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Better Living through Chemistry
May. 16th, 2003 05:02 pmJunkie: It was the fault of the drugs, your honor.
Judge: Yes?
Junkie: Not enough drugs.
Sometimes, I think that sums up my life. Other times, I don't think my life can be summed up, unless one allows negative numbers. Would that count as summed down?
Two weeks ago, I took custody of the fish and fish tak of a friend of mine. This required a huge amount of effort. (If you think hauling 240 lbs. of water, transfering 8 very large fish without harming them, transporting a 4 foot aquarium without breaking it, fitting all that plus the stand and all the other accoutrement necessary to set the tank up when you get home in only two cars, and then get all of this set up again before going to bed, is a cake walk, I suggest you try it. I'll watch.) The whole thing was made far more exciting by the fact that the tank turned out to be a foot longer than I had expected, so it didn't fit in the space I had painstaking cleared for it the night before. That meant that I had to completely dissasemble my 20 gallon tank and move it to another wall, another task which required a significant amount of time. During all that time, the new fish were living in two smallish tubs, holding about 10 or 12 gallons of water, with the only life support an air stone to make sure that they at least had oxygen. I don't know enough about fish keeping to know how dangerous that is for blood parrots, a silver dollar, a severum, a plecostumous, and a Chinese algae eater. I worried and worried the entire time they were in the tubs. I wanted them safely ensconced in their tank with bubblers and filters and heaters and the rest. All in all, I worked for 11 out of 12 hours, starting at 2:00 in the afternoon.
Amongst my many other flaws, I am manic depressive. If you don't think it's a flaw, this is another thing I want to watch you try. Oh, I don't feel the least bit guilty about it. However, it's one of those hard facts of life, like the fact that I'll never be 120 lbs with raven black hair, or that I'm near-sighted and getting more so all the time. I consider them to both be flaws (especially the hair color) but also just the result of random numbers.
Fish? Manic depression? Drugs? Probability? What the hell am I talking about?
One of the un-charming things about my particular instantiation of manic depression is that it is very sensitive to changes in sleep patterns, and it causes changes in sleep patterns. I sleep with the chickens and the eggs. Friday night before moving Sonie's fish tank, I stayed up until 4:30 a.m. cleaning and creating a space for it. I did get 8 hours of sleep, but not at anything like a reasonable hour. The next night, I was up until 3:30 a.m or so, having been working hard for most of 12 hours. It looks like I managed to trigger a mini-mania by messing around with my sleep patterns. I sleep less when I'm manic, and more when I'm depressed. Triggering a manic episode was quite useful. It let me tackle the problems while short on sleep without panicking, and I had energy enough to work until it was done.
The most spectacularly un-charming thing about manic depression is that a manic episode, which can be about the most fun a person can have, is necessarily followed by a depression, the intensity of which is affected by the intensity of the high. I mean, I know you've got to pay the piper if you're going to dance, but frankly, I think he's charging highway robbery prices.
I didn't wake to my alarm Monday morning. This happens to me, and it's been happening more and more as I get older. I woke up at 10 minutes to 11:00. I called in to work instantly, and arrived at noon. It takes roughly an hour by bus to get to work, so I was there as fast as was practically possible. When I came in to work on Tuesday, there was a letter on my desk from my boss. She wanted to meet with me on Wednesday regarding my excessive absenteeism.
At least one person reading this entry is going to agree with my boss that sleeping in, or calling in sick, based solely on manic depression is really just me being lazy. It's not a disease with any obvious symptoms, indeed, it doesn't have any objective symptoms at all, unless it gets so bad that I try to kill myself or otherwise end up hospitalized. How do you tell when someone is really too mentally sick to make it in to work and when they're just playing hooky?. You can't, of course. Here's the trick: Even I'm not sure. There's no doubt that I have manic depression, I respond too well to the medications to doubt. My psychiatrist says that sleep disorders of the type that I have are symptoms of manic depression, based on her better than 20 years of psychiatric practice. I'll take her word for it. Each individual instance, though, is questionable. I could always try harder, couldn't I? I could always do more. Yes, I could. And I do, so many days. Some days, I don't. Am I just taking the easy way out, am I using my mental illness as an excuse? I'm proud of having been able to make it on my own, through some tolerably hard times. I've worked all my adult life, always had a place to live, always been able to buy the cat food, and pay the rent...eventually. Illness may be an explanation, but it is not an excuse. Someone without a foot has a clear disability, and you have no trouble understanding that the person can't walk -- even if now and again he makes a huge effort and walks on his stump for convenience or need. But for those of us who are crazy, there's always the perpetual question: why don't you try harder? And it's even harder for us to answer than for you.
Mental illness is real.. We use terms analagous to other disorders, like illness or disease, trying to describe and explain it. I think those analogies cause a certain amount of error, especially in people who aren't dealing with this crap on a personal or professional basis. Weird brain chemicals aren't the same as having pneumonia, taking anti-depressants isn't quite the same as injecting insulin. I find it useful to remind myself that when we talk about thought and emotion and disorders of perception, cognition, mood, personality, we are speaking in metaphor. The confluence of the concrete with the metaphysical is always at the core of psychiatry, and at the core of most people's discomfort with it. How can neurochemicals trigger profound grief? Or, worse, ecstatic joy? IIs love nothing more than a neurochemical cocktail? Who are we, if our mind is nothing but the product of our brain? Scary questions for many people, scary questions that I deal with every day. The drugs really work. In my case, three different drugs, each at the maximum daily dosage. If I had to buy them at retail price -- I haven't priced it, lately, but it was better than a grand a month, last I did. Even if I wanted to quit my job, I can't. My life is dependent upon good medical insurance. I can't get an insurance policy on a private-pay basis, no insurance company will voluntarily cover me. I have to have a job.
Now what? I expect I'll lose my job, actually. I'm unlikely to be fired. The process for doing so at the U is arduous. However, there are going to be lay-offs in the summer, and there's a possibility that my job may be redefined so that it becomes a UMP job. (Don't ask. University, University Medical School, AHC, UMPhysicians, Fairview University, Fairview Riverside... all connected, all different, really, let's just not go there.) UMP is a different employer, and doesn't have to hire me to fill this position.
I'm an administrative assistant, which is what we call secretaries and receptionists, these days. It's what happens to girls if they aren't paying attention. This is not a job that has flexible hours, it's just the job I happen to have experience in. Despite the fact that my mental illness qualifies me as disabled under the ADA act, there is no accomodation available to me at this job. My supervisor has defined the job such that arriving at 7:45 each and every morning is a vital part of the job. (I think she could define it differently, but there's no way I know to challenge her definition.)
So, what with having triggered a slightly manic state to get the fish all properly housed (and they are beautiful and I'm so glad to have them), which triggered a depression, and a terrible conversation with my boss in which she made it clear that my performance is extremely subpar, I became really, really depressed. I called my psychiatrist and rescheduled my appointment for an earlier date. Today, in fact.
As I said, I'm already on the max daily dosage of the psych meds I already take. (Effexor, Wellbutrin, and Depakote, in case you're interested, plus Ambien so I can sleep at night.) I've always had a twitchy system, highly sensitive to even minute changes in medication, and there isn't any where to go but to change drugs (aieeee, a nightmare! even if the new drug works better than the old one), so she wrote me a prescription for Provigil, which is a wakey-wake drug. It's something they prescribe for narcoleptics. It does something cool about neutralizing the chemical messages that say "I'm tired, I want to sleep" and allows you to feel alert, without being a stimulant. (Imagine how thrilled my psychiatrist is at the thought of giving a manic depressive a straight stimulant, like dexedrine. :-) ) I don't have it, yet, I have to get the prescription filled. However, I'm amused by having to take a drug to stay awake, and another to get to sleep. I feel totally decadent. If it works, then my next trick will be to figure out how to force it down my throat every morning at 6:30 a.m. One problem at a time, Lydia.
My psychiatrist said, today, "I'm so glad you didn't live 50 years ago, when there weren't any drugs. Can you imagine what it would be like?
I thought about my teens and twenties, and said, "Yes," while blinking tears out of the corners of my eyes. Oh, yes, I can remember life without drugs. Better living through chemistry.
Judge: Yes?
Junkie: Not enough drugs.
Sometimes, I think that sums up my life. Other times, I don't think my life can be summed up, unless one allows negative numbers. Would that count as summed down?
Two weeks ago, I took custody of the fish and fish tak of a friend of mine. This required a huge amount of effort. (If you think hauling 240 lbs. of water, transfering 8 very large fish without harming them, transporting a 4 foot aquarium without breaking it, fitting all that plus the stand and all the other accoutrement necessary to set the tank up when you get home in only two cars, and then get all of this set up again before going to bed, is a cake walk, I suggest you try it. I'll watch.) The whole thing was made far more exciting by the fact that the tank turned out to be a foot longer than I had expected, so it didn't fit in the space I had painstaking cleared for it the night before. That meant that I had to completely dissasemble my 20 gallon tank and move it to another wall, another task which required a significant amount of time. During all that time, the new fish were living in two smallish tubs, holding about 10 or 12 gallons of water, with the only life support an air stone to make sure that they at least had oxygen. I don't know enough about fish keeping to know how dangerous that is for blood parrots, a silver dollar, a severum, a plecostumous, and a Chinese algae eater. I worried and worried the entire time they were in the tubs. I wanted them safely ensconced in their tank with bubblers and filters and heaters and the rest. All in all, I worked for 11 out of 12 hours, starting at 2:00 in the afternoon.
Amongst my many other flaws, I am manic depressive. If you don't think it's a flaw, this is another thing I want to watch you try. Oh, I don't feel the least bit guilty about it. However, it's one of those hard facts of life, like the fact that I'll never be 120 lbs with raven black hair, or that I'm near-sighted and getting more so all the time. I consider them to both be flaws (especially the hair color) but also just the result of random numbers.
Fish? Manic depression? Drugs? Probability? What the hell am I talking about?
One of the un-charming things about my particular instantiation of manic depression is that it is very sensitive to changes in sleep patterns, and it causes changes in sleep patterns. I sleep with the chickens and the eggs. Friday night before moving Sonie's fish tank, I stayed up until 4:30 a.m. cleaning and creating a space for it. I did get 8 hours of sleep, but not at anything like a reasonable hour. The next night, I was up until 3:30 a.m or so, having been working hard for most of 12 hours. It looks like I managed to trigger a mini-mania by messing around with my sleep patterns. I sleep less when I'm manic, and more when I'm depressed. Triggering a manic episode was quite useful. It let me tackle the problems while short on sleep without panicking, and I had energy enough to work until it was done.
The most spectacularly un-charming thing about manic depression is that a manic episode, which can be about the most fun a person can have, is necessarily followed by a depression, the intensity of which is affected by the intensity of the high. I mean, I know you've got to pay the piper if you're going to dance, but frankly, I think he's charging highway robbery prices.
I didn't wake to my alarm Monday morning. This happens to me, and it's been happening more and more as I get older. I woke up at 10 minutes to 11:00. I called in to work instantly, and arrived at noon. It takes roughly an hour by bus to get to work, so I was there as fast as was practically possible. When I came in to work on Tuesday, there was a letter on my desk from my boss. She wanted to meet with me on Wednesday regarding my excessive absenteeism.
At least one person reading this entry is going to agree with my boss that sleeping in, or calling in sick, based solely on manic depression is really just me being lazy. It's not a disease with any obvious symptoms, indeed, it doesn't have any objective symptoms at all, unless it gets so bad that I try to kill myself or otherwise end up hospitalized. How do you tell when someone is really too mentally sick to make it in to work and when they're just playing hooky?. You can't, of course. Here's the trick: Even I'm not sure. There's no doubt that I have manic depression, I respond too well to the medications to doubt. My psychiatrist says that sleep disorders of the type that I have are symptoms of manic depression, based on her better than 20 years of psychiatric practice. I'll take her word for it. Each individual instance, though, is questionable. I could always try harder, couldn't I? I could always do more. Yes, I could. And I do, so many days. Some days, I don't. Am I just taking the easy way out, am I using my mental illness as an excuse? I'm proud of having been able to make it on my own, through some tolerably hard times. I've worked all my adult life, always had a place to live, always been able to buy the cat food, and pay the rent...eventually. Illness may be an explanation, but it is not an excuse. Someone without a foot has a clear disability, and you have no trouble understanding that the person can't walk -- even if now and again he makes a huge effort and walks on his stump for convenience or need. But for those of us who are crazy, there's always the perpetual question: why don't you try harder? And it's even harder for us to answer than for you.
Mental illness is real.. We use terms analagous to other disorders, like illness or disease, trying to describe and explain it. I think those analogies cause a certain amount of error, especially in people who aren't dealing with this crap on a personal or professional basis. Weird brain chemicals aren't the same as having pneumonia, taking anti-depressants isn't quite the same as injecting insulin. I find it useful to remind myself that when we talk about thought and emotion and disorders of perception, cognition, mood, personality, we are speaking in metaphor. The confluence of the concrete with the metaphysical is always at the core of psychiatry, and at the core of most people's discomfort with it. How can neurochemicals trigger profound grief? Or, worse, ecstatic joy? IIs love nothing more than a neurochemical cocktail? Who are we, if our mind is nothing but the product of our brain? Scary questions for many people, scary questions that I deal with every day. The drugs really work. In my case, three different drugs, each at the maximum daily dosage. If I had to buy them at retail price -- I haven't priced it, lately, but it was better than a grand a month, last I did. Even if I wanted to quit my job, I can't. My life is dependent upon good medical insurance. I can't get an insurance policy on a private-pay basis, no insurance company will voluntarily cover me. I have to have a job.
Now what? I expect I'll lose my job, actually. I'm unlikely to be fired. The process for doing so at the U is arduous. However, there are going to be lay-offs in the summer, and there's a possibility that my job may be redefined so that it becomes a UMP job. (Don't ask. University, University Medical School, AHC, UMPhysicians, Fairview University, Fairview Riverside... all connected, all different, really, let's just not go there.) UMP is a different employer, and doesn't have to hire me to fill this position.
I'm an administrative assistant, which is what we call secretaries and receptionists, these days. It's what happens to girls if they aren't paying attention. This is not a job that has flexible hours, it's just the job I happen to have experience in. Despite the fact that my mental illness qualifies me as disabled under the ADA act, there is no accomodation available to me at this job. My supervisor has defined the job such that arriving at 7:45 each and every morning is a vital part of the job. (I think she could define it differently, but there's no way I know to challenge her definition.)
So, what with having triggered a slightly manic state to get the fish all properly housed (and they are beautiful and I'm so glad to have them), which triggered a depression, and a terrible conversation with my boss in which she made it clear that my performance is extremely subpar, I became really, really depressed. I called my psychiatrist and rescheduled my appointment for an earlier date. Today, in fact.
As I said, I'm already on the max daily dosage of the psych meds I already take. (Effexor, Wellbutrin, and Depakote, in case you're interested, plus Ambien so I can sleep at night.) I've always had a twitchy system, highly sensitive to even minute changes in medication, and there isn't any where to go but to change drugs (aieeee, a nightmare! even if the new drug works better than the old one), so she wrote me a prescription for Provigil, which is a wakey-wake drug. It's something they prescribe for narcoleptics. It does something cool about neutralizing the chemical messages that say "I'm tired, I want to sleep" and allows you to feel alert, without being a stimulant. (Imagine how thrilled my psychiatrist is at the thought of giving a manic depressive a straight stimulant, like dexedrine. :-) ) I don't have it, yet, I have to get the prescription filled. However, I'm amused by having to take a drug to stay awake, and another to get to sleep. I feel totally decadent. If it works, then my next trick will be to figure out how to force it down my throat every morning at 6:30 a.m. One problem at a time, Lydia.
My psychiatrist said, today, "I'm so glad you didn't live 50 years ago, when there weren't any drugs. Can you imagine what it would be like?
I thought about my teens and twenties, and said, "Yes," while blinking tears out of the corners of my eyes. Oh, yes, I can remember life without drugs. Better living through chemistry.
