Silent hours unfolded as I devoured the words, a symphonic consciousness crescendoing as door after door of new awareness opened inside of me. It was May, 2010, and I was alone in a Vermont hotel room, as I’d let my parents know they should go on without me to meet my sister and her friends for dinner to celebrate the end of their junior year in college. Skipping a social event was nothing new to me by this point; in fact, my family had grown to expect it. The inevitable, “How have you been? What are you doing in life?” had become too much to bear in social situations, those words a stab in the gut, their sharp ferocity leaving me aching for hours afterwards. The only answers I had to offer were entirely tied into my identity as a person with mental illness— Bipolar disorder and Borderline personality disorder, specifically. Indeed, it had become all I was.
How have I been, you ask? You’d really like to know?
I have not been well. In fact, over the last ten years, I’ve been getting progressively worse, and these last four years in particular have sent me further down than I ever thought was humanly possible. In this time, I’ve thought about dying on an almost daily basis, the thoughts invading me with the force of a powerful army. For whatever unfortunate reason, I failed at trying to kill myself a year and a half ago, and I’ve been stuck in the same life ever since. To be honest, the only thing that’s kept me going are these thoughts of death, which I know is waiting patiently for me when I finally decide life is too much, and that my mental illness is too severe.
I’m currently on six psychiatric medications, each of which I’m told serves a very important purpose— Lithium for my mania, Lamictal for mood stabilization, Abilify for my mania and mixed episodes, Effexor for my depression, Ativan for my anxiety and to help me sleep, and Seroquel when I’m overwhelmed with thoughts of suicide and need to sedate myself quickly. They’ve never worked, ever, and I’ve been told that I’m very treatment resistant. Although they keep upping my doses, I’ve only gotten worse.
I don’t remember what it is like to not be medicated, to not have to pour the pills out into the palm of my hand every morning and every night and swallow them down, a residue of bitterness left at the back of my throat. I’ve been on them consistently for ten years, and on and off for three years before that, so I have had a relationship with them since the age of fourteen. I’d imagine I’d feel naked if I went anywhere without them. They have become my security blanket, although I’m no longer sure what they’re keeping me safe from.
So, you’d like to know what I’m doing in my life? Well, I went inpatient on a locked psychiatric unit in New York back in February of this year after coming really close to killing myself. I guess you could say I was glad I asked for help instead of going through with the suicide, so that I could give life another shot, although there are moments when I’m not so sure. That hospital discharged me to a substance abuse day program at the same Hospital on the Hill I went to back in 2008, up in the Boston area, after my suicide attempt. That program didn’t go so well, and I was kindly escorted by hospital security back to that locked unit, where I spent a little time.
Since leaving that unit, I’ve been spending my days— five days a week, usually from 9AM until 4PM— at the hospital’s Intensive Outpatient Program for Borderline personality disorder. I go to groups, individual therapy, and to the occasional meeting with my treatment team, which consists of seven doctors, social workers, and psychologists who meet about me first and then invite me join them afterwards so that they can tell me what I need, since I have no idea what that is, myself. It’s always hard to wait patiently on the sofa beneath the old mahogany paneled walls in the hallway of the Administration Building, staring at that closed door, knowing that they’re talking about me in there, but I’ve been told this program is the best in the country for treating Borderline personality disorder, so who am I to say anything?
I’ve been staying with my aunt and uncle in the suburbs of Boston since leaving the inpatient unit because I can’t handle living alone. I dread the nights, when I am faced with myself, my racing thoughts, and my profound self-hatred, and I watch hour upon hour of Law & Order or South Park on my laptop until my Ativan carries me into deep, dreamless sleep. Waking up every morning to shower, dress, and go to treatment is a challenging task, because I’m still not sure I really see a point to all of this, since I’ll have these issues for the rest of my life. Other than my fellow patients at treatment, and the people I see nightly at meetings I’m attending to help me stay sober, I have no friends, because it’s too exhausting to put the front up that I’m anywhere near being normal.
I’ve never really thought about working towards a career, as I stopped thinking I had it in me to be successful long ago; it also didn’t help that doctors have always told me to be sure to set “realistic expectations” for myself, given the severity of my Bipolar disorder. I’ve haven’t thought about getting into a healthy relationship with a guy because I stopped thinking I deserved it a long time ago, and when I look around at people my age who are getting married, having children, excelling at work, and settling into homes, I am utterly perplexed. I sometimes wonder if I’m really an alien among these healthy, happy, functioning human beings, as I am constantly disoriented and profoundly confused by this thing called life.
Is that a good enough answer to your question?
With that as my truth— this massive secret of who I really was— I couldn’t bear to pretend any more, to diligently weave fabrications with acute precision, vigilant about getting straight which story I told to whom, and when. The contrast between the person most of the outside world probably saw me as and the person known by my family and by the countless psychiatrists, psychologists, social workers, and mental health workers I’d come to know over the decade I’d spent in shrink’s offices, day programs, partial hospital programs, and locked psych wards, was too stark. Tonight, however, these concerns hadn’t even crossed my mind. Alone, hidden underneath my usual baggy sweatpants and hooded sweatshirt, I had stayed behind for a very different reason. I simply couldn’t stop reading.
In the past few years, the vast majority of the books I’d read were of the young adult genre, and the only times I’d read at all were during stays on psych wards, my debilitated concentration coming together just enough to make a meager attempt here and there at breaking up the monotony of being on a locked ward. My hands hadn’t held a piece of non-fiction since college, other than a failed attempt at Malcolm Gladwell’s The Tipping Point while on the Short Term Unit of the Hospital on the Hill in 2008. I simply couldn’t absorb the words, my eyes going back to the beginning of each paragraph three times before I could move on to the next. And here I was, caressing the red dustcover, while my eyes, hungry fiends after years of starvation, digested each and every word of this book I’d accidentally discovered earlier that afternoon.
I’d been wandering around downtown, baffled by the normality and carefree happiness that was everywhere— families excited for summer and proud of their accomplished college grads, yellow labs in bandanas panting in the heat, children in matching Patagonia shorts. When I chose to go out in public, which rarely happened anymore, I couldn’t help but analyze the humanity I’d become so separated from, studying it as if through a glass observation window, fantasizing that one day I’d get so good at pretending I’d maybe have a shot at becoming like everyone else.
At the sight of a bookstore on the next block, my heart flittered; rooms of books were one of the few spaces that provided a temporary sense of relief and escape. I’d trace the spines of soft covers with the tips of my fingers, pulling them out here and there to push my thumb through their pages and inhale the sharp smell of crisp new paper, and imagine myself reading them at home in a comfy chair by a fire, a warm blanket on my lap, a cup of tea at my side. This scene hadn’t existed beyond the confines of my mind in a long time, and I wasn’t sure it ever would, but just the thought of it was enough to let me sigh a deep sigh.
Perusing the shelves, I came to the newly released books, which lay flat on an unfinished cedar display shelf, their covers shining bright under fluorescent lights. As my eyes scanned the images, I locked eyes with a face looking back at me. His eyes peeked out from just above the author’s name, and I was sure I saw pain in them. The top of his bald head was separated by dotted lines, which carved the skin up into designated sections, each labeled with one word. My jaw dropped as I read them. I knew them well, better than most, probably, and some of them I said aloud to myself every day.
Tegretol, Lamictal, Prozac, Klonopin, Wellbutrin, Risperdal, Zyprexa, Xanax, Lithium, Ritalin.
Pharmaceutical drug names for medications that treat mental illness, two of which I had.
What is this book? I thought to myself, heart pounding, as time slowed to a halt around me. Everything on my visual periphery fell away, until the book was the only thing left in my line of sight. I felt a powerful sense that this was predetermined, that this was meant to happen. I hadn’t felt something like this in a long time.
These words— these accumulations of letters arranged strategically by marketing divisions of pharmaceutical companies— marked the destiny of this man, whose eyes were searching for mine, and I realized in a profound moment that I was looking at myself. I now understood the ache I saw, for I had it too, and eight of these ten drugs— two of them in my blood stream in that very moment— had been shaping my own fate since the age of fourteen. I had no idea what the book was about, but without a thought, I had it in my hand, got into the check out line, paid, and went straight back to the hotel.
A few weeks earlier, I’d mustered up any inner confidence I could find to raise the issue of coming off my psychiatric medications with my psychopharmacologist, Ben, who was one of the doctors on my treatment team. Although he initially pushed back, he was willing to listen to me. I told him that since getting sober, my life on the outside had gotten a little more manageable and that I sensed a slight forward momentum, something I hadn’t felt in as long as I could remember. Although I still had no idea of who I was and loathed the person I saw in the mirror, there was something inside of me that had ignited, something deep in my gut that told me if I was ever to have a shot at putting together the scattered pieces of who I was, I had to come off of my medications. I was tired of wondering, “Is it me, or my meds?” any time I thought a thought, or felt a feeling. I was tired of feeling like I was turning my agency over to these inanimate pills that had ruled my life for over a decade. I was tired of the side effects, of the lethargy during the day and the insomnia at night, of the sense that I was separated from the world around me and completely disconnected from any sense of my self.
I simply couldn’t go on this way any longer, and had become ready to begin what I was sure would be the most difficult journey I would ever face. I was ready to discover who I really was, beneath the stacks of prescription sheets that had been ripped off and handed to me and the tens of thousands of tiny capsules and pills that had dissolved into my bloodstream over all those years and shaped me into the person I had become— a zombie, and a total stranger to myself.
Just weeks after this conversation with Ben, who had told me gently that we could reassess the topic in a month’s time, I was holding a book that carried a message I had been completely unaware of until that very moment. I had accidentally discovered Anatomy of an Epidemic, and it was about to transform the way I saw myself, my Bipolar disorder, my relationship to psychiatry, and my future.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
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