions translate into extreme behaviors that disrupt the ability to live a tolerable, functioning life. I wouldn’t take any of these drugs if I didn’t know for a fact the extent to which they make my life work. They’re too potent. But the intent and the effect of the drugs is not to render you neutral; if you lose someone you love, it will still hurt as much as hurt can hurt. NOTHING BOTHERS METhere was a guy on “Sex and the City” who was in bed with Charlotte—he had dated Carrie who called him a sex fiend—and lost interest. This isn’t gonna work, he says, rolling off her. Want to watch a movie? But what’s wrong, is it me? No I’m just not that interested in sex. Carrie said you were obsessed with it! That was before. Before what? Before I started taking Prozac. And you lost interest in sex? Pretty much. And that doesn’t bother you? Pretty much nothing bothers me any more. Now that is the numbing down of humanity. THE DRUGS SPARE MEfrom being brought to my knees. I can take only so much of anything, of life. Sometimes I just shut down, like the power’s out. But I do get back up. I do go on. HOW COME YOU GET TO TAKE A PILL TO FEEL BETTER AND I DON’T GET TO TAKE A PILL TO FEEL BETTER?Because you don’t have an illness. You’re just a human being. Medicine is for illness, it’s not a cure for life. Life you just have to live. “IT IS ARBITRARY, REALLY,”psychiatrists Drs. Edward Halliwell and John Ratey state, “where the line of diagnosis is drawn, where ‘normal’ leaves off and ADD begins. And yet, as Edmund Burke remarked in differentiating night from day, ‘though there be not a clear line between them, yet no one would deny that there is a difference.’” UNPREDICTABLE,seemingly causeless white-out panic attacks are not normal. Screaming on the street is not normal. Limbic rage is not normal. Crying every day is not normal. Lying inert in bed till you’re finally forced to go to the bathroom at 3:00 p.m. is not normal. Alienating or losing friends due to your over-the-top behavior is not normal. Not going to your best friend’s wedding because you’re too depressed and listless to get yourself there, is not normal. Spending the majority of time away from the job that usurps all your energy, flat on your face on the couch is not normal. All these behaviors combined for much of your life as you can recall it, is far from normal. IT WASN’T AS BADas I’m making it sound; these were isolated episodes, not the everyday thing, but it still took me forever to seek help for them. I also had tons of fun living in Portland with my wild hair posse of friends, but was known for being overly emotional. I once smashed a wooden plant stand I’d given to someone to smithereens with an axe handle (that’s not where the name comes from) because he had somehow betrayed or mortally offended me. I remember the amused tolerance with which my friend Ross, who lived in the house as well, just sat there watching me and allowed me to rage, asking me only, “Please don’t break the windows.” I used to be and still am attracted to the wild hair type that I knew would be exciting but not demand too much of me, but I now find I am also drawn to men who make me feel calm, in whose arms I can feel released from the burden of being myself. I CLEARLY REMEMBER,at age 40, lying with my face in a pillow, still in bed one afternoon, telling myself, Woman, if you don’t deal with this thing, you are never going to have a life. You’ll be miserable, if not nonfunctional, or end up ending it all, assuming you have the will to act. Because I finally had to admit, after three decades of living as best I could, that I have a chronic condition that worsens as I age, that I can’t handle on my own. I’D PREFER NOT TOthink of affective disorders as diseases, but they can be life-threatening and deadly. To me it feels more like something is not right. Even in the midst of some fit, I know instinctively that something is not working, literally out of order, like an elevator or toilet you can’t use till it’s repaired. I can observe myself doing these things, but I’m in the grip of something. If you’re lucky like me, the drugs make that off-kilter element work better than it ever did, enough to enjoy some stability and control over my behavior and state of mind. SINCE GETTING ONTO A DRUG REGIME,I no longer shriek shrill epithets into a pay phone on Chestnut St., al fresco diners nearby, because a certain somebody has stood me up once again. In fact, this person, who has so often pushed my wrong buttons, has a heart condition and once told me I was too toxic to keep in his life. With my mental condition at the time, the same was true of him for me, as I constantly set myself up to be disappointed by someone I knew to be unreliable, and then over-reacted when I was, when I could always see it coming. I sent him flowers and we worked it out, and by now those days are long gone. I WAS A LITTLE GIRL AND I HAD A LITTLE CURLPerhaps it was the curl in the middle of my forehead that made life so very very good, and so horrid. But someone recently told me I was “exhibiting lots of the symptoms” that my bipolar drugs “claim to cure,” like lack of focus and drifting off—but there is no weathertight outright cure for bipolar disorder, chronic depression or ADD. STILL CRAZY AFTER ALL THESE YEARS BUT NOTAS CRAZYThe drugs are a stop-gap maintenance tool, a hard-won approximation of what is needed. Sure I could continue to fine-tune all five of my prescriptions by various arbitrary milligrams in every mathematical variation possible, till every symptom subsides, but there are too many impacts on one’s well-being to be able to target all your problems with pills. You still end up being human. Though I may still have symptoms, they do not overwhelm and sabotage me, and that is the point.“Although medication does not always work,” say Drs. Hallowell and Ratey, “when it does work, it works wonders.” A troubled friend recently “accepted that gift of the Pharmaceutical universe and [is] grateful.” He’s “feeling better than ever.” And I am grateful. I hero-worship whoever developed this stuff. STILL I STRUGGLEand occasionally wrestle myself to the ground. Sometimes I wake up feeling like hell and feel like hell all day. Quite often I don’t go to events I’d planned to attend, can’t muster the energy. I still have trouble following conversations and speeches without blanking out here and there, I still have periods of nonspecific mild depression, but more significantly, I was unable to continue with a job I’d held for nine years, and am now determined out of self-preservation never to have one (a job) again. You learn as you go what you can’t handle. My horizons widen when I accept a situation as it is, because I’ve let go of the work and limitations of identifying it as something that has to change. I’m not going to turn myself inside out so I can get a job I don’t want. SOMETIMES THE EASIEST THINGS CAN BE THE HARDESTCan I tell you how painful collating is to me? As soon as even two papers separate, my brain starts going haywire. If I was at the office attempting to copy and sort a six-page proposal and the paper jammed in the middle, I would throw the entire job in the recycling and start over. It would just hurt my brain too much to find what might be missing from what pile and feel confident that I got it right. My brain would have a party trying to confuse me, as it looks to put all the copies in one pile, when dividing the pile is the whole point. THEN THERE’S THE STARTLING CONTRASTbetween my exceptional ability to write English, and my frustrating difficulty speaking it. I have literally tripped over my tongue trying to form words and get a sentence out, because there are too many thoughts rushing to the fore at once. “We hear the ADD adult so painfully describing the verbal rush, the inability to stop the words,” write Drs. Hallowell and Ratey, “and the verbal paralysis, or stuttering, derived from the inability to stop the thoughts long enough to find the words.” That must be partly why I do write—because I can take as long as I want and need to isolate, break down and arrange my thoughts in a logical sequence. Thank God for word processing—you should see my handwritten originals from my 20’s, having to number each paragraph in the order it would appear and draw arrows pointing to the next one, with notations like “see page 6, paragraph 3A.” Now I can write in any order and airlift the text into its proper place. BUT YOU’RE QUICKwith the witty comebacks, said my friend. Well, the real me is pretty sharp and spontaneous. It’s stopping to think that’s the problem. Basically, I can’t think clearly. That’s why I never discuss politics, because I don’t have the time or mental agility to think out a reasoned response. Anyone could easily call me on that and insult me or laugh at me about it. “You’re not thinking clearly!” But my mind is a jumble. I can write clearly, because I have lots of time prepare my copy, and because it’s my passion. It’s generally the case that ADD sufferers are capable of hyper-focusing at times. For instance I can read a novel I’m interested in continuously, but I have a hard time staying with short items like newspaper articles, instructions—even the funny papers. I might read a panel or two and give up. Narratives are easier than nonfiction because they have more flow and momentum. THEN THERE IS THE QUESTIONWhat does the real me consist of? My God-given brain is a beehive, my drugged-up brain is under the influence; who/what/where am I? Well I’m mixed in there somewhere. The real me loves to read; the ADD me does not make it easy. I actually can go for a year or more without reading a single book because I open them and it’s no good, I can’t pay attention and fling them aside. The real me likes to travel the world; the depressive me looks, from a prone position, at the objects I’ve collected and thinks, “I can’t believe I went all the way to Brazil to acquire that mask! How did I ever do it?” I pull a pen out of a jar and sigh with exhaustion when I see it is from Biff’s Gas Station in Grand Island, Nebraska, because having the pen represents all the energy it had taken me to get there and bring it back home. IT’S LIKE BEING TWO DIFFERENT PEOPLEThe real me assembles a beautiful home; the ADD me can’t keep it orderly and clean. If someone’s coming over I blow through like a hurricane, toss everything in paper bags and stuff them in the overflowing closet out of sight. Someday I’ll crack my skull tripping over something. At the same time, “underneath” it all, my home is pleasant and comfortable, because the real me has good taste. The real me acquires things I need; the ADD me can never find them when I need them, a constant source of frustrated anxiety. But I can’t be angry at myself; I have to forgive myself. There’s no telling what kind of person I might have been had I not been manic-depressive with ADD—but it’s irrelevant; that person was never born and never came to be. I can’t divorce myself from bipolar disorder. That is part of who I am. I’M FORTUNATEto have had a house to sell (resources), to have a “direction in life” (a sense of purpose), native intelligence (and an education), a place to live (assets), COBRA Blue Cross coverage (I can still afford it) and market potential as a writer (hope for the future). Many disturbed individuals who have none of these end up on the street or the state hospital. If I for whatever reason lost my health insurance and prescription discount, I could eventually graduate to street crazy. Most people respond to scary hostile “nuts” raging on the street with anger or annoyance or by avoiding them—I avoid them as they might be dangerous, but they make me sad, not angry. They are deserving of compassion. They can’t or don’t know how to get the help they need. Who would choose to act that way? They act that way because they’re out of their minds. They’re to be pitied. Incidentally, Church St. between Duboce and Market is “Street Crazy St.” They just like that block. Someone’s always going on about something when I pass there at night. Some—for one, Princeton Professor Emeritus Robert Bernard Martin—have questioned “whether the eradication of this disease by modern molecular biology would not ultimately be a diminution of the human race.” Look, we’re not all going to walk around like zombies. Talent will out whatever the circumstance. All I know is, the drugs provide a diminution of suffering for millions of people. Perhaps suffering can inspire great art; suffering can also inspire suicide. FLY ME TO THE MOONCertainly a common complaint of bipolar patients is “I miss the highs.” The drugs do stabilize me and in doing so sort of “average out” my emotions. Instead of swinging like a wrecking ball from one extreme to another, my moods are more even (don’t expect miracles, though). I’ll just have to miss those highs, though, that got me $50,000 into debt, had me impulsively screwing around, or making decisions I knew were not like me even as I made them. Like buying three oriental rugs before leaving Portland when I didn’t even know where I’d be living and needed the money to establish myself. When I arrived in Berkeley on my apartment-finding mission, I bought two pieces of furniture, a glass-front bookcase and secretary desk, once again not knowing where I’d live, and had them hold them for me till I moved. All beautiful stuff that I still enjoy, but I continue to go on treasure hunts even with no income. WRONG DIAGNOSIS, WRONG DRUGAnd I made the latter purchases while under the influence of Paxil! The drugs may present their own problems to challenge you, some perhaps as severe in their separate way as your original symptoms. I was misdiagnosed with clinical depression initially. I was counseled by a nurse practioner, not a psychiatrist. Paxil, on its own, demolished my depression but waaaaay exaggerated the mania. For bipolar disorder, it is usually prescribed in conjunction with a mood stabilizer like lithium. Any given drug is no sure-fire fit for you; and finding the ones that are is an excruciating process. You tinker with dosages, switch out drugs, try different combinations, and wait weeks to see the effects, then try again. And again. Some drugs made me nauseous. But on Paxil I felt great, invincible, I could do no wrong. I went on for years like this, in Berkeley, “turning the world on with my smile,” ignoring my personality shift and assuring myself repeatedly, no worries, “everything will fall into place.” It was kind of like a cocaine high, frenetic and overdone. But I knew my judgment was skewed and I went back to the doctor for a more “balanced diet” because the manic shopping sprees where I didn’t even look at the price tag were killing me. Today I don’t have a dime of unsecured debt. IT’S WHY I ONCE WROTE“I’m not the firecracker I used to be.” It’s why, in the very first Ax Files, I chose for the Short Attention Span poem “A loose-flying yellow CAUTION tape/Flits across my chest/Like a beauty pageant banner”—because my beauty comes with a warning: I am not an easy one to know, or love. THAT MANY SPLENDOURED THINGBut I want to stress the healing potential of love. Drugs revolutionized my brain; love would revolutionize my life. It has been focused on myself for so long, I would love to care for someone else. I am very loving and affectionate, but I haven’t really been in a position to offer that to someone consistently, I think, until now. But you need the patience of a saint to love someone with an affective disorder. First, you have to both admit it exists, it’s a real condition with consequences, and then you have to forgive one of you for having it and the other for not. Be inclined to cut the human race a break. It’s not easy on anyone to make it through life, much less with the added challenge of your brain double-crossing you. You need support from friends and loved ones, not judgments. IT TOOK ME FROM AGE 20 TO 40to admit that my condition existed. I was comparing myself to a severely bipolar neighbor and thinking, “I can’t be bipolar, I’m nothing like that.” I was scared to death of lithium and how potent it must be if able to bring this woman back down to earth. There are degrees of everything, and though I never hallucinated, I knew this thing wasn’t going away by itself, and it spurred me to seek help. IT TOOK ME FOUR YEARSto get through reading Driven to Distraction, Recognizing and Coping with Attention Deficit Disorder from Childhood through Adulthood by the above-mentioned Drs. Hallowell and Ratey, which I tossed aside a dozen times, unable to concentrate on it. Wasn’t ready to hear it yet. On the flyleaf I wrote, “Finally finished this book on June 17th 2004 while sitting in Jury Assembly Room 007, San Francisco Superior Court.” THE BOOK EMPOWERED MEto admit ADD is not a joke or a catch-all diagnosis and that I most obviously have it. If you think you or someone you are close to has it, this is must reading. It will explain a lot of things and you might even find that the behaviors that once annoyed you about someone might instead be an opportunity for compassion, if you love that person. If you do love one of these people, you will not have an easy time of it. But life is not an easy time of it. Or you might discover that you are not committed enough to be up to the “high maintenance” challenge. I have marked the margin with a “+” (my “pay particular attention” notation) the passage: “Acknowledge and anticipate the inevitable collapse of X percent of projects undertaken, relationships entered into, obligations incurred. Better that you anticipate these ‘failures’ than be surprised by them and brood over them. Think of them as part of the cost of doing business.” Yes, some things just come with the territory. I DO NOT LIKE TO FOCUSon my disorder and claim or convince myself I can’t accomplish something “because I’m bipolar,” as if that is the controlling factor of my life. An attitude like “My OCD made me do such-and-such,” gives power to “the OCD” to run you. I don’t want to hold myself back thinking I can’t do certain things, and there is a fine line between blaming bipolar for your behavior and knowing yourself and your limitations—but the line is there. Nor do I have to accept my limitations, I can try to surmount them; that’s where the “triumph of the human spirit” comes in. The real me is a positive person who wants to squeeze the tit of life. BUT CERTAIN THINGSabout yourself, you are better off simply accepting than expending ectoplasm faulting yourself that they are not as you want them to be, like it’s a matter of willpower or faith in yourself that they’re not. But willpower and depression are not a matched set. Don’t blame yourself if you can’t muster it. People don’t expect heart patients to pull on their bootstraps and heal themselves, but there is guilt surrounding depression because you feel that so many have it so much worse. “I have so much. I shouldn’t feel this way.” But you do. So I specially and specifically avoid committing myself to ongoing projects and causes, like being the head of a committee, because I know that part of the time, unpredictably, I simply won’t be up to making a contribution, and I don’t want to disappoint people who may be relying on me. I don’t ask myself to live with other people; that has failed miserably too many times already with even my best friends. I can’t live without solitude, and solitude means knowing that no one whom you have to respond to is going to be walking through your front door any time that day or night. I nearly lost my mind living with a roommate who was new to town, didn’t know anyone, and was a free-lance artist working from home. He virtually never left the house. I would stay in my room for hours just to be alone. CALLING ALL NORMALSThough I am intrigued by the prospect of serving on a Civil Grand Jury, I disqualified myself for many reasons (first alarm: “Are you a good listener?”) but one of the questions was “Do you have any physical condition that would interfere with your ability to serve on this grand jury?” and I have to say “yes,” yes I do. As much as I would love to convince myself I could do the job, and soldier forth, I can see there would be too many “stressors” with such a job that I have to protect myself from. It’s too great a commitment. It’s part of the cost of doing business. It’s for one of you normals out there. AND I HAVE GIVEN MYSELF PERMISSIONto be tolerant about the “Wreck Room” my writing studio inevitably becomes. It expands exponentially. If you go in there don’t be surprised. On a regular basis every surface will get covered herky-jerky with leaning, random piles of stuff—papers, mail, books, CDs, pill bottles, objets d’art, dishes, a “Hand Therapy of San Francisco” wrist guard, the electric orchids I got in San Miguel, scraps of paper from twenty years ago inexplicably on the floor, my checkbook, clothes, hand lotion, jewelry, a salt shaker, three pairs of shoes I’d kicked off when I got home, etc. That’s just what’s “out” today. There is nothing orderly about my creative process or the functioning of my brain, and to maintain orderly surroundings is a false front. It requires too much of my always precious energy to sustain the façade; it is far easier on me to just accept this chaos as my native habitat and be pleasantly surprised when I straighten it up. I AM DEFINITELY READY FOR A HIGH-VIBRATIONAL CLEANSING,said a friend, when I told her Karma Moffett is doing his Tibetan Bell Experience thing at Grace Cathedral in May. If you’ve never sat among dozens of bells, bowls and long horns, surrounded by and serenaded with the vibrations of the universe, perhaps you too are due for a high-vibrational cleansing. In the sacred energy vortex that is Grace Cathedral, it’ll knock your socks off. Intense, daddy-o. May 24th, 7:30, part of the SF ARTSfest. Have I driven you crazy? Everyone has a breaking point, and this is mine.
The real Alexandra Jones, world traveler, at 30th Street Station, Philadelphia ------------------------------------------------------------ A late bus
Driven, driven, driven...to school copyright Alexandra Jones 2007 |
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