Tuesday, September 22, 2015

Bipolar: A Different Story. Part 2: the Shame of Western Medicine

In those first really bad days I was lucky to be in an environment where mental health services were free and easy to access. As an undergraduate some amount of the exorbitant fees we paid went into "free" mental health services. As long as we could prove we had insurance we got counseling and psychiatry at no additional cost.

I got into counseling right away but psychiatry (medication) appointments were booked months in advance. I assumed back then that it was just because it was a college campus and in the "real world" going to the psychiatrist would be like going to any other specialty doctor. Appointments could be made to see someone in a few weeks at most and faster in a crisis situation. I did not know how wrong I was. It takes months to get to see a psychiatrist. If you are in a crisis situation it is the hospital or nothing. More on the hospital part later.

When I met with the psychiatrist for the first time they diagnosed me with unilateral depression and gave me prozac which, after some side effects (including sleeping all of the time) they reduced to a very low dose that pretty much didn't do anything either way. A few years after I first started being treated for mental health problems I experienced death in my family and other events I couldn't cope with. This is when I started my real journey down the rabbit hole of psychiatric medications. I went to a primary care doctor and said I needed help. One of the first sentences out of their mouth was "Well, what medication would you like to try?" What? You seriously have no idea what you are doing to the point where you think someone with no knowledge of medicine whatsoever will do a better job then you? I didn't take that for the warning sign it was. I let her experiment with my brain chemistry.

In the next year I tried a lot of different kinds of medication all with very different debilitating side effects. My case isn't unusual. It is the norm. The brain is very complex and we don't really understand what works and why. So we just throw things at it and see what sticks. This process is made worse by the fact that if something is going wrong it is difficult or impossible to get into a doctor right away to make the necessary changes to feel better. Eventually they found just the wrong medication. My roommate found me on the ground laughing hysterically (where I had been for at least half an hour) about how I was going to kill myself and it was going to be awesome. I had it all planned out, every detail. I was scared but also elated. My roommate was horrified and rightly so. So she took me to the hospital.

The hospital was a turning point in my life. I found out later how extremely lucky I was that my hospital experience was largely positive.

Bad things go on in hospital mental wards. They are overcrowded and the staff is usually overwhelmed. People who are there largely don't want to be there but when you are taken to a mental ward you are under lock and key. You can't go outside. Visiting hours are limited. People with very different problems and different degrees of problems are all locked away together. Sometimes doctors and nurses do things that aren't appropriate. They try to convert patients to their religion because it will make the patients feel better and how can you find happiness without god? All in all it isn't the kind of environment that makes people feel better. Basically they take away all of your coping mechanisms and won't let you out until you can successfully fake being better.

For me it was a place where I finally got help. The doctor seemed baffled that no one had tried on of the most basic antidepressants that is usually the first or second thing they try (Zoloft). They had tried me on so many new, experimental, or just less used drugs that no one had tried one of the basics. The hospital environment was also a safe place where they could monitor side effects without the chance of me hurting myself. I also had a wonderful talk with one of the therapists. I asked him what kind of meaning I could have without religion (I just went through a period where I tried really hard to be religious so that I could make some sense of the world). He said simply "What does religion have to do with life having meaning?" It doesn't sound like anything revolutionary now but at the time I was blindsided. It was what I needed to hear at the moment I needed to hear it.

Don't get me wrong. Even though the mental ward helped I never ever want to go back there. It isn't a good place. I need to be able to go outside and be with friends to be healthy. But sometimes people need to go there. And sometimes it helps. If there is no option other than pull the trigger or go to the hospital you literally have nothing to lose by going to the hospital. And if I have to make that choice again I hope I have the presence of mind to choose the hospital.

After the mental ward I graduated from college and moved to a new town. There I got a psychiatrist that actually figured out what was wrong with me. I wasn't just depressed. I was bipolar, and antidepressants by themselves can be very bad for bipolar folks. So I got put on a mood stabilizer and things were a lot better. I was still me but I could get out of bed in the morning. I wasn't so irritable.

I want to be clear here. Medication saved my life. I have no doubt I would be dead without it.
"I believe, without doubt, that manic-depressive illness is a medical illness; I also believe that, with rare exception, it is malpractice to treat it without medication." - Kay Redfield Jamison, John Hopkins School of Medicine in her book "An Unquiet Mind"
I understand I am going to be on medication for the rest of my life. I know that some people can get by without medication but some people can't. And that's okay. We call ourselves a prozac nation but in all honesty people who are on psychiatric medications are deemed as lesser. We just don't want to deal with life. We want to take the easy way. If we just had more self control or were better people  then we wouldn't need to take drugs. We are buying in to big Pharma and are shills to the system. Doctors are lying to us. We should just wake up. We should think happy thoughts and feel better.

That is my least favorite thing about how the mentally ill are treated. Depression is treated as the same as sadness. Everyone gets sad sometimes. And most people get sad but then they feel better. They try to explain to depressed people over and over again the steps they went through to feel better. They then get offended if you try to tell them that those things don't work for you. The depressed person is blamed for not wanting to feel happy. Nothing could be further from the truth.

Being bipolar is viewed as just having emotions. It is what separates us from robots and politicians. I am paraphrasing something I saw someone say on Facebook just last week. Except that normal emotions don't usually keep you in bed for days or weeks at a time. Normal emotions don't make you feel like there are two very different songs playing in your head at the same time at full volume and the only way to slow them down is if you can figure out a way to peel your own skin off.

I am not going to say medication by itself is the way to go. There needs to be other things too. Something to keep you from going up to high or crashing too low. And it is important to have a friend to help you through that. And right now I am beyond grateful to have that friend. A friend who knows what it means to reach heights I can only dream with. Who has a mind that can understand mine. Someone to help me understand Zen and the Art of Squirrel.

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