Monthly Archives: November 2006
MY TAKE ON MEDICATIONS
Most of psychiatry these days has to do with meds, and if you go to a psychiatrist you’re likely to come out of the office with a prescription in your hand. For better or worse, the profession has turned to the “medical model” as the standard treatment for mental illness, meaning that those with MD after their name play a huge role in all this.
When I got started in this business, that is, when I was 22 and didn’t have a clue what was wrong with me, I had no knowledge that there were medications people could take to make them feel better. Rather, I was aware of sedatives such as were given to wild beasts in order to quiet them, and illegal mind-altering drugs that were best avoided. I had never heard of antidepressants, antipsychotics, or mood stabilizers.
I first found out about these drugs that saved my life when I became a “client” at Options Day Treatment in the fall of 1981. I truly believed at that time that this brief experience in this program would cure me, but what I found when I got there shocked me: the people in the program had been in “the system” for years, decades even, and many had no hope of ever getting off the mental health merry-go-round for a long, long time. A fair quantity of the “clients” talked to themselves non-stop. Others could not stop shuffling their feet; this, I discovered, was a side-effect of some of the medications they took. Some contorted their faces into grimaces and twitches. Several were mentally retarded, and many drooled and had significant hygiene problems. One “client” smelled like sour milk; I could never figure out if it was the odor was in his jacket or himself.
I was ashamed, actually, that I came from an upper middle class family, had healthy teeth, and had been educated at UMass and Bennington College. I was embarrassed to admit that I wasn’t on welfare like everyone else, and wasn’t receiving food stamps. In order to convince fellow “clients” that I belonged, I started smoking cigarettes, wearing make-up, and watching soaps. I tried wearing heels, but ended up with nasty blisters.
And then there was the question of meds. I was fascinated. It was more than just “uppers” and “downers” as I had learned in 10th grade biology class. Some medications, which in those days included Imiprimine, Elavil, and the like, took away depression. Lithium leveled mood swings. Thorazine, Prolixin, and Stelazine eased psychosis and mania. And if you were anxious you could take Ativan or Librium.
The list of possibilities increased over the years with the advent of new drugs, the most significant of these being the “newer” antipsychotics that started with Clozapine and continued with Risperdal, Zyprexa, Seroquel (yuck yuck), Geodon, Abilify, and of course the SSRI antidepressants such as Prozac that caused people at least in the US to feel more accepting of psychotropic medication in general. Several anticonvulsants have mood stabilizing properties as well: Tegretol, Depakote, Lamictal, and of course my pal Topamax, and are safer than Lithium.
(In case you were wondering, all this is coming out of my head; I am not reading off some website; this is out of my own knowledge of these meds–impressive, eh?)
Fascination aside, no doctor would give me medication until 1983, though I desperately needed it. Why? I think they had trouble pinning down a diagnosis for me that justified giving me meds. “Spoiled brat” doesn’t have a listing in the Diagnostics and Statistics Manual (DSM-IV), the standard for diagnosing patients.
It baffles me even now why my successive “treatment teams” didn’t give me medication sooner. The Road to Hell was not paved with good intention; it simply wasn’t paved. I think my life may have taken a drastic turn for the better if someone had put me on the right medication early on. By the time I took my very first psychotropic pill (which, incidentally, was Mellaril, an antipsychotic) I was suicidal (and had voiced this to my treatment team),” rarely bathed, had major eating and sleeping problems, drove recklessly, suffered extreme anxiety and panic attacks, and was tortured every day by something I called “Monsters”–these were strikingly similar to the Beings I experience nowadays. I did a tremendous amount of cutting with a dull box-cutter blade I’d found on the front lawn one day that fall; I picked at these arrow-shaped cuts on my arms and they had become infected. And those fools thought I didn’t need meds?
There is one reason I can think of why the docs held off so long. Once you get on the chronic mental patient merry-go-round it’s hard to get off. Meds are a big part of it. Most, I repeat most, people who take medication are not chronic mental patients but “high functioning” people who just need a little help temporarily. For me, though, and for millions of other “chronics” (sorry) taking meds becomes a permanent daily routine. Am I sick of it? Of course I’m damned sick of it! Some people opt for injections they can have once every two weeks or so; that way they don’t have to remember the pills; this is a very popular method used in Canada and parts of Europe to encourage compliance (“compliance”–see?).
Now, I take Thorazine, Risperdal, Topamax, Lamictal, Cymbalta, Abilify, and Synthroid; the latter is for my thyroid. I take enough medication to knock most people out for at least an afternoon, if not all day and all night. Luckily, I don’t get many side effects except for postural hypotension, which is a nuisance and a little scary at times, and I drink a heck of a lot of water.
My medications don’t make me “high.” They make me “normal.” They help me manage my symptoms so that I can function like other people do. Meds help me carry on conversations, take care of myself, eat, sleep, and bathe. Meds help me concentrate on writing. Without meds, I wouldn’t have been able to return to school, earn my degree, and go on to grad school. If there were no such thing as these meds, I’d probably be in some back ward somewhere, if I were alive at all, unable to think straight, unable to converse, unable to relate to others.
It amuses me now to recall that Lithium made my hair curl! It did, better than any perm! Shh…don’t tell my secret…it’ll put hairdressers out of business! (see photo)
Here I am with Tiger in 1992, and the curly hair is from the lithium I took.
It is autumn and I am alone. I have seen this before: autumn and aloneness.
REGARDING MY RECENT SPENDING SPREE
…which may not be over….
Beginning November 12th, I purchased the following from www.ebay.com :
A portable table for a laptop
A cheap pair of speakers for my MP3 player
A USB-powered desk lamp
A small “boom box”
Three music CD’s
A cordless phone
A 2G flash drive
I also purchased a large quantity of AAA batteries from www.batteries.com. I bought a cordless phone from www.amazon.com, the cordless phone I bought from ebay being a “mistake,” and I bought another flash drive from Amazon Marketplace.
I even bid on Thanksgiving Day, yesterday. I was so intent on getting the item that I set my watch alarm for 12:45PM to remind me to rush to the computer so that I could “watch” myself win the auction. Glued to the computer monitor, I refreshed the display every two minutes to see if someone else had bid, counting down the minutes and calling them out to my friend Joshua in Philly, on the other end of the phone, and finally the seconds….
I won. I was the only bidder. I heard Joshua sigh. “So what was it this time?” he asked.
“Huh? What kind of bag?”
“A bag bag. For, like, you know, going to the gym, or a carry-on bag. Brand new.”
“What did your therapist have to say about all this?”
Goldie is my new therapist. She works out of her home in Cambridge. I have to walk some damned wheelchair-unfriendly sidewalks to get there (yes, this does occur to me) in the dark and I’m afraid of getting mugged or knifed. But once I get inside her cozy office I forget about the slippery brick sidewalks laden with wet, brown leaves and the permanent stink of sewage I have to walk through at Harvard’s Holyoke Gate and try to concentrate on this thing called therapy. Dr. R let me get away with changing the subject of conversation at least three times a minute, neatly avoiding uncomfortable topics, but Goldie isn’t going to let me get by so easily. She has “theories” about things. Once, she had a fake spider-web on her front door as a Halloween decoration. When I told her it scared me, she took it down.
I switched the cordless phone to my other ear. “Wait a sec. I gotta log into Paypal.” My Paypal password is/was a combination of numbers and someone’s middle name. “Joshua, you and I both know why I’m spending like I’ve got a million bucks.”
“I hit the lottery.” I clicked on “PAY” without checking to see what I was paying for. “No, really. It’s the Cube Dude.”
“Isn’t it time for you to take your meds?” He knew I was right.
“I miss him like crazy.”
“I know you do.”
QB was everywhere. He was in the bathroom blocking the entrance when I wanted to take a piss. He was lying in front of the refrigerator. He lay beside me at the computer. He barked his fool head off at the janitor guys when they came to the little room next door to get the trash. His scent, his fur, his toys, were everywhere, but he was gone. I was spending money to fill the emptiness that his absence brought on. I felt tremendously foolish just then, Thanksgiving Day, sitting barefoot at my computer, mouse in hand, fighting tears.
“Yeah, I’ll get my meds.”
Later that day I stepped on a sliver of broken glass. I swore, and took it out of my foot, then I remembered when I broke a glass beer mug and QB tried to eat the pieces. A frantic trip to the vet had followed. Then there was the time he ate a huge piece of cloth and threw it up two or three weeks later. Or the time he ate chocolate, poisonous to dogs, and I had to call veterinary Poison Control. Or the time he ate crayons, aluminum foil, a mechanical pencil, god-knows-what-else.
If you were to come over to my apartment today, Friday the 24th, you’d see all kinds of boxes and bubble wrap strewn on the floor, countertops, and tables in the kitchen and living room. You’d see gadgets of all kinds. You’d see dishes in the sink, books everywhere, coffee mugs, junk mail, Sudoku books, stray pennies, stuffed animals, but you wouldn’t see QB. You wouldn’t hear him bark excitedly, feel the umpf when he jumps on you, scratch the super-soft fur on the back of his head where his magic stripe is, or have your Kleenex swiped, shredded, and eaten by the smartest dog on the planet. Instead, you will notice the absence, an absence like a cancer; it grows and devours, it poisons, it asks for more; it is a black hole, the more you put into it, the emptier it grows; the sickness grows, and grows. No amount of spending, no buying–there is nothing, nothing I can buy, no “thing” that will cure it, and if you dig under the layers of selfishness to my true heart, you’ll see that I knew this all along.
THE GYM, PART FOUR
I managed 20 minutes on the elliptical yesterday, not much for most people, but for some reason I struggle with that machine more than the average athlete. Most elliptical machines are built for people taller than me, for one thing; the stride is way too long and too deep for me. But check out these nice ellipticals made by Precor: http://www.precor.com/comm/efx/, and definitely take a peek if you’re wondering what the heck an elliptical machine is.
My current gym, Boston Sports Clubs, (http://www.mysportsclubs.com/regions/BSC.htm), has seven or eight different types of elliptical machines, while my old gym, Planet Fitness (www.planetfitness.com)–of which I am still a member, as it only costs me $10 a month, less than I spend on coffee, but should I drop it will cost considerably more–has two types, both made by Stairmaster http://www.nautilusinc.com/consumer_catalog_primary/opl_brands/stairmaster/ellipticalsandtreadmills/prdcdovr~SM51
0053/StairMaster+ClubStride+5100+Elliptical+Trainer.jsp) and neither feels like a natural stride to me.
You get what you pay for, I suppose.
Now that you’ve clicked on the links, and wished you had $5,000 to spend, just like that, though I am not certain you’d spend it on an elliptical, let me get on with the story:
The real reason I spent a full 20 minutes on the elliptical yesterday was because I was watching a particularly mesmerizing TV show about medics in Iraq. Yes, for the uninformed: we have TV’s we can watch while we work out. At BSC we have individual TV’s at each machine, each with a little “remote” where we can plug in a set of headphones. There is a selection of about 15 stations, of which I prefer CNN.
I’m not going to go into the gory details of the show. You’ve all seen blood guts and gore in movies and on TV; it’s not pleasant. But for some reason, pumping away at the machine, surrounded by others working out, running on treadmills, flipping pages of magazines, bopping to music, with sweat as the only common denominator–this was the solitary activity, while the folks in the war were more connected, more in synch, more loving and caring than we at the gym could ever be.
After the elliptical, I went on to strength training. Since I had a couple of sessions with a trainer, I’ve been doing exercises using a stability ball. (OMG! Here’s a cheap one: http://www.buy.com/prod/nautilus-65cm-stability-ball/q/loc/17250/202526351.html?dcaid=17379 $15.55 incl shipping for 65 cm.) These exercises look simple but are incredible core strengtheners. People assume postures similar to those that children take on while making snowmen; stability balls don’t melt, though, they lose air and get soft, and I wouldn’t suggest sticking a carrot into one.
I then continued my strength training on Nautilus weight machines. (http://www.nautilus.com/nautilus_brand_commercial_equipment/productcategories/strength.jsp?lid=Strength) I don’t do many of these machines. I liked the ones at the old gym better; even though they clunked and clattered, they were well organized and easy to understand.
Stretching exercises were next, most of which I learned at the Cambridge Center for Adult Education’s Huron Ave Studio (http://www.ccae.org/catalog/courses/?id=13&PHPSESSID=ea9dc31d92d08d4cbcd0103f68c6b376). I spend a good half hour stretching. It’s interesting that we spend so much time contracting our muscles and now we must in turn pull them in the opposite direction to keep them balanced and happy.
Working out is the most selfish thing I do, and that includes blogging. At least when I’m blogging I’m reaching out. Maybe even helping people. When I work out, I’m building my body, my muscles. Does anyone else really care? Probably not. Or, rather, I may write about working out, and you may see what I write, and even click on the links, but no one truly wants to read this shit, right?
THE DEATH OF QB
The apartment seemed cold when I arrived home from the veterinary hospital. Cold and dark. Music was still playing on the bathroom radio. QB always preferred it way. Now, it didn’t matter.
I felt like punching something, trashing my apartment, throwing a chair, anything, but it wasn’t anger that drove these impulses; it was an ethereal streak of sadness. That and the shame foisted on me at the animal hospital.
I had left my apartment that evening by taxi with an apparently healthy three-year-old Sheltie. I returned at 1:30am, alone, also by taxi. When the driver asked, “What happened to your dog?” I mumbled something vague, and pretended instead to be interested in his computerized navigation system.
I remembered wryly the imagined headlines that had floated around in my mind only days before: “Killer Sheltie Mauls Mentally Ill Woman.” Or, “Mentally Ill Woman Kills Own Sheltie.”
I wasn’t going to argue with myself the fairness of the situation. Life had already taught me that it wasn’t going to do me any favors. Death can be beautiful but often isn’t, and life is damned ugly when you think about it.
I switched on the desk lamp that served as a makeshift living room light, then turned up the heat some, until I heard the hot air blower click and then rumble. My computer had run a virus scan that night. No threat(s) found. How nice. No messages on the machine.
I tossed my knapsack on the floor near my bicycle. In it were QB’s collar, his leash, and his treats bag that I kept hanging on my key lanyard. Also I had a stash of QB’s favorite junk food treats that I fed to him only a minute before he was injected with poison, while he struggled to remove the IV from his left front leg.
I sat in my swivel chair and cried for a while, putting my tissues in a little pile that QB would surely have raided, shredded, and eaten if he had been with me.
I remembered the smell of feces at the moment of death.
Euthanasia for a dog who is old or sick is a difficult decision, but to put a dog to sleep whose behavior is aggressive and incurable but who is otherwise healthy and well is a decision ten times tougher.
People close to me supported my decision, but I went to the veterinary emergency hospital on my own, just me there by myself, for the purpose of killing my best friend.
I went to bed at 3am, and awoke at 7:30 or so Saturday morning. I put on some coffee, and didn’t bother getting dressed. What was the point? No dog to walk. I needed a shower, to wash off of me the stinking filth of the deed done the night before. But I waited, and made some phone calls instead, wrote some e-mail, and changed the light bulbs in the living room. I waited, because when I walked into the bathroom I thought I saw QB laying on the cool linoleum floor by the toilet, where he liked to hang out. I waited, because I wanted to live with that filth, repugnant as it was, for just a little while longer.
PROZAC PUPPY’S PROGRESS
QB bit me again today, after a long period of improved behavior. I had been hoping that the Prozac was finally starting to take effect, but QB’s extreme behavior today told me otherwise, that he is still unable to maintain self-control under certain circumstances and therefore cannot be externally controlled. When conditions he considers scary or threatening are present, he cannot stop himself from being aggressive.
Today, as we were finishing our jaunt, rounding Lexington Street, QB spotted a stimulus, and began to bark and pull on the leash. I assumed he was barking at the middle-aged gentleman ambling toward us on the sidewalk, dressed in a white t-shirt and painter’s pants, but it was not this man, it was something further along. Was it a squirrel? A Halloween decoration in someone’s yard? Neither of the above. Today’s big bad threat was an Evil Orange Traffic Cone. There seems no rhyme or reason to what QB considers The Enemy, but traffic cones are among the most Evil of them.
QB snarled, jumped, snapped at the cone, and jumped around some more. I considered turning away down a side street, but there were none that led to my building. I assumed that once QB had the opportunity to sniff the traffic cone he’d see that it was harmless. We moved closer. QB growled and barked; the foam leapt from his mouth onto the pavement. I tried to get him into a “sit” position but he was too tensed up to listen. He snarled and jumped, twirled, and snapped his teeth into my thigh.
It was a sharp bite that felt like a needle prick, but it wasn’t deep; it barely broke the skin. Nothing was hurt, I knew, except my spirit. I knew I should get QB away from there as fast as possible, and as we passed the Evil Cone I knew in my heart that if this Evil Cone were an infant, or a child, or a person of any age, and QB felt for that person the way he felt for the Evil Cone, that person would no longer be alive.
As a dog owner and adult citizen I know I am responsible for my dog’s actions. What if he hurts someone? I mean, what if he seriously hurts someone? Can I truly say that any disaster is one hundred percent preventable? Whereas before I would worry about QB jumping on an elderly person and knocking her over, now I worry about QB tearing that person to bits. Of course he’s always on leash, always with me, but what if–
You hear stories about Pit Bulls, kept as attack dogs, that kill people. These dogs are put to sleep. Sometimes you hear about a house pet that kills a newborn baby out of jealousy. The fate of such dogs varies but generally they are spared.
I must say, I’m very frightened.
A SPEAKING ENGAGEMENT
I had a speaking engagement at a NAMI meeting that never happened because the fools that set it up invited the wrong Julie Greene. No kidding. I guess they had her all lined up to speak on my book, Breakdown Lane, Traveled (www.breakdownlanetraveled.com), which of course she didn’t write and most likely had never heard of, and about writing–Lord knows if she ever wrote a word–and healing.
I first heard of this from my friend Brooke Katz, who is quite a celebrity herself, having been featured on all sorts of TV specials and written a book about her recovery from schizophrenia. She does plenty of public speaking about her illness and is well known in NAMI circles and McLean-type places, and she wrote to me saying, “I hear you’re speaking at a NAMI meeting.”
“Huh?” was my reply. “Must be the other Julie Green.” Note: No E.
She wrote back: “She’s talking about writing.”
I began to get worried.
I phoned my mother and left a message. You have to understand a few things about my mother. For one thing, she’s losing her mind. For another, she doesn’t give a flying fuck about me. Her way of pretending to have a bleeding heart is to be very, very active in NAMI, the National Alliance for the Mentally Ill, an advocacy organization made up of patients, parents, caregivers, etc that works on legislation, research, and so on. She knows NAMI but she doesn’t know shit about me. She doesn’t know how I spend my time, who my friends are, what I care about, what makes me happy, and when I told her I was returning to graduate school and had been accepted back into the program, she changed the subject. But at any rate, the message I left said something like, “If I’m the Julie Greene that’s supposed to speak at that NAMI meeting on the 23rd, you can tell the NAMI people I was never contacted at all and cannot speak at their meeting anyway because I have a class that night.
A few days later I received a message on my answering machine that went something like this: “Hi, my name is so-and-so, and I’m, er, from NAMI, and your mother gave me the wrong e-mail address, and we called the wrong Julie Greene and asked her to speak at a NAMI meeting, and I know this is short notice but would you speak on Monday, we’d like you to speak about your book and about writing and healing, please call to confirm tomorrow, I’ll be at the dentist tomorrow, my work phone is–“ I turned the answering machine off. “Sorry, maybe next time,” I told her the following morning. “I’ve got a class, and I’m being workshopped that night.” (Granted, she probably didn’t know what “workshopped” meant, not to mention that spell-check won’t accept the word, either.)
I think the last time I spoke publicly was in 1981 or so, when my illness hadn’t quite taken me into a downward turn yet; I could still tread water. I spoke about music composition and creativity. I used tape recordings of my pieces and displayed musical scores on the overhead projector that everyone could see and follow. I also performed my pieces both on trumpet and voice. I showed the audience how a composer puts together a composition, how intervals work in melody and harmony, how themes intertwine. I did a damned good job of that presentation.
It wasn’t until after the 23rd, after the date of my class and the speaking engagement that never happened that I thought up a topic for my little talk on my book, Breakdown Lane, Traveled, writing, and healing. First of all, I wouldn’t talk about healing. I don’t like the word. It sounds so passive. I would talk about form and content. I would talk about how form and content interrelate in any work of art, and how the concept of form and content relates to creativity and personhood. Then I would bring in mental illness. I don’t totally have the ideas formulated yet.
Yes, it is true: a piece has form and content. Then you slap a title on it, so there will be no mistaking what work we’re talking about: “Julie Greene.”