Southern Vapors: A Comeback Story Not Born of Chemistry

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I am a proponent for the limited use of psychiatric medications. As such I have some fear of being misjudged by the Mad in America audience, whom I gather are categorically opposed to the use of such drugs. By the same token, my experience over the past number of years is largely consistent with what I read on the MIA website and Facebook page in terms of a common goal to raise awareness and change the mental health status quo.

I began this piece one day after the death of Debbie Reynolds and two after that of her daughter, Carrie Fisher, both strong advocates for mental health and the eradication of stigma. It is encouraging that there have been many changes in policies, laws, treatments and public perception in the era covered by those two lives. Lobotomies were still being performed in Ms. Reynolds’ time but are unthinkable now. That’s the good news.

The discouraging news is that there have not been nearly enough changes, that no matter who speaks out — prominent politicians (Patrick Kennedy, Senator Deeds), celebrities (Glenn Close, Catherine Zeta Jones, Demi Lovato) or sports figures (Terry Bradshaw, Brandon Marshall) — the public outcry soon dies away. Until that changes, my role as a writer, advocate and survivor of serious mental health challenges is to keep speaking out. Partly to put a face on those who still struggle, but also to share my own recovery experience. Like most who have been though the mill and exited the other side, psych meds played a large part in my journey.

Being from the South (born in 1953 and raised in Atlanta), my story is properly melodramatic: Gone with the Wind meets One Flew over the Cuckoo’s Nest. Our house indeed looked more like Tara than Tara itself, with servants who came with the property. We were served our meals on silver platters by a privilege that did not, however, insulate me from bouts of depression and anxiety and frequent forays into binge eating. Such afflictions are nothing if not democratic.

My struggles began in 1960, when I was seven years old. They were manageable, albeit debilitating, for many years. Silent endurance characterized my teens and twenties, but that changed abruptly when my attention was drawn to the beguiling world of psychiatry and psychiatric medications at age twenty-nine. Imagine my excitement, the hope that relief from the sucking tar of misery that dogged too many of my days was within my reach. From that moment and for thirty years to follow, I was the willing guinea pig for any number of drugs. During the first twenty-five years of my treatment, the usual suspects were prescribed and combined and titrated up and then down to attempt to address my issues of depression and anxiety. Nothing helped for long. Some of the drugs hurt.

In 2005, the bottom fell out of my life. A painful divorce sent me into a nosedive, spiraling lower and lower, unable to gain any traction at all. My descent into a place where suicide seemed a viable option and my subsequent climb back to mental health are memorialized in my memoir, Southern Vapors.

As recounted therein:

The trial and error associated with prescribing my medication was usually fairly orderly, but during January of 2008, when I was deteriorating fast, my doctors changed my medication seven times in two weeks. I kept a journal: “started Vyvanse, Trazadone and Effexor 1/11/08. Started having symptoms—anxiety, shortness of breath, dry mouth, trembling hands, trouble concentrating and focusing. Stopped Vyvanse 1/13. Still had symptoms. Stopped Trazadone 1/14 per nurse practitioner. Still had symptoms. Restarted Vyvanse 1/16. Stopped Effexor 1/17. Stopped Vyvanse again after a few days—still had extreme anxiety symptoms. Started Zyprexa 1/23.”

I would not like to repeat those two weeks. Ever.

In desperation and with some much-needed financial support from my family, in the summer of 2008 I checked myself into The Retreat at Sheppard Pratt, a highly reputed treatment facility near Baltimore. It is no overstatement to say that the professionals there saved my life. With a combination of drugs and therapy, they stabilized to me to the point that I could be released ten weeks later to return home, resume work and continue on with my treatment. With me I carried a new label: “medication resistant.”

Considering that none of the entire arsenal of traditional psych drugs had made me well in twenty-five years, that seemed to me a reasonable diagnosis. For a few years after, I dutifully sought the care of psychopharmacologists specializing in medication for the treatment resistant. New drugs were tried. One, two, three, more; they all failed. By “failed,” I mean that I still fell into periods of depression, still became anxious, and when I felt overwhelmed, I binged. At the same time, I continued with the fairly intense course of talk therapy recommended by my doctors at The Retreat — individual therapy twice a week and group therapy every Monday.

I began to get stronger. Maybe not exactly happy, but more sanguine about my emotional upsets. Maybe not exactly centered, but experiencing smaller swings for shorter periods.

In time, even the slowest learner, as I must be, can still get the lesson. As my strength and some measure of stability returned, I began to question the logic that insisted that drugs were the answer to my troubles. Was it possible that “medication resistant,” far from translating to “needs different drugs,” could be interpreted to mean “no diagnosable illness?” Simply put, if the pills didn’t work, maybe I wasn’t sick. At least not in the traditional sense.

But if I did not have a diagnosable illness, why did I continue to fall into spells of feeling so damn bad?

Through many hours of talk therapy, I figured it out. Here’s the deal. My early environment, training and experience all left me with a deeply held belief that I was caught in a Leviathan struggle with my mother, a competition as fundamental to my existence as breathing. I believed at a primal level that this competition would be, could be, survived by only one person. I believed with every fiber of my being that my mother would be that survivor each and every time — not me, not ever, not once. That always and forever, in any contest between us, she would be the winner.

Since most everything between us did in fact devolve into a contest, I became programmed for defeat. Which explains why, every time I got to feeling good about myself, I self-sabotaged. Convoluted? Yes, I’ll be the first to admit it. That doesn’t make it untrue. Nor is this a rant against my mother. She died not long ago and my grief is deep. She was a complicated woman and we had a complicated relationship. The point is that my lifelong struggle was generated by an unfortunate combination of nature (my tendency to be vulnerable) and nurture (being raised by an angry and critical parent). It was not born of chemistry.

Feeling scared, impotent, desperate and hopeless became so familiar to me that I did not recognize them as distinct from depression and anxiety. Moreover, in the last couple of decades the words “I am depressed” and “I am stressed out” or “anxious” have come to be used as casually as “I have the flu,” and diagnosed as liberally. No wonder I never thought beyond the labels.

Once I committed to this new way of thinking, I gave up all psych drugs. Klonopin was the last and a real challenge; everything they say about withdrawal from benzos was true for me. When the shakes, insomnia and raging anxiety persisted, I sought the help of an addictionologist. On his advice, I titrated down very slowly, finally ending a dependence I didn’t know I had after six full months.

Once clean, for a short time I became a full-fledged opponent of psych meds in any setting except the treatment of psychosis, an exception based on my minimal understanding of that category of mental illness. They say there’s no one who can be as judgmental about his or her former substance of choice as a reformed addict, and I was no different. I had earned my suspicion, even contempt, for drugs the hard way. In short order, though, I began to feel uncomfortable with such an inflexible point of view. I met too many people I respected who insisted that their lives had been changed by medication. After a couple of years, mine was, too, or if not changed, then improved by an anti-craving medication that tamped down the compulsion to consume food even if it meant crawling across broken glass.

The drug worked well for the first eight months. When the honeymoon period ended, as it always does, the drug’s efficacy began to slip. Falling back into my old ways, I ran to my doctor and asked whether he could bump up the dose. Chasing the dragon. God bless him, the doctor said: “No, this is on you. The drug can’t fix your problem, it can just help. Beyond that, your behavior is a choice.”

Bingo. It was a lesson I had already learned, but wanted to ignore. My life is my responsibility, no one else’s, and everything I do is a choice. I can choose to engage in activities and practices that support mental and emotional wellbeing and address my urges to do things that are unhealthy. Or not. It’s not about the drugs. It’s about working to heal myself to the point that I want to make healthier choices more often. It’s about practicing new behaviors over and over and over again so that they become second nature, replacing the old tendencies to soothe myself in ways that are maladaptive. It’s about choosing community and connection over isolation and the comfort of habit.

In pursuit of those goals, I’ve made some progress in cultivating more self-compassion, resilience, perspective, patience and mindfulness. Unlike drugs, they won’t fail me.

***

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.

19 COMMENTS

  1. You wrote “Lobotomies were still being performed in Ms. Reynolds’ time but are unthinkable now.”
    In hundreds of thousands , lobotomies still go on every day with the slow brain shrinkage from psychiatric drugs. http://www.nature.com/news/2011/110207/full/news.2011.75.html
    In a few hundred, quick lobotomies are still performed, and we still have electroshock brain damage. “Gamma Knife at Rhode Island Hospital ” https://www.youtube.com/watch?v=UwoMvc_CNBE

    “the eradication of stigma.”
    Stigma? What is a person most precious thing? Their freedom. What does/can a psychiatrist do? Lock someone up for their diseased mind. “My terrifying – and valuable – time in a psychiatric ward” https://www.timeshighereducation.com/features/my-terrifying-and-valuable-time-in-a-psychiatric-ward . Is stigma justifiable?

    “Like most who have been though the mill and exited the other side,”
    Keeping ones “Mental health” is never over, you never know what is around the corner.

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  2. This article was excellent! It’s themes – iatrogenic psychiatric illness, the family dynamics etiology of psychiatric “illness”, and the self-determination of Mad people – are the platforms of this website. Kudos to you for sharing your uplifting story with Mad In America. I, too, was a “slow learner” when it came to psychiatry. By giving that “profession” countless “second chances”, I nearly “compromised” myself to death. To this day, I don’t know why I thought I owed psychiatry so much, when it took nearly everything I needed and loved. Ms. Garson, you are totally right to impose some limits on psychiatry’s demands for respect and authority.

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  3. Carrie Fisher a strong advocate for mental health and decreasing stigma? This woman eating 7 psychoactive medications three times a day and promoting the use of brain damaging electroshock? What did one learn from that approach?
    Glenn Close with her affiliation with NAMI and its dis empowering narrative?
    Am I missing something here?

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    • Yes, @truth, I was confused by all this as well. None of those people further[ed] a psychiatry-critical perspective. To the contrary, they perpetuate all the industry narratives, and pharma is thrilled that they either purposely or inadvertently use themselves as industry spokespeople.
      The media photo of the oversized Prozac pill that Carrie Fisher’s ashes were apparently buried in said it all: A joke for Fisher, I guess, but the message to anti-psychiatry people was that it was a fitting urn since her psych pharma likely led to her early death.
      Liz Sydney

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    • Yep. Good ole Glenn had a brain child. Had her sister with an SMI label and a bunch of other “crazies” go to the city park wearing t-shirts advertising their particular flavor of craziness. Thought it would reduce stigma.

      Imagine this: I round up a bunch of people with physical problems and make them don t-shirts like AIDS Carrier. Infectious TB. Leper. Low IQ. You get the picture. Who’s taking the risk? The people who don those t-shirts or the idiot who made them do so? Do you suppose they would reduce discrimination by telling everybody they have these embarrassing problems, by making them their identity?

      After her sister went out with her Bipolar shirt, Glenn deigned to follow wearing her own shirt that said Sister. I guess she thought acknowledging that relationship was stigma enough for herself.

      She even condescended to put one arm around her sister when the cameras were upon them. (Gasp!) The publicity was great for Close’s career. Not sure about her sister’s.

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  4. I appreciate the writing and delighted that someone who is trained as a lawyer has opened up with a mixture of candor and humor about being so taken in by the mental health system and pharma. There is one more hurdle here, which other commenters have pointed out, and that’s to re-examine what exactly it is that Carrie Fisher, Glenn Close, Patrick Kennedy et al are doing when they talk about about being strong advocates for mental health and against stigma. That’s nonsense talk. It’s like saying “I’m strongly in favor of soup and against ugly buildings.” What is really going on with celebrity anti-stigma campaigns is pharma. I wrote a blog post about this quite a while ago, expressing some frustration with not being able to really get at how it is that pharma encourages celebrities to appear as anti-stigma advocates.
    https://rossaforbes.com/the-globalization-of-american-style-thought-campaigns/

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    • It’s not about de-stigmatizing mania, psychosis, suicide attempts, mood swings, and antisocial personality disorder, is it? It’s about normalizing pill-popping so more people will try it, and so fewer people will give up on it. They encourage psych-drug users to wear their drug lists on their sleeves (“Medicated and Mighty!”), and make sure there is a shill or ten on every public discussion platform to empathize, suggest dosage tweaks, and share her own nightmarish “relapse” upon discontinuing her drugs. “That’s when I knew I REALLY needed Sytrexline! Those anti-meds people have no idea what they’re talking about!”

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      • You’re right. It is absolutely about normalizing pill popping. But where is the solid evidence needed in order to tie the industry DIRECTLY to the reason these stigma campaigns were created or continue to flourish. Did pharma create the idea of stigma as a marketing ploy, or is it only too happy to support people who think they have humanitarian impulses in that direction?

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    • Part of the problem if you go around saying “mental illness” does not exist is folks assume you’re denying that people lose touch with reality, cherish bizarre beliefs despite great evidence against them, have mood swings, hallucinate, or become paralyzed through excessive sadness.

      Oldhead and others may think I’m selling out. But rather than argue semantics of what “mental illnesses” are and the nature of what constitutes reality–(Depression, bipolar, schizophrenia exist as man-made categories but not discrete pathological ailments. They are constellations rather than heavenly bodies.)–I try to keep it simple.

      I tell the person that no well-informed psychiatrist believes that chemical imbalances cause mental illnesses. In fact, there’s evidence that it’s caused by emotional pain rather bad neurology.

      Just telling someone this can greatly reduce stigma. Perhaps because they start to see the “mentally ill” as human beings who feel painful emotions rather than biologically inferior critters.

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  5. I’ve read about your story elsewhere, and appreciate your speaking out. You make a good point, “My life is my responsibility, no one else’s, and everything I do is a choice.” This is exactly why psychiatric treatment should be a choice, and never ever forced or coerced, for example, like with lies about “chemical imbalances” and the DSM disorders being “real diseases like diabetes,” since they are not.

    As to your statement, “Once clean, for a short time I became a full-fledged opponent of psych meds in any setting except the treatment of psychosis, an exception based on my minimal understanding of that category of mental illness.” As one who was initially misdiagnosed as “psychotic,” based upon lies from child molesters I later learned from reading my medical records, and because my therapist thought all dreams queries, thoughts, and gut instincts were “psychosis.” I’ll mention there is absolutely no more scientific validity to a “psychosis” diagnosis, than to any other psychiatric diagnosis.

    But I did learn what “psychosis” is, because the current “bipolar” drug cocktail recommendations, which encourage combining the antidepressants and/or antipsychotics, can create “psychosis” via what’s medically known as anticholinergic toxidrome or anticholinergic intoxication syndrome. And since the psychiatric drug induced anticholinergic toxidrome is not listed in the DSM as a possible cause of “psychosis,” it is almost always misdiagnosed as one of the billable DSM “psychotic disorders.” Resulting, of course, in further malpractice and maltreatment.

    I do agree with you, however, there are people who claim to be helped with the psychiatric drugs, so I find it difficult to be anti all psychiatric drugs, to each his own. Although I believe it should be illegal to give a person a mind altering psychiatric drug, without informed consent, which is what my paranoid of a non-existent malpractice suit PCP did initially.

    And absolutely, there are lots and lots of unethical psychological and psychiatric practitioners who do not understand the words “your drugs are making me sick,” and that when someone is “treatment resistant,” made sick with the drugs rather than made better, it means the psychiatrist likely committed malpractice, via a misdiagnosis. And in these cases, I do believe it is appropriate for the psychiatrist to utilize their malpractice insurance for what it was intended, and make proper amends to the person they harmed. Unfortunately today’s psychiatrists aren’t doing this, which of course is proof of their lack of ethics.

    Again, thanks for sharing your story. Healing, for many, results from getting off the psychiatric drugs.

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  6. Thanks for sharing your story, and thanks to MIA for sharing a story written by an older adult (even older than me I admit, as I was born in 1958). I, too, suffered from binge eating. I am surprised they tried drugs on you at such a young age back then since usually they tried therapy and drugs were not used unless you showed up inpatient. I first went to therapy for an eating disorder and was refused drugs and had to beg for them.

    I was also given the “you are competing with your mother” line. That is a stock cookie-cutter phrase they try out on female patients. You can find that one in most of the popular women’s mags these days. I found the theory definitely didn’t fit, although I considered it. They also tried the theory about the “cold and emotionless parents” but that line did not fit, either. They tried in every way they could to blame my parents since that was the only way they knew how to do therapy, which I frankly find sad. I also found that the decades-long strain between my mother and myself was CAUSED by therapy, since the therapists were the ones who originally accused me of having a “bad mother” because they couldn’t think of anything original to say. I also felt that some therapists tended to see their own mothers faults in their patients’ mothers. I think that is called projecting. A few sessions satisfied the therapists’ needs plenty. Hmm… Thanks for sharing your story. It is an interesting journey to read about.

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    • Unfortunately, having some kind of addictive food allergy had already been preempted by Theron Randolph, an allergist, who, NIMH would say, couldn’t be credible, despite having treated 2000 patients, around the time you were a toddler, for psych disturbances, because he wasn’t a psychiatrist, himself.

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  7. Lynn, all you are saying is that your experience of distress was turned into a medical problem and a self-improvement project.

    You didn’t have the courage to look hard enough to see that your experience was not really of just distress, but of injustice. You allowed them to convince you that the real problem was your own experience, and not the actual injustice and abuse.

    And then Psychiatry, Psychotherapy, Life Coaching, and Recovery accomplish nothing, except to keep the victims silent.

    And you wrote a book to promote your views.

    Nomadic

    Stop helping the mental health and recovery system, all it is, is just abuse survivors abusing each other. Please join:
    http://freedomtoexpress.freeforums.org/index.php

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  8. I still say, “sometimes, some folks do seem to do better, for some short length of time, on some drugs”….
    But that’s not how the pseudoscience drug racket known as psychiatry rolls!
    There’s another salient point you ALL seem to be missing. Traditionally, the system has tried to either blame parents/family, or else blame some imaginary “chemical imbalance”. Both are dead-end approaches. It’s far more helpful to think of *relationships*, and understanding both the individual(s) involved, and how they influence and are influenced by, not only each other, but the larger society as a whole…. So-called “mental illness” is either something *none* of us have, or else *ALL* of us have it…. Everything in the catalog of billing codes known as the DSM-5 was literally *invented*. The other parts of your story that I could argue with, aren’t really worth doing so.

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  9. Actually it was a relief to discover my psych “meds” were no better than street drugs. I had always taken them religiously, but THEY NEVER WORKED! Everyone I talked to said that I must not be taking them regularly, or at the right time, or in the right way or everything would be great.

    And I would quit annoying and embarrassing my family. They were the one’s who counted. My own thoughts and feelings were diseased. Because I was crazy my soul was monstrous. Whatever I felt could therefore be dismissed if it couldn’t be buried with brain drugs.

    Unfortunately they decided it was better for them to keep me drugged into a constant low-grade depression. Though it kept dipping once or twice a year requiring hospitalizations cause I thought my life was miserable (?) and no one wanted what I have to offer (!) Not too crazy after all.

    It was slightly better than being kept chained in the attic. I guess.

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