[Content note for depression, anxiety, and the medical treatment thereof]
In a series of posts on the NYT’s “Anxiety” blog, starting in February, Diana Spechler has been documenting the process of (with her doctor’s supervision) going off of the prescription meds that had been treating her anxiety, depression, and insomnia for over a year. Going Off opens with “Breaking Up With My Meds,” outlining how she came into psychopharmacology and why she wanted to get out of it.
I went to the psychiatrist, who told me that with medication, we would aim to get my mood as close to 100 percent as possible, my anxiety as close to 0 percent as possible. Reaching perfection would give me the best shot at success when I later weaned off.
[…]
Now, looking at the depression graph, I see that I never reached 100 percent. I briefly hit 90. I’m fairly certain that feeling 100 percent is an urban legend. “I still want to wean off all of it,” I tell my doctor. I’m taking a fairly low dose of everything now: 200 milligrams of bupropion, my antidepressant; 100 milligrams of trazodone, my sleeping pill; and 1 milligram of lorazepam, for anxiety.
“I’m in a tough spot,” he says, wheeling back to his desk, “because meds do help you. And meds are what I have to offer.”
I’ve written about my relationship with Bipolar II, and particularly the way that my (self-perceived, at least) creativity seemed more plentiful when my mind was more scrambled. I also noted that, having to choose between my current level of wellness and my previous level of creativity, I’ll keep taking those pills. I think back on the scary, unmedicated then, and the stable, medicated now, and there’s no question.
The big difference between Spechler’s situation and mine (outside of the fact that she’d qualify as a writer-writer, rather than a copywriter-and-blogger-with-three-crappy-unfinished-novels-clogging-up-my-hard-drive-writer) is that my drugs play nicely together, and hers didn’t. The three medications she took combined to cause hair loss, constant thirst, a lack of interest in exercise, and — the dread of any writer (even the CABWTCUNCUMHD kind) — a slow, dull mind. For her, by her personal mental-health calculus, the now wasn’t actually better than the then. It was just a different kind of trouble. And so, with her psychiatrist’s reluctant support and close supervision, she looked for another way.
We strike a deal: He’ll help me get off all of my medication if I come in for more appointments, keep in closer contact with him. He recommends a few therapists, too, jotting down their names and numbers on a pad of paper. I doubt I’ll call them. I left therapy a year ago and still enjoy my freedom from it. I’ve tried other alternatives to medication, as well. Yoga. Meditation. A light box. Veganism. Blackout curtains. Fish oil. Quitting alcohol. Quitting caffeine. Nothing has helped as much as meds have. But at this point, I care less about my anxiety and depression worsening, and more about getting back to being me.
[…]
Psychiatric disorders are no pea. Depression and anxiety are diffuse, nebulous, ever-mutating. Pills, on the other hand, are concrete little things — pebbles to pluck from the bottom of a shoe. And that’s my goal — to pluck the pebbles, to get back to basics, to believe in my body as a self-sustaining ecosystem.
I’ve got this, my body is telling me lately. Let me show you I’ve got this.
The series is interesting not only because of the process of getting off of the drugs, but also her accounts of her experiences getting on — her emotional state from the beginning, her relationship with her body, the initial process of auditioning new drugs and new combinations. Her path is dotted with familiar experiences (breaking up with a boyfriend, albeit complicated by her ongoing breakup with her drugs) and experiences that might only seem familiar to some (cyclical anxiety about caring for a houseplant).
She also talks about her muse coming back. That one makes me kind of jealous. Not inclined to follow her path, but jealous just the same.
In her most recent installment, Spechler lists “10 Things I’d Tell My Former (Medicated) Self.” It’s a list aimed at her-in-the-past, not a list of things other people should know about coming down off of psychoactive meds — everyone is different, and her notes pertain directly to past posts in the series — but they are a bit of insight into one mind with not-all-uncommon experiences. And they give an important view of the relationship of society and mental illness, and people with mental illnesses, and people’s perceptions of people with mental illness. Whether you’re starting or stopping meds or not taking them at all:
9. Everyone has an opinion about depression. Everyone has an opinion about psychiatric medication. If you tell people who don’t know you that you’re on medication, or that you’re trying to get off of medication, some might shout their opinions. At times, you’ll feel like you must have wronged them, if all this vitriol is landing on your head. But their reactions have little to do with you. You are all products of a society with arbitrary taboos, a society that has made mental health a fraught topic, that hasn’t learned how to talk about mental health without worrying about what others will think. Let them shout. They need to shout. Don’t be afraid. You have a right to voice your experience. Maybe it’s not just a right but an obligation — to fight this collective shame with your clearest, most honest words.