January 23, 2006

On the rag? Off her meds? It's the Amateur Psychiatric Hour!

I'm sitting in the dark, in my room, in a dorm with thin walls and a vibrant dorm culture, and I'm trying not to cry. You see, a few minutes ago, I heard two of my floormates having a conversation in the hall. Their professor is apparently demanding, unpredictable, and disorganized - at least, that's the way these girls tell it. One was busy complaining about the professor's latest transgression, when her friend (whom I recognized, by her voice, as the nice Master's candidate in Social Services Administration a couple doors down from me) chuckled and said, "Geez, she must really be off her meds this time."

It stung. Probably at least in part because I'm off my meds.

Yeah, it's irresponsible of me to have let my prescription run out. Yeah, this has definitely affected my mood and my behavior - no shit, they're antidepressants, if I felt ok without them I wouldn't need to take them in the first place. But ladies, if your professor is indeed off her meds, there's something going on that's a teensy bit more important than your harshly-graded response papers.

Y'see, being on meds isn't just like popping a few aspirin when you're not feeling well, and forgetting they're in the medicine cabinet otherwise. Meds are a lifestyle. And taking them for a condition, like severe depression, that in all likelihood isn't going away, involves some near-certainties.

- You will, especially in the beginning, need to tell people that you need medication. This may sound all very AA, but you have to admit you have a problem. And you have to admit it to the intake people who will authorize you to make an appointment with the prescriber at the student health center/clinic/wherever you go. You will have to admit it to the nice people at the front desk who will schedule your appointment. You will have to admit it, at least implicitly, to the people who see you walk into the psych-care building, and the people who see you in the waiting room. (No, it doesn't usually help to know they're there for the same thing.) You will have to admit it to your prescriber, a complete stranger who now controls whether or not you're getting the one thing that might make you able to function on a daily basis.

If you work, go to school, or are in a relationship, you're in for even more fun - you may have the priceless opportunity to explain to your boss, profs, adviser, or significant other that your brain chemistry is fucked up enough that you'll be spending the next month or so figuring out how many pills, and of what sort, it will take to finally make sure you can get out of bed in the morning.

Think this is simple? Here's an experiment: walk around for a day with a t-shirt saying "I'm under psychiatric care." Explain to everyone who sees it that yes, you actually mean it. Offer to discuss dosages with them. See them shrink back in revulsion, and remember that you would probably do the same if you knew someone around you was mentally ill. Now imagine always worrying that you will induce that reaction in others - imagine that you still sometimes induce that reaction in yourself - and imagine that you will be required to tell people about it anyway.

- You will be required, later, to go back and justify your need for medication. It's called a med consult, and yes, it's necessary. Your prescriber needs to know that the meds are doing their job, not having side effects that are potentially dangerous, and not in need of adjustment or improvement. What it entails is going back to the same office you had to go to in order to get the meds in the first place and confirming that you still want to continue with the prescription and discussing the effects it's had on you. What it feels like is going up before a one-person review board and proving that you're actually as crazy as they thought you were, and begging them not to stop giving you the only thing that's helping you hold your life together. If you're not a fan of begging to begin with, this is a hard step to adjust to. Enjoy it - it will probably come around every month or three.

- You will screw up. Ok, maybe it's just me that does this, but somehow even my bottomed-out self-esteem won't quite let me believe that. You will forget an appointment, or lose track of a prescription, or forget your insurance card when you go to the pharmacy to pick up a new bottle. And poof! no drugs for you until you get yourself sorted out. And we all know that not having meds only makes you better organized, and more able to tackle seemingly insurmountable challenges like writing appointments down in your agenda and showing up to them.

- You will screw up badly. By this I mean completely forgetting to refill a prescription, balking at scheduling a med consult, or refusing to believe that now you're feeling better you still need meds to keep feeling that way. (After all, once your headache's gone, you don't need more aspirin, right?) And guess what? If you go off your meds, you feel worse than you did before you started taking them. Welcome to headaches, pins-and-needles, dizziness, insomnia, lethargy (yes, those two are a great combo), anxiety, muddle-headedness, and irritation - in addition to the severe depression that made you start taking them in the first place, usually in even harsher form. Withdrawal's a bitch, innit? Now try and fix the situation, when all your emotional and physical energy is going toward psyching yourself up to get out of bed so you can go to the bathroom before you give yourself a urinary tract infection or piss yourself.

- For extra fun, and as a corollary to the rule above, if there is anyone in your life who even remotely cares about you (and no matter how bad it feels, there's usually at least one), you will break their heart. You'll think you can get things under control again before you have to tell them anything. You'll think you can lean on them a little more until you can pull yourself together enough to get back on your meds, and they'll never notice. You'll think you'll both be better off if you don't have to talk about it all again. You'll think you're doing them a favor. And you'll be wrong. And they will notice, or find out. And if you're lucky, they might eventually trust you again. And if you're really lucky, you might - sometime much later - feel like you can be trusted. In the meantime, you get the sheer bliss of trying to get your own act together while also picking up the pieces of a friend, lover, parent, or mentor whose confidence you shattered, who is as worried about you as you now are about them, and who's probably so upset that you can't in good conscience lean on them at all. Enjoy that one.

- You will, especially if you're not noticeably drooling or talking to yourself, get to overhear a truly heartwarming array of comments about what people think mental illness and medication is all about. Everywhere you go, people will volunteer their opinion that anti-depressants just put you into a happy, delusional fog; that people who are depressed should just "snap out of it" or "learn to deal" or "go out and have some fun"; and that they were so very *depressed* to find out that Diet Coke with Lime might be phased out. And if you don't look crazy enough to be offended, you'll get, at no extra charge, to hear jokes about how someone is clearly off their meds...


So, yeah. Here I am: waiting for an appointment so I can have the chance to try and explain to my prescriber that I'm not too irresponsible to be trusted with medication I genuinely need, trying to convince myself to get out of bed to eat something or turn the light on (neither of which I've done today), and trying to figure out how to repair an important relationship that I'm afraid I may have badly maimed. And I have office hours tomorrow - meaning I get to smile, be personable, be organized and genuinely give a shit about other people who, as of a few days ago, actually count on (and pay) me to get things done. Wonderful.

Yeah, if I were those ladies' professor and I had to grade response papers, I'd probably be pretty pissy and/or weepy about it, too. 'Cause, geez, I'm really off my meds this time ...

6 comments:

spork said...

thank you for posting that.

word is tycec, that special kind of awkward reserved for conversations involving psychopharmaceuticals.

dammit, or it was before it rejected me. oqqtpbtw, the noise I'm gonna make if it happens again.

bat dor said...

"You'll think you'll both be better off if you don't have to talk about it all again. You'll think you're doing them a favor. And you'll be wrong."

Yes. (Shame I had to learn that one the hard way.)

emily0 said...

aiptx: when you can't figure out what the fuck the word verification word is and have to cut'n'paste your response & then refresh the page to get a new one.

i'm currently experiencing (for the bzillionth time) you will screw up
poof! no drugs for you until you get yourself sorted out.[...] Welcome to headaches, pins-and-needles, dizziness, insomnia, lethargy (yes, those two are a great combo), anxiety, muddle-headedness, and irritation
[...]

arrghhghghgh.

icarus said...

if there is anyone in your life who even remotely cares about you (and no matter how bad it feels, there's usually at least one), you will break their heart.

sigh.

i tell almost no one.

thank you for this post. it resonated with me.

xo, honey. i love you!

icarus said...

yeah, i just experienced aiptx too. grr.

wannatakethisoutside said...

Thanks for posting that